New analysis about Republicans’ proposed 20-week abortion ban says the common medical procedure is safe, and that delays in care caused by restrictions are why some are forced to seek abortion care later in pregnancy.
The Congressional Research Service (CRS), a division of the Library of Congress that provides policy analysis to members of the U.S. Congress, sought to respond to common questions about the ban in a report published last week. It did not address issues of constitutionality or state regulations on abortion at 20 weeks, nor did it “provide an ethics or morality discussion of second trimester abortion or whether a fetus is a person and has a right to life.”
Dr. Diana Greene Foster, director of research at University of California, San Francisco’s Advancing New Standards in Reproductive Health (ANSIRH), who was cited in the report, called it “very good” in an in email to Rewire.News. “It succinctly compiles a lot of the recent research on later abortions,” Foster said. “I hope that policy makers read it.”
Many of the questions answered in CRS’ report speak to talking points used by the GOP to demonize later abortion care.
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For example, Republicans have long pushed a ban on abortion at 20 weeks, or 22 weeks’ gestation, based on the dubious claim that a fetus can feel pain at this point in a pregnancy. But CRS’ report pointed to a fact sheet from the American College of Obstetricians and Gynecologists (ACOG) as the authority on the matter, quoting a 2013 statement that said a “human fetus does not have the capacity to experience pain until after viability.”
“Rigorous scientific studies have found that the connections necessary to transmit signals from peripheral sensory nerves to the brain, as well as the brain structures necessary to process those signals, do not develop until at least 24 weeks of gestation,” the statement said.
The CRS report addressed how mental health can be affected by having abortions. In particular, it pointed to research finding that having an abortion does not increase the risk of mental health disorders.
Abortion rights opponents often claim that the procedure can have harmful long-term psychological effects, though there is no evidence to support that charge. A 20-week ban authored by the anti-choice group Americans United for Life and adopted by the GOP-majority Arizona legislature in 2012 falsely suggests that those who have abortions are at risk for “psychological or emotional complications.”
When it comes to whether later abortions are safe, the report says that “for women in the United States, the mortality rate associated with childbirth or continuing the pregnancy is higher than the abortion mortality rate.” Though it notes that the risk of mortality goes up as gestational age increases, CRS pointed to research from the National Academy of Sciences, Engineering, and Medicine that found the risk of death from abortion care to be less than the risk of death during colonoscopies, dental procedures, and adult tonsillectomies.
The report mentioned how often later abortion care is performed due to fetal anomaly and life endangerment, speaking to pro-choice advocates who say that later abortions are often for these reasons. Here, CRS again pointed to Foster’s work.
“Based on limited research and discussions with researchers in the field, Dr. Foster believes that abortions for fetal anomaly ‘make up a small minority of later abortion’ and that those for life endangerment are even harder to characterize,” it said.
Though she referred to it as “an extremely minor point in an otherwise excellent report,” Foster noted a small difference between her opinion and how it was characterized in CRS’ analysis.
“What I really believe is that nobody knows what fraction of later abortions are for these reasons,” said Foster. “I wouldn’t state that fetal anomaly and life endangerment are a small minority of later abortions because nobody has statistics on this.”
The report addressed the question of why some may experience delays in seeking or receiving abortion care. Along with factors such as a delay in finding out about a pregnancy and difficulty finding funds for care, the report pointed to federal and state-level restrictions on abortions as a factor.
CRS’ analysis noted recent iterations of the Pain-Capable Unborn Child Protection Act and the Born-Alive Abortion Survivors Protection Act “would require that infants born alive following an abortion procedure be transferred to a hospital for treatment.”
But, the report says, “the legislation makes no provision for the treatment costs or subsequent care needed to support these children, who could become wards of the state.”
“Infants born at 23 weeks’ gestation do not have sufficiently developed lungs and cannot breathe on their own; such infants will die at birth if not given life-sustaining therapies,” it goes on, later explaining that the long-term costs associated with premature infants may also be higher.
“In addition to the health care costs that extremely premature infants will generate post-NICU, other costs—such as day-care services, respite care, school—are likely to be much greater than those for full-term babies,” it said.
CRS’ report did not address whether there is evidence of infants “born-alive” after an abortion, another myth perpetuated by anti-choice activists, though it did address the “medical issues” premature infants face.