Beyond Limits: Stories of Third-Trimester Abortion Care

by Shelley Sella

"Beyond Limits is moving, personal, insightful, and powerfully written. This book helps us to see people who seek abortions with clarity and compassion, as people in the real world, rather than as the objects of an abstract moral or political debate."—Diana Greene Foster, author of The Turnaway Study

A compassionate perspective on late-term abortion that challenges preconceived notions of who gets abortions and why

Within both the anti-abortion and pro-choice movements, third-trimester abortion is often stigmatized and misunderstood. For 20 years, Dr. Shelley Sella saw patients whose diverse backgrounds and circumstances led them to the same difficult to end their pregnancies.

Now, interweaving her own journey as a provider, Dr. Sella invites readers into a typical week at her clinic to demystify the experience. She shares the stories of people like

Clarissa, a mother of 2 whose third suffered a massive stroke in utero with no chance of recoveryMary, a devoted Catholic whose fourth round of IVF offered a late-in-life chance at motherhood, only to be dashed by anomalous test resultsLaura, a mother to 4 already whose bruised arms tell a painful story, one she couldn’t bring herself to write a fifth child into
Beyond Limits is not just a testament to a standard of care grounded in competence, compassion, and sensitivity. It is also a call for a paradigm shift that moves beyond Dobbs, beyond Roe, beyond limits to provide care. And it is a tribute to the real people whose hearts, reasons, and stories are more complex than politicized conversations about abortion lead us to believe.

Genres: Nonfiction, Feminism, Politics, Womens, Medical, Audiobook, Memoir

232 pages, Hardcover

Published June 3, 2025

Reviews

[Lydia · Rating 5 out of 5]

This was a wonderful book. Dr. Sella seems like a kind and empathetic doctor providing care to women who desperately need it. I needed no convincing on this subject. I used to be very anti abortion when I was young, but once I went to medical school it took observing exactly one abortion to completely change my mind. I don’t know if it was in the late second or the third trimester, but this woman was having an abortion for fetal anomalies. It had been a wanted pregnancy and she was devastated. I held her hand and thought “Who am I to judge her?” And then I knew - Who was I to judge any woman! I knew nothing of what led them to the decision. My mind was changed. I hope I am half as compassionate and loving towards my patients as is Dr. Sella. I hope she has a lovely life in retirement.

[Stephanie · Rating 5 out of 5]

So much to learn from this book.

Dr. Sella provides a glimpse of weeks work by highlighting 6 patient's abortion stories. She alternates chapters with a high level memoir of her life and career.

This account is full of straightforward facts surrounding abortion. Must read for anyone.

[Ella · Rating 4 out of 5]

I’m fully the choir being preached to here, but this is an utterly human, necessary book that I long to throw at the sort of people who blather about the horror of late-term abortion

[Jonas Wipf · Rating 2 out of 5]

Reading Beyond Limits was an emotional journey for me. Dr. Shelley Sella's compassionate storytelling brought to light the deeply personal and often heart-wrenching experiences of individuals facing third-trimester abortions. The book does an excellent job of humanizing these patients, showing the complex and varied circumstances that lead them to make such difficult decisions. I found myself moved by the empathy and care Dr. Sella provides to her patients, which is evident in every story she shares.

However, I struggled with the book's strong advocacy for third-trimester abortion. While I appreciate the importance of understanding these experiences, the detailed accounts and the author's unwavering support for this type of care were challenging for me to reconcile with my own views on abortion. The narrative felt somewhat one-sided, lacking a balanced discussion on the ethical and moral complexities surrounding late-term abortion. This made it difficult for me to fully engage with the book.

[Mary Wall · Rating 5 out of 5]

Dr. Sella is a hero 💛

[Joan · Rating 5 out of 5]

I was rather dreading reading this book, but felt I needed the information to be effective at supporting abortion rights for women. The book was instead, fascinating! The author, who was essentially the assassinated Dr. Tiller’s medical heir, describes what a week of work looks like in her clinic that serves women at all stages of pregnancy. I now have a clear understanding of the inherent medical problems in Roe vs Wade, and why simply putting Roe back into place is not a good idea. Pregnancy is simply too complex to be simply judged by which trimester you are in. She answers all the common questions asked in such situations such as, well why did they wait so long? (Very short answer: they likely were fighting socioeconomic factors and stigmatization such as not having enough money to deal with pregnancy.) she explains why she decided to retire and a brief summary of the political situation now.

If you think you are dealing with someone who might be open to changing their beliefs based on information, recommend this book! If you’re on the fence about abortion, read this book! If you want better ammunition over discussions about abortion, read this book! If you want to be reminded what kindness and skill can do to help desperate people, read this book!

[Rachel D’Lima · Rating 5 out of 5]

Eye opening. The author is a very good storyteller and gives answers to so many questions people consistently ask regarding late term abortions. The stories she shared were heartbreaking and inspirational at the same time. it brought a new perspective to my initial views about this topic. There is so much more beneath the surface of this topic that many of us do not understand or are able to visualize

[Lik · Rating 5 out of 5]

A quick read to humanize third-trimester abortions. I do wish she talked more about going beyond Roe/reproductive justice, but I guess that wasn’t her point

[Samantha Conrad · Rating 5 out of 5]

Beautifully written, eye opening and an important resource for all. No matter your views on abortion, I highly recommend this book. Part One was my favorite.

[Mariana Santos · Rating 5 out of 5]

Que livro magnífico 💛 fez me chorar, fez me rir.
Fez-me querer ter mais voz sobre os direitos das mulheres que estão sempre, sempre a ser colocados em causa e a ser perdidos.
É um livro sobre verdades e factos, diferentes realidades e falta de acesso ao sistema de saúde. Sobre governos que não querem saber das mulheres e muito menos respeitam as suas escolhas.
Este livro é também a história desta incrível e corajosa médica e o seu percurso pessoal e profissional. Que exemplo 🌿

[Michelle · Rating 5 out of 5]

So so insightful, thought-provoking, and well written. I will recommend this book to everyone. Dr Sella tells her stories and experience in such an informative and inspiring way. An easy and important read

[Tiffany · Rating 5 out of 5]

dr sella is the coolest girlboss!

[Lyrik Flowers · Rating 5 out of 5]

Beyond Limits by Dr. Shelley Sella is one of the most beautiful, grounding, and necessary books I’ve read in a long time. It’s honest without being sensational, deeply human without ever losing the medical reality, and it treats abortion with the seriousness, tenderness, and respect it deserves. Dr. Sella doesn’t just tell stories. She honors people. Every page felt like a reminder that reproductive healthcare is not a debate topic or a headline. It’s real life, real bodies, real families, real grief, real relief, and real love.

As someone who advocates for reproductive justice, this book genuinely expanded my perspective. It made me reflect on how often we talk about abortion in theory, while Dr. Sella brings you face to face with what it actually looks like in practice. The complexity, the courage, the impossible decisions, and the care that patients deserve regardless of circumstance. She writes with so much compassion and clarity that it’s impossible to walk away unchanged.

And honestly, reading this as someone who wants to become an OBGYN hit even harder. It made me feel even more certain about the kind of physician I want to be. One who leads with empathy, listens without judgment, and protects patients’ dignity in the moments they need it most. This book captures the heart of medicine. Meeting people where they are, providing evidence based care, and treating patients like full human beings, not political symbols.

It’s devastating that abortion has become so politicized, because nothing about this is abstract. People deserve healthcare without shame, surveillance, or barriers created by lawmakers who will never have to live with the consequences. Dr. Sella’s work makes it painfully clear. Restricting abortion doesn’t end abortion. It just increases suffering and risk, and it punishes people for being human.

If you care about bodily autonomy, patient centered medicine, or the truth behind reproductive healthcare, Beyond Limits is essential. It’s powerful, heartbreaking, and somehow still full of hope. The kind of book that makes you feel more informed, more compassionate, and more committed to fighting for a world where care isn’t conditional.

[Vikki · Rating 5 out of 5]

An absolutely fascinating account of Dr. Sella's career and the ways in which her life experiences drove her path. What I found most riveting about this book was Dr. Sella's description of how her clinic cares for the patients they see, how they provide what many patients ultimately describe as the best medical care they've ever received. The level of consideration and concern that go into every aspect of the patients' experience is astonishing, and almost difficult to hear if you are a woman who has--like most of us--mostly ever experienced varying levels of dismissiveness, gaslighting, or indifference from healthcare providers. Sella's lengthy and comprehensive answers to the two questions she's most often asked--"Why did she wait so long?" and "What doesn't she just give the baby up for adoption?"--probably won't convince anyone who's already decided they're antiabortion, but for those who support reproductive freedom but find the idea of third-trimester abortions troubling, these stories are illuminating, heartbreaking, and often infuriating. From teenage girls navigating the complex legal landscape of abortion access alone, to women whose antiabortion doctors deliberately withhold information about their fetuses' medical anomalies, to survivors of rape who cannot face the reality of pregnancy, it is clear that no one arrives at the third trimester seeking an abortion because they just couldn't be bothered to get one sooner. A must-read for anyone who cares about issues of reproductive justice and feminism, this book will help you understand why the people seeking abortions late in pregnancy are as deserving of compassion and care as anyone else.

[Barbara Geffen · Rating 5 out of 5]

Dr. Sella is a board certified Ob-Gynecologist who gradually came to realize her calling as a provider for problematic third trimester abortions. She relates tales of women who came to clinics where she gave care, not just abortions, to women whose lives were upended by unexpected pregnancies which impacted their futures. They made decisions no woman makes lightly. Dr. Sella explains how these decisions are made, either because of a late-in-pregnancy discovery of a fetal anomaly too terrible for a birth or one that impacts the health of the mother (whether physically or emotionally). Some are young teens who didn't know of their pregnancy. Some are older mothers who cannot financially handle another child. Some are fearful of abusive partners. Others want this baby and are upset that it will die soon after birth. Many issues arise for different reasons. Dr. Sella supports all; it's not her choice, but that of the person choosing the abortion. The clinics where she works provide counseling and help for each single woman or couple before arrival, during their 4 days of care, including as they leave. She details the kinds of group discussions that take place and her own involvement with each patient. Interwoven is her own, personal life story, which enhances the meaningfulness of her life's work. She's retired now, engaged in advocacy. This powerfully told memoir is gripping and important.

[Claire Chang · Rating 5 out of 5]

A beautifully written book intertwining a week in Dr. Sella’s life providing essential healthcare to patients seeking abortions and her own personal memoir. She answers the questions of why someone might obtain an abortion and why someone would feel a calling to provide abortions. At the heart of the answer to both these questions is love. It is palpable the love Dr. Sella has for her patients, the stories they bring to the clinic and the stories they’ll live after. Love weaves through her mentors, the staff, and mentees as they navigate how to continue providing care for their patients as the barriers become greater and the nation vilifies abortion.

As a training physician that has found a calling for protecting abortion access and promoting reproductive justice, I was continuously surprised by the ways Dr. Sella’s personal story and patient stories challenged my notions and elicited strong emotions. What an honor it is to have a glimpse at the lives of these patients and Dr. Sella’s own story. I am left with the hope that books like this and the stories that continue to be shared will allow empathy to grow and love to spread so that one day patients won’t need to jump through unnecessary hurdles to access the care they need and want.

[Marissa Rosa · Rating 5 out of 5]

Dobbs passed the year before I started medical school, and I, unfortunately, continue to see its ramifications to this day. One of my first shadowing experiences involved a patient who had a ruptured ectopic pregnancy. Although she sought out care earlier in her pregnancy, she did not receive medication that would terminate her pregnancy, despite this being the standard of care, because she presented to a religiously affiliated hospital in Texas. So, instead of being provided with the appropriate level of care early in her pregnancy, she presented to our hospital with internal bleeding after her fallopian tube ruptured, as expected. Her initial denial of care led to her losing her fertility in our OR. So, as I’m sure readers of this book will agree, abortion, regardless of indication, is healthcare.

On a brighter note, I had the pleasure of meeting Dr. Sella at an annual meeting earlier this month - I will forever be inspired by what she has done for the field, and more importantly, the patients.

[Jessica Van Wyen · Rating 5 out of 5]

Such an Important Book

I am so grateful Dr. Sella wrote and published this book, and even more grateful for her sacred work in abortion care, particular third-trimester abortion care. As someone who chose an abortion at 26 weeks due to non-fatal, but serious, fetal abnormalities I felt seen and understood by her commentary about others in similar circumstances. Perhaps more importantly I appreciated her perspective on abortions for maternal reasons. I’ve been involved and especially interested in the topic of abortions later in pregnancy for four years and still found new food for thought and perspectives from this book. I especially loved the discussion and definition of viable vs. non-viable pregnancies.

Highly recommend this book, to everyone.

[Charlotte Taft · Rating 5 out of 5]

a beautiful and powerful memoir of courage and love

Dr. Shelley Sella has shared her own story and the stories of dozens of the people she has treated in a long and generous career. She highlights the contributions of my friend, Dr. George Tiller, who was murdered by an anti abortion thug, and others who taught and mentored her. She writes about abortion care at its best. She helps us understand the lives and thinking of women who have been all too frequently judged by people not in their shoes. I am deeply grateful for this courageous book and for Dr. Sella’s loving and generous work.

[Kellie Overbey · Rating 5 out of 5]

A must-read for anyone who is interested in abortion, abortion rights, and reproductive justice. Especially for anyone who is confused about what a third trimester abortion actually is. Dr. Sella is clearly a compassionate caretaker of high moral character. I'm grateful to her for sharing her experiences, these stories, and to all the patients she treated who allowed their stories to be told. Until we remove stigma from abortion, and stop fetishizing pregnancy, childbirth, and motherhood, our culture (and our legislators) will continue to put people's lives and health at risk. This book tells the truth about one of the most misunderstood aspects of pregnancy with empathy and respect.

[Inanna Carter · Rating 5 out of 5]

Got to meet Dr Sella and attend her book reading which made this book extra special, but I also love it and her ideas on their own merit.

Love her redefining of “viability” more holistically: “every patient who comes to me for an abortion has considered all factors relevant to their well-being and to their unborn child and concluded this particular pregnancy is non-viable.”

Love the way she practices medicine like a midwife/family member despite being both family med and OBGYN trained. I could only hope to be so patient and humble and empathetic as a doctor or even human

[Jodell Larimer · Rating 5 out of 5]

Compassionate, factual, non-judgmental presentation of reality women face when dealing with life-altering decisions. Presents a clear picture of the lack of health care that touches the lives of all residents in the United States of America and the politics that have created this reality.
This is a book that every politician, every person involved in the legal or judicial process/field and every voter should read.
There but for the grace of God, go I...

[ashwini · Rating 4 out of 5]

A crucial read for everyone. Dr. Sella demystifies and de-sensationalizes 2nd and 3rd trimester abortions through copious case studies of real people she treated. She is unequivocal in her belief that people deserve abortions for any reason at any time. The only thing I would have appreciated is a retelling of a time when she turned someone away—whether that’s due to being too far in the pregnancy, concerns about coercion, or another reason.

[Liz Ruhland · Rating 4 out of 5]

Dr. Sella compassionately explains why women make a choice that I had previously felt was a bridge too far. I had long struggled with this question and now I understand why “maternal indication” patients make this choice. I wish we lived in a country where women didn’t have to choose this, I wish we lived in a country where women could make this choice more easily, and I wish we lived in a country where the people making the decisions for women would read this book.

[Brenda Malkiel · Rating 5 out of 5]

Shelley Sella's book presents the stories of women facing near-impossible choices. This book explores the wrenching decision-making process these women undergo and shows why third-trimester abortions are often the only possible outcome. Not all readers will agree with Sella's arguments, but everyone should hear them.

[David · Rating 5 out of 5]

A phenomenal book. Dr. Sella's compassion knows no bounds and oozes from every page as she tells her own story and her patients' stories dealing with some of the toughest things life can throw at you. Her real talk about third trimester (and, really, all) abortion was hard to put down. Dr. Sella saves people's lives, and we are lucky to have this book to let us have a peak into this world.

[Sarah Baranes · Rating 4 out of 5]

An important work that tells the stories of people needing third trimester abortions. Even for avid abortion right advocates, the situations that lead people to Dr. Sella’s care may have been inconceivable, but in her telling one can imagine how life can so easily put people in that position. Required reading for any one working in that space

[Jill Smith · Rating 5 out of 5]

Wow. Such an eye opening read. As someone who has always whole heartedly supported a woman’s right to choose and access to abortion, I’ve never learned much about third term abortions and reasons they may be necessary. Dr. Sella shared so many raw, emotional and educational stories. In a world where woman are becoming less protected I think this is such an important listen.

[K&E_getlit · Rating 5 out of 5]

4.5 This was beautifully done. I was not expecting this to have so much of Sella's personal story but I'm so glad it did. I thought the format of interweaving patient stories with Sella's day to day work, and facts about abortion worked really well. It certainly cleared a lot of misconceptions I had about the procedure and I hope it can do so for others.

[Karalee James · Rating 5 out of 5]

Pregnant people are capable of deciding if their pregnancies are viable or not!!!! People need family planning, our country does not provide enough resources to be able to carry out a pregnancy every time one occurs. Kids are literally living in poverty everywhere and people are just trying to make a smart decision but our fuck ass Christian Nationalist government won’t let them.