US poised to outlaw late abortion technique

BMJ 1995; 311 doi: (Published 18 November 1995) Cite this as: BMJ 1995;311:1319

America's pro-life advocates experienced a historic step towards outlawing some forms of abortion last week, when the House of Representatives passed a bill prohibiting late abortion using intrauterine cranial decompression. The bill now awaits judgment from the Senate Judiciary Committee for hearings.

The house agreed by a two thirds majority to restrict doctors from performing late term abortions (at 19 or 20 weeks' gestation or beyond), which involve delivering the fetus feet first after first decompressing its skull. If the bill becomes law, doctors who perform this so called partial birth procedure could face up to two years' imprisonment.

The vote comes in the wake of heated abortion debates in the United States, which has seen violent demonstrations in front of abortion clinics. Most recently, two women were shot dead in front of an abortion clinic in the Boston suburb of Brookline last January.

Chris Smith, Republican cochairman of the House Pro-Life Caucus, who introduced the bill in the house, described the vote as “a historic development that will frame the abortion debate for years to come.”

Smith argues that abortion advocates have “sanitised” abortion methods through extensive and elaborate marketing schemes for the past two decades. He said: “This bill brings an end to the cover up of abortion methods.”

After describing partial birth procedure to the House of Representatives, Chris Smith made an emotional speech saying, “Some forms of torture are too odious to inflict on anyone--not on a convicted murderer, not on a laboratory animal, and certainly not on a baby in the process of being born. Let us agree that there are some practices so barbaric that we will not let them happen in America.”

Opponents of the bill, including the Colorado House Representative, Patricia Schroeder, argue that the present wording of the bill means that doctors could legally use the partial birth method only when they reasonably believed that this was the only method that would save the mother's life. Schroeder fears that the bill could have many negative consequences for both women and doctors. “Doctors are in effect ordered by the Congress to set aside the paramount interests of the woman's health and future fertility to avoid the possibility of criminal prosecution.”

Schroeder argues that since the bill provides no exception clause for cases in which a woman's life or health is endangered, it represents “a giant step backwards in the progress of making motherhood safe. “She is concerned that women will be forced to revert to using more dangerous methods to procure abortions. She believes that there should be more discussion of health risks and a more precise definition of when doctors can use the procedure.

Schroeder is joined by many other groups in opposition to the bill, including the California Medical Association, the American Medical Women's Association, the American College of Obstetricians and Gynaecologists, and the American Medical Association.

The bill, which passed through the House of Representatives on a vote of 288 to 139, is due to return to the Senate for a vote at the end of the month.--DIANA BOZALIS, BMJ

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