This post, bending “fair usage” to the limit, quotes extensively from a Humanist article that is not (so far as I can tell) available online. It’s from the March 1998 issue, and written by John M. Swomley, professor emeritus of social ethics at St. Paul School of Theology.)
As I’ve pointed out before, it’s not clear that what the so-called “partial birth” abortion law bans is late-term, D&X abortions. What the language describes is not necessarily late-term, and could include many types of abortion other than D&X.
Nonetheless, even if the ban was limited to only D&X abortions, I’d still oppose it unless it made an exception to protect the health of the mother. So why are D&X abortions sometimes better than the alternatives? This passage from Swomley’s article is virtually a FAQ answering that question.
The term partial-birth abortion was defined in the 1996 legislation as one wherein “the person performing the abortion partially vaginally delivers a living fetus before killing the infant and completing the delivery.” [Blogger’s Note – the current legislation uses a similar, but not identical, definition. -&] The nearest medical term that to some degree meets that definition is an intact dilation and extraction, which involves the deliberate dilation of the cervix, usually over a sequence of days. The fetal body, excepting the head, can then be readily extracted; the fetal head cannot until the doctor reduces the size so it can pass through the fragile and narrow cervical opening. That reduction requires partial evacuation of the intracranial contents.
This raises certain questions. Why is this procedure sometimes necessary? Why not induce labor with drugs? The cervix, which holds the uterus closed during pregnancy, is very resistant to dilation until about thirty-six weeks. Inductions done before this time take two to four days and are physically painful. Because of the danger of uterine rupture, the woman requires constant nursing supervision.
Another question: Isn’t there another option, such as a cesarean section? A cesarean delivery usually involves twice as much blood loss and, before thirty-four weeks of pregnancy, the lower segment of the uterus is usually too thick to use a standard horizontal incision, so a vertical incision is necessary. Any uterine incision complicates future pregnancy, but a vertical incision jeopardizes both the mother’s health and future pregnancies, which would also require a cesarean.
The safest and, hence, better option in some situations is the D&X procedure. Using intravenous anesthesia, the physician can insert small dry cylinders into the cervix that expand gradually as they absorb fluid from the woman. She can usually return home except for twice-daily visits to the clinic or office to be sure that she is dilating and to replace the dilators if required. This, plus a spinal needle to remove some fluid from the fetal head, reduces the chance of lacerating the cervix.
There are still other questions, such as why not let the woman wait until the thirty-sixth week and go into labor? Fetuses with severe defects have a high chance of dying in utero well before labor begins and therefore create a serious threat to the mother. When a fetus dies, its tissues begin to break down and enter the mother’s bloodstream. This can cause clotting problems, making it more difficult for her to stop bleeding. This may then require a surgical delivery or an emergency hysterectomy.
These and other problems are the reason the physician–not the politician–must be able to exercise judgment as to which method to pursue. The “partial-birth” legislation, however, makes the physician liable to criminal penalties if he or she chooses the D&X method, thus deterring doctors from using such procedures.
Compare this to the pro-life lie that “partial-birth abortions are never elected for medical reasons, but rather convenience.”
It’s true that women can get abortions even without using D&X. But in some circumstances, other types of abortions risk injuring the mother, and eliminating her ability to bear children in the future. The best way to protect women’s health and lives is to give women and their doctors the freedom to choose what is best, based on the individual needs of each patient.
