Anti-abortion advocates get it. We love choice too. We believe in personal autonomy. We don’t like being buffeted by circumstances beyond our control. We believe shared values should unite us and be the basis for sound public policy.

Where pro-life and pro-choice advocates diverge is whether choice or autonomy should be absolute. Is there room for nuance in our approach to abortion? Even if we can’t agree on the necessity and morality of early abortion, can we agree there are compassionate alternatives to late abortion?

Colorado voters are being asked to closely examine how they feel about late abortion in anticipation of an initiative that will appear on the ballot in November. Initiative 89 will make unrestricted abortion a constitutionally protected right in our state.

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Initiative 89 prohibits anything that might “impede” access to abortion. This would include parental notification and consent for minors. The measure would restrict the ability of Coloradans to establish standard health and safety regulations for abortion clinics even though they pertain to virtually all other out-patient medical/surgical procedural clinics. This is particularly pertinent for late abortions since they are associated with much higher short-term mortality rates than natural childbirth. 

Initiative 89 is an exercise in absolutes. It goes far beyond Roe/Doe which allowed the restriction of abortion after fetal viability (around 22 weeks) with health/life exceptions. It enshrines a right to abortion in the state constitution for any reason at any time during pregnancy. The developing baby, including those who are cherished, would have no legal value or rights in Colorado — even moments before birth. 

We have met very few people who believe elective late abortions are desirable. Most Coloradans are unaware post-viability abortions performed late in the second and third trimester are common in our state — nearly 500 in 2023. Based on research published by a prominent Colorado abortionist, 70% of these are elective abortions — performed on healthy women with healthy fetuses.

Post-viability abortion occurs long after the mother can feel her baby “kick.” By the late second and third trimester, the fetus can feel pain, cry, respond to her mother’s voice, demonstrate social behavior, acquire taste preferences from her mother’s diet, and establish acoustical memories. They can undergo surgical procedures to correct anatomic abnormalities as independent patients early in the second trimester.  

We commonly hear late abortions are a humane choice. To call this “misinformation” is charitable. We should know since one of us performed second trimester abortions early in our medical career. 

The preferred second trimester abortion procedure is a D&E which involves the systematic dismemberment of a pain-capable fetus. In the most common multi-day third trimester abortion procedure, the fetus is poisoned with digoxin, causing the fetus up to 24 hours of intractable nausea, vomiting and delirium. Only after this protracted poisoning causes death is the fetal corpse extracted. This would never be allowed in a Colorado slaughterhouse but occurs every day in Colorado abortion clinics. 

We know women don’t seek late abortions on a whim. Research shows “women who obtained first trimester abortions and women who obtained abortions at or after 20 weeks gestation were remarkably similar.” The five most common reasons cited for pursuing abortion are: not financially prepared (40%); not the right time for a baby (36%); partner-related reasons (31%); need to focus on other children (29%); and the pregnancy interferes with future opportunities (20%).

For late abortions, not recognizing the pregnancy earlier, trouble deciding about the abortion, disagreeing with the man involved, and access to/coverage for abortion are additional factors. Some third trimester abortions are performed because of fetal anomalies only recognized later in pregnancy, but many are simply because the pregnancy was not appreciated earlier in gestation. 

Understanding what drives women to pursue late abortion shines a bright light on the many opportunities to intervene to reduce elective late abortions. Assisting women and their families through private and public programs could materially impact their decision to abort. Pro-life and pro-choice advocates could agree to make Colorado the state where compassionate alternatives to late abortion are abundant and free.   

Initiative 89 does not write Roe v. Wade into Colorado law. It is wildly more extreme than what the authors of Roe v. Wade envisioned. If you are pro-choice but are repulsed by elective late abortions and the violent procedure they necessitate, then Initiative 89 does not represent your values. If you are pro-choice but feel there should be opportunity for parental involvement for minors, then Initiative 89 does not represent your values. If you are pro-choice but believe prudent health and safety regulations should be an integral part of abortion advocacy, then Initiative 89 does not represent your values. 

Pro-life and pro-choice voters both want what is best for women. We can find common ground by rejecting the extremes embodied in Initiative 89 and giving women meaningful alternatives late in pregnancy. 

Catherine Wheeler, M.D., is president of American Association of Pro-Life Obstetricians and Gynecologists — Colorado. Thomas Perille, M.D., is president of Democrats for Life of Colorado.