David Brooks gets everything wrong about abortion after 20 weeks

David Brooks gets everything wrong about abortion after 20 weeks

››› ››› JULIE TULBERT

After The New York Times published an op-ed by columnist David Brooks claiming Democrats need to support a 20-week abortion ban to remain electorally competitive, several media outlets and pro-choice groups wrote responses that called out Brooks’ inaccurate assumptions. These responses not only highlighted how 20-week bans are based on junk science, but also underscored how the reality of later abortions makes support for abortion access a winning issue for Democrats.


Sarah Wasko / Media Matters

NY Times published an op-ed claiming that Democrats should support 20-week abortions bans

NY Times’ David Brooks: Democrats “need to acknowledge … vulnerability” created by opposing 20-week abortion bans. On February 1, columnist David Brooks wrote an op-ed for The New York Times that was formatted as a memo to “Democratic Party Leaders” from an “Imaginary Democratic Consultant.” Following a failed January 29 Senate vote on a bill that would have banned abortions after 20 weeks of pregnancy, Brooks’ imaginary consultant wondered, “How much is our position on late-term (sic) abortions hurting us?” Brooks claimed that although Democratic donors “want to preserve a woman’s right to choose through all nine months of her pregnancy,” voters would not support such a position. He continued that donors' insistence on supporting abortion rights may come at the expense of electing a Democratic candidate for president, a “chance at congressional majorities” and other “agendas on poverty, immigration, income equality and racial justice.” In considering a world where the Supreme Court overturned Roe v. Wade, Brooks wrote, “There’s a good chance that a lot of states would hammer out the sort of compromise the European nations have — legal in the first months, difficult after that. That’s what most Americans support.” Brooks asserted, still in character as an ill-advised Democratic strategist, “We need to acknowledge our vulnerability here.” [The New York Times, 2/1/18; Rewire, 1/30/18]

Here's how media and pro-choice organizations responded

1. 20-week bans are based on anti-abortion talking points, not science

ThinkProgress: Brooks’ column relied on talking points from the anti-abortion movement. On February 2, ThinkProgress’ Addy Baird wrote that in Brook’s “memo,” he was “taking a cue from an insidious and highly effective talking point in the anti-abortion community” which alleges that “Democrats are taking an extreme stance by opposing” bans on abortion after 20 weeks. Brooks’ rhetoric also leveraged abortion opponents’ “long history of playing on American’s emotions to build support for restricting abortion,” such as when they “characteriz[e] abortion providers as butchers ripping babies limb from limb out of the womb” or “refer to later-term abortion as ‘partial birth abortions’ and ‘dismemberment abortions,’ which aren’t medical terms at all. They’re misleading emotional ploys.” Baird noted:

Brooks writes as if he were an “Imaginary Democratic Consultant.” Taking a cue from an insidious and highly effective talking point in the anti-abortion community, he argues that 20-weeks bans are a moderate policy — and suggests Democrats are taking an extreme stance by opposing them.

[...]

The anti-choice community has a long history of playing on American’s emotions to build support for restricting abortion, characterizing abortion providers as butchers ripping babies limb from limb out of the womb. Anti-choice advocates often refer to later-term abortions as “partial birth abortions” and “dismemberment abortions,” which aren’t medical terms at all. They’re misleading emotional ploys.

[...]

In reality, as ThinkProgress reported in August, reproductive rights activists would be overjoyed if the Democratic Party gave abortion rights protections priority over all other issues combined, but many said they felt the party was instead throwing them under the bus.

Brooks is right about at least one thing: Abortions after 20 weeks are very rare, making up only about 1.5 percent of abortions performed in the United States, according to the Guttmacher Institute. What Brooks does not consider — not even once in his column — the cases in which someone might seek an abortion past this point in their pregnancy.

[...]

But, of course, Brooks didn’t actually want to offer advice to Democrats. He wanted to write a factually incorrect, misleading, dangerous anti-choice memo, and that’s what he did. And then The New York Times ran it unchecked. [ThinkProgress, 2/2/18]

New England Journal of Medicine: A fetus cannot perceive pain until around 30 weeks into a pregnancy. While the anti-abortion movement points to “evidence” that a 20-week ban is needed because fetuses feel pain at that point, science does not bear that out. According to The New England Journal of Medicine, “Study after study has determined that perception of pain is not physically possible until nearly 30 weeks of gestation, when thalamocortical pathways are present and have begun to function.” A 2010 report from the Royal College of Obstetricians and Gynaecologists stated, “Although the cortex can process sensory input from 24 weeks, it does not mean that the fetus is aware of pain. There is sound evidence for claiming the cortex is necessary for pain experience but this is not to say that it is sufficient.” According to the American Medical Association Journal of Ethics, “A comprehensive, nonpartisan, multidisciplinary review of almost 2,000 fetal pain studies concluded that ‘the capacity for functional pain perception in preterm neonates probably does not exist before 29 or 30 weeks.’” The American College of Obstetricians and Gynecologist also gave a similar timeline -- saying a fetus cannot feel pain until the third trimester. [The New England Journal of Medicine, 9/1/16; Royal College of Obstetricians and Gynaecologist, March 2010; American Medical Association Journal of Ethics, October 2014; LiveScience, 5/17/16]

20-week bans are based on politics, not science. In 2013, Dr. Anne Davis, an abortion provider and consulting medical director at Physicians for Reproductive Health, told Salon that the push for 20-week bans caused patients to begin asking her about fetal pain, despite the overwhelming scientific evidence that the fetus does not feel pain at 20 weeks. Davis said, “It’s just another thing these women have to struggle with. And why? These are created concerns. They are not based in science, they are based in politics.” In a May 2016 article, The Daily Beast explained that even the researchers commonly cited by anti-abortion groups and politicians often reject such use of their findings. One doctor, according to The Daily Beast, “told The New York Times that his frequently-cited research ‘did not deal with pain specifically’” and was being misrepresented by anti-abortion advocates. [Salon, 8/7/13; The Daily Beast, 5/19/16]

2. The necessity of abortions after 20-weeks should be acknowledged

HuffPost: Research shows that abortions after 20 weeks “happen either for medical reasons” or due to barriers to accessing abortion. In a February 2 HuffPost article, Anna Almendrala noted, “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.” Almendrala continued that the “medical reasons” could be “several fetal abnormalities that only become apparent during the second trimester” and which “can be fatal,” as well as “certain maternal health conditions that either arise or become more serious once women enter the second trimester.” In addition, for those seeking abortions taking place after 20 weeks for “nonmedical reasons,” Almendrala cited a 2013 survey which “found that they generally experienced logistical delays after making the decision to end their pregnancies.” Delays included “raising money for travel, the procedure itself and other costs related to the termination,” factors which are exacerbated by medically unnecessary abortion restrictions that force patients to drive farther and take multiple trips to a clinic. Almendrala argued that these access problems “would only get worse” in Brooks’ imagined world where the Supreme Court overturns Roe v. Wade because it would mean those seeking abortion “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.” [HuffPost, 2/2/18]

HuffPost guest writer: “20 weeks was the exact point at which options became painfully necessary.” In response to Brooks’ column, HuffPost guest writer Sarah Orsborn wrote a February 3 op-ed about a personal experience that affirmed her belief that people should have access to abortion care after 20 weeks. When Orsborn and her husband “excitedly went in for our big mid-pregnancy ultrasound,” they found out that one of the twins she was carrying had a severe fetal abnormality. Orsborn said that “our baby’s diagnosis was manageable, and we decided to continue the pregnancy,” and noted that “abortion opponents like to use cases like mine to support their bans. After all, didn’t I decide to continue my pregnancy after the diagnosis?” However, Orsborn wrote, “I know that any number of factors could have made our choice a much different one,” which could include “a lack of access to providers, lack of insurance coverage, lack of funds for care or travel, or any other reason.” Further, Orsborn observed that the day of “the ultrasound between 18 and 22 weeks” is “the point that can turn a very much wanted pregnancy into heartbreak” and that for her and her husband, “20 weeks was the exact point at which options became painfully necessary.” As a result, Orsborn resolved to “fight for everyone to have access to the care they need to make the right choice for them.” Orsborn wrote:

On Dec. 16, 2011, my 27th birthday, my husband and I excitedly went in for our big mid-pregnancy ultrasound, happily expecting to find out if the twins I was carrying were boys or girls.

[...]

My jelly-covered belly began heaving with sobs that I tried to stifle as the maternal-fetal medicine expert arrived and attempted to get a better look at Baby B.

As she examined the baby’s “lemon-shaped” head and looked at her spine, she saw the unmistakable signs of myelomeningocele spina bifida, the most severe type of the neural tube defect.

[...]

The biggest thing I learned that day is that the ultrasound between 18 and 22 weeks of a pregnancy isn’t just the happy day when you get to find out if your baby is a boy or a girl. It’s also the point that can turn a very much wanted pregnancy into heartbreak. It’s the point where, peering at fuzzy images on a black-and-white screen, doctors can finally see the anatomical information that reveals something severely wrong with a baby. It’s the point where genetic counselors are brought in and “options” must be discussed.

[...]

For us ― and for many other sobbing women with jelly-covered bellies ― 20 weeks was the exact point at which options became painfully necessary.

[...]

In the end, our baby’s diagnosis was manageable, and we decided to continue the pregnancy.

[...]

I understand that abortion opponents like to use cases like mine to support their bans. After all, didn’t I decide to continue my pregnancy after the diagnosis?

[...]

I know that any number of factors could have made our choice a much different one, and I will fight for everyone to have access to the care they need to make the right choice for them.

[...]

I also feel nothing but love and compassion for anyone else making the choice to terminate after 20 weeks, whether because of a lack of access to providers, lack of insurance coverage, lack of funds for care or travel, or any other reason. Every pregnant person deserves access to a full range of care, not a cruel ban arbitrarily imposed by legislators who will never know what it feels like to be sitting on that table.[HuffPost, 2/3/18]

NARAL Pro-Choice America shared individual accounts of abortion after 20 weeks. In a February 2 post on Medium, NARAL Pro-Choice America highlighted the personal accounts of numerous people who had abortions after 20 weeks, noting that while “skipping over the human aspect of difficult policy issues” may have made it “easier” for Brooks “to write a fake political strategy memo,” his decision to do so “endangers the rights and the lives of the people who live these experiences every day in our country.” The accounts NARAL shared had all previously appeared in various media outlets. For example, in The Hill, Garin Marschall described a severe fetal abnormality that would have resulted in an inability for the fetus “to breathe outside the womb.” Kate Carson wrote for Elle magazine about her pregnancy in which she learned her “little daughter would likely never walk, talk, swallow, or support the weight of her head.” In Esquire, Nicole and Anton Schlesinger described the choice between having an abortion or bringing “a child into the world who would never have a normal life and would probably only live a few months.” As NARAL explained, people “who need this care need it for reasons that include highly complex medical problems that could result in serious, even life-threatening health risks for the woman, or the delivery of a baby unable to survive even hours outside the womb.” [Medium, 2/2/18; The Hill, 1/30/18; Elle magazine, 1/29/18; Esquire, 3/2/16]

OB-GYN in Slate: Brooks failed to understand how abortions after 20 weeks are “devastatingly personal.” OB-GYN Cheryl Axelrod wrote for Slate on February 5 about her own abortion after 20 weeks. Axelrod claimed that Brooks’ column demonstrated “a genuine lack of ability to differentiate between far-right buzzwords that are little more than reproductive dog whistles and the reality of women’s medical care.” The reality, Axelrod argued, is that “for millions like me, it is devastatingly personal. Maternal medical and fetal reasons for these procedures cut across all lines of economics, race, religion, and state. Reproduction does not play favorites.” Axelrod explained her own decision to have an abortion:

In 2009, faced with the alternative of my loved son Thomas horribly suffocating upon delivery, I chose to instead compassionately end the pregnancy. I assume, Mr. Brooks, that you have not witnessed the death of a child whose lungs aren’t developed. It is agonizing. If you had, you might realize that these procedures are intrauterine palliative care and should be viewed as such. [Slate, 2/5/18]

Later abortions are often medically necessary or are needed to address particular personal circumstances. Anti-choice politicians and right-wing media often vilify people who have later abortions and largely ignore the reality that people who seek these procedures do so for a variety of personal and medical reasons. As Media Matters has previously recounted, reading the personal accounts of people who have had later abortions can challenge this imposed stigma. In addition to the stigma inflicted on patients receiving later abortions, restrictions like 20-week bans can also have a disproportionate impact on low-income people. As the Guttmacher Institute explained, these patients may have to delay an abortion to later in pregnancy “because they had difficulty raising funds for the procedure and travel costs, or because they had difficulty securing insurance coverage.” As reported in Harper's Bazaar, "If we accept a law that bans abortion after 20 weeks, we're saying that abortions are okay for women who have the resources to get one immediately. We're saying they're not okay for other women, who might need more time to pay for them." In addition, 20-week bans magnify other restrictions on abortion access -- including waiting periods which can delay a procedure until after 20 weeks. [Media Matters, 10/25/16, 5/20/16; Guttmacher Institute, 9/15/15; Harper's Bazaar, 9/29/17]

3. Polling suggests that the Democratic party would face steep consequences for supporting 20-week abortion bans.

In PopSugar, Planned Parenthood EVP: Brooks needs to “get [his] facts straight” on “what Americans want and need from their government.” In a February 5 post on PopSugar, Planned Parenthood’s Executive Vice President Dawn Laguens highlighted several personal stories from people who had abortions after 20 weeks. She also urged Brooks to “get your facts straight about what Americans want and need from their government right now.” For example, Laguens explained that a survey done by Hart Research Associates found “60 percent of voters say that abortion after 20 weeks should be legal” and that “62 percent of Republican voters say this is not an issue on which their elected public servants should be spending their time.” Laguens also pointed to “the recent Democratic victories of pro-abortion rights candidates in Virginia and Alabama” and a poll by the public opinion research firm PerryUndem “about how Democratic and independent voters want representatives who support abortion rights.” [PopSugar, 2/5/18; Hart Research Associates, 8/28/13, PerryUndem, 1/11/18]

Polling on abortion should be nuanced and not rely on narrow categories. Right-wing media frequently push the idea that Americans largely support a 20-week abortion ban -- often relying on polling data as evidence of their claims. Although polling that presents abortion to respondents using static categories of legality (legal vs. not legal) tends to show that Americans support bans on abortions after 20 weeks, more recent research has found that there’s a drastic drop in support for 20-week bans when people realize that abortions in later stages of pregnancy are often undertaken out of medical necessity or in response to particular personal circumstances. For example, a Harvard T.H. Chan School of Public Health study on the Zika virus found that when asked in the abstract about later abortion, “less than a quarter of people (23%) believe women should have access to a legal abortion after 24 weeks.” However, that flipped when people were asked about access to a later abortion when a pregnant person had been infected with the Zika virus -- with results showing “a majority of Americans (59%) believe a woman should have access to a legal abortion after 24 weeks” in that situation. This was similarly found in the Hart Research Associate survey that was cited by Laguens in her PopSugar article. [Media Matters, 10/12/16, 10/19/16, 10/21/16, 10/2/17, 11/29/17, 1/26/18, 2/2/18; Harvard T.H. Chan School of Public Health, August 2016; Hart Research Associates, 8/28/13]

Abandoning support for abortions rights actually puts Democrats at odds with their voters. As Laguens alluded to, recent polling by PerryUndem has dispelled the inaccurate notion that Democrats must abandon support for abortion rights to appeal to voters. PerryUndem’s researchers looked at people who voted for Hillary Clinton or Donald Trump in the 2016 presidential election (as a proxy for identification as Democrat or Republican) and found that, “three quarters of Clinton voters (75%) say they are more likely to vote for a candidate who supports the right to abortion.” For Trump voters, only 35 percent “say they are more likely to vote for an anti-abortion candidate.” Overall, “Trump voters are four times more likely to vote for a candidate supportive of rights (27%) than Clinton voters are to vote for a candidate against rights (6%).” Tresa Undem, co-founder and partner at PerryUndem, told Vox, “By going after the 8 percent of Democrats who want a candidate who opposes abortion, the party risks losing the 71 percent of Democratic voters who want their candidates to support abortion rights.” Research in 2014 by Stanford and Northwestern University previously found that politicians tended to think their constituents were “far more conservative than they actually were” when in comes to abortion. Indeed, as Vice News reported, “On average, politicians underestimated support for abortion by about 10 percentage points.” [PerryUndem, 1/11/18; Vox, 1/22/18; Vice News, 1/23/18]

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