Partial-birth abortion

From Academic Kids

Partial-birth abortion (PBA) is a term used to refer either to a specific type of late-term abortion, clinically known as intact dilation and extraction (IDX or Intact D&X), or to late-term abortions in general. Both the abortion method and the term partial-birth abortion are controversial. Although not a medical term, partial-birth abortion is commonly used in public discussion of the procedure.

Often the debate over partial-birth abortion is over the name for this type of abortion, as well as the procedure itself. Those who support the term's use say it describes a specific type of abortion in a phrasing that better represents what happens during the procedure. Those who do oppose the term's use say that the term is an deceptive political term invented to appeal to warm public sentiment associated with the birth of a baby.

Contents

1 Etymology

2 Controversy

3 Surgical procedure

4 Law in the United States

5 See also

6 External links

6.1 Legislation, Testimony, and Court Decisions
6.2 Commentary
6.3 Interest Groups
6.4 Other

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Etymology

The procedure was first described by Cincinnati physician W. Martin Haskell, MD, in a monograph that was distributed by the National Abortion Federation in September, 1992 [1] (http://www.vanderbilt.edu/SFL/partial-birth_abortion.htm). In this monograph, Dr. Haskell describes the procedure only as "Dilation and Extraction".

The term partial-birth abortion did not appear until several years later. According to a Lexis Nexis search, it was first used on June 4, 1995 [2] (http://mediamatters.org/items/200412130002) in media coverage of pro-life events in support of legislation. It replaced the earlier, more graphic term brain suction abortion, which was used in an Ohio law that banned the procedure but was blocked by the judiciary. The term brain suction abortion was similar to partial-birth abortion, in that it is a political term created by opponents to the procedure — specifically, pro-life activist Janet Folger [3] (http://www.skeptictank.org/janut1.htm).

In December 2003, the Sixth U.S. Circuit Court of Appeals upheld Ohio's Partial-Birth Abortion Ban [4] (http://www.ama-assn.org/amednews/2004/01/19/gvsa0119.htm). Notable is an exception that allows the procedure when necessary "to preserve the life or health of the mother as a result of the mother's life or health being endangered by a serious risk." The Court held that, "a valid health exception need only permit the partial birth procedure when necessary to prevent significant, as opposed to negligible, health risks." Martin Haskell, who had sued to block the law, declined to appeal the ruling [5] (http://www.jillstanek.net/news/contentview.asp?c=17143).

Ohio's current law [6] (http://onlinedocs.andersonpublishing.com/oh/lpExt.dll/PORC/114b3/11b2e/11b51/11b78?f=templates&fn=document-frame.htm) calls the procedure partial birth feticide though there are no other examples of this exact terminology in law or medicine.

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Controversy

The procedure is highly controversial in several parts of the world. The inventor of the procedure called it "a quick, surgical outpatient method" [7] (http://www.vanderbilt.edu/SFL/partial-birth_abortion.htm) for late second-trimester and early third-trimester abortions. Pro-life critics of the procedure consider it tantamount to infanticide or murder, and the Partial-Birth Abortion Ban Act of 2003 describes it as "a gruesome and inhumane procedure that is never medically necessary" [8] (http://news.findlaw.com/usatoday/docs/abortion/2003s3.html).

Many pro-choice and pro-life advocates see the issue as a central battleground in the wider abortion debate.

A major part of the legal battle over banning the procedure relates to health exceptions, which would permit the procedure in special circumstances. The 1973 Supreme Court decision Roe v. Wade, which declared many state-level abortion restrictions unconsitutional, did allow states to impose some restrictions on second- and third-trimester abortions. The companion ruling, Doe v. Bolton, required that states' restrictions on abortions must provide an exception for the health of the mother, and defined health to include mental as well as physical health, though in his concurring opinion Chief Justice Burger wrote, "plainly, the Court today rejects any claim that the Constitution requires abortions on demand".

Supporters of late-term abortion procedures argue that they prevent the pregnant woman from having to undergo childbirth or abdominal and uterine incisions of a caesarian section (c-section) when the child would not survive. However, the inventor of the procedure has stated that most partial-birth abortions are elective [9] (http://www.nrlc.org/abortion/pba/pbafact10.html). Critics also claim that partial-birth abortion subjects mothers to unnecessary risks [10] (http://www.ppl.org/PJune_PostViability_2001.html) for the convenience of the physician [11] (http://www.nrlc.org/abortion/pba/pbafact10.html). Partial-birth abortion is particularly a target of pro-life advocates because they believe the procedure most clearly illustrates why abortions, and especially late-term abortions, are immoral.

Opponents of a ban on the procedure have also argued that the definition of such a ban is so vague that the law would have a chilling effect on physicians performing any abortion or other gynecological procedures such as D&C (dilation and curettage), used for various conditions of the uterus. However, those who advocate for the fetal right to life consider this as an attempt to muddle the reality that without the ban, a healthy gravida can direct her abortion provider to put a full-term unborn fetus to death in such a violent fashion without any restrictions whatsoever.

Some who want the procedure to remain legal in the United States say that the ban is based on religious objections to the procedure and that to create legislation based on these religion objections violates the First Amendment. Those who want to outlaw this type of abortion counter that under such logic, the laws against murder would also be an unconstitutional enactment of one of the biblical Ten Commandments ("You shall not kill") into law.

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Surgical procedure

See Intact dilation and extraction for a complete description of the procedure.

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Law in the United States

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PBAsigning.jpg

George W. Bush signing the Partial-Birth Abortion Ban Act of 2003, surrounded by members of Congress.

On November 5, 2003, President George W. Bush signed the Partial-Birth Abortion Ban Act (HR 760, S 3), which defined partial-birth abortions as:

an abortion in which --

(A) the person performing the abortion deliberately and intentionally vaginally delivers a living fetus until, in the case of a head-first presentation, the entire fetal head is outside the body of the mother, or, in the case of breech presentation, any part of the fetal trunk past the navel is outside the body of the mother for the purpose of performing an overt act that the person knows will kill the partially delivered living fetus; and

(B) performs the overt act, other than completion of delivery, that kills the partially delivered living fetus

Opponents of the ban claim that this definition could include even the first-trimester vacuum aspiration of embryos through the vaginal canal. Supporters of the PBA Ban deny this, and point to the "Findings" section, which describes the procedure as "an abortion in which a physician delivers an unborn child's body until only the head remains inside the womb, punctures the back of the child's skull with a sharp instrument, and sucks the child's brains out before completing delivery of the dead infant."

The federal PBA Ban contains an exemption for protecting the health of the mother, but opponents argue that it is insufficiently broad. During his time in office, President Bill Clinton twice vetoed legislation that he believed did not include sufficient protections for the health of the mother. The bill states that it "does not apply to a partial-birth abortion that is necessary to save the life of a mother whose life is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy itself." Opponents say this wording is counter to Justice Sandra Day O'Connor's concurring opinion in the 5-4 Stenberg v. Carhart decision, in which the Supreme Court struck down the Nebraska law. O'Connor stated that any ban would have to include an exception for the health of the mother.

As a result, federal judges in San Francisco, New York and Lincoln, Nebraska have blocked the implementation of the law while court cases were being argued. On June 1, 2004, Judge Phyllis Harmon struck down the law in the San Francisco case, stating that "The act poses an undue burden on a woman's right to choose an abortion."

The New York and Nebraska cases are ongoing.

The Partial-Birth Abortion Ban Act (PBA Ban), included an exception for the life of the mother, but not for non-life-threatening health issues. The authors believed that they adequately addressed this in the findings section of the legislation because they have included a large amount of supporting documentation -- including a statement by the American Medical Association -- which they argue demonstrates that there is no medical situation under which this procedure could be used to preserve the physical health of the mother. Broadly worded health exceptions in abortion legislation have previously been interpreted by many American courts to include psychological health, which opponents of the procedure contend is so vague that it renders any attempt at prohibiting abortions toothless.

While some state laws allow late-term abortions in only the most dire of cases under state laws — for example, where the fetus is severely malformed and dying — many of these restrictions are claimed by abortion supporters to be constitutionally invalid. As of February, 2005, 17 states had bans on post-viability abortions that abortion supporters say do not meet Supreme Court requirements: three states allow late-term abortions only when the mother's life is in danger, four other states allow late-term abortions only when the mothers physical (but not mental) health is in jeopardy, and 13 states ban all abortions performed after a certain point in pregnancy. Nineteen (plus the District of Columbia) allow them when necessary to preserve the woman's life, physical health, or mental health.

At least three states (Delaware, Minnesota, and Utah) have no current policy regarding post-viability abortions because the laws in those states are blocked by court order. Most or all of the remaining 47 states, plus the District of Columbia, impose some regulation on late-term abortion [12] (http://www.guttmacher.org/statecenter/spibs/spib_RPA.pdf).

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