The Political is Personal: The Impact of the 20-Week Abortion Ban

Taken from the November/December 2015 issue of the Women's Health Activist Newsletter.

Law after insultingly cruel law is proposed, and too often passed, restricting access to abortion care. When news of the latest heinous law breaks, many of my comrades in the reproductive justice movement — especially those engaged in national policy work in Washington D.C. — curse the selfish and disconnected politicians who promote them, and struggle to comprehend the impact on the millions of women who are now a little less safe and a little less equal.

Along with the cursing and incomprehension, I see the faces the women whose lives are impacted by these laws. I see flashes of the young mail-order bride who came to the clinic seeking an abortion so she could distance herself from her abusive spouse. I see the awkward teenager with the eyebrow piercing, who was able to receive treatment for cervical dysplasia because it was detected at the time of her abortion. I remember the hands held, tissues offered, and jokes cracked to break awkward silences. I remember the unshaved legs and manicured toes in purple padded stirrups and the women they belonged to.

And then, my stomach knots, when I remember why I am remembering these women and their stories: some new restrictive law or policy that makes these real human’s lives worse.

In May 2015, the House of Representatives passed H.R. 36, the Pain Capable Unborn Child Protection Act.1 This bill would ban abortion after 20 weeks post-fertilization, based on the scientifically unfounded idea that fetuses at this stage can feel pain.2 The legislation contains no exception for a woman’s health or fetal anomalies, and has mercilessly narrow rape/incest exceptions. This bill, a version of which already exists in 11 states,3 is egregiously cruel, counter to medical evidence, and arguably unconstitutional. Thankfully, in September, H.R 36 failed in the Senate.

If this bill became law (which happily is unlikely as long as Democrats hold the White House), a woman with a life-threatening condition would be forced to wait — against medical judgment — until she is dying to terminate her pregnancy after 20 weeks, rather than intervene when her condition is less severe and the procedure is safer. This makes a sham of the “life of the mother” exception. Evidently, the preservation of a woman’s health does not warrant intervention — only when she’s on her deathbed could doctors be allowed to practice lifesaving medicine, say the Republican lawmakers behind this bill.

It would mean that a woman who has an anomaly scan (typically performed between 18-20 weeks of pregnancy)4 that reveals a fetal anomaly so debilitating it is incompatible with life would be forced to carry that pregnancy to term only to lose her child hours after birth. It would mean that any woman seeking her constitutional right under Roe vs. Wade to access abortion before viability (usually deemed to occur at 24 weeks post-fertilization) will be barred from doing so.5

The situations described above are hypothetical and, intangible; the real people whose stories are represented by these scenarios remain, too often, unknown to us, and voiceless.

So let me tell you about Sarah.*

Sarah came into the clinic with her husband, devastated but composed. She was devastated because this was the day she would end her wanted pregnancy. She was composed because, with the support of her husband and expertise of her doctor, she had decided that this was the best option for her, her husband, and the child they wanted but would never know.

One week prior to this frigidly cold cloudy morning, Sarah and her husband went to their doctor for an ultrasound. This procedure is used to scan for conditions that indicate chromosomal abnormalities and irregular development that are not detected in earlier diagnostic tests. During Sarah’s ultrasound, performed in her 20th week of pregnancy, her doctor detected a previously unnoticeable abnormality — a severe fetal heart defect. This defect guaranteed a short and brutal life for Sarah’s baby, a life that would begin and end in the Neonatal Intensive Care Unit (NICU) over a matter of days.

Sarah and her husband only had a few weeks to decide how to proceed before they would not longer have the option to terminate the pregnancy, because Minnesota limits abortion after viability to procedures necessary to preserve the mother’s life and health.6 (This choice would also be prohibited under H.R. 36.)

So, a week after the ultrasound that changed their lives, Sarah and her husband arrived at the clinic, heart-broken but resolved to end the pregnancy with a D&E procedure.

I was with Sarah during her two-day procedure. I held her hand while the doctor dilated her cervix to begin the procedure. The next morning, I stroked her hair while the doctor completed the procedure. And I sat with Sarah and her husband as they said a sorrowful goodbye to their baby.

Sarah is just one patient. She is just one story. She is among the one percent of women whose abortion occurs after 20 weeks,7 a number that illustrates this choice springs not from spontaneity or indecision — but from complex and often unforeseen circumstances.

When the House of Representatives passed H.R 36, I saw Sarah’s face.

It is because of patients like Sarah that I understand the gravity of the damage caused by callous and calculated politicians and their transparent agendas. These politicians are not protecting women’s health — they are forcing women to the brink of death before allowing doctors to intervene. They are not sparing developing fetuses from pain — the scientific evidence doesn’t support their fabricated claims. They are simply gearing up to tear down Roe vs. Wade and they are willing to sacrifice Sarah’s autonomy and safety to do so.

Zoe is a recent graduate of Macalester College with a degree in Psychology and Women & Gender Studies. She is a trained abortion doula and a passionate defender of reproductive justice.

* The woman’s name has been changed to protect her privacy.

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1. Library of Congress Website, H.R. 36- Pain Capable Unborn Child Protection Act, District of Columbia: Library of Congress, 2015. Retrieved June 15, 2015 from:

2. Corrigan L, “Navigating the Junk Science of Fetal Pain,” Science Progress, April 29 2013:

3. Guttmacher Institute Website, State Policies on Later Abortions, District of Columbia: Guttmacher Institute, 2015. Retrieved September 19, 2015 from:

4. Todros T, “Prenatal Diagnosis of Congenital Anomalies,” US National Library of Medicine, 2001; 3(2): 3-18.

5. Johnson-Lewis J, “Roe v. Wade Supreme Court Decision,” About Education:

6. Guttmacher Institute Website, State Policies on Later Abortions, District of Columbia: Guttmacher Institute, 2015. Retrieved September 19, 2015 from:

7. Planned Parenthood Website, 20 Week Bans: Planned Parenthood, 2015. Retrieved June 15, 2015 from: