Montreal woman defends late-term abortion: ‘We want everyone to know the baby was having problems’

The Montreal woman who had an abortion at 35 weeks pleaded with people not to judge her, saying the fetus was abnormally small and malformed.

The woman, who asked that her name not be used, said reaction to news reports Wednesday of her late-term abortion provoked dozens of comments on social media, with some calling her a baby killer.

She dismissed suggestions she should have given the child up for adoption rather than abort. “Those people missed the point: I don’t want my baby to suffer,” she said. “No one was living what we were living and they can’t judge us.”

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“It didn’t happen just like that, for silly reasons,” she said. “We want everyone to know the baby was having serious problems and it got worse right up to the termination.”

In late April, the woman and her husband learned they were expecting their first child. At 20 weeks an ultrasound test showed no abnormalities. “Everything was fine,” she said. They were having a boy. The couple bought clothing and ordered a baby crib.

But then at seven months, another ultrasound showed the fetus was abnormally small and had skeletal malformations, likely caused by a genetic mutation. Her doctors at McGill University Health Centre “couldn’t tell us what the baby had, they were guessing,” she said.

The couple sought a second opinion at another hospital and were told the baby might never walk, she said. “It was really a shock to us. They said it’s a rare disease and that he may need operations of the spine, medical interventions, operations… but they couldn’t say which operations,” she said. “We researched and watched videos of other cases, and there aren’t many.

“We couldn’t stand it that our baby would suffer like these babies,” she said. “Our termination choice was serious.”

But when the couple sought at 30 weeks to end the pregnancy, the MUHC refused after consulting a committee of physicians, who based their opinion, in part, on the Quebec College of Physicians guidelines. The 2002 guidelines stipulate that late abortions, after 23 weeks, are reserved for “serious congenital anomalies” or “exceptional clinical situations.” A full-term pregnancy is 40 weeks.

We couldn’t stand it that our baby would suffer like these babies

The college now says it is updating its guidelines so that women can have access to abortion without problem.

The woman followed the advice of her lawyer and sought an abortion elsewhere. Faced with the prospect of an ethics committee at Ste-Justine Hospital deciding on her request, she ultimately got the abortion at an unidentified Montreal hospital.

Quebec Health Minister Gaétan Barrette called the MUHC refusal “legally unacceptable” but morally understandable.

“Legally, every woman — and it’s a Supreme Court decision — has a right to an abortion at anytime before she gives birth,” Barrette said. “On the other hand, we cannot force a doctor to proceed with late abortions.”

An estimated 17 to 42 Quebec women go to the United States every year to terminate a third trimester pregnancy.

While Canadian law is silent on abortion since the Supreme Court struck down the law in 1988, leaders of the nation’s pregnancy specialists says no doctor is under any obligation to perform an abortion and that abortions late in pregnancy can be particularly ethically and morally challenging.

“People do have their right to practise within their own conscience and to make referrals to someone else if their patient is requesting something they can’t accommodate,” said Dr. Jennifer Blake, chief executive officer of the Society of Obstetricians and Gynaecologists of Canada.

“We don’t know what the anomaly (in the Quebec case) is. You can image that at 35 weeks, whether or not it’s legal, as a profession we have to behave in a way that is moral and responsible,” Blake said. “And, at 35 weeks, a baby is capable of survival. We’re not talking an abortion of a fetus that has no ability to live outside its mother’s body.

“We struggle with these issues,” she added. “And these aren’t the cases where you want someone standing up and saying ‘it’s my right.’

“This is where you want everyone stepping back and saying, let’s really understand what’s going on here. Let’s do the right thing.”

In Canada, 2.4 per cent of abortions reported by hospitals (outside Quebec) in 2014 were performed after 21 weeks gestation, according to the Canadian Institute for Health Information.

Dr. Wendy Norman, a leading researcher in women’s reproductive health at the University of British Columbia, said abortions after 24 weeks gestation are rare and would almost always involve extraordinary circumstances — lethal genetic or hereditary anomalies, for example, or birth defects that would mean a lifetime of medical problems.

“The range is almost infinite as to the kinds of things that can go wrong,” she said.

Doctors say that most second, and almost all third trimester abortions involve what is known as “medication-induced fetal demise.” A drug — typically potassium chloride or digoxin — is injected into the fetal heart before labour is induced. Death is immediate. The woman is then given drugs to make her uterus contract, and expel the pregnancy. She will experience labour, the same way she would if she were delivering a live baby, or stillborn.