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No, Late-Term Abortions Don't 'Rip' Babies Out Of Wombs -- And They Exist For A Reason

This article is more than 7 years old.

At last, in Wednesday night’s debate, Hillary Clinton and Donald Trump faced off on the question of abortion. And it quickly became painfully obvious that the only person on stage, including the moderator, who knew much about women’s health was the woman.

When Chris Wallace asked Clinton why she had “voted against a ban on late-term, partial-birth abortions,” Clinton’s immediate response correctly pointed out that “Roe v. Wade very clearly sets out that there can be regulations on abortion so long as the life and the health of the mother are taken into account.”

But from there, the ensuing conversation revealed both Wallace’s and Trump’s ignorance about these procedures.

When Trump, for example, suggested that “you can take the baby and rip the baby out of the womb in the ninth month on the final day,” he appears not to realize that the term for that — and it’s done considerably less violently — is a Cesarean section, a common, safe procedure by which about a third of women deliver their babies every year. In other words, Trump described how more than a million women every year give birth. It’s quite legal, and generally a cause for celebration.

If that sounds a bit flippant, that’s because, as Jen Gunter, an OBGYN who trained in late-term abortions, pointed out on Twitter, “There is no such thing as a ninth month abortion.” Those who seek late-term abortions are seeking them before a pregnancy reaches full term but often and unfortunately after they have discovered in the second or third trimester some problem with the fetus or danger to the mother.

But the inaccuracies started before Trump even responded: Wallace’s question was problematic right out of the gate because of the term he used. “Partial birth” is a political, not medical, term, and it does not refer to all late-term abortions. It refers to a very specific and rare procedure called dilation and extraction*, in which a fetus is partially pulled through the birth canal and then aborted, nearly always when the fetus cannot live outside the womb and typically when the mother’s health is in danger, the fetus has a serious abnormality, or both. Such a procedure is not conducted lightly: the fetus has a fatal defect and will not survive, or the mother is at risk of death herself.

As this NPR article notes about a partial-birth abortion ban passed in 2003, “when some members of Congress tried to amend the bill to ban only those procedures that take place after viability, abortion opponents complained that would leave most of the procedures legal.” And the Supreme Court ultimately declined to strike down the ban anyway. Further, most states don’t allow late-term abortions: just eight states and Washington, D.C., have no restrictions on abortion timing, and the rest have restrictions and other regulations in place.

As noted, these types of abortions are extremely rare. Although both the rate and number of abortions have steadily fallen in the U.S., an estimated 1 million procedures are performed each year, according to the Guttmacher Institute. These procedures remain very safe, considerably more so than pregnancy and birth, in fact. Of these abortions, 91.4% are performed in the first trimester, less than 14 weeks into pregnancy. Just 1.3% of abortions are performed at or after 21 weeks, and an estimated 0.2% of all abortions involve the dilation and evacuation procedure. And why would women seek them in the first place?

“The kinds of cases that fall at the end of pregnancy are often the most heartbreaking, painful decisions for families to make,” Clinton said at the debate. “I have met with women who toward the end of their pregnancy get the worst news one could get, that their health is in jeopardy if they continue to carry to term or that something terrible has happened or just been discovered about the pregnancy. I do not think the United States government should be stepping in and making those most personal of decisions.”

If you have any question about whether the harrowing stories Clinton referred to are really the case, you can read the details of one woman's story yourself. Despite being “overjoyed” at her pregnancy, a discovery of a fatal defect in the fetus led her to the painful decision to have an abortion at 32 weeks — for which she was fortunate to have the resources to seek by flying across the country to Colorado. (She specifically notes, “if the doctors thought there was any way he [the fetus] might make it, I would have taken that chance.”) A number of fetal abnormalities that lead to death or extremely severe disability in a fetus — including the majority of problems caused by a Zika infection during pregnancyare not identified until after the 20th week of pregnancy.

When it was Trump’s chance to respond, his answer went far afield of any medical procedures that actually take place in the real world: “Well, I think it's terrible. If you go with what Hillary is saying, in the ninth month, you can take the baby and rip the baby out of the womb of the mother just prior to the birth of the baby.”

Clinton correctly responded that “that is not what happens in these cases.” Again, even among the 1.3% of abortions occurring after 20 weeks, most are also occurring well before the 38th to 40th weeks, when a baby may be considered full term. The most common procedure for these is a dilation and evacuation, which carries enough risks to the mother that they’re unlikely to be undergoing it unless it’s truly necessary.

Some individuals point to New Mexico as an example of a state with such lax restrictions on abortion that perhaps Trump’s scenario could play out there. In fact, however, New Mexico wouldn’t be the best poster child for the horror story Trump conjured up: just four New Mexico state residents had abortions at 28 weeks or later in 2014, and that dropped to two in 2015. And 28 weeks is still months away from a 38- to 40-week full-term pregnancy. New Mexico also follows a counter-intuitive national trend: states with the fewest restrictions on abortion have shown some of the biggest declines in the number of abortions. As the Albuquerque Journal reported earlier this year, abortions in the state have dropped by 24% since 2010.

What’s gone up, meanwhile, are women coming to New Mexico to seek abortions because neighboring states such as Texas and Oklahoma so tightly restrict them that it’s difficult for women to get safe, timely abortions. If you wonder why some women wait longer in the pregnancy to have an abortion, it’s often because those in places such as Texas may have to save the money or otherwise make arrangements to be able to travel long distances for the procedure. Others don’t know they’re pregnant or are in abusive relationships.

As Christina Cauterucci at Slate points out, Clinton’s deep understanding of this issue and lived experience with other women reveals the importance of having more women in politics. The more Clintons and Wendy Davises that are in office, the more likely it is that abortion and women’s reproductive policies actually reflect women’s experiences and the data on them.

*This sentence has been corrected to reflect the most accurate name for the procedure, called dilation and extraction. The sentence previously used "dilation and evacuation," which is a slightly different procedure. A dilation and extraction is sometimes also called an "intact dilation and evacuation," but this is not the preferred, precise term. 

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