From Northwestern University Medical School and Evanston Northwestern Healthcare (Dr Sprang) and the Division of Maternal-Fetal Medicine, Evanston Northwestern Healthcare (Dr Neerhof), Evanston, Ill.
Controversies section editor: Phil B. Fontanarosa, MD, Senior Editor.
THE ABORTION ISSUE remains in the public eye and the media headlines
largely because of a single late-term abortion procedure referred to in the
medical literature as intact dilation and extraction (D&X) and in the
common vernacular as partial-birth abortion. This article reviews the medical
and ethical aspects of this procedure and of late-term abortions in general.
Intact D&X came to the forefront of public awareness in 1995 during
a congressional debate on a bill banning the procedure. During this debate,
opponents of the ban asserted that the procedure was rarely performed (approximately
450-500 per year) and only used in extreme cases when a woman's life was at
risk or the fetus had a condition incompatible with life.1,2
Following President Clinton's April 1996 veto of a congressionally approved
ban, conflicting information surfaced. Ron Fitzsimmons, executive director
of the National Coalition of Abortion Providers, had stated in November 1995
that "women had these abortions only in the most extreme circumstances of
life endangerment or fetal anomaly."3 However,
he later admitted that his own contacts with many of the physicians performing
intact D&X procedures found that the vast majority were done not in response
to extreme medical conditions but on healthy mothers and healthy fetuses.3
Sprang ML, Neerhof MG. Rationale for Banning Abortions Late in Pregnancy. JAMA. 1998;280(8):744-747. doi:10.1001/jama.280.8.744