Late termination of pregnancy

Late termination of pregnancy (also referred to as late-term abortion) describes the termination of pregnancy by induced abortion during a late stage of gestation. 'Late', in this context, is not precisely defined, and different medical publications use varying gestational age thresholds. In 2015 in the United States, about 1.3% of abortions took place after the 21st week, and less than 1% occur after 24 weeks. Late termination of pregnancy (also referred to as late-term abortion) describes the termination of pregnancy by induced abortion during a late stage of gestation. 'Late', in this context, is not precisely defined, and different medical publications use varying gestational age thresholds. In 2015 in the United States, about 1.3% of abortions took place after the 21st week, and less than 1% occur after 24 weeks. Reasons for late terminations of pregnancy include when a pregnant woman's health is at risk or when lethal fetal abnormalities have been detected. These anomalies may include anencephaly or limb-body wall complex where death occurs almost immediately after birth. Later abortion is not associated with any negative physical or mental health outcomes, and the risk of death following a surgical abortion after 20 weeks is less than that of typical full-term childbirth in the United States. Late termination of pregnancy is more politically controversial than abortion in general. Most countries in Europe permit abortion in later stages of pregnancy if specific circumstances are present. The American College of Obstetricians and Gynecologists states with respect to abortion that 'politicians should never interfere in the patient-physician relationship'. A late termination of pregnancy often refers to an induced ending of pregnancy after the 20th week of gestation, i.e. after a fetal age (time since conception) of about 18 weeks. The exact point when a pregnancy becomes late-term, however, is not clearly defined. Some sources define an abortion after 16 weeks as 'late'. In three articles published in 1998 in the same issue of the Journal of the American Medical Association (JAMA) two chose the 20th week of gestation and one chose the 28th week of gestation as the point where an abortion procedure would be considered late-term. The point at which an abortion becomes late-term is often related to the 'viability' (ability to survive outside the uterus) of the fetus. Sometimes late-term abortions are referred to as post-viability abortions, though this is not a medical term. There is no sharp limit of development, age, or weight at which humans automatically become viable. A 2015 study found that even with active treatment, no infants born at less than 22 weeks survived, at 23 weeks survival without severe impairment is less than 2%, and at 25 weeks, up to 30% might survive without severe impairment. The American College of Obstetricians and Gynecologists and the Society for Maternal and Fetal Medicine states that in cases of delivery occurring before 26 weeks, “given the potential for maternal and perinatal mortality and morbidity, the option of pregnancy termination should be reviewed with the patients.” Because the chance of survival is variable based on interventions available and the weight and sex of the fetus, there is no consensus on viability. The American College of Obstetricians and Gynecologists reports that 23% of abortion providers offer abortions at 20 weeks of gestation and later, most often using a method called dilation and evaluation (D&E). A wanted abortion in any trimester is not associated with mental health harms. Overall, abortion does not increase the risk of experiencing symptoms of depression, anxiety or stress in the short term or over five years. A previous history of mental health conditions, sexual assault, and intimate partner violence were strongly associated with experiencing negative mental health outcomes after the abortion. Reasons for late terminations of pregnancy include when a pregnant woman's health is at risk or when lethal fetal abnormalities have been detected.