My opinion

Responding to my post from a few days ago where I mentioned my dismay over the poorly-reasoned decision by the Supreme Court validating the Partial Birth Abortion Ban Act of 2003, one reader left the following comment:

I don't get how anyone, being either pro-life or pro-choice can be for partial birth abortion. It doesn't even make sense to give the excuse of being for the woman's health, since the child is killed by the doctor as it's actually exiting the birth canal, so I'm not sure what it saves the woman from except having to birth a live child. Have you actually read how it's done? It's a horrific practice, if everyone in this country had to see the procedure done once I'm sure it would be stopped immediately. I understand that the fear is that if ANY rights are taken away, then it's one step closer to stopping legalized abortion. I don't ever see that happening, but I hope that partial birth abortion is done with forever.

Because I believe that there are a lot of misconceptions about this issue – intentionally furthered for political reasons by those who want to undercut a right which profoundly affects women’s lives – I’m going to explain why I hold the view I do. I don’t mean to offend anyone, but I feel strongly about these matters. I don’t want to open up a pro-choice/anti-abortion discussion. If you don’t agree, feel free to speak out on your own blog. I’m not inviting contrary opinions. I’m explaining why I said what I said.

First, the term "partial-birth abortion" is not a medical term. It is not recognized in medical literature, nor is it used by doctors who perform second-trimester abortions. "Partial-birth abortion" is a political phrase designed to inflame the emotions. Period. In fact, the medical community refers to the procedure as "dilation & extraction" ("D&E") or "intact dilation and evacuation." Right out of the starting gate, I have a problem with defining the discussion in terms of the "partial birth abortion" because that term is so biased to begin with. That’s why I also have a problem with Congress purporting to legislate about a medical procedure while framing the legislation in such obvious inflammatory and biased terminology. The wording of the law alone suggests motives which are contrary to the expressed intent of the law.

You’ll remember that the foundation of the right to abortion was stated by the Supreme Court in Roe v. Wade. The central holding of Roe is that up until the point at which a fetus becomes "viable," (or potentially able to live outside of the womb), a woman may lawfully choose to have an abortion for any reason. The court tried to balance the competing interests of women and the government by using trimesters to define the relevant rights: during the first trimester of pregnancy, the state cannot restrict a woman's right to abortion; during the second trimester, the state can only regulate the abortion procedure "in ways that are reasonably related to maternal health"; and during the third trimester when the fetus is deemed to be viable, the state can restrict or ban abortion as it sees fit.

The discussion about the D&E procedure takes place in the context of second trimester abortions, for that is when they are used. But D&E is used rarely, overall: between 85 and 90 percent of all abortions performed in the United States take place during the first three months of pregnancy. So, when people talk about this procedure, they are talking about mid-pregnancy, PRE-viability abortions. And why, you wonder, wouldn’t women wanting an abortion do it in the first trimester? Well, there are significant reasons. Research suggests that adolescents and poor women are more likely than other women to have difficulty obtaining an abortion during the first trimester. Minors may be unaware they are pregnant until relatively late in pregnancy. Poor women’s financial circumstances often prevent them from finding services early in their pregnancies. Further, some women choose to abort their pregnancies when they learn of severe fetal anomalies or confront serious health problems in themselves or their fetuses. Many of those problems cannot be diagnosed or do not develop until the second trimester.

Remember that in our country’s long-standing legal framework, the government may only restrict abortions during the second trimester to protect the health of the woman. A significant number of medical experts say that the intact D&E procedure has been determined to be medically safer for the woman (in certain circumstances) than the alternatives available at this stage of the pregnancy. So, a law which wholly bans this procedure not only runs contrary to Roe v. Wade and subsequent cases, but it also leaves a woman subject to the less safe alternatives. Banning the D&E procedure doesn’t save a single fetus. It simply eliminates one of the safest methods, leaving women exposed to procedures that pose greater medical risk and are, frankly, equally as unpleasant in terms of what happens to the fetus.

And there, I believe, lies the crux of the issue. People react with horror to the concept of "partial birth abortion" because it seems cruel to the fetus. The details of the procedure are horrid... as are the details of every abortion procedure, really. And it’s true: if the standard is cruelty to the fetus, then all abortions are cruel to the fetus. Indeed, the purpose of an abortion is to terminate the life of the fetus. That’s a brutal fact. Any abortion is a horrible act. So, how, logically, can one draw a line? Which abortions are less horrible? The fact that legislators are trying to make these distinctions divorced from medical evidence raises serious concerns because the next logical step is the conclusion that all abortions are cruel to the fetus and must be prohibited.

And that comes back around to the issue of the rights of the woman. In the face of substantial medical evidence that the D&E may be the safest medical alternative for women in certain circumstances, banning the D&E procedure because of its cruelty to the fetus puts the welfare of a pre-viable fetus ABOVE the welfare of the woman carrying it. That thought process not only runs counter to the fundamental principles underlying long-standing law, but it has troubling implications for women.

So, I have a problem with trying to choose which abortion procedures are "good" and "bad" when that judgment is based on the treatment of the fetus, and not on what is safe and medically appropriate for the woman. I have a problem with legislators pretending to protect women, while in reality they’re ignoring substantial medical evidence, not acting based on what is reasonably necessary for the woman’s health, and chipping away at significant rights. I have a problem with the Supreme Court ignoring long-standing legal principles, disregarding medical evidence, and cloaking moral judgment in bad legal reasoning.

And to address the comment specifically, I don’t think anyone is actively FOR "abortion," let alone FOR "partial birth abortion." Like many others, I am for the right to choose whether to bear a child. I am for the availability of safe medical procedures that permit women to control their own bodies. I am for keeping government out of the decision about whether a woman will or should carry and bear a child. I’m also for letting medical decisions be made by medical professionals. I believe that doctors, not legislators, should be in charge of determining which medical procedures are safest and most appropriate under the patient’s specific circumstances.

To me, saying one is "against" this procedure is like saying one is "against" lobotomy, or amputation, or organ removal. They’re all brutal, unpleasant, difficult procedures. No one would choose them if they weren’t necessary. Of course I know what the D&E procedure involves a fetus. But I don’t believe that a non-viable fetus has a right superior or even equal to the right of the woman carrying it.

I know that these are controversial, emotional matters. These are my opinions. And we are all entitled to our own opinions.