What would you do in the following situation?

Jenna, 18, requests an abortion referral. Because she has irregular periods, she didn’t suspect pregnancy until her clothes got tight and the results of a home pregnancy test came out positive.

On exam, her uterus is 16 to 18 weeks in size. The abortion clinic in your town only terminates pregnancies before 12 weeks. You have to request special permission from her HMO to obtain a second-trimester termination elsewhere. You oppose abortion and don’t wish to approve termination of a four-month fetus. Jenna says she can’t afford a child, can’t sleep due to the stress, and wants the abortion quickly, before time runs out.

Part of a series of ethical questions posed by Medical Ecomonics.