When South Carolina Republican Senator Lindsay Graham proposed a nationwide ban on abortions after 15 weeks of pregnancy, the bill sparked controversy across the political spectrum. But few spoke about the potential impact of the growing number of women having children in their 30s.
The proposed ban would allow exceptions for saving women’s lives and for some pregnancies resulting from rape and incest, but lacks exceptions for fetal abnormalities. As such, it not only severely limits options for older women who are coveted for a significantly delayed pregnancy, but also increases the risk of conditions such as Down syndrome.
The median age at childbearing in the United States has risen in recent decades, reaching 30 in 2019 from 27 in 1990. Beyond the duration of the abortion suggested by Mr. Graham, it should be carried out after the pregnancy reaches her 15th week.
Some anatomic abnormalities may not be diagnosed until later in pregnancy. Older mothers are also more likely to become pregnant with conditions that deteriorate as the pregnancy progresses and may require an abortion to save the woman’s life or prevent disability. .
Well-educated women have long delayed fertility, but American women of all economic, racial, and ethnic backgrounds are having children at an older age, according to Census Bureau research statistician Anne Morse. The most important change is that over the past 30 years, median age at childbirth has risen from 24 to 28 and from 27 to 32, respectively, among black mothers and women who were not born in the United States. occurred in
“Across all demographic groups, there has been a significant decline in births among women in their twenties,” says Dr. Morse. Also, fertility rates for women aged 35 to 39 are rising in all demographic groups except Native She-American and Alaska Native women, she said.
Graham’s bill, which is not expected to pass in Congress, which is barely controlled by Democrats, has been controversial even among anti-abortion Republicans, with several Republican senators criticizing reporters. He told the delegation that the matter was best left to the states to decide.
A very small percentage of abortions are performed after the 15th week of gestation. In 2019, 95.6% of abortions reported to the Centers for Disease Control and Prevention occurred before 16 weeks of gestation.
Most of these rare surgeries are performed for younger women or women with unplanned pregnancies, low income, or limited access to care. , more likely to have an abortion after 15 weeks because of the increased risk of fetal abnormalities.
Women in their early 20s have a 1 in 500 chance of conceiving a child with a chromosomal abnormality, but the risk increases to 1 in 270 for women aged 30 and 1 in 60 for women aged 40.
According to various studies, 67% to 85% of women chose to have an abortion after being diagnosed with Down syndrome.
amniocentesis, a procedure to remove amniotic fluid from the uterus to test for chromosomal abnormalities in the fetus, A very important mid-gestation ultrasound to detect structural abnormalities can only be performed after 15 and 20 weeks of gestation, respectively.
Additionally, conditions that can increase pregnancy risk, such as hypertension, asthma, obesity, diabetes, and cardiovascular disease, are more common among older women, putting strain on the heart, lungs, and kidneys as pregnancy progresses. Some doctors point out that it takes longer and causes more problems.
Women with college degrees have children on average seven years later than women without degrees, and the average age of first marriage has risen from 24 in 1990 to 28.
“Many women, including myself, have delayed childbirth in order to get through at least part of their career trajectory,” says Melissa Ms. Dr Simon says.
“It puts you in your mid-to-late 30s, considered high-risk in the world of maternity care,” she added. .”
At least 13 states outright ban abortion, and Georgia bans the procedure at 6 weeks’ gestation. But among states where abortion is legal, Florida is the only state with a 15-week cutoff for her. (In Utah she has an 18-week cutoff, but other states allow her to finish later.)
Graham’s rationale for setting 15 weeks as a national cutoff is incorporated into the title of his law, “Protecting Pain-Sensitive Fetuses from Late-Term Abortion Laws.” The measure claims that the fetus will feel pain after 15 weeks.
But the experience of pain requires the cerebral cortex, which doesn’t develop until the end of the second trimester or the beginning of the third trimester, according to medical experts.
Asked about the scientific basis for this claim, a spokesperson for Graham’s office said the Charlotte Rozier Institute, a research institute at Susan B. Anthony Pro Life America seeking to end all abortions, said: Directed reporters to the website.
Our entry on pain relies primarily on papers published in the journal of medical ethics, which do not challenge the developmental timeline of the fetal cortex, but suggest that other previously developed brain structures mimic pain. It suggests that it may be sufficient for experience.
But Stuart Derbyshire, the author of the paper and an associate professor at the National University of Singapore, said in an interview that he didn’t understand why Graham’s bill chose a 15-week deadline. The American College of Obstetricians and Gynecologists, representing nearly 60,000 providers, called the gestational age mentioned in the law arbitrary and unscientific.
Many scientists say the ability to sense pain depends on consciousness, but Dr. Derbyshire emphasizes that fetuses are not conscious.
“We have made it very clear in this paper that it is not A fetus in the womb saying, “Hmm, it really hurts, today is a bad day.”
The proposed bill would also require that the fetus be hospitalized and attended by a physician trained in neonatal resuscitation to provide care if the abortion is performed after the 15th week of pregnancy. However, according to a study published earlier this year, her 22 weeks is the earliest she can survive outside the womb, and experts say fetuses born before that will not survive.
Advances in technology have made it possible to screen for chromosomal abnormalities earlier in pregnancy than before, but prenatal testing is required to obtain a definitive diagnosis. or amniocentesis.
Although the sampling method can be done sooner than amniocentesis, it cannot be safely done until after the 10th week of gestation, and results are often not known until the 12th or 14th week of pregnancy. It’s not readily available in all medical centers, says Dr. Stephen Chasen, an expert in maternal and fetal medicine.
Many centers rely on amniocentesis, but it is not offered until the 15th week of pregnancy because the risk of complications is too high.
An ultrasound scan to check for structural fetal abnormalities distinct from chromosomal abnormalities is performed as early as 10 to 12 weeks of gestation, while a comprehensive head-to-toe anatomical scan is performed at 20 It takes place in a week.
“There are many structural abnormalities, including very serious conditions involving the brain, heart, kidneys, and skeletal structures, that are not suspected until late or late pregnancy,” Dr. Chasen said.
“The majority of structural abnormalities are not diagnosed or suspected before 15 weeks,” he added. will have to.”