Abortion became a topic in the debates between Hillary Clinton and Donald Trump for the first time Wednesday night when moderator Chris Wallace focused on access to what he called "late-term, partial-birth" procedures.
"Well, I think it’s terrible," Trump said. "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.
"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," he said. "Nobody has that."
Abortion is one of the most polarizing social issues in America. A May 2016 Gallup poll showed that 29 percent of respondents believed it should be legal under any circumstances, 50 percent only under certain circumstances, and 19 percent illegal in all circumstances. Only 2 percent of those surveyed had no opinion.
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"Late-term abortion" is a non-medical term that varies in definition. Most laws agree that it encompasses abortions near the end of the second trimester, when viability -- the fetus' ability to exist independently of the mother -- comes into question. There are three methods used in "late-term" abortion: dilation and evacuation, where the contents of the uterus are surgically removed after dilating the cervix; early labor induction; and intact dilation and extraction, in which the fetus is taken out as it appeared in the womb and which is widely prohibited.
According to the Guttmacher Institute, a nonprofit dedicated to the advancement of reproductive rights, only 1.2 percent of abortions in the United States occur after 21 weeks gestation. Despite their infrequency, Columbia University professor Rachel Adams said that "late-term" abortions have been a hot topic in the political sphere and have served as a means for conservatives to promote an anti-abortion agenda.
"It allows you to make a more viable argument that you're talking about a baby and not a fetus, which I think is a more dividing ethical line," said Adams, who specializes in gender and sexuality studies.
Americans' attitudes toward late-term abortion seem to be changing as a result of microcephaly, the birth defect that can be caused by the Zika virus. A July poll from Harvard University and STAT, the Boston Globe's publication about health and medicine, found that 61 percent did not think a woman should be able get an abortion after 24 weeks, while 23 percent did. But if the respondents were told that there was a serious possibility that the fetus had microcephaly caused by Zika, the numbers flipped: 59 percent favored allowing a woman to get an abortion and 28 percent disapproved.
Adams criticized Trump's incendiary language of "rip(ping) the baby out of the womb" for its violence toward women and the use of the charged word "baby" for an unborn fetus.
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Others took exception to Wallace referring to "partial-birth abortion" in his question.
"Partial-birth abortion is a political term, it's not a medical term," said Laura Ciolkowski, the associate director at Columbia’s Institute for Research on Women, Gender, and Sexuality. "The language that we use to talk about abortion really matters."
Terminology aside, Trump's comments revealed a lack of knowledge of gynecological medical practice, according to experts.
"First of all, there’s no such thing as ninth-month abortions," Ciolkowski said. "We call that Cesarean sections."
Lisa Perriera, a staff physician at Philadelphia Women's Center and associate professor of obstetrics and gynecology at Thomas Jefferson University, called Trump's comments at the debate "completely medically inaccurate."
"Abortion procedures are usually performed until viability, which is nowhere near complete nine-months of pregnancy," she said.
Daniel Grossman, a professor of obstetrics and gynecology at the University of California, has also told Politifact that if there was a risk to a mother's life on her due date "the treatment for that is delivery, and the baby survives.”
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In Pennsylvania, "viability" is legally defined as 23 weeks and six days, but almost all of Perriera's patients have abortions within the first trimester. Among those who don't, it's usually due to a problem with access to healthcare. Because many are on government-issued Medicaid, their procedures aren't covered by insurance and they have to save to be able to afford an abortion, which takes time.
In the rare event of an abortion after 23 weeks and six days, it's often a situation when "the baby is incredibly sick," and the mother finds out late in the pregnancy, Perriera said.
In the debate, Trump said that if his nominees were appointed to the Supreme Court, Roe v. Wade would be reversed "automatically" and issues of abortion would be legislated by the states.
Overturning Roe v. Wade would just make abortion unsafe, according to Perriera.
"It will have really dramatic health outcomes for women," she said. "You will see more women try to self-induce abortion and possibly have an increase in deaths from unsafe abortion."
Cecile Richards, the president of Planned Parenthood, said Donald Trump would block access to Planned Parenthood, attempt to overturn Roe v. Wade, and believed women should be punished for having an abortion.
The comment was a reference a March 30 town hall event when Trump told MSNBC's Chris Matthews that women who had abortions should receive "some form of punishment." He walked back those remarks the same day to say that women should not be punished.
"Make no mistake, Donald Trump would ban abortion in this country," Richards told NBC. "And that's why women will be the reason he's not elected this November."
Ilyse Hogue, president of NARAL Pro-Choice America, said the moment the candidate mentioned reversing the 1973 Supreme Court case "was literally when Donald Trump support bottomed out with independents... His willingness to say that puts him on the wrong side of the vast majority of Americans."
After pushing hard for moderators to ask candidates about abortion access since the primary debates, NARAL activists were thrilled to see Wallace highlight the issue.
"The voters were able to hear a pretty stark contrast in the two candidates," Hogue said.
Some conservatives were annoyed Trump did not directly answer the question of whether he wanted Roe v. Wade overturned.
Evan McMullin, the independent presidential candidate, tweeted: "Why can't @RealDonaldTrump actually say the words 'I want Roe v Wade overturned?' I'm the only pro-life candidate in the race."
Others denounced Clinton’s position.
"Hillary is an extremist on abortion and admitted last night that she is part of a very small, extreme minority of Americans who believe there should be zero restrictions on abortion throughout all nine (months) of pregnancy for any reason," Kristan Hawkins, president of Students for Life, wrote to NBC, emphasizing that she was commenting in a personal, and not official, capacity as a Christian and mother of four.
"While demanding that crimes against children in war torn countries must stop and touting her pro-toddler agenda, she clearly stated that she thinks everyone is worthy of life except children still in their mothers' womb," Hawkins wrote. "You can't claim you are for all rights of women while simultaneously demanding the right to kill pre-born children, half of which are female."
Matt Batzel, national executive director at American Majority Action, tweeted, "Trump: Ripping the baby out the womb, may be okay with Hillary, but is NOT OKAY WITH ME #debatenight #prolife #neverhillary."
However, few pro-life organizations have directly addressed Trump's comments during the debate.
Historically, Clinton has taken a position that abortions should be "safe, legal, and rare." In the debate, she emphasized that abortion policy has to take into account the life and health of the woman, especially during "late-term" procedures.
"You should meet with some of the women that I have met with, women I have known over the course of my life," Clinton said on Wednesday night. "This is one of the worst possible choices that any woman and her family has to make. And I do not believe the government should be making it."
Many abortion-rights supporters were cheered by Clinton's performance.
"Hillary did a wonderful job of bringing it back to the real crisis of access in this country," said Hogue with NARAL Pro-Choice America. "We have now a presidential candidate in Hillary Clinton --partly because she's a woman, partly because she's an excellent leader -- (who) has chosen to listen to real stories of women."
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