Why some parents will end pregnancies if Missouri restores abortion ban | Opinion

As a nurse and researcher who specializes in pregnancies complicated by fetal conditions, I’ve spent 16 years studying what happens when prenatal testing reveals a potential physical or developmental disability. And here’s what most people don’t expect: Policies that limit abortion after a certain number of weeks can actually push families toward ending a pregnancy.

Families facing an unexpected diagnosis are often overwhelmed, uncertain and still learning what it even means. They need time. Time to understand. Time to recalibrate hope. Time to weigh what they can carry — for themselves and their child.

Yet that’s precisely what abortion restrictions rob them of.

Missouri is now at a pivotal crossroads. After voters passed a landmark amendment in 2024 restoring abortion rights up to viability (24 to 26 weeks), the state became the first in the nation to overturn its near-total ban. But access remains limited and under threat. Procedural care is scarce, and a new proposed amendment would repeal those protections and replace them with one of the most restrictive abortion laws in the country, banning abortion in most cases after 12 weeks.

For Missouri families receiving complex prenatal diagnoses, these shifting policies raise urgent questions: Will care be available? Will they have enough time to make informed decisions?

While some prenatal screenings can be done early, many serious problems surface only during the second-trimester anatomy scan, usually between 18 and 20 weeks. And even those scans just raise questions. It can take weeks more for families to get follow-up testing, insurance approvals, specialist care and emotional support. These steps don’t occur quickly. Yet under even so-called “liberal” abortion restrictions, families are increasingly forced to make irreversible decisions in just a few days.

The result? These deadlines can lead some families to end pregnancies they might have continued if they’d had more time, support or unrestricted access to the health care they need, including abortion care.

Over and over, I’ve seen families act not from certainty but from fear — fear that time is slipping away before they can gather the information they need to make decisions. And that fear is only deepening. Right now, families have more to process than ever before — at the very moment they’re being given less time to do it.

Conservative mother describes threat to child

The recent sweeping federal cuts to Medicaid will harm children with disabilities, cutting funding for therapies, equipment and other critical supports that help families navigate a wide range of pediatric conditions. In a recent commentary for The New York Times, Rachel Roth Aldhizer, a conservative mother of a profoundly disabled child, described how those changes now threaten the home-based services that keep her son alive. She’s not alone.

A decade ago, parents facing a disability diagnosis could talk to other families and get a real sense of what life might be like. But now? Even experienced families don’t know what to expect. The landscape is shifting underneath them.

Maybe you’re thinking: Isn’t this what mandatory waiting periods are for? A three-day pause between fetal diagnosis and abortion care to encourage reflection? But in practice, these delays just tighten the window. They become one more thing that families must worry about as they scramble to schedule appointments, confirm insurance, take off work and travel for care.

So perhaps your next thought is: If the goal is to prevent people from ending pregnancies because of the bias against those with disabilities, then why not ban abortion when testing suggests the baby may have a disability?

As someone who’s dyslexic — and proud of it — I understand that impulse. I remember when researchers claimed to find a “dyslexia gene.” They were wrong, but it raised the possibility that my brain’s differences could someday be flagged in prenatal screening. In a world biased against disability, that was a frightening prospect.

But we know from decades of evidence that bans don’t stop abortion. They just make it more dangerous and more stigmatized. And they don’t end disability bias either.

Decisions made from love, not fear

In the rare cases when families do have the time they need, I’ve seen unexpected possibilities take shape. I’ve seen families who once believed they could never raise a child with disabilities learn what these conditions really look like, find support and come to a place not just of acceptance, but of deep meaning and hope.

Even in cases where the baby’s life will be heartbreakingly short, I’ve witnessed the beauty of a decision made from love, not fear. A child born into a family that really knew they could support them, or believed they had just enough in place to try. That’s what time allows: not just survival, but dignity. Not just coping, but connection.

Some people will still choose to end the pregnancy — and they should have the right and support to do so. It may be based on concerns for the child’s suffering or their own ability to stay employed and keep their family housed and stable. It may come after exhausting every avenue of support. It becomes a decision grounded in love, not fear.

To reduce discrimination against people with disabilities, we need reproductive health policies that give families time to learn about a condition, find the support they need, and decide what’s right for them.

For families already confronting the fear and uncertainty of an unexpected diagnosis, the path ahead is hard enough. We can at least offer them time.

Abigail Wilpers is a registered nurse, a senior fellow at the Leonard Davis Institute of Health Economics at the University of Pennsylvania and an assistant professor at the University of Pennsylvania School of Nursing.

This story was originally published October 12, 2025 at 5:03 AM.