Why I Provide Second Trimester Abortions
By Radha Lewis, MD
Most women who choose abortion do so very early in their pregnancy (more than 90% in the first trimester ), but for a small percentage, this is not the case. I know that even some staunch supporters of abortion rights begin to have doubts about abortion in the second trimester. But as an abortion provider, I understand why some women need later procedures, and I do everything I can to support them.
I chose to be an abortion provider to prevent undue suffering for my patients, and to assist their access to safe, affordable care in a politically hostile environment. Two patients I saw this week perfectly illustrate the need for later abortions–and have reminded me why our continued efforts to ensure abortion access for all women, including those who are more than 12 weeks pregnant, is crucial.
The other day, a colleague and I cared for Rita, a 36-year-old mother of five who was nearly five and a half months pregnant. Rita had always been healthy, but was now hospitalized for more than four weeks at two different hospitals. An infection in her heart had destroyed two of Rita’s heart valves, requiring open-heart surgical repair, then a second operation to install a pacemaker.
This young mother unsuccessfully requested an abortion from the dozens of doctors who treated her, but nobody was willing to provide this service until Rita’s heart surgeons declared that her pregnancy threatened her life. Within 72 hours, I found myself in an operating room taking care of Rita so she could recover and return home to care for her family.
The following day, I was called to meet a young woman who had been hospitalized in the psychiatric ward after visiting a local Planned Parenthood to terminate her undesired pregnancy. Alice had confided to a clinic worker that she had considered putting a knife into her stomach. The clinic immediately referred her to our hospital’s psychiatric unit for treatment, where she was admitted as suicidal and potentially unable to make her own medical decisions.
During my first visit, this scared and vulnerable 18-year-old told me that she was not suicidal but desperate–she had been locked in her house for the past four months, since confiding in her older sister that she wanted an abortion. Like Rita, Alice was also now five and a half months pregnant and nearing the time at which abortion would no longer be legally available to her.
Unlike Rita, Alice lay in a hospital bed for nearly two days while departmental politics played out around her. At the end of two days, Alice was discharged back into the care of her sister, with a note confirming that she was not suicidal, and an appointment to follow up at Planned Parenthood for her abortion the following week (the latest possible date she could legally have an abortion). Not surprisingly, Alice didn’t show up for the appointment, and we couldn’t reach her by phone.
Although Alice’s circumstances were not life-threatening in the same way as Rita’s, I argue that they are no less significant. But they were not sufficient to persuade the large hospital in the liberal state of California where I practice. Instead, nonexistent “hospital policy” was invoked by disapproving administrators and senior pro-life physicians. As a result, she was sent home to have a child she does not want, or take matters into her own hands with potentially devastating consequences.
In my experience, every woman who comes in seeking a second trimester abortion has a compelling reason to do so. I have yet to meet a woman who makes this decision with anything but the utmost gravity. In an era where politicians, zealots, and hospital administrators are chipping away at a woman’s right to abortion, we must advocate for these women’s access to abortion services, and show them our sympathy, compassion, and unwavering support.
Dr. Radha Lewis is completing a fellowship in family planning and an MS in clinical and biomedical investigations. She graduated from the Georgetown University School of Medicine and completed her residency at the University of California, San Francisco and Sutter Medical Center in Santa Rosa, California. She is a fellow with Physicians for Reproductive Choice and Health .