A child that faces a bedridden life. A girl with intellectual disabilities raped by a family member. Victims of domestic violence or reproductive coercion. There are a variety of distressing reasons women have later stage terminations.
There is no easy definition of when an abortion is considered “late” or “late-term”. It’s generally considered anything after 20 weeks’ gestation, but the states and territories have a patchwork of legislation with various milestones.
What is clear is that later terminations are the new target of anti-abortion activists, now that abortion has been decriminalised across Australia.
On Wednesday South Australia’s upper house voted on legislation that would force women seeking an abortion after 27 weeks and six days – an extremely rare occurrence – to be induced, to deliver the child alive, and keep it or adopt it out.
It was narrowly defeated – nine were in favour and 10 opposed from the 22-person house. The president only casts a deciding vote, while prominent Liberal critic of the bill, Michelle Lensink is absent for cancer treatment.
The Liberal frontbencher Ben Hood, who introduced the bill, says the woman’s right to end a pregnancy is kept because the pregnancy ends when the baby is born.
“The innovation of this bill is that it allows a mother to end her pregnancy throughout all nine months and indeed, right up to birth,” he says.
The Greens have a different label for it: “forced birth”.
About 1% of all terminations are carried out after 20 weeks.
According to SA Health data gathered in the 18 months after abortion reform in the state, fewer than five terminations were performed after 27 weeks.
Terminations at that point can only be done with the approval of two doctors, and only if it is necessary to save the life of the pregnant person or save another foetus, or poses significant risk of injury or mental health of the pregnant person, or if there is a significant risk of serious foetal anomalies.
Hood said in the upper house on Wednesday night that his bill did not “force birth”. He said any termination at 28 weeks already involved “birth” because women had no other option in how to remove the fetus from the body.
“The only difference is that the baby will have a chance to live,” he said.
He has previously said that, once born, if the baby “isn’t compatible with life”, it would then be given palliative care.
He said on Wednesday night the babies would be admitted to neonatal units, “receiving the best medical attention available if the mother does not wish to keep the baby”.
Adoption would be a compassionate alternative, he said.
Hood indicated on ABC radio that he was not abandoning his mission.
The attorney general, Kyam Maher, says the “Trumpian” bill would wind back abortion care and poses a “real and significant danger, not only to the physical health and safety of all women, but to women’s fundamental right to bodily autonomy”.
He also hit out at the vitriol, nastiness and inflammatory attacks deployed in the campaign.
“I’d encourage those who’ve been involved in this sort of debate to reflect on whether the hyper polarised US style of personal politics really reflects well on SA,” he says.
The bill bears similarities to so-called “born-alive” laws, which have percolated in the US for years. A federal “born alive” bill in Australia was found to have no legal, ethical or medical basis to support it.
The Katter’s Australian party leader, Robbie Katter, has proposed similar legislation in Queensland.
Both Katter and Hood have thanked the anti-abortion activist Joanna Howe for her work on their legislation. Howe wants “an Australia where abortion is unthinkable”.
Hood thanked Howe on Wednesday, and said the other people who informed the bill wanted to remain anonymous. Several earlier speakers noted that Hood’s bill was drafted by Howe and anonymous experts while the review that informed decriminalisation involved thousands of experts and many respected institutions who did not remain anonymous, and that it involved months of investigation and a 560-page report.
Abortion has also crept up as a serious issue in the lead up to the Queensland election after Labor accused the Liberal National party of a “secret plan” to limit abortion rights and the LNP failed to quell the speculation.
The various campaigns have been accused of using misinformation in an attempt to limit access to terminations.
Reasons women might need a late termination include foetal abnormalities, life-threatening conditions, and psycho-social reasons such as the baby being the result of rape or incest.
‘We can’t do this to the baby’
Tiffany’s first baby had spina bifida.
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Her baby would have been paralysed from the neck down. She chose a termination. Six years later, Tiffany* was pregnant again. At the 20-week scan, she was told this baby also had spina bifida, but it was not as bad.
“They said wait another two weeks, we’ll do another scan and we’ll go from there,” she says.
“You’re stressing, you’re freaking out. Two weeks felt like an eternity.”
After waiting two weeks and undergoing another scan, Tiffany was again told it didn’t look too bad and she should do another scan in two weeks.
“At 24 weeks, it got worse,” she says.
“He started developing fluid on the brain. It was affecting his nerves, down the spine. It went from numb toes to ‘he’s not going to be able to walk’.”
Another two weeks, another scan. “Everything was failing,” she says. “We did all these tests because I needed to make sure I was making the right decision … we sat down and said ‘we can’t do this to the baby’. He’d be bedridden, have surgery after surgery, a lifetime of hospital visits.”
At 28 weeks, she had the procedure.
An SA Law Reform Institute review of abortion law heard about a girl with an intellectual disability who had been sexually abused by a family member and did not realise she was pregnant until late in the pregnancy.
She made it clear she did not want the pregnancy to proceed. If she had not been able to have an abortion, if she had been forced to have the child, it would have had a “severe and adverse affect on her”, the institute said in its report.
Jacquie* and her husband had a two-year-old and another baby on the way.
They did the usual testing, including a 16-week scan and an amniocentesis. “We got the results back and they said everything was fine,” she says. “But I had a gut feeling and remember saying to my hubby that something was just off.”
At 24 weeks, they got a call. “They said they got the results wrong,” she says. “We thought, ‘shit’. So we were told at 24 weeks that our child did have Down syndrome and we had to make a choice within 24 hours.
“We just had to make the decision around our family and what was best for us. To this day we never say it was the right decision. It was the best choice for us at that time. We had to think about our little one.”
Jacob Mangelsdorf is a counsellor at Red Tree Foundation, an organisation which supports people grieving the loss of a child.
He says the parents that come to him are suffering an “incredibly complex grief”. “We’re not talking about an easy choice. We’re not talking about something that’s without a high level of complexity,” he says.
“It’s not just losing that baby, it’s about processing that loss and the decision, [thinking] ‘in some ways I made that choice to end that baby’s life’.
“There’s always that little part of their brain grappling with that. It’s really important to acknowledge that the mum at that point has had 20-something weeks to bond with that baby.”
Tiffany says hospitals and health authorities need to do better in supporting women going through horrific experiences like hers. And people need to stop judging others, she says.
“Everyone has an opinion and their own beliefs.
“But if you’re not in my shoes, you don’t know.”
* Full names have not been used to maintain privacy of those interviewed
The Red Nose grief and loss support line is available 24/7 for anyone affected by the loss of a pregnancy, stillbirth or death of a baby or child on 1300 308 307
