Abortion - Just Facts

(This page contains comprehensive and scholarly details about the topic of abortion. For a more concise list of essential facts, click here. For an even shorter list of basic facts, click here.)

» The footnotes contain detailed source documentation. Click the footnote numbers [1, 2, 3…] to access this content and click the browser “Back“ button to return to the same place in the main text.

One of the major battlegrounds for this issue concerns terminology. In keeping with our Standards of Credibility, the language used here is explanatory and precise. Hence, expressions such as “pro-life” and “pro-choice” are replaced by words that articulate specific positions.

Perhaps the largest point of contention involving terminology is the label applied to what or who is being aborted. Those who think abortion should be generally illegal often use the terms “unborn child” and “unborn baby.” According to Webster’s College Dictionary and Black’s Medical Dictionary, the word “child” can apply prior to birth,[1] [2] but both of these sources employ the word “baby” only from the point of birth onwards.[3] [4] Those who think abortion should be generally legal often use the word “fetus,” a clinical term derived from a Latin word meaning “offspring” or “newly delivered.” [5] Dorland’s Illustrated Medical Dictionary defines a fetus as

In sum, when referring to humans, the words “fetus” and “fetal” are applicable from nine weeks after fertilization until birth.[7] [8] Yet, numerous major news organizations have misapplied these terms to both before and after this period.[9] [10] [11] [12] [13] [14] Furthermore, journalism guidelines disparage the use of medical jargon,[15] [16] [17] but journalists selectively employ it in their coverage of this issue. Despite widespread usage of “fetus,” the media commonly employs the word “mother” to refer to a pregnant woman and rarely, if ever, the more specific and clinical term “gravida.” [18] [19] Conversely, when the topic is not abortion, press outlets sometimes shun “fetus” and use words such as “baby” or “child” in its place.[20]

In accord with the common journalism standard to “never use … a scientific word or a jargon word if you can think of an everyday English equivalent,” [21] the term utilized by Just Facts to describe the object of an abortion is “preborn human.” This conveys reality in everyday language and is consistent with medical usage. For example, the embryology textbook, Before We Are Born - Essentials of Embryology and Birth Defects, states:

Similarly, another embryology textbook bears the title Human Life Before Birth and phrases such as “human in utero” and “human females ... in utero” appear in creditable medical texts.[23] [24] [25] It would also be scientifically inconsistent to assert that a child born at 24 weeks after fertilization is a human, while one in womb at 37 weeks is not.

Note that unless otherwise stated, the word “abortion” is used here in the sense of an induced abortion; not a spontaneous one, which is also called a miscarriage.[26]

* The average length of a full-term pregnancy is 38 weeks. Obstetricians normally use a figure of 40 weeks, but this is actually the time between the first day of the last menstrual period and childbirth. On average, the first day of the last menstrual period occurs 2 weeks before fertilization.[27] [28] [29]

* Following are facts about human development. They are organized according to the number of weeks since fertilization. Weeks after the first day of the last menstrual period (LMP) are shown in parentheses.

Fertilization normally takes place within one day of intercourse, but can occur up to six days later.[30] [31] At fertilization, the genetic composition of a preborn human is formed.[32] This genetic information determines gender, eye color, hair color, facial features, and influences characteristics such as intelligence and personality.[33]

Genetically speaking, with the exception of identical twins,[34] [35] once a woman conceives a preborn human, the odds against her conceiving the same one again are greater than 10⁶⁰⁰ to one.[36] [37] For perspective, there are roughly 10⁸⁰ atoms in the known universe.[38]

The eyes and spinal cord are visible and the developing brain has two lobes.[39] [40]

The heart is beating and a circulatory system is in place.[41] The portion of the brain associated with consciousness (the cerebrum) and internal organs such as the lungs are beginning to develop and can be identified.[42]

Muscles and nerves begin working together. When the upper lip is tickled, the arms move backwards.[43] The portion of the brain associated with consciousness (the cerebrum) has divided into hemispheres.[44]

More than 90% of the body structures found in a full-grown human are present. The medical classification changes from an embryo to a fetus. This dividing line was chosen by embryologists because from this point forward, most development involves growth in existing body structures instead of the formation of new ones.[46] [47] The preborn human moves body parts without any outside stimulation.[48]

All parts of the brain and spinal cord are formed. The heart pumps blood to every part of the body.[49] The whole body is sensitive to touch except for portions of the head. The preborn human makes facial expressions.[50]

Electrical signals from the nervous system are measurable. After an abortion, efforts to suckle will sometimes be observed.[52] [53]

The portion of the brain responsible for functions such as reasoning and memory (the cerebral cortex) has the same number of nerve cells as a full-grown adult.[58] [59]

Up through approximately this point in time, according to the Supreme Court’s rulings in Roe v. Wade and Planned Parenthood v. Casey, a pregnant woman can abort at will. (More details in the section on Constitution and Law.)

The blink-startle reflex and taste buds are functional. The preborn human will swallow more amniotic fluid if a sweetener is added to it.[64] [65] The grip is strong enough to hold onto an object that is moving up and down.[66] If born and given specialized care, the survival rate is more than 80%.[67]

If exposed to an 85 decibel noise while sleeping (about as loud as a blender), preborn humans exhibit the “motor behaviors that accompany the crying state.” [68] [69] Premature infants born at this time are more sensitive to pain than infants who are born at 38 weeks, and infants who are born at 38 weeks are more sensitive to pain than infants at 3-12 months after birth.[70] [71]

Average point in time when humans are born. At birth, the medical classification changes from a fetus to a neonate.[73] [74]

At any point prior to birth, according to the Supreme Court’s rulings in Roe v. Wade, Doe v. Bolton, and Planned Parenthood v. Casey, a pregnant woman can abort to preserve her “health.” One example from Roe v. Wade of what may be considered harmful to a mother’s health is the work of caring for a child. (More details in the section on Constitution and Law.)

* The 2008 Democratic Party Platform states that abortion should be generally legal, supports the Supreme Court ruling in Roe v. Wade, and supports the use of taxpayer funding to perform abortions. The platform also states that the Democratic Party

* The Republican Party Platform states that abortion should be generally illegal and supports a Constitutional Amendment that would assure preborn humans the right to life. It opposes “using public revenues to promote or perform abortion” and states

* Since 1989, several Democrats including Jim Oberstar of Minnesota have sponsored at least 11 resolutions proposing a Constitutional Amendment that would guarantee preborn humans the right to life, all of them containing an exception to protect the life of the mother.[77]

* Since 1989, several Republicans including Ann Emerson of Missouri have sponsored at least 23 resolutions proposing a Constitutional Amendment that would guarantee preborn humans the right to life, all of them containing an exception to protect the life of the mother. Six of these resolutions also include exceptions for cases of rape and incest.[78]

* The National Right to Life Political Action Committee has endorsed John McCain for president and stated that it “strongly opposes Barack Obama.” [79]

* The National Right to Life Committee has praised Sarah Palin, described her candidacy as thrill[ing], and disapproved of Joe Biden.[80] Sarah Palin is a member of Feminists for Life,[81] an organization “dedicated to systemically eliminating the root causes that drive women to abortion…” [82]

* The Political Action Committee of NARAL Pro-Choice America (formerly the National Abortion Rights Action League) has endorsed Barack Obama for President and given his voting record a 100% rating for the years 2005-2007.[83] It has given John McCain’s voting record a 0% rating for the years 2002-2007.[84]

* NARAL has stated that they have “have a longstanding relationship” with Joe Biden “that is open, positive, and constructive…” [85] For the past five years, NARAL has scored Biden’s voting record as follows: 75%, 100%, 100%, 100%, 36%.[86] NARAL has described Sarah Palin’s candidacy as “especially troublesome.” [87]

* In interviews conducted in August 2008, John McCain and Barack Obama were asked, “At what point does a baby get human rights?”

* In January 2008, the following message from John McCain was read at a “March for Life” in Washington, D.C.:

* Seven months later, McCain stated that he would not necessarily rule out selecting a running mate who generally supports legalized abortion.[92]

* In April 2007, John McCain told ABC News that “he still wants to change the GOP’s abortion platform to explicitly recognize exceptions for rape, incest, and the life of the mother.” [93]

* In response to a 1998 questionnaire that asked if he supported the “complete reversal of Roe vs. Wade,” John McCain answered “Yes.” [94] [95]

* Barack Obama and Hillary Clinton have voiced support for Roe v. Wade and stated that this would be reflected in their appointments to the Supreme Court.[99] [100] [101] They have also stated that they support a ban on late term abortions, but only with an exception for the “health” of the mother.[102] [103]

* In a July 2008 interview, Obama was asked to clarify his position on late-term abortions and stated:

* A few days later, a reporter asked for clarification of these remarks and Obama responded that late-term abortion bans must have an exception for “serious clinical mental health diseases,” but this does not mean that “if a woman just doesn’t feel good then that is an exception. That’s never been the case.” He also stated:

* The Roe v. Wade verdict provides several examples of what may constitute a risk the health of the mother. These include the “stigma of unwed motherhood” and the “distress” “associated with the unwanted child.” Roe v. Wade and Doe v. Bolton, which were issued by the Supreme Court on the same day with the order that they “are to be read together,” mandate that abortion be legal up until the point of birth if any one physician willing to perform an abortion decides it is necessary to preserve a mother’s health.[106] [107] (More details in the section on Constitution and Law.)

* Speaking before a Planned Parenthood national conference in July 2007, Barack Obama stated: “I put Roe at the center of my lesson plan on reproductive freedom when I taught Constitutional Law. … On this fundamental issue, I will not yield and Planned Parenthood will not yield.” [108] [109] When asked what he do to “ensure access to abortion” and make certain his judicial nominees are “true to the core tenets of Roe v. Wade,” he stated:

* The Freedom of Choice Act was introduced in the U.S. Senate in April 2007 by 13 Democrats including Barbara Boxer (California), Frank Lautenberg (New Jersey) and Max Baucus (Montana).[111] One month later, Barack Obama signed on as a cosponsor.[112] Its stated objective is to “protect, consistent with Roe v. Wade, a woman’s freedom to choose to bear a child or terminate a pregnancy…” It would invalidate “every Federal, State, and local statute, ordinance, regulation, administrative order, decision, policy, practice” that interferes with the termination of any “pregnancy prior to viability” and any pregnancy “after viability where termination is necessary to protect the life or health of the woman.” [113]

* On the same day this bill was introduced in the Senate, a bill with the same name and parallel verbiage was introduced in the House of Representatives.[114] It currently has 108 sponsors (107 Democrats and one Republican).[115] [116] The Senate bill currently has 20 sponsors (19 Democrats and one Independent).[117]

* According to data from the Guttmacher Institute, an organization whose “Guiding Principles” includes support for legalized abortion,[119] [120] the total number of abortions, the number of abortions per women of reproductive age, and the number of abortions per pregnancy each declined every year between 2001 (when Bush took office) and 2005 (the last year for which numbers are available). The total declines of this period are as follows:

* In June 2008, Howard Dean stated that the Democratic Party “believes that we ought to significantly reduce the number of abortions in this country.” A reporter asked Dean how he could reconcile this assertion with the party’s support for taxpayer funding of abortions. Dean replied it is “total nonsense” that public funding of abortions increases the abortion rate.[122]

* Barack Obama’s presidential campaign web site states that “Obama will make available a new national health plan to all Americans.” [124] This plan includes taxpayer funding of abortions.[125]

* The President of the United States appoints judges to the Supreme Court. These appointments must be approved by a majority of the Senate.[126] Senate rules allow for a “filibuster,” in which a vote to approve a judge can be blocked unless 60 of the Senate’s 100 members agree to let it take place.[127] [128]

* Once seated, federal judges serve for life unless they voluntarily resign or are removed through impeachment, which requires a majority vote of the House of Representatives and two-thirds of the Senate.[129]

* For implications relating to the appointment and approval of judges, see the section on Constitution and Law.

* The American Civil Liberties Union (ACLU) supports the use of taxpayer funding to perform abortions. In making its case for this position, the ACLU website poses the following rhetorical question:

* The ACLU is opposed to taxpayer funded school choice programs. One of their arguments for this stance is:

* No sources are cited for the statements above. According to the U.S. Centers for Disease Control, whose death statistics from legal abortions have been accepted and used by Planned Parenthood,[133] [134] [135] in the year before Roe v. Wade (1972), there were 39 deaths from illegal abortions. In the year after Roe v. Wade (1974), there were 26 deaths from legal abortions.[136]

* The following three graphs were constructed to discern an effect of Roe v. Wade on the collective rate of legal and illegal abortion-related deaths:

* In 1988, the Centers for Disease Control (CDC) reported that the coding system used to classify pregnancy-related deaths “precludes a determination of the real causes of maternal death.” [138] Hence, the graph below was constructed to show the incidence of all pregnancy-related deaths.

* In 1988, the CDC reported that the coding system used to classify deaths in general is inadequate because only a single code is assigned to each death, but “several factors may contribute to a death.” [140] Hence, the graph below was constructed to show the death rate from all causes for women of reproductive age.

* “Christiansen & Collins, 2006” contains no information about the risk of death associated with abortion or childbirth. It contains figures for the risk of death “once a woman has become pregnant” as compared to the number of live childbirths in the U.S. These figures are not broken down to show abortion or childbirth-related deaths.[143]

* Citing data from the CDC, a previous version of the same Planned Parenthood Fact Sheet states that the “risk of death associated with childbirth is about 10 times as high as that associated with abortion.” [144] [145] [146]

* The CDC has reported the following information about the data it provides for pregnancy-related deaths:

- Codes placed by individual doctors on death certificates are the “core source” of identifying pregnancy-related deaths. (2001) [147] (2005) [148]

- No “single source of information captures all pregnancy-related deaths” because of inadequate physician training and knowledge in filling out death certificates, medical records that “fail to indicate that the events leading to death began with pregnancy,” and “medical and autopsy records that cannot be located or are not available for review.” (2001) [149]

- “Death certificates alone may not provide adequate information on the sequence of events that led to death. Ultimately a single code is assigned to classify the underlying cause of death. Often, however, several factors may contribute to a death; therefore, the death cannot be adequately described with a unidimensional code.” (1988) [150]

- The second most common method of identifying pregnancy-associated deaths is “computerized linking of deaths among women of reproductive age with birth certificates and fetal death certificates.” (2005) [151] In four cases in which this has been done, the number of pregnancy-related fatalities identified increased by 30%, 68%, 129% and 153%. (2001) [152]

- One state out of 50 provides information that can be used to link abortion data to computerized death records. (2001) [153]

- The “coding system used by national vital statistics and states to describe maternal deaths... precludes a determination of the real causes of maternal death.” (1988) [154]

- “In most cases, the state is the level at which pregnancy-related deaths are reviewed…” (2001) [155]

- States are not required to report their abortion data to the CDC and privacy agreements with certain states require “strict confidentiality” on abortion-related fatality data. (2008) [156] [157]

* A 2002 national survey of physicians found that 98% think the reporting of medical practice errors is obstructed due to fear of lawsuits.[158]

* From 1989 through 1992, the CDC’s National Center for Health Statistics reported zero abortion-related deaths in the state of Maryland.[159] [160] [161] [162]

- Erica Kae Richardson (16 years-old) was admitted to an emergency room on March 1^st with a punctured uterus from an abortion carried out earlier that day at a clinic in Laurel, Maryland. She died shortly after midnight on March 2^nd.[163] [164] [165] [166]

- Paramedics arrived at an abortion clinic in Suitland, Maryland on July 12^th to find Debra M. Gray (34 years-old) in cardiac arrest after being administered anesthesia without the presence of an anesthesiologist. She was taken to a hospital and died three days later.[167]

- Paramedics arrived at an abortion clinic in Suitland, Maryland on September 10^th to find Susanne Renee Logan (32 years-old) in cardiac arrest with an oxygen mask placed upside down on her face. It was found that she had been given anesthesia without the presence of an anesthesiologist, and when she reacted to it, was given another drug not indicated to mitigate the effects of the anesthesia. The paramedics resuscitated Ms. Logan, she stayed in a coma for four months, and was generally paralyzed until her death in 1992.[168] [169] [170]

- Gladys Estanislao, a 28-year-old college student, was found lifeless on a bathroom floor 17 days after undergoing an abortion procedure at a clinic in Bethesda, Maryland. Her autopsy revealed that the pregnancy was not in her womb, but in her fallopian tube, which caused it to rupture and resulted in her death.[171] [172] [173] This condition, called an ectopic pregnancy, is screened by a blood test or ultrasound, has a mortality rate of 1 in 2,000, and is typically diagnosed on the first visit to a gynecologist.[174] [175] [176]

* In 1987, the New York City Commissioner of Health wrote a letter to abortion clinics warning them to be careful about using too much anesthesia. The letter stated:

* For the same time period, the CDC’s Division of Reproductive Health reported a total of 42 legal abortion-related deaths in the United States.[178]

* If both of these numbers are accurate, it would mean that 71% of the legal abortion-related deaths in the United States occurred in one city where about 3% of the population lived.[179]

* A 2007 paper in The Journal of Reproductive Medicine cites 59 studies that exhibit a statistically significant association between abortion and the risk of premature births in subsequent pregnancies. In five of the largest and more recent of these studies, all found increases in premature births before 32 weeks gestation in women who had an abortion. All of these studies also found that this risk escalated when more than one abortion was performed.[181] Children born before 32 weeks gestation are at increased risks for early death, cerebral palsy, blindness, deafness and other health complications.[182]

* The country of Finland has socialized medicine and keeps detailed health records of its citizens.[187] A search of these records over the years 1987-1994 found that 1,347 women of reproductive age (15-49 years old) committed suicide. A 1996 study of this data found that women who had an abortion were about 5.9 times more likely to commit suicide in the year following this event than women who delivered a child:

* The State of California pays the costs of childbirths and abortions for low income women. A study of 173,279 California women who had a state funded childbirth or abortion in 1989 found that 53 of them committed suicide within eight years of their childbirth or abortion. A 2002 study of this data found that women who had an abortion were about 2.5 times more likely to commit suicide in the eight years following this event than women who delivered a child:

* The California study cited above controlled for mental disorders by eliminating those women who had been treated for a psychiatric problem in the year prior to their childbirth or abortion. When this was done, it was found that women who had an abortion were about 3.3 times more likely to commit suicide in the eight years following this event than women who delivered a child:

* In October 2001, The Society of Professional Journalists, “the nation’s most broad-based journalism organization,” [192] adopted “Diversity Guidelines” reaffirming “their commitment” to use “language that is informative and not inflammatory.” These guidelines state that it is “misleading” to use “word combinations” such as “Islamic terrorist” or “Muslim extremist” “because they link whole religions to criminal activity.” The same document states:

* In April of 2007 at a Republican “Unity Dinner” in Iowa, John McCain stated:

* In an article about this event in the New York Times written by Adam Nagourney, it is stated that John McCain and Mike Huckabee “presented themselves as lifelong opponents of abortion rights.” Four times in this article, candidates are characterized as opponents of abortion rights and never as supporters of rights for the unborn.[196]

* Melloni’s Illustrated Medical Dictionary defines “partial-birth abortion” as follows:

* On the television show “NOW with Bill Moyers,” PBS journalist Brenda Breslauer stated:

* The book, English for Journalists, states that medical literature is a “common source” of jargon and:

* A 2005 house editorial in the Chicago Tribune uses the term “intact dilation and extraction” to identify “certain late-term abortions.” It does not contain the term “partial birth” and provides no description of the procedure.[210]

* Roe v. Wade and its accompanying ruling, Doe v. Bolton, mandate that abortion be legal up until the point of birth if any one physician willing to perform an abortion decides it is necessary to preserve a mother’s health.[213] [214]

* Since this time, the Associated Press, Quinnipiac University, the Pew Research Center, NBC News, the Wall Street Journal, and Harris Poll have all conducted polls in which they characterized Roe v. Wade as making abortion legal in the first “three months of pregnancy.” [216]

* In three articles published by the Associated Press in 2007 and 2008, it is asserted that the United States “permits abortions within the first 12 weeks of pregnancy.” [217] Media outlets that carried one or more of these stories include ABC, CBS, MSNBC, Fox News, Yahoo News, AOL News, USA Today, Los Angeles Times, Boston Globe, Washington Post and more than 50 other local, state, national and international publications.[218]

* In July 2000, Nina Totenberg, National Public Radio’s “award-winning legal affairs correspondent” stated:

* None of the news items cited above mention that “health,” as defined by Roe v. Wade and Doe v. Bolton, can include circumstances such as the “stigma of unwed motherhood” and the “distress” “associated with the unwanted child.” [222] [223] (More details in the section on Constitution and Law.)

* In 1987, Republican President Ronald Reagan asked his Surgeon General, Dr. C. Everett Koop, to prepare a “comprehensive report” concerning “the health effects of abortion on women.” [224]

* In 1989, Koop wrote a letter to Reagan stating that he and the staff people in several Public Health Agencies reviewed almost 250 studies and found that each had flaws which prevented them from drawing “scientifically sound conclusions.” [225]

* Koop’s letter did not state what Jennings, Rather, or Brokaw said it did. It stated:

* In 1985, the Los Angeles Times polled 3,165 newspaper reporters and editors working at 621 newspapers. It found that approximately 85% were in favor of abortion being generally legal. The same poll found that 51% of the general public were in favor of abortion being generally legal.[227]

* In December 2001, Hal Bruno, the former political director of ABC News, was asked what percentage of people at ABC News were “pro-choice.” He replied:

* A Zogby poll done about a year before the interview asked people if they agreed with the following statements:

- 24 states have a law in effect that requires parental consent for a minor to have an abortion.[233]

- 3 states have a parental consent law that is blocked by a court order or ruling.[234]

- 11 states have a law in effect that requires parental notification for a minor to have an abortion.[235]

- 4 states have a parental notification law that is blocked by a court order or ruling.[236]

- 8 states have no laws requiring parental consent or notification for abortions.[237]

* In the State of New Hampshire, it is against the law for anyone under 18 years of age to get a body piercing unless their parent or guardian is physically present when it is performed and signs a consent form.[238]

* In the State of New Jersey, it is against the law for anyone under 18 years of age to get a tattoo or body piercing without written consent from their parent or legal guardian.[239]

* In the State of California, it is against the law for anyone under 18 years of age to use a tanning machine without written consent from their parent or legal guardian.[240]

* In New Hampshire, New Jersey and California, it is legal for a girl of any age to get an abortion without her parent’s consent or knowledge.[241] [242] [243]

* A 2005 CBS poll found that 80% of the public was in favor of “requiring that at least one parent be told before a girl under 18 years of age could have an abortion.” A 2005 FOX News poll found 78% support for the same measure and 72% support for requiring minors “to get permission or consent” from a parent or guardian before having an abortion.[244]

* In 1996, Barack Obama’s Illinois Senate campaign completed a candidate questionnaire and then resubmitted it with amended answers on the following day. In response to the question, “Do you support parental consent/notification for minors seeking abortions?”, the answers were:

* When these questionnaires were published by Politico.com during the 2008 Presidential contest, Obama’s campaign asserted that a staffer filled them out and some of the responses do not reflect Obama’s views.[247] [248]

* Both of the questionnaires contain answers written in first person voice (e.g., “I strongly favor,” “I support it”). The first has a cover sheet that specifies a “Date of Interview” and “Place of Interview.” [249] The second has notes in what appear to be Obama’s handwriting on the first page.[250] In response to these revelations, Obama’s presidential campaign wrote:

* On a 2001 vote in the Illinois Senate for a parental notification bill, Barack Obama voted “Present.” [252] [253]

* Illinois Senate rules state that “a majority of those elected” (30 Senators) must vote in favor of a bill for it to pass. Thus, a vote of “Present” has the same result as a vote of “No.” [254]

* With regard to Obama voting “Present” on this and other abortion-related bills, Pam Sutherland, the president and CEO of the Illinois Planned Parenthood Council stated:

* In response to a 2004 candidate questionnaire that asked, “Do you support parental … notification or consent to obtain an abortion?”, Barack Obama’s U.S. Senate campaign answered:

* The 2001 parental notification bill on which Obama voted “Present” had bypass provisions for “sexual abuse,” “neglect,” “physical abuse,” and cases where notification “would not be in the best interests of the minor.” [258] [259]

* In response to a 2007 candidate questionnaire asking if minors should “be required to seek their parents” consent before having an abortion, Barack Obama’s presidential campaign did not explicitly answer the question and stated that

* Every one of the 35 states with a parental consent or notification law in effect has a bypass provision that permits exceptions in various circumstances such as when notifying a parent not be in a “minor’s best interests.” This is also the case with a Congressional bill that Obama filibustered. Six of the seven states with a parental consent or notification law blocked by a court order or ruling have similar bypass provisions. The one exception is New Mexico, which has a 1969 law on its books that the state attorney general ruled unenforceable in 1990.[261] [262] [263]

* The Democratic Party Platform makes no explicit reference to parental consent or notification laws.[264] The Republican Party Platform supports parental notification laws and makes no explicit reference to parental consent laws.[265]

* John McCain is a cosponsor of a bill to prohibit transporting minors across state lines to circumvent state laws that require parental involvement in a minor’s abortion.[266]

* Sarah Palin supports parental consent legislation and when Alaska’s Supreme Court struck down such a statute in a 3-2 decision, she backed a constitutional amendment aimed at restoring it.[267] [268] [269] The only Supreme Court appointee Palin has had the opportunity to select replaced one of the justices who voted to strike down this law.[270] [271]

* In September 2008, Newsweek published a “Web Exclusive” written by Katie Paul entitled:

This 1,250 word article mentions one law that was liberalized in Alaska during Sarah Palin’s tenure. This was the parental consent law struck down by Alaska’s Supreme Court.[272]

* On September 16, 1988, 17-year-old Rebecca Suzanne Bell of Indianapolis, Indiana was admitted to a hospital with pneumonia and suffered a fatal cardiopulmonary arrest that night.[273] During her autopsy, “evidence of recent pregnancy with recent partial abortion” was discovered. The “cause of death” listed on the autopsy report is “Septic Abortion with Pneumonia” and the “manner of death” as “Undetermined.” [274] According to Merriam-Webster’s Medical Dictionary, a “septic abortion” is a “spontaneous or induced abortion associated with bacterial infection…,” and pneumonia is “a disease of the lungs … that is caused especially by infection.” [275] [276]

* Indiana had (and has) a parental consent law in effect.[277] [278] According to a receipt from a local Planned Parenthood and Becky’s friend Heather Clark, the two of them visited Planned Parenthood, where it was suggested that Becky travel 100 miles to Kentucky to circumvent the Indiana law.[279] [280]

* Heather Clark stated that Becky chose not to tell her parents about the pregnancy because she was recently hospitalized with a drug problem and thought that they would kick her out of the house if they knew she was pregnant.[281] Ms. Clark also stated that after she and Becky went to Planned Parenthood, Becky wavered about having an abortion and considered running away and putting the baby up for adoption.[282] [283]

* The county coroner (who did not perform the autopsy and is now deceased[284]) told Becky’s parents that she had died from pneumonia and the source of the infection was an illegal abortion performed with unsterile instruments.[285] [286] [287] Her parents came to blame Becky’s death on Indiana’s parental consent law.[288] This led to media attention and Becky’s parents embarking on a speaking tour of 23 states with an advocacy group to lobby against parental involvement laws.[289] [290] [291]

* Since this time, Becky Bell’s case has been cited as an argument against parental consent laws on 60 Minutes,[292] ABC News,[293] CNN’s Larry King Live,[294] in the magazines Seventeen, Rolling Stone,[295] Newsweek,[296] in an American Civil Liberties Union pamphlet,[297] and in an original HBO movie named “Public Law 106: The Becky Bell Story.” [298] In the last three years, this argument has been repeated in at least 13 different publications including a legal journal.[299] [300] [301] [302] When a parental notification law was put on the ballot in Oregon in 1990, polls found opposition to it at 22%. After Becky’s parents toured the state appearing at rallies and on television and talk shows, the measure was defeated with 52% voting against it.[303]

* Around the time that the Becky’s parents appeared on 60 Minutes,[304] James A. Miller, the research director of an organization dedicated to “promot[ing] and defend[ing] the sanctity of life,” [305] corresponded several times with Dr. Jesse Giles, the author of the autopsy report and one of two pathologists who signed it.[306] In an editorial published in the Baltimore Evening Sun and in a press release, Miller wrote that Giles said:

- He used word “abortion” on the autopsy report in the sense of a spontaneous abortion (i.e., miscarriage[307]); not an induced abortion.

- He was “astounded” that 60 Minutes and Becky’s parents “would assert that my (autopsy) report proves that there was an instrumented, illegal abortion.”

- He did not write the word “septic” on the autopsy report. Another pathologist placed the word “septic” in front of the word “abortion” on the report’s cover page.[308] [309]

* The other pathologist who signed the autopsy report was Dr. John Pless. He supervised the autopsy, as Dr. Giles was a fellow in training at the time.[311] In a 1990 newspaper article, Dr. Pless is quoted as stating, “I cannot prove she had anything but a spontaneous abortion [i.e., miscarriage],” but that he found evidence of infection in Becky’s reproductive system, and thus it seemed probable that an induced abortion was performed.[312]

* The description of the reproductive system in the autopsy report contains no mention of an infection.[313]

* When contacted by Just Facts, Dr. Pless confirmed his view as quoted above and stated that the “same micro-organism” that caused the pneumonia “was cultured in the uterus and the lung.” [314] When it was pointed out the autopsy report contains a list of “Specimens for Culture” which does not include the uterus,[315] he said his memory may be faulty, but “the only possible source of the infection was the uterus” because there “was no upper airway disease - so the only possibility was spread from the uterus.” [316] [317]

- a 2006 paper in the Journal of Medical Microbiology states that the type of bacteria found in Becky’s lungs exists in various strains that selectively infect specific body tissues and not others,[318] [319]

- two recent medical texts indicate that the type of pneumonia Becky had is typically preceded by (not accompanied by) mild upper airway disease,[320] [321]

and hence, the absence of upper airway disease does not indicate the bacteria did not enter through the upper airway, he responded:

* The HBO movie cited above shows Becky going with a friend to obtain an illegal abortion.[323] [324] All primary sources researched for this case contain no testimony or documentation of such an event. This includes the coroner’s report,[325] autopsy report,[326] Becky’s mother’s written account,[327] and an article in the Cleveland Plain Dealer in which the reporter quotes Becky’s father and her “closest friend” Heather Clark. Ms. Clark, who accompanied Becky to Planned Parenthood, told the reporter that Becky did not have an induced abortion. She also said that when she visited Becky (four days after she had gotten sick and the night before she passed on), Becky asked her to schedule an abortion in Louisville, Kentucky for two days later.[328]

* In March 1989, six months after Becky Bell’s death, 16-year-old Erica Kae Richardson of Cheltenham, Maryland was assisted by her aunt in obtaining an abortion without her mother’s consent or knowledge. Erica’s aunt, a registered nurse, first took her to Washington Hospital Center, which would not perform the abortion because the pregnancy was 19 weeks along. She then took her to the Metropolitan Women’s Center in Laurel, where Dr. Gene Crawford carried out the abortion, puncturing her uterus in the process. Erica died several hours later from “rupture of [her] lower uterus and cervix with complications, including hemorrhage into the pelvic cavity surrounding the uterus and air embolism.” [341] [342] [343] [344]

* The current Maryland notification law allows abortion providers to bypass notifying a parent if, in their opinion, the minor is “capable of giving informed consent to an abortion.” The law also stipulates that abortion providers cannot be prosecuted or sued for failing to notify a girl’s parents.[345]

* A 2000 U.S. Department of Justice study of crimes reported to law enforcement agencies in twelve states from 1991-1996, found that the incidence of forcible rape peaked at the ages of 14 and 15.

* A 1987 survey of U.S. woman aged 18-22, found that of those who had intercourse at 15 years of age or younger, 40% had been forced to have sex against their will or were raped.[347] [348]

* A 2006 U.S. Department of Justice study found that 58% of female forcible rape victims were raped before their 18^th birthday.[349]

* Arkansas law requires written consent of a parent (not a step-parent) before an abortion is performed upon a female who is less than 18 years of age.[350] In 2006, a 15-year-old Arkansas girl accused her 41-year-old stepfather of raping her, getting her pregnant, forcing her to have an abortion in Illinois (where there is no parental consent or notification law in effect), and continuing to rape her afterwards.[351] [352] [353] [354]

* The girl’s claim that she was taken to an abortion clinic in Granite City, Illinois was corroborated by a photo of her stepfather’s car at this facility.[355] He was arrested, charged with a dozen counts of rape and committed suicide before trial.[356] [357]

* In 2006, the U.S. House of Representatives passed a bill that would have made it illegal to take a minor across state lines to circumvent state laws that require parental involvement in a minor’s abortion. It required that abortion providers in states without parental involvement laws give at least 24 hours notice to a parent before performing an abortion on a minor who resides in another state. This provision included exceptions for parental abuse, neglect, and if the physical health of the minor was endangered.[358] 93% of Republicans voted for it and 71% of Democrats voted against it. (Click for a record of how each Representative voted.)

* After being approved by the House, the bill was sent to the Senate where it was blocked by a filibuster conducted by 37 Democrats, 4 Republicans, and 1 Independent. Participants in the filibuster included Hillary Clinton, Joe Biden, Barack Obama, Arlen Specter and Olympia Snowe. (Click for a record of how each Senator voted.)

* A sexual relationship between a 22-year-old man and a 13-year-old girl is illegal in all 50 states and the District of Columbia.[359] All states have laws requiring healthcare and other workers who interact with children in a professional capacity to report suspected cases of child abuse, which in 29 states and the District of Columbia, explicitly includes a sexual relationship between a 22-year-old man and a 13-year-old girl.[360]

* In 2002, Life Dynamics, an organization dedicated to ending legal abortion,[361] phoned more than 800 Planned Parenthood and National Abortion Federation abortion clinics and offices. In these calls, a woman from Life Dynamics told workers at these facilities that she was 13-years-old, had been impregnated by her 22-year-old boyfriend, and wanted to get an abortion to hide the situation from her parents.[362]

* In more than 90% of the phone calls, the Planned Parenthood and National Abortion Federation workers did not act to report the matter.[363]

* Some workers encouraged the caller to come in for the abortion and lie about the age of the person who impregnated her.[364]

* Some workers told the caller that they were required to report the situation, but weren’t going to do so.[365]

* In states that have parental notification laws, some workers told the caller to find a person who was old enough to impersonate one of her parents and have them sign the required paperwork. In one state that requires a notarized signature from a parent, a worker told the caller that the facility had a notary public who would notarize a fraudulent signature for her.[366]

* After Life Dynamics released the recordings, Planned Parenthood issued the following statement:

* A Connecticut TV station (WTIC – Fox 61) scrutinized the recordings of the phone calls to the abortion clinics in Connecticut. They found that the dial tones recorded on the tapes matched the phone numbers of the facilities, the names of the people on the tapes matched the names of the workers at the facilities, and the content of the conversations matched what was reported by Life Dynamics.[368]

* In briefs submitted to the United States Supreme Court regarding a Minnesota parental consent law,[369] the American Psychological Association asserted that the law should be struck down on the grounds that

* In a brief submitted to the United States Supreme Court regarding a death penalty sentence in Missouri for a person who committed a capital murder at the age of 17, [372] the American Psychological Association asserted that crimes committed by minors should never be subject to the death penalty on the grounds that:

* Partial birth abortion, as described in American News Medical (a newspaper published by the American Medical Association[374]), entails

* According to the executive director of the National Coalition of Abortion Providers, this procedure was typically performed at 20+ weeks. (Not specified if this is after conception or last menstrual period.) [379]

* In June 1995, Republican Congressman Charles Canady of Florida sponsored a bill to ban the use of the partial birth abortion procedure on live preborn humans except if “necessary to save the life of a mother.” [381] It was cosponsored by 20 Democrats and 135 Republicans.[382] This bill passed Congress with 90% of Republicans voting for it and 62% of Democrats voting against it. It was vetoed by Democratic President Bill Clinton. A vote to override the veto passed in the House and failed in the Senate by 8 votes.[383] [384]

* In March 1997, Republican Congressman Gerald Solomon of New York sponsored a bill to ban the use of the partial birth abortion procedure on live preborn humans except if “necessary to save the life of a mother.” [385] It passed Congress with 95% of Republicans voting for it and 62% of Democrats voting against it. It was vetoed by Democratic President Bill Clinton. A vote to override the veto passed in the House and failed in the Senate by 3 votes.[386] [387]

- The executive director of the National Abortion Federation told the press that the partial birth abortion procedure “is not taking place on live fetuses, the way it’s being portrayed. The fetal demise has already occurred…” [388]

- Dr. Martin Haskell, who is credited with inventing the procedure,[389] sent a letter to Congress asserting, “Statements that fetuses are not dead until nearly the end of the procedure are not accurate. Death occurs early in the procedure if not before.” [390]

- Two years earlier, American Medical News interviewed Dr. Haskell and reported:

- After it was pointed out that this article conflicted with his assertion to Congress,[392] Haskell and the National Abortion Federation wrote letters to Congress stating that he and the other doctor had been “quoted out of context.” [393] [394] Consequently, the publication, which had tape-recorded the interviews, released a transcript of the contested quotes. When the interviewer said, “Let’s talk first about whether or not the fetus is dead beforehand,” Haskell responded:

- Dr. James McMahon, the other doctor interviewed for the American Medical News article, sent a letter to Congress affirming that a preborn human “feels no pain through the entire series of procedures” because the mother is given an anesthetic beforehand, which induces “a medical coma” and “neurological fetal demise.” [396]

- Afterwards, the President of the American Academy of Anesthesiologists, the President-Elect of the Society for Obstetric Anesthesia and Perinatology, the Chair of the Department of Anesthesiology at the University of Alabama Birmingham Hospital, and an Associate Professor at the Department of Pediatrics and Anesthesiology at Emory University testified before Congress regarding the effects of anesthesia given during partial birth abortions. A monthly newsletter of the American Academy of Anesthesiologists summarized the hearing as follows:

- The transcript of the interview with Dr. Haskell also revealed that he stated:

- One week after this information was released in a congressional report,[401] the American Civil Liberties Union, National Organization for Women, People For the American Way and 50 other organizations sent a joint letter to Congress stating that partial birth abortions were “most often performed” in cases “of severe fetal anomalies or a medical condition that threatens the pregnant woman’s life or health.” [402]

- One month after this, Planned Parenthood issued a press release asserting that partial birth abortion is “done only in cases when the woman’s life is in danger or in cases of extreme fetal abnormality.” [403]

- One week after this, the executive director of the National Coalition of Abortion Providers appeared on ABC’s “Nightline” and stated that partial birth abortions were done only in extreme situations of danger to a woman’s life and fetal anomalies.[404] [405] [406]

- Four months after this, the national policy director of Planned Parenthood testified to Congress: “The truth is that the procedure is only used when the woman’s life or health is in danger or in cases of extreme fetal anomaly.” [407]

- Six months later, two doctors at a New Jersey abortion clinic spoke with a local newspaper under condition of anonymity. They independently stated that their clinic performs roughly 1,500 partial birth abortions a year, most of which are elective and not for medical reasons.[408] [409]

- Six months after this, the executive director of the National Coalition of Abortion Providers told the New York Times and American Medical News that he “lied through [his] teeth” when he appeared on Nightline. Disowning his previous statements, he asserted that partial birth abortions are “primarily done on healthy women and healthy fetuses…” [410] [411]

- The same week this information was published, Renee Chelian, president of the National Coalition of Abortion Providers stated:

* In February 2003, Republican Senator Rick Santorum of Pennsylvania sponsored a bill to ban the use of the partial birth abortion procedure on live preborn humans except if “necessary to save the life of a mother.” [413] It was cosponsored by 2 Democrats and 43 Republicans.[414] Congress passed this bill with 95% of Republicans voting for it and 62% of Democrats voting against it. It was then signed into law by Republican President George W. Bush.[415] [416] John McCain and Joe Biden voted for this bill. (Click for a record of how each Congressman voted.)

* This law does not ban late-term abortions; only the partial birth procedure.[417] It does not prohibit giving a lethal injection to a preborn human and performing a partial birth abortion afterwards.[418] It does not prohibit dismemberment abortions, in which “the fetal limbs are pulled off the body in utero, sometimes while the fetus is still alive.” [419] [420]

* After this law was enacted, several abortion providers challenged it in court.[421] In April 2007, the U.S. Supreme Court upheld the constitutionality of the law in a 5-4 vote.[422] Of the five Supreme Court justices who ruled to uphold the law, Barack Obama voted against the nomination of two of them and identified two of the others as judges he would not have nominated.[423] [424] [425] Of the four justices who voted to strike down the law, John McCain has identified all of them as judges he would not have nominated.[426]

* The day after the Supreme Court ruling was issued, 13 Democrats in the U.S. Senate and 57 in the House of Representatives introduced legislation that would overturn the ban on partial birth abortions.[427] [428] [429] [430] Barack Obama has stated that the “first thing” he would do as President is sign this bill into law.[431]

* In March of 1970, a pregnant woman by the name of Norma McCorvey sued the state of Texas to challenge the constitutionality of a state law that prohibited abortion except to save the life of the mother. McCorvey wanted to keep her identity secret and assumed the fictitious name Jane Roe. The name of the Dallas County district attorney responsible for enforcing the law was Henry Wade. Thus, the case was entitled Roe v. Wade.[432] [433] [434]

* Before the United States Supreme Court, the attorney for Roe argued that the Texas law was unconstitutional because it violated the Ninth and Fourteenth Amendments.[435] The Ninth Amendment reads:

* In support of this view, the attorney for Roe stated that “liberty to these women would mean liberty from being forced to continue the unwanted pregnancy.” [438]

* During oral arguments, one of the judges asked the attorney for Roe if her case was dependent on the assertion that pre-born humans have no Constitutional rights. After some back and forth, the attorney for Roe responded:

At this point, the Chief Justice cut her off and started to ask another question. He then interrupted himself and asked:

* The attorney for the State of Texas argued that preborn humans are protected under the Fifth Amendment.[440] The portion relevant to the argument states:

* During oral arguments, one of the judges contested this viewpoint by asserting that the Fourteenth Amendment defined what the term “person” meant, and that it did not include preborn humans.[442] The relevant clause reads:

* The attorney for the State of Texas responded that the only way to understand what the Constitution means by the word “person” was to go to “the teachings at the time the Constitution was framed.” He then quoted from William Blackstone, who is described in Simon & Shuster’s New Millennium Encyclopedia as a “British jurist and legal scholar, whose work Commentaries on the Laws of England was used for more than a century as the foundation of all legal education in Great Britain and the U.S.” [445] In this work, Blackstone wrote that life is a “right” that

* To further support his position, the attorney for the state of Texas appealed to the Declaration of Independence and started to quote the following sentence from it, but was cut off by one of judges: [447]

* On January 22, 1973, the Supreme Court released its ruling. Seven of the judges ruled in favor of Roe and two of the judges opposed the ruling. The ruling overturned the laws of 30 states that prohibited abortion except to save the life of the mother.[449]

* The majority ruled these laws unconstitutional on the basis that they violated the Fourteenth Amendment, stating that it protects “the right to privacy,” and that this includes “a woman’s qualified right to terminate her pregnancy.” [450] The relevant portion of the Fourteenth Amendment reads:

* The Fourteenth Amendment does not contain the word “privacy” or any synonym for it. [452] [453] It was adopted in 1868 to address a number of issues relevant to the Civil War, such as ensuring constitutional rights for black people.[454]

* The majority wrote that they were “not in a position to speculate” as to “when life begins” and criticized the State of Texas for “adopting one theory of life,” namely, that life begins at conception.[455]

- Used the term “potentiality of human life” in reference to preborn humans who are capable of living outside the mother’s womb.[456]

* The majority created rules regarding the types of abortion legislation that states could enact based upon the three trimesters of a typical pregnancy:

- First trimester: States cannot prohibit abortions. They can require that abortions be done by licensed physicians, but other than this, they cannot regulate the manner in which they are performed.[458] In an internal court memo written before the ruling was issued and made public 15 years later, the author of the decision (Justice Harry Blackmun) wrote that the ruling contains “dictum” and this first trimester timeframe is “arbitrary.” [459] [460] (Click for full text of letter.)

- Second trimester: States cannot prohibit abortions. They can regulate the manner in which they are performed for the purpose of protecting the mother’s health. The ruling cites examples of the types of regulations that are permissible. These include establishing “qualifications [for] the person who is to perform the abortion” and setting rules regarding “the facility in which the procedure is to be performed.” [461]

- Third trimester: States can prohibit abortions after “viability” (meaning the point where a preborn human is capable of living outside their mother’s womb), but cannot prohibit abortions “where it is necessary, in appropriate medical judgment, for the preservation of the life or health of the mother.” [462] The ruling cites examples of what may be considered harmful to a woman’s health. These include the “stigma of unwed motherhood,” the work of caring for a child, and the “distress” “associated with the unwanted child.” [463] [464]

After listing these examples and others, the majority wrote that this portion of their ruling does not permit abortions “at whatever time, in whatever way, and for whatever reason” a woman chooses.[465] They repeated this assertion four times using varying words, but listed no example of a circumstance where abortion could be prohibited.[466]

* On the same day that the Supreme Court released Roe v. Wade, it issued another ruling in a case entitled Doe v. Bolton. The same seven judges who ruled in favor of Roe also ruled in favor of Doe, and the same two judges opposed the ruling.[467] The majority wrote that this ruling and Roe v. Wade “are to be read together.” [468]

* In this case, the State of Georgia had a law prohibiting abortions unless the pregnancy would “seriously and permanently” injure the health of the mother.[469] A lower court struck down this law and the majority of the Supreme Court agreed. The ruling stated that abortion laws with exceptions for the health of the mother must allow for factors such as emotional health, psychological health, familial concerns, and the woman’s age.[470]

* The Georgia law also required that the doctor who would perform the abortion, two other doctors, and a committee of the medical staff at the hospital where the abortion was to be done needed to agree that the abortion was necessary to preserve the health of the mother.[471] The lower court upheld this law and the Supreme Court struck it down. The majority ruled that only the doctor who would perform the abortion needs to determine that the abortion was necessary to preserve the health of the mother. Any abortion provider could make this decision based solely on their “best clinical judgment.” [472]

* Dr. Warren Hern is a late-term abortion practitioner, author of “the nation’s most widely used textbook on abortion standards and procedures,” a participant in crafting “the first version of the National Abortion Federation Program Standards for Abortion Services,” and “one of the experts in late abortion sought out by the national media…” [473] [474] In May 1997, he stated:

* In 1992, the Supreme Court decided a case entitled Planned Parenthood v. Casey. In this case, the majority reaffirmed the central element of Roe v. Wade, but did away with the “rigid trimester framework.” [477]

* As in Roe v. Wade, the majority ruled that states cannot prohibit abortions prior to viability, and laws that prohibit abortion after viability must include an exception for the “health of the mother.” [478] (With regard to viability, as of 2007, the youngest premature baby to survive was born at 21 weeks and 6 days gestation.[479])

* Contrary to Roe v. Wade, the majority ruled that states could enact laws that regulated abortion throughout pregnancy, as long as they did not create a substantial obstacle to obtaining an abortion. An example of what would be acceptable is a law requiring that doctors provide women with certain information before they perform abortions.[480]

* A 2007 British study found that 3.2% of preborn humans aborted on the basis of diagnoses for conditions such as Down’s Syndrome, heart defects, and kidney problems, survived for a median time of 80 minutes after birth, 36% of them for an hour or less, 6% for six hours or more.[481]

* In 2003, a child was born in Britain at 24 weeks gestation following three abortion procedures. As of 2005, he is healthy and is the “first long-term abortion survivor” to be born this prematurely.[483] [484]

* In 2007, twin brothers Ieuan and Gabriel Jones were born at 31 weeks gestation. Eleven weeks before this, it was found that Gabriel was underweight and his heart three times normal size. Doctors thought he would die and suggested an abortion to protect the life of his twin. An attempt was made to sever his umbilical cord, but doctors were unable to cut through it. Subsequently, the mother’s placenta was cut in half to isolate the twins from one another. The boys were delivered via caesarian section, and as of November 2007, were seven months old and both healthy.[485] (Click for photos.)

* In 2007, Finely Crampton was born three weeks premature after an attempted abortion at 8 weeks. His mother previously gave birth to two boys with kidney disorders, one of whom died after 20 minutes, and another who has one kidney. She was on the birth control pill when she became pregnant and decided to abort because she “couldn’t cope with the anguish of losing another baby.” At 19 weeks, she discovered the abortion was not successful and decided to carry to term. As of June 2008, Finley is 6 months old, “has minor kidney damage,” and is “expected to lead a normal life.” [486] (Click for photo.)

* Gianna Jessen was born in 1977 after surviving an abortion at seven-and-a-half months gestation.[487] [488] She has cerebral palsy as a result of the procedure.[489] She is now 31-years old and is a marathon runner, writer, singer, and “travels the world to campaign against abortion.” [490]

* In July 2000, two registered nurses who worked in the labor and delivery unit of Christ Hospital in Oak Lawn, Illinois testified before a U.S. Congressional subcommittee. Both described instances at the hospital in which they had personally seen babies who were born alive after an abortion and left to die without any care or comfort provided.[491] [492] A spokesman for the hospital’s parent corporation estimated that 10-20% of the abortions it performs on preborn human with genetic defects result in live births for short periods of time.[493]

* In 2001 and 2002, identical bills were introduced in the Illinois legislature with three paragraphs of operative text stating that anyone “born alive at any stage of development” is considered a “person” under Illinois state law including those born as a result of “abortion.” [494] [495] Barack Obama, as an Illinois state senator, voted against both of these bills.[496] [497]

* In 2002, the U.S. House of Representatives passed by a voice vote, the U.S. Senate passed by unanimous consent, and President Bush signed a bill stating that anyone “born alive at any stage of development” is considered a “person” under federal law including those born as a result of “abortion.” [498] [499] [500] This bill contained the same operative language as the Illinois bill except for the following paragraph.

* At a debate in October 2004, Barack Obama was criticized for voting against the Illinois bills and replied:

* In 2003, an amendment was proposed to an Illinois bill to make the operative language the same as the federal bill that Obama said he would have voted for.[502] [503] The amendment was referred to a committee chaired by Obama, where it was unanimously passed. The bill was then voted down by Obama and five other Democrats on the committee.[504] [505] [506] [507]

Sources

[1] Entry: “child.” Webster’s College Dictionary. Simon & Schuster, 1999. Definition 1a: “an unborn or recently born person.”

[2] Entry: “Fetus.” Black’s Medical Dictionary. Edited by Dr. Harvey Marcovich. 41^st edition. Scarecrow Press, 2006. Pages 269-270. Page 269: “The name given to the unborn child after the eighth week of development.”

[3] Entry: “baby.” Webster’s College Dictionary. Simon & Schuster, 1999. Definition 1a: “an extremely young child; especially: infant.”

[4] Entry: “Neonatal Intensive Care.” Black’s Medical Dictionary. Edited by Dr. Harvey Marcovich. 41^st edition. Scarecrow Press, 2006. Page 487: “The provision of a dedicated unit with special facilities, including one-to-one nursing and appropriate technology, for caring for premature and seriously ill newborn babies.”

[5] Entry: “fetus.” Merriam-Webster’s Collegiate Dictionary, Encyclopædia Britannica Ultimate Reference Suite, 2004. The etymology of this word is: “Middle English, from Latin, act of bearing young, offspring; akin to Latin fetus newly delivered, fruitful— more at feminine.”

[6] Entry: “fetus. Dorland’s Illustrated Medical Dictionary. 29th edition. W. B. Saunders Company, 2000. Page 661.

[7] Entry: “fetal. Dorland’s Illustrated Medical Dictionary. 29th edition. W. B. Saunders Company, 2000. Page 661: “of or pertaining to a fetus; pertaining to in utero development after the embryonic period.”

[8] Textbook: Langman’s Medical Embryology. By T. W. Sadler. Ninth edition. Lippincott Williams & Wilkins, 2004. Page 117: “The period from the beginning of the ninth week to birth is known as the fetal period.”

[9] For example, in April of 2001, the U.S. House of Representatives passed the “Unborn Victims of Violence Act.” This bill would make it a crime for someone to harm a “child in utero.” (It does not apply to any situation relating to an abortion with the consent of the mother.) The bill defines a child in utero as “a member of the species homo sapiens, at any stage of development, who is carried in the womb.” In their coverage of this vote, CNN, Reuters, the New York Times, Washington Post, ABC, USA Today, MSNBC, and CBS all used the word “fetus” or “fetal” as a blanket phrase for humans at any stage prior to birth. As shown by Black’s Medical Dictionary and Dorland’s Illustrated Medical Dictionary, their application of this term is inaccurate.

[10] For another example: Column: “Where’s the Baby? The AP misses the point.” By Kathryn Jean Lopez. National Review, March 13, 2002. http://www.nationalreview.com/nr_comment/nr_commentprint031302.html

{This column criticizes the Associated Press for misapplying the word “fetus” to humans who are born alive after an abortion. As shown by Black’s Medical Dictionary and the Royal College of Obstetricians and Gynaecologists, their application of this term is inaccurate. The same applies to the next example.}

[11] Article: “Obama’s View on Abortion May Divide Catholics.” By John M. Broder. New York Times, August 6, 2008. http://www.nytimes.com/2008/08/07/us/politics/07catholics.html

Republicans are gearing up campaigns to depict Mr. Obama as a radical on the question of abortion, because as a state senator in Illinois he opposed a ban on the killing of fetuses born alive.

[12] Press Release: “RCOG Statement on the article ‘One baby in 30 left alive after medical termination’ (Daily Mail, 20 April 2007).” Royal College of Obstetricians and Gynaecologists, April 20, 2007. http://www.rcog.org.uk/index.asp?PageID=1925

If the fetus has had a lethal injection, it will normally die. However, there are some instances when there are signs of life at birth. All babies must be treated with dignity and respect. Palliative care should be provided till the baby dies where relevant.

{Note that the Royal College of Obstetricians and Gynaecologists utilizes the word “baby” after the point of birth.}

[13] For another example: “Column: “Fetus or baby?” By Christine Chinlund. Boston Globe, February 17, 2003. http://www.boston.com/

Some pretty impartial sources, from the American College of Obstetricians and Gynecologists to Webster’s Dictionary, say that any unborn child is considered a fetus.

{Later in the column, the author quotes the following definition of “fetus” from Webster’s, which does not support the assertion she made: “An unborn offspring, especially in its later stages and specifically in humans, from about the eighth week after conception until birth.” The author did not attempt to substantiate the claim about the American College of Obstetricians and Gynecologists and I could find no such information on their website.}

[14] For another example: News Release: “States May Provide SCHIP Coverage for Prenatal Care.” United States Department of Health and Human Services, September 27, 2002. http://www.hhs.gov/news/press/2002pres/20020927a.html

The final regulation, which will be published in the Federal Register on Wednesday, October 2, allows states to file a state plan amendment to use existing SCHIP funding for coverage for children from conception to birth and up to age 19.

{As the quote above explains, the regulation is applicable from the point of conception onwards, yet the following three articles use the word “fetus” to describe the beneficiaries.}

1) Article: “HHS Proposes Insurance for Fetuses; Opponents Call It a Ploy to Pave Way for Ban on Abortion.” By Alan Cooperman & Amy Goldstein. Washington Post, February 1, 2002. Page A-01.

2) Article: “ ‘Unborn child’ coverage moves ahead: Abortion rights advocates oppose the new regulation.” By Catherine Berger. CNN, September 27, 2002. http://archives.cnn.com/2002/ALLPOLITICS/09/27/wh.unborn.child/index.html

The regulation allows states to expand eligibility to cover a fetus under the State Children’s Health Insurance Program (SCHIP) without having to receive a waiver from HHS.

3) Article: “Government Gives Fetuses ‘Unborn Child’ Status.” Fox News (with contribution from the Associated Press), February 1, 2002. http://www.foxnews.com/story/0,2933,44448,00.html

[15] Book: English for Journalists. By Wynford Hicks. Second edition. Routledge, 1998. Page 73:

Jargon is specialized vocabulary, familiar to the members of a group, trade or profession. If you write for a newspaper or general magazine you should try to translate jargon into ordinary English whenever you can. …

A common source of jargon is scientific, medical, government and legal handouts.

[16] Book: The New Oxford Guide to Writing. By Thomas S. Kane. Oxford University Press, 1988. Page 199:

Jargon is technical language misused. Technical language, the precise diction demanded by any specialized trade or profession, is necessary when experts communicate with one another. It becomes jargon when it is applied outside the limits of technical discourse.

[17] Book: The New York Public Library Writer’s Guide to Style and Usage. Edited by Andrea J. Sutcliffe. Stonesong Press/Harper Collins, 1994. Page 586:

When writing for a specialized audience—one familiar with the topic or field—a writer must use jargon; it is the common idiom. When writing for a lay audience or the general public, a writer should use jargon only when necessary and define it carefully. Where plain English serves equally well, it should be used instead.

[18] Dorland’s Illustrated Medical Dictionary. W.B. Saunders Company, 2000. 29th edition. Page 770 defines a gravida as “a pregnant woman.”

[19] For example, the following searches were performed on July 9, 2008:

Organization	Search results for			Notes
Organization	“fetus”	“abortion” AND “mother” AND “fetus”	“gravida”	Notes
New York Times	3,229	615	1 *	1981-current
Washington Post	3,225	632	0	1987-current
ABC	> 500	53 †	1 ‡	all available
NBC	2,830	477	0	all available

* Gravida is the title of a publication of the Westchester Women’s Poetry Collective.

† The website of ABC News does not have “AND” search capability, and so the search was performed through Google Advanced Search.

‡ The article is not written in English.

[20] For instance:

1) Article: “Parents of slain pregnant woman forgive suspect.” By Dan Nephin. Associated Press. July 25, 2008. http://news.yahoo.com

The parents of a slain pregnant woman said Friday they have forgiven the suspect charged with killing their daughter and cutting her baby out of the womb.

2) In February 2003, The Boston Globe published an article about a pregnant woman who was shot on a subway in the abdomen, entitling it:

“Passenger shot, her fetus dies as men clash on T.”

{Readers of the Globe sent letters objecting to the use of the word “fetus” in this context because they felt the clinical language was dehumanizing. The paper’s ombudsman responded, stating that the Boston Globe was “technically correct and wrong at the same time.” [Article: “Passenger Shot, Her Fetus Dies As Men Clash On T.” By Michael S. Rosenwald. Boston Globe, February 6, 2003. http://www.boston.com/]}

3) Article: “Baby saved as heroes lift bus off crushed mom.” Associated Press, August 15, 2008. http://www.msnbc.msn.com/id/26209074/

Dozens of strangers converged from all directions to lift a 5-ton bus off the body of a pregnant woman — a heroic effort that managed to save the life of her child but was too late for her.

[21] Book: Writing for Journalists. By Wynford Hicks, Sally Adams & Harriet Gilbert. Routledge, 1999. Page 125:

This emphasis on plainness and simplicity has been repeated by those who lay down the law about journalistic style. The Economist Pocket Style Book, first published in the 1980s, quotes George Orwell’s ‘six elementary rules’ from his famous essay, ‘Politics and the English Language’, written in 1946. …

5. Never use a foreign phrase, a scientific word or a jargon word if you can think of an everyday English equivalent.

[22] Book: Before We Are Born

Essentials of Embryology and Birth Defects. By Keith L. Moore & T.V.N. Persaud. W.B. Saunders Company, 1998. Fifth edition. Page 500.

[23] Textbook: Human Life Before Birth. By Frank J. Dye. Harwood Academic Publishers, 2000.

[24] Textbook: Pediatric Toxicology: Diagnosis and Management of the Poisoned Child. By Timothy B. Erickson, William R. Ahrens, Steven E. Aks, Carl R. Baum, Louis J. Ling. McGraw-Hill, 2005. Page 46: “The categories of human in utero exposure consist of maternal drugs of abuse, maternal environmental exposure, and maternal prescription drug use.”

[25] Textbook: Review of Medical Physiology. By William F. Ganong. 22nd edition. McGraw Hill, 2005. Page 259: “Exposure of human females to androgen in utero does not change the cyclic pattern…”

[26] Entry: “abortion.” American Heritage Dictionary of Science. Edited by Robert K. Barnhart. Houghton Mifflin, 1986. Page 2:

a birth that occurs before the embryo or fetus develops enough to live on its own, usually during the first twelve weeks of pregnancy (spontaneous abortion)… SYN: miscarriage.

[27] Textbook: Before We Are Born - Essentials of Embryology and Birth Defects. By Keith L. Moore & T.V.N. Persaud. W.B. Saunders Company, 1998. Fifth edition. Page 109: “The expected date of delivery (EDD) of a fetus is 266 days, or 38 weeks, after fertilization; that is, 280 days, or 40 weeks, after LNMP (Table 7-1).”

[28] Book: Color Atlas of Life Before Birth. By Marjorie A. England. Year Book Medical Publishers, 1983. Page 12: “Most clinicians do not know the fertilization date; the only date available to them is the first day of the last menstrual period. They use this date to define a menstrual age stretching from time 0, which is usually 14 days before fertilization….”

[29] Book: How Life Begins. By Christopher Vaughn. Random House 1996. Page 8: “In other words, most obstetricians figures are based on a forty-week pregnancy when you’re actually pregnant for only thirty-eight weeks.”

[30] Book: Color Atlas of Physiology. By Agamemnon Despopoulos & Stefan Silbernagl. Fifth edition. Thieme, 2003. Page 308: “Fertilization usually takes place on the first day after intercourse…”

[31] Textbook: Langman’s Medical Embryology. By T. W. Sadler. Ninth edition. Lippincott Williams & Wilkins, 2004. Page 122: “The oocyte is normally fertilized within 12 hours of ovulation. However, sperm deposited in the reproductive tract up to 6 days prior to ovulation can survive to fertilize oocytes. Thus, most pregnancies occur when sexual intercourse occurs within a 6-day period that ends on the day of ovulation.”

[32] Book: Psychological Development and Early Childhood. By John Oates, Clare Wood & Andrew Grayson. Blackwell, 2005.Page 217 states that a ‘genotype’ is: “The complete set of genes present in an individual. The genotype is determined at fertilization when genetic information from the egg and sperm is combined. “

[33] Book: Mayo Clinic Guide to a Healthy Pregnancy. By the Mayo Clinic. Collins, 2004. Page 45 (section on fertilization): “This genetic material will determine your baby’s sex, eye color, hair color, body size, facial features and – at least to some extent – intelligence and personality. … Your baby’s sex is determined at the moment he or she is conceived.”

[34] Book: Genetic Destinies. By Peter Little. Oxford University Press, 2002. Page 34: “Identical twins have exactly the same DNA and it so follows that any feature that is defined by gene differences should be identical between them.”

[35] Note that even though identical twins have the same genes, they vary in certain biological respects because of epigenetic differences. This is explained in the paper: “The marks, mechanisms and memory of epigenetic states in mammals.” By Vardhman K. Rakyan & others. Biochemical Journal, May 15, 2001. http://www.biochemj.org/bj/356/0001/3560001.pdf

Page 1:

These modifications interfere with the DNA–protein interactions that facilitate transcription, resulting in transcriptional silencing of the epigenetically modified allele. Epigenetic modifications can, therefore, cause phenotypic variation in the absence of genetic differences.

[36] Teaching guide: “Human Genetic Variation.” By BSCS and Videodiscovery under a contract from the National Institutes of Health, National Human Genome Research Institute, 1999. http://science.education.nih.gov/supplements/nih1/genetic/guide/pdfs...

Page 7:

The human genome comprises about 3 × 10⁹ base pairs of DNA, and the extent of human genetic variation is such that no two humans, save identical twins, ever have been or will be genetically identical.

[37] Calculation performed with information and data from the following sources:

a) Book: The Developing Human: Clinically Orientated Embryology. By Keith L. Moore & T. V. N. Persaud. Seventh edition. Saunders, 2003. Page 16: Human development begins at fertilization when a male gamete or sperm (spermatozoa) unites with a female gamete or oocyte (ovum) to form a singe cell – a zygote.” Page 33:

The zygote is genetically unique because half of its chromosomes come from the mother and half from the father. The zygote contains a new combination of chromosomes that is different from that in the cells of either of the parents. This mechanism forms the basis of biparental inheritance and variation of the human species.

b) Book: Population and Evolutionary Genetics: A Primer. By Francisco J. Ayala. Benjamin Cummings Publishing Company, 1982. Page 53:

Considerable genetic variation exists in most natural populations. … Consider humans with a 6.7% heterozygosity detectable by electrophoresis. If we assume there are 30,000 structural gene loci in a human being, which may be an underestimate, a person will be heterozygous at 30,000 X 0.067 = 2010 loci. Such an individual can theoretically produce 2²⁰¹⁰ ≈ 10⁶⁰⁵ different kinds of gametes [reproductive cells].

c) Book: Human Reproductive Biology. By Richard E. Jones & Kristen H. Lopez. Third edition. Academic Press, 2006. Page 46 states that women living in developed countries experience about 450 ovulation cycles in a lifetime.

CALCULATION: 10⁶⁰⁵ possible genetically unique reproductive cells per woman / 450 ovulation cycles = 2.2X10⁶⁰². This figure only accounts for the genetic variation of the female. Therefore, the odds against a woman conceiving the same preborn human twice (with or without the same mate) are actually much higher than this.

[38] Calculation performed with information and data from the following sources:

a) Textbook: Foundations of Modern Cosmology. By John F. Hawley & Katherine A. Holcomb. Oxford University Press, 1998. Page 454: “There are perhaps 10⁸⁰ baryons in our visible universe, and about 10⁹ photons per baryon.”

b) Book: The Inflationary Universe. By Alan Guth. Helix Books, 1997. Page 108: “Since we believe that the observed universe has a baryon number of 10⁷⁸, the conservation of baryon number would imply that it always had a baryon number of 10⁷⁸.”

c) Book: Six Easy Pieces: Essentials of Physics Explained By Its Most Brilliant Teacher. Addison-Wesley, 1995. This book is comprised of six chapters taken from the book, Lectures on Physics, by Richard Feynman. Page 85: “There are a number of strange particles, a neutron and a proton are examples, which are called baryons.”

d) Article: “Atom.” World Book Encyclopedia, 2007 Deluxe Edition. “Tiny as atoms are, they consist of even more minute particles. The three basic types are protons, neutrons, and electrons. Each atom has a definite number of these subatomic particles.”

{As shown above, all atoms contain at least one baryon, and thus 10⁸⁰ represents a rough maximum for the number of atoms in the visible universe.}

[39] Book: The First Nine Months of Life. By Geraldine Lux Flanagan. Simon & Shuster, 1962. Second edition. Page 35 states that in the third week, “the brain has two lobes” and “the early spinal cord is bordered by the future vertebrae and muscle segments.” A picture shows the brain lobes and spinal cord.

[40] Book: Gray’s Anatomy - The Anatomical Basis of Medicine and Surgery. Churchill Livingstone, 1995. Page 329 states that at 19-21 days, “The cranial half of the groove, representing developing brain, begins to develop cephalic flexure, optic primordia become visible…”

[41] College textbook: Biology: Investigating Life on Earth. By Vernon L. Avila. Second edition. Jones and Bartlett, 1995. Page 693: “First, the embryo has its own circulatory system, complete with a heart that started beating only 24 days after conception…”

[42] Book: Gray’s Anatomy - The Anatomical Basis of Medicine and Surgery. Churchill Livingstone, 1995. Page 329 states that at 21-27 days:

[P]rimary cerebral vesicles appear. … Rudimentary limb buds appear and the heart tubes fuse into a common loop in which contractile activity commences. The primordia of the thyroid gland, lungs, liver, pancreas, and mesonephric tubules are all identifiable.

[43] Book: The First Nine Months of Life. By Geraldine Lux Flanagan. Simon & Shuster, 1962. Second edition. Pages 52-53:

In the sixth and seventh weeks, nerves and muscles work together for the first time. If the area of the lips, the first to become sensitive to touch, is gently stroked, the baby, who then is still an embryo, responds by bending the upper body to one side and making a quick backward motion with the arms. This is called a “total pattern” response because it involves most of the body rather than the approximate local part.”

{The details above are documented by photos. Page 52 notes, “All of the photographs in this book that show the movement of the baby are taken from” films made by Davenport Hooker at the University of Pittsburgh.}

[44] Book: Gray’s Anatomy - The Anatomical Basis of Medicine and Surgery. Churchill Livingstone, 1995. Page 329 states that in the 6^th and 7^th weeks, “The pontine flexure, cerebral hemispheres and cerebellum are developing.”

[45] Seven weeks after fertilization. Intrauterine picture taken under the direction of Professor Andrzej Skawina, Collegium Medicum Jagiellonian University (Krakow, Poland); Antoni Marsinek, MD, The Czerwiakowski Gynecological and Obstetrics Hospital (Krakow, Poland); Photographers: Andrzej Zachwieja, Jan Walczewski. There are a number of different photographers who have taken intrauterine photos. We asked several individuals if we could use their pictures and Life Issues was the only one who gave us permission. The pictures from Life Issues look similar to those taken by the other photographers.

[46] Book: Gray’s Anatomy - The Anatomical Basis of Medicine and Surgery. Churchill Livingstone, 1995. Page 95:

When mammalian embryos reach a certain size, growth rather than morphogenesis occurs. The embryo is referred to as a fetus; this occurs at 56-57 postovulatory days in humans when the onset of bone marrow formation in the humerus can be seen (Streeter 1949); at this stage more than 90% of the named structures of the adult body have appeared.

[47] Book: The First Nine Months of Life. By Geraldine Lux Flanagan. Simon & Shuster, 1962. Second edition. Page 48:

The appearance of the first bone cells marks the end of the embryonic period. This criterion was chosen by embryologists because the beginning bone formation coincides with the essential completion of the body.

[48] Book: The First Nine Months of Life. By Geraldine Lux Flanagan. Simon & Shuster, 1962. Second edition. Pages 52-53: “By the beginning of this third month the baby moves spontaneously, without being touched, for the first time.”

[49] Article: “Fetus.” By Frank D. Allan in the Encyclopedia of Human Biology. Academic Press, 1997. Volume 3. Page 955 states that in the tenth week:

Division of the heart into chambers is complete, and a definitive vascular system carries blood to and from all parts of the body. … All components of the brain and spinal cord are formed, and nerves link the stem of the brain and the spinal cord to all tissues and organs of the body.

[50] Book: The First Nine Months of Life. By Geraldine Lux Flanagan. Simon & Shuster, 1962. Second edition. Pages 53-54:

In the ninth and tenth weeks, if the baby’s forehead is touched, he may turn his head away and pucker up his brow and frown. … [T]he entire body becomes sensitive to touch with a notable exception: the sides, back and top of the head.

[51] Eleven weeks after fertilization. Intrauterine picture taken under the direction of Professor Andrzej Skawina, Collegium Medicum Jagiellonian University (Krakow, Poland); Antoni Marsinek, MD, The Czerwiakowski Gynecological and Obstetrics Hospital (Krakow, Poland); Photographers: Andrzej Zachwieja, Jan Walczewski. There are a number of different photographers who have taken intrauterine photos. We asked several individuals if we could use their pictures and Life Issues was the only one who gave us permission. The pictures from Life Issues look similar to those taken by the other photographers.

[52] Article: “Fetus.” By Frank D. Allan in the Encyclopedia of Human Biology. Academic Press, 1997. Volume 3. Page 962 states that in the third month, “Electrical activity of the nervous system is discernible… Attempts to suckle have been seen in utero and in aborted fetuses of 3 months.”

[53] Textbook: Human Genetics: Concepts and Applications. By Ricki Lewis. Third edition. McGraw Hill, 1998. Page 56: “By week 12, the fetus sucks its thumb, kicks, makes fists and faces, and has the beginnings of baby teeth.”

[54] Ultrasound taken on November 25, 1997. Gestational age (GA) is 14 weeks and 4 days counted from the LMP. This falls under the category of 15 weeks after LMP and 13 weeks after fertilization.

[55] Textbook: Before We Are Born - Essentials of Embryology and Birth Defects. By Keith L. Moore & T.V.N. Persaud. W.B. Saunders Company, 1998. Fifth edition. Page 106: “Limb movements, which occur at the end of the embryonic period (8 weeks), become coordinated by the 14^th week, but are too slight to be felt by the mother.”

[56] Book: Embryology (Board Review Series). By Ronald W. Dudek & James D. Fix. Second edition. Lippincott Williams & Wilkins, 1998. Page 246 states that in weeks 13-16, “Eye movements begin.”

[57] Sixteen weeks after fertilization. Intrauterine picture taken under the direction of Professor Andrzej Skawina, Collegium Medicum Jagiellonian University (Krakow, Poland); Antoni Marsinek, MD, The Czerwiakowski Gynecological and Obstetrics Hospital (Krakow, Poland); Photographers: Andrzej Zachwieja, Jan Walczewski. There are a number of different photographers who have taken intrauterine photos. We asked several individuals if we could use their pictures and Life Issues was the only one who gave us permission. The pictures from Life Issues look similar to those taken by the other photographers.

[58] Paper: “Pain and its Effects in the Human Neonate and Fetus.” By K.J.S. Anand & P.R. Hickey. New England Journal of Medicine, November 19, 1987. Page 1322 states that “by 20 weeks each cortex has a full complement of 10⁹neurons.” {This article uses the obstetric method of counting from the last menstrual period as evidenced by the chart on page 1322, which uses a gestation of 40 weeks for pregnancy. Two weeks must be subtracted to provide the actual time since fertilization.}

[59] Article: “Brain.” New Millennium Encyclopedia. Simon and Shuster, 1999.

The cerebrum is the largest part of the human brain, making up approximately 85 percent of the brain’s weight; its large surface area (cortex) and intricate development account for the superior intelligence of humans, compared with other animals. … A large part of the human cortex, the frontal area, is used for awareness, intelligence, and memory.

[60] Ultrasound taken on December 24, 1997. Gestational age (GA) is 19 weeks and 4 days counted from the last menstrual period. This falls under the category of 20 weeks after LMP and 18 weeks after fertilization.

[61] Article: “Fetus.” American Medical Association Complete Medical Encyclopedia. Edited by Jerrold B. Leikin & Martin S. Lipsky. Random House, 2003. Page 558: “At 20 weeks, the fetus… now sleeps and wakes and hears sounds.”

[62] Twenty weeks after fertilization. Intrauterine picture taken under the direction of Professor Andrzej Skawina, Collegium Medicum Jagiellonian University (Krakow, Poland); Antoni Marsinek, MD, The Czerwiakowski Gynecological and Obstetrics Hospital (Krakow, Poland); Photographers: Andrzej Zachwieja, Jan Walczewski. There are a number of different photographers who have taken intrauterine photos. We asked several individuals if we could use their pictures and Life Issues was the only one who gave us permission. The pictures from Life Issues look similar to those taken by the other photographers.

[63] Ultrasound taken on May 31, 1999. Gestational age (GA) is 21 weeks and 5 days counted from the last menstrual period. This falls under the category of 22 weeks after LMP and 20 weeks after fertilization.

[64] Book: Embryology (Board Review Series). By Ronald W. Dudek & James D. Fix. Second edition. Lippincott Williams & Wilkins, 1998. Page 247: Weeks 21-24: “Blink-startle reflex is demonstrable on vibroacoustic stimulation of mother’s abdomen.”

[65] Entry: “Fetus.” Encyclopedia of Human Biology. Academic Press, 1997. Volume 3. By Frank D. Allan. Page 962:

Taste buds are functional at 6 months, and the modality for sweetness is well differentiated. Increased “drinking” of the amniotic fluid is effected when sweet substances are introduced.

[66] Book: The First Nine Months of Life. By Geraldine Lux Flanagan. Simon & Shuster, 1962. Second edition. Page 71 states: “In the fifth and sixth months the grip becomes strong. This baby is holding a rod and moves his arm up and down as the rod is moved.” {This is documented by a photo. Page 52 notes, “All of the photographs in this book that show the movement of the baby are taken from” films made by Davenport Hooker at the University of Pittsburgh.}

[67] Paper: “Very Low Birth Weight Outcomes of the National Institute of Child Health and Human Development Neonatal Research Network, January 1995 Through December 1996.” By James A. Lemons et al., including Avroy A. Fanaroff. Pediatrics, January 2001. http://www.pediatrics.org/cgi/content/full/107/1/e1

{Figure 3 is a bar graph of “Mortality before discharge by gestational age as estimated by best obstetrical estimate…” The term “obstetrical estimate” implies that the weeks are counted from LMP. To confirm, I wrote Dr. Fanaroff. He replied: “We do not try to get to the issue of day of conception hence when we refer to gestational age we are always going back to the Last Menstrual Period.” The graph indicates that the mortality rate at a gestational age (LMP) of 26 weeks is less than 20%. Hence, the survival rate at 24 weeks after fertilization is more than 80%.}

[68] Paper: “Fetal homologue of infant crying.” By J L Gingras and others. Archives of Disease in Childhood - Fetal and Neonatal Edition, April 27, 2005. Pages F415-F418. http://adc.bmj.com/

Page F415:

in a stable state (quiet or active sleep), the fetus was challenged with [vibroacoustic stimulation]. [This] was provided by an artificial larynx (model 5c; Western Electric) that emits fundamental tones of about 100 Hz and 95 dB and was mechanically altered to provide exactly 0.5 second of stimulation. … The physiological intrauterine noise intensity has been reported to be about 85 dB.⁵

Page F418:

“The behaviors were seen in all gestational ages studied, indicating that the behavior occurs as early as 28 weeks gestation, and possibly earlier.”

[69] Advisory: “Hearing Conservation Program.” University Health Services, University of Cincinnati, Revised June 11, 1999. http://ehs.uc.edu/Advisories/Advisory_33_0.PDF

Noise Source	Decibels
Lawn mower, food blender	90

[70] Paper: “Pain and its Effects in the Human Neonate and Fetus.” By K.J.S. Anand & P.R. Hickey. New England Journal of Medicine, November 19, 1987. Page 1325:

Most recently the motor responses of 124 healthy full-term neonates to a pinprick in the leg were reported to be flexion and adduction of the upper and lower limbs associated with grimacing, crying, or both, and these responses were subsequently quantified. Similar responses have also been documented in very premature neonates, and in a recent study, Fitzgerald et al. found that premature neonates (<30 weeks) not only had lower thresholds for a flexor response but also had increased sensitization after repeated stimulation.

Page 1325:

In other studies of the cry response to painful procedures, neonates were found to be more sensitive to pain than older infants (those 3 to 12 months old)…

{This article uses the obstetric method of counting from the last menstrual period, as evidenced by the chart on page 1322, which uses a gestation of 40 weeks for pregnancy. Two weeks must be subtracted to provide the actual time since fertilization.}

[71] Paper: “Symptom Management: Acute Pain, Chapter 3 - Pain in Preverbal Children.” United States National Institutes of Health, Publication Number 94-2421. June 1994. http://www.nih.gov/

Page 2 cites one possible reason why younger humans are more sensitive to pain:

Serotonin (5HT) is a biogenic amine transmitter that serves an important role in pain modulation. … Serotonin levels in the young infants are low and may limit the effectiveness of the endogenous pain control mechanisms (Fitzgerald 1991b).

[72] Paper: “Very Low Birth Weight Outcomes of the National Institute of Child Health and Human Development Neonatal Research Network, January 1995 Through December 1996.” By James A. Lemons et al., including Avroy A. Fanaroff. Pediatrics, January 2001. http://www.pediatrics.org/cgi/content/full/107/1/e1

{Figure 3 is a bar graph of “Mortality before discharge by gestational age as estimated by best obstetrical estimate…” The term “obstetrical estimate” implies that the weeks are counted from LMP. To confirm, I wrote Dr. Fanaroff. He replied: “We do not try to get to the issue of day of conception hence when we refer to gestational age we are always going back to the Last Menstrual Period.” The graph indicates that the mortality rate at a gestational age (LMP) of 30 weeks is a little less than 5%. Hence, the survival rate at 28 weeks after fertilization is more than 95%.}

[73] Textbook: Before We Are Born - Essentials of Embryology and Birth Defects. By Keith L. Moore & T.V.N. Persaud. W.B. Saunders Company, 1998. Fifth edition. Page 109: “The expected date of delivery (EDD) of a fetus is 266 days, or 38 weeks, after fertilization; that is, 280 days, or 40 weeks, after LNMP (Table 7-1).”

[74] Entry: “neonate.” Dorland's Illustrated Medical Dictionary. 29th edition. W. B. Saunders Company, 2000. Page 1184: “a newborn infant.”

[75] 2008 Democratic Party Platform: “Renewing America’s Promise.” Democratic National Committee, August 25, 2008. http://www.presidency.ucsb.edu/ws/index.php?pid=78283

The section entitled “Choice” states:

The Democratic Party strongly and unequivocally supports Roe v. Wade and a woman’s right to choose a safe and legal abortion, regardless of ability to pay, and we oppose any and all efforts to weaken or undermine that right.

The Democratic Party also strongly supports access to comprehensive affordable family planning services and age-appropriate sex education which empower people to make informed choices and live healthy lives. We also recognize that such health care and education help reduce the number of unintended pregnancies and thereby also reduce the need for abortions.

The Democratic Party also strongly supports a woman’s decision to have a child by ensuring access to and availability of programs for pre- and post-natal health care, parenting skills, income support, and caring adoption programs.

[76] 2008 Republican Platform. Republican National Convention, August 26, 2008. http://www.gopplatform2008.com/2008Platform.pdf

[77] Search performed on May 27, 2008 at http://thomas.loc.gov/. Bill texts from the 101^st to 110^th Congresses searched for: “amendment to the Constitution of the United States with respect to the right to life.” Sample result:

H. J. RES. 23

Proposing an amendment to the Constitution of the United States with respect to the right to life.

IN THE HOUSE OF REPRESENTATIVES

January 4, 1995

Mr. VOLKMER [Harold L. Volkmer (Democrat – Missouri)] introduced the following joint resolution; which was referred to the Committee on the Judiciary

JOINT RESOLUTION

Proposing an amendment to the Constitution of the United States with respect to the right to life.

Resolved by the Senate and House of Representatives of the United States of America in Congress assembled (two-thirds of each House concurring therein), That the following article is proposed as an amendment to the Constitution of the United States, which shall be valid to all intents and purposes as part of the Constitution when ratified by the legislatures of three-fourths of the several States:

Article—

SECTION 1. With respect to the right to life, the word `person’ as used in this article and in the fifth and fourteenth articles of amendment to the Constitution of the United States applies to all human beings irrespective of age, health, function, or condition of dependency, including their unborn offspring at every state of their biological development.

SECTION 3. The Congress and the several States shall have the power to enforce this article by appropriate legislation.

SECTION 4. This article shall be inoperative unless it shall have been ratified as an amendment to the Constitution by the legislatures of three-fourths of the several States, within ten years of the date of its submission to the States by the Congress.

[78] Search performed on May 27, 2008 at http://thomas.loc.gov/. Bill texts from the 101^st to 110^th Congresses searched for: “amendment to the Constitution of the United States with respect to the right to life.” Sample result:

H. J. RES. 9

Proposing an amendment to the Constitution of the United States with respect to the right to life.

IN THE HOUSE OF REPRESENTATIVES

January 7, 2003

Mrs. EMERSON [Jo Ann Emerson (Republican -Missouri)] introduced the following joint resolution; which was referred to the Committee on the Judiciary

JOINT RESOLUTION

Proposing an amendment to the Constitution of the United States with respect to the right to life.

Resolved by the Senate and House of Representatives of the United States of America in Congress assembled (two-thirds of each House concurring therein), That the following article is proposed as an amendment to the Constitution of the United States, which shall be valid only when ratified by the legislatures of three-fourths of the several States within seven years after the date of final passage of this joint resolution:

Article—

SECTION 1. With respect to the right to life, the word `person’ as used in this article and in the fifth and fourteenth articles of amendment applies to all human beings irrespective of age, health, function, or condition of dependency, including their unborn offspring at every state of their biological development.

SECTION 2. No unborn person shall be deprived of life by any person: Provided, however, That nothing in this article shall prohibit a law permitting only those medical procedures required to prevent the death of the mother of an unborn person: Provided further, That nothing in this article shall limit the liberty of a mother with respect to the unborn offspring of the mother conceived as a result of rape or incest.

SECTION 3. The Congress and the several States shall have power to enforce this article by appropriate legislation.

[79] Home page of the National Right to Life Political Action Committee. Accessed August 2008 at http://www.nrlpac.org/

National Right to Life PAC supports Senator John McCain for election as President of the United States and strongly opposes Barack Obama.

[80] Press release: “National Right to Life Praises Palin.” National Right to Life, August 29, 2008. http://nrlc.org/press_releases_new/Release082908.html

[81] Press release: “FFL Member Nominated for Vice President of the United States.” Feminists for Life, August 29, 2008. http://www.feministsforlife.org/news/ffl-member-sarah-palin-vp.htm

[82] Web page: FFL’s Mission: Page 2. Feminists for Life, Accessed August 2008 at http://www.feministsforlife.org/who/joinus.htm

[83] Web page: “NARAL Pro-Choice America PAC endorses Sen. Barack Obama for President!” Accessed June 20, 2008. http://www.prochoiceamerica.org/elections/statements/obama.html

[84] Web page: “Senator John McCain (R-AZ).” Accessed June 21, 2008.

http://www.prochoiceamerica.org/elections/statements/mccain.html

[85] Press release: “Statement from NARAL Pro-Choice America on Sen. Barack Obama’s Vice-Presidential Selection.” NARAL Pro-Choice America, August 23, 2008. http://www.prochoiceamerica.org/elections/election-pr/pr08232008_biden...

[86] NARAL’s rating of Biden’s voting record for all years in which they issued a numerical score for him:

2007	2006	2005	2004	2003
75%	100%	100%	100%	36%

2002	2000	1999	1998	1996
100%	90%	46%	65%	43%

1995	1993	1992	1991	1990
33%	60%	100%	85%	85%

Data compiled from the following sources:

1) Web page: “Delaware: Senate Pro-Choice Score.” NARAL Pro-Choice America, August 25, 2008.

http://www.prochoiceamerica.org/choice-action-center/in-congress/...

2) Web page: “Voting Record: Senator Joe Biden (D‐DE).” NARAL Pro-Choice America, May 11, 2007. Previously located at www.prochoiceamerica.org/elections/statements/candidate-record-biden.pdf (currently unavailable).

[87] Press release: “McCain Selects Anti-Choice Sarah Palin as Running Mate.” NARAL Pro-Choice America, August 29, 2008. http://www.prochoiceamerica.org/

[88] Article: “Barack Obama, John McCain discuss faith, issues at Saddleback Church forum.” By Maeve Reston and Seema Mehta. Los Angeles Times, August 17, 2008. http://www.latimes.com/news/nationworld/nation/la-na-saddleback17-2008...

[89] Obama was asked a similar question several months earlier at a “Democratic Candidates Compassion Forum at Messiah College.” CNN, April 13, 2008. A video clip of this exchange is available at http://www.youtube.com/watch?v=l0YxdV3J4Jw

Moderator: “Senator, do you personally believe that life begins at conception, and if not, when does it begin?”

Obama: “You know, I, I, um – this is something that I have not, ah, I think come to a firm resolution on. Ah, I think it’s very hard to know what that means, when life begins. Is it when a cell separates? Is it when, ah, the soul stirs? Ah, so I don’t presume to, to know the answer to that question. Ah, what I know, ah, as I’ve said before, is, is that, ah, there is something extraordinarily powerful about potential life and that, ah, that has a moral weight to it that, ah, we take into consideration when we’re having these debates. …”

[90] Article: “Barack Obama, John McCain discuss faith, issues at Saddleback Church forum.” By Maeve Reston and Seema Mehta. Los Angeles Times, August 17, 2008. http://www.latimes.com/news/nationworld/nation/la-na-saddleback17-2008...

[91] Article: “Zubik immerses himself in March for Life.” By Ann Rodgers. Pittsburgh Post-Gazette, January 23, 2008. http://www.post-gazette.com/pg/08023/851345-84.stm

[92] Article: “McCain: Won’t Rule Out Pro-choice Running Mate.” By Stephen F. Hayes. Weekly Standard, August 13, 2008. http://www.weeklystandard.com/Content/Public/Articles/000/000/015/...

I think that the pro-life position is one of the important aspects or fundamentals of the Republican Party,” McCain said. “And I also feel that--and I’m not trying to equivocate here--that Americans want us to work together. You know, Tom Ridge is one of the great leaders and he happens to be pro-choice. And I don’t think that that would necessarily rule Tom Ridge out.

[93] Article: “McCain Still Wants GOP’s Abortion Platform Changed.” By Teddy Davis. ABC News, April 16, 2007. http://blogs.abcnews.com/politicalradar/2007/04/mccain_still_wa.html

[94] Article: “McCain Softens Abortion Stand.” By Terry M. Neal. Washington Post, August 24, 1999. http://www.washingtonpost.com/wp-srv/politics/campaigns/wh2000/stories...

McCain has a long antiabortion record in his 17-year congressional career. He has said he opposes abortion with the exceptions of rape, incest and to prevent a woman’s death. In a National Right to Life Committee questionnaire last year, he answered “yes” when asked if he supported the complete reversal of Roe v. Wade.

[95] Article: “McCain Makes Conflicting Statements on Abortion.” National Right to Life News, September 14, 1999.

Moreover, on July 22, 1998, McCain filled out, signed, and returned NRLC’s 1998 Congressional Candidate Questionnaire, on which McCain was asked, “Do you support the complete reversal of the Roe v. Wade and Doe v. Bolton decisions, thereby allowing the state legislatures and the Congress to once again protect unborn children?” McCain responded, “Yes.”

[96] Article: “McCain Gets Boost From Bush’s Troubles: Senator greeted warmly at Commonwealth Club.” By Carla Marinucci. San Francisco Chronicle, August 20, 1999. http://sfgate.com/cgi-bin/article.cgi?f=/c/a/1999/08/20/MN75761.DTL

[97] Article: “McCain’s Abortion Stance Is Angering Both Sides.” By Carla Marinucci. San Francisco Chronicle, August 25, 1999. http://sfgate.com/cgi-bin/article.cgi?f=/c/a/1999/08/25/MN54171.DTL

[98] Web page: “Human Dignity and the Sanctity of Life.” John McCain 2008. Accessed June 20, 2008. http://www.johnmccain.com/Informing/issues/95b18512-d5b6-456e-90a2...

John McCain believes Roe v. Wade is a flawed decision that must be overturned, and as president he will nominate judges who understand that courts should not be in the business of legislating from the bench.

Constitutional balance would be restored by the reversal of Roe v. Wade, returning the abortion question to the individual states. The difficult issue of abortion should not be decided by judicial fiat.

However, the reversal of Roe v. Wade represents only one step in the long path toward ending abortion. Once the question is returned to the states, the fight for life will be one of courage and compassion - the courage of a pregnant mother to bring her child into the world and the compassion of civil society to meet her needs and those of her newborn baby. The pro-life movement has done tremendous work in building and reinforcing the infrastructure of civil society by strengthening faith-based, community, and neighborhood organizations that provide critical services to pregnant mothers in need. This work must continue and government must find new ways to empower and strengthen these armies of compassion. These important groups can help build the consensus necessary to end abortion at the state level. As John McCain has publicly noted, “At its core, abortion is a human tragedy. To effect meaningful change, we must engage the debate at a human level.”

[99] “Obama Statement on 35th Anniversary of Roe v. Wade Decision.” January 22, 2008. http://www.barackobama.com/2008/01/22/obama_statement_on_35th...

Thirty-five years after the Supreme Court decided Roe v. Wade, it’s never been more important to protect a woman’s right to choose. Last year, the Supreme Court decided by a vote of 5-4 to uphold the Federal Abortion Ban, and in doing so undermined an important principle of Roe v. Wade: that we must always protect women’s health. With one more vacancy on the Supreme Court, we could be looking at a majority hostile to a women’s fundamental right to choose for the first time since Roe v. Wade. The next president may be asked to nominate that Supreme Court justice. That is what is at stake in this election. …

This anniversary reminds us that it’s not enough to protect the gains of the past – we have to build a future that’s filled with hope and possibility for all Americans.

[100] Speech: “Barack Obama before Planned Parenthood Action Fund.” July 17, 2007. Transcribed by Laura Echevarria. http://lauraetch.googlepages.com/barackobamabeforeplanned...

I have worked on these issues for decades now. I put Roe at the center of my lesson plan on reproductive freedom when I taught Constitutional Law. …

On this fundamental issue, I will not yield and Planned Parenthood will not yield.

[101] Press Release: “On Anniversary Of Roe, Clinton Announces Agenda For Reproductive Health Care. Hillary for President, January 22, 2008. http://www.hillaryclinton.com/news/release/view/?id=5404

When I’m President, I will appoint judges to our courts who understand that Roe v. Wade isn’t just binding legal precedent, it is the touchstone of our reproductive freedom, the embodiment of our most fundamental rights, and no one - no judge, no governor, no Senator, no President - has the right to take it away.

[102] Article: “Q&A: Barack Obama.” Interview by Sarah Pulliam and Ted Olsen. Christianity Today, January 23, 2008. http://www.christianitytoday.com/ct/2008/januaryweb-only/104-32.0.html

“Ultimately, women are in the best position to make a decision at the end of the day about these issues. With significant constraints. For example, I think we can legitimately say — the state can legitimately say — that we are prohibiting late-term abortions as long as there’s an exception for the mother’s health. Those provisions that I voted against typically didn’t have those exceptions, which raises profound questions where you might have a mother at great risk.”

[103] Article: “Clinton Seeking Shared Ground Over Abortions.” By Patrick D. Healy. New York Times, January 25, 2005. http://www.nytimes.com/2005/01/25/nyregion/25clinton.html

“Mrs. Clinton supported a proposed ban on late-term abortions as long as it included an exception to protect the health of the mother; in turn, she has opposed such a ban when it lacked that exception.”

[104] “Interview with Barack Obama.” By Cameron Strang. Conducted on July 1, 2008. Relevant Magazine. http://www.relevantmagazine.com/life_article.php?id=7591

[105] Blog: “Obama revisits abortion.” By Jan Crawford Greenburg. ABC News, July 05, 2008. http://blogs.abcnews.com/legalities/2008/07/obama-revisits.html

[106] Ruling: “Roe v. Wade.” U.S. Supreme Court, January 22, 1973. Case 410 U.S. 113. Decided 7-2. Majority: Blackmun, Burger, Brennan, Douglas, Stewart, Marshall, Powell. Concurring: Burger, Douglas, Stewart. Dissenting: White, Rehnquist. http://caselaw.lp.findlaw.com/scripts/getcase.pl?court=US&vol=410&invol=113

Section XI:

For the stage subsequent to viability the State, in promoting its interest in the potentiality of human life, may, if it chooses, regulate, and even proscribe, abortion except where necessary, in appropriate medical judgment, for the preservation of the life or health of the mother.

Section VIII:

Specific and direct harm medically diagnosable even in early pregnancy may be involved. Maternity, or additional offspring, may force upon the woman a distressful life and future. Psychological harm may be imminent. Mental and physical health may be taxed by child care. There is also the distress, for all concerned, associated with the unwanted child, and there is the problem of bringing a child into a family already unable, psychologically and otherwise, to care for it. In other cases, as in this one, the additional difficulties and continuing stigma of unwed motherhood may be involved. All these are factors the woman and her responsible physician necessarily will consider in consultation.

Section XI:

In Doe v. Bolton, post, p. 179, procedural requirements contained in one of the modern abortion statutes are considered. That opinion and this one, of course, are to be read together.

[107] Ruling: “Doe v. Bolton.” U.S. Supreme Court, January 22, 1973. Case 410 U.S. 179. Decided 7-2. Majority: Blackmun, Brennan, Stewart, Marshall, Powell. Concurring: Burger, Douglas. Dissenting: White, Rehnquist.

http://caselaw.lp.findlaw.com/scripts/getcase.pl?court=us&vol=410&invol=179

Section IV:

C. … the medical judgment may be exercised in the light of all factors -- physical, emotional, psychological, familial, and the woman’s age -- relevant to the well-being of the patient. All these factors may relate to health. …

D. The appellants next argue that the District Court should have declared unconstitutional three procedural demands of the Georgia statute: … (2) that the procedure be approved by the hospital staff abortion committee; and (3) that the performing physician’s judgment be confirmed by the independent examinations of the patient by two other licensed physicians. …

We conclude that the interposition of the hospital abortion committee is unduly restrictive of the patient’s rights and needs that, at this point, have already been medically delineated and substantiated by her personal physician. …

There remains, however, the required confirmation by two Georgia-licensed physicians in addition to the recommendation of the pregnant woman’s own consultant (making under the statute, a total of six physicians involved, including the three on the hospital’s abortion committee). We conclude that this provision, too, must fall.

The statute’s emphasis, as has been repetitively noted, is on the attending physician’s “best clinical judgment that an abortion is necessary.” That should be sufficient. The reasons for the presence of the confirmation step in the statute are perhaps apparent, but they are insufficient to withstand constitutional challenge. … If a physician is licensed by the State, he is recognized by the State as capable of exercising acceptable clinical judgment. … If a physician is licensed by the State, he is recognized by the State as capable of exercising acceptable clinical judgment.

[108] Article: “Obama Abortion Dodges Blessed by Planned Parenthood.” By Teddy Davis. ABC News, July 17, 2007. http://blogs.abcnews.com/politicalradar/2007/07/obama-abortion-.html

Speaking to ABC News as Obama was preparing to… [address] Planned Parenthood’s national conference in Washington, D.C…

[109] Speech: “Barack Obama before Planned Parenthood Action Fund.” July 17, 2007. Transcribed by Laura Echevarria. http://lauraetch.googlepages.com/barackobamabeforeplanned...

[110] Speech: “Barack Obama before Planned Parenthood Action Fund.” July 17, 2007. Transcribed by Laura Echevarria. http://lauraetch.googlepages.com/barackobamabeforeplanned...

[Question from Dessa Cosma]

[111] Bill: “S.1173 - Freedom of Choice Act.” Introduced in the United States Senate, April 19, 2007. http://thomas.loc.gov/

To protect, consistent with Roe v. Wade, a woman’s freedom to choose to bear a child or terminate a pregnancy, and for other purposes.

[Introduced by Barbara Boxer (D-California) for herself, Patty Murray (D-Washington), Debbie Stabenow (D-Michigan), Jeff Bingaman (D-New Mexico), Robert Menendez (D-New Jersey), Frank Lautenberg (D-New Jersey), Benjamin Cardin (D-Maryland), Chuck Schumer (D-New York), Diane Feinstein (D-California), Hillary Clinton (D-New York), Barbara Mikulski (D-Maryland), Max Baucus (D-Montana), Maria Cantwell (D-Washington).]

[112] Congressional Record S6017. United States Senate, May 11, 2007. http://frwebgate.access.gpo.gov/cgi-bin/getpage.cgi?dbname=2007_record...

At the request of Mrs. BOXER, the name of the Senator from Illinois (Mr. OBAMA) was added as a cosponsor of S. 1173, a bill to protect, consistent with Roe v. Wade, a woman’s freedom to choose to bear a child or terminate a pregnancy, and for other purposes.

[113] Bill: “S.1173 - Freedom of Choice Act.” Introduced in the United States Senate, April 19, 2007. http://thomas.loc.gov/

SEC. 4. INTERFERENCE WITH REPRODUCTIVE HEALTH PROHIBITED. …

(b) Prohibition of Interference- A government may not-

(1) deny or interfere with a woman’s right to choose—

(A) to bear a child;

(B) to terminate a pregnancy prior to viability; or

(C) to terminate a pregnancy after viability where termination is necessary to protect the life or health of the woman; or

(2) discriminate against the exercise of the rights set forth in paragraph (1) in the regulation or provision of benefits, facilities, services, or information. …

SEC. 6. RETROACTIVE EFFECT.

This Act applies to every Federal, State, and local statute, ordinance, regulation, administrative order, decision, policy, practice, or other action enacted, adopted, or implemented before, on, or after the date of enactment of this Act.

[114] Bill: “H.R. 1964 IH - Freedom of Choice Act.” Introduced in U.S. House of Representatives, April 19, 2007. http://thomas.loc.gov/

[Introduced by Jerrold Nadler (New York), 56 other Democrats, and one Republican who has since withdrawn his sponsorship.]

SEC. 2. FINDINGS. …

(9) Further threatening Roe, the Supreme Court recently upheld the first-ever Federal ban on abortion, which has no exception to protect a woman’s health. The majority decision in Gonzales v. Carhart and Gonzales v. Planned Parenthood Federation of America permits the government to interfere with a woman’s right to choose to terminate a pregnancy and effectively overturns a core tenet of Roe v. Wade by abandoning more than 30 years of protection for women’s health. …

SEC. 4. INTERFERENCE WITH REPRODUCTIVE HEALTH PROHIBITED.

(a) Statement of Policy- It is the policy of the United States that every woman has the fundamental right to choose to bear a child, to terminate a pregnancy prior to fetal viability, or to terminate a pregnancy after fetal viability when necessary to protect the life or health of the woman.

(b) Prohibition of Interference- A government may not—

(1) deny or interfere with a woman’s right to choose—

(A) to bear a child;

(B) to terminate a pregnancy prior to viability; or

(C) to terminate a pregnancy after viability where termination is necessary to protect the life or health of the woman; or

(2) discriminate against the exercise of the rights set forth in paragraph (1) in the regulation or provision of benefits, facilities, services, or information. …

SEC. 6. RETROACTIVE EFFECT.

[115] Web page: “Cosponsors: H.R. 1964: Freedom of Choice Act (House of Representatives).” U.S. Library of Congress, Accessed September 2008 at http://thomas.loc.gov/

[Sponsored by Jerrold Nadler and 108 cosponsors. One of the original sponsors of the bill, Republican Jon C. Porter (Nevada) withdrew 4 days later. The party of each sponsor is identified in the next note. The only Republican is Christopher Shays of Connecticut.]

[116] Web page: “H.R. 1964: Freedom of Choice Act.” GovTrack, Accessed September 2008 at http://www.govtrack.us/congress/bill.xpd?bill=h110-1964

[117] Web page: “Cosponsors: S.1173: Freedom of Choice Act (Senate).” U.S. Library of Congress, Accessed September 2008 at http://thomas.loc.gov/

[20 sponsors:] Barbara Boxer (CA), Max Baucus, Max (MT), Jeff Bingaman (NM), Sherrod Brown (OH), Maria Cantwell (WA), Benjamin Cardin (MD), Hillary Clinton (NY), Diane Feinstein (CA), John Kerry (MA), Frank Lautenberg (NJ), Joseph Lieberman (CT), Robert Menendez (NJ), Barbara Mikulski (MD), Patty Murray (WA), Barack Obama (IL), Bernie Sanders (VT), Charles Schumer (NY), Debbie Stabenow (MI), Jon Tester (MT), Sheldon Whitehouse (RI).

[118] Transcript: “Meet the Press, Guest: Howard Dean (Chairman of the Democratic Party).” NBC News, May 22, 2005. http://www.msnbc.msn.com/id/7924139/

[119] Article: “Alan F. Guttmacher 1898-1974.” By Frederick S. Jaffe. Family Planning Perspectives, March 20, 1974. http://www.guttmacher.org/about/alan-bio.html

While Alan F. Guttmacher was president of the Planned Parenthood Federation of America and a leader in the International Planned Parenthood Federation in the 1960s and early 1970s, he saw the need for the institution that now bears his name, and he nurtured its development.

[120] Web page: “The Guttmacher Institute’s Future.” Approved by the Guttmacher Institute’s Board of Directors, June 23, 2005. http://www.guttmacher.org/about/mission.html

Guiding Principles …

The Institute works to protect, expand and equalize access to information, services and rights that will enable women and men to …

• exercise the right to choose abortion …

[121] Paper: “Abortion in the United States: Incidence and Access to Services, 2005.” By Rachel K. Jones & others (all with the Guttmacher Institute). Perspectives on Sexual and Reproductive Health, March 2008. Pages 6-16. http://www.guttmacher.org/pubs/journals/4000608.pdf

Data extracted from Table 1 on page 9:

Year	Reported Abortions	Abortions per 1000 women aged 15-44	% of pregnancies ending in abortion (excluding miscarriages)
2001	1,291,000	20.9	24.4
2002	1,269,000	20.5	23.8
2003	1,250,000	20.2	23.3
2004	1,222,100	19.7	22.8
2005	1,206,200	19.4	22.4

NOTE: The Guttmacher Institute was contacted in September of 2008 to see if any later numbers were available. They responded: “Our most recent abortion data are from 2005. In order to comprehensively gather the number of abortions, we have to survey every known abortion provider in the United States. This process is very time consuming and expensive and therefore, our studies can only be undertaken every few years.”

[122] Article: “Howard Dean’s Abortion Contortions.” By John McCormack. Weekly Standard, June 12, 2008. http://www.weeklystandard.com/Content/Public/Articles/000/000/015/...

NOTE: This article provided the roadmap to the related facts above and below.

[123] Article: “Rights Without Access: Revisiting Public Funding of Abortion for Poor Women.” By Heather Boonstra and Adam Sonfield. The Guttmacher Report on Public Policy, April 2000. http://www.guttmacher.org/pubs/tgr/03/2/gr030208.html

[124] Web page: “Health Care: Barack Obama’s Plan.” Accessed June 23, 2008. http://www.barackobama.com/issues/healthcare/

• Obama’s Plan to Cover Uninsured Americans: Obama will make available a new national health plan to all Americans, including the self-employed and small businesses, to buy affordable health coverage that is similar to the plan available to members of Congress. The Obama plan will have the following features:

• Guaranteed eligibility. No American will be turned away from any insurance plan because of illness or pre-existing conditions.

• Comprehensive benefits. The benefit package will be similar to that offered through Federal Employees Health Benefits Program (FEHBP), the plan members of Congress have. The plan will cover all essential medical services, including preventive, maternity and mental health care.

[125] Article: “Democrats pledge support for wide access to abortion.” By Mike Dorning. Chicago Tribune, Jul 18, 2007. http://www.chicagotribune.com

Asked about his proposal for expanded access to health insurance, Obama said it would cover “reproductive-health services.” Contacted afterward, an Obama spokesman said that included abortions.

[126] The Constitution of the United States. Signed September 17, 1787. Enacted June 21, 1788. http://justfacts.com/constitution.asp

Article 2, Clause 2, Section 2:

[The President] with the Advice and Consent of the Senate, shall appoint Ambassadors, other public Ministers and Consuls, Judges of the supreme Court…

[127] Report: “Filibusters and Cloture in the Senate.” By Richard S. Beth & Stanley Bach. Congressional Research Service, Updated March 28, 2003. http://www.senate.gov/reference/resources/pdf/RL30360.pdf

Summary (page 2 in pdf):

The filibuster is widely viewed as one of the Senate’s most characteristic procedural features. Filibustering includes any use of dilatory or obstructive tactics to block a measure by preventing it from coming to a vote. The possibility of filibusters exists because Senate rules place few limits on Senators’ rights and opportunities in the legislative process. …

Senate Rule XXII, however, known as the “cloture rule,” enables Senators to

end a filibuster on any debatable matter the Senate is considering. Sixteen Senators

initiate this process by presenting a motion to end the debate. The Senate does not vote on this cloture motion until the second day after the motion is made. Then it usually requires the votes of at least three-fifths of all Senators (normally 60 votes) to invoke cloture. Invoking cloture on a proposal to amend the Senate’s standing rules requires the support of two-thirds of the Senators present and voting.

Page CRS-10:

Invoking cloture usually requires a three-fifths vote of the entire Senate—”three-fifths of the Senators duly chosen and sworn.” If there are no vacancies, therefore, 60 Senators must vote to invoke cloture. In contrast, most other votes require only a simple majority (that is, 51%) of the Senators present and voting, assuming that those Senators constitute a quorum. In the case of a cloture vote, the key is the number of Senators voting for cloture, not the number voting against. Failing to vote on a cloture motion has the same effect as voting against the motion: it deprives the motion of one of the 60 votes needed to agree to it.

There is an important exception to the three-fifths requirement to invoke cloture. Under Rule XXII, an affirmative vote of two-thirds of the Senators present and voting is required to invoke cloture on a measure or motion to amend the Senate rules. This exception has its origin in the recent history of the cloture rule. Before 1975, two-thirds of the Senators present and voting (a quorum being present) was required for cloture on all matters. In early 1975, at the beginning of the 94^th Congress, Senators sought to amend the rule to make it somewhat easier to invoke cloture. However, some Senators feared that if this effort succeeded, that would only make it easier to amend the rule again, making cloture still easier to invoke. As a compromise, the Senate agreed to move from a maximum of 67 votes (two-thirds of the Senators present and voting) to a minimum of 60 votes (three-fifths of the Senators duly chosen and sworn) on all matters except future rules changes, including changes in the cloture rule itself.¹¹

[128] “Standing Rules of the Senate: Rule XXII: Precedence Of Motions.” Accessed June 20, 2008. http://rules.senate.gov/senaterules/rule22.php

2. Notwithstanding the provisions of rule II or rule IV or any other rule of the Senate, at any time a motion signed by sixteen Senators, to bring to a close the debate upon any measure, motion, other matter pending before the Senate, or the unfinished business, is presented to the Senate, the Presiding Officer, or clerk at the direction of the Presiding Officer, shall at once state the motion to the Senate, and one hour after the Senate meets on the following calendar day but one, he shall lay the motion before the Senate and direct that the clerk call the roll, and upon the ascertainment that a quorum is present, the Presiding Officer shall, without debate, submit to the Senate by a yea-and-nay vote the question:

“Is it the sense of the Senate that the debate shall be brought to a close?” And if that question shall be decided in the affirmative by three-fifths of the Senators duly chosen and sworn -- except on a measure or motion to amend the Senate rules, in which case the necessary affirmative vote shall be two-thirds of the Senators present and voting -- then said measure, motion, or other matter pending before the Senate, or the unfinished business, shall be the unfinished business to the exclusion of all other business until disposed of.

Thereafter no Senator shall be entitled to speak in all more than one hour on the measure, motion, or other matter pending before the Senate, or the unfinished business, the amendments thereto, and motions affecting the same, and it shall be the duty of the Presiding Officer to keep the time of each Senator who speaks. Except by unanimous consent, no amendment shall be proposed after the vote to bring the debate to a close, unless it had been submitted in writing to the Journal Clerk by 1 o’clock p.m. on the day following the filing of the cloture motion if an amendment in the first degree, and unless it had been so submitted at least one hour prior to the beginning of the cloture vote if an amendment in the second degree. No dilatory motion, or dilatory amendment, or amendment not germane shall be in order. Points of order, including questions of relevancy, and appeals from the decision of the Presiding Officer, shall be decided without debate.

After no more than thirty hours of consideration of the measure, motion, or other matter on which cloture has been invoked, the Senate shall proceed, without any further debate on any question, to vote on the final disposition thereof to the exclusion of all amendments not then actually pending before the Senate at that time and to the exclusion of all motions, except a motion to table, or to reconsider and one quorum call on demand to establish the presence of a quorum (and motions required to establish a quorum) immediately before the final vote begins. The thirty hours may be increased by the adoption of a motion, decided without debate, by a three-fifths affirmative vote of the Senators duly chosen and sworn, and any such time thus agreed upon shall be equally divided between and controlled by the Majority and Minority Leaders or their designees. However, only one motion to extend time, specified above, may be made in any one calendar day.

[129] The Constitution of the United States. Signed September 17, 1787. Enacted June 21, 1788. http://justfacts.com/constitution.asp

Article III, Section 1:

The Judges, both of the supreme and inferior Courts, shall hold their Offices during good Behaviour…

Article II, Section 4:

The President, Vice President and all civil Officers of the United States, shall be removed from Office on Impeachment for, and Conviction of, Treason, Bribery, or other high Crimes and Misdemeanors.

Article I, Section 2, Clause 5:

The House of Representatives shall chuse their Speaker and other Officers; and shall have the sole Power of Impeachment.

Article I, Section 3, Clause 6:

The Senate shall have the sole Power to try all Impeachments. … And no Person shall be convicted without the Concurrence of two thirds of the Members present.

[130] Web page: “Public Funding for Abortion.” ACLU, July 21, 2004. Accessed July 2008 at http://www.aclu.org/reproductiverights/lowincome/16393res20040721.html

[131] Web page: “Oppose Taxpayer Subsidies for Religious Schools.” ACLU, March 19, 2003. Accessed July 2008 at http://www.aclu.org/religion/vouchers/16160res20030319.html

[132] Web page: “Five Ways to Prevent Abortion (And One Way That Won’t).” Planned Parenthood. January 1, 2004. Updated 9/22/06. http://www.plannedparenthood.org/issues-action/abortion/...

[133] Fact Sheet: “Abortion after the First Trimester.” Planned Parenthood. Accessed October 2002 at http://www.plannedparenthood.org/

Presently the death rate from abortion at all stages of gestation is 0.6 per 100,000 procedures (Paul et al., 1999).

NOTE: “Paul et al., 1999” is a secondary source that cites the CDC. See next note.

[134] Book: A Clinician’s Guide to Medical and Surgical Abortion. By Maureen Paul & others. Churchill Livingstone, 1999. Page 19:

In the United States mortality [from abortion] was (per 100,000) 2.6 during the period 1972-1976, 0.9 in 1977-1981, 0.7 in 1982-1986, and 0.6 in 1987-1991 (based on deaths reported by the CDC and number of abortions from AGI).

NOTE: This corresponds to the figure for subsequent years quoted in the next note.

[135] Document: “Abortion Surveillance Fact Sheet.” National Center for Chronic

Disease Prevention & Health Promotion, Centers for Disease Control, updated June 7, 2002. http://www.cdc.gov/od/oc/media/pressrel/fs020606b.htm

The case-fatality rate for known legal induced abortion for 1993 to 1997 was 0.6 deaths per 100,000 legal abortions.

[136] Report: “Abortion Surveillance -- United States, 1996.” By Lisa M. Koonin and others. Division of Reproductive Health, National Center for Chronic Disease Prevention

and Health Promotion, Centers for Disease Control, July 30, 1999. http://www.cdc.gov/mmwr/preview/mmwrhtml/ss4804a1.htm

Table 19.

NOTE: The data in this source and the sources cited in the next note come from different divisions of the CDC and are at variance with one another due to methodological dissimilarities. It was necessary to use data from both divisions because the data from this source only goes back to 1972 and the sources in the next note do not isolate legal vs. illegal abortion-related deaths.

[137] Constructed with data from the following sources:

1) Report: “Table 290F. Deaths For Approximately 64 Selected Causes, By 10-Year Age Groups, Race, And Sex: United States, 1950-59.” National Center for Health Statistics, Centers for Disease Control. Accessed August 2008 at http://www.cdc.gov/nchs/data/dvs/dx1950_59.pdf

Page 169 (in pdf).

2) Report: “Table 290A. Deaths For 60 Selected Causes, By 10-Year Age Groups, Race, And Sex: United States, 1960-67.” National Center for Health Statistics, Centers for Disease Control. Accessed August 2008 at http://www.cdc.gov/nchs/data/statab/dx196067.pdf

Page 169 (in pdf).

3) Report: “Table 290A. Deaths For 69 Selected Causes, By 10-Year Age Groups, Race, And Sex: United States, 1968-78.” National Center for Health Statistics, Centers for Disease Control. Accessed August 2008 at http://www.cdc.gov/nchs/data/dvs/dx196878.pdf

Page 358 (in pdf).

4) Report: “Resident population by age, color, and sex: United States, 1950-1959.” National Center for Health Statistics, Centers for Disease Control. Mailed to Just Facts from the aforementioned agency, August 7, 2008.

5) Report: “Population by age groups, race, and sex for 1960-97.” National Center for Health Statistics, Centers for Disease Control. Accessed August 2008 at http://www.cdc.gov/nchs/data/statab/pop6097.pdf

Pages 19, 21 (in pdf).

[138] Report: “Maternal Mortality Surveillance, United States, 1980-1985.” By Lisa M. Koonin & others. Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention, December 1, 1988. http://www.cdc.gov/mmwr/preview/mmwrhtml/00001754.htm

Finally, the coding system used by national vital statistics and states to describe maternal deaths includes a combination of outcomes of pregnancy (e.g. ectopic pregnancy, abortion), immediate causes of death (e.g., hemorrhage), and underlying obstetrical conditions that contribute to death (e.g., obstructed labor). This system of classification precludes a determination of the real causes of maternal death. To develop strategies to prevent maternal deaths, public health personnel need to know the immediate cause of death as well as the underlying conditions that led to death.

[139] Constructed with data from the following sources:

1) Report: “Table 290F. Deaths For Approximately 64 Selected Causes, By 10-Year Age Groups, Race, And Sex: United States, 1950-59.” National Center for Health Statistics, U.S. Centers for Disease Control and Prevention. Accessed August 2008 at http://www.cdc.gov/nchs/data/dvs/dx1950_59.pdf

Page 167 (in pdf).

2) Report: “Table 290A. Deaths For 60 Selected Causes, By 10-Year Age Groups, Race, And Sex: United States, 1960-67.” National Center for Health Statistics, U.S. Centers for Disease Control and Prevention. Accessed August 2008 at http://www.cdc.gov/nchs/data/statab/dx196067.pdf

Page 167 (in pdf).

3) Report: “Table 290A. Deaths For 69 Selected Causes, By 10-Year Age Groups, Race, And Sex: United States, 1968-78.” National Center for Health Statistics, U.S. Centers for Disease Control and Prevention. Accessed August 2008 at http://www.cdc.gov/nchs/data/dvs/dx196878.pdf

Page 363 (in pdf).

4) Report: “Resident population by age, color, and sex: United States, 1950-1959.” National Center for Health Statistics, U.S. Centers for Disease Control and Prevention. Mailed to Just Facts from the aforementioned agency, August 7, 2008.

5) Report: “Population by age groups, race, and sex for 1960-97.” National Center for Health Statistics, U.S. Centers for Disease Control and Prevention. Accessed August 2008 at http://www.cdc.gov/nchs/data/statab/pop6097.pdf

Pages 19, 21 (in pdf).

[140] Report: “Maternal Mortality Surveillance, United States, 1980-1985.” By Lisa M. Koonin & others. Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention, December 1, 1988. http://www.cdc.gov/mmwr/preview/mmwrhtml/00001754.htm

Death certificates alone may not provide adequate information on the sequence of events that led to death. Ultimately a single code is assigned to classify the underlying cause of death. Often, however, several factors may contribute to a death; therefore, the death cannot be adequately described with a unidimensional code.

[141] Constructed with data from the following sources:

Pages 1, 43, 199, 208 (in pdf).

Pages 1, 40, 200, 210 (in pdf).

Pages 2, 73, 406, 422 (in pdf).

Pages 19, 21 (in pdf).

[142] “Fact Sheet: Abortion After the First Trimester in the United States.” Lead author: John Mugge. Revised by Deborah Golub. Planned Parenthood, 2004. Current as of May 2007. http://www.plannedparenthood.org/files/PPFA/fact-trimester-abortion.pdf

Page 3:

The risk of death from medication abortion through 63 days’ gestation is about one per 100,000 procedures (Grimes, 2005). The risk of death with surgical abortion is about one per 1,000,000 through 63 days’ gestation (Bartlett et al., 2004). The risk of death from miscarriage is about one per 100,000 (Saraiya et al., 1999). But the risk of death associated with childbirth is about 10 times as high as that associated with all abortion (Christiansen & Collins, 2006).

[143] “Pregnancy-Associated Deaths: A 15-Year Retrospective Study and Overall Review of Maternal Pathophysiology.” By Lydia R. Christiansen & Kim A. Collins. American Journal of Forensic Medicine and Pathology, March 2006. Pages 11-19. http://www.ncbi.nlm.nih.gov/pubmed/16501342

Page 11:

Pregnancy-related death is defined by the International Classification of Diseases, Tenth Revision (ICD-10) as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the cause of death. In the year 2000, a collaborative effort involving World Health Organization (WHO), UNICEF, and UNFPA estimated 660 maternal deaths in the United States. This averages 11 maternal deaths per 100,000 live births reported.

Page 13:

The risk of death from complications of pregnancy decreased approximately 99% during the 20^th century, from approximately 850 maternal deaths per 100,000 live births in 1900 to 7.5 in 1982.⁴

Page 18:

It is evident that homicides, suicides, and accidents account for a large proportion of pregnancy-related deaths.

{Note that the figures from ‘Christiansen & Collins, 2006’ cannot be used as a comparator for the others studies cited by Planned Parenthood in the note above (i.e., Grimes, Bartlett) because these studies are limited by gestational age and do not apply to “all abortion.”}

[144] Fact Sheet: “Abortion after the First Trimester.” Planned Parenthood. Accessed October 2002 at http://www.plannedparenthood.org.

Presently the death rate from abortion at all stages of gestation is 0.6 per 100,000 procedures (Paul et al., 1999). The risk of death associated with childbirth is about 10 times as high as that associated with abortion (AGI, 1998).

NOTE: “Paul et al., 1999” and “AGI, 1998” are secondary sources that cite the CDC. See next two notes.

[145] Book: A Clinician’s Guide to Medical and Surgical Abortion. By Maureen Paul & others. Churchill Livingstone, 1999. Page 19:

[146] Web page: “Facts in Brief \Induced Abortion.” Alan Guttmacher Institute. Accessed October 2002 at http://www.agi-usa.org/

The risk of death associated with childbirth is about 10 times as high as that associated with abortion. …

The data in this fact sheet are the most current available. Most are from research conducted by The Alan Guttmacher Institute and/or published in its peer-reviewed journals. An additional source is the Centers for Disease Control and Prevention.

NOTE: The url at which this source was previously located contains a newer version of this web page that does not make the claim that “risk of death associated with childbirth is about 10 times as high as that associated with abortion.” [Web page: “Facts on Induced Abortion in the United States.” Alan Guttmacher Institute, July 2008. http://www.guttmacher.org/pubs/fb_induced_abortion.html]}

[147] Report: “Strategies to Reduce Pregnancy-Related Deaths: From Identification and Review to Action.” By Cynthia Berg and others. Division of Reproductive Health, U.S. Centers for Disease Control and Prevention, 2001. http://www.cdc.gov/reproductivehealth/Products&Pubs/PDFs/Strategies...

Page 14:

Sources of pregnancy-related deaths are listed below in order of simplicity and convenience:

^■Death certificate cause-of-death codes—the core source for finding cases.

^■Manual review of death certificates.

^■ Pregnancy check boxes on death certificates.

^■ Computerized linkages of vital records.

^■Other computerized data sources.

^■ Obstetricians, other clinicians, and groups.

^■The news media.

^■Autopsy and medical records.

[148] Correspondence: “Chang and Berg Respond To Horon.” By Jeani Chang & Cynthia J. Berg. American Journal of Public Health, November 2005. Pages 1879-1880. http://www.ajph.org/cgi/content/full/95/11/1879-a

[149] Report: “Strategies to Reduce Pregnancy-Related Deaths: From Identification and Review to Action.” By Cynthia Berg and others. Division of Reproductive Health, U.S. Centers for Disease Control and Prevention, 2001. http://www.cdc.gov/reproductivehealth/Products&Pubs/PDFs/Strategies...

Page 13:

Currently, no single source of information captures all pregnancy-related deaths, despite all deaths and essentially all live births in the United States being registered by Vital Statistics. Several reasons account for this failure:

■ Lack of physician training in, or knowledge about, how to fill out a death certificate.

■ ICD coding rules that make the cause-of-death code on a death certificate fall outside the range of conditions considered to be pregnancy-related (in ICD-9, those codes are 630–676; in ICD-10, chapter O).

■ Reliance on death certificate data to estimate cause of death.

■ Medical records that fail to indicate that the events leading to death began with pregnancy, especially if the death occurred during the postpartum period.

■ Medical and autopsy records that cannot be located or are not available for review.

[150] Report: “Maternal Mortality Surveillance, United States, 1980-1985.” By Lisa M. Koonin & others. Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention, December 1, 1988. http://www.cdc.gov/mmwr/preview/mmwrhtml/00001754.htm

[151] Correspondence: “Chang and Berg Respond To Horon.” By Jeani Chang & Cynthia J. Berg. American Journal of Public Health, November 2005. Pages 1879-1880. http://www.ajph.org/cgi/content/full/95/11/1879-a

We have no choice but to rely on the methods used by each reporting area to determine whether a death (including a death because of homicide) is pregnancy-associated. As stated in our discussion, the cause of death on death certificates is the most common way of ascertaining pregnancy-associated deaths. Next is computerized linking of deaths among women of reproductive age with birth certificates and fetal death certificates; we believe this system is used in about half the reporting areas.

[152] Report: “Strategies to Reduce Pregnancy-Related Deaths: From Identification and Review to Action.” By Cynthia Berg and others. Division of Reproductive Health, U.S. Centers for Disease Control and Prevention, 2001. http://www.cdc.gov/reproductivehealth/Products&Pubs/PDFs/Strategies...

Page 18:

Linking vital records

Death certificates for reproductive-aged women who die can be linked with certificates of reportable pregnancy outcomes (live births and fetal deaths) that occurred during the preceding year. Although many states require that induced abortions be reported, only one includes on its records identifying data that could be used to link those records with other computerized records. Linking data sets is being done in an increasing number of states, and published reports indicate that such links can increase case ascertainment by 36% {This is a typo. It should be 30%. See Table 3 below, which I confirmed by examining the cited source.} to 153% (Table 3, Box 3). However, linking vital records cannot ensure that all pregnancy-related deaths will be identified, since only about two-thirds to three-quarters of pregnancy-related deaths are associated with either a live birth or a fetal death. Excluded from linkages would be deaths associated with ectopic pregnancies, induced and some spontaneous abortions, gestational trophoblastic disease, and undelivered pregnancies.

Page 19:

[153] Report: “Strategies to Reduce Pregnancy-Related Deaths: From Identification and Review to Action.” By Cynthia Berg and others. Division of Reproductive Health, U.S. Centers for Disease Control and Prevention, 2001. http://www.cdc.gov/reproductivehealth/Products&Pubs/PDFs/Strategies...

Page 18:

Linking vital records

[154] Report: “Maternal Mortality Surveillance, United States, 1980-1985.” By Lisa M. Koonin & others. Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention, December 1, 1988. http://www.cdc.gov/mmwr/preview/mmwrhtml/00001754.htm

[155] Report: “Strategies to Reduce Pregnancy-Related Deaths: From Identification and Review to Action.” By Cynthia Berg and others. Division of Reproductive Health, U.S. Centers for Disease Control and Prevention, 2001. http://www.cdc.gov/reproductivehealth/Products&Pubs/PDFs/Strategies...

Page 25:

Maternal mortality review committees

In most cases, the state is the level at which pregnancy-related deaths are reviewed, although the process can occur in some very large cities and counties. The legislation that enables maternal mortality review and the review committee’s place within the governmental organization vary widely from state to state.

[156] Web page: “CDC’s Abortion Surveillance System: FAQs.” Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control. Updated January 22, 2008. http://www.cdc.gov/reproductivehealth/Data_Stats/Abortion.htm

Are states required to report their abortion statistics to CDC?
No, states and areas voluntarily report data to CDC for report preparation. CDC’s Division of Reproductive Health prepares surveillance reports as data becomes available. There is no national requirement for data submission or reporting. …

Can I obtain a public use dataset for my own analysis?
No public use dataset is available. To obtain data for this surveillance system, CDC assures states and areas that we will maintain strict confidentiality of data provided to us.

[157] Phone call to the Division of Reproductive Health, Centers for Disease Control, July 1, 2008.

Just Facts requested a state-by-state breakdown of the data in Table 19 of “Abortion Surveillance --- United States, 2004,” which shows abortion-related fatalities for 1972-2003. The CDC would not release this data on the grounds that it would violate their privacy agreements with certain states.

[158] Paper: “Physician and Public Opinions on Quality of Health Care and the Problem of Medical Errors.” By Andrew R. Robinson and others. Archives of Internal Medicine, October 28, 2002. Pages 2186-2190. http://archinte.ama-assn.org/cgi/reprint/162/19/2186

Page 2186: “Uniformly, physicians believed that fear of medical malpractice is a barrier to reporting of errors and that greater legal safeguards are necessary for a mandatory reporting system to be successful.”

Page 2189, Table 4: “Medical malpractice litigation is a barrier to the reporting of

medical errors.” [98.4% of physicians in the national sample agreed with this statement.]

[159] Report: “Vital Statistics of the United States, 1989. Volume II – Mortality,

Part A.” National Center for Health Statistics, Centers for Disease Control and Prevention, 1993. http://www.cdc.gov/nchs/data/vsus/mort89_2a.pdf

Page 13 (in pdf):

SYMBOLS USED IN TABLES

Data not available ---

Category not applicable . . .

Quantity zero —

Page 262 (page 277 in pdf): “Table 1-25. Deaths From 282 Selected Causes, by Race — United States and Each State: 1989.”

Cause of death	Maryland (all races)
Legally induced abortion	—

NOTE: Abortion-related mortality data provided by the CDC’s National Center for Health Statistics is at variance with that provided by CDC’s Division of Reproductive Health due to methodological dissimilarities. The National Center for Health Statistics is only cited here because the Division of Reproductive Health does not break down their national data on a state-by states basis. In July 2008, Just Facts filed a Freedom of Information Act Request with the CDC for this data and is awaiting a response.

[160] Report: “Vital Statistics of the United States, 1990. Volume II – Mortality,

Part A.” National Center for Health Statistics, Centers for Disease Control and Prevention, 1994. http://www.cdc.gov/nchs/data/vsus/mort90_2a.pdf

Page 262 (page 278 in pdf): “Table 1-25. Deaths From 282 Selected Causes, by Race — United States and Each State: 1990.”

Cause of death	Maryland (all races)
Legally induced abortion	—

[161] Report: “Vital Statistics of the United States, 1991. Volume II – Mortality,

Part A.” National Center for Health Statistics, Centers for Disease Control and Prevention, 1996. http://www.cdc.gov/nchs/data/vsus/mort91_2a.pdf

Page 262 (page 278 in pdf): “Table 1-25. Deaths From 282 Selected Causes, by Race — United States and Each State: 1990.”

Cause of death	Maryland (all races)
Legally induced abortion	—

[162] Report: “Vital Statistics of the United States, 1992. Volume II – Mortality,