The Los Angeles Times on Sunday examined the late-term abortion procedures called "intact dilation and extraction" and "dilation and evacuation." Intact dilation and extraction involves removing the fetus feet-first except for the head. Physicians then use suction to collapse the head, usually after injecting the fetus with a drug to kill it before beginning the procedure, according to the Times. The procedure is banned by a federal law (S 3) that was upheld by a 5-4 U.S. Supreme Court ruling last month. The law bans so-called "partial-birth abortion," which is a term created by the National Right to Life Committee in 1995 and is not used by physicians, according to the Times.
Dilation and evacuation -- which uses suction and forceps to remove fetal tissue from the uterus and, in the process, breaks up the fetus -- is not banned by the law, but physicians sometimes begin the procedure and end up performing an intact dilation and extraction, the Times reports. "If you intend to do a standard [dilation and evacuation] and then find that you have to do a procedure that the law bans, then, as I understand it, you are not breaking the law," Eleanor Drey, an ob-gyn and medical director of the Women's Options Clinic at the University of California-San Francisco, said.
She added that physicians are not sure what would violate the law. According to the Times, physicians are "especially concerned" about cases of second trimester miscarriages in which intact dilation and extraction must be performed to protect the health or life of the woman. Most late-term abortions are performed because of "developmental defects" in the fetus, such as fluid in the brain or organs growing outside the body, the Times reports (Beckman, Los Angeles Times, 5/7).
Los Angeles Times Examines Surgical, Medical Abortion
The Times also on Sunday examined the differences between surgical and medical abortion. According to the Times, although many women in the first trimester "have a clear choice" about the type of abortion they have, choosing the "right procedure isn't always simple." Surgical abortions involve a suction device that is used to remove the contents of the uterus. The drug mifepristone, sold under the brand name Mifeprex by Danco Laboratories, is taken in combination with the drug misoprostol to induce a medical abortion up to 49 days' gestation. Surgical abortions are nearly 100% effective, while medical abortions "have a low but measurable failure rate," according to the Times. Surgical abortion also can "be done relatively quickly," while medical abortions "typically take longer to complete," the Times reports. According to the Times, the decision between medical and surgical abortion "can be pragmatic or emotional, based on considerations such as cost, availability or a preference to have the abortion at home or in the doctors' office" (Ulene, Los Angeles Times, 5/7).