More than 80 percent of abortions in the United States happen before 10 weeks, in the embryonic stage of pregnancy. But in the politics of abortion, the arguments and almost all of the ads focus on the other end, on the much rarer abortions later in pregnancy.
This has never been more evident, or consequential, than this year. It’s the first presidential election year since the Supreme Court overturned Roe v. Wade. Ten states are voting on abortion rights ballot measures, including states that are battlegrounds for the presidency and control of Congress, and polls show that abortion has newly energized Democrats and women.
The closing weeks of the campaign have become a race to paint the other side as more extreme.
Republicans and groups that oppose abortion rights argue that Democrats are pushing abortions “for any reason” in the seventh, eighth and ninth month of pregnancy, even after birth. “Jon Tester supports aborting a healthy, full-term baby the day before it’s due,” Tim Sheehy, the Republican challenger for Senate in Montana says, falsely, on his campaign website. Donald Trump went further into inaccuracies, saying Democrats would allow women to “execute the baby.”
Democrats and sponsors of abortion rights ballot measures have leaned into graphic stories of women with much-wanted pregnancies who sought abortions in medical emergencies or because of fetal anomalies diagnosed late in pregnancy. In stark ads, women tell of being denied abortions until they were close to death. “I remember the doctor handing me a baby boy that was blue, and I just held him, because he was so cold,” says Deborah, a Florida woman who carried a pregnancy to 37 weeks after being told at 23 weeks the child would not survive. “This ban is torture.”
Both sides play to emotion and ambivalence: Polls show that Americans overwhelmingly support abortion in the first trimester, but, beyond that, their answer is some version of “it depends” — on why women seek abortion, and how late.
Talking about late abortions has long been especially persuasive: In the mid-1990s, as abortion opponents campaigned against a rare second-trimester procedure they called “partial-birth abortion” — describing fetuses dismembered, their skulls crushed — polls showed a sudden, sharp drop in support for abortion, even among women and Democrats. The number of Americans identifying as “pro-life” rose.
The opposite has happened in the two years since the court overturned Roe, with polls showing that voters are more likely to support abortion ballot measures if they have heard stories about women with pregnancy complications forced to travel out of state — that’s true even among Republicans and those who say abortion should be illegal in most cases.
“The more granular you get in terms of threats to women’s health, at every trimester, the more support you’re going to find for abortion,” said Lydia Saad, a pollster at Gallup who has written about the effect of talking about abortions later in pregnancy. “The more graphic you get about the development of the fetus or the procedure, the more pushback you’re going to get. That’s why the issue is so potent.”
There is no evidence that abortions are happening right up until birth, much less after — at that stage, doctors say it is a delivery of a live child, and infanticide, which is illegal everywhere. It’s also true, as anti-abortion activists say, that not all later abortions are in cases of medical emergencies or fetal abnormalities. But there’s also no evidence to support their charge that these cases happen regularly, with women aborting healthy but inconvenient pregnancies.
The Centers for Disease Control and Prevention reports that about 94 percent of abortions happen before the end of the first trimester, at or before 13 weeks. Less than 1 percent happen after 21 weeks (in the fifth month).
That percentage has actually declined over the last decade, as tests now detect pregnancy earlier, and more women use abortion pills in the early weeks.
Last year, there were an estimated 9,300 abortions after 21 weeks. But the C.D.C. and most states do not specify exactly when after 21 weeks those abortions happen — whether they are at, say, 22 weeks, or 36 weeks — or the reasons women sought them. That leaves a huge gap for hypotheticals, just at the point in pregnancy that polls show Americans begin to qualify their support for abortion.
Most states prohibit abortion after viability, when the fetus can survive outside the uterus; with medical technology, that’s now about 24 weeks. A fetus is “at term,” meaning it can survive on its own without intervention, at 37 weeks. And “late-term” refers to pregnancies that go beyond the usual 40 weeks — meaning that “late-term abortions” do not happen.
Viability was the standard the Supreme Court set in Roe, the 1973 decision that established a constitutional right to abortion, and most abortion ballot measures seek to reinstate that same threshold.
But even if someone wanted to get an abortion beyond viability, it’s difficult and expensive to find a place that will do it. Only 14 facilities in the United States publicly offer abortions beyond 24 weeks of pregnancy. Most of those stop at 26 weeks, three go until 28 weeks and one, in Colorado, until 32 weeks. Women have to find an appointment and arrange and pay for last-minute travel, not to mention the cost of the late procedure, which itself can cost from a few thousand dollars to $25,000.
This means that not many abortions happen after viability, even in states with no gestational limit. In Michigan, for example, where voters enshrined a right to abortion in the state Constitution in 2022, data for the next year shows only two abortions after 24 weeks: one between 25 and 28 weeks, and one after that.
There was one post-viability abortion in Ohio last year, sometime between 28 and 36 weeks. In Minnesota, there were two in 2022, one at 25 weeks and one at 32 weeks. And in Texas, there were eight abortions between 23 and 26 weeks in 2020, the last year before a ban took effect, and none later.
Most states do not report the reasons for these abortions. But in Florida, which does, there have been three post-viability abortions this year: one in a case of a “serious” fetal abnormality and two because of fatal abnormalities. In the four previous years, there were no abortions past 24 weeks.
The outlier is Colorado, where there were 137 abortions at or beyond 28 weeks — the start of the seventh month — in 2023. Of those, the state says most were between weeks 28 and 29; 8 percent, or roughly 10 abortions, were at 32 weeks or beyond.
Colorado is home to the clinic run by Dr. Warren Hern, the only provider in the country who publicly offers abortions after 32 weeks. Now 86, Dr. Hern has been doing abortions since Roe and fiercely defends a woman’s right to choose abortion at any stage of pregnancy; he specializes in late procedures, and many of his patients travel from other states. Anti-abortion activists hold him up as proof that third trimester abortions do happen, and not always because of dire medical diagnoses.
In particular, they cite two papers he published, in 2005 and 2014, and a profile of him in The Atlantic, where he said he had done an abortion for sex selection.
But they misquote those papers to argue that just 20 percent or 30 percent of the abortions he has performed late in pregnancy were for medical reasons. In fact, those percentages include abortions done earlier in pregnancy, before viability.
In an interview, Dr. Hern said that the abortions he does after 28 weeks are for serious fetal anomalies or because the woman’s life is at risk, and that “generally speaking” he would not provide one after 33 weeks, “and not if she just doesn’t want” a child.
“These are tough calls, and I’m here to help people, but I’m not an abortion dispensing machine,” he said. “I’m not going to give it to anybody who walks in the door.”
Anti-abortion activists also try to make their case using two papers by Diana Greene Foster and Katrina Kimport of the University of California, San Francisco. Timothy P. Carney, a senior fellow at the American Enterprise Institute quoted them to argue last year that “many abortions after 20 weeks happen without dire diagnoses for the mother or baby,” and that “there is plenty of evidence that elective late-term abortions happen every day in the United States.”
Yet these researchers, too, say their work has been misinterpreted and does not support the claim that many late abortions terminate healthy pregnancies.
Opponents of abortion rights seize in particular on a line in a study Dr. Kimport published in 2022, looking at why women have abortions in the third trimester. One reason was that they had obtained new information. And, in the sentence anti-abortion activists like to quote, “For some respondents, the new information they obtained was that they were pregnant.”
But for most women in the study, the new information was a medical diagnosis that could not be detected earlier in pregnancy. The study notes that only a “small subset” of women do not find out they are pregnant until the third trimester. They often have no reason to believe they are pregnant: They have no symptoms, or continue to get regular periods. And the study was based on interviews with only 28 women — not designed to be representative.
“They can’t make these claims based on their own efforts because there isn’t evidence of their claims,” Dr. Kimport said in an interview. “If this was something that was so rampant, they ought to be able to find data.”
Meanwhile, polls show support for abortion rising — even for abortions in the second and third trimester. Most Americans still qualify that support. “But if you’re going to force them to choose,” said Ms. Saad, at Gallup, “they will choose legal with no restrictions rather than make it illegal for everyone.”
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