In the last of the three presidential debates, there were three predictable outcomes.
Fox News Sunday host Chris Wallace finally asked a question about abortion, focusing on later abortion and the infamous but nonexistent procedure known as “partial-birth abortion.” Predictably, and as is the norm with the treatment of abortion issues by virtually all cable and radio outlets these days, Wallace’s framing of the issue was fundamentally flawed, because it was based on falsehoods spread for years by the anti-choice movement that, although widely and soundly debunked, nonetheless remain firmly implanted in the minds of mainstream media hosts. Also predictable was GOP nominee Donald Trump’s response to Wallace’s ill-informed question, which was right out of the anti-choice playbook as well.
The third almost certain outcome came after the debate, when MSNBC Hardball host Chris Matthews (the only cable host who led a post-debate discussion on abortion) and some of his panelists promoted these same myths and misinformation.
By the end of the evening, thanks to each of these men and the people they interviewed, what began as a loaded and misleading question morphed into a huge conflation of second-trimester abortion procedures, third-trimester c-sections, and induced deliveries. It might have been hilarious if it were not so dangerous.
In the debate, Wallace asked Democratic presidential nominee Hillary Clinton the following:
I want to ask you, Secretary Clinton, I want to explore how far you believe the right to abortion goes. You have been quoted as saying that the fetus has no constitutional rights. You also voted against a ban on late-term, partial-birth abortions. Why?
Clinton replied by saying:
Because 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. And when I voted as a senator, I did not think that that was the case.
The kinds of cases that fall at the end of pregnancy are often the most heartbreaking, painful decisions for families to make. 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. So you can regulate if you are doing so with the life and the health of the mother taken into account.
In response to Clinton, Trump stated:
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.
Now, you can say that that’s OK and Hillary can say that that’s OK. But it’s not OK with me, because based on what she’s saying, and based on where she’s going, and where she’s been, you can take the baby and rip the baby out of the womb in the ninth month on the final day. And that’s not acceptable.
And, honestly, nobody has business doing what I just said, doing that, as late as one or two or three or four days prior to birth. Nobody has that.
Let’s dispense with Trump’s assertions by offering facts. The notion inherent in Wallace’s question and perpetuated by Trump that third-trimester abortions are performed “on demand” is an anti-choice myth meant to target women as being irresponsible and garner support for efforts to ban all abortions in the United States. As Clinton noted, Roe v. Wade makes exceedingly clear that states can impose limits on abortion care later in pregnancy that do not compromise the health or life of a pregnant person. In theory, abortion is accessible when needed under these circumstances. In real life and because of myriad restrictions and barriers to access, it is exceedingly difficult if not sometimes impossible to terminate a pregnancy in the last trimester, even when a wanted pregnancy goes horribly wrong or woman’s life is in imminent danger.
Roughly 90 percent of all abortions in the United States occur within the first trimester and, but for a tiny fraction, the rest take place in the second trimester. In a phone interview with Rewire, Diane Horvath-Cosper, MD, MPH, who has provided abortions for ten years in hospital and clinic settings and who is a reproductive health advocacy fellow at Physicians for Reproductive Health, explained the differences in abortion procedures.
Assuming they have real access to medical choices, a person seeking abortion in the first trimester might opt for either medication abortion or surgical abortion through dilation and curettage (commonly called “D and C”). For an abortion between 14 to 28 weeks’ gestation, a physician would most likely employ either dilation and extraction (“D and X”) or dilation and evacuation (“D and E”), depending on the medical situation. In both cases, the fetus is dead before being removed from the uterus. It is these second-trimester procedures that Wallace, Trump, Matthews, and others were conflating with third-trimester procedures.
Third-trimester abortions are exceedingly rare, and in any case it’s not clear what people mean when they talk about “abortion” in the third trimester. Dr. Horvath-Cosper pointed out that problems can arise in the third trimester of a pregnancy warranting urgent medical care, such as late-developing fetal anomalies incompatible with life, fetal death in utero, or an imminent threat to the health or life of the pregnant person. Depending on the health situation of the pregnant person and whether the fetus is viable, a doctor might induce labor, such as in the tragic case of Rose, or perform a cesarean section, whichever ensures the best outcome for the patient(s).
Is the induction of labor to deliver a fetus that died in utero an “abortion?” We would normally call that a stillbirth. Is it an “abortion” to perform a cesarean section when a fetus or pregnant person is in distress later in pregnancy? Most people would call that what it is, a c-section. The terminology is almost irrelevant to the core goal, which is to ensure the best health outcomes for the patient(s) involved. In any case, lumping all of these together to stigmatize abortion care is deeply inaccurate.
Of this discussion, Dr. Horvath-Cosper noted: “Inflammatory statements [like those made at the debate] demonstrate the callous misrepresentation of medical realities and complex situations faced by both patients and their physicians.”
In his question, Wallace also referred to “partial-birth abortion,” setting up a straw man for the much-discussed unicorn of abortion procedures. According to Dr. Horvath-Cosper, “The fact they are even using the term ‘partial-birth abortion’ reveals they don’t know what they are talking about. The whole discussion conflates a lot of separate and medically incorrect things and piles them on top of each other.”
The term “partial-birth abortion” was created as part of the initial efforts in the 1990s by the anti-choice movement to ban specific abortion procedures that physicians might use in second-trimester abortions (such as dilation and evacuation or dilation and extraction, as noted above), based on their medical judgment. The apocryphal tales of “ripping babies from the womb” echoed in Trump’s answer have been used repeatedly by anti-choice groups to stigmatize later abortion care and incite public anger against abortion generally.
Despite the fact that the procedure does not exist, laws were passed at the state, and eventually the federal level, to ban “partial-birth abortion.” And undoubtedly because the procedure does not actually exist—and because medical science generally is of little concern to anti-choice legislators—the language of these laws was vague and did not specify what was actually being banned. Nonetheless, in the 2007 decision Gonzales v. Carhart, the Supreme Court applied the ban to dilation and extraction procedures.
The ban has caused confusion and consternation for doctors and other medical providers whose first obligation is to their patient, and is undoubtedly not supported by any medical evidence. The “partial-birth abortion” ban, then, used a fake name for a fake procedure to ban a medically sound and necessary procedure, all based on ideology, not science or on the health or needs of the pregnant person. More recently, anti-choice legislatures have focused on banning dilation and evacuation procedures as well, thereby leaving women and their physicians with fewer and fewer options.
While Chris Wallace failed in his duty at the debate to ask evidence-based questions that could shed light on what the candidates actually know about abortion and what positions they actually support, Chris Matthews took up the baton of misinformation in his post-debate panel.
Matthews opened his first post-debate panel by talking about abortions “two or three days before birth,” suggesting that Trump had won the “ideological argument that it’s bad … first of all, partial birth is a particular procedure … it’s a procedure,” Matthews inaccurately but repeatedly asserted. “It’s not just late term, it’s a procedure.”
Except again, it’s not a procedure, it doesn’t exist, and was a political tool to ban a second-trimester abortion.
MSNBC commentator Joy-Ann Reid tried to rescue the conversation by pointing out that an emergency delivery in the late third trimester would likely happen via cesarean section. Unfortunately, her point and the entire conversation was lost in the tide of misinformation and lack of any credible medical voice.
The misinformation continued to flow as conservative radio host Hugh Hewitt brought up Kermit Gosnell, the Pennsylvania man who ran an illegal abortion clinic and was arrested and convicted of his crimes. Gosnell has nothing to do with the issues at hand—because he broke the laws by which legitimate providers abide—but throwing him in is a staple of the right-wing lie machine.
In a later interview, speaking with Trump spokesperson Kellyanne Conway and Trump surrogate former New York Mayor Rudy Giuliani, Matthews presided over yet another wholly misleading exchange. First, he asked Conway and Giuliani whether they were surprised that Trump had used “such graphic language about partial-birth abortion and ripping the child out of the womb days before delivery.” Conway, in her rat-a-tat-tat chatter, claimed that Democrats were for “abortion anyone anytime anywhere,” and herself mixed up her trimesters and procedures, with Giuliani concurring it’s “killing a baby.”
Perhaps the most inadvertently relevant comment of the evening came when Conway, railing against nonexistent Democratic support for abortions “anyone, anytime, anywhere,” said “we know too much about science and medicine.” However, none of the three appear to know much of anything when it comes to science, medicine, pregnancy, miscarriage, or abortion.
Matthews, like Wallace, has talked for years about abortion issues but seems not to have bothered to learn anything at all about actual abortion care. As gatekeepers to policymakers and candidates, these men must do better than regurgitating anti-choice talking points when it comes to women’s bodies and women’s lives. It’s time for media elites, and most especially male media elites, to stop expounding on abortion care unless and until they know what they are talking about.