Advancing New Standards in Reproductive Health (ANSIRH), University of California San Francisco, Oakland, California, USA.
Perspect Sex Reprod Health. 2022 Jun;54(2):38-45. doi: 10.1363/psrh.12190. Epub 2022 Apr 10.
In the United States, third-trimester abortions are substantially more expensive, difficult to obtain, and stigmatized than first-trimester abortions. However, the circumstances that lead to someone needing a third-trimester abortion may have overlaps with the pathways to abortion at other gestations.
I interviewed 28 cisgender women who obtained an abortion after the 24th week of pregnancy using a modified timeline interview method. I coded the interviews thematically, focusing on characterizing the experience of deciding to obtain a third-trimester abortion.
I find two pathways to needing a third-trimester abortion: new information, wherein the respondent learned new information about the pregnancy-such as of an observed serious fetal health issue or that she was pregnant-that made the pregnancy not (or no longer) one she wanted to continue; and barriers to abortion, wherein the respondent was in the third trimester by the time she was able to surmount the obstacles to abortion she faced, including cost, finding a provider, and stigmatization. These two pathways were not wholly distinct and sometimes overlapped.
The inherent limits of medical knowledge and the infeasibility of ensuring early pregnancy recognition in all cases illustrate the impossibility of eliminating the need for third-trimester abortion. The similarities between respondents' experiences and that of people seeking abortion at other gestations, particularly regarding the impact of barriers to abortion, point to the value of a social conceptualization of need for abortion that eschews a trimester or gestation-based framework and instead conceptualizes abortion as an option throughout pregnancy.
在美国，与孕早期堕胎相比，孕晚期堕胎费用更高、更难获得，且更具污名化。然而，导致某人需要进行孕晚期堕胎的情况可能与其他孕期堕胎的途径有重叠。
我使用改良时间线访谈方法，对 28 名接受孕 24 周后堕胎的顺性别女性进行了访谈。我对访谈进行了主题编码，重点描述了决定进行孕晚期堕胎的经历。
我发现了需要进行孕晚期堕胎的两种途径：新信息，即受访者获得了关于妊娠的新信息，例如观察到胎儿严重健康问题，或她怀孕了，这使得她不再希望继续妊娠；以及堕胎障碍，即受访者在能够克服面临的堕胎障碍，包括费用、找到提供者和污名化时，已经处于孕晚期。这两种途径并非完全不同，有时会重叠。
医学知识的固有局限性以及在所有情况下确保早期妊娠识别的不现实性，说明了消除孕晚期堕胎需求的不可能性。受访者的经历与在其他孕期寻求堕胎的人之间的相似性，特别是关于堕胎障碍的影响，表明需要从社会角度看待堕胎，避免基于孕期或孕次的框架，而是将堕胎视为整个孕期的一种选择。
