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Madison — A statehouse fight looms next year over the least common but most controversial segment of abortions, as opponents seek to ban the procedure for pregnancies after 20 weeks in Wisconsin.

Abortion opponents are working with Republican lawmakers on a still unreleased bill to ban the practice, calling it their top priority here for the next two years. Officials with Wisconsin Right to Life said that they'll seek to show that fetuses at that stage of development can feel pain from the procedure, a position disputed by a key medical group.

The ban would carry an exception for the life of the mother but not her health.

"Unborn babies can't cry out when they feel pain," said Right to Life legislative director Chelsea Shields. "The Fetal Pain Prevention Act gives us an opportunity to be a voice for the voiceless."

Abortion rights activists respond that some mothers and fetuses could suffer more if lawmakers take away the option of an abortion at that stage in a pregnancy. They say some women who do use the procedure now wanted to carry their fetus to term but faced a serious and unexpected medical problem.

"Some of these situations are just really, really heart-wrenching," said Tanya Atkinson, executive director of Planned Parenthood Advocates of Wisconsin. "The reality is that not every pregnancy ends the way a family hopes it will. A bill like this makes a really, really difficult situation even more difficult."

Nine other states have passed bans on abortions after 20 weeks from conception and two states, Mississippi and North Carolina, have based their bans on the procedure after 20 weeks from a woman's last menstrual period. Right to Life officials in Wisconsin say they're looking at the language of other states' bans but haven't yet settled on their own approach.

Heather Weininger, executive director of Right To Life in the state, said the ban's exemption would be limited to cases where the life of a woman was endangered. She said she worried that an exception to protect the health of a woman could be manipulated by a doctor to justify the procedure in cases where the mother might suffer mental distress or minor physical effects.

The eventual bill will likely include language that would allow the state health department to move up the ban to an earlier week in pregnancies if future research shows fetuses can feel pain at that stage, Weininger said. Shields said that Right to Life had not yet compiled research backing its position on when fetuses perceive pain.

In 2012, the American Congress of Obstetricians and Gynecologists opposed similar legislation in Congress, citing a 2005 study in the Journal of the American Medical Association that reviewed the then-available evidence and found that fetuses are unlikely to feel pain before the third trimester of a pregnancy, which starts around 28 weeks.

A majority of fetuses born after 24 weeks survive, while the majority of those born in the weeks leading up to that time cannot be saved by doctors, the group's statement said.

The use of late-term abortions in Wisconsin is infrequent and is falling even faster than the practice as a whole. Last year, late abortions made up just 1% of the total procedures done in Wisconsin, according to state figures.

"You can see the limited number of people who are actually using them," Weininger said.

For Atkinson, the fact that fewer women are using the procedure is beside the point.

"Families need to make their own decisions with their medical provider," Atkinson said. "Frequency is not the question."

She pointed to cases of women such as Christy Zink of Washington, D.C., a George Washington University professor who spoke out in 2012 against the proposed ban then before Congress.

In a statement at the time, Zink said that she had been "overjoyed" to become pregnant but only learned at 21 weeks that her unborn son suffered from severe birth defects that essentially meant he was missing one side of his brain and that if born at all he would suffer from frequent seizures that would require surgeries to remove more of his brain.

"If this (congressional) bill had been passed before my pregnancy, I would have had to carry to term and give birth to a baby who the doctors concurred had no chance of a life and would have experienced near-constant pain," Zink said in her statement. "If my son had survived the pregnancy — which was not certain — he might have never left the hospital.... The decision I made to have an abortion at almost 22 weeks was made out of love and to spare my son's pain and suffering."

Weininger said that in some cases women who have the procedure after 20 weeks received a diagnosis earlier than that and could have acted sooner. Zink noted that her son's condition could not have been detected earlier during the pregnancy and that after the diagnosis she and her husband took time to consult with medical specialists in an unsuccessful search for better options.

In 2013 in Wisconsin, doctors performed 85 abortions after 20 weeks of pregnancy, or 1.4% of the total of 6,251 abortions done that year. That was down from 2012, part of a decades-long decline in abortion, particularly late-term procedures.

Abortions after 20 weeks have fallen 54.2% from their 2003 total of 201 procedures. That compares with a 39.5% drop in the total number of abortions over the same period.

Two-thirds of Wisconsin women receiving the procedure in 2013 were between the ages of 20 and 29, according to the state figures. The state report, however, cautions that the figures on the length of pregnancies may have some inconsistencies because of reporting differences among health care providers.

Gov. Scott Walker and other Republican leaders in the state have said that their focus next year will be on creating jobs and improving schools, but they haven't ruled out passing a late-term ban. In his career, Walker has opposed abortion first as a lawmaker and then as governor.

In July 2013, for instance, the governor signed a bill passed by GOP lawmakers that required women seeking abortions to get ultrasounds, and mandated that doctors performing the procedure must have admitting privileges at a hospital within 30 miles of where they do their work.

Abortion providers sued over the admitting privileges requirement and within days U.S. District Judge William Conley blocked that provision of the law. The requirement remains stalled as Conley considers his final decision on whether it violates the constitutional right to access abortion.

Affiliated Medical Service has said it would have to stop performing abortions at its Milwaukee clinic because doctors there don't have admitting privileges. Affiliated's clinic is the only one in the state that provides abortions after 19 weeks of pregnancy.

The state's other clinics are run by Planned Parenthood and are in Milwaukee, Madison and Appleton.

Atkinson had no comment on whether Planned Parenthood would challenge any late-term abortion ban if one is approved in Wisconsin.

But Weininger of Right to Life said that her group is writing the bill with a view to protecting it against a potential lawsuit.

"I think we cannot expect otherwise," she said of a legal challenge.