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Partial birth abortion (view source)
Revision as of 19:17, October 24, 2010
, 19:17, October 24, 2010added line drawings (which for some reason do not display properly, though they seem to be formatted correctly), and establishing the proper historial context for the illustration of the cranioclast.
[[File:Cranioclast.jpg|thumb|200px| Cranioclast: an instrument used to crush
[[File:Lilpba1_(2).gif|thumb|200px| Line illustration of extraction abortion procedure, grasping the fetal leg]]
'''Partial Birth Abortion''' is a late-term [[Abortion|abortive procedure]] in which all of a fetus (except for the head) is removed from the womb through the [[cervix]] (the same pathway through which birth occurs; hence the name), and is then killed. The official medical term is "intact dilation and extraction" abortion.
'''Partial Birth Abortion''' is a late-term [[Abortion|abortive procedure]] in which all of a fetus (except for the head) is removed from the womb through the [[cervix]] (the same pathway through which birth occurs; hence the name), and is then killed. The official medical term is "intact dilation and extraction" abortion.
[[File:Lilpba3.gif|thumb|200px| Line illustration of extraction abortion procedure, pulling the fetus into position]]
The procedure accounts for 0.17% of all abortions in the U.S., but due to its grisly nature, has become an important battleground within the greater [[abortion controversy]]. <ref>http://www.abortioninfo.net/facts/pba.shtml</ref>
The procedure accounts for 0.17% of all abortions in the U.S., but due to its grisly nature, has become an important battleground within the greater [[abortion controversy]]. <ref>http://www.abortioninfo.net/facts/pba.shtml</ref>
==History==
==History==
[[File:Cranioclast.jpg|thumb|200px| Cranioclast: an instrument used to crush
the baby's skull so as to allow the extraction.]]
Prior to [[Roe vs. Wade]] and [[Doe vs. Bolton]], there was no such concept as a post-viability abortion. Abortion was, by definition, the death, either natural or inflicted, of a pre-viable fetus. The closest practice to what we know as late abortion was the [[destructive operation]], performed to remove a fetus who had died during [[obstructed labor]]. The destructive operation is sometimes still used in areas that lack the medical facilities to perform safe Cesarean sections<ref>[http://www.springerlink.com/content/l701707824138666/ Savita Rani Singhal, Pooja Chaudhry, Krishna Sangwan and Suresh Kumar Singhal, "Destructive operations in modern obstetrics", ''Archives of Gynecology'', Volume 273, Number 2, 107-109]</ref><ref>[http://www.meb.uni-bonn.de/dtc/primsurg/docbook/html/x5765.html Nelson Awori et al., ''Primary Surgery'', Online Edition on special wish of the editors Maurice King and Peter C. Bewes expressed on the 8th. DTC Symposium in Jena 1999]</ref>, but elsewhere it has been supplanted.<ref>[http://www.gfmer.ch/Obstetrics_simplified/caesarean_section.htm Diaa M. EI-Mowafi, ''Obstetrics Simplified'']</ref>
With ''Roe'' and ''Doe'', the Supreme Court declared that there was a Constitutional right to an "abortion" even past fetal viability. US abortionists thus were limited in scope only by their own willingness to destroy fetal life. It was only after the [[Planned Parenthood vs. Casey]] decision that states were permitted to limit post-viability abortions. Many still do not, or do not enforce laws that [[Casey]] had established as enforceable.
In the immediate post-''Roe'' era, abortions past the midpoint in pregnancy were typically performed by [[saline abortion | instillation]], in which drugs or chemicals, alone or in combination, were used to cause fetal demise and induce labor. These abortions carried with them numerous drawbacks. They were risky for the mother, since the chemicals used to kill the fetus could severely injure or even kill the mother if they entered her bloodstream.<ref name="Wagatsuma1">Wagatsuma, T.: "Intraamniotic Injection of Saline for Therapeutic Abortion," ''American Journal of Obstetrics and Gynecology'', November 1, 1965</ref> They were also logistically challenging, requiring a typical multi-day hospital stay. Furthermore, they required a delay until about 16 weeks into the pregnancy, prior to which point there was not sufficient amniotic fluid for the practitioner to extract and replace.<ref name="Cates1">Cates, W. Jr., Schulz, K.F., Grimes D.A., et al: "The Effects of Delay and Method of Choice on the Risk of Abortion Morbidity," ''Family Planning Perspectives'', 9:266, 1977.</ref>
In the immediate post-''Roe'' era, abortions past the midpoint in pregnancy were typically performed by [[saline abortion | instillation]], in which drugs or chemicals, alone or in combination, were used to cause fetal demise and induce labor. These abortions carried with them numerous drawbacks. They were risky for the mother, since the chemicals used to kill the fetus could severely injure or even kill the mother if they entered her bloodstream.<ref name="Wagatsuma1">Wagatsuma, T.: "Intraamniotic Injection of Saline for Therapeutic Abortion," ''American Journal of Obstetrics and Gynecology'', November 1, 1965</ref> They were also logistically challenging, requiring a typical multi-day hospital stay. Furthermore, they required a delay until about 16 weeks into the pregnancy, prior to which point there was not sufficient amniotic fluid for the practitioner to extract and replace.<ref name="Cates1">Cates, W. Jr., Schulz, K.F., Grimes D.A., et al: "The Effects of Delay and Method of Choice on the Risk of Abortion Morbidity," ''Family Planning Perspectives'', 9:266, 1977.</ref>
[[File:Lilpba3_(2).gif|thumb|200px| Line illustration of extraction abortion procedure, grasping the fetal leg]]
The dilation and evacuation (D&E) abortion technique had already been developing, "in part because surgeons needed a `right now' solution to complete suction abortions inadvertently started in the second trimester and in part to provide a means of early second trimester abortion to avoid necessary delays for instillation methods." As practitioners became more skilled and more confident, they performed D&E later and later in pregnancy, and this method began to eclipse the use of instillation methods.<ref name="Haskell">Haskell, M.: "Dilation and Extraction for Late Second Trimester Abortion," Presented at the National Abortion Federation Risk Management Seminar, September 13, 1992</ref>
The dilation and evacuation (D&E) abortion technique had already been developing, "in part because surgeons needed a `right now' solution to complete suction abortions inadvertently started in the second trimester and in part to provide a means of early second trimester abortion to avoid necessary delays for instillation methods." As practitioners became more skilled and more confident, they performed D&E later and later in pregnancy, and this method began to eclipse the use of instillation methods.<ref name="Haskell">Haskell, M.: "Dilation and Extraction for Late Second Trimester Abortion," Presented at the National Abortion Federation Risk Management Seminar, September 13, 1992</ref>
[[File:Lilpba4_(2).gif|thumb|200px| Line illustration of extraction abortion procedure, creating a hole in the base of the skull]]
As one practitioner noted, "Classic D&E is accomplished by dismembering the fetus inside the uterus with instruments and removing the pieces through an adequately dilated cervix."<ref name="Haskell"/> He also noted that at and beyond 20 weeks of gestation, most abortionists found the fetal tissues too tough to easily tear apart. Thus, methods were developed to kill the fetus in-utero a day or more prior to dismemberment, so as to allow autolysis or softening of the fetal tissues. This method, however, also carried a risk of infection.<ref name="Haskell"/>
As one practitioner noted, "Classic D&E is accomplished by dismembering the fetus inside the uterus with instruments and removing the pieces through an adequately dilated cervix."<ref name="Haskell"/> He also noted that at and beyond 20 weeks of gestation, most abortionists found the fetal tissues too tough to easily tear apart. Thus, methods were developed to kill the fetus in-utero a day or more prior to dismemberment, so as to allow autolysis or softening of the fetal tissues. This method, however, also carried a risk of infection.<ref name="Haskell"/>
[[File:Lilpba5_(2).gif|thumb|200px| Line illustration of extraction abortion procedure, suctioning out the fetal brain]]
[[California]] [[abortionist]] [[James McMahon]] is credited with resolving the difficulty, around 1983, by developing what he called "intrauterine cranial decompression", involving extensive dilation of the cervix to extract the fetus feet-first, then kill it just before completing the delivery by removing the [[brain]] with a suction cannula.<ref>Tumulty, K.: "[http://www.time.com/time/nation/article/0,8599,1613078,00.html The Abortion Ruling: An Isolated Win?]" ''Time'', April 20, 2007</ref> [[Ohio]] abortionist [[Martin Haskell]] indicated that he stumbled across the method himself independently of McMahon:
[[California]] [[abortionist]] [[James McMahon]] is credited with resolving the difficulty, around 1983, by developing what he called "intrauterine cranial decompression", involving extensive dilation of the cervix to extract the fetus feet-first, then kill it just before completing the delivery by removing the [[brain]] with a suction cannula.<ref>Tumulty, K.: "[http://www.time.com/time/nation/article/0,8599,1613078,00.html The Abortion Ruling: An Isolated Win?]" ''Time'', April 20, 2007</ref> [[Ohio]] abortionist [[Martin Haskell]] indicated that he stumbled across the method himself independently of McMahon: