HEALTH
02/02/2018 08:41 pm ET Updated Feb 04, 2018

What David Brooks Doesn’t Understand About Abortions After The Second Trimester

He's willing to endanger women's lives for the approval of people who have a medically inaccurate fantasy about why these abortions occur.

As much as New York Times columnist David Brooks likes to distance himself from President Donald Trump’s brand of republicanism, there is at least one thing the two men have in common: They both have a horribly inaccurate picture of why women get abortions after 20 weeks, what the procedure entails and the toll abortion restrictions take on women.

The medical reality of why parents seek abortions after the midpoint of their second trimester is so utterly tragic that contrasting it with Brooks’ fantasy would be funny if it weren’t so infuriating. 

In his most recent column, Brooks imagined that he was a Democratic consultant asking party leaders to consider dropping the right to abortion as a political priority. He fixated on the fact that this week, Democratic lawmakers voted as a block against banning abortions at 20 weeks, even though some babies can be born as early as 22 weeks and survive outside of the womb. He argued that Democrats could strike a blow against Republicans by dropping abortion as a political issue, and that while donors might not like it, most of the voters would.

“One of our talking points is that late-term abortions are extremely rare,” said Imaginary Consultant Brooks. “If they are extremely rare, why are we giving them priority over all of our other issues combined?”

We’ll grant Brooks one thing — so-called “late-term” abortions, or terminations after 20 weeks, are exceedingly rare. Of the approximately 650,000 abortions that were reported to the U.S. Centers for Disease Control in 2014, a little over 1 percent of those abortions took place after 21 weeks gestation, which is about halfway through the second trimester. The vast majority of those abortions — 92 percent — were performed before the end of the first trimester, or within 13 weeks or less.  

Abortion is legal and available in the U.S., but 43 states already have some kind of time limit on when the procedure can take place. So why do a tiny minority of women choose to get abortions after 20 or so weeks?

That’s a tricky one to answer. Because hospitals are not required to report the pregnancy terminations they conduct for fetal anomalies or to preserve the life of the mother, no one can accurately estimate the proportion of late second-trimester abortions that take place for medical reasons as opposed to other reasons. 

But there is enough research to know that abortions after 20 weeks are rare, and that they happen either for medical reasons or because abortion access is so uneven and inconvenient that women are struggling to get them in a timely manner.  

We know there are several fetal abnormalities that only become apparent during the second trimester — usually discovered during an anomaly scan that takes place anytime between 18 to 22 weeks. These abnormalities can be fatal and include things like irregular development of the brain, lack of vital organs and genetic conditions. We also know there are certain maternal health conditions that either arise or become more serious once women enter the second trimester, like pre-eclampsia or heart failure.

These reasons for terminating pregnancies are borne out in the stories of women who have been brave enough to come forward about their own second-trimester abortions. 

Alexandra W., a woman from San Francisco, told HuffPost in 2016 about the anguish she felt when she decided to abort her son, the result of a very wanted pregnancy. Because of a rare birth defect in which his kidneys didn’t form properly, her son was not urinating in the womb, which meant that there wasn’t enough amniotic fluid in his sac to cushion him and allow him to develop normally. She decided to terminate the pregnancy at almost 21 weeks because he was being crushed

Cecily Kellogg, a woman who had an abortion at nearly six months’ gestation in 2004, told USA Today in 2012 that she had developed severe pre-eclampsia, and one of the twins she was carrying had already died when she and her doctors decided to perform an abortion on the other twin to save her life. 

We hear you, Brooks ― anecdotes are not data. But how many gut-wrenching stories, published in mainstream media and personal blogs, do you need to read before you realize that an abortion after 20 weeks is often an unwanted procedure of last resort?   

As for second-trimester abortions that take place for other reasons, a 2013 survey of 272 women who sought abortions after 20 weeks for nonmedical reasons found that they generally experienced logistical delays after making the decision to end their pregnancies, even if they decided to end their pregnancies while still in the first trimester. 

Almost two-thirds of these women said they delayed their procedure because they were raising money for travel, the procedure itself and other costs related to the termination. Compared to women who got abortions in the first trimester, they were also four times more likely to travel more than three hours to get to the abortion facility, and twice as likely to say they had problems securing medical insurance to cover the abortion. 

In his column, Brooks imagines that the overturning of Roe v. Wade would be a happy outcome for the Democratic Party because “the pro-life movement would turn its attention away from national elections” and “single-issue anti-abortion voters would no longer be automatic Republicans.” 

In reality, there’s evidence that Democrats stand to lose more voters than they would gain if they dropped abortion rights. There is also ample research that more abortion restrictions would make a second-trimester procedure more likely.

If Roe v. Wade were overturned and, as Brooks so glibly put it, 21 states outlaw abortion at any stage, access problems like the scenarios described in the study would only get worse. Women in states where abortion was banned would have to travel farther, be gone longer and raise more money for the procedure — resulting in even more second-trimester abortions. 

Brooks is asking Democrats to make a Faustian deal: drop the right to abortion for women and gain more votes and political influence for other legislative priorities.

What he doesn’t acknowledge, or doesn’t want to understand, is that to capitulate on abortion rights to gain the vote of a person who lives with a fantasy about why 20-week abortions happen in the first place not only endangers the lives and well-being of several thousand flesh-and-blood women with real problems, but it will also end up increasing the rate of second-trimester abortions anyway. 

Brooks ends his column by asking Democrats to rethink their priorities and assess what the country needs most right now. 

I’d argue that America doesn’t need a Democratic Party that tramples over women’s rights for the remote possibility of greater political influence. There’s already enough of that happening on the other side. 

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