From fetal defects and women's health risks to late recognition of pregnancy and lack of money, the reasons for second-trimester abortions vary, say doctors who support a clinic that would perform the procedures in Madison.

"Unfortunately, some women don't find out that there is a lethal anomaly or other problems with their fetus until quite late," said Dr. Julie Fagan, a women's health specialist at University of Wisconsin Hospital.

But opponents say the only situation where a woman should consider an abortion at any stage — a serious threat to her life — would require her to go to a hospital, not a clinic.

"It's illogical that if something is life-threatening, you're going to schedule it as an outpatient," said Dr. Karla Dickmeyer, an obstetrician-gynecologist at Meriter Hospital. "A clinic would make it too easy."

The UW Hospital board is scheduled to vote today in a public meeting on whether to support the proposed clinic at the Madison Surgery Center.

The surgery center, owned by UW Hospital, its doctor group and Meriter, is at 1 S. Park St. Its board is expected to take up the proposal in a private meeting Feb. 25. The boards of Meriter and the doctor group, the UW Medical Foundation, have decided to support the clinic.

Doctors would perform about 125 abortions a year on women 19 to 22 weeks pregnant, according to Dr. Laurel Rice, chair of obstetrics and gynecology at the university. Abortions are restricted after viability, or 24 weeks.

The service would replace the practice of Dr. Dennis Christensen, who performed abortions up to 22 weeks at a Planned Parenthood clinic on the East Side until he retired in December.

Planned Parenthood will continue to offer abortions up to 19 weeks. Milwaukee is the nearest place offering abortions after 19 weeks.

Anti-abortion groups say the proposed clinic in Madison could violate laws against using government money for abortions and force unwilling employees to participate. UW officials say no state funding will be used for the abortions, though the doctors' salaries include state money. Anyone can opt out, the officials say.

The abortions in question are relatively rare. Of the 8,267 abortions in Wisconsin in 2007 — the lowest number since 1974 — 18 percent were in the second trimester, or after 13 weeks, according to the Wisconsin Department of Health Services.

Just 9 percent of the procedures were done after 16 weeks and 3 percent after 20 weeks.

Many women don't get abortions until the second trimester because that is when tests that show problems with the fetus are done, Fagan said.

A blood test and an ultrasound at 10 to 14 weeks can show a risk for heart defects, Down syndrome and other causes of mental retardation, according to the American College of Obstetricians and Gynecologists. Cells from the placenta can be sampled to confirm the conditions.

Another blood test at 15 to 20 weeks, if positive, can be followed by amniocentesis to detect chromosomal abnormalities.

Many women skip those tests and get their main indication of fetal health in a detailed ultrasound at 18 to 20 weeks. It can reveal defects such as anencephaly, a body lacking most of the brain. The condition is usually fatal within hours or days after birth.

Dr. Fredrik Broekhuizen, medical director for Planned Parenthood of Wisconsin, said women's health risks are another reason for second-trimester abortions.

Women may be diagnosed with cancer, he said, and conditions such as diabetes, heart disease and high blood pressure might get worse during pregnancy and pose a significant risk.

Broekhuizen, who does abortions at Froedtert Hospital in Milwaukee, said women with irregular menstrual cycles also may not realize they are pregnant until the second trimester.

Other women, especially those who are young, poor or who live in rural areas, may take longer to decide to have an abortion or to find the money or transportation to do so, he said.

"These are true health needs of women," he said. "There really would be a lack of access without the clinic in Madison."

Dickmeyer, the obstetrician-gynecologist at Meriter who opposes the clinic, said late recognition of pregnancy and socioeconomic issues don't justify having an abortion clinic.

"We need to take responsibility for these pregnancies," she said.

It's reasonable to provide abortions if a woman's life is truly threatened, but hospitals do that so a clinic is not needed, Dickmeyer said.

"Just because something is legal doesn't necessarily mean it's the right, upstanding thing to do," she said.

Susan Armacost, legislative director for Wisconsin Right to Life, said doctors include too many factors, such as psychological problems, in the health risks for which abortion is considered.

Fetuses with abnormalities as severe as anencephaly should be allowed to live as long as they can, Armacost said.

"If the baby is going to die, it's going to die," she said. "Just let the baby be."

ABORTION CLINIC PROPOSAL

WHAT: UW Hospital board meets to consider a proposed abortion clinic.

WHEN: 2-5 p.m. today.

WHERE: UW Medical Foundation building, 7974 UW Health Court, Middleton.

FOR INFORMATION: 608-833-6090.

WHAT'S NEXT: The board of the Madison Surgery Center, which would run the clinic near Meriter Hospital, is expected to take up the issue Feb. 25.