Photo-Illustration: by Preeti Kinha/Photos Getty

In recent weeks, the anti-abortion movement has seized upon one of its favorite subjects with even more fervor than usual: abortion after 20 weeks. People purporting to be “pro-life” spent days deluging Virginia delegate Kathy Tran with death threats, wrongly accusing her of supporting infanticide after she introduced a bill that would make it slightly easier for women in the state to get later abortions. Trump seized upon this vicious momentum in his State of the Union address, expressing his disgust at the Virginia bill, as well as with “lawmakers in New York” who recently voted to legalize abortion after 24 weeks in cases where the fetus isn’t viable or the mother’s health is at risk. According to Trump, the latter group “cheered with delight upon the passage of legislation that would allow a baby to be ripped from the mother’s womb moments before birth.”

This isn’t true, of course, but that doesn’t matter to those using it to incite outrage. The point is to demonize procedures after 20 weeks, depicting them as barbaric and tantamount to murder as a means of demonizing abortion in general. This sort of rhetoric necessarily dehumanizes the women who choose to get such procedures, reducing them to mere vessels — sites of violence, not individuals with needs and feelings of their own. The only one granted any degree of humanity here is the fetus.

The reality of abortion after 20 weeks is far too complicated to reduce to some sort of abstract, incendiary ethical quandary. Only one percent of procedures take place this far along, which makes sense — abortion is more dangerous, more invasive, and far more expensive after this point. The choice to end a pregnancy after 20 weeks is often one borne of desperate circumstances: Many fatal fetal abnormalities can’t be detected until that point, and women who terminate later for nonmedical reasons are more likely to be young, unemployed, and to live far from abortion clinics; substance abuse, depression, and intimate-partner violence can also be factors.

There are countless complex reasons someone might decide to get an abortion after 20 weeks. It is, according to those who’ve made that choice, something you can never fully understand until it’s happened to you. To get a better understanding of what’s really at stake in this debate, the Cut spoke to four women who had later abortions. Some felt conflicted afterwards; others simply felt relieved. But what they all had in common was a firm conviction that they’re the only ones who know what’s best for their bodies and their families, that this isn’t something that can be neatly legislated or moralized about, and that putting arbitrary restrictions around the ability to access reproductive health care is barbaric and inhumane.

In their own words, here are their experiences:

Kate, Massachusetts, had an abortion at 35 weeks when she was 29

Doctors had assured Kate her pregnancy was healthy until she was seven months along. After a series of tests, her gestating daughter was diagnosed with Dandy-Walker malformation and agenesis of the corpus callosum, two serious brain malformations. Because Kate was so far along when the fetal abnormality was detected, she had to fly to Colorado for her procedure, which cost $25,000.

One of my doctors said, “We might be able to offer you abortion, but we just don’t know. It’s so late.”

I had not decided in my head because I just had not processed anything yet. But I did know for sure that I didn’t want my doctors knowing that I was considering abortion, because I was worried about what they’d think of me and how they might take it out on me. So I was keeping it very close to the chest that I was scared … I didn’t want them to know how scared I was.

I remember saying, “What can a baby like mine do? Does she just sleep all the time?” The doctor winced when I said that, and he responded, “Babies like yours are generally not comfortable enough to sleep.” That’s when I knew for sure.

People always assume that I didn’t consider other options. I considered every other option, and I considered in depth. Things that I never thought I’d do — I mean, a lot of people say, “I never thought I’d have an abortion.” I could envision myself having an abortion growing up. I never thought that I would consider putting a child of mine up for adoption. But I did. I thought hard about it.

I have both the emotional truth of this experience and the factual truth of this experience. And the truth is that nobody cares.

I have to be very clear that I also care about my own life: I did not want the life of her mother for myself, and I did not want that life for my daughter. It’s very easy to talk about the compassion for my child, which I absolutely had and was a huge driving factor in this decision. It’s harder to talk about what I deserve, in terms of quality of life. But that also matters, and I have come to greater comfort talking about that, too. No one really wants to hear that.

If she had lived a matter of weeks, we would have been into the millions of dollars [in debt]. So people say, “You had to pay $25,000,” and that was more than we can afford, more than we had. But then when people are forced, from lack of funds, to carry to term, then what happens? Millions of dollars.

It hurts so much [to see the way anti-choice groups and politicians discuss later abortions]. It hurts so much. Because I feel so powerless. Because I have both the emotional truth of this experience and the factual truth of this experience. And the truth is that nobody cares. Everyone just cares about being able to remain morally superior in their mind. The politicians don’t care. They care about power. They don’t care about babies! They just care about staying in office.

Laura, New York, had an abortion at 23 weeks and 5 days when she was 27

Doctors detected some issues with Laura’s pregnancy at her 20-week scan, but it wasn’t totally conclusive. By the time she finished getting a series of follow-up examinations — including an MRI, level two ultrasound, and amniocentesis — she was a few days into her 23rd week of pregnancy. Her doctors told her that her daughter had a severe brain abnormality, possibly Dandy-Walker. But because this happened before New York passed the Reproductive Health Act, which allows abortions post-24 weeks in case of fatal fetal abnormality, she only had until 23 weeks and 6 days to make her choice.

Based on all of the symptoms — the missing kidney, they also diagnosed her with a small thorax, they thought that she had intrauterine growth restriction, the small cerebellum — they said that all those symptoms kind of suggested that it could be Dandy-Walker. With that, there was no guarantee that she could have a normal life. More likely than not, there was no way she could be self-sufficient.

I was extremely conflicted … I wanted to know if we had a fighting chance. If we did, great, we would take it, but I didn’t have enough information. Financially, if I’m beyond 24 weeks, I would have had to fly across the country. The only place that you’re able to do a termination so late is in Colorado. It’s like $20,000 for a termination there.

I knew that she wouldn’t have a life. She wouldn’t. And thinking about that, thinking, If I’m gone, who’s going to take care of her? How? It’s all of those things, all of those things. And the unknown, the not knowing, and then on top of that because I didn’t have time to make my decision. I was rushed into it. I literally [had the abortion] when I was 23 weeks and 5 days.

If I had been able to kind of prolong it … If they had said, “You’re 23 weeks, going on 24, but in this case, the state allows you to have more time to think it through,” I could have gone to see more specialists. I wanted to see a genetic counselor. If I’d had time, I would have gone to see a whole range of specialists that could have given me better information.

It could have given me more time to grieve in my own way, instead of having everything so rushed. I didn’t have days; I had hours. I had hours.

It could have helped with the grieving process. I could have had a clearer mind. I only got her footprints. Now that I think about it, maybe I should have asked for her handprints. Maybe I should have asked for a lock of her hair. I should have asked for more pictures. But I didn’t. I didn’t have the mind to ask for those things at that moment.

Beth, Oregon, had an abortion at 28 weeks when she was 22

Beth didn’t realize she was pregnant because she has PCOS, and had been told for years she was infertile. Once found out, she unknowingly went to a crisis pregnancy center. By the time she figured out how far along into her pregnancy she actually was, it was too late for her to get an abortion in Oregon, so she had to fly to New Mexico and pay $10,500 for the procedure.

The [crisis pregnancy center] website and everything made it seem just like a regular health clinic. There were no words that stood out to me — because I’d read about crisis pregnancy centers. I was aware that they existed because I’d seen them in the news, but nothing about this appeared to be one.

I was going through a tough time with my family. I was, at the time, relatively estranged from them, and a big part of that was because I had been in this previously toxic relationship, and we grew apart because of it. My relationship had just ended the week before, but my relationship with my family … there was no time to heal with my family.

The crisis pregnancy center told me that I was 16 weeks along. I left that situation feeling like I didn’t have any more clarity, and it didn’t really add up. I ended up going to a hospital in town, just deciding that it didn’t matter what I did; I was going to have to tell my family anyway.

I feel like it’s important to share my story because my health wasn’t at risk and because I didn’t have a fetal anomaly — I just needed health care and I sought it out.

The hospital ultimately told me that I was a few days away from being 26 weeks. I think [the crisis pregnancy center] had a better idea, and they knew that if they wasted just a few more days of my time, I wouldn’t have had a choice — which is true. Had I believed them, I wouldn’t have had a choice. I was able to go to a clinic in Albuquerque because I got all my paperwork and everything filed, all set to go, before it was too late legally.

A big part of why I knew I needed this abortion was because I knew I couldn’t stay connected to someone who was this toxic in my life. I don’t think it would have been healthy for me; it wouldn’t have been healthy for our child. I just knew that I needed to leave that in the past and I needed to move forward. I knew that I couldn’t afford to be a parent. I could barely afford all the work I was missing to go to all these doctors’ appointments.

I feel like it’s important to share my story because my health wasn’t at risk and because I didn’t have a fetal anomaly — I just needed health care and I sought it out. I remember when I was looking for stories like mine on the internet — anyone who had an abortion later on in their pregnancy, anyone who didn’t have some way to justify it other than they wanted it — and I couldn’t find that anywhere. That broke my heart, and it made me feel isolated and alone and different and wrong.

Megan, Connecticut, had an abortion at 21 weeks when she was 33

Doctors detected an abnormality with Megan’s pregnancy during a routine anatomy scan; after subsequent tests, her fetus was diagnosed with hypoplastic left heart syndrome (HPLH), a complex and rare birth defect that leaves the left side of the heart critically undeveloped.

On January 9, I went for my anatomy scan with my husband. During that ultrasound, the ultrasound tech started saying some weird things that didn’t make a lot of sense … At that point, I had a sinking feeling that things were not quite right.

They later confirmed that they suspected it was the hypoplastic left heart syndrome. They didn’t understand what was going on with the kidneys — one of them would never function based on how swollen it was, and the other one was fluid-filled also, but they weren’t sure what the function would be of that kidney.

[After I got the abortion] the first thing I said when I woke up from anesthesia and saw my surgeon standing there was, “Thank you.” I’m so grateful, not only that I had the ability to make a choice, but that there are physicians and medical professionals every day who are helping women make choices about their own bodies and allowing women to have control over these things. I think feeling grateful was something I didn’t expect in the face of this tragedy and trauma, but it’s definitely a big part of my experience.

I only just returned to work last week, on Thursday, and I was just feeling like I had to be very cautious about who I feel like I can tell my full story to, because there’s so much misperception and misinformation. Women who are getting post-20 week abortions are not doing this because they just decided all of a sudden, “Oh, never mind, I changed my mind.” Most people are going to that 20-week appointment thinking they’re going to find out the sex and go merrily on their way. It does feel frustrating and ostracizing; people are being called murderers. Women in this position already feel horrible enough … and the way this is all kind of being villainized makes it hard to share and honor the memory of a child.