Sunday, April 22

Elections have Consequence : SCOTUS Abortion Decision

In the wake of the Supreme Court's landmark decision to ban so-called "partial-birth" abortions even when the health and life of the mother are endangered, it's about time we began to look at some of the likely results and consequences of this decision.

First lets start with what the legislation of the 108th Congress specifically prohibited under S[3]:
    The Congress finds and declares the following:
      (1) A moral, medical, and ethical consensus exists that the practice of performing a partial-birth abortion--an abortion in which a physician deliberately and intentionally vaginally delivers a living, unborn child's body until either the entire baby's head is outside the body of the mother, or any part of the baby's trunk past the navel is outside the body of the mother and only the head remains inside the womb, for the purpose of performing an overt act (usually the puncturing of the back of the child's skull and removing the baby's brains) that the person knows will kill the partially delivered infant, performs this act, and then completes delivery of the dead infant--is a gruesome and inhumane procedure that is never medically necessary and should be prohibited.
This proceedure as described is known as Dilation and Evacuation (D&X) and according to a report from Raw Story when this issue began to be originally raise in 1992, the proceedure which was invented in 1992, had only been performed twice on pregnancies older than 24 weeks (which is the Roe mandated cut-off).

In their act, the Congress argued that late-term abortions, whether they were before or after the cut-off, should be prohibited simply because the procedure itself induces labor and thus the baby once being "partially born" should be allowed to complete the process.
(H) Based upon Roe v. Wade, 410 U.S. 113 (1973) and Planned Parenthood v. Casey, 505 U.S. 833 (1992), a governmental interest in protecting the life of a child during the delivery process arises by virtue of the fact that during a partial-birth abortion, labor is induced and the birth process has begun. This distinction was recognized in Roe when the Court noted, without comment, that the Texas parturition statute, which prohibited one from killing a child `in a state of being born and before actual birth,' was not under attack. This interest becomes compelling as the child emerges from the maternal body. A child that is completely born is a full, legal person entitled to constitutional protections afforded a `person' under the United States Constitution. Partial-birth abortions involve the killing of a child that is in the process, in fact mere inches away from, becoming a `person'. Thus, the government has a heightened interest in protecting the life of the partially-born child.

Yet D&X or "partial-birth" isn't the only procedure that at this point to protect the health and/or life of the mother under conditions where the fetas has become essentially non-viable, but is not neccesarily still-born.

From Raw Story:

What the guys on sidewalks with giant pictures on sandwich boards don’t tell you is that {D&X} was developed as an alternative to an older, more ghastly procedure: dilation and evacuation. This is when the mother is partially dilated and some sort of grasping tool is used to pull the fetus out—piece by piece.

This procedure is somewhat dangerous to the mother, though, as bones begin to calcify at about 13 weeks gestation (24 weeks is the legal point of viability, at which time states are allowed to limit abortion rights), and shards or even entire body parts can be accidentally left in the uterus after the fetus is dismembered inside, causing infection and other injury.

Congratulations, right-to-lifers! Now that the safer alternative is illegal, this even more horrific procedure is what doctors will once again have to resort to. You haven’t stopped a single abortion, but you’ve placed the slutty mother’s life at risk. You must be proud.

So with all the above in mind, let's see what law describes as actions, if performed by a doctor ,are now a Federal Crime (and note that there are some loopholes and exceptions.)

Sec. 1531. Partial-birth abortions prohibited

    `(a) Any physician who, in or affecting interstate or foreign commerce, knowingly performs a partial-birth abortion and thereby kills a human fetus shall be fined under this title or imprisoned not more than 2 years, or both. This subsection 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. This subsection takes effect 1 day after the enactment.
    `(b) As used in this section--
      `(1) the term `partial-birth abortion' means an abortion in which the person performing the abortion--
        `(A) 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;

As I read this legislation, it appears that the two partial-birth abortions noted by Raw Story would be exempt from prosecution if it was likely the mother would die, but not neccesarily if she might be at risk of significant injury including sterility. The doctor in question would have to demonstrate to their local medical board that the life of the mother was at risk.

His other option would be to perform the far more risky, Dilation and Evacuation.

The question then is exactly who would fall into the group of women needing this procedure to protect their health, but are now prohibited from receiving this care by law?

According to this Chart from the CDC (below) Over the past 15 years the rate of abortions has taken a significant downturn.

It should be noted that several states (Alaska, California, West Virginia and Oklahoma) have not provide all of their data to the CDC since 1998, but even which that limitation this overall sampling is instructive. Between 1994 and 1998 the number of legal abortions recording by the CDC fell from a total 1,333,520 to 1,186,039 a total drop of 147,481 per year or 11%. However that level of decline has not continued, based on the available numbers - excluding the non-reporting states - 1998 total was 884,273 which by 2003 had reached 839,713 for a reduction of 44,560 per year or just 5.03%. In fact, between 2001 and 2002 the abortion rate actually increase by 1,400. (Which indicates that Howard Dean was quite right to say that abortions have increased under George W. Bush)

One truly alarming state is that fact that childen less than 15 are significantly more likely to have an abortion (in ratio to 1000 live births) than women of other ages. (See Figure 2)

Fortunately the stats indicate that only 4,581 such abortions occured in 2003 (only 0.6% of the total) however the general trend for the past several years has been for abortions specifically among teens and young teens to be on the increase, which may explain why the overall abortion numbers have remained essentially flat since 2002 (See Figure 3)

(From Table 5. Not shown) The 2003 stats for legal abortions for children less than 15 years of age is 4,229. In 2002 that figure was 4,196 which is the lowest it's been since the 70's, reversing the trend of previous years where in 2001 it was 4,319 and in 2000 it was 4,537.

Not only do children of this age range have a higher rate of seeking abortions, they also have a higher rate of seeking late abortions (after the first 16 weeks of gestation) where procedures such as "partial-birth" are more likely to be employed due a several problems with the fetus and/or pregnancy.

Even though the available CDC data indicates that only 1.4% of abortions occured after the 21 week gestation period (and prior to the 24 week cut-off) that still accounts for over 9.383 incidents in 2004. Clearly not all of these procedure would fall under "partial-birth" procedure and even for those that did, only some could legitimately be used to protect the life of the mother and thus be protected by the current exception in the law - while others would be prohibited.

The National Right to Life Coalition has claimed in 2003, using numbers from the Alan Guttmacher Institute (AGI), which they assert are more accurate since they don't they survey doctors directly rather than depend on reporting through the states, that the number of "partial-birth" abortions in 2000 was over 2200.

For the second survey in a row, AGI asked abortionists how many of what it calls "Dilation and Extraction" (D&X) abortions the abortionists performed. These are partial-birth abortions. AGI projects there were some 2,200 performed in 2000, which it says represents only 0.17% of all abortions.

At this point it's very difficult to tell exactly what the impact will be. It's possible that some doctors may attempt to dodge the law in order to fulfill thier hippocratic oath and preserve not just the life but also the health of their patients. Some may simply option for the riskier, but apparently still legal evacuation procedure since no actual birth, partial or otherwise occurs. And still another group may comply with the law and allow severe injury to their female patients in order to protect themselves from prosecution and jail.

But what we do know is that a high and growing proportion of these women will be young girls, particularly teenages under the ages of 19 and even 15 who will be permently affective by this supreme court decision for the remainder of their lives - if they're lucky enough to survive at all.


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