“Under the bill’s actual text, virtually any claim of impairment would suffice to meet the act’s requirements,” wrote National Review’s David French. “Anxiety? Depression? The conventional physical challenges of postpartum recovery? Any of those things could justify taking the life of a fully formed, completely viable, living infant.”

French appears to be worried that women will seek, and doctors will perform, late-term abortions for trivial reasons. But there’s contempt for women embedded in the idea that, absent legal prohibition, someone on the verge of giving birth might instead terminate her pregnancy to avoid the brutalities of labor.

“No matter what the law were, in real life, these things don’t happen,” said Frances Kissling, president of the Center for Health, Ethics and Social Policy and the former head of Catholics for a Free Choice. “I am not saying that there would not be one woman out of 20 million who decided at the 33rd week of pregnancy that she needed an abortion, and I would suggest that she probably does have mental health problems. However, this woman is not going to find anyone who will do this.”

Kissling is well known in the pro-choice movement for thinking deeply about the ethical gray areas surrounding abortion. As she points out, there are only about a dozen doctors in the country who perform third-trimester abortions at all, and she’s spoken to several of them, asking specific questions about patients they’ve turned down. “What I have learned is that all of them have limits and have declined to do abortions in certain circumstances for certain reasons,” she said. (The murderous abortionist Kermit Gosnell, serving a life sentence in prison, is an exception, but he was operating outside the law.)

A person who is ambivalent about abortion might wonder why, if the situations put forward by Gilbert and French are so unthinkable, pro-choice people would object to laws making them illegal. But the law is a blunt instrument for making judgments about extreme and unusual contingencies.

Having extra doctors sign off on each late abortion safeguards against (mythical) cavalier terminations, but it means that women in anguished, urgent situations need to jump through extra hoops. Abortion opponents treat mental health exemptions as easily exploited loopholes, but one instance in which they’re invoked is when a woman learns that her fetus has little chance of surviving outside the womb, and can’t face the prospect of going through labor only to watch her baby die.