Why Did She Wait So Long? Later Abortions and the Implications of the New Nebraska Ban

Susan Yanow and Kimberley Bullard

In April 2010, the Nebraska legislature banned abortions after 20 weeks of pregnancy for all reasons except for the life and physical health of the mother. The reality is that women need later abortions for many of the same reasons women need any other abortion.

*The stories in this article are true summaries of women who presented for services at the ParkMed Physicians clinic in New York during 2009.  Details have been changed to protect the anonymity of the women.

At 17, Rachel* was a high school senior when her steady boyfriend forced her to have sex. Rachel’s period was not regular, and like her family, Rachel had always considered herself pro-life. When she finally realized that she was pregnant and thought about her strong desire to go to college and her life goals, she realized that for her, abortion was the right decision.

Rachel called the nearest clinic and was informed that her state had a parental consent law, requiring her to get the consent of a parent or a judge because she was under 18. For the next three weeks Rachel feared telling anyone, especially family, but after much deliberation and anxiety she finally told her mother. While her mother was initially angry, within a few days she agreed to help Rachel get an abortion. They called the nearest clinic and got the first available appointment, one week away.  At the appointment, Rachel and her mother were shocked when the ultrasound showed that Rachel was already five months (20 weeks) pregnant. The clinic did not offer abortions past 14 weeks. They referred her to a clinic five hours away, but because of limited physician availability that facility had no appointments for three weeks. They also learned that the clinic could not accept the health insurance that Rachel’s family had. Since Rachel’s procedure would take two days to perform, they would also need to make arrangements to stay in a hotel. Rachel and her mother spent the next three weeks borrowing $2,500 to pay for the travel, hotel, and abortion. On the day that Rachel finally had her abortion, she was 2 days shy of 24 weeks pregnant.

Rachel’s story is more common than many might think. “Pro-choice” or “pro-life,” most people do not realize that although only one percent of abortions occur at 21 weeks or later, this one percent represents about 11,000** women in the United States who get later abortions every year.[1],[2]  Many of these women must raise $2,000 to $4,000 to get the abortion they need. These women are disproportionately young and poor, and many already have a job. Some struggle to cover the cost of birth control pills, in addition to food and the next month’s rent. Pulling together the money for an abortion takes time and sacrifice. 

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This is compounded by the fact that the nearest abortion provider is often in another state. In addition to various state regulations that restrict access to abortion care, such as waiting periods and parental consent laws, only a few facilities nationwide provide abortions late in the second trimester. Since these abortions usually require two or more days to complete and are not widely available, women who must travel to these providers have to make extensive arrangements for travel, childcare, and accommodations. These all add to the cost for the woman, and as she scrambles to put all the pieces together, the cost of her abortion continues to rise. At 10 weeks the average abortion costs $450.  Each additional week may add $100 or more.  Studies have found that many women who obtain later abortions tried to have the abortion sooner but could not overcome these financial, geographic, and political barriers. [3],[4]

For Rachel, being unfamiliar with the symptoms of being pregnant, having irregular periods, her ambivalence about abortion coming from growing up in a “pro-life” family, and being in denial about the fact that her boyfriend had raped her all contributed to late recognition of her pregnancy.  Restrictive policies, a delayed referral, and needing to travel to find a provider who could help her pushed her to present much later for the abortion she needed.

Diana* already had special-needs three year-old twins when she found herself pregnant a second time.  She brought up the idea of abortion with her abusive, alcoholic husband who angrily rejected the idea, despite their current financial and emotional strain.  He demanded she deliver a son for him, a “normal one,” not some “freak show” like before, and punched and kicked her when she argued.

During Diana’s 20th week of pregnancy, after weeks of fear and contemplation, she secretly borrowed money for an abortion from her sister.  Before bed that night, she hid clothing and her purse in the bathtub, planning to slip away with the twins in the pre-dawn hours.  When her husband caught her attempting to leave, he beat her ferociously. Three weeks later, her bruises still present, Diana found another opportunity to leave, this time leaving the twins with her sister. She feared for their safety and her own, but was resolute in her decision to terminate her pregnancy.

She took a bus to New York City, now 23 weeks pregnant, but the abortion was more expensive than planned. A friend offered to contribute, and together they spent another few days raising the additional $300. Diana was lucky; in spite of the delays and obstacles, she found help raising the money and was able to get to New York City where there are abortion providers who could take care of her.

Diana’s story, like Rachel’s, is a typical example of “the perfect storm”- the intersection of life situation, funding and regulatory barriers, scrambling to find a provider and needing to travel – all circumstances that may lead a woman to seek an abortion later in her pregnancy. However, most Americans are unaware of how women find themselves in the center of this storm. According to a 2010 Gallup poll, 45 percent of Americans consider themselves to be pro-choice. Nevertheless, only one quarter of Americans support women’s right to end an unwanted pregnancy in the second trimester.[5] Many Americans become uncomfortable with later abortion because they focus on the developmental level of the fetus rather than on the rights of the pregnant woman, overlooking the myriad reasons that women need later abortions. Without the full picture of women like Rachel and Diana, it is easy to assume that women who obtained later abortions had total control over when to come for abortion care and simply chose to delay. These women are often misjudged as careless and immoral and of not taking responsibility for presenting earlier for abortion care.

The reality is that women need later abortions for many of the same reasons women need any other abortion. A woman or girl is not yet ready to start a family; she’s about to start college; she’s just lost her job; she was raped; she needs to look after her existing children.  Later abortions, like earlier abortions, happen because birth control fails, because the choice of when and how to be sexual is not always a woman’s choice, because obtaining health insurance is slow or out of reach, or because the decision to fully commit to the children that she already has is a moral decision that women take seriously. For some women, a diagnosis of fetal anomaly comes late in pregnancy, for some it comes earlier.  For others, partners leave, houses disappear in hurricanes or floods and their new situation means they no longer feel they can parent a new child. Women who seek early and later abortions alike do not make a decision about a pregnancy in isolation; each woman’s decision is impacted by her location, health, socioeconomic status, race, nationality, religious beliefs and family circumstances.

In April 2010, the Nebraska legislature banned abortions after 20 weeks of pregnancy for all reasons except for the life and physical health of the mother. This law will go into effect on October 15.  What little public discussion there has been about this new law has centered on the constitutionality of the ban or the scientific credibility of the reasons for the ban.  Scarce attention is being paid to the women whose abortions will be prohibited if the ban is allowed to go into effect.

The stories of the women who need later abortions must be placed at the center of the debate.  The Rachels and Dianas of Nebraska have lost access to the abortions that they need. While we may not all agree with the decisions these women make, we can develop empathy and understanding for their situations, along with the awareness that these women are struggling to do the best they can with time against them.  Support for women seeking later abortions needs to start with each of us.

*The stories in this article are true summaries of women who presented for services at the ParkMed Physicians clinic in New York during 2009.  Details have been changed to protect the anonymity of the women.

**Estimated from CDC data containing all states but CA, LA, and NH, plus Guttmacher State Profile data for CA, LA, and NH.


[1] Centers for Disease Control and Prevention. Abortion Surveillance–United States, 2006. Surveillance Summaries, 27 November 2009. MMWR 2009;58(No.SS-8).

[2] Guttmacher Institute. State Center. Accessed 30 July 2010. At: http://www.guttmacher.org/statecenter/sfaa.html

[3] Finer LB, Frohwirth LF, Dauphinee LA, Singh S, Moore AM. Timing of steps and reasons for delays in obtaining abortions in the United States. Contraception. 2006 Oct;74(4):334-44.

[4] Drey EA, Foster DG, Jackson RA, Lee SJ, Cardenas LH, Darney PD. Risk factors associated with presenting for abortion in the second trimester. Obstet Gynecol. 2006 Jan;107(1):128-35.

[5] Gallup Poll News Service. Abortion. Accessed 21 July 2010. At: http://www.gallup.com/poll/1576/abortion.aspx#1

News Politics

Anti-Choice Democrats: ‘Open the Big Tent’ for Us

Christine Grimaldi & Ally Boguhn

“Make room for pro-life Democrats and invite pro-life, progressive independents back to the party to focus on the right to parent and ways to help women in crisis or unplanned pregnancies have more choices than abortion,” the group said in a report unveiled to allies at the event, including Democratic National Convention (DNC) delegates and the press.

Read more of our coverage of the Democratic National Convention here.

Democrats for Life of America gathered Wednesday in Philadelphia during the party’s convention to honor Louisiana Gov. John Bel Edwards (D) for his anti-choice viewpoints, and to strategize ways to incorporate their policies into the party.

The group attributed Democratic losses at the state and federal level to the party’s increasing embrace of pro-choice politics. The best way for Democrats to reclaim seats in state houses, governors’ offices, and the U.S. Congress, they charged, is to “open the big tent” to candidates who oppose legal abortion care.

“Make room for pro-life Democrats and invite pro-life, progressive independents back to the party to focus on the right to parent and ways to help women in crisis or unplanned pregnancies have more choices than abortion,” the group said in a report unveiled to allies at the event, including Democratic National Convention (DNC) delegates and the press.

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Democrats for Life of America members repeatedly attempted to distance themselves from Republicans, reiterating their support for policies such as Medicaid expansion and paid maternity leave, which they believe could convince people to carry their pregnancies to term.

Their strategy, however, could have been lifted directly from conservatives’ anti-choice playbook.

The group relies, in part, on data from Marist, a group associated with anti-choice polling, to suggest that many in the party side with them on abortion rights. Executive Director Kristen Day could not explain to Rewire why the group supports a 20-week abortion ban, while Janet Robert, president of the group’s board of directors, trotted out scientifically false claims about fetal pain

Day told Rewire that she is working with pro-choice Democrats, including Sen. Kirsten Gillibrand and Rep. Rosa DeLauro, both from New York, on paid maternity leave. Day said she met with DeLauro the day before the group’s event.

Day identifies with Democrats despite a platform that for the first time embraces the repeal of restrictions for federal funding of abortion care. 

“Those are my people,” she said.

Day claimed to have been “kicked out of the pro-life movement” for supporting the Affordable Care Act. She said Democrats for Life of America is “not opposed to contraception,” though the group filed an amicus brief in U.S. Supreme Court cases on contraception. 

Democrats for Life of America says it has important allies in the U.S. House of Representatives and the U.S. Senate. Sens. Joe Donnelly (IN), Joe Manchin (WV), and Rep. Dan Lipinski (IL), along with former Rep. Bart Stupak (MI), serve on the group’s board of advisors, according to literature distributed at the convention.

Another alleged ally, Sen. Bob Casey (D-PA), came up during Edwards’ speech. Edwards said he had discussed the award, named for Casey’s father, former Pennsylvania Gov. Robert P. Casey, the defendant in the landmark Supreme Court decision, Planned Parenthood v. Casey, which opened up a flood of state-level abortions restrictions as long as those anti-choice policies did not represent an “undue burden.”

“Last night I happened to have the opportunity to speak to Sen. Bob Casey, and I told him … I was in Philadelphia, receiving this award today named after his father,” Edwards said.

The Louisiana governor added that though it may not seem it, there are many more anti-choice Democrats like the two of them who aren’t comfortable coming forward about their views.

“I’m telling you there are many more people out there like us than you might imagine,” Edwards said. “But sometimes it’s easier for those folks who feel like we do on these issues to remain silent because they’re not going to  be questioned, and they’re not going to be receiving any criticism.”

During his speech, Edwards touted the way he has put his views as an anti-choice Democrat into practice in his home state. “I am a proud Democrat, and I am also very proudly pro-life,” Edwards told the small gathering.

Citing his support for Medicaid expansion in Louisiana—which went into effect July 1—Edwards claimed he had run on an otherwise “progressive” platform except for when it came to abortion rights, adding that his policies demonstrate that “there is a difference between being anti-abortion and being pro-life.”

Edwards later made clear that he was disappointed with news that Emily’s List President Stephanie Schriock, whose organization works to elect pro-choice women to office, was being considered to fill the position of party chair in light of Rep. Debbie Wasserman Schultz’s resignation.

“It wouldn’t” help elect anti-choice politicians to office, said Edwards when asked about it by a reporter. “I don’t want to be overly critical, I don’t know the person, I just know that the signal that would send to the country—and to Democrats such as myself—would just be another step in the opposite direction of being a big tent party [on abortion].” 

Edwards made no secret of his anti-choice viewpoints during his run for governor in 2015. While on the campaign trail, he released a 30-second ad highlighting his wife’s decision not to terminate her pregnancy after a doctor told the couple their daughter would have spina bifida.

He received a 100 percent rating from anti-choice organization Louisiana Right to Life while running for governor, based off a scorecard asking him questions such as, “Do you support the reversal of Roe v. Wade?”

Though the Democratic Party platform and nominee have voiced the party’s support for abortion rights, Edwards has forged ahead with signing numerous pieces of anti-choice legislation into law, including a ban on the commonly used dilation and evacuation (D and E) procedure, and an extension of the state’s abortion care waiting period from 24 hours to 72 hours.

News Politics

NARAL President Tells Her Abortion Story at the Democratic National Convention

Ally Boguhn

Though reproductive rights and health have been discussed by both Democratic Party presidential nominee Hillary Clinton and Sen. Bernie Sanders (I-VT) while on the campaign trail, Democrats have come under fire for failing to ask about abortion care during the party’s debates.

Read more of our coverage of the Democratic National Convention here.

Ilyse Hogue, president of NARAL Pro-Choice America, told the story of her abortion on the stage of the Democratic National Convention (DNC) Wednesday evening in Philadelphia.

“Texas women are tough. We approach challenges with clear eyes and full hearts. To succeed in life, all we need are the tools, the trust, and the chance to chart our own path,” Hogue told the crowd on the third night of the party’s convention. “I was fortunate enough to have these things when I found out I was pregnant years ago. I wanted a family, but it was the wrong time.”

“I made the decision that was best for me — to have an abortion — and to get compassionate care at a clinic in my own community,” she continued. “Now, years later, my husband and I are parents to two incredible children.”

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Hogue noted that her experience is similar to those of women nationwide.

“About one in three American women have abortions by the age of 45, and the majority are mothers just trying to take care of the families they already have,” she said. “You see, it’s not as simple as bad girls get abortions and good girls have families. We are the same women at different times in our lives — each making decisions that are the best for us.”

As reported by Yahoo News, “Asked if she was the first to have spoken at a Democratic National Convention about having had an abortion for reasons other than a medical crisis, Hogue replied, ‘As far as I know.'”

Planned Parenthood Federation of America President Cecile Richards on Tuesday night was the first speaker at the DNC in Philadelphia to say the word “abortion” on stage, according to Vox’s Emily Crockett. 

Richards’ use of the word abortion was deliberate, and saying the word helps address the stigma that surrounds it, Planned Parenthood Action Fund’s Vice President of Communication Mary Alice Carter said in an interview with ThinkProgress. 

“When we talk about reproductive health, we talk about the full range of reproductive health, and that includes access to abortion. So we’re very deliberate in saying we stand up for a woman’s right to access an abortion,” Carter said.

“There is so much stigma around abortion and so many people that sit in shame and don’t talk about their abortion, and so it’s very important to have the head of Planned Parenthood say ‘abortion,’ it’s very important for any woman who’s had an abortion to say ‘abortion,’ and it’s important for us to start sharing those stories and start bringing it out of the shadows and recognizing that it’s a normal experience,” she added.

Though reproductive rights and health have been discussed by both Democratic Party presidential nominee Hillary Clinton and Sen. Bernie Sanders (I-VT) while on the campaign trail, Democrats have come under fire for failing to ask about abortion care during the party’s debates. In April, Clinton called out moderators for failing to ask “about a woman’s right to make her own decisions about reproductive health care” over the course of eight debates—though she did not use the term abortion in her condemnation.