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August 26, 1998

Rationale for Banning Abortions Late in Pregnancy

Author Affiliations

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.

JAMA. 1998;280(8):744-747. doi:10.1001/jama.280.8.744

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