text: Under a new Arizona abortion law that takes effect Thursday, more babies with fatal fetal defects are expected to be carried to term, even though they will die within minutes, hours or days. But more will also be done to help their families get through the trauma of losing a child. 
   
   House Bill 2036 forbids doctors from aborting most fetuses with a gestational age of 20 weeks or older, even in situations where the doctor discovers the fetus has a fatal defect. The law also defines gestational age as beginning on the first day of the woman's last period, meaning abortions are actually banned starting at 18 weeks of pregnancy -- typically about the same time a doctor would perform ultrasounds where most abnormalities are detected. 
   
   Eight other states also ban abortions after 20 weeks, but Arizona is the only one with a law that actually pushes the ban back to 18 weeks into the pregnancy. 
   
   According to state records, women in Arizona terminate about 100 pregnancies a year after 20 weeks, but it's unclear how many of those are because of a problem with the pregnancy. 
   
   The new law requires doctors to offer information about perinatal hospice services to women considering abortion at any stage of their pregnancy because of a fatal fetal abnormality. It also requires the state to maintain a website list of organizations that provide services. 
   
   The two organizations that offer such help, MISS Foundation and Embrace, provide counseling and comfort, help develop birth plans, attend births, organize meals, create mementos, make funeral arrangements and prepare families for every outcome. 
   
   The Legislature provided no funding for such services, and volunteers for the two groups, while thrilled the state and doctors will spread the word about the service, worry they'll be overwhelmed when the law takes effect. 
   
   In other states with similar abortion restrictions, most of the programs for families continuing with a difficult pregnancy are hospital- or hospice-based. They also often don't provide services as broad as the Arizona organizations do, such as services that extend to the entire family and continue after delivery. 
   
   The Arizona organizations scrape by with private donations and volunteer help. Unlike similar pediatric programs for sick children or hospice services, before-birth programs are a relatively new idea and not billable to insurance companies. Participating families aren't asked to pay for help. 
   
   "This law may have intended to do good, but it can really adversely affect non-profit organizations that desperately want to help people but maybe can't help the number of people who now come to us," MISS Foundation founder and CEO Joanne Cacciatore said. "We are already stretched very, very thin. I don't know where this money would come from." 
   
   Cacciatore said one or two families a month facing a pregnancy with a fatal prognosis contact MISS Foundation. 
   
   "They're finding us on their own," she said. "I don't know what will happen when the Legislature opens this up." 
   
   Berdette Carrasco, Dana Southworth, Christina Portillo and Dani Baxter run Embrace while juggling full-time jobs and caring for their own families. They do what they do because they have expertise in obstetrics and therapy, and are compelled to help others. Carrasco and Southworth have gone through the loss of one of their own children because of a fetal anomaly. 
   
   "The natural order is that grandparents die," Southworth said. "It's not children dying before parents. It shatters our order." 
   
   Carrasco said she doesn't know how many new families the new law may bring to them, but they are trying to prepare for everyone who may need their help. 
   
   "There will be people now having to continue a pregnancy without an option (in Arizona)," she said. "We want to support these families." 
   
   Getting help 
   
   Julia Gonzales still had an option when she learned earlier this year that there was something very wrong with her baby. Her daughter Carmen is due any day now, but she likely won't live long enough to take her first breath. 
   
   Eighteen weeks into the pregnancy, doctors diagnosed Carmen with anencephaly, a neural-tube defect in which babies develop without most of their brain or skull. 
   
   As a devout Catholic, Gonzales, 30, refused to consider abortion. 
   
   "I didn't even have the idea in my mind to stop the pregnancy," she said. "And then two weeks after they told us, we saw her. She was a girl. But we never expected it would be this bad. Sometimes I wonder why I didn't stop the pregnancy." 
   
   Gonzales is an example of what an unknown number of Arizona women will be required to face under HB 2036. But she's also getting the kind of help that will be more accessible under the new law. 
   
   Gonzales struggles to speak through her tears when she thinks about what will happen when Carmen is born. But she is determined to spend every moment she can with her daughter. She's getting through each day largely with the help of the women who run Embrace. 
   
   Resource for families 
   
   Embrace has about 20 clients. The Gonzales family and one other are awaiting the births of their children. Some of the other families are grieving the death of their child while others are learning how to care for and celebrate children with various health challenges. 
   
   "Bereavement is a piece of what we do, but not everything," Carrasco said. "A lot of babies with congenital anomalies will survive. We are meeting needs of the family that are not just medical, but are also emotional." 
   
   She said their goal is to give families a single resource to help coordinate every need they may have. When Embrace workers first meet with a family, they provide them with accurate medical information about their child's diagnosis and connect them with other families who faced similar diagnoses. 
   
   "Obstetricians tend to not have enough time to educate," Portillo said. "Sometimes we are the first person to really explain something." 
   
   They prepare the family physically and emotionally for what to expect when their child is born. 
   
   Carrasco said she doesn't expect that to change much when more families seek help because they have no choice in continuing with the pregnancy. 
   
   "We have dealt with a couple of families that, because of late diagnosis or a lack of prenatal care, they didn't have a choice," she said. "I don't feel that there was a difference between the people choosing and those who did not by the time they get to this place in their pregnancy." 
   
   She said the fear, sadness and stress are the same. 
   
   "These families are hurting," Carrasco said. "As the delivery happens, regardless of the outcome, the level of stress is significant. There is a dramatic difference in a family not having anyone to help and them having an organization that knows what they're going through." 
   
   The Embrace workers go to doctor appointments with the families and help translate medical jargon that can become overwhelming. They meet in advance with the delivery staff to ensure everyone understands what the family wants the delivery to be like, and are there to help during labor and delivery. 
   
   "We do everything we can to give this child the best quality of life, even if it's just one second of life," Carrasco said. 
   
   Moving away from guilt 
   
   Gonzales, her husband, Joaquin, and 4-year-old twins Christian and John Carlos have met with the Embrace women half a dozen times. Gonzales' doctor told her about them when she was diagnosed, but she never called. Her doctor called Embrace and asked them to help. 
   
   "If that doctor hadn't called Berdette (Carrasco), I wouldn't have been able to make it this far," Gonzales said. 
   
   Before they got involved, Gonzales and her husband struggled to talk to each other about the baby, and her extended family refused to acknowledge the situation. Now the adults are starting to talk to the twins about how sick their baby sister Carmen is and how she will die. 
   
   "At the beginning, I was fighting with God every day," Gonzales said. "When I started talking with Berdette and Dana, they showed me God had a purpose. Thanks to them, it's been easier going through this." 
   
   Southworth pushes them to move away from guilt, from asking why and instead focusing on their love for Carmen. 
   
   "Love her where she's at. What are places you would want to take her? Go there now before she's born and make memories," she tells them. 
   
   Gonzales is trying, but she's not there yet. "How do you enjoy it when you know your daughter's going to die?" she sobbed. "I know I have to enjoy every move she makes inside me, but I can't. I'm trying to find a reason God gave us this baby." 
   
   Prepared no matter what 
   
   Not every family Embrace works with has a sad ending. Mike and Kelly Ely learned 18 weeks into their pregnancy that their son Preston had DiGeorge syndrome. The chromosomal disorder has a wide range of outcomes, most of which aren't known until the baby is born. Preston could have been born blind and deaf, with learning disabilities, deformed features or heart defects. He also could have died at birth. 
   
   "Embrace was a huge support system," Kelly Ely said. "They made us feel so much more comfortable going forward with the pregnancy." 
   
   She said Embrace workers explained what they could expect and helped the couple cope emotionally. 
   
   The Embrace workers also helped the couple communicate with each other and assured them it was OK to be excited about the pregnancy. 
   
   Preston was born with heart defects and had surgery at a week old. He has club feet, which can be corrected. Now 5 months old, he's a beautiful, bright-eyed, happy baby. "He's a little miracle," Kelly Ely said. 
   
   Support through it all 
   
   Together the Gonzales family and Embrace staff have written out a birth plan giving instructions to the hospital staff. Gonzales is terrified of what Carmen will look like, and at the same time feels guilty that fear makes her a bad mother. 
   
   "I'm so scared about seeing her," she said. "When I remember her, I don't want to remember her looking like that. I'm so worried I won't be a good mom for her." 
   
   When she's born -- no matter how long she lives -- Julia and Joaquin will bathe Carmen, dress her in a gown and have a priest baptize her. A professional photographer will capture the only family photos they'll ever take with her. They'll take as long as they need to say goodbye. 
   
   "This is their last chance to parent their child," Southworth said. 
   
   The women of Embrace have prepared the Gonzales family as best they can. But nothing can prepare parents to watch their child die at birth. And nothing can dissuade them from holding out hope for the impossible. 
   
   "We're expecting a miracle," Gonzales said. "When you hear her heart, it's hard to believe she's not strong." 
   
   So in the end, when there is no miracle, the women of Embrace will offer the most important thing they have -- they'll be there. 
   
   "We can't fix this, but we can let them know how much we care," Southworth said. ||||| Arizona's ban on abortions starting at 20 weeks of pregnancy is poised to take effect this week as scheduled after a federal judge ruled Monday that the new law is constitutional. 
   
   U.S. District Judge James Teilborg said the statute may prompt a few pregnant women who are considering abortion to make the decision earlier. But he said the law is constitutional because it doesn't prohibit any women from making the decision to end their pregnancies. 
   
   The judge also wrote that the state provided "substantial and well-documented" evidence that an unborn child has the capacity to feel pain during an abortion by at least 20 weeks. 
   
   Republican Gov. Jan Brewer signed the measure into law in April, making Arizona one of 10 states to enact types of 20-week bans. 
   
   Arizona's ban, set to take effect Thursday, prohibits abortions starting at 20 weeks of pregnancy except in medical emergencies. That is a change from the state's current ban at viability, which is the ability to survive outside the womb and which generally is considered to be about 24 weeks. A normal pregnancy lasts about 40 weeks. 
   
   The New York-based Center for Reproductive Rights and another group filed a notice that they would be appealing Teilborg's decision to the 9th U.S. Circuit Court of Appeals. 
   
   "Today's decision casts aside decades of legal precedent, ignoring constitutional protections for reproductive rights that have been upheld by the United States Supreme Court for nearly 40 years and threatening women's health and lives," said Nancy Northup, the center's president and CEO. 
   
   Maricopa County Attorney Bill Montgomery, who was sued as part of the challenge, said there was no telling whether the appeals court would prevent the law from taking effect. Commenting on Monday's decision, Montgomery said, "I thought it was sound legal reasoning and reached the appropriate conclusion." 
   
   Brewer also lauded the ruling, saying in a statement that it protects women and children. 
   
   Teilborg held a hearing Wednesday on a request from abortion-rights groups that he temporarily block the law's enforcement. 
   
   The groups' lawyer said during the hearing that the ban crosses a clear line on what U.S. Supreme Court rulings permit, and it intrudes on women's health decisions at a key point in pregnancy. Montgomery argued the state Legislature was justified in enacting the ban to protect the health of women and to shield fetuses from pain. 
   
   A second Arizona anti-abortion law enacted earlier this year also faces a court challenge. That law would bar public funding for non-abortion health care provided by abortion doctors and clinics. 
   
   The anti-abortion laws are among many approved by Arizona's Republican-led Legislature. The other laws include restrictions on clinic operations, mandates for specific disclosures and a prohibition on a type of late-term abortion. 
   
   Attorney Janet Crepps of the Center for Reproductive Rights argued at Wednesday's hearing that under Supreme Court decisions starting with the 1973 Roe vs. Wade ruling that legalized abortion, states can only regulate how abortions are performed, not ban them, before a fetus is viable. 
   
   Montgomery said that not implementing the 20-week ban would doom fetuses that might be saved due to advances in medicine. 
   
   While North Carolina has long had a 20-week ban, Nebraska in 2010 was the first state to recently enact one. Five more states followed in 2010: Alabama, Idaho, Indiana, Kansas and Oklahoma. 
   
   Along with Arizona, Georgia and Louisiana approved 20-week bans this year, though Georgia's law doesn't take effect until 2013. 
   
   The Center for Reproductive Rights said none of the 20-week bans have so far been blocked by courts.
target: – Arizona's new law banning abortions beginning at what the state defines as 20 weeks of pregnancy is constitutional, a US district judge has ruled, setting the stage for the law to go into effect this week. The new law may force some pregnant women to opt for an abortion earlier, but the measure is constitutional because it doesn't ban abortions outright, determined Judge James Teilborg. He also said the state provided "substantial and well-documented" evidence that a fetus can feel pain by at least 20 weeks gestation, reports AP. The ban is set to go into effect for all women except in cases of medical emergencies on Thursday. The New York-based Center for Reproductive Rights has filed a notice that it plans to appeal the decision to the 9th US Circuit Court of Appeals, but it's not clear if that will hold up the law. The law will complicate "fetal defect" cases in which a number of babies with fatal problems must now be carried to term but will likely die in minutes or days after birth, reports the Arizona Republic. The new law forbids doctors from aborting most fetuses with a gestational age of 20 weeks or older, even in situations where the doctor discovers the fetus has such a defect. But the law defines gestational age as beginning with the first day of a woman's last period, which means most fetuses will typically have an actual gestational age of 18 weeks when abortions can no longer be performed. That's about the time ultrasound tests are conducted to detect abnormalities, notes the Republic.