Fact check: Are late-term abortions ever ‘medically necessary’? | 2024 US Election News

Health care is considered “medically necessary” when it is necessary to maintain or restore a patient’s health. And, despite social media posts that say otherwise, abortion can fall into that category in emergency situations — even in the third trimester.

“Abortion is not medically necessary in the last trimester. Literally never. They’re just creating an ic-section,” said the November 6 Threads site (part of the Instagram social network).

Posts have been flagged as part of Meta’s efforts to combat fake news and misinformation in the News Feed.

There are cases when an abortion may be medically necessary to preserve or save a woman’s life in any trimester, say doctors and reproductive health experts.

Obstetrics and gynecology (OB-GYN) experts told us that the claim does not understand how and when surgical components are used in abortion procedures, while simplifying many complex conditions and interventions that can accompany pregnancy.

C-sections are considered a major invasive surgery that involves removing the fetus through an incision in the abdomen and can carry risks of health problems, such as bleeding. They are not usually coded as abortions, and are usually performed with the intention of delivering a viable fetus that will survive. The American College of Obstetricians and Gynecologists does not recommend performing this type of surgery in the case of abortion, due to the increased risks for the pregnant patient, which, in addition to bleeding, can include infection and damage to the surrounding organs.

“Abortion is not a simple medical problem,” Dr. Deborah Bartz, an OB-GYN who provides abortions to complex medical patients in Boston, wrote in an email. “The health conditions of each pregnant person are different. This causes serious medical complications (from) patient to patient that health care professionals evaluate and evaluate.”

For a pregnant woman, serious complications from the conditions can include placental abruption, bleeding from placenta praevia, and preeclampsia or eclampsia, experts say. Pregnancy can also make existing conditions, such as chronic kidney disease and heart disease, worse.

“Pregnancy causes important physiological changes in the human body,” said the American College of Obstetricians and Gynecologists in a 2019 statement when some of these allegations began to spread. “These changes can worsen existing or pre-existing conditions, such as kidney or heart disease, and can be life-threatening or even fatal.”

Determining which medical intervention is appropriate depends on the specific condition of the patient, says the organization. This can lead to situations where “termination of pregnancy, in the form of abortion, is the only treatment that can save the patient’s life or save his life.”

Bartz said the project’s claim “can only be true if every pregnancy and fetus is healthy, and every pregnant person is healthy”. This is not true.

“Fetal distress and/or maternal health issues really make a third-trimester abortion a medical necessity,” Bartz said. “There are many ways to have an abortion, and ic-section can be one of those ways.”

Abortion is a medical intervention designed to terminate a pregnancy before birth. While a healthy fetus can usually achieve viability — the ability to live outside the womb — at about 24 weeks of pregnancy, some pregnancies are not viable, experts say. That means they cannot survive outside the womb no matter how far along in the pregnancy they are born.

Pregnancy is divided into three trimesters. The third – and final – trimester starts from about week 28 to week 40, when the pregnancy is considered full term. Most abortions in the US, about 91 percent, occur in the first trimester. Only about 1 percent occur after 21 weeks, and less than 1 percent occur in the third trimester.

“The concept of ‘three months’ is more legal than medical; not everyone agrees on when the ‘first trimester’ begins,” said Dr. Daniel Grossman, professor of obstetrics, gynecology and reproductive sciences at the University of California, San Francisco. “A healthy fetus at 28 weeks may have a fair chance of survival, but a fetus with a critical health condition or abnormal growth at 28 weeks may have a low chance of survival after birth.”

fetal disorders such as anencephaly, Trisomy 13, Trisomy 18 and renal genesis are almost universally dangerous outside the womb, said Bartz, and sometimes newborns suffer from many conditions, which are not serious, which may cause a serious health condition that leads to death. on delivery.

“Think of anencephaly or acrania, problems where the baby’s skull does not grow, and most of the head is missing. Those embryos cannot function at any stage of pregnancy,” wrote Dr. Jonas Swartz, a North Carolina OB-GYN, in an email. “If a patient presents at 32 weeks with a fetus with anencephaly, ic-section is not the best way to reduce the risk for that woman. Abortion is a low risk. At that age of pregnancy, it may be a termination of induction for the purpose of giving birth to the female genitalia. The fetus may have an injection to stop the heart before starting the exercise.”

In a twin pregnancy, for example, one twin can have a problem that means it won’t survive and could threaten the well-being of the other twin, Swartz said. Often, doctors will offer an abortion by giving a feticidal injection or cutting the umbilical cord of the sick twin to save the life of the other. “In some cases, this may be safer in the third trimester,” he said. “Surgery at that time can endanger the life of a healthy twin because you will be giving birth prematurely.”

Although some patients get the chance to decide whether to terminate an unviable pregnancy – another option that often carries a sick fetus to term – sometimes there are health risks for the pregnant woman. In these cases, Bartz said, a medical professional may need to intervene.

“For example, if preeclampsia begins in the third trimester and the pregnant woman’s high blood pressure becomes life-threatening, delivery (and thus, abortion) of the non-viable fetus is necessary. If this delivery of drugs causes death, it is considered an abortion,” said Bartz.

Grossman said that performing a c-section in this situation will increase the chances of complications for the pregnant woman, without benefiting the fetus that is expected to die. Some conditions that may not allow the fetus to be delivered through the vagina, such as when the patient has large fibroids of the cervix, abdominal cerclage or placenta on the cervix, can make a c-section the preferred method – if it is considered safe for the pregnant patient.

Our decision

The Threads post stated that “abortion is not medically necessary in the last trimester. Literally never. They just do a C-section.”

This is a misunderstanding and oversimplification of how abortion and fertility care work during pregnancy, say OB-GYNs and other reproductive health professionals.

There are many complex medical conditions that may affect the fetus or the pregnant patient that – although rare – can lead to a medically necessary abortion later in the pregnancy. Abortions can be performed in a variety of ways, experts say, and although ic-section is not usually the preferred method, it can be used depending on the patient’s condition.

We weigh this claim lies.