Abortion (cont.)

Medical Author:

Suzanne R Trupin, MD

Suzanne R Trupin, MD

Dr. Suzanne Trupin is a Clinical Professor of Obstetrics and Gynecology at the University Of Illinois College Of Medicine at Urbana-Champaign. She graduated from Stanford University and completed her medical training at New York Medical in Valhalla, New York. She received her residency training at the University of Southern California Women's Hospital in Los Angeles, California. She is Board-Certified by the American Board of Obstetrics and Gynecology.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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The Supreme Court case of Roe v Wade was the result of the work of a wide group of people who worked to repeal the abortion laws. In 1969, abortion rights supporters held a conference to formalize their goals and formed the National Association for the Repeal of Abortion Laws (NARAL).

• Lawyers Linda Coffee and Sarah Weddington met the Texas waitress, Norma McCorvey, who wished to have an abortion but was prohibited by law. She would become plaintiff "Jane Roe." Although the ruling came too late for McCorvey's abortion, her case was successfully argued before the US Supreme Court in a decision that instantly granted the right of a woman to seek an abortion.
• In 1973, the Roe v Wade law, in the opinion written by US Supreme Court justice Harry Blackmun, the court ruled that a woman had a right to an abortion during the first 2 trimesters (6 months) of pregnancy. He cited the safety of the procedures and the basic right of women to make their own decisions.
• Since this ruling, the states have regained much control. Serious restrictions have been placed on abortion services. Debate continues by federal and state lawmakers. The US Senate approved the first federal ban on a specific abortion procedure (called partial-birth abortion, defined later in this topic) in October 2003. The bill was signed by President George W. Bush.

When does "life" begin? That is one of the issues surrounding the controversy about abortion. The legal issues are these:

• Loosely defined, the term viability is the ability of the fetus to survive outside the mother's womb without life support. A number of landmark US Supreme Court decisions dealt with this question. In Webster v Reproductive Health Services (1989), the court upheld the state of Missouri's requirement for preabortion viability testing after 20 weeks' gestation (gestation is the period of time a fetus develops in the mother's uterus, usually 40 weeks). However, there are no reliable or medically acceptable tests for viability prior to 28 weeks' gestation.
• The preamble to this law states that life begins at conception, and the unborn are entitled to the same constitutional rights as all others. By 1992, in a ruling controversial for its inclusion of mandatory waiting periods, elaborate consent processes, and record-keeping regulations, Planned Parenthood v Casey tried to address the issue of viability by inserting language recognizing that some fetuses never attain viability (for example, a developing fetus with certain brain disorders will never live on its own). In Colautti v Franklin, the court overturned a Pennsylvania law requiring doctors to follow specific directives in certain medical cases and recognized the judgment of the doctor in these matters.

Parental consent

Various federal and state decisions have tried to require parental notification, waiting periods, informed consent, and abortion counseling.

People against abortion argue that parents need to be informed about and approve an abortion for a daughter younger than 18 years. Those supporting the rights of a woman to choose abortion say parental consent is not required for a woman to carry a pregnancy to term (the birth of a baby), nor do parents need to give permission for a woman seeking birth control such as pills or an intrauterine device (IUD). Parents are also not consulted when a woman seeks treatment for a sexually transmitted disease.

Research shows that many young women younger than 18 years do involve their parents in their decision to abort (45%). Laws requiring parental consent are forcing minors to obtain abortions much later in their pregnancies. Some minors must travel great distances to states with no such law.

Intact dilation and extraction

The recently crafted political term partial-birth abortion loosely means "partially vaginally delivering a living fetus before killing the fetus and completing the delivery." This definition broadly includes all methods of second-trimester abortion (done after the first three months of pregnancy. A 2007 Partial Birth Abortion ban was passed by the Supreme Court, and although its wording is open to interpretation, it essentially states that the act of termination of fetal life cannot occur in a partially extracted fetus.

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