the freedom to choose health: abortion in national news(note: i avoided using the words "woman" and "mother" to refer to pregnant patients in this piece out of respect for the fact that not all people who can become pregnant identify as women or mothers. just something to think about.)
Ryan Thoreson has some good analysis on the recent Ayotte v. Planned Parenthood ruling over at demapples.com, so instead of rephrasing what he's said, I'll just urge you to check out his thoughts.
But despite the seemingly heartening outcome he highlights, choice advocates shouldn't celebrate prematurely. While justices ruled unanimously--yes, unanimously, on an abortion case--that a New Hampshire law requiring parental notification and a waiting period for minors seeking abortion services must include an exception for cases in which the minor's health is in jeopardy, they did not, as they have in past instances, declare the entire law unconstitutional because it lacked such an exception. Instead, they sent it back to the Lower Court to determine whether legislators actually intended to omit an emergency medical clause from the law.
What is the significance of this difference? Well, it may serve to make Alito seem less immediately threatening to reproductive choice issues as the confirmation vote approaches. (more in expanded post)
As a result of the Ayotte ruling, the court may decline to accept other abortion restriction cases that don’t include health exceptions, instead sending them back to be reviewed. This delay takes the bite out of choice advocates’ warnings that, if confirmed, anti-Roe Alito will have the opportunity to vote on abortion-related cases during his first year on the bench. It is anticipated that three such abortion restriction cases will be pending in the coming months (two have already made their way up to the top), and will be decided only after O’Connor is out of the picture. One of them, Gonzales v. Carhart, tests the federal Partial-Birth Abortion Ban Act of 2003, which Congress passed despite the Supreme Court's unfavorable ruling on a similar Nebraska state law. The ACLU, the American College of Obstetricians and Gynecologists and others have already come out in opposition to the ban.
Few political catch-phrases irk me more than "partial-birth abortion," a term fabricated by anti-choice factions in order to conjure images of infants halfway through vaginal delivery (or as Bush put it when he signed the Ban Act into law, "children who are inches away from birth"). What irks me even more is that it’s often the sole phrase used in the media to refer to actual medical procedures of a certain kind. In the words of the immortal Jersey Slugger, "Grrr."
Let us transcend the rhetoric. The medical names for the procedures in question are intact dilation and extraction (commonly called D&X) and dilation and evacuation (a.k.a. D&E), and they are not performed in the midst of delivery contractions, but typically during the second or (rarely) early third trimester of pregnancy. (Third trimester abortions are performed only when the life or health of the patient is at grave risk, or when the fetus is not viable.) Late-term abortions are very rare (90% of abortions take place in the first trimester), and are most often wanted pregnancies in which serious and unfortunate complications have arisen. And guess what--the need for these procedures is reduced if patients have reliable access to comprehensive prenatal care. That's right: effective, affordable/universal health care could reduce demand for abortions. Ah, pipe dreams.
Supporters of the ban argue that the D&X procedure is not the only option available to patients who choose to terminate their pregnancies in later stages, so it should be nixed in favor of less 'gruesome' options. They're partly right--D&X isn't the only choice for patients and their doctors. Thing is, it appears to be the safest option in most cases: the primary alternative, a hysterotomy (not to be confused with a hysterectomy), is a major operation, akin to a caesarian section ("C-section"). Despite a dearth of information available on the relative safety of certain abortion procedures (curious--you'd think it might be an important thing to study), the available evidence was sufficient to convince the District Court of New Jersey that a hysterotomy carries a greater risk of health complications than intact dilation and extraction, and dilation and evacuation.
As with any medical treatment decisions, the first priority should be the health and well being of the patient, and the decision should be made not by politicians, but by patients and their medical practitioners who have the experience to be able to make appropriate judgments.
So, with respect to the ‘partial birth abortion’ issue, I have two simple requests:
Congress, please pass laws that promote citizens' health and safety rather than imperil them. I'd be much obliged. Soon, we may not be able to rely on the Court to protect us.
And journalists, hedging statements by referring to a D&X abortion only as “a late-term procedure that critics call ‘partial birth’ abortion” doesn’t count as being objective. If you’re going to use the inaccurate, pop-culture term, at least give us the medical name as well. Actually, in the interest of fairness, I should say that I realize that the language of most ‘partial-birth abortion’ bans that have been enacted is so vague that it can apply to procedures other than D&Es and D&Xs; because of the way the laws are phrased, it’s difficult to pin down precisely what the term does and does not include. So maybe you are trying to play it safe, sticking to the precise(ly imprecise) political terminology. But that doesn’t help the rest of us to be any more informed…so bring on the nuance! Bring on the complexity! We can take it.