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The group blog of The American Prospect

SO WHAT IS THE "BORN ALIVE INFANT PROTECTION ACT" -- REALLY?

Conservative attacks on Obama's old vote against Illinois' Born Alive Infant Protection Act (BAIPA) have been percolating online for months, and burst into the mainstream Saturday, when Rick Warren asked the candidate about his position on BAIPA at the Saddleback Church forum (see Sarah Posner's latest for more on that). Today the New York Times weighs in with a piece parsing the language of the two separate "born alive" bills that Obama opposed in the Illinois state senate: The first, which NARAL did not oppose and which has a federal antecedent, would have defined as a "child" any fetus "born alive" during either a birth or abortion, making it a crime for doctors to withhold medical care from such babies, regardless of their eventual viability outside of the womb. The second bill would have allowed legal action against hospitals, doctors, and nurses that did not provide such care, and is the one pro-choice groups were more concerned about. They worried it would create a climate of fear in which practitioners would not perform abortions or complicated births because of the legal risks.

I first wrote about Obama, the anti-choice movement, and BAIPA in March, for RH Reality Check. Undoubtedly, NARAL made a smart political move when it decided not to oppose BAIPA; nobody wants to be painted as the cold-hearted group or individual who opposes life-saving interventions for babies. But if you're scratching your head about the intent of these bills -- wouldn't any doctor be compelled to save the life of any baby? are fetuses really "born alive" during abortions? -- you're not alone. It's worth going into some detail to clarify how BAIPA operates as a classic anti-choice strategy, distorting the very nature of abortion in order to horrify the public and erode support for choice.

In order for a fetus to be "born alive" during an abortion, that fetus would have to be removed from the womb relatively intact. But 90 percent of abortions are performed through aspiration (usually in the first 16 weeks of pregnancy), in which a surgical vacuum is used to empty out a woman's uterus. The vast majority of the remaining 10 percent of abortions consist of dilation and evacuation, which is usually performed after 16 weeks of pregnancy, often when a woman's health or life is at risk. Under that procedure, the aspiration process is sometimes preceded by an injection into the abdomen that ensures fetal demise. 

The kind of abortion BAIPA really targets is so-called "partial birth abortion," or dilation and extraction, which accounts for less than one-fifth of one percent of all American abortions. It is used most often to end wanted pregnancies in which expectant parents learn their baby will not be viable outside of the womb. During the operation, the fetus' skull is collapsed inside of the woman, after which labor is induced and she delivers the fetus. Difficult stuff, and not a procedure any woman or doctor undergoes lightly or happily. That's why so few of these operations take place each year. But here the fetus is removed intact. Under BAIPA, this would open up doctors and nurses performing dilation and extraction to accusations of delivering "live" babies. It would be almost impossible to make such a claim when the result of an abortion is an aspirated mass of blood and tissue.

What is BAIPA? It's not a bill about babies at all -- doctors are already required to save babies' lives, and any ethical doctor would do so. BAIPA is a bill meant to reshape the language we use to talk about abortion and mislead the public about the possible outcomes of typical abortion procedures.

--Dana Goldstein



COMMENTS

That's an interesting and valuable explanation, but in the course of reading the details, it made me think that when we explain the details of abortion procedures, we're already playing defense within a conservative frame (you've seen how they get off on waving pictures of bloody fetuses, right?).

What about adding a "This is what John McCain and abortion-criminalizers would have women undergo in America" section that would explain in similarly blunt and graphic detail what happens to *women* who are denied abortions?

Maybe Jonathan Weisman could write it, since he's apparently such an expert on the candidates and the issue now. (/snark)

Although equally as true, this is a bit different from the explanation I read a few years ago, which is more or less repeated here:

http://newsweek.washingtonpost.com/onfaith/catholicamerica/2008/07/wolf_at_the_door.html

Effectively, the BAIPA that Obama opposed effectively required that doctors disregard the parents' wishes that their infants be provided palliative care in situations like these; instead, doctors would be forced to provide care that might or might not trivially extend the lifespan of the infant and but would certainly cause these infants to suffer needlessly.

It was an inhuman bill. Obama was right to oppose it, and brave to do so, too, given that he's been branded "pro-infanticide" for having done so.

"when we explain the details of abortion procedures, we're already playing defense within a conservative frame"

Well put.

Why should this be? Is it because pro-choice people are, despite what they say, deeply shaken by abortion? And don't want to talk about what it actually is? Let alone watch what happens?

On no other issue do liberals actually refuse to look at the facts, and look at the pictures.

This is the swamp that you will enter when you try to court the "evangelical" vote. A candidate has to be willing to sit there as an opponent or moderator gets graphic and merely point out that health care issues should be decided by the patient and physician. No one wants Rick Warren telling doctors how they can treat patients during extreme medical emergencies.

Obama has only himself to blame for this. Once you start saying that a pastor has any role in healthcare you are courting trouble.

"Is it because pro-choice people are, despite what they say, deeply shaken by abortion?"

No. Next question?

"On no other issue do liberals actually refuse to look at the facts"

Do tell us which "facts" we're refusing to look at, won't you?

Another bit of context that shouldn't be forgotten, particularly in regard to the second bill: At the time of Obama's vote, Illinois had the nastiest malpractice climate in the country. Doctors--and especially obstetricians, who are way, way up there on the "most-sued" list--were leaving the state in droves; some entire counties didn't have a single ob/gyn. In short, there was already a "climate of fear" in Illinois; legislators were trying very hard not to make it even worse.

The fact that criminalized abortion kills women? Or the fact that states that restrict abortion are the worst ones to be a woman - or a child?

No, wait, those facts are the ones that anti-choice types don't care about.

"This is the swamp that you will enter when you try to court the "evangelical" vote."

It has nothing to do with the evangelical vote. This stuff makes its way to screeching cable news shows and people who are ambivalent about abortion--quite a few of those-- get turned off.

Unless we really think that people in this country live in nicey-nice world, where they really believe that "any doctor" would "do the ethical thing" and not whatever some elite power couple who didn't want, say, "a Down's Syndrome baby" just because they just can't handle the social strain, thereby compelling the medical profession into something it might find unethical.

Your world, maybe. I find that completely believable.

Please keep up the pro-death voting record, Mr. O.

Please keep up the pro-death voting record, Mr. O.

"The fact that criminalized abortion kills women?"

No, those women are killed by desperation, ignorance, and apathy, caused by a lack of support, from family, society and government. As for making abortion legal, if you make a wrong thing safer, it's still a wrong thing.

"Or the fact that states that restrict abortion are the worst ones to be a woman - or a child?"

So?

What if they *weren't*?

There is nothing stopping you -- or anyone -- from being anti-abortion, but *pro* contraception, *pro* sex education, *pro* social services and support networks.

That is, if you think about it.

Most pro-choicers just don't think about it. They don't look at the pictures. They don't want to know about "the details of abortion procedures". They just look at who's in favor of abortion rights, and who's anti, and go with the group they're more comfortable with. Politics as a fashion statement.

Sorry, that last comment was by me.

Actually, although the overall point is on target in that this issue is being used to distort Obama's record, BAIPA was not targeting one method of abortion. It was much bigger than that. For a detailed account go to: http://blogs.chicagotribune.com/news_columnists_ezorn/2008/08/bornalive.html#more

I can't believe Dana Goldstein is still pushing this "BAIPA = ban on partial birth abortion" line to excuse Obama's votes.

Barack Obama's campaign has never made this claim and pro-choice organizations didn't make this claim when the legislation was introduced, nor do they now. The only person making this claim is Dana Goldstein.

Why?

Because anyone who reads the legislation will see that it says "complete expulsion or extraction." Abortions by D and X include only the partial extraction of the child.

Goldstein, however, appears to be either too lazy to read the actual legislation or she can't understand it. Either way, she has no clue what's she's talking about.

The abortion technique where children were being born alive is known as induced labor abortion.

"BAIPA is a bill meant to reshape the language we use to talk about abortion"

The perversity of this statement is chilling.

When chattel slavery was the law of the land, supporters of legalized slavery avoided discussing what was actually happening by talking about "peculiar institutions," "property rights," and "states' rights."

Today, supporters of legalized abortion avoid talking about what is actually happening by using such vacuous phrases as "reproductive freedom" and "choice." (Remember that no one was ever required to own slaves: people got to choose whether or not to own them. In those days, our society was "pro-choice" about slavery.)

The hard fact is that a human being dies in every single abortion, except when the abortionist screws up, in which case the child is born alive. I can see why supporters of legalized abortion are terrified of the debate being framed in this manner, in much the same way supporters of legalized chattel slavery didn't want folks to smell the slave ships or witness the scars on the backs of runaways.

"and mislead the public about the possible outcomes of typical abortion procedures."

What in the world is misleading about all this? You're concerned the law would apply only rarely? Feel free to focus on spreading the word that children (you'll call them fetuses) nearly always die in abortions, and in those rare cases where the child is born alive, the child isn't worthy of legal protection because late-term abortionists can be expected to behave ethically.

Go for it.

No, those women are killed by desperation, ignorance . . .

Caused by criminalized abortion, which you support. Decriminalize abortion, and fewer women die, period.

That's a fact. Which you and your ilk don't care to address. Or perhaps you and your ilk are quite comfortable with pictures of dead women?

I don't support criminalizing abortion.

I *do* think abortion is a wrong thing which should be eradicated.

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