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Term And Partial Birth Abortions: The Mythical Arch-Nemeses Of The Anti-Choice Movement

"Let’s Talk About Roy Moore’s Extremism on Abortion"

Dr Jennifer Gunter, Contributor
OB/GYN, writer, sexpert, defender of evidence-based medicine, Canadian Spice

Here’s what data — and logic — tell us about late-term abortions.

10/23/2016 07:42 pm ET Updated Oct 24, 2016

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What is a partial birth abortion?

I don’t know and I am trained in later-term abortions (by that I mean procedures after 16-18 weeks). I don’t do them anymore, but I know what I am talking about.

"The more women say how these procedures saved their lives, the more the anti-choice movement responds with cruelty."

First of all, one can’t be partially born. In obstetrics, you are pregnant or you aren’t, and you are delivered or you are not. For example, there is an obstetrical emergency called shoulder dystocia where the fetal head delivers but the shoulders get stuck. It’s an emergency and if you don’t act appropriately and promptly, the outcome can be horrendous. Even in this situation, the pregnancy is not delivered until every part is delivered. Using the term “partial birth abortion” is like saying “cutting out half the guts” when you really mean a hemicolectomy. The former is a very imprecise and poor descriptor for the latter.

The American Congress of OB/GYNs (ACOG) has taken this term “partial birth abortion” to mean an intact dilation and evacuation without fetal demise before the procedure. Some also call this procedure a dilation and extraction or D & X. It involves delivering the smallest fetal part through the cervix and decompressing the cranium with suction if needed. That may be hard for some to read, but this is surgery.

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When might a later term abortion and specifically D & X be indicated?

Anytime a woman after 20 weeks needs to be delivered. Remember: with D & X the complication rate 0.5-5 percent, and a c-section has a complication rate of 27 percent (but complication rates with c-sections rise the more premature the delivery and with maternal health problems, like infection or high blood pressure).

Consider a woman at 35 weeks and her fetus has Potter syndrome. This is typically not compatible with life (basically no kidneys or lungs). She did not want to have a termination and elects to go through with the pregnancy and deliver at term. She is now 35 weeks and her fetus is a transverse lie (meaning it’s laying sideways not head down or bottom down) and so can’t come out vaginally with a normal labor. The doctors can’t even attempt to turn it head down with a procedure called an external cephalic version because with Potter syndrome there is no fluid and without fluid you can’t turn a fetus. Her choices are a c-section or a D & X.

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As an OB/GYN, I can come up with hundreds of scenarios where a D & X is the medically preferred procedure. Every timeI think something is just too catastrophic to happen, the human body surprises me. With the “partial birth” abortion ban, the government took the safest medical option off the table in most states. According to ACOG “the safety advantages of intact dilatation and evacuation (intact D&E) procedures are widely recognized—in medical texts, peer-reviewed studies, clinical practice, and in mainstream, medical care in the United States.”
The ninth month myth

I’ve summarized this elsewhere, but suffice it to say that later procedures – after 23 weeks – happen because of A) maternal health issues like the ones I’ve described above B) fetal anomalies as described above or C) both. There is zero evidence that fetuses who are “perfect” or those with minor abnormalities, like a cleft lip, are being aborted at 24 weeks ? never mind close to the due date. Data aside, let’s just use logic.

https://www.huffingtonpost.com/entry/term-and-partial-birth-abortions-the-mythical-arch-nemeses-of-the-anti-choice-movement_us_580d4427e4b02444efa3f33a

On the question of abortions it is inarguable that extreme religious conservatives put their perceived loyalty to their interpretation of
what their religious orthodoxy commands them to think, feel and act ahead of serious and understanding concern for women's health.