partial birth abortion


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Abortion, partial birth

 

Definition


Partial birth abortion, medically known as intact dilation and extraction (IDX), is a method of late-term abortion that ends a pregnancy and results in the death and intact removal of a fetus from the uterus. In the United States, as of late 2008 the procedure was illegal.

Purpose


Partial birth abortion, or IDX, is performed to end a pregnancy in the mid to late second trimester. It is typically performed between weeks 19 and 26 of pregnancy. IDX is highly controversial. Some physicians argue that IDX has advantages that make it preferable to other late-term abortion procedures in some circumstances. One advantage is that the fetus is removed largely intact, allowing for better evaluation and autopsy of the fetus in cases of fetal abnormalities. Intact removal of the fetus also may carry a lower risk of puncturing the uterus or damaging the cervix. Another perceived advantage is that IDX ends the pregnancy without requiring the woman to go through labor. This may reduce the emotional trauma of ending the pregnancy when compared to other methods of late-term abortion. In addition, IDX may offer a lower cost and shorter procedure time. Regardless of any perceived advantages, the procedure is illegal in the United States. Even before the procedure became illegal, it was performed only rarely.

Legal Controversies


Before 2003, the legality of IDX rested with each individual state. In 2003, U. S. President George W. Bush signed into law the federal Partial-Birth Abortion Ban Act banning partial birth abortions nationwide and implementing fines or jail terms for physicians who perform them. A federal judge then declared the law unconstitutional, so that the government was not able to enforce it. A series of court battles over the constitutionality of the law continued until 2007. One legal issue centered on the fact that the legislation did not provide for exceptions in life-threatening cases where the procedure was needed to protect the mother's health. Another issue was the breadth and scope of the definition of partial-birth abortion. Three federal appeals courts ruled that the law was unconstitutional. Nevertheless, in April 2007, the U. S. Supreme Court upheld the law, ruling that it was constructional, thus allowing for its enforcement.

Precautions


IDX is currently illegal in the United States. Women considering IDX in countries where the procedure is legal should be aware of the highly controversial nature of this procedure. One controversy common to this and all late-term abortions is determining at what point in the pregnancy the fetus is viable (able to survive outside the mother' body). In technologically advanced countries, fetuses generally are viable at 28 weeks of pregnancy; some fetuses as young as 24 weeks survive. Another area of controversy specific to IDX is that fetal death does not occur until after most of the fetus's body has exited the uterus. Because of these concerns, many physicians who perform abortions do not perform IDX; this tends to limit the availability of the procedure.

Description


IDX first involves administration of medications to cause the cervix to dilate. Dilation usually occurs over the course of several days. Next, the physician rotates the fetus to a footling breech position. The body of the fetus is then drawn out of the uterus feet first, until only the head remains inside the uterus. The physician then uses an instrument to puncture the base of the skull, which collapses the fetal head. Typically, the contents of the fetal head are then partially suctioned out, which results in the death of the fetus and reduces the size of the fetal head enough to allow it to pass through the cervix. The dead but otherwise intact fetus is then removed from the woman's body.

Preparation


Medical preparation for IDX involves an outpatient visit to administer dilation medications such as laminaria. Psychological preparation is desirable.
In addition, preparation may involve fulfilling local legal requirements, such as a mandatory waiting period, counseling, or an informed consent procedure reviewing stages of fetal development, childbirth, alternative abortion methods, and adoption.

Aftercare


IDX typically does not require an overnight hospital stay. A follow-up doctor's visit usually is scheduled to monitor the woman for any complications.

Risks


With all abortion, the later in pregnancy an abortion is performed, the more complicated the procedure and the greater the risk of injury to the woman. In addition to associated emotional reactions, IDX carries the risk of injury to the woman, including heavy bleeding, blood clots, damage to the cervix or uterus, pelvic infection, and anesthesia-related complications. There also is a risk of incomplete abortion, meaning that the fetus is not dead when removed from the woman's body. Possible long-term risks include difficulty becoming pregnant or carrying a future pregnancy to term.

Normal results


The expected outcome of IDX is the termination of a pregnancy and death of the fetus.

Key Terms


Cervix
The narrow outer end of the uterus that separates the uterus from the vaginal canal.

Footling breech
A position of the fetus while in the uterus where the feet of the fetus are nearest the cervix and will be the first part of the fetus to exit the uterus, with the head of the fetus being the last part to exit the uterus.

Laminaria
A medical product made from a certain type of seaweed that is physically placed near the cervix to cause it to dilate.

For Your Information

Resources


Websites

  • Mears, Bill. "Justices Uphold Ban on Abortion Procedure." CNN.comApril 18, 2007 [cited December 6, 2008]. http://www.cnn.com/2007/LAW/04/18/scotus.abortion/index.html.

Organizations

  • Planned Parenthood Federation of America, Inc. 810 Seventh Ave., New York, NY 10019. (800) 669-0156. http://search.plannedparenthood.org.

Abortion

partial birth abortion

Intact dilation & extraction, intact dilatation & evacuation, intact D&E, D&X Medical ethics A late-term abortion in which the fetus is partially vaginally delivered alive before the skull is collapsed, killing the fetus before complete delivery
References in periodicals archive ?
And, in fact, the majority of Americans opposed partial birth abortion.
Symbolism, of course, counts for a lot in the abortion debate, which explains why Santorum and his supporters pushed so hard for a partial birth abortion ban, while opponents put so much energy into fighting it.
Saporta says the main problem with the 1997 Partial Birth Abortion Ban Act is it doesn't address a specific medical procedure.
This decision ignores countless medical studies showing that partial birth abortion is never medically necessary under an accurate definition of 'health.
What the New Jersey court's decision on partial birth abortion epitomizes, what Chief Justice Lamer's concern for quoting pro-choice correctness represents, is the truth that the most grotesque impulses from the beginning of this century of blood are not only still alive and well at its end, but will carry on unabated well into the next.
Unlike the Partial Birth Abortion Ban Act, Hoyer-Greenwood focuses on when abortions are performed rather than how they are performed.
Lawmakers have again introduced legislation to prohibit the so-called partial birth abortion procedure.
None of these clinical details are in the bill itself, which defines a partial birth abortion as one in which the doctor ``partially vaginally delivers a living fetus before killing the fetus and completing the delivery.
Carhart, where Kennedy concluded, "Nebraska's ban on partial birth abortion furthers purposes States are entitled to pursue" and that "Nebraska was entitled to find the existence of a consequential moral difference between the [D&X and D&E] procedures.
The best case against partial birth abortion is a simple description of what happens and to whom it happens.
5 /PRNewswire/ -- Today, in a White House ceremony attended by Knights of Columbus Supreme Knight Carl Anderson and other prominent pro-life leaders, President Bush signed into law the Partial Birth Abortion Ban Act.
After today's passage by the House, Blunt said, "President Bush will sign the ban on partial birth abortion when it reaches his desk.

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