I have had the good fortune to work on reproductive issues in nearly every major country in the world. Virtually all, save the United States have enacted legislation that both protects women’s rights and maintains and ethical medical standards. Protests and rancor are almost unheard of outside the US. Why can’t we find a solution that the overwhelming majority of Americans would quietly support? To that end, I have a proposal that incorporates the best thinking from around the civilized world.

During the first 12 weeks a women may terminate the pregnancy for her own personal reasons. After 12 weeks abortion is permissible, at any time if there is a medical or ethical reason. The decision should be made by women, their physician and where appropriate a medical ethicist. Politician, judges, and lawyers should be excluded from the process as they are uniquely unqualified to opine on such matters.

Why do most countries choose 12 weeks for a women to decide if she wishes to have a child. Simply, it is a function of the classical definitions of the pregnancy. Approximately 6 to 9 days  after conception the fetus implants and we can detect HCG in the mothers urine (pregnancy test). We call that chemical pregnancy. At 6 weeks when a heart-beat is detected we generally agree that  this is a clinical pregnancy. It is not until 12 weeks after uteroplacental shift that the placenta takes over the hormone production necessary to maintain the pregnancy. We characterize this as an on-going pregnancy i.e. one where spontaneous miscarriage is unlikely.

The 12 week rule clearly corresponds to the period after which women know that the risk miscarriage is dramatically reduced and it is time to tell the world.

I hope this is helpful.


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