Intact dilation and extraction (IDX), misnamed "partial-birth abortion" by anti-choice politicians, is hard to justify. Not surprisingly, only 23 percent of Americans believe the procedure should be legal, according to an April 2003 ABC News poll. I am among those 23 percent.
The recent Supreme Court case, Gonzales v. Carhart, upheld the 2003 Partial-Birth Abortion Act in a 5-4 decision. The legislation outlaws IDX, making exceptions only in cases that are necessary to save the life of the mother.
Opponents of the Partial-Birth Abortion Act point out that it excludes concerns for the health of the woman. Indeed, an implication of the bill is that any mental or physical damage to the woman cannot be considered unless it is fatal.
Admittedly, IDX is gruesome — there is no other word for it. But if we are to consider its merits, then a (brief) description of the procedure is necessary — uncomfortable though it may be.
According to the American Medical Association, the procedure consists of dilating the cervix in order to pull the fetus out in a breech position (the head is delivered last). The body is then extracted from the fetus, leaving only the head inside the birth canal. The doctor subsequently makes an incision at the base of the skull, suctioning out the brain. This causes the skull to collapse, allowing the remaining parts of the fetus to flow through the birth canal.
IDX, then, does not make for pleasant dinner conversation — to say the least.
How can this practice be justified? Answering this question first requires context. According to a 2000 survey conducted by the Allan Guttmacher Institute, merely .17 percent of all abortions were performed with the IDX method. It is a form of late-term abortion used during the second trimester.
Given the unsavory nature of IDX, few would argue for its use except in cases that concern the woman's health. This is the opinion of the AMA, which "recommends that the procedure not be used unless alternative procedures pose materially greater risk to the woman." It is not surprising, then, that IDX is used so rarely.
Late-term abortions occur for a variety of reasons, including a lack of access to abortion facilities. Recent decades have witnessed a steady unraveling of Roe v. Wade, and a conservative political backlash has made it more difficult for women to afford and acquire information about abortion. The result has been an increase in abortions after the first trimester. The irony is impossible to miss: Conservatives have created the conditions for a particular form of abortion, which they are now rallying against.
IDX is advantageous over other forms of late-term abortion for a variety of health reasons. These include (suicidal) depression, hydrocephalus (a condition which causes massive swelling of the fetus' head) and protection of the uterus, among others.
Ultimately, a certified abortion provider is the most qualified person to determine the necessity of IDX. It is his duty to uphold the ethical obligations of his profession, and this entails the use of IDX only when the woman's health is in danger. Beyond that, its use should be prohibited, as the AMA has asserted.
Polls consistently show a majority of Americans continue to support a woman's right to a first-trimester abortion. This support is usually premised on a commitment to privacy and the right of each individual to control her own body.
These justifications are weakened when the second trimester is entered. The feeling now is that the woman's right to her own body is not the only concern; the fetus, increasingly resembling a human life, also merits consideration. The manner in which IDX treats that fetus only empowers the belief that a wrong has been committed.
When examining the validity of IDX, two mutually exclusive angles are to be considered: the right of the woman to maintain her health and a moral concern for the status of the fetus. In the end, I only hesitantly give more weight to the former. I think the opinions of the scientific community (as represented by the AMA) deserve more credence than Pat Robertson or Tom Delay.
The use of IDX is undoubtedly a more troubling political issue than most to confront. It is not hard, for example, to see that prohibiting two people from marrying — just because they happen to be of the same sex — is wrong. Weighing the two sides of the IDX debate is highly subjective — it is dependent on one's political philosophy. In this context, why not let the woman decide?
Kyle Szarzynski ([email protected]) is a sophomore majoring in Spanish and history.
