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Healthcare is considered “medically necessary” if it is necessary to maintain or restore a patient’s health. And despite social media posts to the contrary, emergency abortions can fall into that category – even in the third trimester.


“Abortion is never medically necessary in the last trimester. Literally never. They just do a C-section,” says one November 6 Topic post said.


The post was flagged as part of Meta’s efforts to combat false news and misinformation on its news feed. (Read more about our collaboration with Metaowner of Facebook, Instagram and Threads.)


There are situations in which abortion would be medically necessary to preserve a woman’s health or save her life in any trimester, doctors and reproductive health experts say.


Obstetricians told us the claim misunderstands how and when caesarean sections are used in abortion procedures, while oversimplifying the many complex conditions and interventions that can accompany pregnancy.


C-sections are considered a major invasive surgery that removes the fetus through an incision in the abdomen and can carry risks for health complications, such as bleeding. They are not typically coded as abortions and are usually performed for the purpose of delivering a live fetus that will survive. The American College of Obstetricians and Gynecologists advises against performing this type of surgery in the context of abortion, due to the increased risks to the pregnant patient, which in addition to bleeding can include infections and damage to surrounding organs.


“Abortion is not an easy medical issue,” wrote Dr. Deborah Bartz, a gynecologist who provides abortions to medically complex patients in Boston, said in an email. “Each pregnant person’s individual health condition is unique. This results in profound medical complexity (from) patient to patient that health care professionals consider and balance.”





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For a pregnant woman, serious complications due to conditions can exist placental abruptionbleeding out placenta previaAnd preeclampsia or eclampsiasay experts. Pregnancy can also cause underlying conditions, such as chronic kidney disease and heart disease, to worsen.


“Pregnancy brings significant physiological changes to a person’s body,” according to the American College of Obstetricians and Gynecologists. in a 2019 statement when some of these claims first spread. “These changes can worsen underlying or pre-existing conditions, such as kidney or heart disease, and can seriously compromise health or even cause death.”


Determining the appropriate medical intervention depends on a patient’s specific condition, the organization said. This can lead to situations where “termination of pregnancy, in the form of an abortion, is the only medical intervention that can preserve a patient’s health or save his life.”


Bartz said the post’s claim “would only be true if every pregnancy and fetus were healthy, and every pregnant person were completely healthy.” That is not the reality.


“Fetal abnormalities and/or maternal health complications absolutely make third-trimester abortion a medical necessity,” Bartz said. “There are multiple methods of performing an abortion, and a cesarean section may be one of those methods.”


An abortion is a medical procedure intended to end a pregnancy before birth. Although a healthy fetus can typically achieve viability — the ability to live outside the womb — around 24 weeks of gestation, some pregnancies are never viable, experts say. That means they are unable to survive outside the womb, no matter how far along in the pregnancy they are born.


Pregnancy is divided into three trimesters. The third – and final – trimester runs from approximately week 28 to week 40, when a pregnancy is considered full term. The vast majority of abortions in the US, approximately 91%, occur in the first trimester. Only about 1% occur after 21 weeks and much less than 1% occur in the third trimester.


“The concept of ‘trimesters’ is more legal than medical; not everyone agrees on when the ‘last trimester’ begins,” says Dr. Daniel Grossman, professor of obstetrics, gynecology and reproductive sciences at the University of California-San Francisco. “A healthy fetus at 28 weeks may have a reasonable chance of survival, but a fetus with a serious medical condition or that is not growing normally after 28 weeks is unlikely to survive after delivery.”


Fetal abnormalities such as anencephaly, Trisomy 13, Trisomy 18 And renal agenesis are almost universally fatal outside the womb, Bartz said, and sometimes fetuses suffer from multiple, less serious conditions that, when taken together, can result in a worsened health scenario leading to death during childbirth.


“Consider anencephaly or acrania, problems in which the fetal skull does not develop and most of the head is absent. Those fetuses are not viable at any stage of pregnancy,” Dr. wrote. Jonas Swartz, a gynecologist from North Carolina, said in an email. “If a patient presents at 32 weeks with a fetus with anencephaly, a cesarean section is not the best way to minimize the risk to that woman. An abortion has a lower risk. At that gestational age, it would likely be a termination of induction The purpose of a vaginal delivery is that the fetus may receive an injection to stop the heart before induction begins.”


For example, in a twin pregnancy, one twin may have an abnormality that means it will not live and potentially threatens the well-being of the other twin, Swartz said. Often doctors will offer to perform an abortion by either administering a feticide injection or cutting the umbilical cord of the sick twin to save the other’s life. In some circumstances, this may be safer in the third trimester, he said. “Performing a cesarean section at that time would endanger the life of the healthy twin because you would be delivering him prematurely.”


Although some patients are given the opportunity to decide whether to terminate a non-viable pregnancy – with the other option often being carrying a fatally ill fetus – health risks sometimes arise for the pregnant woman. In these cases, Bartz says a medical professional may need to intervene.


“For example, if preeclampsia develops in the third trimester and the pregnant person’s high blood pressure becomes life-threatening, delivery (and thus an abortion delivery) of a nonviable fetus is necessary. If this induced delivery leads to death, considered an abortion,” Bartz said.


Grossman said a C-section in this situation the risk of complications for the pregnant woman would increase, without any benefit for the fetus, which is expected to die. In other situations where the fetus cannot be delivered vaginally, such as when a patient has large fibroids in the cervix, an abdominal cerclage, or a placenta over the cervix, a cesarean section may be the method of choice – if it is considered safe. for the pregnant patient.


Our statement


A Threads post claimed that “abortion is never medically necessary in the last trimester. Literally never. They just do a C-section.”


This is a misunderstanding and oversimplification of how abortion and reproductive care during pregnancy work, say obstetricians and other reproductive health experts.


There are several complex medical situations that can affect a fetus or pregnant patient and that, while rare, can result in medically necessary abortion later in pregnancy. Abortions can be performed in a variety of ways, experts say, and while a cesarean section is not usually the preferred method, it can be used depending on the patient’s case.


We rate this claim as false.




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