Even in states where abortion is legal, many restrict the procedure after 'fetal viability.' Here's what that means and why some abortions happen later in pregnancy.
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00:00In September 2022, I had my anatomy scan and I found out that there were some problems with
00:07my baby. It took me a couple of weeks to figure out the full extent of that. Because I live in
00:12a rural state like Montana, I had to travel out of state to get more advanced maternal care.
00:18And so that really delayed my diagnostic timeline. At 24 weeks, I got the full diagnosis.
00:25My son had a condition called Eagle Barrett syndrome, which affects the development of
00:30the renal system, the abdominal muscles, potentially the diaphragm. And we realized
00:35that this was really not a viable pregnancy. And so we decided to have an abortion to end
00:40the pregnancy. Several years ago, I was pregnant with my son, Teddy. It was a planned and deeply
00:49wanted pregnancy that was progressing without issue. And I had a routine ultrasound around
00:5632, 33 weeks. And during that ultrasound, I learned that he had suffered from a catastrophic
01:03stroke in utero. And he would either die in utero or be consigned to a life, however brief,
01:11of pain and suffering. So at that point in time, I was a patient at Mass General Hospital in Boston.
01:18And I was denied care. Because I live in Montana, abortion is safe and legal in Montana.
01:24But because of the Armstrong Amendment that we currently have in our constitution,
01:28abortion is banned at viability. So seeking care in my home state was not an option.
01:34And this was several months post Dobbs decision in 2022. And so a lot of the clinics who could
01:40give third and second trim, second trimester and third trimester abortion care were overwhelmed
01:46with clinics with, excuse me, with patients from out of state because their timelines had
01:50been pushed out to due to restrictions in their home state. And so I had to wait an extra two
01:56weeks to end my pregnancy. And so I was 26 weeks by the time that I could say goodbye to my son.
02:03I was forced to seek care out of state. And I was fortunate enough to have the resources to do so.
02:10I had an 18 month old at the time. I have a loving husband who's a wonderful partner.
02:15And we had the resources to drop everything to drive 500 miles to Bethesda, Maryland,
02:22and seek care at the care clinic there. The burden there is large. It requires a lot of logistics,
02:29a huge financial investment of traveling and paying out of pocket for care. And I was just
02:36floored that I wasn't able to access health care in my home state, which I think is arguably one
02:43of the most progressive in the U.S. To be blunt about the experience of seeking my abortion,
02:49it was absolute hell. The providers wouldn't refer me. So I had to arrange my own medical care.
02:55I had to call the clinic. That was the worst phone call of my life. They were extremely
03:00compassionate. Bless them. But it was it was hell. And then I had to wait two weeks. And that time,
03:08it is just so surreal because you're still pregnant. The world still sees you and treats
03:13you as pregnant. And so you have random people like congratulating you. Oh, when are you due?
03:18But your baby is going to die. And, you know, you've you've made that decision,
03:23that impossible decision, because it doesn't feel like a choice when you get a diagnosis like that.
03:29It's really just determining how and when do do I let my baby go? Because this isn't salvageable.
03:37And it's really just hell to keep grappling with that in such a prolonged period of time.
03:41I felt incredibly naive that I didn't understand the nuances of our state law
03:48here in Massachusetts. So the simple structure is that we have a 24 week ban on the books,
03:56often referred to as a viability ban or a gestational ban. And there are certain
04:01narrow exceptions for receiving care after that 24 week limit. And so, you know, I learned about
04:09this very fragile network of last stop clinics, depending upon how far along you are in your
04:14pregnancy. I was about 33 weeks at the time. There are a handful of clinics that will provide
04:19later abortion care, Colorado, D.C., Maryland or the primary. So I was able to I was lucky that I
04:28was able to secure an appointment and receive that compassionate care and to give my son peace
04:34and to give my family peace. And many other patients are not so lucky. I get really angry
04:39thinking back on it because it's like all of the medical providers that have been so involved in
04:44helping me coordinate care for this pregnancy vanished. And we're seeing it come out in other
04:48states. Doctors are terrified to touch pregnant patients with potential complications. And so I
04:55think I saw the early buddings of that. Especially now, after the fall of Roe, we're seeing patients
05:01pushed further and further into pregnancy. So this very fragile network of independent last
05:06stop clinics with courageous later abortion providers are really struggling to stay afloat.
05:12And they are inundated with patients. It's incredibly difficult to secure an appointment,
05:17even if you have the resources to travel. So the stakes are so high. It's not just an inconvenience
05:23of being denied care and having to travel. It's the likelihood that you're going to have to forego
05:28care and you're going to have to, against your will, carry a pregnancy to term and birth a
05:34severely compromised pregnancy, in my case, and likely watch your child suffer and die. And we're
05:39seeing that happen across the country. The phrase late-term abortion and post-birth abortion are
05:45incredibly misleading and damaging, and I would call them outright lies. First of all, a late-term
05:51abortion, that's so subjective. What does late mean? In Texas, late is anything past six weeks.
05:58And so I think it's really important when we talk about abortion care to use medically
06:03accurate language. So I talk about my abortion in terms of the gestational age I was at. I was at 26
06:10weeks. I also talk about second trimester and third trimester abortion care, which is what
06:17people conceptualize as late-term abortions. But again, late is subjective. And so I think we need
06:23to be very intentional about the language we choose. Similarly, post-birth abortion,
06:30I have a special ire for that language because that language is targeting families who gave birth
06:36to an infant that will die, that is dying. And they are talking about parents who opted for
06:42comfort care instead of prolonging the inevitable and prolonging that infant's suffering.
06:48I get very emotional about that because I know that would have been my family
06:52if I hadn't gotten my abortion. There are a lot of myths about later abortion. There's the myth
06:58of partial birth abortion and afterbirth abortion, right? There's the myth of the monster flippantly,
07:07casually pursuing a third trimester abortion. There is the myth that patients in blue states
07:13have unfettered access to abortion care throughout pregnancy. And then I think there is the most
07:19vexing myth of them all is that Roe is enough. And that I think is the most vexing myth that
07:24we're grappling with right now within the pro-choice movement. And seeing states codify
07:32access to abortion is exciting. And we have momentum and it shows that abortion still wins
07:42on the ballot. And as a later abortion patient, when I look at the actual language and see the
07:49limitations, it is heartbreaking because I know that patients like me are continuing to get left
07:55behind. Ballot initiatives that have passed in other states, I see them as a really good
08:00foundation. But the problem is that they have viability language in there. And viability
08:05language, that's legalese. That's not a medical term. Because what does viability mean? Does it
08:11mean an infant's born and survives for an hour, survives for a day, survives for a year, survives
08:17indefinitely on extreme medical intervention? What does it mean to be viable? At what point?
08:23It's just far too complicated and nuanced to legislate. And these legislators, I envy them
08:30a lot because they live in this fantasy world where it's very black and white. But that's not
08:36the clinical reality of pregnancy. Pregnancy is complicated. It's nuanced. And every pregnancy
08:42is different. I wish that people understood that third trimester abortion seekers are not monsters.
08:49Many of us are mothers trying to make the best decision we can for our child, for our baby, for
08:56our family, for our future fertility, for our own well-being. And these circumstances are incredibly
09:05complicated, medically complex. And the decisions about pursuing an abortion later in pregnancy
09:12cannot be left up to public opinion. And they can't be left up to politicians or the government.
09:18These choices need to be made between the patient and their health care providers.