At the third presidential debate last week, Donald Trump made a dramatic statement about abortion. He claimed that you can “rip the baby out of the womb” in the ninth month of pregnancy, “as late as one or two or three or four days prior to birth.”
His statement is not based on medical or legal fact, and his claim that this happens demands a response. And that’s exactly what happened: later that night, and in the following days, there was a storm of responses from women’s health advocates and activists as well as from women who have had late-term abortions and the doctors who provide them. All were determined to set the record straight.
Dr. Jen Gunter, an OB-GYN who has performed many late-term abortions, was quick to clear things up on her blog:
There are no ninth month abortions. Really. A ninth month abortion is a unicorn and so it’s ridiculous to even discuss it. Terminations after 24 weeks are for severe fetal anomalies.
So what was Trump talking about? His statement harkened back to the misleading term “partial birth abortion” — a term that has no medical meaning but is interpreted to mean a later-term abortion. The term was coined as a political phrase in 1995 by the anti-abortion advocacy organization the National Right to Life, in an effort to prevent second trimester abortions. It’s not a medical term because there is no such thing as a partial-birth abortion, much as there is no such thing as a nine-month abortion.
In an article on Vox.com, Dr. Gunter explains,
I’m a doctor who was trained to do late-term abortions. I did them for five years in residency and for 10 years in practice and I have no idea what Trump is talking about. I have even practiced in states with no gestational age limit for abortions. So while I no longer perform abortions, I know much more about this subject than Donald Trump or any of his advisers can ever hope to know.
In order to understand more about what exactly late-term abortions are, it’s helpful to know what they aren’t. They aren’t the majority of abortions in the United States. The vast majority of abortions — 91 percent — are early abortions, those performed in the first trimester (the first 13 weeks) of pregnancy. The rest, except for a tiny fraction, take place in the second trimester, at or before 26 weeks. Late-term abortions, generally defined as those performed at or after 21 weeks of pregnancy, are rare. In fact, only 1.3 percent of abortions in the United States are performed at that stage.
Most women who have late-term abortions have them because the fetus has severe fetal anomalies (birth defects) that are often incompatible with life. Less frequently a woman has one when her own health is at risk or for “personal reasons,” such as being unable to access an abortion earlier. Behind each of these scenarios, however, exist thousands of women with their own deeply personal and nuanced experiences.
Alyson Draper, a 40-year-old Mormon woman, is one of the eighty percent of women who had a later term abortion because the fetus had birth impairments. She shared her story of “the most wanted and planned pregnancy ever,” because she desperately wanted people to understand that her experience was not at all what Trump described:
I had to have a late term abortion. It was the worst moment in my life. What made it even worse was the State of Utah had made it illegal.
I had one dead twin. The other had severe Spina Bifida. It was so bad that his brain had developed outside his head, and his spine was open clear to the lumbar level. There was ZERO hope, and no medical miracle that could save him. Our dreams were shattered. These twins were from IVF. I was forty, and there would be no more pregnancies.
Draper needed a late-term abortion not only because of these circumstances, but also because her own life was at risk. Abortions to protect the health of the mother usually involve precarious situations, when a woman has a life-threatening condition like heart failure, lupus, or an infection in the uterus.
As for personal reasons why women undergo later term abortions, they are not what anti-abortion legislators like to frame as casual, flippant, or simple. It’s usually because of difficulty in finding an abortion provider who performs late-term abortions or the challenge of coming up with the out-of-pocket cost which can rise into the thousands of dollars.
While it can be politically expedient to frame late-term abortion in such graphic terms (“partial birth” or “ripped from the womb”), the reality of the procedure used is nothing like that. It is, however, surgery. And, as Dr. Gunter writes, images of surgical procedures are graphic.
The procedures used are either dilation and evacuation (D&E) or dilation and extraction (D&X). Both carry minimal risk and do not require hospitalization. The most common method is D&E, which involves removing the fetal and placental tissue with a combination of suction and instruments. A small number of second-trimester abortions are done by inducing labor with drugs, a procedure called induction abortion.
Unfortunately, because dilation and extraction has been ruled by the Supreme Court as “partial birth abortion” (again, there is no medical procedure with this name), doctors cannot use this safe method to terminate later term pregnancies.
And this is the real consequence of the language used in the third debate. It’s not only that there is no medical or legal basis for what Trump described that night. It’s that perpetuating false information can have a devastating impact on women’s health and lives. A D&X is often the safest way to help women like Alyson Draper (and so many thousands of others) in desperate need of a medical procedure they never wanted to have in the first place.
Late-term abortions, those that happen at or after 21 weeks, are rare. It’s important to debunk the myths surrounding them so that women and their partners can get the care they need and deserve.