Partial-birth abortion (or PBA) is a controversial term used in the current debate over the issue abortion procedure. The debate over PBA is about the term as well as the procedure. The debate over the term can be divided into two basic camps: one who insist that the term identifies a specific type of abortion which ought to be banned and one who insist that the term is an entirely political one used in an attempt to frame the debate in the way favorable to those making the argument.
Regardless of an individual's feelings, the phrase "partial-birth abortion" is a legal term rather than a medical one. The actual term used by medical professionals, whether or not they actually involved in performing abortions, is "Intact dilation and extraction" ("IDX" or "Intact D&X") and can also refer to a procedure performed to remove a dead fetus after a natural miscarriage.
Abortion is very controversial, and late-term abortions, especially beyond the point in pregnancy when the fetus is viable, are especially so.
The procedure now referred to as IDX was first described by Cincinnati physician W. Martin Haskell, MD, in a monograph that was distributed by the National Abortion Federation in September, 1992 . In this monograph, Dr. Haskell describes the procedure as "Dilation and Extraction".
The term "partial-birth abortion" did not appear until several years later.
According to a Lexis Nexus search, the phrase was first seen in a major newspaper on June 4, 1995  in media coverage of pro-life events in support of that bill. The term "partial-birth abortion" entered official usage when legislators drafted a bill to ban the procedure as the result of lobbying from the Christian Coalition, an active pro-life organization. It supplanted the earlier and more graphic term "brain suction abortion," which was used in an Ohio law that attempted to ban the procedure - though the term "brain suction abortion" was, like "partial birth abortion", an invention of pro-life activists. The former term was coined by extremist Janet Folger .
The procedure is very controversial. The inventor of the procedure called it "a quick, surgical outpatient method" for late second-trimester and early third-trimester abortions. Pro-life critics of the procedure call it "infanticide" or "murder," and the Partial-Birth Abortion Ban Act of 2003, expressing the opinions of those who wrote the law, describes it as "a gruesome and inhumane procedure that is never medically necessary" .
But both pro-choice and pro-life advocates see the partial-birth abortion issue as a central battleground in the more general abortion debate.
A major part of the legal battle over banning partial-birth abortion relates to health exceptions, which would permit the procedure in special circumstances. The 1973 Supreme Court decision Roe v. Wade, which declared many state-level abortion restrictions unconsitutional, did allow states to impose some restrictions on second- and third-trimester abortions. The companion ruling, Doe v. Bolton, required that states' restrictions on abortions must provide an exception for the health of the mother, and defined health to include mental as well as physical health, though in his concurring opinion Chief Justice Burger wrote, "plainly, the Court today rejects any claim that the Constitution requires abortions on demand."
The Partial-Birth Abortion Ban Act (PBA Ban), which was enacted in 2003 and challenged in 2004, included an exception for the life of the mother, but not for non-life-threatening health issues. Broadly worded health exceptions in abortion legislation have previously been interpreted by many American courts to include psychological health, which opponents of the procedure contend is so vague that it renders any attempt at prohibiting abortions toothless.
While some state laws allow late-term abortions in only the most dire of cases under state laws — for example, where the fetus is severely malformed and dying — many of these restrictions are claimed by abortion supporters to be constitutionally invalid. As of February, 2005, 17 states had bans on post-viability abortions that abortion supporters say do not meet Supreme Court requirements: three states allow late-term abortions only when the mother's life is in danger, four other states allow late-term abortions only when the mothers physical (but not mental) health is in jeopardy, and 13 states ban all abortions performed after a certain point in pregnancy. Nineteen (plus the District of Columbia) allow them when necessary to preserve the woman's life, physical health, or mental health.
At least three states (Delaware, Minnesota, and Utah) have no current policy regarding post-viability abortions because the laws in those states are blocked by court order. Most or all of the remaining 47 states, plus the District of Columbia, impose some regulation on late-term abortion .
Supporters of late-term abortion procedures argue that they prevent the pregnant woman from having to undergo childbirth or abdominal and uterine incisions of a caesarian section (c-section) when the child would not survive. However, critics claim (and the inventor of the procedure has confirmed) that most partial-birth abortions are elective. Critics also claim that partial-birth abortion subjects mothers to unnecessary risks for the convenience of the physician. Partial-birth abortion is particularly a target of pro-life advocates because they believe the procedure most clearly illustrates why abortions, and especially late-term abortions, are immoral.
Opponents of the PBA Ban have said that claim is "inherently contradictory in view of the fact that none of the proposed bans have contained exceptions for cases in which the fetus is dying or already dead" and they have also argued that the definition of such a ban is so vague that the law would have a chilling effect on physicians performing any abortion or other gynecological procedures such as D&C (dilation and curettage), used for various conditions of the uterus.
Some opponents of the PBA Ban in the United States say that the proponents' argument is based on religious objections to the procedure and that to create legislation based on these religion objections violates the principle of separation of church and state. Supporters of the ban say such arguments are equally applicable to other forms of homicide.
Since the nature and even the name of the procedure is so widely disputed, both opposing views will be listed with no editorialization or commentary. These descriptions represent only the point-of-view of the author and the organization which provided them. They should both be considered extremely biased and supporting the POV of the authors.
(Pro-Choice position) Planned Parenthood description
- Dilation and Evacuation
- Dilation and evacuation (D&E) is performed in two steps.
- The first step of a D&E involves cervical preparation (softening and dilation).
- The vagina is washed with an antiseptic.
- Absorbent dilators may be put into the cervix, where they remain for several hours, sometimes overnight. Misoprostol may also be used to facilitate dilation of the cervix.
- During the second step of a D&E
- The woman may be given medication to ease pain and/or prevent infection.
- A local anesthetic is injected into or near the cervix. General anesthesia can also be used.
- The dilators are removed from the cervix.
- The fetus and other products of conception are removed from the uterus with surgical instruments and suction curettage. This procedure takes about 10-20 minutes.
(Pro-Life position) National Right to Life description
- Partial-Birth Abortion
- Abortionists sometimes refer to these or similar types of abortions using obscure, clinical-sounding euphemisms such as "Dilation and Extraction" (D&X), or "intact D&E" (IDE) which mask the realities of how the abortions are actually performed.
- This procedure is used to abort women who are 20 to 32 weeks pregnant -- or even later into pregnancy. Guided by ultrasound, the abortionist reaches into the uterus, grabs the unborn baby's leg with forceps, and pulls the baby into the birth canal, except for the head, which is deliberately kept just inside the womb. (At this point in a partial-birth abortion, the baby is alive.) Then the abortionist jams scissors into the back of the baby's skull and spreads the tips of the scissors apart to enlarge the wound. After removing the scissors, a suction catheter is inserted into the skull and the baby's brains are sucked out. The collapsed head is then removed from the uterus.
Controversy over life and health
The Partial-Birth Abortion Ban Act of 2003, like most earlier legislative attempts to ban PBAs, includes an exception for situations in which a partial-birth abortion is necessary to save the life of the mother, even though the bill's Findings section says that such situations never occur. That provision was intended to broaden support for the legislation, and prevent judicial challenges. However, broadly-worded "health" exceptions, which would include ephemeral considerations like "psychological well-being," are not included. Opponents of these laws question their constitutionality without such exceptions. During his two terms in office, President Clinton twice vetoed partial-birth bans because he said they did not adequately address this issue. The Supreme Court likewise struck down as unconstitutional a Nebraska state law in Stenberg v. Carhart that did not include a health exception. Pro-life advocates were staunchly against including a broadly-worded health exception because they believed that under the current legal definition of "health," mental or psychological health could be included, in their view nullifying the law. They believed that they adequately addressed this in the findings section of the most recent version of the legislation (cited below), because they have included with the legislation a large amount of supporting documentation -- including a statement by the American Medical Association -- which they argue demonstrates that there is no medical situation under which this procedure could be used to preserve the physical health of the mother. However, federal courts in 2004 in San Francisco, Nebraska and New York have blocked implementation of the federal PBA Ban; those cases are under appeal.
Law in the United States
On November 5, 2003, President George W. Bush signed the Partial-Birth Abortion Ban Act (HR 760, S 3), which defined partial-birth abortions as:
- an abortion in which --
- (A) the person performing the abortion deliberately and intentionally vaginally delivers a living fetus until, in the case of a head-first presentation, the entire fetal head is outside the body of the mother, or, in the case of breech presentation, any part of the fetal trunk past the navel is outside the body of the mother for the purpose of performing an overt act that the person knows will kill the partially delivered living fetus; and
- (B) performs the overt act, other than completion of delivery, that kills the partially delivered living fetus
Opponents of the ban claim that this definition could include even the first-trimester vacuum aspiration of embryos through the vaginal canal. Supporters of the PBA Ban deny this, and point to the "Findings" section, which describes the procedure as "an abortion in which a physician delivers an unborn child's body until only the head remains inside the womb, punctures the back of the child's skull with a sharp instrument, and sucks the child's brains out before completing delivery of the dead infant."
The federal PBA Ban contains an exemption for protecting the health of the mother, but opponents argue that it is insufficiently broad. The bill states that it "does not apply to a partial-birth abortion that is necessary to save the life of a mother whose life is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy itself." Opponents say this wording is counter to Justice Sandra Day O'Connor's concurring opinion in the 5-4 Stenberg v. Carhart decision, in which the Supreme Court struck down the Nebraska law. O'Connor stated that any ban would have to include an exception for the health of the mother.
As a result, federal judges in San Francisco, New York and Lincoln, Nebraska have blocked the implementation of the law while court cases were being argued. On June 1, 2004, Judge Phyllis Harmon struck down the law in the San Francisco case, stating that "The act poses an undue burden on a woman's right to choose an abortion."
The New York and Nebraska cases are ongoing.
In December 2003, the Sixth U.S. Circuit Court of Appeals upheld Ohio's Partial-Birth Abortion Ban. Its exception allows the procedure only when necessary "to preserve the life or health of the mother as a result of the mother's life or health being endangered by a serious risk." The Court held that, "a valid health exception need only permit the partial birth procedure when necessary to prevent significant, as opposed to negligible, health risks." Martin Haskell, who had sued to block the law, declined to appeal the ruling..
Ohio's current law calls the procedure "partial birth feticide." Ohio's previous attempt to ban PBAs, which was blocked by the courts, called the procedure "brain suction abortion."
Biased links (both pro-life and pro-choice)