Looking for The Straight Dope on Partial Birth Abortions

I am aware that Partial Birth Abortions is a GREAT DEBATE these days. However, I do not wish for this thread to BECOME a debate on whether the the proceedure should be legal or not***. Instead, I have a couple of questions which I believe can be answered factually.
[ul]
[li]The term “partial birth abortion” is colloquial, is it not? Assuming it is, what does the medical community call the procedure?[/li][li]Late-term abortions (of which PBAs are included) are very rarely performed in this country, is that true?[/li][li]PBAs, despite being particularly gruesome medical proceedures, are done because other methods of late-term abortions are more dangerous, is this true?[/li][li]Almost all late-term abortions are done (at least in this country) because of complications in the pregnancy that can potentially harm the woman and/or the viability of the fetus in becoming a healthy kid, is that true? As opposed to a woman choosing an abortion without these concerns.[/li][/ul]
I would love some citations to back this up as well. It seems that everywhere I look online, I hear someone else saying something else on the subject, but I know there has to be reliable and unbiased information on the above somewhere…

[sub]*** I realize that this has the potential to become a debate. I will attempt to not invoke the ire of the GQ Mods and keep things as factual as possible, and I hope you fine Dopers will do the same…[/sub]


Yer pal,
Satan

*TIME ELAPSED SINCE I QUIT SMOKING:
Ten months, two days, 18 hours, 2 minutes and 7 seconds.
12350 cigarettes not smoked, saving $1,543.97.
Extra life saved: 6 weeks, 21 hours, 10 minutes.

See my Sig File FAQ: http://pages.prodigy.net/briank.o/SigFAQ.htm*

You can find some of what you are looking for here: http://boards.straightdope.com/sdmb/showthread.php?threadid=46841

I read a series of three books that are directly related to this topic. They also had storylines, so they are not just fact books. They were however, written by a physician that apparently had alot of experience with the subject. I learned much more than I cared to know by reading these books. I don’t recall the names of all of them but one was Stainless Steel Hearts. It was one of three in a series, I don’t know if it was 1, 2, or 3. The author is Harry Lee Kraus. Prepare yourself though, the books also deal with the christianity aspect of the whole partial birth abortion process.

[QUOTE]
Originally posted by Satan *
I am aware that Partial Birth Abortions is a GREAT DEBATE these days. However, I do not wish for this thread to BECOME a debate on whether the the proceedure should be legal or not
. Instead, I have a couple of questions which I believe can be answered factually.

[li]Almost all late-term abortions are done (at least in this country) because of complications in the pregnancy that can potentially harm the woman and/or the viability of the fetus in becoming a healthy kid, is that true? As opposed to a woman choosing an abortion without these concerns.**[/li][/QUOTE]

The large majority of late term PB abortions in the US are done for lifestyle reasons that have nothing to do with imminent physical danger to the woman’s life. There was, in fact, some controversy surrounding this issue a few years ago with, IIRC, a doctor who was a member of Planned Parenthood re-canting the party line that virtually all late term PB abortions were medically necessiated and fessing up that they were actually for lifestyle reasons.

I’ll see if I can find a cite for this.

I’ll try to keep this in GQ, but I’m definitely partisan on this subject.

The fact that they’re cheap and quick might also have something to do with it.

Not true. A while back, Congress held hearings on partial-birth abortions. The consensus was that while some fetuses are aborted due to birth defects, the vast majority of late-term abortions are for non-medical reasons. The whole “save the life of the mother” line is very likely a smokescreen. Quite a few doctors testified to Congress that aborting a fetus to save the mother’s life is almost unheard of. About the only situation where it legitimately occurs is when fetility treatments screw up and cause a woman to be pregnant with like 7 or 8 babies at the same time. Those situations are rare, however. Thanks to the C-section, the days when women died in childbirth are over. Unless you’re giving birth to Wolverine or Sonic the Hedgehog, there’s no medical reason why a pregnancy would endanger the mother.

Actually, NONE of them are done to prevent imminent danger to the mother’s life.

In fact, the American Medical Association has said that there is no medical justification for this particular procedure. It’s no less dangerous than other procedures, especially since it requires a forcible and premature dilation of the cervix. It’s only true purpose is to harvest fetal organs while blood flow to the fetus remains.

If the mother is endangered for some reason, the fetus can be delivered by C-section. There is no compelling reason to have a late-term abortion – much less a partial birth abortion.

As Diceman said, this whole “life of the mother” issue is just a smokescreen – and a pretty lame one at that.

As someone who had toxemia and pre-eclampsia while pregnant, and also had partially detached retinas, I disagree with you. I don’t know if a PBA would have helped me, but not getting pregnant, or being able to abort (I was living in a country where abortions were illegal) would have prevented a lot of medical problems for me.

And I think that women do still die in childbirth, it’s just a lot rarer these days.

The SDMB search engine throws up heaps of threads which have dealt with this topic, but cantrip’s posts in mblackwell’s link are some of the best you’ll come across on the topic - although not for the faint-hearted.

Oh man.

Here is a great cite.

The New England Journal of Medicine – January 11, 2001 – Vol. 344, No. 2 “Partial-Birth Abortion” and the Supreme Court
The medically appropriate term is intact dilation and evacuation or dilation and extraction. Ther article above basically reviews the SCOTAS decision on the Nebraska anti-partial birth abortion law. The reason the law was struck down was because it is medically vague and can endanger the life of a woman (in violation of Roe vs. Wade, basically). 90% of abortions are performed between week 12, usually by vacuum aspiration Anything after week 15 has to be done by dilation and evacuation, which is similar to vacuum aspiration except that the cervix is more dilated and more instrumentation is passed through the cervix. Intact dilation and evacuation, which involves some dismemberment, is performed after week 16. Confused about the nomenclature? So was the SCOTAS.

The Nebraska law (and other laws like it) have no exceptions for health of the mother and make no distinguishment of late second trimester intact D&E from early D&E. The law, as it would stand, would possibly make all abortions after 12 weeks illegal. Even to save the life of the mother. Remember that amnio and chorionic villi sampling can only be done around this time anyway.

There are no good numbers for intact D&E. The SCOTAS estimated between 640 and 5000, performed for a number of reasons :
“…including reducing the danger caused by the passage of sharp bone fragments through the cervix, minimizing the number of surgical instruments used (and thereby decreasing the likelihood of uterine perforation), reducing the likelihood of infection, and helping to ensure the removal of all fetal tissue. Dilation and extraction is also the preferred method for fetuses with hydrocephaly and anomalies incompatible with fetal survival.”

The line is extremely skinny. It is not a clear cut border between D&E and intact D&E. The line is too fine for the SCOTAS. Any law written against partial-birth abortion so far would criminalize many first and second trimester abortions. This is the point.

Now only last thing IMHO (I hope this won’t push it over into GD)
Anybody who says a 22 week abortion is performed “all the time” for “lifestyle choices” is pushing an agenda. This is not an easy procedure, nor is it widely performed. Late second trimester abortions are done quite rarely and any law against them would only serve to kill women.

And childbirth is still riskier than any abortion procedure. Women die in childbirth (as Lynn said) of preeclampsia and kidney failure and hemorrhage still.

Is a partial birth abortion the one where they breach the baby during the “giving birth” and suck the brains out?

JThunder, I think you mean that c-section or induction of labor would be the alternatives when the mother’s life is at risk. C-section as a ‘solution’ is contraindicated in some cases, such as severe eclampsia, where the mother’s blood pressure cannot be stabilized enough for an emergency c-section (as was the case with my SIL, who very nearly died despite an early induction - they couldn’t stabilize her enough for a c-section, but fortunately she delivered vaginally while they were trying to prep her for the C). Pre-eclampsia/Eclampsia can only be resolved by getting the baby out, and getting it out before the mother hits a crisis point - and sometimes that means NOW, no matter what the result for the baby (prematurity is one issue).

Oh, and I highly recommend the linked thread (in case anyone is being lazy and skipping it) - very informative! Read it if you have a question, and you might not need to post (it answered a few of mine…).

Agendas aside the OP’s question relative to this reply was:

“Almost all late-term abortions are done (at least in this country) because of complications in the pregnancy that can potentially harm the woman and/or the viability of the fetus in becoming a healthy kid, is that true? As opposed to a woman choosing an abortion without these concerns.”

From the horses mouth(s) (ie the doctors performing abortions) the FACT is that in the large majority of cases imminent danger to the health of the mother is NOT a primary consideration in the decision to undergo a late term partial birth abortion. The main reason late term PB abortions are performed is that the mother does not wish to carry the fetus to term and is using PB abortion as a method of birth control and lifestyle convenience.

To make the argument that the mother’s health is in relatively greater danger because without the LTPBA the mother will have to carry the child to term and that this is somewhat more dangerous on a statistical basis with the life endangerment risk going from extremely small (LTPBA) to very small (delivery) is a little disingenuous with respect to critiquing the aforesaid factual answer to OP’s question.

see http://www.ama-assn.org/special/womh/library/readroom/vol_280a/cv80000x.htm

Small part of article below:

"Partial-Birth Abortion (Intact D&X)

Intact D&X came to the forefront of public awareness in 1995 during a congressional debate on a bill banning the procedure. During this debate, opponents of the ban asserted that the procedure was rarely performed (approximately 450-500 per year) and only used in extreme cases when a woman’s life was at risk or the fetus had a condition incompatible with life.[1,2] Following President Clinton’s April 1996 veto of a congressionally approved ban, conflicting information surfaced. Ron Fitzsimmons, executive director of the National Coalition of Abortion Providers, had stated in November 1995 that “women had these abortions only in the most extreme circumstances of life endangerment or fetal anomaly.”[3] However, he later admitted that his own contacts with many of the physicians performing intact D&X procedures found that the vast majority were done not in response to extreme medical conditions but on healthy mothers and healthy fetuses.[3]

In newspaper interviews, physicians who use the technique acknowledged performing thousands of such procedures a year. One facility reported that physicians used intact D&X on at least half of the estimated 3000 abortions they perform each year on fetuses between 20 and 24 weeks’ gestation.[3] In another report, Dayton, Ohio, physician Martin Haskell, MD, who had performed more than 700 partial-birth abortions, stated that most of his abortions are elective in that 20- to 24-week range and that “probably 20% are for genetic reasons, and the other 80% are purely elective.”[4] The late James T. McMahon, MD, of Los Angeles, Calif, detailed for the US Congress his experience with more than 2000 partial-birth abortion procedures. He classified only 9% of that total as involving maternal health indications (of which the most common was depression), and 56% were for “fetal flaws” that included many nonlethal disorders, some as minor as a cleft lip.[5]"

If you want to debate this, I would be happy to debate in a new thread in GD (although this ground has been covered before). I do stand by my argument, although I believe assigning legitimate percentages would be nearly impossible. I stand by it in the sense that I think that these type of abortions constitute a minority of all abortions performed, and any laws serving to restrict abortions at this time period would only serve to kill women.

I also assert that any laws written so far to restrict intact D&E (or PBA if you will) would have served to criminalize many kinds of abortions (as did the SCOTUS – ick I mispelled the acronym in my previous post – idiot).

I will agree that this is a gruesome procedure. I will agree that it is not a good solution. I will agree that abortion of any kind used as birth control is suboptimal. If you want to pass laws limiting it, however, I won’t support you unless you suggest something better (i.e. universal access to birth control, vigilant sex ed, etc.)

[[Anybody who says a 22 week abortion is performed “all the time” for “lifestyle choices” is pushing an agenda. This is not an easy procedure, nor is it widely performed. Late second trimester abortions are done quite rarely and any law against them would only serve to kill women.]]

Many of these abortions are performed because it has been discovered that there is a very severely malformed fetus with no chance at survival. Anencephaly (absence of the cerebral hemispheres)or microencephaly, for example.

I’d like a clarification, please. Some folks here are saying these abortions are NEVER done for “saving the mother’s life”. I’m no OB/GYN, but it would seem to me that it is well within the realm of possibility that a child could develop pretty much fully towards the end of pregnancy and then die of something or other such as getting the umbilical cord wound around its neck. Surely then, the woman has a fully developed fetus within her that will do her in if it stays aboard. If it does not deliver itself up naturally (and would this always happen?), then it sounds like a late-term induced delivery is necessary. Does this (delivery of a dead, developed fetus) count as a late term abortion?

Coming close to the above would be a child still more or less alive but known to be damaged in some way, either congenitally or from some external means. Surely this happens. And surely in at least some of these cases, the damage is of such a nature as to present a serious danger to the mother. How, then, can it be said that these abortions are NEVER done for “saving the mother’s life”?