{
  "id": "R45161",
  "type": "CRS Report",
  "typeId": "REPORTS",
  "number": "R45161",
  "active": true,
  "source": "EveryCRSReport.com",
  "versions": [
    {
      "source": "EveryCRSReport.com",
      "id": 580718,
      "date": "2018-04-30",
      "retrieved": "2018-05-10T10:16:12.889318",
      "title": "Abortion At or Over 20 Weeks\u2019 Gestation: Frequently Asked Questions",
      "summary": "Legislation at the federal and state levels seeking to limit or ban abortions in midpregnancy has focused attention on the procedure and the relatively small number of women who choose to undergo such an abortion. According to the Guttmacher Institute, about 926,200 abortions were performed in 2014; 1.3% of abortions were performed at or over 21 weeks\u2019 gestation in 2013. A 2018 National Academies of Sciences, Engineering, and Medicine study found that most women who have abortions are unmarried (86%), are poor or low-income (75%), are under age 30 (72%), and are women of color (61%).\nStages of Pregnancy and Abortion Procedures\nA typical, full-term pregnancy spans 40 weeks, separated into trimesters: first trimester (week 1 through week 13), second trimester (week 14 through week 27), and third trimester (week 28 through birth). Abortion in the second trimester can be performed either by using a surgical procedure or by using drugs to induce labor. According to the Centers for Disease Control and Prevention (CDC), in 2014 a surgical method was used for 98.8% of U.S. abortions at 14-15 weeks\u2019 gestation, 98.4% at 16-17 weeks, 96.6% at 18-20 weeks, and 90.2% at 21 weeks or later.\nProposed Legislation Related to Abortion\nLegislation in the 115th Congress, the Pain-Capable Unborn Child Protection Act (H.R. 36, S. 1922, S. 2311), would prohibit an abortion if the probable postfertilization age of the fetus is 20 weeks (equivalent to 22 weeks of gestation) or greater, with certain exceptions to save the life of the mother or if the pregnancy is the result of rape or incest. If the Pain-Capable Unborn Child Protection Act becomes law, a physician performing an abortion procedure \u201cmay do so only in the manner which, in reasonable medical judgment, provides the best opportunity for the unborn to survive.\u201d This provision would not allow the physician to use the surgical abortion procedure. \nIf enacted by the 115th Congress, both the Pain-Capable Unborn Child Protection Act and the Born-Alive Abortion Survivors Protection Act (H.R. 37, H.R. 4712, S. 220) would require that if a fetus is \u201cborn alive\u201d during an abortion procedure, a health care practitioner present at the time must \u201cexercise the same degree of professional skill, care, and diligence to preserve the life and health of the child as a reasonably diligent and conscientious health care practitioner would render to a child born alive at the same gestational age\u201d in the course of a natural birth. Both bills would require that infants born alive following an abortion procedure be transferred to a hospital for treatment. Failure to comply with these requirements would have to be immediately reported to a \u201cState or Federal law enforcement agency or both.\u201d The legislation makes no provision for the treatment costs or subsequent care needed to support these children, who could become wards of the state.\nMedical Issues and Costs Associated with Premature Infants\nInfants born at 23 weeks\u2019 gestation do not have sufficiently developed lungs and cannot breathe on their own; such infants will die at birth if not given life-sustaining therapies. However, some infants are simply too small for the smallest breathing tube, or have lungs that are too premature for the infant to survive even if therapy is given. At 22-23 weeks, infants weigh about 1 pound and have delicate skin, which tears easily if exposed to extensive contact. The rate of survival without moderate to severe impairment is low, ranging from 9% at 22 weeks\u2019 gestation to 30% at 24 weeks\u2019 gestation. Treating extremely premature infants in the neonatal intensive care unit (NICU) is expensive. According to a 2016 study of all births in California from 1998 through 2000, mean hospital costs (and length of stay) for surviving infants born at 24 weeks were $297,627 (109.6 days) and $272,730 (101.7 days) for surviving infants born at 25 weeks of gestation. In addition to the health care costs that extremely premature infants will generate post-NICU, other costs\u2014such as day-care services, respite care, school\u2014are likely to be much greater than those for full-term babies.\nScope of This Report\nThis report provides answers to frequently asked questions concerning abortions that are performed in the second trimester of a woman\u2019s pregnancy because Congress and many state legislatures are considering legislation that would limit or ban abortions in midpregnancy. This report does not discuss constitutional or legal questions nor does it discuss all the many varying state regulations regarding such abortions. This report also does not provide an ethics or morality discussion of second trimester abortion or whether a fetus is a person and has a right to life.",
      "type": "CRS Report",
      "typeId": "REPORTS",
      "active": true,
      "formats": [
        {
          "format": "HTML",
          "encoding": "utf-8",
          "url": "http://www.crs.gov/Reports/R45161",
          "sha1": "8b9470ae7f01a5021e4fcee0cd61d2a14a7d59fb",
          "filename": "files/20180430_R45161_8b9470ae7f01a5021e4fcee0cd61d2a14a7d59fb.html",
          "images": {}
        },
        {
          "format": "PDF",
          "encoding": null,
          "url": "http://www.crs.gov/Reports/pdf/R45161",
          "sha1": "7bc7f70c2e0bad8c7914f47de6ea4f2834b32131",
          "filename": "files/20180430_R45161_7bc7f70c2e0bad8c7914f47de6ea4f2834b32131.pdf",
          "images": {}
        }
      ],
      "topics": [
        {
          "source": "IBCList",
          "id": 4848,
          "name": "Abortion & Family Planning Services"
        }
      ]
    },
    {
      "source": "EveryCRSReport.com",
      "id": 580095,
      "date": "2018-04-11",
      "retrieved": "2018-04-16T13:08:48.911689",
      "title": "Abortion At or Over 20 Weeks\u2019 Gestation: Frequently Asked Questions",
      "summary": "Legislation at the federal and state levels seeking to limit or ban abortions in midpregnancy has focused attention on the procedure and the relatively small number of women who choose to undergo such an abortion. According to the Guttmacher Institute, about 926,200 abortions were performed in 2014; 1.3% of abortions were performed at or over 21 weeks\u2019 gestation in 2013. A 2018 National Academies of Sciences, Engineering, and Medicine study found that most women who have abortions are unmarried (86%), are poor or low-income (75%), are under age 30 (72%), and are women of color (61%).\nStages of Pregnancy and Abortion Procedures\nA typical, full-term pregnancy spans 40 weeks, separated into trimesters: first trimester (week 1 through week 13), second trimester (week 14 through week 27), and third trimester (week 28 through birth). Abortion in the second trimester can be performed either by using a surgical procedure or by using drugs to induce labor. According to the Centers for Disease Control and Prevention (CDC), in 2014 a surgical method was used for 98.8% of U.S. abortions at 14-15 weeks\u2019 gestation, 98.4% at 16-17 weeks, 96.6% at 18-20 weeks, and 90.2% at 21 weeks or later.\nProposed Legislation Related to Abortion\nLegislation in the 115th Congress, the Pain-Capable Unborn Child Protection Act (H.R. 36, S. 1922, S. 2311), would prohibit an abortion if the probable postfertilization age of the fetus is 20 weeks (equivalent to 22 weeks of gestation) or greater, with certain exceptions to save the life of the mother or if the pregnancy is the result of rape or incest. If the Pain-Capable Unborn Child Protection Act becomes law, a physician performing an abortion procedure \u201cmay do so only in the manner which, in reasonable medical judgment, provides the best opportunity for the unborn to survive.\u201d This provision would not allow the physician to use the surgical abortion procedure. \nIf enacted by the 115th Congress, both the Pain-Capable Unborn Child Protection Act and the Born-Alive Abortion Survivors Protection Act (H.R. 37, H.R. 4712, S. 220) would require that if a fetus is \u201cborn alive\u201d during an abortion procedure, a health care practitioner present at the time must \u201cexercise the same degree of professional skill, care, and diligence to preserve the life and health of the child as a reasonably diligent and conscientious health care practitioner would render to a child born alive at the same gestational age\u201d in the course of a natural birth. Both bills would require that infants born alive following an abortion procedure be transferred to a hospital for treatment. Failure to comply with these requirements would have to be immediately reported to a \u201cState or Federal law enforcement agency or both.\u201d The legislation makes no provision for the treatment costs or subsequent care needed to support these children, who could become wards of the state.\nMedical Issues and Costs Associated with Premature Infants\nInfants born at 23 weeks\u2019 gestation do not have sufficiently developed lungs and cannot breathe on their own; such infants will die at birth if not given life-sustaining therapies. However, some infants are simply too small for the smallest breathing tube, or have lungs that are too premature for the infant to survive even if therapy is given. At 22-23 weeks, infants weigh about 1 pound and have delicate skin, which tears easily if exposed to extensive contact. The rate of survival without moderate to severe impairment is low, ranging from 9% at 22 weeks\u2019 gestation to 30% at 24 weeks\u2019 gestation. Treating extremely premature infants in the neonatal intensive care unit (NICU) is expensive. According to a 2016 study of all births in California from 1998 through 2000, mean hospital costs (and length of stay) for surviving infants born at 24 weeks were $297,627 (109.6 days) and $272,730 (101.7 days) for surviving infants born at 25 weeks of gestation. In addition to the health care costs that extremely premature infants will generate post-NICU, other costs\u2014such as day-care services, respite care, school\u2014are likely to be much greater than those for full-term babies.\nScope of This Report\nThis report provides answers to frequently asked questions concerning abortions that are performed in the second trimester of a woman\u2019s pregnancy because Congress and many state legislatures are considering legislation that would limit or ban abortions in midpregnancy. This report does not discuss constitutional or legal questions nor does it discuss all the many varying state regulations regarding such abortions. This report also does not provide an ethics or morality discussion of second trimester abortion or whether a fetus is a person and has a right to life.",
      "type": "CRS Report",
      "typeId": "REPORTS",
      "active": true,
      "formats": [
        {
          "format": "HTML",
          "encoding": "utf-8",
          "url": "http://www.crs.gov/Reports/R45161",
          "sha1": "61a402de4b67db6a4f9e5acf4a83eb53287376f8",
          "filename": "files/20180411_R45161_61a402de4b67db6a4f9e5acf4a83eb53287376f8.html",
          "images": {}
        },
        {
          "format": "PDF",
          "encoding": null,
          "url": "http://www.crs.gov/Reports/pdf/R45161",
          "sha1": "31ac10b0aa7139bf25f17ac522b9c60a6ccfd7a4",
          "filename": "files/20180411_R45161_31ac10b0aa7139bf25f17ac522b9c60a6ccfd7a4.pdf",
          "images": {}
        }
      ],
      "topics": [
        {
          "source": "IBCList",
          "id": 4848,
          "name": "Abortion & Family Planning Services"
        }
      ]
    }
  ],
  "topics": [
    "Constitutional Questions",
    "Economic Policy",
    "Health Policy"
  ]
}