CLAIM: Abortion is never medically necessary to protect the health of the mother.
AP’S ASSESSMENT: False. Doctors say there are multiple situations in which abortion is medically necessary to save the life of the pregnant mother. Some posts claim that such an instance would be considered “preterm delivery,” but experts say that misuses medical terminology. A procedure to end a pregnancy before a fetus is developed enough to survive outside the womb is defined as an abortion regardless of the reasoning behind it.
THE FACTS: The U.S. Supreme Court’s decision last month to end constitutional protections for abortion has prompted more than a dozen states to enact strict limits or total bans on the procedure.
The ruling also has reinvigorated misinformation about what constitutes an abortion and whether the procedure can be medically necessary.
“Abortion is never medically necessary to save the life of the mother,” read a widely shared Facebook post from an anti-abortion nonprofit.
“There are maternal health emergencies that require the mother and child to be separated through natural delivery, c-section, or the removal of a child in an ectopic pregnancy situation,” another widely shared post read. “And sometimes the child is sadly too young to survive. But this is not an abortion because every effort is made by doctors to preserve the lives of BOTH patients – mother & child.”
But doctors told The Associated Press that there are many circumstances in which abortion — meaning the termination of a pregnancy — can be medically necessary.
“Without question, abortion can be medically necessary,” The American College of Obstetricians and Gynecologists said in a 2019 statement after similar claims spread online. “There are situations where pregnancy termination in the form of an abortion is the only medical intervention that can preserve a patient’s health or save their life.”
Those situations might include, for example, a pregnant woman’s water breaking before 20 weeks of pregnancy, according to Dr. Kristyn Brandi, a practicing OB-GYN and abortion provider and the board chair for the advocacy organization Physicians for Reproductive Health.
When a woman’s water breaks far too early, it makes it unlikely a fetus’ lungs will be able to develop enough to survive. It also presents a very high risk of infection and septic shock in the pregnant mother, Brandi said. In such an instance, a doctor’s recommendation to protect the mother’s life would often be to end the pregnancy through an abortion.
Other times, if a woman has a heart condition, Brandi said, the increased blood production during a pregnancy may jeopardize her heart’s ability to support her or the fetus.
“And so there may be some reasons why a pregnant person may become sick during a pregnancy, that may cause us to recommend to end the pregnancy before it becomes too unsafe for that person,” Brandi said.
Other examples of complications that could necessitate abortion to save the mother’s life might include kidney or liver failure, said Dr. Cindy Duke, an OB-GYN and virologist who is also the founder and medical and laboratory director of the Nevada Fertility Institute.
Doctors say it’s misleading to claim that the solution to a life-threatening complication in a pregnancy is delivery rather than abortion. That’s because in medical literature, “abortion” refers to the termination of a pregnancy for any reason, according to Dr. Louise P. King, an OB-GYN and the director of reproductive bioethics at Harvard Medical School Center for Bioethics. If a fetus can’t survive outside the womb, ending that pregnancy is considered an abortion.
She said if a patient prefers to refer to an abortion as a “delivery,” doctors may use that terminology to “meet patients where they are,” but “that does not change the nature of that procedure.”
In addition, any delivery before 20 weeks of pregnancy is medically defined as an abortion, according to Brandi. The term “preterm delivery” isn’t typically used until after 20 weeks or even later, at 23 or 24 weeks, when the fetus has a chance of surviving outside the womb, she said.
Brandi said some of the laws being enacted to limit abortion access are not written by medical professionals and aren’t clear about when abortions are allowed to protect the health of the mother.
“When we get a diagnosis, our job is to immediately act,” she said. “And it’s hard for us to figure out, based on these laws, when is the time we’re allowed to intervene in a case where someone’s health is in jeopardy.”
The treatment methods for miscarriage and abortion overlap, Emily Godfrey, associate professor of family medicine and obstetrics and gynecology at the University of Washington School of Medicine, told the AP. Abortion restrictions create a chilling effect among medical providers, even when the procedures don’t constitute abortions, she said.
“With legislators outlawing abortion, because that is a term that we use for disruption of any pregnancy regardless of where it is, it makes the treatment of patients who do show up with ectopic pregnancy or miscarriage or septic abortion very difficult to treat,” she said.
Associated Press writer Josh Kelety in Phoenix contributed to this report.
This is part of AP’s effort to address widely shared misinformation, including work with outside companies and organizations to add factual context to misleading content that is circulating online. Learn more about fact-checking at AP.