In 2020, 97.8% of abortions in Virginia took place at 15 weeks of gestation or earlier, according to the Centers for Disease Control and Prevention.
After 15 weeks, there were 346 abortions, or about 2.2%, in the state that year, which is the latest data available. Of those, 108 — less than 1% — took place after 20 weeks of gestation.
Gov. Glenn Youngkin wants to change that, and Tuesday’s election could decide whether he succeeds. Youngkin has said he would sign any bill “to protect life” that lands on his desk, according to the Washington Post, and has mentioned the possibility of compromising on a 20-week limit. But he has spoken most frequently in favor of outlawing abortion after 15 weeks of gestation, with exceptions in cases of rape, incest or to protect the life of the mother.
“We’ve made it very clear across the entire Commonwealth where a reasonable limit stands. Virginians know that I would sign a bill to protect life at 15 weeks, when a baby feels pain with exceptions,” Youngkin said in an email last week. (While fetuses respond to stimuli at around 16 weeks, there isn’t sufficient scientific basis behind Youngkin’s claim that fetuses can “feel pain at 15 weeks,” according to Newsweek’s fact check.)
Abortion is a key issue for 60% of registered voters in Virginia, the only Southern state that has not enacted new abortion limits after the Supreme Court overturned Roe v. Wade in June 2022, according to an October poll conducted by George Mason University and the Washington Post.
With all 140 seats in the General Assembly up for grabs, other organizations, states and countries are watching Virginia’s races closely for indicators of how abortion will affect the 2024 presidential election. Information on Hampton Roads candidates’ stances is available at PilotOnline.com.
The subject has become nearly radioactive in the commonwealth, where abortion is legal until 26 weeks and six days of gestation, as it was under Roe. Asked to speak on the medical facts of pregnancy between 15 and 25 weeks, several providers of prenatal care in Hampton Roads declined, with one large health care organization saying it didn’t have any experts with “accurate and complete” knowledge of fetal development, and another indicating it lacked anyone with the “knowledge or willingness” to wade in.
More than one health care professional acknowledged privately that they were concerned about backlash and that any medical facts they shared could be misconstrued as taking a position on the controversial issue.
Dr. Nisha Verma, a complex family planning specialist who previously served as a policy fellow with the American College of Obstetricians and Gynecologists, feels the medical facts of pregnancy are widely misunderstood.
She works in Georgia, where abortion is illegal after an embryonic heartbeat can be detected. That typically happens roughly three weeks after conception, or about five to six weeks’ gestation.
The first big misunderstanding Verma encounters, she said, is when pregnancy begins. The typical week-based measurements of pregnancy, known as gestational age, start before conception. Instead, pregnancies are dated from the first day of the last menstrual period before the pregnancy began.
“People don’t understand when they’re talking about these bans, like a six-week ban … for many people that’s sooner than they know they’re pregnant,” she said.
In many cases, people who are more likely to discover a pregnancy late — after seven weeks of gestation — also are those who are more likely to seek abortion.
On average, people realize they’re pregnant at about 5.5 weeks of gestation, according to a study published in the Maternal and Child Health Journal in 2017. Previously, the study said, there was little analysis of trends in timing of pregnancy awareness among U.S. women.
But almost one in four women — 23% — don’t know they’re pregnant until after seven weeks or more, according to the study. It found that late pregnancy awareness was more common in younger women and in cases of unintended pregnancies.
In 2020, one-third of people who had abortions in Virginia were under 25, and an additional 29.3% were under 30, according to CDC data. The 2020 datasets didn’t include information on unplanned pregnancies in Virginia specifically, but said that up to 42% of those in the U.S. end in abortion. The CDC also published a report this year that found about 42% of U.S. pregnancies were unplanned in 2019, the last year of data analyzed.
Another of the most frequent misunderstandings she encounters, Verma said, is on the limitations of testing before the all-important anatomy scan, usually done between 18 and 20 weeks.
In a normal pregnancy, Verma said, there are typically only two ultrasounds: one at the end of the first trimester, between 10 and 13 weeks, and then the anatomy scan. In many cases, even when a condition can be detected earlier in pregnancy, doctors must watch and wait to see how it will develop, Verma said.
“Even if a patient comes back with a screening test at 11 weeks that is concerning … we may do a follow-up ultrasound and not be able to definitely confirm that diagnosis until later in pregnancy,” she said.
A 2018 report from the Congressional Research Service, Congress’ public policy research institute, found very little data available on how many abortions are sought later in pregnancy due to fetal abnormalities, remarking, “Many of the women whose lives are at risk would be treated under emergency circumstances at a hospital rather than at a dedicated abortion clinic, making numbers more difficult to obtain.”
Around 3% of pregnant women in the U.S. receive a fetal anomaly diagnosis, the report said, and 80% of them choose to terminate the pregnancy.
Reporting from The 19th News, a nonprofit newsroom that reports on gender and policy, found that few abortion bans have fetal anomaly exceptions.
“Abortion care after 20 weeks is pretty rare, less than 1%,” Verma said. “And in most cases when that’s happening, it is because something has gone really wrong with the patient, or the pregnancy.”
Katrina Dix, 757-222-5155, katrina.dix@virginiamedia.com
