The Neiswanger Institute for Bioethics at Loyola University

The Narrow Battle Ground of Late Term Abortion

Over at Poynter Online's Everyday Ethics column, Kelly McBride talks to Art Caplan about the recent Supreme Court ruling on late-term abortions:

Doctors seek to abort these fetuses for three general reasons – if the mother’s health is critical because of a pregnancy-induced condition that cannot be controlled, if the fetus has a deadly infection that could spread to the mother, or if tests reveal the fetus has a fatal deformity that will doom the child to death. In the last scenario, many doctors would prefer to give a woman a choice to end the pregnancy, rather than force her to wait for natural labor to start, which could be months away.

By failing to describe the detail in these scenarios journalists create an environment where we can all believe the worst. If I’m against abortion, I might imagine reckless women aborting perfectly healthy babies at 26-28 weeks, the same gestational age of many babies currently in the neonatal intensive care. If I’m in favor of legal abortion, I might envision women dying, because infection sets in or her blood pressure rises too high.

In fact, neither scenario is likely, Caplan says. Doctors can still end a pregnancy and extract a fetus in these cases. The Supreme Court ruling affirmed a law that says doctors can’t take any action to harm the fetus during the process or after it is out of the womb.

It is still possible to ensure the fetus dies in the womb, Caplan said. Using an ultrasound for guidance, doctors can still inject potassium chloride into the fetus’ blood stream or heart, he said.

“This is about euthanasia, not Roe vs. Wade,” Caplan told me during a phone conversation. “Doctors are saying, 'I can’t do this procedure because I don’t know what to do about the fetus.' ”

comments

"if the fetus has a deadly infection that could spread to the mother"
This really happens? I'm trying to think how a fetus could have an infection that it did not get from the mother. What's the mechanism?

Laura, a quick Google search shows several options, including something called fetal membrane infection, which appears to be caused by a bacteria that works its way from placental sack to uterus, to mother.
I didn't read far into any of the other avenues of infection, but they do appear to be there.

I did a quick Google search too.
I've known women who've had premature rupture of membranes. Typically if labor doesn't occur within a short period of time it's induced. Is that what you're talking about? Because this is not a late-term abortion, it's a premature birth.
All the other fetal-infection things I've read have been infections that spread from mother to child.

Laura - I asked an ob/gyn in literal passing the other day, and she confirmed that a fetus can contract bacterial or viral infections that can threaten the mother. Didn't have a chance to ask for further details, as we were headed in opposite directions and both running late.

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