Access to Later Abortion Care Dwindles as clinics Face Closures and opposition

The closure of a Colorado clinic highlights the challenges in obtaining abortions later in pregnancy,as demand rises and political tensions persist.

One Tuesday morning in April, Alicia Moreno and her colleagues at a Boulder abortion clinic received news that the clinic’s owner, Dr Warren Hern, would be closing the facility that Friday. This clinic was one of the few in the U.S. providing abortions past the second trimester, and after 50 years, it was shutting down.

The staff quickly began to assist the dozen patients scheduled for abortions that week, finding alternative arrangements. Moreno and others contacted abortion clinics nationwide to find available appointments. They also had to reschedule flights and hotels,ensuring affordability for the over 90% of patients who relied on external funding.

“It was hardest on the patients that were already scheduled,” Moreno said. “They’re already in a really shitty circumstance, and we’re just like: ‘Haha, just kidding. You’re not coming to Colorado now. you’re going to DC in four days.'”

Abortions later in pregnancy are uncommon; in 2022, about 1% occurred at or after 21 weeks, according to CDC data. Though, research suggests that the demand for later abortions might potentially be increasing. Before Roe v Wade was overturned, about 8% of abortion patients in states that now ban the procedure had second-trimester abortions. After Roe, that number rose to 17%, according to research involving Diana Greene Foster, the principal investigator behind the Turnaway Study.

While the demand for later abortions is rising, the supply has not kept pace. With the Boulder abortion clinic now closed, these procedures will become even more arduous to access.

Later abortion procedures can be a sensitive topic, even among those who support abortion rights.While 70% of Americans believe abortion should be legal in the first trimester, only 22% support its legality in the third trimester.

“The way that I conceptualize it is that, yes, if I didn’t intervene, often, this pregnancy would continue,” said Dr Diane Horvath, medical director of Partners in Abortion Care, a Maryland clinic that performs abortions up until 34 weeks of pregnancy. Her clinic sees six to eight patients each week who are at least 26 weeks along. “This is a potential life that I am taking part in ending, and I am completely cozy with that, as the life of the pregnant person and their needs are always more notable to me.”

‘Gross lack of understanding’

Only nine states permit abortions after viability,which is typically around 24 weeks of pregnancy. Just 17 clinics in the U.S. provide abortions after that point, with only three routinely performing them past 28 weeks.

Research indicates that peopel who seek later abortions frequently enough do so as of late-breaking news, such as a fetal anomaly diagnosis or realizing they are pregnant later than expected. Young people and those who used contraception are more likely to miss early signs of pregnancy, according to Greene Foster.

“There’s a really gross lack of understanding of what people go through and why they might make this decision to terminate a pregnancy later in pregnancy,” said Dr Jennefer Russo, the chief medical officer of DuPont Clinic, a Washington DC-based abortion clinic that offers the procedure until 32 weeks of pregnancy. “I’ve had patients whose partners have died during their pregnancy.There’s lots of different decisions that people could make in response to that event. But even just at the basic level of finances, if you don’t have the financial and emotional support of a partner, in this world being a single parent is really difficult.”

In U.S. politics, there is often little room for such complexity. In the lead-up to the 2024 election, campaigners behind ballot measures to codify abortion rights generally drew the line at viability, and most of these measures passed.Democrats have capitalized on voter outrage over the overturning of Roe, but have frequently enough avoided discussing later abortions. When Donald Trump insinuated in a debate that kamala Harris supported abortions in “the seventh month, the eighth month, the ninth month” of pregnancy, Harris responded, “That’s not true.”

Republicans have equated later abortion with infanticide. “President Trump has told me that he wants to end late-term abortions,” Robert F Kennedy Jr, secretary of the Department of Health and Human Services, told senators during his confirmation hearings earlier this year. “I serve at the pleasure of the president. I’m gonna implement his policies.” (“Late-term abortion” is a medically