Abortion is a popular issue” has been a common refrain in the airwaves as pundits and politicians recount the winners and losers of the midterm elections. Abortion was certainly a motivating factor for voters, who backed ballot measures protecting abortion access in five very politically different states.

One referendum in particular, Montana’s, is a critical bellwether for just how supportive of abortion access the nation is becoming. Fifty-three percent of Montanans voted no, which is particularly notable in a state where 57 percent of voters supported President Donald Trump’s reelection.

But what was too often missed amid the political commentary about the efforts to protect abortion access was the way Montana’s failed referendum was worded: Anti-abortion lawmakers intentionally used biased, medically inaccurate, inflammatory language to confuse and outrage voters. The ballot measure claimed to create protections for “infants born alive during abortion,” legislating an imagined situation to demonize and further criminalize abortion providers by threatening a felony charge punishable with a 20-year jail sentence and $50,000 fine. The danger for abortion providers lies not only in the threat of jail time but also within the violent language that went unchallenged in the public conversation.

The overblown myths weaponized by anti-abortion groups are never-ending. But failing to address anti-abortion myths allows them to persist into perpetuity. This specific propaganda effort is particularly tricky; the bill text uses uninformed technical medical language aimed at portraying abortions later in pregnancy and palliative postnatal care as gruesome and dehumanizing. It was yet another reincarnation of a successful anti-abortion campaign during the abortion bans of the Bush years. In 2002, as the nation’s policing and national security surveillance tightened, President George W. Bush signed the so-called Born Alive Infants Protection Act to confuse the public into believing that abortion is infanticide and limit the autonomy of all abortion patients and providers. It changed the way some of the public understands later abortion.

True, later abortion has always been the most controversial aspect of abortion care. But as anti-abortion lawmakers have pushed access out of reach in many states, abortion patients have had to travel even farther to seek care. In recent years, and particularly now post-Dobbs, such travel has only increased costs and logistical hurdles while contributing to widespread delays in care and thus increased rates of later abortions.

Even with broad acceptance of abortion legalization, we can’t seem to shake off this misinformation campaign. It persists today, as recently as 2016, when a Republican-led Congress demanded an inquiry and report by the Centers for Disease Control and Prevention (CDC) on the topic. In at least six states, anti-abortion legislators called for medically unnecessary mandatory reporting by abortion providers of cases where a living fetus was delivered—conjuring the assumption that this is a common occurrence. Anti-abortion advocates in several states pounced on pro-choice legislators who tried to explain the medical rarity of these situations and how a provider might respond to offer the best care possible. Anti-abortion advocates conflated abortion with infanticide time and time again, including then-President Trump himself.

Like the disproportionate focus on all later abortion procedures, anti-abortion advocates are magnifying an incredibly specific, yet visceral, aspect of abortion care in an effort to sow abortion stigma towards all procedures. According to the CDC, there have been 147 such cases between 2003 and 2014. Putting that into context, these cases comprise 0.0003 percent of all live births, 0.001 percent of all abortions, and 0.05 percent of all infant deaths during this period.

According to the CDC data, 97 of the 143 documented cases involved a complication or one or more congenital anomalies experienced by the pregnant person. In these cases, it appears that labor was induced either because the pregnant person was having a medical complication, such as severe preeclampsia or placental bleeding, or because of a severe fetal malformation. Importantly, when this happens, it is known that the fetus cannot survive long after birth, either because of the gestational age of the fetus or because of the severity of the congenital anomaly, and comfort care is typically provided until the infant dies.

More than just perpetuating stigma, “born alive” proposals harm providers and patients. Given that the majority of these cases took place during a pregnancy that was likely very much wanted but could not continue safely, such legislation can make a painful situation worse. Once a provider determines that a patient is pregnant with a fetus with a condition that is believed to be incompatible with life, the patient has three options: abortion, palliative care, or full neonatal resuscitation and treatment. If measures like Montana’s succeed, providers could be legally bound to attempt full neonatal resuscitation, regardless of the patient’s wishes and despite any evidence against its long-term success. In other words, rather than protecting fetuses, these proposals could make it harder for providers to do their jobs and for patients to make choices for themselves and their families during an already difficult time.

While exceptionally rare, these cases provide vivid anecdotes for anti-abortion advocates, and are one piece of a broader misinformation campaign aimed to confuse and scare the public and ultimately foster public approval for banning abortion. Now post-Dobbs, it’s more critical than ever to tackle abortion myths and misinformation to lessen their rhetorical power—and particularly to defang the “ick factor” of abortion that antis use to rally support. Otherwise, the public remains confused and misinformed, while stigma and myths continue to hog the spotlight.