by Adele
In 2002, Shelley Sella, M.D., became the first woman doctor in the U.S. openly providing third-trimester abortions. She was one of only three doctors providing them—currently there are ten. Retiring in 2024, she spent the last 20 years of her OB/GYN career operating at her clinic, Southwestern Women’s Medical Options in Albuquerque, NM.
A HISTORY IN THE WOMEN’S MOVEMENT
Sella’s practice was informed by her experience in the feminist healthcare movement. At her internship at Los Angeles Feminist Women’s Health Center, she learned to treat patients as peers, explaining procedures in non-technical language. She observed the benefits of a group setting for holding discussions with patients, giving them pregnancy test results, and explaining options. Patients spontaneously shared experiences and supported each other.
She learned third-trimester abortion techniques working with Dr. George Tiller, who had held group sessions with patients. Tiller was later murdered by an anti-abortion fanatic. She learned from him to organize the patients into two groups. Those with “fetal indications” for abortion are carrying a fetus with medical problems. The second group, those with “maternal indications,” need abortions because of the woman’s health or life circumstances.
Over the years, Sella wrote down patients’ stories and vividly relates some of them. She describes the medical situations of fetuses with severe abnormalities, often undetectable until advanced pregnancy. If the patient undergoes childbirth, always much riskier than abortion, she would watch her baby suffer if the abnormalities are fatal. In other cases, the child would need numerous surgeries and expensive, life-long care. Patients may also be poor, or caring for children or elderly parents.
THE REASONS FOR LATE-TERM ABORTIONS
The stories of “maternal-indication” patients answer a question Sella often hears. This is why women “wait so long” to get late-term abortions. The many reasons include barriers to accessing early abortion such as poverty, domestic abuse, or anti-abortion laws. Sella explains the shock some patients feel, causing them to be in denial about pregnancy. This often happens to teenagers or rape survivors. She includes testimonies of women who have put babies up for adoption or considered doing so. The trauma of this experience answers another frequently heard question of why women don’t “just put the baby up for adoption.”
Sella writes: “Understanding third-trimester abortions is the key to understanding all abortion care. If we can open our hearts to the most desperate among us, we can understand all who seek to have an abortion. We must understand accepting ANY gestational limits is a slippery slope to the total bans we are seeing in increasing numbers of states.”
She explains that court decisions, including Roe v. Wade, often place limits on abortion based on “viability.” They define this as the point the fetus can live outside the womb. In practice, babies surviving birth at twenty-three weeks have a 44% mortality rate. They often have severe medical complications. These are facts reproductive justice advocates need to know since even they tend to use “viability” as a benchmark for acceptable limits to abortion access.
In January 2026, Medical Students for Choice arranged for Sella to talk about her book at Texas Tech University. Right-wingers pressured the University into cancelling. Sella gave the talk on Jessica Valenti’s YouTube channel, which gives updates on reproductive rights news in conjunction with her blog on Substack, Abortion, Every Day. Valenti observed that the cancellation was “an attack on the next generation of health care providers and an attack on their knowledge.” Sella stated the good news; more people are being trained to perform third-term abortions and “people are interested in this work in a way they weren’t 20 or 30 years ago.”
Sella explains that anti-abortion people can change their minds when they hear women’s real-life stories. Abortion should be managed by doctors and patients with this direct knowledge, not by judges and politicians with political agendas. Beyond Limits is an important contribution to a more informed society.