Chapter  8:    Abortion

Section 2.  Social Context

Summary by James Rowe, QCC, 2005

            Abortion, even after thirty years of legalization in the United States, remains a dividing issue amongst Americans. A Gallup poll conducted 2000 shows a 44-48% split in favour of pro-choice, in marked contrast to a 1995 poll which showed a 33-56% split in favour of the pro-choice viewpoint. The terms “pro-choice” and “pro-life” being significantly subjective, it is more useful to resort to percentages for various factors: 

Half of the population considers abortion the same as murder, although 32 percent still consider it “sometimes the best course of action in a bad situation.”

60 percent declared that Roe v. Wade was good on the whole.

80 percent support a mandatory waiting period and parental consent.

45 percent stated that the abortion dispute is about the life of the fetus. 44 percent responded that it was about the woman.

60 percent favour the government staying out of abortion decisions.

75 percent rejected the notion of a constitutional amendment banning abortion.

49 percent considered the reasons why women had an abortion as “not serious enough”.

In 1989, 50 percent concluded that a woman not wanting to marry the man who impregnated her was not a viable reason for abortion. In 1998, that figure rose to 62.

In 1998 61 percent of people concluded that abortion should be legal in the first trimester. Only 15 percent in concluded the same in the second, with only 7 in the third.

65 percent concluded that drugs preventing implantation of fertilized eggs constituted birth control, not abortion. 20 percent concluded otherwise.

50 percent prefer chemical/drug induced abortion within the first seven weeks, compared to 36 percent who held opposing views.

Men and women conclude virtually the same as regards the availability of abortion and the extent of regulation, with 32 percent of women and 31 percent of men believing in general availability, 44 percent of women and 45 percent of men favouring strict limits, and only 21 percent of women and 23 percent of men thinking abortion ought to cease.

21 percent of eighteen-21 year olds say abortion ought to not be permitted, 23 percent of for those thirty to forty-for, 20 percent for forty-five to sixty-four, and then 25 for sixty-five and over.

74 percent of Catholics concluded that abortion ought to be available generally or under strict limits, with Protestants at 76 percent. 26 percent of Catholics and 24 percent of Protestants concluded that abortion ought to never be available.

For people polled who noted that religion was “extremely important” in their lives, 45 percent asserted abortion ought to never be allowed, whilst 23 percent of those who rated it as “very important” concluded likewise. This same view was held by the super-minority of 9 percent for those who claimed religion was not so important in their daily lives.

28 percent of those with high school diplomas stated abortion should not be permitted, but only 24 percent for those with high school degrees, 19 percent with “some college”, and 18 percent of those with college degrees.

80 percent of Americans believe abortions ought to be available to women who are significantly endangered by the pregnancy, with 75 percent contending that abortion ought to be legal in cases where a serious defect is know to a great deal of certainty to exist in the child.

43 percent concluded that a family with low-income and not being able to afford another child warrants abortion, with 39 percent not agreeing that a married woman who doesn’t want anymore children ought to be able to have an abortion.

Several contributing factors may be part of American views on the subject, either for or against, including in vitro fertilization allowing for selection of embryos free of disease (even if others are discarded), “selective reduction” of one or more developing babies to help the others survive the availability of the “morning after” pill, and technology that allows premature children to live at younger and younger ages. The latter issue, wedded to contraception and new pro-life fervour, is considered by some to be the reasons for a drop in abortion rates from a high in 1990 of 1.6 million, to a low in 1995 of 1.2 million, with rates generally declining from 1990-1997 17.4 percent. Few suspect a return to 1990’s level of abortions.

All in all, Americans seem to have etched out a “middle of the road” position regarding the matter of abortion.

Abortion statistics

Surgical abortions in the United States (1965–1996)

Since the first states decriminalized abortion in 1967, there have been over 38,000,000 reported surgical abortions in the U.S. 1,878,990 were committed before Roe v. Wade, the 1973 Supreme Court case that lifted all restrictions. An average of 1,600,000 babies are killed annually.

Chemical abortions in the United States (1965–1996)

Because many contraceptive measures are abortifacients (drugs that induce or cause abortions), it is important not to overlook the number of children killed by chemical abortions. Since 1965, an average of 11 million women have used abortifacient methods of birth control in the United States at any given time. This means about 14 million chemical abortions are committed in the United States each year, giving a total of 450 million chemical abortions between 1965 and 1996.

Total abortion in the United States (1965–1996)

If you add up the number of surgical and chemical abortions, the total is more than 486,000,000. Keep in mind that it is now 1999, three years after the most recent figures were compiled. If you add another 1.6 million surgical abortions per year (4.8 million) and another 14 million chemical abortions per year (42 million), the numbers jump to more than 532 million babies killed in the United States alone.

Methods of abortion

  • Suction aspiration: This is the procedure most often used in the first trimester of pregnancy (the first three months). The abortionist inserts a suction tube (similar to a vacuum hose with an extremely sharp end) into the mother's womb. The suction and cutting edge dismember the baby while the hose sucks the body parts into a collection bottle.
  • Dilation and curettage (D&C): In this procedure, the abortionist uses a loop shaped knife to cut the baby into pieces and scrape the uterine wall. The baby's body parts are then removed and checked to make sure that no pieces were left in the mother's womb.
  • Dilation and evacuation (D&E): This form of abortion is used to kill babies in the second trimester (24+ weeks). The abortionist uses a forceps to grab parts of the baby (arms and legs) and then tears the baby apart. The baby's head must be crushed in order to remove it because the skull bone has hardened by this stage in the baby's growth.
  • Dilation and extraction (also known as D&X or partial-birth abortion): Used to kill babies well into the third trimester (as late as 32 weeks old), the abortionist reaches into the mother's womb, grabs the baby's feet with a forceps and pulls the baby out of the mother, except for the head. The abortionist then jams a pair of scissors into the back of the baby's head and spreads the scissors apart to make a hole in the baby's skull. The abortionist removes the scissors and sticks a suction tube into the skull to suck the baby's brain out. The forceps are then used to crush the baby's head and the abortionist pulls the baby's body out the rest of the way.
  • Salt poisoning: This technique is used in the second and third trimester. The abortionist sticks a long needle into the mother's womb. The needle contains salt which is then injected into the amniotic fluid surrounding the baby. The baby breathes in, swallows the salt and dies from salt poisoning, dehydration, brain hemorrhage and convulsions. Taking nearly an hour to die, the baby's skin is completely burned, turns red and deteriorates. The baby is in pain the entire time. The mother goes into labor 24 - 48 hours later and delivers a dead baby.
  • Prostaglandins: Used during the second and third trimester, prostaglandin abortions involve the injection of naturally produced hormones into the amniotic sac, causing violent premature labor. During these convulsions the baby is often crushed to death or is born too early to have any chance of surviving.
  • Hysterotomy: Performed in the third trimester, this is basically an abortive Cesarean section (C-section). The abortionist makes in an incision in the mother's abdomen and removes the baby. The baby is then either placed to the side to die or is killed by the abortionist or nurse.
  • Chemical abortion:
    • RU-486: RU-486 blocks the hormone that helps develop the lining of the uterus during pregnancy (progesterone). This lining is the source of nutrition and protection for the developing baby. The tiny boy or girl is starved to death and then a second drug, misoprostol, causes contractions so that the dead baby is expelled from the womb.
    • Methotrexate: this highly toxic chemical directly attacks and breaks down the baby's fast-growing cells. It also attacks the life-support systems the baby needs to survive. When the systems fail, the baby dies. Misoprostol is then used to cause contractions and push the dead baby out of the womb.
    • Abortifacient birth control (the pill, Depo-Provera, Norplant, the IUD, emergency contraception): These abortion-causing chemicals and devices can act to kill preborn children in the earliest days of life. It is well known that abortifacient methods of birth control may act to inhibit ovulation and prevent conception. However, most women don't know they also act to alter the lining of the womb so that the implantation of a newly conceived child cannot occur. If the child cannot implant in the lining of the womb to receive nourishment, he dies.

Partial-Birth Abortion

Widespread debate began in 1995 over the abortion method of “dilation and extraction” - generally called “partial-birth abortions” by pro-life supporters, late-term abortion in a more neutral setting – which medical experts assert, and statistics affirm (with only 1 percent of abortions being of these types), are rarely performed and only under extreme cases. These procedures, performed after 20 weeks of pregnancy, are decried by critics as exceptionally brutal, with the three main methods involving either the doctor pulling out the fetus after dilating the cervix and often surgically sucking out the brains to allow for skull-collapse to facilitate an easier removal (the method most commonly called “partial-birth abortion”), the doctor (in a process called intact dilation and extraction) injecting dioxin into the uterus to stop the fetal heart and then inducing labour, or for the doctor to dismember the child bit by bit in the womb (with or without killing it through another means prior to this) and pulling out each part separately. One high-risk pregnancy specialist declared that, “Any procedure done at this stage is pretty gruesome.”

Aside from the assumed cruelty towards the unborn displayed in the procedure, fetal viability is most often used as a reason to ban the process by those opposing it. Many claim that due to recent advances in the care of the extremely premature (so called micropremies of two-weeks of age) it is ethically wrong to kill what would otherwise be able to live, although most premature children, the younger the worse off, still have an exceedingly high chance of irreversible physical and mental problems resulting from their abridged fetal development. Moreover, the American College of Obstetrics and Gynecology estimates that fewer than four percent of babies which are born within the twenty-three to twenty-five week range survive, whilst other experts doubt that anymore than one percent of babies born twenty-five weeks or earlier survive. Some states have opted to make twenty-three or twenty-four weeks the cut off period for elective abortion due to the possibility of survival, whilst some place such a barrier as low as twenty. In either case, only the health and safety of the mother or fetal defects can warrant abortion afterwards.

Needless to say, legislative battles have raged within the individual states and on a federal level, with the Supreme Court of the United States siding more often with lessening controls over abortion than not. Indeed, it can be said that the Supreme Court has essentially ruled that legal interference into what sort of abortion procedures are or not legal is unconstitutional, although should legislation pass in the congress (like it recently has) banning such things, the Supreme Court would have little to no power in overturning such things.

Lastly, we might look at the reasons for late term abortions for some insight into the mindset of those going in for the procedure. No statistics are available for the reasons women have such abortions, but physicians generally claim either the mother’s health, fetal defect, or social reasons (teenagers in denial being amongst these).

Specifically considering recent developments, the debate is far from finished as to what place “late-term abortions”, if any, have in United States medical practice.

Abortion’s Crucial Legal and Political Decisions:

Supreme Court Decisions:

Roe v. Wade: Norma McCorvey, of Dallas Texas, a poor and unwed expecting mother, wished to have an abortion, but under Texas Law, abortion was criminal save for saving the mother’s life, and due to this, and the inability to go to California where she might have procured an abortion, had a child which she later gave up for adoption. Later she was approached by a public interest attorney who asked if she’d be a part of a class-action lawsuit against Henry Wade, district attorney of Dallas, to challenge the constitutionality of the Texas laws against abortion. Courts ruled in favour of her, but Wade appealed all the way to the Supreme Court, which would later decide that it was illegal to restrict abortion before the first twelve weeks, one could restrict abortion to the health of the mother, and in the final trimester, states may limit abortion in all cases barring those which do not preserve the health of the child. This was the case which essentially created the pro-life v. pro-choice debate which still rages to the present day.

Roe V. Balton: The Supreme Court ruled that abortions needn’t be restricted to hospitals, adding that emotional and psychological considerations were connected with the health of the mother.

Planned Parenthood v. Danforth: A Missouri law requiring the husband’s consent to abortion was struck down, as well as parents of minor daughters not having an absolute veto over a choice for abortion.

Maher v. Roe: The Court decided that courts needn’t pay for abortions.

Harris v. McRae: The Court upheld a federal law, the Hyde Amendment, banning the use of federal Medicaid funds to pay for abortion.

City of Akron v. Akron Center for Reproductive Health: A decision was reached which struck down a law that women wanting an abortion be given counseling that specific statement of “the unborn child is a human life from the moment of conception” and having to wait twenty-four hours, minimum, to make their decision.

Webster v. Reproductive Health Services:

The Supreme Court ruled that a Missouri law which contained the following mandates:

  1. No public employees are allowed to perform an abortion unless it is to save the mother’s life.
  2. Public hospitals, clinics, or other publicly-funded facilities cannot be used to perform abortions, unless the woman’s life is in danger, no matter what the money source.
  3. Physicians are required to test the viability of the fetus if the physician has reasons to suspect the woman is twenty weeks over more pregnant.

Planned Parenthood v. Casey: A 5-to-4 decision upheld all sections of a Pennsylvania law save for the provision that a married woman must notify her husband of her intention to have an abortion. The aspects of the law kept were:

1.      A physician must inform a woman of the inherent risks of the procedure, the stage of her pregnancy, and the alternative of keeping the child.

2.      After receiving information the woman must wait twenty-four hours before undergoing an abortion.

3.      A girl under eighteen must secure informed consent of at least one parent before having an abortion, with a parent attending counseling with a parent. Consent may also be obtained from a court.

 Madsen v. Women’s Health Center: A Florida Circuit Court issued an injunction to assure clear access to the Aware woman Center for Choice in Melbourne, Florida, which imposed a 300-foot protected zone around the clinic where no protestors could go to, and forbade the making of excessive noise or the displaying of any sign that could be read inside the clinic. The case was appealed, but the Supreme Court ruled, in a 6-3 decision, upheld the injunction, but modified the buffer zone to thirty-six feet.

Schenck v. Pro-Choice Network: Concerning a New York injunction ordering the cessation of the blockading of entrances to a clinic and the intimidation and harassment of women seeking the abortion, the Supreme Court ruled in favour of the injunction 6-3. The court would, however, strike down an 8-2 section of the law which established a nebulous fifteen-foot buffer zone which separated protestors and those who entered or leaved a clinic, due to the indefinite boundaries unnecessarily impeding on free speech, although the court would allow, in another 6-3 decision, that only two protestors at a time be allowed within a fixed fifteen-foot buffer zone to talk in a non-threatening manner to women, but to “cease and desist” and withdraw out  of the zone if asked to.

Hill v. Colorado: In a 6-4 decision, the court upheld a Colorado law which was meant to protect abortion clinic doctors, patients, and visitors from harassment by protestors via instituting a hundred-feet zone around health-care facilities which does not allow for one to approach closer than eight-feet to talk to, nor ask permission to pass out a leaflet.

Federal Policies:

President G.W. Bush signed into law, in his first full day in office, an executive order that cut off federal funds to international family planning programs that provided abortion or abortion counseling. This ban was a reinstitution of one imposed during the Reagan administration. Critics object on the foundation that this could derail efforts towards population stability in an increasingly crowded world.

The Bush presidency has also seen the federal ban on funding for embryonic stem-cell research including the destruction of life, which is the only method known whereby such stem-cells might be procured.

In September of 2002, the Bush administration also extended coverage to fetuses under the Children’s Health Insurance Program, under the pretense that poor women may receive prenatal care, although critics claim otherwise as to the intent of such.

RU-486: Abortion in Pill-Form.

RU-486, known also as mifepristone, was developed by French endocrinologist Etienne-Emile Baulieu, in 1980, and developed by the Roussal-Uclaf pharmaceutical company, and first legalized in France in September of 1988. The drug works by blocking the action of progesterone, a hormone involved in the preparation of the uterine wall for the implantation of a zygote, with an intravenous or oral dose of prostaglandins (separate to the oral taking of RU-486) provoking uterine contractions which expel the lining, including the zygote, in a manner consistent with “an unusually heavy period”. The drug’s effectiveness is reliant on being taken within the first five to seven weeks in the pregnancy, with doctors stressing it ought to be taken as early as possible. RU-486 may also act as “morning after pill” via its potential to prevent implantation at all. Clinical trials of over 200,000 women in France confirmed the safety of the drug and its 95.5 percent effective rate, with oral prostaglandins boosting the effectiveness to 96.9, although some women do not abort and others suffer heavy bleeding, the former requiring surgical intervention. Recent studies also point to a potential in preventing endometriosis (a major cause of infertility) and fibroid tumors, with other studies suggesting the drug might help prevent Cushing’s syndrome and breast cancer.

After a brief conflict in October of 1988 when the Roussal-Uclaf was almost stripped of its patent, in France, Roussel licensed the drug for use in China, Sweden. A conflict, however, would arise in the United States due to the opposition from pro-life groups which did not take kindly towards the potential marketing of another form of abortion in the United States. The National Right-to-Life Coalition claimed of that RU-486 was tantamount to, “chemical warfare against an entire class of innocent humans.” Aside from fiery rhetoric, the NRL and other groups informed drug companies that they’d enact a total boycott of their products if they tried to make anything related to RU-486. General fear of such reprisals has prevented worldwide adoption, with critics of anti RU-486 measures, including the drug’s creator, lambasting the efforts as morally improper and discriminatory, citing the potential to save the lives of many women who die from improper abortions each year. In 1993, however, this would change when Roussel-Uclaf licensed the drug to Population Council, a nonprofit research organization which intended to find a manufacturer, establish clinical trials, and apply to the FDA to allow the drug’s usage in the US. In 1996, the FDA was convinced of the safety of the drug, and pronounced it fit to manufacture, sell, and prescribe in the United States, but no company would willingly produce it. This situation was eventually remedied when Danco Laboratories stepped up to accept production of RU-486 under the name Mifeprex, and once the deal was struck, the FDA went on to give final approval, restricting its prescription in only the very limited degree of requiring a physician qualified to determine the length of a pregnancy and practicing within one hour of facilities that offered surgical abortion. President G.W. Bush would denounce the FDA as wrong in its decision, with other abortion opponents calling the drug “baby poison” and vowed to seek legislative prohibition of its usage. Pro-choice advocates obviously rejoiced.

Due to many considerations, including doctors preferring surgical abortion, the baroque system of laws governing abortion, and counseling and other related laws, the practice of abortion has been impacted sparsely, with most abortions still being surgically performed. Whether this will change or not depends on variables incapable of being presciently calculated, specifically as involves the political landscape.

The Morning-After Pill:

Each year, roughly one million women obtain an abortion in the United States, with 2.5 million more women finding themselves carrying unwanted pregnancies which they opt not to abort. The morning after-pill, the common parlance for a contraceptive method which uses a higher dose of the common birth-control pill, presents the opportunity to prevent pregnancies from occurring, even if taken after intercourse, hence the notion of “the morning-after”. The risks are few, with nausea and vomiting being predominate. The non-medical downfalls, however, are mostly linked to the nature of uncertainty as involves whether or not one is pregnant after intercourse, with the morning-after pill blurring the line that separates abortion and contraception and preventing an ethical dilemma, albeit a minor one due to general feeling that abortion so early is permissible and few Americans being against contraception. Even the National Right to Life Committee does not condemn the usage of such a pill outright, although it cautions women to seek out the physician’s “best medical judgement” to determine whether the pill would produce an abortion or prevent fertilization. Washington, Alaska, California, and Oregon are even apart of program meant to see whether or not these types of emergency contraception can be safely distributed without prescription. In France a similar drug can be dispensed by a nurse, with Norway and the UK offering similar drugs over the counter.

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© Copyright Philip A. Pecorino 2002. All Rights reserved.

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