recently Trump said something about how they execute babies after birth based on certain abortion laws and I've seen social media blow up with discussions about that so I wanted to try to shed a little bit more light than heat when we're talking about so-called afterbirth abortion there are at least three distinctions that we need to be making first of all there's a distinction between ending a pregnancy when there is an adverse prenatal diagnosis versus when there's not so in some cases parents find out that there's some sort of adverse prenatal diagnosis and they decide to have an early induction of Labor usually per viability or maybe just post viability with the anticipation and the hope of a live birth so that they can say goodbye to their child sometimes when people use the word abortion that's what they're describing other times a woman will seek a later abortion per viability or post viability when there is no adverse prenatal diagnosis when there's nothing particularly threatening to her health either there's no medical emergency involved why would she do that well she might do that because she had some sort of major change in life circumstances that wasn't related to medical conditions or because she struggled for a variety of reasons to decide whether or not she wanted to abort up until that point or she wanted to get an abortion sooner but she didn't have the time and money and other resources to do it or she just didn't know she was pregnant sooner either way in cases where a woman is seeking an abortion per viability or post viability and there is no adverse prenatal diagnosis they will induce fetal demise before they induce labor and usually this is by injecting a fetocide into the child's heart or maybe their brain or the amniotic fluid less often but sometimes they transect the umbilical cord and they wait for the child to bleed out but in any case in these situations it would be very very rare to have a live birth for this kind of abortion because they induce fetal demise precisely to avoid that still there are thousands of abortions at 21 weeks or later in the United States every year and so sometimes mistakes can happen and if a child is born Alive by mistake during one of these procedures you can understand how some people might be concerned conned about the conflations and the perverse incentives of the people in the room who were just aiming at that child's death and are now responsible for making decisions about whether life-saving interventions are appropriate for essentially a very premature baby so that's the first thing is the difference between abortion for adverse prenatal diagnosis versus abortion when there is no medical emergency involved now the second distinction is realizing that when you have adverse prenatal diagnosis there are a variety of severities to them people say fatal fetal anomaly but what we mean by fatal can be really very able so there are some conditions where the child was very unlikely to survive to birth in the first place and even less likely to survive long after but there are other conditions where survivability is going to vary a lot depending on how much the medical team chooses to intervene so for example even with triem 13 and tricy 18 there is some research to show that if the medical team is willing to do interventions for example for heart defects or other problems that they would give to children without trimes no big shock really the survivability goes up a lot there can also be be problems with the accuracy of prenatal testing there can be inaccurate estimations of gational age there can be inaccurate prenatal diagnosis in the first place false positive rates things like that and all of this can mean that sometimes you could induce labor and then birth a child that's a little bit more compatible with life than they originally thought so in these gray area cases how are people making decisions between offering Comfort Care only versus life-saving interventions to try to help the baby survive and finally there are distinctions between actively killing a child Trump used the word execute versus withholding potentially life-saving interventions from a child now I would love to tell you that actively killing babies literally never happens and I do think it's exceedingly exceedingly rare but you need look no further than reading the grand jury report of the Kermit goell case and by the way don't do it unless you're ready it's really really horrible to see that there are some cases where so-called abortion providers and their staff struggle to make major ethical distinctions between on the one hand injecting poison Into the Heart of a late stage fetus and on the other hand taking that minutes later now born baby and snipping their spinal cord regardless I think most of the discussions about so-called afterbirth abortion are really fears about abortion providers having perverse incentives to exaggerate the degree of incompatibility with life and withhold life-saving interventions from children that were born Alive by mistake after a failed abortion procedure so are there a whole bunch of sociopathic providers executing otherwise healthy infants born premature Alive by mistake after early induction of Labor no but are these failed abortion cases limited to only intended live birth for children with fatal fetal anomalies so their parents can say goodbye also no