A kind of late-term abortion, D&X (also know as partial birth abortion) has been in the news for several years. Many states have passed legislation banning this procedure because of its immoral nature. The Congress has also passed legislation to ban the procedure, all of which have been vetoed by President Clinton. A description of the procedure and why it is never medically necessary follows. Warning: the description below is graphic and upsetting to most people. Do not continue if you are unwilling to suffer some emotional trauma.
Where is the most dangerous place in the United States? Contrary to what most people might think, it is not the inner city, or even death row in many states. The most dangerous place to be in the United States is in the womb of our nation's women. One out of five pregnancies is terminated (the fetus is killed) by the mother.1 In other nations, the death toll is even higher. For example, over 50% of all pregnancies in Russia are terminated through abortion.1 Proponents of abortion want it to be "safe and rare," something it has never been. More than 95% of all abortions are performed purely for convenience (i.e., not using birth control). However upsetting these statistics may be, they seem mild to the reality of late-term abortions, performed on tens of thousands of viable fetuses every year. Babies often survive the procedure to be born alive (see Testimony of Gianna Jessen, an abortion survivor). However, since they are unwanted, they are left alone to die - a process that often takes many hours (see Testimony of Jill L. Stanek, RN).
The D&X procedure itself is rather gruesome.2 The abortion practitioner instrumentally reaches into the uterus, grasps the fetus' feet, and pulls the feet down into the cervix. The reason this is done is not as a medical necessity, but to avoid actually birthing the baby. If the baby were fully born, killing it would be considered murder. The fetus is then pulled down the birth canal until it has been entirely birthed except the head. Surgical scissors are forced into the base of the fetal skull while the fetus is lodged in the birth canal. This blind procedure risks maternal injury from laceration of the uterus or cervix by the scissors and could result in severe bleeding and the threat of shock or even maternal death. A suction apparatus is introduced into the hole in the base of the skull and the fetus' brains are removed through aspiration. The baby is then born dead. The entire procedure is performed on the fetus without the use of anesthesia even though it is clearly capable of feeling pain (studies have shown that the ability to feel pain begins early in the second trimester3).
D&X is most commonly performed between 20 and 24 weeks and thereby raises questions of the potential viability of the fetus. Information from 1988 through 1991 indicates a 15% viability rate at 23 weeks' gestation, 56% at 24 weeks, and 79% at 25 weeks.4 Proponents of D&X have 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.5, 6 In actuality, one facility alone admitted to performing 1500 of these procedures, the vast majority of which were carried out on healthy mothers with normal fetuses.7 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."8 James T. McMahon, MD, of Los Angeles, CA, in detailing for the US Congress his experience with more than 2000 partial-birth abortion procedures stated that only 9% of those involved maternal health indications (of which the most common was depression).9 In fact, the insertion of instruments into the uterus is not without risks, since 1 out of 6,000 of these kinds of procedures results in the death of the mother (death from childbirth is 1 out of 13,000).10
Is the procedure ever medically necessary? First of all, the procedure itself requires several days to perform, since the cervix must be dilated first. This means that the procedure is never used in an emergency to save the life of the mother. In addition, the procedure is medically risky to the mother. According to Drs. M. LeRoy Sprang and Mark G. Neerhof:
"None of these risks are medically necessary because other procedures are available to physicians who deem it necessary to perform an abortion late in pregnancy. As ACOG policy states clearly, intact D&X is never the only procedure available."11
In writing for the Journal of the American Medical Association, Drs. M. LeRoy Sprang and Mark G. Neerhof, conclude with the following statement:
"Intact D&X (partial-birth abortion) should not be performed because it is needlessly risky, inhumane, and ethically unacceptable. This procedure is closer to infanticide than it is to abortion."11
- Do Fetuses Feel Pain During An Abortion? - A new scientific study shows that cortical brain responses to pain occur in infants as young as 25 weeks gestational age.
- Science and Abortion- The Scientific Basis for a Prolife Position
- Is Abortion or Childbirth Safer for a Woman?
- The Bible and Abortion - the biblical basis for a prolife position
- Confessions of a Pro-Life Atheist - Why Abortion Rights is not a Religious Question
- "After Birth Abortion": Infanticide (Killing Babies) is Okay According to Doctors
- Statement of Brenda Pratt Shafer, R.N. - Before the Subcommittee on the Constitution Committee on the Judiciary, U.S. House of Representatives. A pro-choice nurse who watched in horror the procedure of partial birth abortion. (Off site)
- Testimony of Gianna Jessen, Hearing on H.R. 4292, the "Born-Alive Infants Protection Act of 2000", House Judiciary Subcommittee on the Constitution, July 20, 2000
- Testimony of Jill L. Stanek, RN, Hearing on H.R. 4292, the "Born-Alive Infants Protection Act of 2000", House Judiciary Subcommittee on the Constitution, July 20, 2000
- M. L. Sprang and M. G. Neerhof. 1998. Rationale for Banning Abortions Late in Pregnancy. Journal of the American Medical Association 280:744-747. (Off site)
- Testimony by Curtis Cook, M.D., Maternal Fetal Medicine, Butterworth Hospital Michigan State College of Human Medicine
- Letter Regarding Partial Birth Abortion - AMA
- Testimonies of women who have had abortions:
I had a quick sonogram and then received a shot of methrotrexate. This is a drug that is used for cancer treatment, it stops cell growth. After the shot, I came home... I went to bed that evening around 9 p.m. I used the suppositories as soon as I went to bed. I remember feeling the contractions start about half an hour later. In the beginning, they were mild, but within an hour the pain was severe. I continued contracting and bleeding most of the night. Around three in the morning, I went to the bathroom. I had been passing a lot of clots most of the evening. I assumed that the pain and pressure I was feeling was from more clots. When I stood up, I noticed that the pain and the pressure was not from clots, but from passing the placenta. When I looked in the commode, I saw laying in the center of the placenta my baby. I saw the baby's perfectly formed hands, the little fingers. I remember the scream that came from my mouth... [from a 7 week abortion] (I used to be Pro-choice...But...)
- Percentage of Pregnancies Aborted by Country compiled by Wm. Robert Johnston.
- American College of Obstetricians and Gynecologists (ACOG) statement of policy. Approved by the
executive board January 12, 1997 and distributed to ACOG chairs.
The procedure according to the ACOG review panel on intact D&X:
- the deliberate dilation of the cervix, usually over a sequence of days
- instrumental conversion of the fetus to a footling breech
- breech extraction of the body, excepting the head
- partial evacuation of the intercranial contents of a living fetus to effect vaginal delivery of a dead but otherwise intact fetus.
- Giannakoulopoulos X, Sepulveda W,
Kourris P, Glover V, and Fisk NM. 1994. Fetal plasma cortisol and beta-endorphin response to
Slater, R, A. Cantarella, S. Gallella, A. Worley, S. Boyd, J. Meek, and M. Fitzgerald. 2006. Cortical Pain Responses in Human Infants. The Journal of Neuroscience 26: 3662-3666.
- Allen MC, Donohue PK, Dusman AE. 1993. The limit of viability: neonatal outcome of infants born at 22 to 25 weeks' gestation. N Engl J Med. 329:1597-1601.
- Jouzaitis C. Foes line up anew on late abortions. Chicago Tribune. February 27, 1997:3.
- Seelye KQ. House, by broad margin, backs ban on late type of abortion. New York Times. March 21, 1997:A1, A14.
- Gianelli DM. 1997. Abortion rights leader urges end to "half truths." American Medical News. March 3, 1997;3, 4, 55, 56.
- Gianelli DM. 1996. Bill banning partial-birth abortions goes to Clinton. American Medical News. April 15, 1996:9, 10.
- Statement of representative Charles T. Canady (R-Fla). Congressional Record; July 24, 1996.
- Facts in Brief: Induced Abortion. 1996. New York, NY: Alan Guttmacher Institute.
- M. L. Sprang and M. G. Neerhof. 1998. Rationale for Banning Abortions Late in Pregnancy. Journal of the American Medical Association 280:744-747.
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