Who — Trump or Hillary — was confused or dishonest about abortion at the last debate?

I'm reading "Fact-Checking the Debate Fact-Checkers on Abortion" by Ramesh Ponnuru at The National Review.

Many news outlets accused Trump of misrepresenting Clinton’s position by bringing up the possibility of killing “the baby on the ninth month on the final day.” This does not happen, said the fact-checkers. But go back and read the transcript: What Trump said (in two iterations) was that “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.” That is the logic of her position on late-term abortion, which is that an abortionist should be free to perform an abortion at any stage of pregnancy if there is a health reason for it, including a reason of emotional health. Some journalists were touting this criticism of Trump’s comments and defense of Clinton’s position, which ends up saying that abortions at the very end of pregnancy never happen but should still be legal because of the principle of the thing. Trump grasps that logic and says he objects to it. “Now you can say that that’s okay and Hillary can say that that’s okay, but it’s not okay with me.” You can agree with Trump or you can agree with Clinton, but you can’t truthfully say that there’s no difference between their stated positions.

The link at "this criticism" goes to a blog post by Dr. Jen Gunter, "Donald Trump confuses birth with abortion and no, there are no ninth month abortions." I'm reading that now. She quotes Trump's "I think it’s terrible 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." Her first objection is is: "we don’t rip anything in OB/GYN." They use sharp instruments and make neat cuts.

Perhaps we can forgive Donald Trump for not knowing this as it is hard to believe that a man who bragged that he doesn’t change diapers and said he wouldn’t have had a baby if his wife had wanted him to actually physically participate in its care would have attended the birth of his own children. It’s certainly not for the faint of heart as there is, after all, lots of blood coming out the “wherever.”

That's amusingly written — if you're in the mood to be amused on this subject — but it's willfully ignoring Trump's motivation to use inflammatory rhetoric. He's not purporting to accurately describe a medical procedure but to dramatize the perspective of the baby who is getting killed. To be fair, it probably feels better to get killed with sharp instruments than to be ripped apart. And yet "partial-birth" abortion is illegal under federal law and the Supreme Court upheld that ban precisely because there is another method of late-term abortion, and that method — if I may believe Justice Kennedy's opinion in Gonzales v. Carhart — does involve ripping:

The doctor grips a fetal part with the forceps and pulls it back through the cervix and vagina, continuing to pull even after meeting resistance from the cervix. The friction causes the fetus to tear apart. For example, a leg might be ripped off the fetus as it is pulled through the cervix and out of the woman. The process of evacuating the fetus piece by piece continues until it has been completely removed....

That grabbing and ripping is the the method that remained legal after the "partial-birth" abortion ban. (Gunter eventually describes this procedure: "The fetus is essentially taken apart with a D and E to fit through the dilated cervix." But, she says, this is not "ripping," but "simply surgical technique.")

Gunter says:

Trump’s statement, as incorrect as it may be, supports the fallacy of the due-date abortion. 

Supports the fallacy. In other words, he didn't say doctors were agreeing to perform abortions as late as the due date, but he caused people to picture this nonexistent event. His words, as Ponnuru observes, are about Hillary's philosophical principles: Hillary sees no role for the law to do anything in the hypothetical situation. Hillary, for her part, doesn't defend herself by saying we don't need laws about things that are not happening in the real world. She rests on the belief in the woman's autonomy. (As I would put it: The woman has sovereignty over the interior of her own body and the only legitimate law is her law.)

Back to Dr. Gunter:

Talking about abortion from a medical perspective is challenging when you are not a health care provider. Even someone familiar with the laws can get confused. For example, Mrs. Clinton made an error speaking about late-term abortion when she said it was a health of the mother issue. Typically it is not (it’s almost always fetal anomalies).... I don’t know where Mrs. Clinton got this “bad news at the end” of the pregnancy being about maternal health.... [N]o one is performing health of the mother abortions at 38 or 39 weeks we just do deliveries. It’s called obstetrics.

Was Clinton confused? It might be a political choice not to talk about destroying a defective child.

Gunter proceeds to school us in birth defects, which, she says, are the reason for 80% of abortions that take place after 21 weeks. The defects, she says, "could range from Down syndrome to anomalies incompatible with life." Gunter shifts quickly to abortions that take place after 24 weeks, considered the point of viability, after which the woman no longer has a constitutional right to have an abortion for any reason. She writes:

After 24 weeks birth defects that lead to abortion are very severe and typically considered incompatible with life. 

Typically. What's hidden behind that word? Are we still destroying children with disabilities that do not mean that they'll die before birth or soon after? After 24 weeks, Gunter tells us, the doctor can either induce labor (after killing the fetus with an injection so that the "partial-birth" approach to removing the fetus won't violate the federal law) or use the ripping (it's not ripping!) method described above (which is called "dilation and extraction").

I’ve never heard of a dilation and extraction for any other reason than severe birth defects and often it is for a woman who has had two or three c-sections for whom inducing labor might pose other health hazards, like uterine rupture. Are we to force women to have c-sections for a pregnancy that is not compatible with life?

A good question. I've had 2 c-sections myself, and the second one was recommended because, after the first one, there was a danger of uterine rupture. But what I don't understand here is why wouldn't waiting for a natural birth be the alternative to a c-section? It is natural birth, not abortion, that is parallel to a c-section, since it is intended to keep the baby alive. Gunter doesn't even seem to notice the ethical question why would we accept the deliberate destruction of the fetus at this point? Is it euthanasia (because the fetus is suffering)? Is it for the mental peace of the woman once she knows that this pregnancy is not going to result in a healthy baby? Does it matter whether the disability is fatal? Remember Gunter wrote of birth defects that are "typically considered incompatible with life." So some but not all of these babies would, if not actively killed, go on to die a natural death.

Gunter tells us that some women "might think they can make it to term and then at 34 weeks cave and ask to be delivered because they just can’t bear one more person asking them about their baby":

Do they just smile and walk away or say, “Well, actually, my baby has no brain and will die at birth?” Some women go to term and others can’t. To judge these women for requesting an early delivery is cruel on so many levels. I wrote more about it here if you are interested.  Regardless, terminations for birth defects isn’t ripping “the baby out of the womb in the ninth month.” At 38 or 39 weeks it’s always an induction and is simply called a delivery.

Notice the language glitch: It's "isn't ripping" because it's "called a delivery." Of course, the official terminology avoids the ugly word "ripping." But calling it "delivery" aligns with calling it "partial-birth," which is what horrified people more than the dilation and extraction method and produced the federal law that the Supreme Court upheld in Carhart. Gunter has talked about both methods, above, but she switched to speaking only of the delivery method (with isn't illegal when the body is already dead because of the injection). But Gunter has shifted to talking about abortions after 38 or 39 weeks and now she's telling us there is no longer a choice between the 2 methods. So in that sense, there is no "ripping."

But Trump's use of "ripping" wasn't technical. It was dramatic rhetoric expressing how horrible it is to deliberately kill a human being who is this far along in development. Dr. Gunter is interested in presenting medical practitioners as expert and ethical, but she's not very attuned to the way clinical terminology can sound heartless or deceptive. I'm not convinced by her effort to skewer Trump on his use of the word "rip." Her better argument has to do with how unlikely it is that any baby is killed on the last day of a full term pregnancy, but Ponnuru deals with that argument well: Trump is testing Clinton's principle. Nevertheless, Trump is making people think about the reality, not merely a hypothetical. He's distracting us if he's alarming us about things that aren't happening. I'd like to see the candidates concentrate on the matters that genuinely will occupy their attention if they get into office.

Clinton was also confused or dishonest, as Gunter explains. I suspect that she doesn't want to delve into the ethical questions surrounding the disabled, especially if we're talking about anomalies that begin with Down syndrome.



I suspect that Hillary Clinton feels most comfortable and most politically effective talking about the feelings of women and seeming to empathize with their struggles, referenced abstractly, before scrambling to the high ground of individual autonomy.