1. History of Abortion

2. The Experience of Abortion Before 1973, (legalized abortion) women undergoing abortion had horrific experiences. Physicians were rude, some demanded sex, some lectured or scorned women. If damaged occurred, women had no legal recourse. It cost a lot. Poor women could not afford it.

3. Despite the danger and horrific experience, in the 50’s and 60’s, hundred of thousand of American women had illegal abortions. Many died as a result! Because they were embarrassed for what they did, they would go to emergency room at the last minute—when it was too late.

4. 1962 In 1962 in Phoenix, Arizona, Sherri Finkbine became pregnant. During the second month, she took and anti-nausea medicine not knowing it produced a deformed fetus. She requested abortion, but the DA threatened her to prosecute the abortion. She flew to Sweden and had a therapeutic abortion, where abortions where abortion had been legal since 1940! This case caused many people to demand legalized abortion. 18 states started liberalizing laws about abortion.

5. 1968 In 1968, Pope Paul VI issued his encyclical that declared use of birth control to be a sin! The encyclical shook many Catholics. At Catholic U, not being allowed to teach about contraception, Catholic priests left priesthood and the university.

6. Roe v. Wade January 22, 1973 The U.S. Supreme Court, in a 7-2 decision, affirms women's right to have an abortion under the 14 Th Amendment to the Constitution.

7. 1971 - The case is filed by Norma McCorvey, known in court documents as Jane ROE against Henry WADE, the district attorney of Dallas County from 1951 to 1987, who enforced a Texas law that prohibited abortion, except to save a woman's life. Why would state want to regulate abortion? Is it a form of paternalism?

8. The Case: The Constitutional Question: Does the Constitution embrace the right of a woman to obtain an abortion, nullifying the Texas prohibition? Answer: Yes! The ruling allows for legal abortions during the entire pregnancy, but set up conditions to allow states to regulate abortion during the second and third trimesters.

9. The Decision: The Court held that a woman's right to an abortion fell within the right to privacy protected by the 14 Th Amendment. The decision gave a woman a right to abortion during the entirety of the pregnancy and defined different levels of state interest for regulating abortion in the second and third trimesters. The ruling affected laws in 46 states.

10. Legal Timeline: 1971 - The Supreme Court agrees to hear the case filed by Norma McCorvey, Jane ROE, against Henry WADE. The Texas law had been declared unconstitutional in an earlier federal district court case. Wade ignored the decision and both sides appealed.

11. December 13, 1971 - October 11, 1972 - The case is argued before the U.S. Supreme Court. January 22, 1973 - The U.S. Supreme Court, in a 7-2 decision, affirms the legality of a woman's right to have an abortion under the 14 Th amendment to the Constitution. By the commencement of court case, Jane had already given birth to her baby!

12. Norma McCorvey has since come forward and changed sides on the abortion debate. In 1997, McCorvey started Roe No More, a pro- life outreach organization.

13. June 17, 2003 - Norma McCorvey (Jane Roe) files a motion with the U.S. District Court in Dallas to have the case overturned! She asked the court to consider new evidence that abortion hurts women. Included are 1,000 affidavits from women who say they regret their abortions.

14. September 14, 2004 - A three-judge panel of the 5th U.S. Circuit Court of Appeals in New Orleans dismisses a motion from the original plaintiff in Roe v. Wade to have the case overturned.

15. The Law: Trimester Rule of Roe v Wade First trimester: woman has the right to end pregnancy and state can’t do anything about it. Second trimester: the state may limit—but not entirely prohibit—the woman’s right to abortion by regulating it for the sake of woman’s health. After viability—24-28 weeks—the state may regulate or ban abortion, except to save life of woman.

16. How Many Abortions are we talking about?

17. About 21% of all American pregnancies end with abortion. (2011) When pregnancy is unintended 40%. In 2011, 1.06 million abortions performed. Number of abortions seems to be declining. – Wider availability of contraception. – Education(?)

18. Why Women Get Abortion

19. -unmarried women account for one-third of abortions in America. -Reasons for seeking abortion include the following: 21% Inadequate finances 21% Not ready for responsibility 16% Woman’s life would be changed too much 12% Problems with relationships, unmarried 11% Too young and/or immature 8% Children are grown; she has all she wants 3% Baby has possible health problems <1% Pregnancy caused by rape/incest 4% Other

21. ABORTION BY RACE - Blacks comprise only 13% of the population of America but account for 37% of all abortions. - Black women are five times more likely to abort than white women. - 69% of pregnancies among Blacks are unintended, while 54% among Hispanics and 40% among Whites. - Planned Parenthood, the largest seller of abortions in the US, has located 80% of its clinics in minority areas targeting minorities for abortion.

24. ABORTION HOW IT’S DONE

25. Medical Abortion Medical abortion, or non-surgical abortion, is a way to terminate an early pregnancy using medications. A medical abortion is performed from the time a woman suspects she is pregnant up until 9 weeks from her last menstrual period. Some insurance companies limit it to 7 weeks or less. In clinical practice, medical abortion is about 95 percent to 98 percent effective, causing a woman to completely pass the pregnancy without the use of surgery.

26. Medications The medications prescribed for medical abortion are mifepristone and misoprostol. Mifepristone blocks the action of the natural hormone progesterone on the uterus, causing the lining of the uterus to shed, as it does during a period, and stops the growth of the pregnancy. Misoprostol causes the uterus to contract and initiates bleeding and cramping. A medical abortion results when mifepristone is combined with misoprostol.

27. How It Works A medical abortion involves giving the medication and then confirming that the pregnancy has been terminated. Woman is given mifepristone. At home, woman places misoprostol in vagina. At some point during this period woman returns to Dr.’s office to make sure the abortion is complete.

28. Medical abortion is NOT the same as emergency contraception, a/k/a “the morning-after pill.” Emergency contraception prevents a pregnancy. Therefore, once pregnancy has occurred, this is no longer effective. Medical abortion, on the other hand, is used to terminate an unwanted pregnancy.

29. Surgical Abortions There are many methods of abortion. The procedure used depends on the stage of pregnancy and the size of the fetus. 3 main categories: 1.Invade the uterus and kill the fetus by instruments. 2.Kill the fetus by administration of drugs and then induce labor and the delivery of a dead fetus. 3.Invade the uterus by abdominal surgery.

30. Dilation Dilation of the uterus is attained by inserting a series of instruments of increasing size into the cervix. In a normal birth, dilation occurs slowly over many hours. Artificial dilation can result in permanent physical injury to the mother.

31. How is it Done? What does it Look Like?

32. At Eight Weeks

33. At this early stage of development, suction abortions are performed using a tube, requiring little dilation of the cervix. This is called "menstrual extraction." However, if all the fetal remains are not removed, infection results, requiring full dilation of the cervix and a scraping out of the womb.

34. Suction Aspiration Most common method of abortion during the first 12 weeks of pregnancy. General or local anesthesia is given and her cervix is quickly dilated. A suction tube with a knife-edged tip is inserted into the womb. This is connected to a vacuum machine. The vacuum tears the fetus and placenta into small pieces that are sucked through the tube into a bottle and discarded.

35. This is what it looks like

37. Dilation and Curettage (D&C) This method is similar to the suction method with the added insertion of a hook-shaped knife (curette) that cuts the baby into pieces. The pieces are scraped out through the cervix and discarded.

39. At Twelve Weeks

40. By the end of the third month all arteries are present, including the coronary vessels of the heart. Blood is circulating. Vocal chords are complete, and the child can cry (silently). The brain is fully formed, and the child can feel pain (?) The eyelids now cover the eyes, and will remain shut until the seventh month.

41. 14 weeks: Muscles lengthen and become organized. The mother will soon start feeling the baby kicking and moving inside. 16 weeks: Five and a half inches tall and only six ounces in weight, eyebrows, eyelashes and fine hair appear. The child can grasp with his hands, kick.

42. At Eighteen Weeks

43. Dilation and Evacuation (D&E) This method is used up to 18 weeks. Instead of the hook-shaped knife used in D&C, a pair of forceps is inserted into the womb to grasp part of the fetus. The teeth of the forceps twist and tear the bones of the unborn child. This process is repeated until the fetus is totally dismembered and removed. Usually the spine must be snapped and the skull crushed in order to remove them.

45. Salt Poisoning (Saline Injection) Used after 16 weeks (4 months) A long needle injects a strong salt solution through the mother's abdomen into the baby's sac. The baby swallows this fluid and is poisoned by it. It also acts as a corrosive, burning off the outer layer of skin. It normally takes an hour for the baby to die from this. Within 24 hours, labor will usually set in and the mother will give birth to a dead or dying baby. (There have been many cases of these babies being born alive. They are usually left unattended to die. However, a few have survived and later been adopted.)

46. This is what it looks like

47. At 6 Months (24 weeks)

48. At around six months, 24 weeks, a fetus may be viable. as the word is used in United States constitutional law since Roe v. Wade, viability is the potential of a fetus to survive outside the uterus after birth. There is no precise, age, or weight at which a fetus becomes viable. According to studies 20% to 35% of babies born at 23 weeks survive, 50% to 70% at 24 to 25 weeks survive, and more than 90% at 26 to 27 weeks, survive.

49. Prostaglandin Chemical Abortion This form of abortion uses chemicals that cause the uterus to contract intensely, pushing out the developing baby. The contractions are more violent than normal, natural contractions, so the unborn baby is frequently killed by them—some have even been decapitated. Many, however, have also been born alive.

50. This is what it looks like

51. Hysterotomy or Caesarean Section Used mainly in the last 3 months of pregnancy, the womb is entered by surgery through the wall of the abdomen. The technique is similar to a caesarean delivery, except that the umbilical cord is usually cut while the fetus is still in the womb to cut off his oxygen supply and causing him to suffocate. Sometimes the baby is removed alive and simply left in a corner to die of neglect or exposure.

52. At 30 Weeks (7 months + 2 weeks)

53. Partial-Birth Abortion Five steps to a partial birth abortion: 1.Guided by ultrasound, the abortionist grabs the fetus's legs with forceps. 2.The fetus's leg is pulled out into the birth canal. 3.The abortionist delivers the fetus's entire body, except for the head. 4.The abortionist jams scissors into the fetus's skull. The scissors are then opened to enlarge the skull. 5.The scissors are removed and a suction catheter is inserted. The fetus's brains are sucked out, causing the skull to collapse. The dead fetus is then removed.

56. Abortion: The Philosophical Arguments

57. 2 Principal Moral Considerations 1. The moral status of the fetus Is the fetus a person? At what stage in its development does it becomes a person? Conception? 1st trimester? Birth? 2. The rights of the pregnant woman Does the pregnant woman have the right to decide if she is going to carry the baby to term or not?

58. An Important Distinction As you consider this issue, it is important to distinguish two questions: 1.Is abortion morally wrong? 2.Should abortion be illegal? These are distinct issues. Not everything that is immoral is necessarily illegal. We may, for example, want to say that being unfaithful in one’s marriage is immoral, but we may not want to see it made illegal.

59. The Moral Status of the Fetus Much of the debate in regard to abortion has stemmed from whether the fetus is a person or not. If the fetus is a person, then it has the rights that belong to persons, including the right to life. The concept of personhood, in other words, is the bridge that connects the fetus with the right to life.

60. Criteria of Personhood Possible criteria Conceived by humans Genetic structure Physical resemblance Presence of a soul Viability ?

61. Arguments against abortion People who believe abortion is morally wrong use arguments like the following: Killing innocent human beings is wrong Human life begins at conception Therefore the fetus is an innocent human being Therefore killing the fetus is wrong Therefore abortion is always wrong

62. A fetus is a person A fetus has a unique genetic code A fetus is a unique individual It is immoral to kill an individual Therefore, abortion is immoral

63. Killing potential people is wrong It is wrong to destroy potential human life From conception onwards the fetus is a potential human being Therefore it is wrong to destroy the fetus Therefore abortion is always wrong

64. Killing beings with 'a future like ours' is wrong It is wrong to kill beings that would have a future like ours if they lived In most cases the fetus, if not aborted, would have a future like ours It is wrong to kill such a fetus Therefore abortion is usually wrong

65. Causing pain is wrong It is wrong to cause pain and suffering A fetus is sufficiently developed to feel pain by 18 weeks Therefore it is wrong to carry out an abortion after 18 weeks of pregnancy

66. Increasing tolerance of killing is wrong Allowing abortion is legalizing killing Legalizing killing reduces people's respect for life Reducing society's respect for life is a bad thing - it may lead to euthanasia, genocide and increased murder rates Therefore abortion is always wrong

67. Arguments in favor of abortion People who don't believe abortion is always morally wrong use arguments like these:

68. The fetus is not necessarily a 'person' with the right to live A collection of human cells does not have the right to live just because it is of the human species. Otherwise amputating a limb would be murder A collection of human cells only has the right to live by virtue of certain facts These are either: It has reached a particular stage of development that makes it a moral 'person' It possesses certain properties that make it a moral 'person'

69. It is not always wrong to end the life of an innocent person There are many cases where we have to choose which of two innocent people will live and which will die: Conjoined twins, where the operation to separate them may cause one twin to die Mountaineering, when one person can only save his own life by cutting the rope supporting a fallen colleague The case of a woman who had to abandon one of her children to save the other

70. 'Potential human beings' don't have rights Only 'actual' human beings have rights A fetus is not a human being yet, but a potential one Thus a fetus doesn't have rights, such as the right to life Therefore, abortion is not immoral

71. The pregnant woman has moral rights too Under some circumstances these may override the fetus’s right to live These moral rights include: The right to ownership of her own body The right to decide her own future The right to take decisions without moral or legal intervention by others The pregnant woman has the right to life - where not aborting the fetus would put the mother's life or health in danger, she has the moral right to abort the fetus

72. The Rights of the Pregnant Woman What right does a woman possess that would entitle her to choose an abortion? Right to privacy—This is the right specified in Roe v. Wade. Right to ownership of her own body. Right to equal treatment. Right to self-determination. Women have the right to decide about their own futures. It is morally repellent to force a woman to bear a child against her will.

73. Without access to legal abortions, women will be forced to obtain unsafe, illegal abortions. -If states could outlaw abortions, many would -Women in those states who couldn’t afford to travel would turn to ‘back alley’ alternatives. -Considering the risk of botched abortions, it is better that abortion is legal. -Therefore, abortion should be legal.

74. The sick violinist analogy. (Judith Jarvis Thompson) Suppose you awakened to find yourself hooked up through intravenous tubes to a desperately ill violinist. The violinist requires the shared use of your kidneys for nine months – or else he’ll die. Clearly, it would be generous if you agree to continue such an arrangement. But can the state compel you to save the violinist? Clearly not. Likewise, Thompson reasons, the state cannot compel a woman to continue a pregnancy.

75. Who (Should) decides? Physicians Individual doctors Professional organizations The government Laws Court decisions Regulation Those directly involved The pregnant woman The biological father Other family members

76. Feminist Concerns about Abortion Many feminists see abortion issue within context of: History of oppression of women History of danger and death for women when abortion is illegal

77. Feminist View Women have been exploited by men throughout history. Should women be forced to bear children in a way in which men are not? If women’s decision is regulated by law, women will always be potential slaves of biological reproduction?

78. Rights of the Father To what extent do the father’s preferences count in making this decision? Mothers actually give birth, fathers don’t. Society usually places primary responsibility on the mother. Fathers don’t even always know they are fathers; mothers always do.

79. Principle of the Double Effect. This principle aims to provide specific guidelines for determining when it is morally permissible to perform an action in leading to a good end, knowing that the action will also bring about bad results. Four conditions must be met: 1. The action itself must be either morally good or at least morally neutral; 2. The bad consequences must not be intended; 3. The good consequences cannot be the direct causal result of the bad consequences; and 4. The good consequences must be proportionate to the bad consequences. Abortion. A doctor who is against abortion may still remove the uterus or fallopian tubes of a pregnant woman, knowing the procedure will cause abortion, in cases in which the woman is certain to die (examples: uterine cancer and ectopic pregnancy, the embryo attaches outside the uterus). In these cases, the intended effect is to save the woman's life, not to terminate the pregnancy, and the effect of not performing the procedure would result in the greater evil of the death of both the mother and the fetus.

80. The Edelin Case

81. Kenneth C. Edelin Young African American Dr. (35) at Boston City Hospital. First African-American chief resident in OB/GYN in history! Began in October 1973 Massachusetts did not pass an abortion law until August 1974.

82. Dr. Holtrop, Edelin’s supervisor, admitted “Alice Roe” a poor 17-year-old African-American student. Apparently she was raped by her father. He estimated her to be 22 weeks pregnant. Enrique Giminez, resident, estimated her 24 weeks. Giminez testified against Edelin. Hospital did not have ultrasound machine! Holtrop assigned abortion to Edelin.

83. Edelin first planned the abortion by injecting saline solution into amniotic sac. Due to the position of placenta, he decided for a hysterotomy. Giminez, who watched the procedure, later testified that Edelin made cesarean section and waited 3 minutes, thus “killing” fetus by oxygen depravation. Edelin testified that Giminez confused 2 different incisions, thinking Edelin was waiting.

84. DA charged Edelin with manslaughter. DA concluded that when Edelin cut the placenta, the fetus was viable and thus a person. Edelin waited 3 minutes and this constitutes wanton, reckless conduct. The goal of legal abortion is to end pregnancy not kill fetus.

85. Judge McGuire instructed jury that a fetus is not a person, and To decide whether – 1. Had the fetus been born alive outside mother? – 2. If so, did the fetus die as a result of wanton, reckless behavior? – Jury said yes to both and Edelin was convicted of manslaughter. In 1976, 3 years later, Massachusetts Supreme Court overturned Edelin’s conviction. No evidence of criminal conduct was found.

86. Ethical Issues There was a delay between incision and extraction of fetus. But even if Edelin was innocent, legally, were his actions ethical? He could have removed fetus, allowed it to breathe. The baby may have been adopted. Perhaps Edelin should have proposed this option to the mother (but we don’t know all the facts)

87. Criteria for Solution Who will be significantly affected by the decision made? What facts are relevant to a solution? What ethical principles are relevant? Which principles may conflict? What actions or policies deserve consideration? What are the most attractive solutions? Do reasons exist for giving priority to the interest of a party rather than another? Who has the authority to decide?

88. Informed Consent Before a woman can be truly free to make her own choice, she must make a decision based on factual information about all aspects of abortion: the risks of the procedure, adoption, and parenting. The abortion industry’s silence in these matters is based on the fact that it is a billion dollar business, the profitability of which depends on the number of women having abortions, the speed, efficiency, and minimizing of contact between physician and pregnant woman.

89. Perhaps abortion is a skillfully marketed product sold to women in time of crisis. When they find out the product is defective, it’s too late. Final Thought