October 11, 2024
3 read me
Third trimester abortions are moral and necessary health care
Abortion after 20 weeks is an end to suffering. Denying someone that care is barbaric
They travel dozens, hundreds, sometimes thousands of kilometers seeking health care. They have such severe fetal conditions that their babies will not survive. Or they are too young to consent to sex, let alone become parents. In other cases, it’s their first chance to escape domestic violence, or they live in states with so many restrictions that they couldn’t. earlier access to abortion care.
According to most estimates, a small number—1 percent— abortions occur after 20 weeksand not in the horrible way people want you to believe.
As I fill a syringe with a chemical that will stop the heart of the fetus, what I am doing is fulfilling the request of my patients to end their suffering, whether it is a baby with brittle bone disease who will not survive labor and delivery, or a parent who will not survive childbirth. don’t bear witness to that. The polarizing political rhetoric of “getting babies out of the womb before they’re born” or “no one gets an abortion at their due date” is simplistic and wrong. Abortion later in pregnancy is very important for people who need it. For them, politics is irrelevant. They need the attention they need.
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In contrast to what people think of doctors who provide abortion care late in pregnancy, all of us who do this work have given it a lot of thought. moral and ethical consequences of doing that. We have concluded that not only is it in line with our personal values, but it would be a violation of our conscience and professional ethics to refuse. Conscious refusal of care, in which physicians cannot be forced to provide care to which they are morally opposed, is often discussed, but conscious care receives less attention. I perform third trimester abortions because it would be against my moral code to endanger someone’s life and well-being. forcing her to give birth against their wishes and better judgement.
Within the idea of a moral code is a distinction between moral simplicity and moral clarity. Terminating a pregnancy in the third trimester is not morally right simple. Even people who support abortion care sometimes see these abortions earlier in the pregnancy. The moral clarity, however, it comes from remembering that few events affect the course of a person’s life more than the decision to give birth or not, and the conditions under which to do so. People seeking abortion care have already done their moral calculations and concluded that terminating the pregnancy is the right decision.
People are certainly best placed to judge the circumstances of their own lives, but it is strange that many politicians seem comfortable leaving this moral choice to individual state legislators. When a person’s instinct is to suffer in order not to need their children, or to avoid suffering in the first place, I have a moral obligation to assist in this dire choice, because not doing so would be senseless.
Hanging in my office is this Atul Gawande quote: “Sometimes we can offer a medicine, sometimes only a salve, sometimes not even that. But whatever we can offer, our interventions, and the risks and sacrifices they entail, are only justified if they serve the larger purposes of a person’s life. When we forget that, the suffering we do can be barbaric. When we remember, the good we do can be unique.”
When my patient is ready, I slowly inject the substance and watch the fetal heartbeats slow down…slow down…and stop. I remove the needle. I hold her hand. I tell him the injection worked. I tell him how sorry I am for being in this situation. However, they thank me. They always thank me. This kind of gratitude used to amaze me, until one of my patients explained that this kind of compassionate care “makes an unbearable situation a little more bearable.”
I later induce labor and terminate the pregnancy. Along with the deep sadness that hangs in the room, I often see love and comfort—unbearable grief but also relief. I hope that having some agency and choice in how their devastating situation ends gives this person and their family at least a little peace of mind. What I do know is that denying agency during that time would be brutal.
This is an opinion and analysis article, and the views expressed by the author(s) are not necessarily their own. American scientific
