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How Physicians Are Responding to the “Partial Birth” Abortion Ban

August 10, 2007

The notion that the recent Supreme Court’s upholding of the “partial birth” abortion ban is not about “saving babies” but rather about making providers afraid to perform abortions due to the imprecise language, and therefore creates barriers for women while keeping abortion technically legal has been discussed before. Today, the Boston Globe reports on just how providers are responding, and it shouldn’t come as too big of a surprise:

In response to the Supreme Court decision upholding the Partial-Birth Abortion Ban Act, many abortion providers in Boston and around the country have adopted a defensive tactic. To avoid any chance of partially delivering a live fetus, they are injecting fetuses with lethal drugs before procedures.

Because the ban is not technically a “late term” abortion ban as supporters might have you believe, physicians worry that a fetus could accidentally partially emerge while living, and so they might run afoul of the law, which doesn’t specify fetal age and carries a prison sentence.

In Boston, three major Harvard-affiliated hospitals — Massachusetts General, Brigham and Women’s, and Beth Israel Deaconess — have responded to the ban by making the injections the new standard operating procedure for abortions beginning at around 20 weeks’ gestation, said Dr. Michael F. Greene, director of obstetrics at Mass. General. “No physician even wants to be accused of stumbling into accidentally doing one of these procedures,” Greene said.

The report also states that “Medical staff inject either the heart drug digoxin or potassium chloride, a potentially poisonous salt also used in state executions.

San Francisco’s Darney and colleagues have studied both chemicals, long used in late-term abortions that involve simply inducing labor. Darney said his group concluded that digoxin was safe but offered no advantages in the actual abortion procedures, despite some clinical experience suggesting it made them easier. They found no safety record for potassium chloride, but a few case reports suggested that it could be dangerous if accidentally injected into the woman instead of the fetus.

As a result, some providers are not doing the shots, while others are leaving it up to the woman. At one Oregon clinic, any woman having an abortion after 20 weeks is being required to have the shot, despite the lack of study and because of the ambiguity of the law.

The Globe reports that medical education that would help train new providers is also being affected. In one clinic, “Medical students and nursing students are no longer invited to watch later-term abortions, for fear one might misinterpret the procedure and lodge a criminal complaint.

I’m troubled by the idea that physicians are performing an unnecessary injection that may pose an additional risk to women for fear of accidentally breaking the law. The physicians aren’t blameless here, choosing to subject women to an injection rather than risk liability. However, in deliberately framing the ban in a vague, non-evidence-based manner, this seems to be precisely the outcome supporters desired. The ban was never going to outrightly prevent women from having abortions – it simply makes it harder and perhaps more dangerous for them to obtain, and you still end up with an abortion either way.

Previous related posts:
Supreme Court Upholds Abortion Ban
Physician Commentary on the Partial Birth Abortion Ban Act of 2003
American College of Obstetricians and Gynecologists Responds to Supreme Court Decision
More Doctors React to the Supreme Court Abortion Ban

5 Comments leave one →
  1. Cynthia Choo permalink
    August 15, 2007 12:58 am

    Reference: “Presented without comment – Natural Family Planning vs. “Contraception””

    You did not present without comment. You commented, referring to Natural Family Planning as dorky… PC…

    To be medically accurate, it would be completely appropriate to know that Natural Family Planning is free, is at least as effective in preventing an unwanted child as “the Pill,” and is difficult to learn about if you want to have the opportunity. A doctor who practices and teaches Natural Family Planning told me recently that generally medical students do not learn Natural Family Planning in med school. I invite you to check it out.

  2. Cynthia Choo permalink
    August 15, 2007 1:06 am

    I have one more comment on Natural Family Planning. I stated that it is difficult to learn about if you want to have the opportunity. It is not that it is difficult to learn how to do Natural Family Planning. The difficulty is that it is not generally taught. I have recommended to my doctor friend that it would be good to have Natural Family Planning classes at community colleges.
    I had a young lady work for me one summer who had managed to major in biology. During the course, she became fascinated by the marvel that is the human body and wanted to take better care of hers. She became a vegetarian. She wanted to get off birth control pills, so began looking for an alternative. She asked her college biology teachers. She looked for resources in her college library. These were to no avail. Finally she met someone, she couldn’t remember the circumstances, who introduced her to Natural Family Planning. She was thrilled! She liked dealing with her own biology in a self-respectful manner. It may help others, too.

  3. August 15, 2007 6:56 am

    I’m not sure why these NFP comments are here instead of on the post you’re referring to, but if you go back to it you’ll see that I said, “it is “contraception” in the dorky, useless PC role.” I definitely did not call NFP dorky, and I didn’t want to say anything too negative about it because I knew the folks in the video are Catholic and that NFP is part of that belief structure. I did say in the comments that one of the videos bothered me a bit, but otherwise didn’t want to get into launching a huge criticism. I don’t think it’s for everybody, but I’m sure it works for some people.
    I do appreciate your comment, and you make a good point that most people aren’t taught the ins and outs of their bodies enough to make NFP work consistently. I’m going to try to see what I can find about it, and perhaps do a post later.


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