National Journal: How 20-Week Bans Force Women To Carry Dying Fetuses

October 16, 2013 — National Journal examined how 20-week abortion bans affect couples who are told their fetus will not survive or will be born with severe mental or physical problems.

The article focuses on Arkansas' efforts to enact such a ban (Reinhard, National Journal, 10/10). In March, the Arkansas Legislature overrode a veto by Gov. Mike Beebe (D) to pass a bill (HB 1037) that prohibits abortion after 20 weeks. The measure includes exceptions for cases of rape or incest or to save a woman's life, but it does not include exemptions for fatal fetal disorders (Women's Health Policy Report, 3/4). The state also enacted a law banning most abortions after 12 weeks of pregnancy, but a judge has blocked the measure while a court challenge continues.

National Journal reports that some disorders -- including severe brain and heart defects, as well as conditions that cause organs to grow outside of the body cavity -- can go undetected until 20 weeks or later, according to the American Congress of Obstetricians and Gynecologists.

So far, 12 states have banned abortion at 20 weeks, when many couples are just finding out about severe or fatal defects. Women in states that do not permit exemptions for fetal disorders could be forced to continue their pregnancies, sometimes against their own wishes and those of their partner. Continuing such pregnancies also can put the woman's health at risk, according to National Journal.

Struggles To Care for Disabled Children

Six of the states that have enacted such bans -- Alabama, Arkansas, Georgia, Louisiana, Oklahoma and Texas -- are in the South, which has the highest poverty rates, largest number of residents who lack health coverage and lowest median incomes in the U.S. Therefore, families in these states are "among the most disadvantaged when it comes to caring for unwanted and disabled children," according to National Journal.

A study published by the Brookings Institution and the Woodrow Wilson School of Public and International Affairs at Princeton University found that the average cost of raising a child with disabilities can be as much as $30,500 per year.

Dean Baker, a co-founder of the Center for Economic and Policy Research, said, "However you feel about abortion, you can anticipate higher costs if you prevent it." He added, "If these states aren't prepared to increase funding for Medicaid and for children with disabilities, someone is going to suffer."

Abortion-rights opponents argue that there is a "slippery slope" for defining fetal abnormalities. Jerry Cox, founder of the Arkansas Family Council, said, "Is Down syndrome an abnormality? Spina bifida? Doesn't that create a search-and-destroy system where only the perfect children get to be born, and the imperfect babies are aborted?"

Couples Profiled

According to National Journal, most couples who choose abortions at 20 weeks or beyond "had every intent to carry their babies to term, until forced ... to make a swift and excruciating decision."

Of two couples profiled in the article who received prenatal diagnoses of severe fetal anomalies, one decided to have an abortion and one did not. The Sanders, the couple who decided to have an abortion, recounted painful memories of learning of their fetus' fatal disorder. The fetus' brain had failed to divide and was growing outside of the skull, a chamber was missing from the heart, and there was a problem with the kidneys.

Abbey Sanders said that she would ask lawmakers to consider what they would do if a loved one of theirs faced a similar situation. She said, "If your wife was in these circumstances, would you force her to carry that baby?" adding, "I don't think I could have gone on any longer, and any woman who was forced to would have lost her mind."

The other couple -- Arkansas Rep. Andy Mayberry and his wife, Julie -- cited their religious beliefs as the reason they chose to continue the pregnancy after being told the fetus had spina bifida. National Journal notes that unlike the Sanders, the Mayberrys did not receive a fatal diagnosis. Their daughter, now 11, is "in a wheelchair and faces myriad health problems that have warranted 16 surgeries," and is "also a former Little Miss Wheelchair Arkansas, a straight-A student, and a member of her church youth choir."

Julie Mayberry testified before the Arkansas House in support of the 20-week ban, saying, "Without challenges, we don't have champions, and if you abort these babies before they even have the right to life, you have not given the opportunity for all of us to see what God had planned for this child" (National Journal, 10/10).