I will try to answer why the need for parital birth abortions may be necessary even though I am not a obstetrician. The problem is, there are no clean cut or sigular answers. This is what characterizes so much of medical decision making and involves balancing so many variables and options at the same time.
First of all, less than a thousand or actually 600 of these partial birth abortions were preformed in the last year. The physician who is nationally known for this procedure is a Dr. Warren Hearn who has stated time and time again that it has been done under the most dire emergencies. Second, it is almost never done on demand. Most women who carry a child to late term want the baby!
The simple decision of PBO involves severe birth defects. One particular that comes to mind is the child with skeletal dysplasia who within moments of birth gasps and suffocates to death. The others have been mentioned regarding anencephelopathy (Born with only mid brain) etc.
The harder decision comes in aborting the non defective fetus to protect the mother.
The practice of high-quality medicine requires that physicians be knowledgeable about and able to perform a variety of procedures to accomplish a given treatment or therapy. Planning any procedure is done in consultation with the patient, and it is based on the medical judgment, experience, and training of the provider, and the individual circumstances of the patient's condition. Sometimes, as a result of developments during a surgery or in a patient's condition, it becomes necessary to adapt and choose a different course or modify the procedure as it progresses. These decisions are often quite complex and mandate that physicians use their best professional and clinical judgment, most often right on the spot. These are decisions that should be made by physicians and their patients alone. Indeed, when performing surgery, there is not time for a call to Congress, the Supreme Court, or anyone else in order to obtain clarification of the statutory intent or to request a waiver!
The conditions that come to mind are the women who have gone into congestive heart failure,chronic renal failure patients, chronic lung diseases like pulmonary hemosiderosis etc. Many have the disease and were advised not to get pregnant due to the dangers of pregnancy but got pregnant and some developed the condition (heart failure, renal failure) while pregnant due to peripartum cardiomyopathy, HELP syndrome etc.etc.
Late term pregnancy is characterized by huge intravascular increase in plasma volume and an increased coagulopathic state which put a tremendous burden on a weak heart, lungs and strains the capacity of the excretory functions of the kidneys. Some women are tenuously controlled with medicines, dialysis, repiratory devices etc. However, there comes a time when emergency C -sections cannot be done due to the dangers of the anesthesia on failing hearts and lungs. (Remember, anesthesia is still the most dangerous aspect of any surgery and which is why anesthesiologists have higher malpractice rates than any surgeon!). Labor is so intensive on normal hearts and lungs (I was worn out during my 24 hours of labor and I biked 200 miles a week until my third trimester!) it would probably kill these women. In fact, many women are in the throes of labor and both women and child are decompensating quickly and for whatever reason, a c-section may not have been an option after the obstetrician weighed the benefits and risks and felt a paritial birth abortion was necessary. In fact, the child at this point has already suffered permanent hypoxic damage. Once again, no specifics since I am not an obstetrician.
Of more concern is the fact that disgruntled family members may sue the obstetrician for monetary awards if they can use a flimsy law to prove the doctor had committed a federal crime.
It is frightening and horrific that the government is becoming more intrusive about playing a role in medical decision making. (Let's not forget the Florida case where Bush's sibling governor, Jeb Bush ,ordered doctors to restart feeding tube on a women in persistent vegetative state after the husband had wanted her care withdrawn.).
Just my two cents.
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