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, Medical, Memoir, Womens, Politics, Audiobook

227 pages, Kindle Edition

Published June 3, 2025

Reviews

[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

[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.

[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.

[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

[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.

[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.

[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.

[Heather · Rating 5 out of 5]

Even as someone very much in favor of legal, accessible abortion, I only knew the tip of the iceberg about third-trimester abortion care. This was an eye opening read, which I know the people who probably most need to learn from it will never come near.

[Ana Gorski · Rating 5 out of 5]

“Women and families are intellectually, emotionally, spiritually, and ethically competent to struggle with complex health issues, including abortion, and come to decisions that are appropriate for themselves” — George Tiller, MD

This book is so precious 💫 Thank you Dr. Shelley Sella!

[Brittany · Rating 5 out of 5]

A stunning description of third-term abortion care. I learned so much- I had no idea my understanding was so lacking. Such a moving and caring telling of third-term care and the patients that seek it.

[Claire · Rating 5 out of 5]

Dr. Sella is intelligent and empathetic. Stories like hers, the women who she has treated are always important but even more so in the current climate. No one wants third trimester abortion, they are a medical necessity that must be protected.

[Amy Lutzke · Rating 4 out of 5]

Enlightening.

[Ronnie Gottilla · Rating 5 out of 5]

A must read!!!

[Sophie Schott · Rating 5 out of 5]

Deeply compassionate. Went to her book event at Politics and Prose and was moved by her straightforward kindness and matter-of-fact care for patients who need later abortions.

[Lesley Levine · Rating 5 out of 5]

Excellent compassionate discussion of difficult situations. Should be required reading for every ob-gyn, if not every doctor.

[Marie Thomas · Rating 5 out of 5]

Anyone whonhasbqualms about third trimester abortion needs to read this book.

[Lisa Bennett · Rating 5 out of 5]

A book that anyone who has questions about third trimester abortions, particularly the question why, OR has an opinion about third trimester abortions, should read. Well written, educational and compassionate.

[Emily Kahn · Rating 5 out of 5]

Wow wow wow. This was a beautifully written book, that brought me to tears many times throughout