April 21, 2006

Premature Babies Adopted!

by PG

[Sorry, Blogger is down, so an unabashedly political and non-legal post is going on De Novo.]

Also recently appearing on Southern Appeal:

Life of the mother, my a*s
Filed under: Abortion
By Steve Dillard (Email) @ 1:16 pm

PBA can, in no way, be characterized as a “life-saving measure.”

The link in the post is to a video of William R. Lile, Jr., DO, a specialist in obstetrics and gynecology, depicting a "partial birth abortion." I watched it and made a list of information not included in the video, which otherwise struck me as accurate.

1) "Partial birth abortion" is not a term that appears in medical literature except in articles about law and policy debates. What is shown in the video appears to be a procedure called dilation and extraction (also intact D&X and intrauterine cranial decompression).

2) D&X cannot be performed at "any" stage of pregnancy, only when the fetus is sufficiently large that it must be taken partially out of the uterus to be killed. In the first trimester of pregnancy, when abortions cannot be restricted legally, the embryo (term used until 8th week of development)/ fetus is killed through use of prescription drugs like RU-486, or by being vacuumed out of the uterus. In the second trimester, 12-20 weeks after the woman’s last period, abortion can be done through the dilation and evacuation procedure, in which the fetus is killed while still entirely inside the uterus. This procedure carries much more risk to the woman than does D&X, because of the danger of uterine perforation that the fetus’s broken bones present.

3) One cannot be an abortionist without being a doctor. If an abortionist loses her medical license, she no longer is legally permitted to perform abortions. Therefore when Dr. Lile says he is using the term doctor “loosely” in referring to an abortionist, there is nothing loose about it legally, only ethically; many people believe that by killing fetuses, an abortionist violates the Hippocratic Oath: “First, do no harm.”

4) In the video, there is no plastic pregnant woman out of which Dr. Lile draws the plastic infant. The doll is pulled out from under a black cloth instead. A black cloth cannot be anesthetized and transfer that anesthetic through the placenta to the fetus inside it, but a woman can, and thus a real fetus is unlikely to be doing the kicking Dr. Lile describes.

5) Dr. Lile concludes, “Babies that would do just fine, we have babies that do well at 23, 24, 25 weeks in our intensive care nursery, and we have great survivals, these [being aborted] are babies that are even further along than that.”

The statement pointed up the inaccuracy of his implying that the procedure he acts out is done in the first trimester, as I do not know of any fetus that has survived leaving the uterus in the first trimester; these are uniformly miscarriages, also known as “involuntary abortions,” that result in a dead fetus. No fetuses that gestated for less than 20 weeks are documented to have survived even a full week after delivery. On average, the air sacs in the fetus’s lungs do not form until the 24th week of gestation, so the babies that survive delivery (particularly if they survive “neurologically intact,” i.e. not disabled to the point of never being independently mobile nor able to communicate effectively with others) at that point are likely to be those whose lungs developed earlier than average and who therefore were more capable of oxygen absorption and brain development in the NICU. U.S. and Canadian obstetric guidelines say any baby born at 25 weeks or later should be resuscitated, so Dr. Lile’s claim that babies of that level of gestation or greater can be said to do “just fine” has greater statistical accuracy.

6) There is a genuine lack of documentation on how abortion, particularly late term abortion, happens in America. People who want to keep it legal say that D&X is very rare and most often performed when the mother’s life or health is at risk, or the fetus is dead or unable to survive delivery. People who want to make it illegal say that it happens more often and that the life and health exception is a “canard,” particularly with regard to mental health.

No one has told me about a woman she knows who got an abortion after the first trimester simply because she couldn’t make up her mind to do it before then. However, one of my classmates told me about a friend who is kept literally sane by medication that, if she were to become pregnant, would cause significant birth defects in the fetus. I am not going to deride such a situation by saying that the mental health exception is stupid or meaningless. My roommate and close friend from college told me about her sister, who aborted a dead fetus. I am not going to say that women should be compelled to deliver dead or soon-to-be dead fetuses.

Abortion is an inherently unpleasant procedure even for women who regard the embryo as a parasite, and traumatic for those who feel an emotional connection to the fetuses they kill. The movement to make abortion illegal has many supporters who have decided that because they didn’t want the abortions they had, all abortions must be unwanted. (I am not the first to analogize this to an idea that people who misunderstand Catharine MacKinnon and Andrea Dworkin have: that in a world where rape occurs, all sex must be rape.)

The lack of documentation is the fault of the pro-choice movement. It has allowed its defense of abortion recipients’ privacy and own dislike of what Ronald Dworkin calls the “cosmic tragedy” of abortion to blind it to the need for real facts to combat the prohibitionists’ claims. Encouraging women to speak about the circumstances of their abortions is a beginning, but anecdotes are not enough; statistics on the number of late-term abortions performed, the reasons given, the documentation of pre-existing mental health conditions, etc. are necessary. Until then, Feddie and his ilk will continue to sneer, “Life of the mother, my ass.” (They may well continue to sneer it afterwards, but at least then pro-choicers can retort with accurate numbers.)

7) The dilemma of what to do about the fetus that threatens its mother’s life or health is a serious one in bioethics and health care policy. One could go with the Presbyterian pro-life lobby, and perform a Caesarian section (mother’s health permitting) followed by as much medical help to the fetus as possible regardless of its stage of development. This is not a practice followed by the majority of American obstetricians and pediatricians; as aforementioned, deliveries at 23 weeks or earlier are supposed to receive comfort or hospice care, not CPR, because of how unlikely it is to result in a good outcome.

Dr. Lile appears to think that any fetus that can be delivered by dilation and extraction can be transformed by the miracles of “our intensive care nursery” into “great survivals.” This typifies the American attitude that health care is a realm of inexhaustible resources, such that a country that cannot seem to fund full prenatal care – including nutritious food, regular checkups, substance abuse rehabilitation, etc. – to prevent premature deliveries nonetheless will pony up the funds to provide every premature baby with state-of-the-art medical care until it either dies or is adopted by a couple eager to raise a disabled child. (Such people do exist, and their generosity shames the rest of us, but they’re in smaller supply than Dr. Lile may realize. The current fashion among adopters is to want any child “as long as it’s healthy,” which indicates progress from sexism and racism but not prejudice against disability.)

However, in a country with majority support for banning Partial Birth Abortion, perhaps the government simply could impose an extra fraction of a percent of tax on all incomes above the median (to tax low income people further would be an extraordinarily self-defeating way to reduce the number of abortions) with the money specifically going to extraordinary care for premature babies. People like Feddie who find the idea of an abortion’s being a life-saving measure patently absurd can be put on a list of responsible adults who will promise to parent the babies that survive to go home.

My proposal would respond to one branch of feminism’s feelings about abortion: it is bad, but in an environment that fails to support women and children it must be permitted; come the revolution, however, abortion will be unnecessary. I haven’t heard of Feddie’s being in favor of more aid to women specifically, and such a program may subvert the womanifest destiny to mother, but this would do something for the children.

April 21, 2006 03:13 AM | TrackBack
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