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.

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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

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* 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.

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Specializes in nursery, L and D.

Thanks KellNY, I see what your saying about blood supply, gosh, that poor woman. I'll bet the docs don't know exactly what to do either, it has got to be a once in a lifetime thing, that you would have to treat a patient with this womans problems. I can't imagine being in her situation. I'm glad dig is usually done, haven't had any experiences with this yet, just your usual pprom, or delivery of under 24 weeker, where they usually are born alive. Now that I am at a bigger hospital, I might have to deal with this at some point.

"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 think if this were me i'd get more opinions from cardiac. i know lots of people who are medically managed who have aneurysms, my own dad included. so, i'd want to know first if there was a way to medically manage this so i could still have my baby.

i realize this is all speculation since we don't have exact info on the aneurysm.

of course these are all rare examples. heartbreaking examples nonetheless.

thanks for the respectful conversation.

steph

Specializes in High Risk In Patient OB/GYN.

i think if this were me i'd get more opinions from cardiac. i know lots of people who are medically managed who have aneurysms, my own dad included. so, i'd want to know first if there was a way to medically manage this so i could still have my baby.

oh, i totally agree, i'd get 2nd and 3rd opinions if there were time.

but we're the major cardiac center in this area (we've won awards and get life flights in often, sometimes from out of state), and our specialists were concerned enough to have an attending in the city paged at night, right then and there. the residents said cardiac turned white when they saw the echo.

the hospital she went to for her "2nd opinion" doesn't do cardiac surgery...they life flight or ambulance them here.

i'm not really comfortable discussing this particular case any further, as i've changed enough minor details and am teetering on the edge of overstepping my boundaries here.

Kell and fergus, I want to thank you for being able to take on this topic without getting so ticked that your brains shoot out of your nose.

You've taught me a lot.

Roe v. Wade made abortion legal in all fifty states up to the time of delivery. Up until six months, there is very little restriction, any restrictions are usually the clinic/physician's personal choices. AFter six months, the inidividual state can regulate it, must be in a hospital, as an inpt, for mother's health only, etc.

There is a rather infamous clinic, I think it is in Kansas City that not only does late abortions, but honest to God offers funeral services for the infant also. I think that is most twisted logic I have ever seen. If I can find the link to it, I will edit my post and put it in here.\

I found it:

http://www.drtiller.com/remembrance.html

This guy is in Witchita. He is an FP MD, not OB-Gyn. Last I looked, he wanted 10K up front for third trimester ab's, up to abt. 36 weeks. I had a pt. w/ multiple anomalies who was set to go there. Her baby died in utero the evening before she was to leave for his clinic. Gee, I wonder if he gives a refund. I am sorry, but I think (my opinion) that there's lots of greed on his end. If you are very pro-choice, I suppose he's helping women, but only the ones who can afford the astronomical cost. There are many untruths on both sides of this issue and it doesn't help those who do want an honest debate of this issue.

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.

Maybe I'm just special (sarcasm here) but YES I HAVE MADE IT KNOWN TO GOD AND EVERYONE THAT I WILL PERISH BEFORE MY FETUS (ergo baby) WILL. And that is not some half-baked fantasy.

I WILL DIE, IF NECESSARY, aortic aneurism or no. Maybe that sounds crazy to you but God as my witness I would go, and don't be so self-assured that I would cower and repent and change my mind because I have been in a life and death situation before (no it wasn't pregnancy related) and when you are in this situation it is funny but something changes and you really feel quite comfortable with the idea you are fading out.

It's easy to assume everyone thinks life is worth clinging to at all costs when you've never stood on the edge of the abyss yourself.

Syringe or scissors it's a wretched practice, and it is too easy to use what appears to others to be the obvious when making an argument for such an objectionable procedure when I would bet those arguing for the mother's life are as comfortable with the idea of this procedure as if it is a matter of convenience. And just because some people feel that repeating information somehow gives their argument/experience more legitimacy and makes it more "right" doesn't make it so. There is no excuse.

Think I'll stick with taking care of the old folks.

Kell and fergus, I want to thank you for being able to take on this topic without getting so ticked that your brains shoot out of your nose.

You've taught me a lot.

Oh now, nobody's brains are shooting anywhere.

Oh now, nobody's brains are shooting anywhere.

I dunno. My synapses are firing. Yours?

Maybe I'm just special (sarcasm here) but YES I HAVE MADE IT KNOWN TO GOD AND EVERYONE THAT I WILL PERISH BEFORE MY FETUS (ergo baby) WILL. And that is not some half-baked fantasy.

I WILL DIE, IF NECESSARY, aortic aneurism or no. Maybe that sounds crazy to you but God as my witness I would go, and don't be so self-assured that I would cower and repent and change my mind because I have been in a life and death situation before (no it wasn't pregnancy related) and when you are in this situation it is funny but something changes and you really feel quite comfortable with the idea you are fading out.

It's easy to assume everyone thinks life is worth clinging to at all costs when you've never stood on the edge of the abyss yourself.

Syringe or scissors it's a wretched practice, and it is too easy to use what appears to others to be the obvious when making an argument for such an objectionable procedure when I would bet those arguing for the mother's life are as comfortable with the idea of this procedure as if it is a matter of convenience. And just because some people feel that repeating information somehow gives their argument/experience more legitimacy and makes it more "right" doesn't make it so. There is no excuse.

Think I'll stick with taking care of the old folks.

I'm not saying you would change your mind, just that it's easy to say you never would do something when you aren't facing the very real possibility of a completely preventable death. Dying along with your fetus and leaving the rest of your family to mourn you might be something you'd do. It might not. Neither decision makes a woman a monster. If a woman chooses to live and stay with her husband and other children, she's making a moral decision too. Personally I think a preventable death is no different than suicide and I have strong feelings on that topic because of my life experiences, but I don't think people are immoral if they feel differently.

BTW, I don't believe in this procedure as a matter of convenience. I can't believe it would ever be used in that way simply because there is nothing about it that could be described as convenient. If you knew about the different procedures, you'd see why. For convenience, it would be a D&E. A D&X is harder to do and it's harder to find a provider who does them. The only reason a woman would choose a D&X over a D&E is if she wants an intact body to mourn over at the end of it. Women who want to get rid of a fetus for convenience alone wouldn't want that.

I don't know why you'd bet on how I feel about something when you could just ask me and get the answer from the horse's mouth.

I dunno. My synapses are firing.

I don't get emotionally involved in these topics anymore. I will correct misinformation about the procedure itself and why its chosen. Beyond that I don't care that someone who doesn't work with the type of patients I have in high risk OB has judgements about the procedure and the people who do them. They have a right to their opinions. I have a right to mine.

I don't get emotionally involved in these topics anymore. I will correct misinformation about the procedure itself and why its chosen. Beyond that I don't care that someone who doesn't work with the type of patients I have in high risk OB has judgements about the procedure and the people who do them. They have a right to their opinions. I have a right to mine.

No, there is no reason to start fuming, and I know there is misinformation no matter where you go, and while I am not so so arrogant as to think I have all the answers on this subject I believe I have enough knowledge to decide where I stand on it and why. I know people die from childbirth and there are times it could be prevented and there are people who choose to let the baby perish...no, I don't believe they are monsters and I hope to God I'm never in their position, but I know what I will do if I ever am. In fact, before I went to the hospital this last time to have the baby, I told my husband if I become incapacitated and he had to make the decisions, if they told him it was me or the baby he knew which choice to make and don't feel guilty about it.

Got no argument from the old man. After all, I've got enough life insurance for them to live on the interest.

Anyway...

Like I said, I believe in freedom of choice but I still don't have to agree with it. And I still say there is no such thing as a medically necessary PBA.

Specializes in High Risk In Patient OB/GYN.

Like I said, I believe in freedom of choice but I still don't have to agree with it. And I still say there is no such thing as a medically necessary PBA.

Technically you're right. Just like there's no such thing as a medically necessary appendectomy (we could just let it rupture and treat with abx and pain meds without surgical intervention) or a medically necessary CABG (we could treat with meds and provide end of life care when the time comes) or a medically necessary c-section (we could let nature take it's course so to speak, or hope for the best despite the risks God or the Universe will take care of everything.

Those procedures, while not medically necessary, sure are medically indicated or are necessary in order to preserve the life or health of the patient (as is a D&X at times, again, when the baby is often incompatable with life).

In reality, nothing is simply "NECESSARY" (not even breathing). Sure we run the risk of dying if it's not done, or suffering very poor effects. But we're each left a choice.

So I agree with you, motorcyclemama. (especially about it being a choice that you yourself wouldn't have to make. I hope again that none of us ever have to make that choice. I wish no woman or man would ever have to make that choice)

Now....

Had you said that there were no such thing as a medically INDICATED or beneficial D&X then I'd have to respectfully disagree with you. And since you think I'm just repeating myself over and over, I'll just refer you to my previous posts. ;)

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