In Colorado, the percentage of abortions performed after 21 weeks is higher than the national average, at 3.3%- a figure higher than any other state in the CDC's data except New Mexico.
The statistics do not account for the fact that women have traveled from other states to Boulder for decades to avail themselves of Hern's late-term abortion services. At least 11% of all abortions performed in Colorado are on out-of-state residents, according to the CDC data.
Each year, about 200 to 300 babies are aborted after 21 weeks gestation in Colorado. Dilation and evacuation abortions are typically used in the second trimester of pregnancy, and result in the crushing of the head and eventual dismemberment of an unborn child.
The trend in Hern's statistics suggest that the proportion of all patients seeking abortions because of fetal disorders increased over time from 2.5% to 30%.
Hern credited this increase to "gradual change in clinic policy to accept patients with more advanced gestations, more requests for late termination of pregnancy because of fewer options being available elsewhere, and advances in fetal diagnosis."
"Genetic disorders"- as opposed to "structural anomalies"- were the most common disorders among the babies aborted, appearing in 40% of cases.
Of those cases, 63% of the genetic disorders were Trisomy 21, commonly known as Down syndrome. Hern reported 237 total abortions of babies with Down syndrome.
The most common "structural anomalies" reported were neural tube defects such as anencephaly and spina bifida; but some of the babies were aborted for reasons such as extra fingers or toes, cleft hands or lips, or because two twins were conjoined.
The median age of all 1,005 patients in Hern's study was 32, and the median gestational age was 24 weeks, or five and a half months. He said many patients who request abortions after 30 weeks have had their fetus evaluated as "normal" around 18 to 20 weeks.
Patients seeking particular kinds of abortions at Hern's clinic tended to request abortions, on average, around eight months into their pregnancies.
For example, some patients carrying twins requested an abortion for one of the twins-"selective termination"- usually because of a fetal abnormality.
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Hern writes that in these cases, the abortions were generally done after 32 weeks- more than seven months- gestation to "permit optimum development and survival probability for the healthy twin."
Patients seeking "selective termination" or "induced fetal demise"- an injection to kill the fetus before the abortion operation- tended to be in their mid-30s in age. Hern said these patients typically request abortions between 33 and 36 weeks- over eight months- gestation.
Several of his patients suffered major complications, including major unintended surgery, hemorrhage requiring transfusion, and pelvic infection, he reported.
A Nebraska couple filed a lawsuit against Hern and the Boulder Abortion Clinic in 2015, alleging that Hern left a nearly two-inch piece of a fetus' skull inside a patient's uterus during a late-term abortion, apparently forcing a patient to undergo a hysterectomy.
In 2016, Hern was the subject of a congressional investigation into the practices of late-term abortionists. The panel requested information on any infants who were born alive at his clinic and the babies' records thereafter. According to the Denver Post, Hern refused to provide any of the requested documentation, calling the panel a "witchhunt."
During May 2019, Hern argued in a New York Times op-ed that because women are more likely to die in childbirth than from complications related to an abortion, "pregnancy is dangerous; abortion can be lifesaving."