What Everyone Needs to Know About Second Trimester Abortions

Most of us don’t think we’ll ever have an abortion, until we become one of the half of all women in the US who has an unwanted pregnancy.  And if we think about it at all, we assume we’d get an abortion pretty early in the pregnancy.  While 90 percent of abortions do happen before 12 weeks, some women seek abortions later in their pregnancies.

Most women do not try to have later abortions. In fact, in a study done by Finer et al, nearly three fifths (58 percent) of women in the survey reported that they would have preferred to have had the abortion earlier than they did. In another study done by Drey et al, 29 percent or one third of women who ended up having abortions during their second trimester were in their first trimester when they made the first call to an abortion clinic. If this is the case, what causes women to have second trimester abortions?

First, let’s learn a bit about second trimester abortions. Drey’s study outlines the following basic information:

• One out of every ten abortions performed in the United States happens during the second trimester
• Second trimester abortions carry an increased risk of complications and are more expensive to obtain then first trimester abortions
• The American public tends to favor restrictions on later termination

These restrictions vary state by state. In some states, like California and New York, Medicaid can cover the cost of an abortion. In others, such as Pennsylvania, Medicaid funds are forbidden from covering the procedure unless the woman is a survivor of rape, incest, or has a medical condition that threatens her life. And in other states still, Medicaid and private insurance are banned from covering abortion no matter the situation. This means that if a woman doesn’t live in a progressive state and if she doesn’t have health insurance that covers an abortion, she will have to spend time raising money towards the cost of her procedure. Depending on how long this takes, the cost of the procedure could go up weekly (as it often does in the second trimester). In the world of abortion funding, this is called “chasing the fee” and is kind of a Dante-esque hell. The longer she waits to have the abortion and the more time it takes her to raise the money, the more the abortion will cost, causing her to have to raise more money and further delay the procedure.

There are other types of anti-choice legislation that can affect a woman’s access to abortion services.  She often has to jump through hoops to be able to make an appointment for the procedure. This could be anything from a 24-hour waiting period from the time she makes the appointment to the time of the procedure, getting parental consent, spousal consent, a mandatory counseling session, signed doctor’s notes, or sessions before a committee or before the police. Many women barely have time to schedule a full-day clinic visit, not to mention dozens of hours spent making sure she abides by these laws. This means taking hours or days off of work, arranging childcare, and arranging travel, not to mention other logistics.

Who are these women who have later abortions, and why do they have them? According to Drey’s study, women who have later abortions tend to be young and of low-income status. Specifically, Dryer found that women under 18 took longer to identify pregnancy symptoms and poor women had to delay their abortion because they had to make arrangements, such as raising money, getting childcare, or transportation to the clinic.

Finer found very similar causes of delay. Second trimester abortion patients, according to his study, were significantly more likely to say that it took them a long time to make arrangements to have the abortion. This is because there are many abortion providers who only provide abortions to 12 or 14 weeks, and the number of providers decreases further later in pregnancy. Many states have NO abortion providers after 14 or 16 weeks. In addition, second-trimester patients were significantly more likely to indicate that they were delayed because they needed time to raise money for the procedure and because it took time to talk to their parents.