In the U.S., most abortions are procured within the first 12 weeks of pregnancy. Yet our political discussions about reproductive freedom frequently center on late-term abortions. And so it went Wednesday during the final 2016 presidential debate, with a segment on Roe v. Wade quickly devolving into arguments about "partial birth abortion."
In Hillary Clinton's ideal world, "you can take a baby and rip the baby out of the womb of the mother just prior to the birth of the baby," Donald Trump told debate viewers. "Based on what she is saying and based on where she's going and where she's been, you can take baby and rip the baby out of the womb. In the ninth month. On the final day."
As many people have pointed out, this is not true, at least not in any meaninful way. While there are a few states where a woman could theoretically get an elective abortion at any point in pregnancy, it would not be done via "intact dilation and evacuation"—the medical term for the procedure people refer to as "partial birth abortion"—or anythng like "rip[ping] the baby out of the womb." And while intact dilation and evacuation (D&X) is legal when a woman's life is at stake if she doesn't terminate the pregnancy, there's little chance a woman who's been wanting her pregnancy up until that point, or the doctor treating her, will choose D&X when there are less controversial and legally ambiguous ways to accomplish the abortion.
There's also little evidence that anyone actually chooses to terminate a pregnancy "at nine months." Just a little over 1 percent of U.S. abortions take place at any point after around five months pregnancy.
Trump's understanding of how abortions work, and when they are and aren't allowed, is severely lacking. But he's not alone: a lot of people seem to believe that U.S. laws permit any pregnant woman to abort a fetus at any time for any reason. So let's take a closer look at later-term abortion laws in America…
"Partial-birth abortion" is illegal in the U.S. Politicians who bring up "partial birth abortion" do so because they know it can spur strong and visceral reactions of disgust and moral indignation, not because it's especially relevant to U.S. health care, morals, or laws circa 2016. For 13 years, since 2003, federal law has prohibited physicians from performing D&X procedures, aka partial birth abortions, at any point in a pregnancy. Almost a decade ago, in 2007, the Supreme Court upheld the ban as constitutional. In addition, 19 states have their own laws against these sorts of abortions. While the federal ban does include an exception for situations where the mother's life is endangered, abortion doctors claim they avoid the procedure anyway, as there are other options with less liklihood of legal repercussions. Even before the federal ban, D&X procedures accounted for just 0.2 percent of all abortions, and most of these were performed before the point where a fetus can feel pain or survive on its own outside of the womb.
Late-term abortion is illegal in most of the U.S. A typical human pregnancy lasts 38 weeks after an egg is fertilized. Only seven states and the District of Columbia allow abortion at any point during a pregnancy, according to reproductive-research org the Guttmacher Institute. In the other 43 states, abortion is banned—with limited exceptions, such as for the safety of the mother—after the second trimester, after the point of fetal viability (when a fetus could live on its own outside the womb), or after a specified number of weeks (generally 20-24). When exceptions are required, many states require two physicians to sign-off on the procedure before it's permissable.
Very few U.S. women abort after 20 weeks pregnancy. Even with late-term abortion allowed in some parts of the country and under certain circumstances, nearly all abortions performed in the U.S. happen before the end of the second trimester. According to U.S. Centers for Disease Control and Prevention data from 2012, 65.8 percent of abortions took place within the first eight weeks of pregnancy, and 91.4 percent occurred within the first 13 weeks. Just 7.2 percent of abortions were performed between 14 and 20 weeks gestation, which means just 1.3 percent of abortions took place at or after 21 weeks pregnancy. And, from 2003 through 2012, the CDC saw a significant shift toward earlier abortions, with the percentage occuring within the first six weeks up 24 percent during the study period. The percentage of abortions occurring at or after 13 weeks, meanwhile, remained relatively consistently throughout the study period and never rose above 9 percent.
Late-term abortions are generally a last resort. While abortion opponents push the idea that women get late-term abortions because they change their minds last minute, or just can't be bothered to do it sooner—that they use late-term abortion "as birth control"—getting a surgical abortion is a serious, invasive, and expensive procedure, especially the later in pregnancy it takes place. Pregnancy itself is also quite difficult on women's bodies, and disruptive to their day-to-day lives. To believe there are women routinely putting their bodies through months of unwanted pregnancy, shelling out thousands of dollars, and undergoing serious surgery rather than use condoms or get an IUD or get an earlier abortion or whatever requires believing not just that most women are immoral or irresponsible but also, and simultaneously, wealthy, stupid, and masochistic. But abortion doctors, medical groups, and people who've gotten late-term abortions themselves all attest that these aren't decisions most women or medical professionals take lightly. Abortions procured in the third-trimester generally involve situations where the mother's life or health is in jeopardy, the fetus will die outside of the womb anyway, or the fetus is found to have a severe genetic abnormality that wasn't previously apparent.
Trump was OK with "partial birth abortion" in 1999. "Would a President Trump ban partial birth abortion?" Tim Russert asked the future Republican nominee on Meet the Press in 1999. "Look, I am very pro-choice," said Trump, before eventually answering that no, he would not ban partial-birth abortions. Trump apparently reconsidered shortly thereafter: In his 2000 book, The America We Deserve, he writes that after learning more about the procedure, he would indeed support a ban. As for what he told Russert, Trump explains that his "pro-choice instincts" led him to say no.