Timing of steps and reasons for delays in obtaining abortions in the United States

Second Trimester Abortion Provision: Breaking the Silence and Changing the Discourse

“…In the US, the known risk factors associated with presenting for second trimester abortion include: adolescence, drug and alcohol addiction, poverty, difficulty obtaining funding for the abortion, and African-American race. 1,2,23 Delays in obtaining second trimester abortion come when a woman does not realise she is pregnant (perhaps a surrogate for poor health or lack of education), has logistical delays, experiences denial about the pregnancy, is uncertain about the decision to have an abortion, or has a change in life circumstances or relationships that makes a previously desired pregnancy undesired. 1,2,23 These factors are all part of the texture and complexity of women's lives, complexity that the pregnant woman herself best understands.…”

“…1,2,23 Delays in obtaining second trimester abortion come when a woman does not realise she is pregnant (perhaps a surrogate for poor health or lack of education), has logistical delays, experiences denial about the pregnancy, is uncertain about the decision to have an abortion, or has a change in life circumstances or relationships that makes a previously desired pregnancy undesired. 1,2,23 These factors are all part of the texture and complexity of women's lives, complexity that the pregnant woman herself best understands. Therefore, rather than see the gradualist demand for ''good reasons'' as a threat to choice, we can see it as helping to focus the terms of the abortion debate on women themselves, in the contexts of their lives.…”

“…Many of the factors that lead women to have second trimester abortions are not readily reversible (for example, difficulty with the abortion decision, not recognising pregnancy earlier). [1][2][3] We must ask, therefore, how doctors determine how late in pregnancy they will provide abortion services.…”

The Adolescent’s Right to Confidential Care When Considering Abortion

“…5, 10, 58, 69 Minors generally suspect pregnancy later in its course than do adults. 70 Adolescents are often confused about their right to confidential care, and even a perceived lack of confidentiality in health care regarding sexual issues deters them from seeking services. 71 -74 Once the minor presents for pregnancy counseling, mandatory parental involvement laws can delay medical care further.…”

“…90,91 Compared with peers who terminate their pregnancies, adolescents who bear children are at significantly higher risk of educational deficits and economic disadvantage; children born to teen mothers also have a greater risk of negative health, social, and economic consequences. 16,70,96 Some adults support mandatory parent notification because they believe that it will protect the adolescent from making a decision she might regret later. Most adolescents, however, express satisfaction with their ultimate pregnancy decisions, provided they believe that the decisions were their own.…”