Senator Lindsey Graham of South Carolina surprised us all on Tuesday by proposing a federal ban on abortions after 15 weeks of pregnancy with almost no exceptions. The pro-choice side was understandably outraged, while Republicans recoiled at having a federal ban back in the spotlight after their efforts to avoid the issue before the midterm elections.
Graham’s pitch was likely just a political ploy aimed at shifting the conversation away from where it had been focused since Roe fell: on miscarriages, ectopic pregnancies and rape, leaving Republicans playing defense. He knows his bill isn’t likely to come to a vote. And the absence of exceptions for the health of pregnant women make it a non-starter with the majority of Americans.
But the clamor over Graham’s bill also creates an opportunity for abortion-rights supporters to make a proposal of their own, one that expands access to first-trimester abortions so that fewer women ever reach the stage of needing an abortion after 15 weeks.
Many people are uncomfortable with the idea of second-trimester abortion even as they remain wary of limiting women’s health options. Only 36% of Americans think abortion in the second three months of pregnancy should be legal in most circumstances, which is why Republicans have often had success campaigning against it, even though it is a rare occurrence. Some 93% of abortions happen at or before 15 weeks, and less than 2% happen after 18 weeks. A pro-choice proposal could start by suggesting legislation that would make first-trimester abortions much easier to obtain across the country.
Most women who have second-trimester abortions would have preferred to end their pregnancies earlier, but had a difficult time saving money for the procedure or the travel needed to obtain it. Around two-thirds of Americans believe first-trimester abortion should be legal.
Women seeking later abortions tend to be younger and poorer; more likely to be victims of domestic abuse or single mothers; and live further away from an abortion provider. Telling their stories might make more Americans realize that if first-trimester abortion become more accessible, second-trimester abortion will become that much rarer, while women in difficult circumstances will get the health care they need.
No amount of improving first-trimester abortion access can cover every medical eventuality, and some level of second-trimester abortion will always be necessary. One in 13 women don’t discover they are pregnant until the end of their first trimester. Late discovery is especially likely when the pregnancy occurred despite the use of birth control — about half of women seeking abortions used birth control the month they got pregnant, and 1 in 10 women on the pill get pregnant every year. And there will always be women who face heartbreaking medical complications that either didn’t exist earlier in the pregnancy or couldn’t be diagnosed without prenatal screening tests (which generally take place between 12 weeks and 20 weeks).
But many of the 7% of abortions that happen after 15 weeks could be avoided if medication abortion (which is only meant to be used in the first 12 weeks) were cheaper and easier to obtain. Offering universal coverage for first-trimester abortion, making abortion services far more widely available and getting rid of patronizing mandatory waiting periods also would reduce the incidence of second-trimester abortion.
And most importantly, making first-trimester abortions easier to get would mean there are fewer women in the grim position of saving for an abortion and trying to find a provider while feeling more pregnant with each passing week.
Republicans have spent so much time talking about things like “partial-birth abortions” (a political coinage, not a medical term) because later abortions are politically unpopular. Advocates for reproductive rights should keep the focus on the people who need abortions, and how the best way to help them is to make early termination easier to get.
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This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.
Sarah Green Carmichael is a Bloomberg Opinion editor. Previously, she was managing editor of ideas and commentary at Barron’s and an executive editor at Harvard Business Review, where she hosted “HBR IdeaCast.”
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