partial birth abortion

Specialties Ob/Gyn

Published

THE OUTCOME of what is almost certain to be a legal battle fought all the way to Supreme Court will hinge on whether the justices accept the findings of Congress that the procedure is never medically necessary and poses additional health risks to the mother.

DENOUNCED AS 'UNCONSTITUTIONAL'

Abortion rights supporters have pledged a court challenge. "This bill is unconstitutional," argued Sen. Barbara Boxer, D-Calif., citing the lack of an exemption in cases where the health of the mother is in jeopardy. The bill does exempt a partial-birth abortion that is necessary to save the life of a mother.

The procedure involves partial delivery of a fetus until the head or part of the lower body is outside the mother's body.

At that point, the doctor punctures the skull of the fetus with a scissors, then inserts a suction tube and vacuums out the developing brain, killing the fetus.

The bill, sponsored by Sen. Rick Santorum, R-Pa., says the procedure "blurs the line between abortion and infanticide in the killing of a partially born child just inches from birth."

It was approved by a vote of 64 to 33, with 16 Democrats joining 48 Republicans in supporting it, while three Republicans and independent Jim Jeffords of Vermont joined 29 Democrats in opposing it.

Advertisement

Not voting were Sens. Joe Biden, John Edwards and John Kerry, all Democrats.

The House is expected to pass the bill in about a month. Congress twice before passed legislation to impose a ban, but former President Clinton vetoed both measures.

JAIL SENTENCE OR FINE

The bill says that anyone who performs the procedure known as partial-birth abortion "thereby kills a human fetus" and will be fined or imprisoned for not more than two years.

A woman upon whom a partial-birth abortion is performed may not be prosecuted under the bill.

The Santorum bill includes a non-binding amendment, approved by a 52 to 46 vote Wednesday, that says it is the sense of the Senate that the Supreme Court's 1973 Roe v. Wade decision, which legalized most abortions in every state, "secures an important constitutional right" and should not be overturned.

Supreme Court Justices

MSNBC Interactive

* Nine who have the final say

The battle after Bush signs the bill will center on how much deference the courts give to the findings of fact that Congress made with regard to the abortion procedure.

The bill says that based on testimony Congress has found that "a partial-birth abortion is never necessary to preserve the health of a woman" and "poses significant health risks to a woman upon whom the procedure is performed."

The legislation also says that Congress found that "the gruesome and inhumane nature of the partial-birth abortion procedure and its disturbing similarity to the killing of a newborn infant promotes a complete disregard for infant human life."

SUPREME COURT PRECEDENT

In a 2000 decision called Stenberg v. Carhart, the Supreme Court affirmed lower court rulings that had struck down a Nebraska abortion statute similar to the Santorum bill.

A five-justice majority held that the Nebraska law was invalid because it lacked an exception for the preservation of the health of the mother.

The majority also said the Nebraska law imposed an undue burden on a woman's ability to get an abortion. The court had ruled in a case called Casey v. Planned Parenthood in 1992 that states could regulate abortion but not place "a substantial obstacle in the path of a woman seeking an abortion of a nonviable fetus," that is, a fetus that could not survive outside the mother's womb.

The majority relied on a lower federal court's factual findings that the partial-birth abortion procedure was medically as safe as, and in many cases safer than, alternative abortion procedures. The Santorum bill relies on congressional testimony that disputes that federal court's findings.

MSNBC.com's

Specializes in elder care.

alright, here's a little background: i'm a recently graduated, newly licensed LPN, and the topic of abortion did come up frequently during schooling. i have had three pregnancies, gave birth to three babies, and after having lost one of those children at age 7 1/2, i'm pretty much pro-life.

anyway. i have always wondered just exactly which maternal conditions would be so life-threatening that abortion would be the only option to save the mother's life? could have, should have asked my instructors but never really found the right time to ask that question. my mistake, i know.

here's another thought, and i'm sure i will be stepping on some people's toes, religious belief-wise (sorry in advance!): WHAT IF at the onset of menarche barrier (diaphragm) or hormonal (depo, pill, etc.) contraception were available AT NO COST to actually protect from unwanted pregnancy? after all unplanned pregnancies happen all the time. yes, i know. all those things are available, but by the time most girls/women get on some b/c method they have already been sexually active. we are all human, right? and yes, i do realize that no form of b/c (except abstinence) is 100% effective, and that "accidents" (contra failure, rape, incest, etc.) do happen. however, if b/c were universally available, wouldn't that cut down on the chances of unplanned pregnancies? granted, it would literally take an act of congress/senate to make that happen, and i'm sure the pharma companies would throw a screaming hissy fit. would funding for that be a "health tax" that everyone would pay? who knows, and i sure don't!

as far as the PBA, i find it beyond barbaric, horrific--more like the stuff that nightmares are made of. what monster dreamed up that particular procedure, anyway?

and by the way: i didn't mean to hijack this thread, just wanted some answers to the maternal health question and to put in my 2cents worth. thank you.

as far as the PBA, i find it beyond barbaric, horrific--more like the stuff that nightmares are made of. what monster dreamed up that particular procedure, anyway?

So, clearly, you didn't read anything that the posters who have actually dealt with this procedure wrote.

Specializes in elder care.

yes, i read, and understood. it's just my opinion. like everyone else, i have my own and am entitled to state it, as have others on this thread, thank you very much. besides that, that wasn't the reason for me to enter this thread anyway. please don't jump in the middle of me. no offense, okay?

no offense, okay?

Okay. But it's hard not to respond to such strong words, farm girl.

Specializes in elder care.

agreed. i'll step off my soap box now. have nice day, and i will try to choose my words a little wiser in the future.

People keep talking about the "medically necessary" reasons for partial-birth abortion, which, by the way, I understand why some people believe it is necessary but this still does not justify it to me when there are other ways, especially when an OB doctor who had been a doctor over 30 yrs says he has never seen a medically necessary reason for a PBA.

But aside from the excuses you can't get away from the cold hard facts. It's atrocious, I would rather die with the baby in me than have such a procedure done and I mean that wholeheartedly. And you can't tell me it isn't done in normal pregnancies for whatever reason...maternal "distress" or whatever. Babies die in utero and shortly after birth and there is nothing that can be done about that but I feel it takes an unfeeling automaton that can suck the life out of a baby (deformed or not) and go home to dinner.

I can't help it this is the way I see it.

Specializes in Maternal - Child Health.
People keep talking about the "medically necessary" reasons for partial-birth abortion, which, by the way, I understand why some people believe it is necessary but this still does not justify it to me

motorcycle mama,

You are absolutely correct that there are no "medically necessary" reasons for partial birth abortion. There ARE medically necessary reasons to bring an end to a pregnancy, for example, severe PIH, DIC, overwhelming infection, trauma, and other conditions which pose an IMMEDIATE threat to a mother's life. In those cirumstances, it is necessary to end the pregnancy in order to salvage the mother's life, and health. HOWEVER, it is NEVER necessary to deliberately and actively kill the fetus in order to accomplish this. Inducing labor and delivering the fetus will suffice. If the fetus is non-viable, it will either pass away during the birth process, or shortly thereafter, in a warm, peaceful environment, possibly in its patents' or a nurse's arms.

Specializes in High Risk In Patient OB/GYN.
If the fetus is non-viable, it will either pass away during the birth process, or shortly thereafter, in a warm, peaceful environment, possibly in its patents' or a nurse's arms.

Or possibly in a cold metal basin set on the counter. I guess it depends who's working that day and how busy the unit/how acute the case....sorry, but if mom's bleeding out, hypertensive, etc, she's our concern and the nonviable baby will most likely not be swaddled and coddled, but placed, at best in an incubater to die alone.

I have 27 year old a patient (well, had....she signed out AMA 2 days ago :( ) who, at 19+ weeks, while getting her pre-cerclage EKG was found an abnormality. They did an echo. Found to have a very large Aortic Aneurysm (not abdominal)--bulging and noted vessel taughtness. Tell that woman that her termination wasn't medically necessary.

I have no idea what she'll decide--which method...but in her case a D&X may be the best option-with her history of cervical incompetance, the laminarias and dilating rods used with a D&E could further weaken her cervix and destroy her ability to have a viable child in the future, after losing what will now be 4 pregnancies. A D&X--again, after the amniotic sac has been injected with dig--would allow her to be dilated with medications instead of mechanically to a smaller diameter. She won't be holding any babies while they peacefully pass on--she'll be under general anesthesia being prepped for major open heart surgery. I believe it was fergus who mentioned, if she opts for a D&E (the usual 2nd rimester TOP method), her fetus will be pulled out in about 15 different pieces during the D&E. Is this really less barbaric than having the baby die peacefully in utero?

Jolie-This patient (along with others) was not a candidate for labor or delivery. Her aneurysm may well have bursted if her body were put under that stress, and she could have easily exsanguinated on the OR table in minutes. So sometimes, yes, we must sometimes actively and deliberately "kill the fetus" or end it's life in order to preserve that of the mother.

There is no reason to turn a fetus into a breech position so that you can deliver all but the head, jam some scissors into the skull to rip a hole into it and suck the brains out while the half born baby twitches and jerks. But that's not what happens in practice. The amniotic sac (for the 4th time? 5th time now being clarified?) is injected with digoxin, causing cardiac arrest. In hydrocephaly-a common reason to perform this procedure, all that is injected into the skull is a simple syringe, the fluid being manually drained.

You can read true stories like these and ignore them, continuing to say there is no real reason and just thinking that those who opt to participate in, provide, and receive a D&X are monsters.

That's your choice, I suppose. If this thread hasn't shone any light on the subject for you at all (not saying that all people should be die-hard supporters) than I'm not sure you're open to the answers of the questions that are repeatedly being asked.

, I would rather die with the baby in me than have such a procedure done and I mean that wholeheartedly.

Easy to say when it isn't a reality. I hope no one on this board ever has to make that decision in real life.

Inducing labor and delivering the fetus will suffice. If the fetus is non-viable, it will either pass away during the birth process, or shortly thereafter, in a warm, peaceful environment, possibly in its patents' or a nurse's arms.

Unfortunately labor isn't really an option for severe hydrocephalus. The birth process is impossible. It's either a large incision and operative delivery (not a great option for someone with PIH or HELLP) or a D&X. Whatever you'd choose is what's best for you. I don't think women or their health care providers are barbaric if they choose differently.

Unlike at Kelly's hospital, I've never worked somewhere where fetal demises were just plunked somewhere. We always have someone to do bereavement care, though it's not usually the L&D people because like she said, their first priority is often a crashing mother.

Specializes in High Risk In Patient OB/GYN.

Fergus-(just to clarify) We often have the mother or father hold the baby, if reasonably intact (obviously not after a D&E...shudder...). If not, a nurse will sometimes be available to swaddle and hold the baby. But unfortunately there are undeniable times where a mother is crashing or having a seizure or we are short staffed, etc. It's sad, but true.

Most of our TOPs, elective or urgent/emergent are done via D&C or D&E, so there is no "baby" to care for afterward, and with the very few D&X procedures done here, the patient experiences an IUFD.

And thank you for pointing out that labor is NOT always an option, as with severe hydrocephalus, serious current or past maternal cardiac issues (as mentioned in my PP), Eclampsia, severe trauma, and many of the other reasons that make a termination medically necessary.

Specializes in Maternal - Child Health.
Fergus-

And thank you for pointing out that labor is NOT always an option, as with severe hydrocephalus, serious current or past maternal cardiac issues (as mentioned in my PP), Eclampsia, severe trauma, and many of the other reasons that make a termination medically necessary.

If labor is not an option, then a partial birth abortion isn't an option, either, as it involves laboring, albeit to a lesser dilation than an intact lady partsl delivery. And if an operative delivery is indicated, there is still no benefit to the mother's life or health to destroy the baby in the process.

While I understand the the life of a crashing mother is of primary importance, it is beyond my comprehension that a breathing baby would be left to die in an OR basin.

+ Add a Comment