Explaining Obama, Defining Abortion Terms

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abortion, Democratic Party

One of the reasons we as a nation cannot sensibly discuss the abortion issue is that most people don’t know what the bleep they are talking about. Most American adults seem to know next to nothing about the physiological realities of pregnancy and gestation. They know there is sex at one end of the process and a baby at the other, but what goes on in between is, um, hazy.

Today there’s much hysteria coming from both Left and Right about some statements made by Barack Obama over abortion. Since what he said pretty much squares with my own opinion going way back, I’m having a hard time seeing the Big Bleeping Deal. However, when people like Jeff Fecke, who is normally fairly sensible, makes statements like “So Obama went and said third-trimester abortions shouldn’t have legal protection yesterday,” then I despair of ever having a sensible conversation with ANYBODY on this issue.

Obama essentially said he agreed with the Roe v. Wade guidelines, with one exception. That is, while Roe v. Wade allows for a physical and mental health exception to third-trimester abortion bans, Obama said maybe there shouldn’t be an exception for “mental distress.” And that’s it. But to read some people you’d think Obama just joined the Right to Life movement.

But here goes … Quoting Obama from an interview in Relevant Magazine:

Strang: Based on emails we received, another issue of deep importance to our readers is a candidate’s stance on abortion. We largely know your platform, but there seems to be some real confusion about your position on third-trimester and partial-birth abortions. Can you clarify your stance for us?

Obama: I absolutely can, so please don’t believe the emails. I have repeatedly said that I think it’s entirely appropriate for states to restrict or even prohibit late-term abortions as long as there is a strict, well-defined exception for the health of the mother.

Now we have to stop and define “late-term abortion.” What is “late-term”? During their long fight against intact D&E abortions, the Fetus People conflated intact D&E with “late-term abortion,” even though D&E is mostly a second trimester procedure, which in my book is MID-term. In fact, to a lot of Fetus People and even normal people, “late-term abortion” is a synonym for what the Fetus People call “partial-birth abortion,” even though there are other procedures that can be used to terminate a second- or third-trimester pregnancy.

So our first source of confusion is, exactly what does Obama mean by “late-term abortion”? When I use the phrase I mean third-trimester abortion, regardless of the method used. Since the interviewer had just mentioned third-trimester abortion, I’m going to assume that’s what Obama meant by it.

If so, what Obama said basically confirms the Roe v. Wade decision. Roe v. Wade permits states to ban third-trimester abortions, as long as there’s a “life and health” exception made for the mother. As I wrote in a couple of posts last year (“Late-Term Confusion” and “More Late-Term Confusion“), most states have had such bans on the books for a long time, and NARAL has been OK with this, because it conforms to Roe v. Wade guidelines.

And I suppose I had better explain trimesters, because based on comments flying around the web today I’m the only bleeping woman on the planet who has ever been pregnant and knows what trimesters are. A pregnancy is nine months long, right? Stages of pregnancy are divided into three three-month periods. Months 1-3 are the first trimester, months 4-6 are the second trimester, and months 7-9 are the third trimester. There are medical and physiological reasons these three stages are distinctive; they are not just arbitrary divisions the Supreme Court thought up. I will get into more of these distinctions later.

Now, I don’t think that “mental distress” qualifies as the health of the mother. I think it has to be a serious physical issue that arises in pregnancy, where there are real, significant problems to the mother carrying that child to term. Otherwise, as long as there is such a medical exception in place, I think we can prohibit late-term abortions.

This is a departure from Roe v. Wade, because Roe v. Wade allows for a mental health exception as well as a physical health exception in third-trimester abortions. The question in my mind is whether a third-trimester abortion might be helpful for a woman experiencing emotional or psychiatric stress. My thoughts:

There are many reasons third-trimester abortions are different from first- and second-trimester abortions. One big difference is that once the pregnancy has entered the third trimester there’s a likelihood the fetus will be viable, meaning it can survive outside the womb. Most of the time if a third-trimester pregnancy has to be terminated because of the mother’s health, every effort will be made to save the baby. It is unusual, although not unheard of, for the baby to have to be sacrificed to save the mother.

On the other hand, until very late in the second trimester there is zero possibility a fetus will survive outside the womb. From about the last week of the second trimester until about the end of the seventh month — well into the third trimester — survivability is iffy, but possible. After that the odds the baby will survive improve considerably. So are we straight on this point?

The problem with terminating a third-trimester pregnancy because the mother is emotionally or psychologically stressed is that you’re probably going to end up with a live infant, but one with more medical problems than it would have had if the pregnancy had gone full term. And this could cause the woman more stress in the long run. This is not sensible.

Regarding “mental distress” — as someone with intimate experience with severe postpartum depression, I appreciate mental distress as well as anyone. But by the third trimester it’s too late to avoid the physiological effects of pregnancy and childbirth, and if we’re talking about a purely psychiatric condition I suspect, medically, it would be extremely unusual for termination of pregnancy to be necessary or even helpful.

On the other hand, if it is discovered that the fetus has an anomaly that is “incompatible with life,” as the med journal articles put it — meaning there is no way the fetus will survive more than a few hours after birth — and the mother wants to terminate rather than live with the heartbreak, I say let her terminate. That’s a point that needs to be clarified.

Also, please note: In the case of elective abortion — meaning, IMO, a woman aborts because she doesn’t want to go through with the pregnancy — by the time you hit the beginning of the third trimester, you’re too late. You are as pregnant as anyone ever was. You’ve probably put on most of your pregnancy weight. You’ve gone through all the physiological and hormonal changes. Your innie is now an outie. And abortion at that point is a big bleeping deal medical procedure every bit as difficult as childbirth itself.

I’m explaining this because remarkable numbers of people don’t seem to understand why defending a right to elective abortion in the third trimester is insane. No woman in her right mind willingly carries a pregnancy that far and then decides to abort. Doctors won’t perform such abortions, anyway. Even Roe v. Wade permits states to ban third-trimester elective abortions.

And NARAL, please note, is fine with states banning third-trimester abortions as long as the “life and health” exception provided by Roe v. Wade is included in the ban. Again, most states have had such bans on the books for a long time.

However, I believed back in the 1970s that NARAL made a big mistake by not supporting some clear legal gestational limits for elective abortion based on the Roe v. Wade guidelines. Without such clear limits, the Fetus People have been able to market many urban legends about women in their ninth month of pregnancy suddenly deciding to “kill their babies” and terminate a healthy pregnancy. Most states eventually adopted gestational limits, but people are so confused about what’s legal and what isn’t that the urban legends seem credible.

Well, back to Obama —

The other email rumor that’s been floating around is that somehow I’m unwilling to see doctors offer life-saving care to children who were born as a result of an induced abortion. That’s just false. There was a bill that came up in Illinois that was called the “Born Alive” bill that purported to require life-saving treatment to such infants. And I did vote against that bill. The reason was that there was already a law in place in Illinois that said that you always have to supply life-saving treatment to any infant under any circumstances, and this bill actually was designed to overturn Roe v. Wade, so I didn’t think it was going to pass constitutional muster.

The various “born-alive” bills are based on the common Fetus People fantasy that infants aborted in the second trimester might live if only they had some medical care. They won’t, until possibly the very last week of the second trimester. Until then, any infant born by any means, gentle or otherwise, will die.

Ever since that time, emails have been sent out suggesting that, somehow, I would be in favor of letting an infant die in a hospital because of this particular vote. That’s not a fair characterization, and that’s not an honest characterization. It defies common sense to think that a hospital wouldn’t provide life-saving treatment to an infant that was alive and had a chance of survival.

Of course it defies common sense, and I very much doubt it ever happens, law or no law.

So that’s what Obama said, and according to RedState Obama is “rejecting at least some of the extremism of NARAL, Emily’s List, and other radical abortion organizations.” The only place where Obama and NARAL actually may part company is on the issue of mental distress, and in that case I might lean in Obama’s direction myself, as I said.

And for the record, I support elective abortion for any reason until about 20 weeks’ gestation, and all data for years have shown us that nearly all elective abortions in the U.S. are performed by about 15 weeks’ gestation.

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48 Comments

46 Comments

  1. Jill  •  Jul 4, 2008 @10:58 pm

    I appreciate the depth with which you parse the very complex concepts involved in the idea of partial-birth abortion. And I won’t judge specifically what you’ve concluded. But I would urge you to take a look at and, if you have an interest in it, listen to a Diane Rehm show from April 2007. I wrote about it here and here’s the pertinent part:

    I’ve just finished listening to this very disturbing hour on Diane Rehm.

    About midway through the edition, the anti-abortion advocate from the Family Research Council (the group that anointed Ken Blackwell as a senior fellow), Cathy Cleaver Ruse, completely, totally and unbelievingly…devalued and discounted the role of a woman’s mental health status when choosing to have a legal medical procedure.

    What did she say:

    Ruse was seeking to make her point that partial birth procedures are never medically necessary to save the life of the mother and that they are performed on healthy women.

    To make this point, Ruse referred to health statistics from the state of Kansas (which you can see here, and I have reviewed), the only state that has kept stats on partial-birth procedures. Then, she indicated that in 1999, 182 partial birth procedures were reported to have been performed in Kansas. Then, she emphasized that in all those instances, according to the report, physicians indicated that the major bodily function that would have been impaired if the procedure was not performed would be mental, not physical.

    So – to Ruse, mental health needs are not needs at all, and certainly not health needs.

    My concerns are multiple but the first thing that hit me about the consequences of Obama’s statement is the enormous possible setback of getting parity for mental health on so, many, levels. My background is in law and social work and years at a children and family mental health agency. I live in Ohio which JUST passed a mental health parity law after nearly two decades of trying.

    The repercussions go beyond partial-birth abortion but a total slippery slope. I look forward to reading your thoughts.

  2. maha  •  Jul 4, 2008 @11:46 pm

    Jill — I appreciate what you’re saying. It’s not a simple issue.

    First, let’s be clear we’re talking about third trimester abortions only.

    Second, let’s be clear that we’re not talking about the so-called “partial birth” procedure, which is a whole ‘nother issue. “Partial birth” (intact D&E) is mostly a second trimester procedure. It is extremely misleading to conflate it with “late-term” abortion. Late term abortions can be performed several different ways, most of which do not resemble intact D&E. So please don’t use the term “partial birth” here.

    Third, let’s be clear that pregnancy terminations in the third trimester will nearly always result in a live baby, unless there is something physically wrong with the fetus or the pregnancy. Physicians are not going to kill a healthy, viable infant, in spite of the overheated fantasies of the Fetus People. But if the infant has not gone full term he/she might have physical problems he would not have had otherwise. Once the infant is viable, then the infant’s health and well-being IS a consideration.

    Fourth, let’s be clear that terminating a third-trimester pregnancy is a whopping big medical procedure as challenging as full-term childbirth.

    Fifth, let’s be clear that once we’re in the third trimester, full term childbirth is not that far in the future.

    Sixth, would a third-trimester pregnancy termination really relieve a woman’s mental distress, or make it worse? Who’s to know?

    Maybe a psychiatrist would have a different view. I don’t have a problem with having the mental health exception on the books, but I wonder how often it actually applies to real-world situations, if ever?

    My impression is that offering to compromise on the mental health exception (if that’s what Obama was doing; it’s not clear) is a symbolic gesture that would have no effect on the real world, but makes Obama seem less radical to the electorate. Or something.

    There have been some attempts by Democratic legislators going back to the late 1980s to pass a gestational limit that would ban third trimester abortions with only a physical health of the mother exception. The thinking behind this is that it would take the fire out of a lot of Fetus People propaganda. It never goes anywhere because right-wingers kill it. They want the propaganda more than the ban.

  3. Bananaphone  •  Jul 5, 2008 @2:39 am

    Great post, it brings up a lot of good thoughts to consider. As I recall from my own abortion experiences (though it’s been many years, and science may have progressed enough for these rules to change), mid-term abortions are the norm because clinics don’t perform abortions prior to 15 weeks or so. It has something to do with the fetus being too small at that point, so it raises the risks of health complications due to missed tissues. I know they diagnosed my pregnancy fairly early but scheduled the procedure for week 13-15 (can’t remember exactly) to prevent health risks.

    You bring up excellent points about why all the fears about third trimester abortions are nothing but hot air. Thanks so much!

  4. maha  •  Jul 5, 2008 @5:53 am

    Bananaphone — Alan Guttmacher says that these days 62.5 percent of abortions in the U.S. are performed in the first 9 weeks of pregnancy, and 9 out of 10 are performed in the first 12 weeks of pregnancy. The procedures are all different now.

  5. Jill  •  Jul 5, 2008 @8:40 am

    Maha -

    Thanks for taking the time to write more about the “Defining abortion terms’ part of your post, and point. I can’t argue with them at all because one, I definitely don’t have the facility with this topic that you seem to, second, it reads reasonably and three, it isn’t really what provoked me re: what Obama is quoted as saying.

    As you can guess from my comment, it’s the “explaining Obama” part of your post’s title that intrigues me, and that your comment doesn’t address as much. I think you try to here,

    Maybe a psychiatrist would have a different view. I don’t have a problem with having the mental health exception on the books, but I wonder how often it actually applies to real-world situations, if ever?

    My impression is that offering to compromise on the mental health exception (if that’s what Obama was doing; it’s not clear) is a symbolic gesture that would have no effect on the real world, but makes Obama seem less radical to the electorate. Or something.

    There have been some attempts by Democratic legislators going back to the late 1980s to pass a gestational limit that would ban third trimester abortions with only a physical health of the mother exception. The thinking behind this is that it would take the fire out of a lot of Fetus People propaganda. It never goes anywhere because right-wingers kill it. They want the propaganda more than the ban.

    But the fact remains, Obama and his campaign really need to explain, themselves, what he was thinking and is thinking. We can’t judge whether the quote shows a lack of sophistication in understanding mental health or if he was deliberately using the language he used (and he’s usually pretty deliberate, from what I can tell).

    And, again, the implications elsewhere for downgrading mental health in this scenario could be grave, if Obama does not clarify his meaning here.

    I come at this from the perspective of someone who has followed and wanted mental health parity at different levels for almost three decades. Red flags go up – and they can be brought down.

    But the explanation of the abortion terms alone, isn’t making it go down yet.

  6. maha  •  Jul 5, 2008 @9:28 am

    Jill — I agree I’d like to have a better understanding of what he means by “mental distress.” We’re all just guessing here.

    But I’d also like to know what real-world circumstances would call for a third-trimester abortion strictly for psychiatric reasons. And, I say again, if this were strictly for psychiatric reasons, it wouldn’t be an “abortion.” It would be “delivering the baby early.” Do you understand that?

    If the mother were severely psychotic, maybe, but you’re still talking about “delivering the baby early.” That probably would not be covered by an abortion ban, since it would result in a live birth.

    If you want to check to find out if it is EVER necessary to sacrifice a normal, viable (third trimester) fetus because of the mother’s psychiatric illness, let me know. I’d be interested.

    If there is no real-world circumstance that calls for sacrificing a normal, viable fetus because the mother has a psychiatric illness, then exactly what is the point of defending a mental health exception where third trimester abortions are banned? As I said, I’m in sympathy with permitting abortion if the fetus is so compromised it’s not going to live anyway, but that’s a different situation.

    Believe me, as someone with near-lifelong clinical depression, I am way in sympathy with mental health parity. But I’m also in sympathy with reproductive rights.

    You’re thinking in absolutist terms, which I sort of understand, but your absolutist stance could be getting in the way of coming to some kind of resolution on the abortion issue, which is an equally worthy cause.

  7. felicity  •  Jul 5, 2008 @9:48 am

    I have had direct experience with pregnant, relatively young single women ostrasized by their families and on the doorstep of the homeless shelter I ran because they had nowhere else to go. If they told me they were pregnant, they’d more than likely get an abortion as soon as possible. If they told me they were going to have a baby, they never would get an abortion.

    Therefore, I find it difficult to believe that a woman, due to ‘mental stress’ would suddenly in her third-trimester decide to abort which speaks to your question of how often do demands for third-trimester abortions actually come up in the real world.

  8. Jill  •  Jul 5, 2008 @10:00 am

    I’m not quite sure what you mean by absolutist – I’m pretty uninvolved in reproductive rights in general, probably too uninvolved, to be honest! I’ve not said or written anything, ever I think! – on where I draw the line and so on.

    I’m many, many more times focused on and get my ears up when I hear phrases like “mental distress” bandied about in any context. This time with Obama it was in this context of abortion, but it could have been related to the treatment of veterans or the ADA or the death penalty. It was his reference to the concept of “mental distress”, not the fact that it was in the context of reproductive rights, that caught my attention.

    Again, I refer you to that Diane Rehm piece and also, if you aren’t familiar with Charmaine Yoest, I would urge you to review some of the ways in which this issue and Obama get used. Yoest was a Huckabee senior advisor and is the VP for communications at the Family Research Council.

    These are reasons why concepts and/or phrases about mental health are loaded and have to used with incredible care.

    My question continues to revolve around what he means, what he intends and a recognition of what allowing for a hierarchy between mental and physical health in one setting could end up being used in order to apply or imply a hierarchy in other settings.

    Thanks.

    I want to add that the role of defining – legally and colloquially – what we mean when we use different phrase related to mental health – comes up in pretty much every single sector of life, and gets legislated or dealth with in court cases on a daily basis and in relation to everything that touches our lives. These are the reasons why this is an issue for me far far more than the implications for a procedure that apparently accounts for a miniscule and almost statistically insignificant number of abortions overall.

  9. maha  •  Jul 5, 2008 @11:29 am

    I’m not quite sure what you mean by absolutist

    I mean that your stand on mental health parity seems absolutist to me. If you are arguing in favor of a symbolic right for which there is no actual need, to the possible detriment of other kinds of rights, that’s pretty absolutist.

    These are reasons why concepts and/or phrases about mental health are loaded and have to used with incredible care.

    I agree completely. Most peoples’ ideas about mental health are still stuck in the Middle Ages.

  10. Jill  •  Jul 5, 2008 @11:39 am

    I don’t consider myself an absolutist in that way, no. There are absolutely times when mental health and physical health deserve different treatment, but the questions of who makes that distinction and defines and applies that distinction are very important. Again, I’d like to hear from Obama himself re: what was he in fact thinking (not in that snarky “what was he THINKING” way) so that we can understand how he embraces mental health both on the macro and micro-level. Again – my concern and focus is on that, far more than the abortion aspect.

    Thanks again.

    Oh last thing – here in Ohio, moving past the Middle Ages has included just last year passing legislation that removed the terms idiot, lunatic and one other I forget at the moment from our laws and I believe they’re working to get them out of the Ohio Constitution too. So – again, I just want to see some care when these ideas get discussed by the candidates. That’s all.

  11. LongHairedWeirdo  •  Jul 5, 2008 @1:51 pm

    Before I start, let me say I’m not about to pile on Obama for what he said, but I do have the little twitch to my arm that says “if he was my bud, I’d smack him upside the head” (do I have to add “playfully, the way pals do” to avoid Secret Service issues? If so, consider it added). Then, once I had his attention, I’d explain why it bugs me.

    But on to your points. First: I don’t think there’s a “life and health” exception. I think there’s a “health” exception. Dying has a deleterious effect on one’s health.

    The reason I think this matters is that a lot of anti-abortion folks are perfectly willing to allow an abortion that “saves the life” of the mother… not one that, say, protects her future fertility, or that merely sharply reduces the risk she will die, but if it’s clear that without an abortion, she will die, they’ll be okay with that.

    Second, I don’t like splitting hairs on “mental distress”. If a doctor is willing to assert that an abortion is necessary to protect a woman’s health, I honestly don’t care if it’s “only” her mental health. I’d rather go with what the doctor says. If the doctor thinks it’s important enough to certify that the abortion is necessary for a woman’s health, I’d rather go with that, than have a law in place that might create fuzzy areas in which women end up not getting proper medical treatment.

    This is the only thing that bugs me about what Obama said. It creates an opening and you know that the anti-abortion folks will try to use it as heavily as possible.

  12. Raphael  •  Jul 5, 2008 @3:01 pm

    I don’t have much to add that hasn’t already been said by someone else, but this surprised me:

    “could be getting in the way of coming to some kind of resolution on the abortion issue,”

    Do you really think that there’ll ever be one?

  13. Al  •  Jul 5, 2008 @3:36 pm

    I think you are missing the point. Obama is backtracking for his politital survival on this issue as he has on so many others. Who is he or any other politician to decide what health risks are acceptable for a woman to endure before the government will grant her autonomy over her body?

    More Obama backtracking. More Obamacans rationalizing how clever it is for him to trade off progressive values for a victory in November. I guess when Obama says Change We Can Believe in he means “change” as in “loose change”, the kind you find in the pocket of an old pair of pants you haven’t worn in years …because that’s about how much his kind of change is worth.

    And PS … When Obama says, “I don’t think that mental distress qualifies as the health of the mother” … there’s no reading between the lines … it is what it is.

  14. A Canadian Reader  •  Jul 5, 2008 @4:21 pm

    An interesting, thoughtful post. Thank you.

    I don’t know whether you’re aware of the fact that Dr. Henry Morgenthaler–a pioneer who put his medical career and freedom on the line to provide women in Canada with safe abortions when abortion was still illegal–just received the Order of Canada. Needless to say, his appointment to the Order was extremely controversial, though I think that this too will blow over. I met Dr. Morgenthaler once at a party and, like many women before me, shook his hand warmly and thanked him from the bottom of my heart.

    The whole issue of mental health and abortion is not something that I can personally speak to, but I recommend you read the recent week-long series of articles on mental health and mental health care in the Globe and Mail. As a society, we still don’t accept mental illnesses as being truly worthy of our care and concern. Add abortion to the mix and watch everything explode.

    Anyway, those were just a few personal reflexions on an extremely difficult issue. I am 100% in favour of a woman’s right to choose, yet I know that the decision to have an abortion is not one that is taken lightly. It is a necessary, though sad, decision that women must sometimes make. I know. I’ve been there and done that. Once in a while, I muse about the child who was not born and rejoice in the joy I get from my two beautiful children. The abortion was a sad event in my life, but it does not define me.

  15. A Canadian Reader  •  Jul 5, 2008 @4:29 pm

    I just looked up Dr. M. on the Wikipedia. In the article, his name is spelled Morgentaler. No “h”.

  16. maha  •  Jul 5, 2008 @5:54 pm

    I think you are missing the point. Obama is backtracking for his politital survival on this issue as he has on so many others. Who is he or any other politician to decide what health risks are acceptable for a woman to endure before the government will grant her autonomy over her body?

    As I thoroughly explained in the post above that you didn’t bother to read all the way through before you commented, we’re talking about third trimester abortions exclusively. Roe v. Wade permits states to ban elective third trimester abortions, and most have done so. So the “full autonomy” thing really isn’t an issue here.

    Now, I don’t think the government should have any say in what health risks a woman must endure to qualify for the “life and health” exception. I think this should be at the physicians’ discretions.

    But as I also thoroughly explained in the post above that you didn’t bother to read all the way through before you commented, I question whether a psychiatric exception is needed at all in the third trimester. I’m not going to re-explain this for your benefit; I am not your monkey. If you want to understand what the post is about, I suggest you actually read it. Thanks much.

  17. maha  •  Jul 5, 2008 @5:57 pm

    First: I don’t think there’s a “life and health” exception. I think there’s a “health” exception. Dying has a deleterious effect on one’s health.

    “Life and health” is the standard phrase. It refers to exceptions to an abortion ban when the mother’s life or health are at risk.

    The reason I think this matters is that a lot of anti-abortion folks are perfectly willing to allow an abortion that “saves the life” of the mother… not one that, say, protects her future fertility, or that merely sharply reduces the risk she will die, but if it’s clear that without an abortion, she will die, they’ll be okay with that.

    If Obama had suggested compromising the physical health protections of Roe v. Wade, I’d have had a fit about it. But he didn’t. He clearly said that a physical health exception should remain in place.

  18. Jill  •  Jul 6, 2008 @10:13 am

    Maha – Jan Crawford Greenburg at ABC’s Legalities blog has a clarification from Obama. I wrote about it here and here’s her post.

  19. Wm Livingston  •  Jul 6, 2008 @2:15 pm

    Can’t help but wonder how many, if any, of those posting here debasing the value of life are parents? How many are young males seeking to justify avoiding the responsibilities of parenthood and marriage?

  20. Betty Cracker  •  Jul 6, 2008 @4:54 pm

    Once the infant is viable, then the infant’s health and well-being IS a consideration.

    There’s the rub. I happen to agree with you. But not everyone does. Some normally sensible feminist bloggers I generally agree with are discussing this very issue and insisting (absurdly, in my opinion) that to place any restrictions whatsoever on abortion at any stage of a pregnancy is tantamount to infantilizing women and overthrowing reproductive freedom. More fodder for the Fetus People.

  21. debcoop  •  Jul 6, 2008 @5:44 pm

    Roe allows for the regulation of abortions…not the banning of abortions…in the third trimester and long as the mother’s life and health are observed. Health has always meant mental health. That even precedes Roe…in NY when it repepaled its abortion laws…the health regulations governing it included mental health.

    So you are making a personal disagreement based on your definition of your own personal case.

    And since he said late term….that amorphous term, when the right wakes up to what agift he just made them, they will start using that to attack the basis of abortion in the other 2 trimesters in which there are no, NO, conditions imposed on a women’s right to make that decision for her…..financial, personal, familial, health, fetal abnormalities etc, etc. Doe v Bolton, the sister decision to Roe, decided on the same day….

    In Doe v Bolton, the Court said a doctor could decide to perform an abortion based on “all factors—physical, emotional, psychological, familial, and the woman’s age—relevant to the well-being of the patient. All these factors may relate to health.”

    What could easily happen here is that instead saying the decision, whatever it is and on whatever basis it is made, is between the woman and her conscience, we are retreating to a standard that is a laundry list which says if your reason isn’t one of these acceptable reasons then you have to right to make that decison about your life, your body.

    You are at least correct when you say this statement by him violates Roe. What a thing to say. A Democratic candidate who makes a statement that subverts Roe.

  22. debcoop  •  Jul 6, 2008 @6:43 pm

    I need to make it clear that your analysis is based on what you think he referred to…third trimesters….not the actual words he used “late term” However he did use the phrase “late term”. It may have been sloppy on his part, but using that phrase instead of third trimester, which you are right has a legal meaning in terms of Roe, he has potentially opened a big can of worms.

    You may say it was sloppy, careless, he didn’t mean it…..but it’s a dangerous phrase which could undermine Roe even further….as I said above.

    I will disagree with your defense of why there is no need for a mental distress standard in the 3rd trimester. There are all sorts of things that happen in the world.that we cannot foresee…that is why we have general rules and not specific rules on matters like this. for instance…from a 10 year who is so skinny and ignorant of her own body that she may not know she is pregnant to women at the other end of the reproductive lives who may also have anomalous pregnancies, ones where they may not know they are pregnant (happened to me….fetus died in utero though unbeknownst to me for a very long time) These women and girls may still need an abortion. They may not have pressing physical health needs. They may have fetuses with anomalies…you may think that’s a good reason…I do…but that doesn’t meet the narrowing standard our presumptive nomineee seems to be creating all on his own.

  23. LongHairedWeirdo  •  Jul 6, 2008 @8:39 pm

    “Life and health” is the standard phrase. It refers to exceptions to an abortion ban when the mother’s life or health are at risk.

    Okay, but (datapointing) I honestly don’t remember ever having heard it before now. I’ve heard of “health” and I’ve heard of “life”, but I’ve never heard them paired.

  24. maha  •  Jul 6, 2008 @10:04 pm

    debcoop — you are mistaken here –

    Roe allows for the regulation of abortions…not the banning of abortions…in the third trimester and long as the mother’s life and health are observed.

    This is incorrect. Reo allows for some regulation in the SECOND trimester, but in the THIRD, (and this is a direct quote from Roe v. Wade)

    For the stage subsequent to viability the State, in promoting its interest in the potentiality of human life, may, if it chooses, regulate, and even proscribe, abortion except where necessary, in appropriate medical judgment, for the preservation of the life or health of the mother.

    PROSCRIBE — proscribe \proh-SKRYB\, transitive verb:
    1. To denounce, condemn, or forbid as harmful; to prohibit.
    2. To put outside the protection of the law; to outlaw.
    3. To publish the name of (a person) as condemned to death with his property forfeited to the state.

    It’s called a “ban” in some places.

    Also, I want to return to a point nobody seems to get — you do realize, I hope, that if a pregnancy must be terminated in the third trimester and the fetus is healthy, then what the doctors will do is deliver the baby early, which is not an abortion in my book. From 24 to 27 weeks’ gestation it has some chance of survival, and after 28 weeks’ gestation is has a very good chance of survival.

    Chill. Also get your facts straight next time.

  25. maha  •  Jul 6, 2008 @10:06 pm

    Can’t help but wonder how many, if any, of those posting here debasing the value of life are parents? How many are young males seeking to justify avoiding the responsibilities of parenthood and marriage?

    Since I don’t see anyone debasing the value of life, I would say zero.

  26. Micheline  •  Jul 6, 2008 @10:32 pm

    Maha,

    The following is Obama’s clarification:

    According to Linda Douglass, the Obama campaign’s senior spokesperson, the senator from Illinois was making a distinction in the magazine interview between medically diagnosed mental illness and the kind of mental distress that an unwanted pregnancy causes many a pregnant mother.

  27. maha  •  Jul 6, 2008 @10:51 pm

    Micheline — thanks. I had read that, but I’ve been too busy today to write a follow up.

    I see that plenty of people are still having fits over Obama’s alleged sellout of abortion rights, however. Why can’t people sit down and think things through before they throw their tantrums?

  28. debcoop  •  Jul 7, 2008 @3:18 am

    Maha

    I did not talk about 3rd trimester healthy babies. You did. However I did talk about fetal anomalies and I did talk about the second trimester.

    Further my point.was that..his sloppy language could have an impact on abortion prior to 3rd trimester. You answered an issue I didn’t bring up, not the one I did.

    Viability was not in the second trimester when Roe was written, it was 28 weeks, firmly in third trimester. Which is why I said what I did. Now some have argued that the viability standard must prevail over the trimester divisions, I don’t agree with that. Theoretically, though not in a practical sense in the medical world, viability can keep getting pushed back even into the first trimester.

    From Dr.George Tiller’s website….I will link..he’s the doctor who does the vast majority of third trimester terminations in the country.

    He cites the kinds and percentages of fetal abnormalities of fetuses he has aborted. Central nervous system…like anencephaly, genetic, etc. He cites the average gestational age at abortion 27 weeks. He cites the tissue samples from autopsies performed on these fetuses. It seems those fetuses were not delivered, they were aborted.

    I don’t think women who decide to get third trimester abortions are willing or want to actually deliver a live child nor does Dr. Tiller.

    http://www.drtiller.com/fasum.html

    Mental distress it seems fits exactly what one would feel if the child has severe fetal abnormalities…Indeed the the mental health exception is the one which covers almost all fetal abnormalities …so Linda Douglas’s clarification only makes the transgression against Roe even more compelling.

  29. maha  •  Jul 7, 2008 @5:48 am

    debcoop:

    I did not talk about 3rd trimester healthy babies. You did. However I did talk about fetal anomalies and I did talk about the second trimester.

    debcoop, in comment 21 above, you said (emphasis added):

    Roe allows for the regulation of abortions…not the banning of abortions…in the third trimester and long as the mother’s life and health are observed.

    And I said you were wrong, which you were.

    And may I add that I hate to try to reason with people who can’t be intellectually honest.

    Viability was not in the second trimester when Roe was written, it was 28 weeks, firmly in third trimester.

    Not true. I have an obstetric textbook published in the late 1960s (it belonged to my mother, who was an obstetric nurse for many years) that puts earliest viability at 24 weeks. It had been 24 weeks some time before that. So in 1973, it was 24 weeks.

    And lo, it says in Roe v. Wade itself,

    Viability is usually placed at about seven months (28 weeks) but may occur earlier, even at 24 weeks.

    You might want to read the Roe v. Wade decision sometime so you know what’s actually in it.

    Then you said,

    I don’t think women who decide to get third trimester abortions are willing or want to actually deliver a live child nor does Dr. Tiller.

    We’re talking apples and oranges. If you could calm down enough to read what I’m writing, instead of hysterically projecting something else onto what I’m writing, maybe we could communicate. Do try.

    I agree that when the fetus is so compromised it’s not going to live anyway, the woman should be allowed to terminate the pregnancy. I said this in the post. I also said this is a point that needs to be clarified. Roe v. Wade doesn’t clarify this, either.

    However, I was not talking about a circumstance in which the fetus is compromised. I was focused only on the words “mental distress.” Read again what I wrote in comment #24 (emphasis added):

    Also, I want to return to a point nobody seems to get — you do realize, I hope, that if a pregnancy must be terminated in the third trimester and the fetus is healthy, then what the doctors will do is deliver the baby early, which is not an abortion in my book.

    I’m saying that if the pregnancy has to be terminated because the woman is in extreme psychological distress, and if a fetus is healthy and viable and can be delivered, all efforts will be made to save it. This is reality. The circumstance in which the fetus is compromised is something else entirely.

    Frankly, given Linda Douglas’s clarification, I don’t see a “transgression” against Roe at all. And since you clearly don’t know what Roe v. Wade actually says, I can’t imagine how you would judge whether it had been transgressed or not. I do see some points that need to be spelled out more clearly, but as I said, Roe doesn’t spell them out, either.

  30. Jill  •  Jul 7, 2008 @7:14 am

    Maha – you post does a great job helping people understand the context as it relates to abortion. Why spoil it by suggesting that anyone who is objecting to what Obama has said is someone who hasn’t thought things through and is throwing a tantrum?

    Just to be sure, I read that as saying that you don’t see any other way to look at what he’s said and you don’t recognize that others see it differently. That’s really unfortunate, because I’ve raised the issue as it relates to the perception and reality of how mental health is treated in the law and society on a broad base and you’ve really spent no time on that, at all.

    Why? If it’s because you think it’s not going to happen, fine. If it’s because you think I’m being disingenuous, just say so.

    I’ve written you personally and I’ve made it very clear as to why the defining of mental health in every context, EVERY context, is so important to me.

    Your comments here about people just not thinking things through or else they’d get it is really kind of insulting, let alone not true for everyone.

  31. maha  •  Jul 7, 2008 @7:36 am

    Jill — I’m sorry, but the kind of overwrought hand-wringing displayed by debcoop is part of an old and tiresome pattern that threatens to help elect John McCain. Circular firing squads, eating our own, that sort of thing.

    There is cause for discussion and disagreement here, but too many people are going out of their way to find reasons to tear down Obama. Like it or not, he’s the nominee. There’s a distinction between reasonable discussion and clarification and picking a candidate apart to destroy him, and debcoop clearly seems bent on the latter.

    I’ve written you personally and I’ve made it very clear as to why the defining of mental health in every context, EVERY context, is so important to me.

    That’s fine, and I respect that. But do you want to make progress, or just talk about it? We need a progressive majority in government. Electing Obama (and a Democratic majority in Congress in 2008) by itself won’t accomplish that, but it’s a start. Electing McCain would be a huge setback.

    So yes, let’s discuss, but let’s do it in a reasoned and constructive manner.

    Also, I apologize for not answering your email. I’m swamped. I don’t actually have time to respond to comments, either. It’s only 7:30 am and I’ve already spent more time on this blog than I intended to today. I may have to shut down comments just so I can focus on my other work.

    Update: One more thing — one of the biggest reasons progressivism died in the 1970s is that progressives put too much work into single-issue advocacy (see archives for discussion). This has set up a situation in which many worthy causes simply compete with each other for funds and attention. Meanwhile the Right put together a coalition in which advocates of various causes compromised on their own issues in order to elect GOP candidates. That’s why they ran roughshod over the Dems since the 1980s.

    So while I respect your passion for your cause, I also suggest stepping back and looking at the bigger picture — the totality of progressive causes, which are interrelated, but which don’t always agree on fine points.

  32. Jill  •  Jul 7, 2008 @9:57 am

    Maha- thanks for taking the time to respond. As the parent of three school-aged children who traverses the same six roads 15 times a day, even after carpooling for the sake of gas etc., I know what busy looks like. No response was expected but just a broader acknowledgement of the difference views out here.

    You infer that I’m a single issue voter but you have no basis for that except that I’ve commented for the first time on your blog in this thread. You can choose to look for yourself should you want, and I don’t feel that I need to defend myself, and of course people are allowed to be one-issue voters if they want to be, but I’m none of those things. This is the issue at the moment that is one of a few I’m trying to address (Esmin Green being another, Rene Marie and her singing of the Black National Anthem is another, Google giving access to Viacom of all YouTube records is another, gun control another and on and on).

    I actually feel that it is me who sees the bigger picture here because I’m urging that Obama’s campaign think before it speaks when it starts using one very controversial area of health care and law (as it relates to so many areas of functioning in daily life) – mental health, with another – abortion and reproductive rights.

    But I recognize that you are saying, seeing the bigger picture re: the White House race. Again – other than this being my first time commenting here, I’m not sure why you would think I don’t see the bigger picture.

    I’ve written countless times now that I won’t be voting for McCain and I won’t not vote. But I will never stop pushing for the Dem. party candidate to do or be what I hope and wish for.

    And in this case, it’s more thoughtful and thorough. Obama did not speak specifically, he conflated ideas and caused this confusion. He has shown that he knows how to parse an idea and set the tone for the discussion (patriotism and race being two very clear examples). He needs to take the same care with everything – why shouldn’t I expect that? In fact, because he is the nominee, I should expect it even more so, IMO.

    I’ve never threatened any illogical behavior nor have I or would I encourage others to do such stuff.

    Frankly, it’s destructive to judge others for how far they can go or not go in criticizing. I’m not pulling punches either (and I understand the distinction you’re trying to make re: tearing Obama down). And as a voter and a citizen – and a patriot – to be expected to do that is, IMO, unpatriotic.

  33. maha  •  Jul 7, 2008 @10:31 am

    Jill — Um, you do realize my post #29 was not addressed to you, right? You seem rather hypersensitive about something that doesn’t concern you.

    This blog just went past its sixth anniversary (July 3), and for ten years before that I was debating political issues on various forums and even, God help us, USENET. In the early years I tried reasoning with everyone, but after a while you figure out who can be reasoned with and who can’t.

    I tend to respond to people with whatever they display. I am reasonable with reasonable people, but throw a snit at me and I’ll slam you right back.

    So, no lectures from amateurs about how to run my blog, thanks.

  34. Jill  •  Jul 7, 2008 @10:50 am

    Why you are being rude, only you can say – maybe it’s how busy you are. I certainly know how that can be.

    I’m not sure why it matters whether a comment comes from someone you deem to be an “amateur” at what I’m not sure – versus someone you deem to not be an “amateur” or what the threshold is. But having been on CNN, BBC, the local NPR’s regional reporter roundtable numerous times, with a law degree and a social work degree, a three-year old blog, several writing awards, published op-eds, features and essays in national papers and speaking on panels such as the keynote for the American Association for Political Consultants, I sure hope you’re not talking about me.

    If you want to check on that, you can go here.

    Wow. Please tell me you got up on the wrong side of the bed. This is the Internet and the blogosphere – where is your entitlement coming from and why? Whew.

    Talk about needing to chill.

  35. maha  •  Jul 7, 2008 @11:18 am

    Goodbye, Jill. We’re done talking now.

  36. no  •  Jul 7, 2008 @5:48 pm

    You wrote:

    The various “born-alive” bills are based on the common Fetus People fantasy that infants aborted in the second trimester might live if only they had some medical care.
    ——————————-
    Actually, the point is that any living thing should be entitled to the comfort that comes from medical care, even if only for a few minutes.

  37. maha  •  Jul 7, 2008 @5:53 pm

    Actually, the point is that any living thing should be entitled to the comfort that comes from medical care, even if only for a few minutes.

    How often does a 2nd trimester fetus survive even a few minutes? Even so, I agree with palliative care, but I believe most “born alive” bills call for more aggressive care.

  38. tomjones  •  Jul 7, 2008 @11:02 pm

    Maha, I am impressed by your nearly boundless patience, and your willingness to call BS when you see it. I’m only newly coming at my opposition to third-trimester (although I would prefer this were more exactly pin-pointed as “post viability,” though I imagine this varies from woman to woman) abortions. It is non-controversial to me that an exception for the life and health of the mother be permitted in the third trimester. Your well-reasoned discussion of the thornier issues of “mental distress” or “mental health” have given me a lot to chew over. If you ever do discern to what extent third-trimester abortions are performed for the mental health of a woman, please see fit to update this post or author a new one. Thanks!

  39. Joyful Alternative  •  Jul 8, 2008 @1:53 am

    You are so amazingly patient, Maha! You are inspiring.

    And I also appreciate your post, probably because that’s exactly how I interpret the topic. In the third trimester, interests other than the woman’s become important.

  40. Dan S.  •  Jul 10, 2008 @8:28 am

    However, I believed back in the 1970s that NARAL made a big mistake by not supporting some clear legal gestational limits for elective abortion based on the Roe v. Wade guidelines. Without such clear limits, the Fetus People have been able to market many urban legends about women in their ninth month of pregnancy suddenly deciding to “kill their babies” and terminate a healthy pregnancy. Most states eventually adopted gestational limits, but people are so confused about what’s legal and what isn’t that the urban legends seem credible.

    I have to wonder about this, though – that is, how much of a constraint legal reality really is upon urban legends? At the margins, surely, but beyond that, I don’t know. Think of all the people who are convinced that Obama is Muslim (and has a radical pastor . . .). I’m also thinking of this post about how high-(political)-info conservatives are less likely to correctly identify the fact of growing economic inequality, compared not just to liberals, but even to low-info conservatives. (Liberals show the opposite relationship – what’s really striking, though, is that low-info conservatives are also more likely to recognize growing inequality than low-info liberals.).

    But regardless, clarity is generally a good thing.

  41. Dan S.  •  Jul 10, 2008 @8:33 am

    ah, that should be “thinking of this post about how . . .”

  42. maha  •  Jul 10, 2008 @8:54 am

    Dan — IMO if NARAL had endorsed a clear gestational limit for elective abortion soon after Roe v. Wade, I think it would have made a big difference.

    You don’t even have to reach the “low information” voters; if just most journalists had gotten it into their heads that elective abortion after X months is illegal, coverage of abortion issues would have been drastically different in the years that followed.

    Instead, journalists have been extremely compliant in accepting the Fetus People view of things, such as using “late-term abortion” as a synonym for “intact D&E” — what the Fetus People call “partial-birth abortion” — when in fact intact D&E is nearly always a second-trimester procedure, and there are other, entirely different ways late-term pregnancies can be terminated.

  43. David  •  Jul 12, 2008 @12:57 am

    Fetus People? And you all would be what then? Dead fetus people?

  44. maha  •  Jul 12, 2008 @7:55 am

    Fetus People? And you all would be what then? Dead fetus people?

    Since I’ve given birth twice, I call myself a “mother.”

    I call anti-reproduction rights activists “Fetus People” because their brains are undeveloped, and because it’s a nuisance to call them “anti-reproduction rights activists.” I refuse to call them “pro life” because they aren’t. FYI, my daughter calls the Fetus People “Dead Fetus People” after she saw some of them with a dead pickled fetus in a jar.

  45. Steve  •  Aug 8, 2008 @1:18 pm

    Perhaps “one of the reasons we as a nation cannot sensibly discuss the abortion issue” is that folks resort to name calling, such as terming people who disagree with them as “Fetus People” as opposed to “normal people” (“normal–you know, like me”) and then defned their use thereof with logic like “I call anti- reproduction rights activists ‘Fetus People’ because their brains are undeveloped”.

  46. maha  •  Aug 8, 2008 @2:02 pm

    Steve — dumb enough to respond to a post that scrolled off the front page weeks ago, I see. Well, no matter. There is nothing to discuss. If you are opposed to abortion, don’t have one.

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