Why Would Anyone Have A Late Term Abortion?

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“And what woman gets to 24 weeks without knowing they’re pregnant?” the student in the front row asks me. Rhetorically.

This class, on abortion law reform, is never easy. I remind the students that we don’t know what experiences the person next to us has lived and so we must debate issues respectfully. Or try to. Or at the very least, pretend to.

I have just run through a short history of abortion law in Victoria.

Until 2008, abortion was a crime unless a doctor honestly and reasonably believed that it was necessary to preserve the life or health of the woman.

Currently, a termination before 24-weeks gestation is a personal decision made by a woman. After 24-weeks, doctors must approve that decision based on their consideration of whether continuing with the pregnancy could harm the woman’s life or health.

This seeks to balance a woman’s right to control her body with the viability of a foetus after 24-weeks. Like most compromises, it’s imperfect. It angers some for taking agency away from the woman, others for not giving more recognition to the foetus. In both failings, it challenges the notion that once you are a person in law, you are a person in law. Yet it matches the data that the majority of Australians support the right to choose, and an unspecified subset of those supporters view the right as capable of limitation based on considerations like gestational age and reasons for seeking the abortion.

Abortions after 20 weeks account for less than 1 per cent of all abortions in Australia.

“And what woman gets to 24 weeks without knowing they’re pregnant?” The question still hangs in the air. And I think how a rhetorical question is a judgment. Which is not a bad thing, but it needs to be an informed one.

So I answer.

Without knowing they’re pregnant? Those who are in denial or too traumatised to find out because the pregnancy resulted from rape, from incest. Those too young to know the signs. Those who have a mental illness or an intellectual disability and do not understand that they are pregnant.

But it’s not always a question of not knowing. There are those who know too much. Who must make an excruciating choice after test results diagnosing severe foetal abnormality. For instance, the test for Anencephaly happens at 15-20 weeks. Babies with this neural tube defect are born without a forebrain and the remaining tissue exposed. If not stillborn, they die shortly after.

And then there are physical and mental bombs dropped on women without regard for gestational stage; life circumstances that change in ways that were never imagined. Traumatic diagnoses about their own health. Partners leave or die.

Which is to say that unlike the conclusion drawn by my student – a student clever enough to get into law school– this is not about being oblivious.

I can hear the student’s moral compass recalibrating. I check in with my own.

Late term abortion is a polarising issue. And not just in terms of “us” and “them”. It promotes an internal ambivalence among the pro-choice women I know. An ambivalence I see in my own shifting usage of “abortion” and “termination”, “foetus” and “baby”, “woman” and “mother”.

But, I am sure of two things.

First, the punitiveness of public judgment diminishes with the amount of information received. Despite the popularity of the sound-bite media and the knee-jerk politicking it supports, we are contextual creatures; our empathy is aroused in direct proportion to the amount of information we have about human adversity. This doesn’t mean we have to agree that late term abortions for psychosocial reasons are morally correct or that supporting them means that we would choose one for ourselves. But it does mean that we should reframe discussions about them to accurately convey the traumatic circumstances in which they are sought – circumstances in which we all could have found ourselves or those we love.

Second, the abortion decriminalisation legislation was passed in Victorian Parliament by elected representatives. Yet despite the law on the books, a woman may not be able to exercise her rights in a timely manner, if at all.

Public hospitals almost exclusively carry out late term abortions for reasons of foetal abnormality. The one private clinic that carries out late term abortions for psychosocial reasons will do so up to 24 weeks. So if a woman in crisis cannot afford private health care or cannot access that particular clinic or if that clinic is at capacity or if she is over 24 weeks pregnant – she will be forced to give birth. She will be forced to give birth despite democratically passed reforms giving her another option. Access to late term abortion must be addressed as an issue of equitable access to legal health care.

I don’t have the answers to all the student’s questions. But I know that underlying the letter of the law is always a human story, often a trauma, and that that law must reflect the social values and political system that give it such power over our lives and  bodies in the first place. The Abortion Law Reform Act 2008 did this at the level of principle. But resources must be made available so that it can do so in practice.

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