President Donald Trump is already starting to turn an extremely rare medical procedure into a key component of his re-election bid.
The president hopes to force Democrats to confront their support for so-called late-term abortions, which are relatively unpopular among voters, in a race that otherwise features Democratic policy proposals that Americans overwhelmingly support, such as increased access to health care and higher taxes on the wealthy.
Opponents of the practice, including Trump, call any termination of a pregnancy after about 21 weeks a "late-term abortion." That is a notably uncommon practice — accounting for just about 1 percent of abortions in 2015, according to the Centers for Disease Control and Prevention — and its legality varies from state to state.
Pollsters say that Democrats should try to avoid the topic of "late-term" abortions. While taxes on top earners and Medicare for all poll at well over 50 percent approval, just a tenth of Americans consistently support abortion in the third trimester (which starts at the 28th week of pregnancy).
But shunning the subject could be difficult as the president uses the high profile of his office to accuse his opponents of standing by as children are murdered. And, on top of the president's own efforts, a vast network of anti-abortion groups has pledged to come out in full force to mobilize their base in the lead-up to Election Day.
"The pro-life movement is energized," said Carol Tobias, president of the National Right to Life Committee, America's largest anti-abortion group. "We are going to be encouraging our volunteers, our people in every community, to make people aware that the end game [for Democrats] is abortion with no limits for nine months."
Trump in recent weeks started talking about abortion on Twitter for the first time since he was elected president, and mentioned the issue in his State of the Union address, something he had not done in either of his first two addresses to Congress.
"Democrats are becoming the Party of late term abortion, high taxes, Open Borders and Crime," the president wrote in a post on Twitter late last month.
Vice President Mike Pence accused Democrats in an article published the same day of a "shameless embrace of a culture of death."
During his State of the Union address Tuesday, Trump doubled down, using graphic language and calling on Congress to take up legislation barring late-term abortions.
"There could be no greater contrast to the beautiful image of a mother holding her infant child than the chilling displays our nation saw in recent days," Trump said on Tuesday.
Celinda Lake, a leading Democratic pollster, said it was surprising that the president addressed the issue in the major speech to Congress, calling it a "fake" issue.
She noted that polling on the issue depended on the specific question that was asked, and encouraged Democrats to focus on messaging that referenced the health of the mother, and a woman's right to make medical decisions in consultation with her doctor.
Nearly all abortions are performed within the first trimester, according to the Centers for Disease Control and Prevention. Abortions that are performed afterward are generally done if the fetus is not viable, or to protect the life of the parent.
"I think it shows how desperate he is to shore up the vote," Lake said. "It's not the kind of thing to put in a broad public debate."
Trump's presidential campaign did not respond to a request for comment.
But abortion opponents are cheering the president's decision to talk more about the issue, which they say will put Democrats on the defensive.
"I do expect this issue, this conversation to grow louder and louder with the 2020 election," said Steven Aden, the chief legal officer and general counsel of Americans United for Life, a national anti-abortion group.
Democrats vying for their party's nomination for president, he said, will have to defend abortions that take place in the later weeks of a pregnancy.
"It is an albatross around their neck," he said.
Sens. Kamala Harris and Cory Booker did not respond to a request for comment for this article.
Sen. Kirsten Gillibrand said in a statement that there is "zero place for politicians to be involved in these very complicated medical decisions, and they should only be made between a woman and her doctor - period, full stop."
"The role of government is to ensure that women have access to vital healthcare, and I believe that any bill restricting access to medical care and safe abortion services is an attack on women's rights," she said.
An aide to Sen. Elizabeth Warren said Warren is "committed to protecting a woman's right to choose and believes that politicians shouldn't interfere in choices that are between a woman and her doctor."
And Michael Hopkins, a spokesperson for former Maryland Rep. John Delaney, said it was unfortunate that Trump "focuses on divisive issues as opposed to unifying issues."
"Imagine if the president would have instead focused on family planning, an issue that everyone agrees deserves more attention," he said.