Abortion: The Numbers Game

Warren M. Hern

The Washington Post Taking Exception Thursday, October 17, 1996

Recent articles in The Post and statements by Newt Gingrich and other members of Congress have left the absolutely false impression that thousands of abortions are performed in the seventh, eighth and ninth months of pregnancy for reasons that do not involve a woman’s life or health or a severe fetal anomaly. Nothing could be further from the truth. It is important to understand the facts, since the Republican-dominated Congress has voted again to criminalize some later abortions.

As one of the very few physicians who provide third-trimester abortions, I am deeply distressed by this false impression, purposely propagated by antiabortion fanatics and Republican leaders such as Bob Dole. I can assure the public and members of Congress that I know of no physician who will provide abortion – by any method for any reason – in the seventh, eight or ninth month of pregnancy except when there is a risk to the woman’s life or health or when there is a severe fetal anomaly.

I was one of the physicians quoted in the Sept 17 Health section article “Late-Term Abortions; Who Gets Them and Why.” I was quoted accurately, and I assume other physicians were as well. But the article never makes clear what type of abortion method and what gestation of pregnancy is being discussed. For example, one of my colleagues is paraphrased as stating that 55 percent of abortions performed after 20 weeks are done for non-medical reasons. The article fails to note that this physician is referring to his own limited practice, which does not include third-trimester abortions. He is not referring to third-trimester abortions – but the article implies that he is. The article also equates abortions at 13 weeks with abortions at 22 weeks, when they are quite different both in terms of patient profile and clinical requirements. Readers, including The Post’s own Richard Cohen (who wrote an op-ed column about the issue on Sept. 24), can certainly be forgiven for being confused by the article.

The facts are these:

● Third-trimester abortions are extremely uncommon; fewer than 600 are performed per year. This irrefutable fact is documented by the Alan Guttmacher Institute (AGI), the institution acknowledged by the Centers for Disease Control as having the most complete information on abortion practice. When Richard Cohen wrote in a June 1995 op-ed column that “just four one-hundredths of one percent of abortions are performed after 24 weeks,” and that “most, if not all, are performed because the fetus is found to be severely damanged or because the life of the mother is clearly in danger,” he was absolutely correct. The AGI statistics Cohen quoted are accurate. If anything, the extimates overstate the actual number of third-trimester abortions. In my own practice, which is internationally known as specializing in late abortion, I have only performed about a dozen abortions for women whose pregnancies were advanced beyond 26 weeks so far this year, and I never have performed more than about 50 in a given year. In every single case, there was some compelling medical reason for the abortion. On the day before the Senate voted on the so-called “partial-birth abortion” bill last month, I performed an abortion for a woman who came with her husband from Europe to end a 33-week pregnancy that was threatening her life. The pregnancy was deeply desired by the couple, but the fetus was severely impaired, and the woman’s life would have been at great risk if she had continued until term.

● Abortions in the late second trimester – 20 weeks to 26 weeks – are also extremely limited, especially after 24 weeks of gestation. Only one percent of all abortions are performed at this stage of pregnancy.

● Abortion providers and pro-choice groups have not claimed that second-trimester abortions are performed only in the cases of risk to the woman’s life or health or fetal abnormalities. A significant percentage of second-trimester abortions at and after 16 weeks are, indeed, in wanted pregnancies that have been diagnosed with a serious, untreatable medical condition afflicting either the pregnant woman, the fetus, or both. Those second-trimester, pre-viability abortions – by whatever method performed – that are not done for medical indications have been repeatedly found to be constitutionally protected by the Supreme Court.

The confusion on the issue of numbers of abortions at different states is not due, as Richard Cohen says, to misrepresentation of the facts by the pro-choice movement. At least part of the confusion lies in the constant misuse by all parties of the imprecise phrase “late-term” to describe all abortions that occur from 20 weeks and later in pregnancy. “Late-term” is in itself a nonsensical phrase. Either a pregnancy is at “term” (nine months), or an abortion is performed “late” in pregnancy (how late is late?).

The most reprehensible aspect of this controversy is the political manipulation of some facts by political leaders for the purpose of electing Republican candidates for public office. That is a sordid and unacceptable exploitation of deep personal tragedyfor the sake of gaining power.

The writer is a member of the medical advisory board of the National Abortion Federation.