The Truth Revealed: “Partial Birth” Abortion: The Truth Revealed: “Partial Birth” Abortion Michelle Shuff MS II University of California, San Francisco AMSA Reproductive Health Policy Coordinator


What is “Partial Birth” Abortion: What is “Partial Birth” Abortion “Partial Birth” created in 1995 to reframe the abortion debate on the fetus rather than the woman and to gain the support of the American Public. Not a true medical term, so many types of procedure many become banned (even as early as 13 weeks).


Types of Abortions: Types of Abortions Medical: Use Mifepristone (RU-486) or Methotrexate. Option for the first 49-63 days of 1st trimester Surgical: 3 types Vacuum aspiration (MVA or dilation and suction curettage, D&C) mainly first trimester (up to 14 weeks) Dilation and Evacuation (D&E): 2nd trimester (also called a non-intact D&E) Dilation and Extraction (D&X): 2nd trimester (also called intact D&E) They account for .2% of all abortions, around 2000-3000 per year in US.


Why Have an Abortion After the 1st Trimester?: Why Have an Abortion After the 1st Trimester? Barriers to service Geographic: 16% of women travel 50 to 100 miles and 8% must travel over 100 miles Provider shortage: 87% of counties in the US have no abortion provider (more physicians must be trained) Financial: first trimester abortion ~ $400 (75% pay out-of-pocket), price increases as pregnancy develops (Ex. $2000 at 20 weeks) Most private insurances and insurance for public employee DON’T cover abortion, with certain restrictions mandated by each state.


Why Have an Abortion After the 1st Trimester?: Why Have an Abortion After the 1st Trimester? Medical Indications: Discovery of serious fetal anomalies Down’s syndrome (amniocentesis done around 18 weeks) Women’s health is threatened or aggravated by pregnancy Infections Heart failure Diabetes Depression Renal Disease Malignant Hypertension, including preclampsia


Why Have an Abortion After the 1st Trimester?: Why Have an Abortion After the 1st Trimester? Lack of emotional support from partner or family. Psychological denial of pregnancy, as may exist with rape or incest, or just in general. Lack of pregnancy symptoms, seeming continuation of periods, irregular menses Legal restrictions Parental content and judicial bypass laws Mandatory waiting periods


Overview of U.S. Courts: Overview of U.S. Courts US District Courts: 94 judicial districts US Circuit Court of Appeals: 12 regions US Supreme Court: nine justices, 2 new Bush appointed justices (life positions) Samuel Alito John Roberts


Simple Overview of U.S. Court System: Simple Overview of U.S. Court System


2003 Federal Partial Birth Abortion Ban: 2003 Federal Partial Birth Abortion Ban Nov 2003: Congress passed and Bush signed the first ever federal legislation to criminalize abortion. Ban abortions as early as 12-15 weeks (intact D&E), a procedure that doctors say are the safest for women’s health in the 2nd trimester. No exception for a woman’s health Punish doctors fines and up to 2 years in prison Opposed by American College of Obstetricians and Gynecologists and other medical organizations.


Signing of the 2003 Federal Partial Birth Abortion Ban: Signing of the 2003 Federal Partial Birth Abortion Ban


District Court Challenges to 2003 Partial Birth Abortion Ban: District Court Challenges to 2003 Partial Birth Abortion Ban A federal district court issued an order to temporarily prevents its enforcement. Planned Parenthood Federation of America (PPFA), National Abortion Federation with ACLU, and four doctors representing the Center for reproductive Rights all challenged the constitutionality of this ban in 3 different district courts around the country. RESULT: 2004, All 3 courts struck down the ban because it had no exception for a woman’s health.


More Appeals…..: More Appeals….. Bush Administration appeals all three district court decisions to their respective U.S. Circuit Court of Appeals. (2nd, 8th, and 9th courts) RESULT: ALL 3 courts upheld the decision of the their lower district courts.


Appeals to the Supreme Court: Appeals to the Supreme Court Under the Bush Administration, Attorney General Gonzales made a case to the U.S. Supreme Court to challenge the 8th circuit Court in Carhart v. Gonzales case and the 9th Circuit Court in Planned Parenthood v. Gonzales case. Arguments were heard November 8th, 2006 and decisions are expected June 2007


Outcomes of the Case: Outcomes of the Case If the Supreme Court decides to uphold the Circuit courts’ decision that the Federal Abortion Ban of 2003 is unconstitutional: Then the Ban will be gone forever and a new one must be written, passed by the Senate and signed by the President. If they decide that it is constitutional: THE BAN BECOMES FEDERAL LAW


Implication of Federal Abortion Ban: Implication of Federal Abortion Ban Creates an Ethical Dilemma for Physicians Doctors would be forced to perform a procedure that they know is less safe and thus knowingly endanger their patients or else…… Risk imprisonment and/or revocation of their medical license if they do not abide. Many physicians will just stop performing abortions in the 2nd trimester. Will result in more dangers for women receiving 2nd trimester abortions and will further increase the shortage of providers.


A History Lesson Learned?: A History Lesson Learned? In 2000, the Supreme Court (5-4 vote) found a similar State Ban on “partial birth” abortion in Nebraska (Stenburg v Carhart) to be unconstitutional for 2 important reasons: So broadly worded that it would have prevented doctors from performing procedures used in 90% of abortions in the 2nd trimester. (imposed an undue burden on a woman’s constitutionally protected right to choose an abortion) No protection for the woman’s health. The Court reinforced a precedent that all abortion-related restrictions MUST include an exception for women’s health.


Anti-Choice Activism: Anti-Choice Activism States have started chipping away reproductive freedoms: parental notification, partial birth abortion, waiting periods, lack of insurance coverage for abortion. Anti-Choice Senate and Judges have a lot of power (moving from the state level to the the federal level or from low Federal Courts to high Federal Courts). Creating false term such as “Partial Birth” and “Pro-life” in order to influence and frame their debate.


Choice Messaging:: Choice Messaging: How to get out the message: Do not fall into using anti-choice terminology: Use Anti-Choice as opposed to Pro-Life (is anyone really pro-death?) Use the true medical terms, such as 2nd term abortion. Reclaim words or phrases: You are Pro-life! Pro-healthy Women and Pro-healthly Children


Group Discussion: Group Discussion What is a “Partial Birth” abortion? Is this law about “late-term” or third trimester abortions”? What do you know about this, what have you heard about this and how would you deal with opposition who says that “partial birth” abortion is wrong?


Group Discussion: Group Discussion When do most abortions occur and how safe are they? What do you know about this, what have you heard about this and how would you deal with opposition who says that abortion is dangerous?


Group Discussion: Group Discussion As a medical professional what role do you have a physician to influence a patient who does something you do not agree with? Ex. A woman who come to you for her 6th abortion and is not using birth control. How would you counsel her? Ex. You personally do not agree with abortion. You would not have one nor perform one and your patient comes in with an unintended pregnancy.


Group Discussion: Group Discussion What role should the government play or not play in a woman’s decision to terminate her own pregnancy. Where would the line be drawn?


What Can You Do?: What Can You Do? Get Educated on the Issues: Join HPAC listserve on AMSA website Join listserves of other Reproductive Policy organizations (links on AMSA HPAC page) Get Motivated and Act: Give a talk at your school Organize letter writing campaigns and phone-ins Write letters to the editor Attend an AMSA leadership conference and learn how to lobby your legislators Join AMSA national leadership


Words of Wisdom: Words of Wisdom “ No woman can call herself free who does not own and control her own body. No woman can call herself free until she can choose consciously whether she will or will not be a mother.” -------Margaret Sanger


Acknowledgements: Acknowledgements Michelle Debbink, HPAC Chair Julia Skapik, Medical Malpractice and Health Quality Coordinator All of the Health Policy Action Committee for their great work and inspiration!