The proposed federal ban on abortion at or after 20 weeks post-fertilization (equivalent to 22 weeks’ gestation) is harmful to women’s health and fundamentally misguided. The bill is premised on faulty science, would fall hardest on the most vulnerable women, and contains provisions that could lead to the targeting of abortion providers. Instead of pursuing such a ban, those concerned about later abortions should work to help women access abortion care earlier in pregnancy and should also promote policies to prevent unintended pregnancy.
The 20-week abortion ban, misleadingly labeled as the Pain-Capable Unborn Child Protection Act, is based at least in part on the assertion that fetuses can experience pain starting at 20 weeks post-fertilization—a claim that is not supported by the preponderance of scientific evidence. The bill is also patently unconstitutional, since it would prohibit abortion before viability without any exception to preserve a woman’s health. The bill also includes particularly callous and cruel rape and incest exceptions that force rape victims to wait 48 hours and make two visits to see two different providers before having an abortion.
Moreover, the 20-week abortion ban would fall hardest on low-income women, the very group bearing a disproportionate burden of unintended pregnancies. According to a study by researchers at UCSF, women obtaining an abortion at or after 20 weeks’ gestation were much more likely than women obtaining an abortion in the first trimester to report delays because they had difficulty raising funds for the procedure and travel costs, or because they had difficulty securing insurance coverage.
In addition to the harmful ban on safe abortion care, the bill would impose a little-noticed provision that could be used to target abortion providers. The bill would require abortion providers to submit annual summaries of abortions provided at or after 20 weeks post-fertilization to the National Center for Health Statistics (NCHS). Requiring physicians to report certain abortions directly to NCHS serves no discernible public health purpose, but rather appears to be part of an ongoing trend to politicize U.S. abortion surveillance.
The bill also requires NCHS to issue annual reports of all reported abortions, with patients’ identifying information protected. However, given ongoing threats against and harassment of providers, it is alarming that the bill says nothing about protecting physician and provider information and confidentiality. This is in clear contrast to many state policies, as 34 of the 46 states with abortion reporting requirements specifically protect the confidentiality of providers.
Ultimately, the 20-week abortion ban, if enacted, would constitute a significant failure of public health policy. Rather than coercing women’s abortion decisions, policymakers should focus on making abortion care more accessible earlier in pregnancy. Indeed, it is the cumulative effect of the tidal wave of abortion restrictions in large swaths of the country that may in fact push many women into having abortions later than they would have otherwise wanted.
If Congress were serious about reducing the need for later abortion, it would remove the numerous legal obstacles that delay women’s ability to access abortion care, such as waiting periods and bans on public and private insurance coverage for abortion. And, rather than cutting or otherwise obstructing access to contraceptive services, it would augment funding and support for these services to help women avoid unintended pregnancy in the first place.
