The Health Exception

In the comments, Ari wants to know what Barack Obama meant by 'mental distress'. It's something of a dog whistle for anti-choicers. Most late-term abortion bans include an exception for certain cases: usually, it's something like cases of rape or incest, plus cases where carrying the fetus to term would endanger the life or health of the mother. A long-time complaint of the Forced Pregnancy Lobby (their complaint! not mine!) is that Doe v. Bolton (the companion case to Roe v. Wade) defines "health" too broadly, including "all factors—physical, emotional, psychological, familial, and the woman's age—relevant to the wellbeing of the patient". In the eyes of the Lobby, as long as a patient can get Planned Parenthood's physician to agree that raising the child will be 'stressful', they can terminate the pregnancy.

It's unclear how this works in practice. In 1987, the Guttmacher Institute surveyed women who obtained abortions and found that among those who had late abortions almost none gave reasons related to either maternal or fetal health. The top three reasons were (1) not being sure they were pregnant, (2) having trouble making arrangements (raising money; travel going to a clinic that would not accept her because the doctor is a tool), and (3) taking time to make a decision. But the study defined "late" as 16 weeks into pregnancy or later, so most of these abortions took place at the point where the practice is mostly unregulated. According to the CDC, fewer than 1.4% of women obtain abortions after 20 weeks of gestation—and we are still not at the 27 week line where states have the chance to substantially proscribe abortions. Planned Parenthood claims the CDC has found that less than 0.5% occur after 24 weeks. In an ideal world, the Lobby would not waste so much breath on the health exception when there are so few late-term abortions.

So, what's really going with third-trimester abortions? Are doctors in the forty states (and for those counting at home, that's all the Red States and half the Blue States) that have "no third-trimester abortions except when the mother's life or health is at risk" laws performing them for any patient who walks in the door? It's hard to tell. As Obama points out, NARAL doesn't fight third-trimester bans so long as the bans have a health exception, and the group doesn't suggest that the health exception includes "a matter of feeling blue" (which is different, from, say, a family history of depression). Given how rare third-trimester abortion are, it seems sensible to take these statements as face value; it would be crazy for NARAL and other pro-choice groups to risk their credibility by hiding problems like "family financial considerations" under the health exception for years on end.

So what do Obama's statements to Relevant magazine get him? After all, he's restating existing law, but to a group of people that might think existing law permits more abortions than it really does. Well, we don't really know that either. The interview with an outlet like Relevant is analogous to campaigning in Montana; it's a tactic that hasn't been tried in so long that we have no way of knowing if there are reachable voters there or not. Now, I'm skeptical that any of this is going to work; the evidence from the 2006 midterms is that the voters who switching to Democrats look more like existing Democrats than they do like conservative Republicans, and I doubt that will change this time. And it's hard to argue for the "Democrats need to do more to appeal to heavily religious voters" line without sounding like the Will Saletans or Amy Sullivans of the world.

Comments

[ari]

Thanks.

[Ursula]

Are doctors in the forty states (and for those counting at home, that's all the Red States and half the Blue States) that have "no third-trimester abortions except when the mother's life or health is at risk" laws performing them for any patient who walks in the door? It's hard to tell.

"Tonight at 11: Are homo-abortionist jizzporiums coming to your town? We don't know- BUT THEY MIGHT BE. Although the HRC says otherwise. And we could take that at face value."

RETRACTION! RETRACTION! RETRACTION! I'm writing to the editor about this.

[ari]

Every time I see "HRC," I think Hillary Rodham Clinton. I think the Human Rights Campaign might need to do some rebranding. (And I really don't mean that as a slap to Senator Clinton.)

[ari]

And by the way, this:

"Tonight at 11: Are homo-abortionist jizzporiums coming to your town? We don't know- BUT THEY MIGHT BE. Although the HRC says otherwise. And we could take that at face value."

made me laugh out loud. I mean, I won't stoop to any of that lol crap, but I literally chuckled aloud upon reading that.

[Venkat Rao]

Good And U Are Absolutely Right.
Health