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"Partial Birth" Abortion, Total Confusion

<!---TITLE--->Partial Birth Abortion
BY CYNTHIA COOPER

vote buttonSitting barefoot on her couch at home, Faye Hornung is shifting through papers, trying to piece together information about the abortion she had two and a half years ago. The 46-year-old mother isn't agitating about whether getting an abortion was the right thing to do. She knows, as more than one doctor told her, that it was what needed to be done under the circumstances - her unborn baby was severely deformed and had little chance of surviving.

Framed by stuffed animals that belong to her six-year old daughter, Hornung is searching newspaper articles to determine if the procedure her doctor used is the one that politicians refer to when they talk about "partial-birth abortion."

abortion quote It is not a simple question for Hornung to answer. Judges across the country are also having difficulty defining it.

Banning late-term abortions or all abortions?

According to many legal experts, state and federal attempts to outlaw so-called "partial birth abortions" do not adequately define just what constitutes this type of an abortion, but rather use this undefined catch-all phrase in an attempt to outlaw all abortions. At issue are the very principles that underlie women's right to choose an abortion first set out by the U.S. Supreme Court in Roe v. Wade in 1973.

In April, the U.S. Supreme Court will hear arguments on a Nebraska "partial birth abortion" law, which was already rejected as unconstitutional by federal district and appellate courts. The law, which never took effect, refers to "an abortion in which a person performing the abortion partially delivers vaginally a living unborn child," and applies, without limitation, to all trimesters of a woman's pregnancy.

By wiping out any reference to the period of gestation of a fetus and by skipping over the fact that virtually all abortion methods involve removing (or "delivering") the fetus through the vagina, the law means nearly every woman's abortion could be subject to review by a determined prosecutor.

In 30 states, nearly identical laws have been passed banning "partial birth abortion." In 20 out of the 21 challenges that have been mounted, courts have tossed out the bans.

A judge in Michigan wrote, "The 'plain language' of the statute clearly left the physicians who testified confused as to its meaning and application." The term "partial birth abortion," noted another judge, was coined by anti-abortion activists and had no medical meaning.

One woman's Story

The right to choose is no abstraction to Hornung, although, she says, "choice" may be the wrong word to describe her situation. She can recite with precision the events that led up to her abortion in August 1997.

"The doctor calls me on a Wednesday at about 3 o'clock," says Hornung, a freelance photographer. He said he had results from her amniocentesis, the test to detect chromosomal or genetic deformities in a fetus.

"It's not good news," he said. "Trisomy 18" is the term she heard next. She wrote it on a sheet of paper and traced the letters over and over again, as if the repetitive action might give her some insight into what it was.

"What's that?" she asked. "It means it's a very deformed fetus," her doctor replied. "Deformed how?" asked Hornung. "Very deformed." Only later, did Hornung learn the full implications of Trisomy 18: blindness; deafness; undersized; possibly stillborn; babies born with it rarely live beyond 6 months.

"I was in shock -- I was hyperventilating," says Hornung, who suffered several miscarriages before delivering a healthy baby in 1994. In that pregnancy, she had been careful not to plan in advance in case something went wrong. This time had been different. "In my head, I had a name. I knew it was a girl. I was thinking a lot about my daughter having a baby sister. I was giving this baby a personality."

Devastated, Hornung began frantic phone calling. Her husband rushed home from work. Despite the fact that "partial-birth abortion" laws would ban abortions even in cases of severe fetal anomalies, such as Hornung's, or in situations in which the woman's health is endangered, Hornung's doctors, relatives, and friends all supported her decision to get an abortion. But where? And how?

Rare procedure

Second trimester abortions are more rare than others, and fewer doctors perform them. The Kaiser Family Foundation, a health care research institute, estimates that one-third of the nation's 40,000 Ob-Gyns perform at least one abortion each year. Abortions are provided regularly at about 2,000 clinics and hospitals, according to a 1996 analysis by the Alan Guttmacher Institute, a policy and research institute that studies reproductive health. But only 470 provided abortions in the 19th week..

Of the approximately 1.3 million abortions each year, only 10 percent take place after the first trimester of pregnancy (12 weeks or under) according to the Centers for Disease Control. At 19 weeks, a fetus is still "pre-viability" -- the point at which it can live outside the womb, which occurs in the earliest cases at 23-24 weeks, and in most cases at 26 weeks, according to the Guttmacher Institute.

Post-viability abortions, which constitute less than .04 percent of all abortions, are already limited in all states by court decisions, and in 40 states specific laws also restrict them. Laws in four states prevent or restrict abortions after 20 weeks.

Health and politics

Hornung's own obstetrician didn't do second trimester abortions. Hornung scrambled. As a New Yorker, she had resources, as long as she could find them. But in 95 percent of the non-metropolitan counties in the U.S., women have no abortion provider, according to the Guttmacher Institute.

If "partial birth abortion" laws were in effect, doctors who use a procedure that is deemed by a prosecutor to fall under the law, can be arrested. In some states, such as Wisconsin, the penalties call for life imprisonment.

Later in the afternoon, as her neighbors sat with her, Hornung found a clinic in Manhattan that could help her. The clinic's medical personnel explained that the procedure would take two days. On the first day, dilators would be inserted to open up the cervix. On the second day, the fetus would be removed.

Intact dilation and extraction, the ostensible target of "partial birth abortion" laws, is slightly different. According to the American College of Gynecologists and Obstetricians, it involves several days of dilation, turning the fetus in the womb, and, in order to prevent injury to the woman, collapsing the head of the fetus before it is pulled through the cervix. The Guttmacher Institute estimates, at most, 650 such abortions took place in the country at 14 facilities in 1996, far less than one percent of all abortions. Several courts have found that the vague definition in the "partial birth abortion" laws would also sweep in the similarly-named dilation and extraction method -- the procedure Hornung underwent.

After the dilators were inserted, Hornung, a slight woman, went home and climbed into bed. As predicted, she experienced cramping. The next morning, she returned to the clinic. She was given general anesthesia and the doctor removed the fetus. Everything proceeded as smoothly as it could under the circumstances.

There was an aftermath. Hornung felt sadness, a deep disappointment at losing the opportunity to have another healthy child. She also became increasingly angry at articles with outrageous comments by anti-abortion proponents, bandying the terms "partial birth abortion." They "added insult to injury," she says.

Finally, she asked her clinic doctor. Had she had a so-called "partial-birth abortion?" Her doctor responded firmly. "We do what we have to do," he said. "The distinctions are political, nothing else."

Cynthia Cooper is a free-lance writer living in New York City.


 
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