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Tuesday, April 16, 2024

What a Reported Trump Plan on Restricting Abortion Would Mean

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A nationwide ban on abortions after 16 weeks of pregnancy — which Donald J. Trump is considering backing, according to a New York Times report — would prevent very few abortions in the United States.

Mr. Trump, the front-runner to be the Republican presidential nominee, has not publicly spoken about the proposal. It would most likely keep in place more restrictive bans in the nearly half of states that have them, but would be a change for states where abortion remains largely unrestricted.

Such a law, which would require congressional action, would affect only a small minority of women seeking abortions. Before Roe v. Wade was overturned in 2022, just 4 percent of legal abortions happened at 16 weeks or later, according to Centers for Disease Control and Prevention data from 41 states in 2021, the most recent available. Those women tend to have medically complicated pregnancies.

By supporting such a ban, Mr. Trump may be trying to thread a needle: He could claim credit among conservatives for imposing more abortion restrictions, as he has done for installing three Supreme Court justices who helped overturn Roe. But he could also try to appease more moderate Americans who are wary of stricter abortion bans. The relatively small number of abortions that would be prevented, and the unpopularity of further abortion restrictions as reflected in polling, suggest that it may be a difficult balancing act to pull off.

A national 16-week limit would be more politically popular among Americans than complete abortion bans, but still not broadly popular. Around 40 percent of voters have said they are comfortable with abortion restrictions at around that time in a woman’s pregnancy, though public opinion on such matters is complicated.

It is also later than Mississippi’s previous 15-week ban — the law at issue in the Supreme Court’s Dobbs decision that ended the constitutional right to abortion.

The few people who get abortions at this stage of pregnancy are likely to face serious health risks, said Dr. Maria Isabel Rodriguez, director of the Center for Reproductive Health Equity at Oregon Health and Science University.

“The people seeking abortions at 16 weeks, while it’s a small number of women, are the people at greatest risk for maternal mortality and morbidity,” she said.

Many of the most serious pregnancy complications happen late in pregnancy, and many fetal abnormalities, including those to the fetus’s brain, spinal cord or heart, cannot be detected until later than 16 weeks. They are often not found until 20 weeks of pregnancy, when doctors perform a major anatomy scan. Recent lawsuits have highlighted the experiences of women who learned of major medical conditions after 16 weeks of pregnancy, such as ruptured membranes or a fetus developing without a skull.

Some women without medical problems also get abortions late in pregnancy because they learned they were pregnant late or struggled to get to an abortion provider sooner. Even in states where abortion remains legal, not all clinics provide abortions after the first trimester. Dr. Rodriguez said she believes more women in states with bans have been obtaining abortions later in pregnancy since Dobbs, because they needed to arrange out-of-state travel.

There have been no major studies measuring the share of abortions occurring after any gestational cutoff since Dobbs. Twenty states already restrict abortion before 16 weeks — most of those ban it entirely, and two, Arizona and Florida, ban it after 15 weeks.

For Mr. Trump, a 16-week abortion ban might represent his best option on a politically treacherous issue. Supporting such a policy would make him more moderate on the issue than many Republicans, and could allow him to argue that other conservatives have gone too far. But it would also allow him to maintain some fidelity to anti-abortion voters who have supported him.

“We strongly agree with President Trump on protecting babies from abortion violence at 16 weeks,” said Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life America, a group that has long supported more extensive abortion restrictions.

But while a 16-week ban might seem like a middle-ground position to some voters, it’s not a popular political one. Even some voters who say they oppose second-trimester abortions have little interest in a nationwide ban. A New York Times/Siena College poll in July found that voters opposed a federal 15-week ban, 53 percent to 38 percent, despite longstanding polling showing a majority of Americans oppose abortions after the first trimester.

In another Times/Siena poll, a generic Republican candidate who backed a national ban on abortions after 15 weeks of pregnancy held a one-point lead over a Democratic opponent. But a higher share of voters said they’d prefer a Republican who left abortion policy up to the states, the legal status quo.

In some ways, a 16-week ban would make U.S. law more similar to that of peer countries. Only about a dozen countries allow abortion without any restrictions after 16 weeks; under Roe, the United States was part of a small group that did so until roughly 23 weeks. The most common cutoff worldwide is 12 weeks. But many of those countries also have robust policies to allow exceptions.

“Nearly all of them allow abortion on broad grounds beyond 16 weeks, such as risk to the person’s mental health and in some cases due to the social and economic impact of the pregnancy,” said Katy Mayall, director of strategic initiatives at the Center for Reproductive Rights, which studies abortion laws around the world and fights U.S. abortion restrictions in courts.

The proposal Mr. Trump is said to be considering would have much narrower exceptions than European laws, allowing later abortions only in cases of rape, incest or threats to the woman’s life.

The recent experience in states with similar abortion bans suggests those exceptions would be used infrequently. Because American abortion laws tend to impose significant criminal penalties on medical providers, doctors have been reluctant to provide abortions in ambiguous cases, even when there are serious threats to women’s health.

Nate Cohn contributed reporting.

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