Late Term Abortions

This paper describes the prevalence of late term abortions, explains the reasons why they are performed, and argues that any effort to ban late term abortions in Canada would necessarily infringe on women’s constitutional rights.

Incidence of Late Term Abortions
The Canadian Medical Association’s abortion policy defines abortion as the active termination of a pregnancy up to 20 weeks of gestation (Canadian Medical Association, Policy on Induced Abortion, 1988). 90% of abortions in Canada are performed during the first 12 weeks of pregnancy, and just over 9% of abortions take place between 12 and 20 weeks of gestation. A mere 0.4% of abortions take place after 20 weeks of gestation. These are considered late term abortions.
Why Late Term Abortions are Necessary
A very small number of abortions occur after 20 weeks of gestation primarily because the fetus is gravely or fatally impaired, or the woman’ s life or physical health is at risk, or both (Statistics Canada, Therapeutic Abortions, 1995). Many impairments or health risks are not detectable until after the 24th week of gestation. In 1998 an American Doctor, George Tiller, opposed efforts to ban late term abortions in Kansas, using “statistics and photos of catastrophic pregnancies he had aborted.” The images showed fetuses with missing skulls or spinal cords, and in one case twins fused into a single body (Dave Ranney, “Tiller: Abortion Bill an Insult to Women,” Wichita Eagle, April 11, 1998, and Colleen McCain and Dave Ranney, “Five Kansas Families share Deeply Personal Stories,” Wichita Eagle, April 19, 1998).

Those opposed to abortion rights have portrayed women as having late term abortions out of “selfish convenience” or because they “suddenly can’t get into a bathing suit.” This misrepresentation of women’s decision making with regard to abortion is always inaccurate, but especially so in cases of late term abortion. Most women who terminate their pregnancies after 20 weeks wanted to have a child, and were forced to consider abortion for medical reasons. Other women may be in desperate social circumstances, such as an abusive relationship, or they may be very young teenagers who have delayed abortion care because they were in denial about the pregnancy.
Who Performs Late Term Abortions
Hospitals and some clinics in Canada perform abortions on request up to about 20 weeks, and a few centres do abortions up to 22 or 23 weeks. However, most of the very small number of abortions performed over 20 weeks gestation in Canada are done to protect the woman’s physical health, or because of serious fetal abnormalities. Such problems cannot be discovered until an amniocentesis test is done on the fetus later in pregnancy. Rare abortions after 22 or 23 weeks gestation are also done in Canada for some cases of lethal fetal abnormalities, where the fetus cannot survive after birth.

Since abortion services after 20 weeks are not always readily accessible in all parts of Canada, women are sometimes referred to clinics in the United States (Kansas, Washington State, and Colorado). Such procedures and associated expenses may be funded in full or part by some provincial governments.
Why Late Term Abortions Should not be Banned or Regulated
Late term abortions have been inappropriately labeled “partial-birth” abortions by those opposed to abortion rights (see Position Paper #5a). These lobbyists are most likely referring to a specific procedure called D&X (dilation and extraction), which is often, though not always, used in later term abortions in the United States. The Partial-Birth Abortion Ban Act was signed into U.S. law by President George W. Bush in 2003. Yet this legislation has already been successfully overturned because it fails to leave an exception for the life and health of the mother.

Anti-abortion activists in Canada typically mimic the efforts of their American counterparts. Some have suggested that “partial-birth” and late term abortions should be banned in Canada. The point is moot because this abortion technique is rarely if ever used in Canada. Late-term abortions done in Canada are generally performed via induction of labour. In any case, such a ban would infringe on women’s constitutional right to the security of the person. At the same time, it would award politicians more rights than pregnant women as well as their doctors – making medical advice secondary to political legislation. All medical care, including abortion care, should be based on clinical standards with the goal of meeting patients’ needs and minimizing risk to patients. Physicians should not face criminal prosecution or imprisonment for providing clinically appropriate care for their patients.
Canada is one of only two countries in the world with no laws restricting abortion. Because of that, Canada serves as a respected role model for abortion care internationally. Abortion is a health procedure and as such, can be left up to the discretion of the doctor and patient. It requires no extra regulation, in the same way that childbirth or heart surgery require no extra regulation. It would be reactionary and counter-productive to pass any restriction against abortion, because that would endanger women’s health and lives, and infringe on women’s equality rights (only women get pregnant, so abortion restrictions amount to discrimination against women). It would also give the anti-abortion movement something to build on, and agitate from. Abortion opponents target rare cases of late term abortion, describing it in horrific detail, to evoke an emotional response in listeners. Their ultimate goal is to restrict all abortion rights. What these lobbyists strategically fail to mention, however, is that banning late term abortions would force women pregnant with dying fetuses to give birth at great risk to their own health, undermining both the rights of women and the medical authority of doctors.