Mercy Abortions: What Dr. Tiller Did

The number one reason for abortions past 24 weeks is the late discovery of a fetal anomaly incompatible with life.

Editor’s Note: AnnRose first posted this piece last July on Huffington Post. She has reposted it now because of its relevant to the current conversation about late-term abortion care.

Fewer than 2200/year or 0.2% of the 1.3 million abortions
performed yearly are past 24 weeks.  But, the anti-abortion
propagandists have successfully maligned procedures at this stage of
pregnancy by calling them "Partial Birth Abortions" (not a medical
term, but a political one).  Even pro-choice Democrats don’t understand
the reality of late abortion.

I call abortions past 24 weeks Mercy Abortions…and I’ll tell you why.

For 14 years, I worked at Midtown Hospital in
Atlanta, a woman’s hospital specializing in late abortion.  The
hospital opened in 1977 because at that time, Georgia law mandated that
an abortion past 12 weeks had to be performed in a hospital.  Abortion
had just been made legal in 1973 and it became the first procedure to
be widely performed on an outpatient basis.

Let me repeat that:  Early abortion was the first medical procedure to be widely performed on an outpatient basis.  That means that medical professionals performing abortions invented outpatient health care in this country.

But, abortions past 12 weeks were still rare and very few hospitals would allow them to be performed.

At that time, there were 2 types of procedures for abortions:

  • Vacuum aspiration performed from about 7 weeks until 12 weeks.
  • Saline induction abortions performed from about 16 weeks to 24 weeks.


So, you can see that there was a gap where women couldn’t get
abortions from 12 weeks until 16 weeks.  That meant that a woman who
was 13 weeks pregnant had to wait 3 weeks before she could get an
abortion.  Then she had to undergo what is essentially a medically
induced miscarriage.

As abortion medical professionals matured and were able to openly
discuss options and medical procedures and medicines and investigate
problems, procedures became more refined.  Now, induction type
abortions have been pretty much eliminated, and more sophisticated
procedures involving instrumentation and general anesthesia and
abortifacent drugs have made abortion even more safe and accessible and
comfortable for women throughout all stages of pregnancy…early to

And, let me add a few more things about the evolution of abortion in this country.

  • Abortion was the first widely performed outpatient procedure.Abortion procedures have barely tripled in price
    from the early 70’s.  In the 70’s an early abortion was about $150.
    Now they are about $400.  Name any other medical procedure that’s only
    tripled in cost in the past 35 years.  You can’t.
  • Abortion clinics were some of the first medical
    providers to mandate informed consent.  And the consent is very
    detailed, unlike the general consent you sign in a hospital.
  • Abortion clinics were some of the first medical providers to openly advertise directly to consumers.
  • Abortion is one of the safest medical procedures
    performed.  It’s 8-12 times safer than childbirth.  The mortality rate
    is very low.

I could go on and on, but want to now focus on Mercy Abortions. These are abortions past 24 weeks.

Who are the women who delay into the second and third trimester?  There are several characteristics:

  • In general, they are younger.
  • They are less educated.
  • They are more rural, where healthcare is more inaccessible.
  • They tend to be poorer than women who get early abortions.
  • And they have more lifestyle and emotional issues.
    Oftentimes, the unintended pregnancy is the easiest of their problems
    to solve.


Now, I’m sure your first concern is Why.  Why would a woman wait so long?  Here’s a few of the many reasons why women delay getting abortions:

  • Money.  Many women don’t have $400 sitting around
    in a savings account to pay for an early abortion.  Delay happens in
    raising the money, borrowing it, pawning stuff for it, etc.
  • Denial.  Many young women especially so want not to
    be pregnant that they deny their obvious symptoms of pregnancy and
    attribute them to other causes.  They’re missing their period because
    they’re irregular. They’re gaining wait because they’ve been eating
    too much.  They’ve got the flu.  Many young women even hide their
    pregnancies from their parents with big baggy shirts, fake periods,
  • Fetal anomalies.  


I’m going to discuss fetal anomalies in detail because this is the number one reason women get abortions past 24 weeks.

That’s why I call them Mercy Abortions.  

One of the largest providers of late abortions, Dr. George Tiller
in Wichita, KS, has been the object of harassing investigations by
Kansas authorities, culminating in an unprecedented Grand Jury trial
prompted by anti-abortionists.  He was just recently vindicated and the
Grand Jury refused to bring charges.  But, his detractors won’t stop, and more harassment is anticipated.

Another major provider of late abortions is Dr. Warren Hern in Boulder CO.

Both of these doctors are extremely compassionate and committed
medical professionals.  I’ve been to both clinics and have known them
personally and can attest to their credibility as both doctors and
humane individuals.

Without a doubt, the number one reason for abortions past 24 weeks
is the late discovery of a fetal anomaly incompatible with life.  I’ve
talked with many women who find themselves in this situation and it is
always an extremely difficult and heart-wrenching situation.  Many
women even underwent infertility treatments to become pregnant.  But,
when the pregnancy goes horribly awry, a Mercy Abortion
is the best solution in a no-win situation.  These are women who need
abortion more than many others.  Therefore, it’s ironic that they are
the ones being punished by focusing on the procedures that are life-saving for them.

One of the reasons for this is that many of these anomalies aren’t
apparent in pregnancy until the later stages.  Also, most women get a
sonogram paid for by insurance in the early weeks of pregnancy, but
don’t get another one until well after 20-22 weeks.  

Imagine if you can that you are happily carrying a baby that you’ve
wanted all your life.  You’ve had the baby showers and decorated the
room already.  Then comes the devastating news that the baby is
anencephalic.  That means that the baby has no brain and will die a
horrible death shortly after birth.  

The Prognosis:

There is no cure or standard treatment for anencephaly and the
prognosis for affected individuals is poor. Most anencephalic babies do
not survive birth, accounting for 55% of non-aborted cases. If the
infant is not stillborn, then he or she will usually die within a few
hours or days after birth from cardiorespiratory arrest.

In almost all cases anencephalic infants are not aggressively
resuscitated since there is no chance of the infant ever achieving a
conscious existence. Instead, the usual clinical practice is to offer
hydration, nutrition and comfort measures and to "let nature take its
course". Artificial ventilation, surgery (to fix any co-existing
congenital defects), and drug therapy (such as antibiotics) are usually
regarded as futile efforts. Clinicians and medical ethicists may view
the provision of nutrition and hydration as medically futile.
Occasionally some may even go one step further to argue that euthanasia
is morally and clinically appropriate in such cases.

You’re 28 weeks along and the OB/GYN that’s been caring for you
can’t help you out.  You see, the hospital where he practices will
gladly take your money and let you give birth there, but they won’t let
your OB/GYN perform a Mercy Abortion on you so that
you can maintain your fertility for future pregnancies and lessen the
devastation on you and your family by ending the pregnancy now.  

Oh no.  The powers that be want you to carry that anencephalic baby
for 10 more weeks, then give birth, then slowly watch it die right in
front of your eyes.  Now, if that’s how you want to handle the
situation, fine.  But, if you’d like a more merciful ending to this
tragic situation, a trip to Dr. Tiller or Dr. Hern might be in order.
For now, that is.

You say.  "This is just an isolated instance."  Oh no
this scenario is played out every day.  And many of the families that
this happens to are anti-abortion.  But, at that moment where they are
told that the pregnancy is flawed, many choose the Mercy Abortion to alleviate their suffering and the suffering of their child.

Mercy Abortions are also extremely necessary in maintaining the woman’s fertility so that a successful pregnancy can be possible in the future.

So, as Democrats committed to pro-choice values, let’s not jump into
the Rovian trap that the anti-abortion framing has given us on late
abortions. They demonized a procedure that mercifully saves women and
promotes healthy families.  It may be you or someone in your family
that needs a Mercy Abortion in the future.