How to Decide Whether to Abort a Wanted Pregnancy

It’s the stuff of nightmares: midway through your pregnancy, you learn your child has, or may have, terminal defects. Or perhaps you learn they will survive, but will never live independently and insurance will not pay for all of the care they need. Maybe you’re thinking of terminating the pregnancy–or perhaps you’re afraid to even consider that thought out loud — but, how to decide whether to abort a wanted pregnancy is tough.

As you weigh your options, know this: There is no right choice. No matter what you choose, you may feel guilt and trauma. You will think about this decision for the rest of your life. And critically, your baby is a child–a wanted person whose death you are allowed to grieve, even if you choose that death. By the time most people contemplate a termination for medical reasons (TFMR), their pregnancy has progressed to or close to the point of viability. This is a much more challenging decision than an early abortion.

No one can tell you which decision is right. But here are some questions to ask yourself as you decide whether to get an abortion:

• What is the diagnosis, and how confident are you in it? Some tests are only screening, risk-based tests that indicate you have a higher risk of certain defects. Others are more definitive. No matter what the diagnosis is, get a second and third opinion. Read as much as you can.
• What is the best-case and worst-case scenario? Some diseases, like Down syndrome, have a wide range of outcomes–from a relatively normal, healthy life to total disability and even death. Other diseases have a more dire prognosis. Make sure you understand the range of potential outcomes for your baby.
• How much will the baby suffer if they are born?
• Will I be able to care for this baby? Consider things like insurance coverage, the ability to fund care after you die, and how the birth (or abortion) might affect any other children you have.
• Are other people pressuring me? You do not have to justify your decision to others; you don’t even have to tell them about your decision. It’s ok to say a late abortion was a stillbirth. It’s ok to say you didn’t know the baby had birth defects. You do not owe anyone an explanation.
• Do I have support, no matter what my decision is? Can someone take care of me after the abortion, or help me raise my child?
• If the diagnosis is terminal, is hospice care for the baby an option?
• What are the risks to me of carrying the baby to term? In many cases, birth defects endanger both the mother and the baby, and giving birth is always more dangerous than abortion.
• How likely are you to get pregnant again? One baby can never replace another, but people with a long history of infertility or no other children may opt to carry the pregnancy to term.
• Can you talk to someone else who has dealt with this diagnosis? Knowing what to expect and the lived reality can help you decide what option is best for you.

If you choose abortion, know that the baby will not feel pain. And if you choose to give birth, be sure to recruit a compassionate care team who will help you along the way. This is a long and lonely road, with no clear answers. But you are the best person to make decisions for your baby. Trust yourself. There is a way through this.