What it's like to get an abortion at 21 weeks

The Supreme Court overturned Roe v. Wade. Follow along with Yahoo's coverage.

For New York writer April Salazar, the right to abortion is deeply personal.

Back in 2013, Salazar and her husband made the decision to have an abortion when she was far along in her pregnancy — 21 weeks gestation — after doctors discovered their in-utero son had a lethal birth defect.

“It was very surprising to find myself, in my mid-30s and happily married and wanting so badly to be a mom, and to find myself needing an abortion,” Salazar tells Yahoo Life. “No one can ever imagine until they live through it, and unfortunately the people making choices for us are the people who will never live through it.”

Salazar had had a difficult time conceiving, and ultimately went through eight rounds of IUI to become pregnant that first time. After getting through her first trimester, Salazar remembers breathing a sigh of relief, believing that her unborn baby had made it through the most uncertain phase of pregnancy. But an anatomy scan at 18 weeks would reveal the devastating diagnosis.

“I knew that we were going to see a lot of images of our baby. I was actually squeezing my husband's arm in excitement,” recalls Salazar. “During that appointment we got our initial diagnosis — that our baby had lethal skeletal dysplasia."

Skeletal dysplasia is the medical term for a group of 400 conditions that affect bone development, neurological function and cartilage growth. Many cases can be diagnosed via ultrasound, and severe cases can be fatal.

"They saw that our baby's limbs were unusually short and his chest was unusually small and his lungs would never develop properly," says Salazar. “We were told that our baby would never be able to breathe on his own. In a very short time period, like minutes, he would die of suffocation.”

Stunned and devastated, Salazar listened as doctors presented options. They revealed that some people choose to end pregnancy in these cases, rather than carry the baby to term.

“I was shocked and I just said, ‘I can’t give birth to a baby just to watch him die.’ And my husband without hesitation said, ‘Of course not, that would be cruel,’” says Salazar. “That erased any doubts that I had. It would have been cruel to him and it would have been excruciating for us.”

According to the Centers for Disease Control and Prevention, the majority of abortions, around 93%, occur in the first 13 weeks of pregnancy. In 2019, a little more than 6% occurred between 14 to 20 weeks gestation, and less than 1% were performed after 21 weeks. About one third of states currently have laws that ban abortion after 20 weeks.

As a resident of New York City, Salazar lived in a state where she had access to abortion care, but remembers it was difficult to find a reputable clinic. “A lot of the results are places that offer misleading information that’s meant to dissuade people from having an abortion,” says Salazar.

Salazar also had to learn about the options available for a second-trimester abortion. She learned that a surgical procedure called dilation and evacuation (D&E) was common, in which doctors use dilation, suction and special medical tools like forceps. The alternative is to have doctors induce labor for a vaginal birth.

“I ended up choosing the D&E because it was actually the safer procedure than going through childbirth,” says Salazar.

While Salazar has always been a pro-choice advocate, she never planned to have an abortion. But she says she feels empowered by the decision she was able to make for herself and her family. And now, after eventually becoming pregnant again through IUI and being the mother of a young daughter, Salazar is horrified in a whole new way by the overturning of Roe v. Wade.

“It’s devastating, to be honest. I have my own daughter, and it's horrifying to think that she is going to grow up in a world in which she can’t make choices for herself that keep her safe and healthy,” says Salazar.

Today, Salazar is keeping her focus on other women who may find themselves grappling with the decision she faced back in 2013. She encourages those needing help to seek out local groups that can provide emotional support and practical support when it comes to things like finding abortion care.

Speaking out about her abortion is still an emotional experience for Salazar, but she is committed to using her voice to fight for all women's right to choose.

“I think that we have a very long road ahead of us now," says Salazar. "But I think by sharing our stories, by supporting each other, by donating to abortion funds and supporting that kind of care I do think we can eventually reverse this."

—Video produced by Olivia Schneider

This story was originally published on June 17, 2022, and has been updated.