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In 2019, a US Senate Bill entitled the "Born-Alive Abortion Survivors Protection Act" garnered a great deal of attention to the issue of live birth after abortion despite live birth being an uncommon complication of abortion.[1][2] The bill would mandate that medical providers resuscitate neonates delivered showing signs of life during an abortion process. [1][2] During the debate around this issue, US Republicans alleged that medical providers "execute" babies although there are in fact existing US laws that would punish an execution as homicide, and US abortion experts refute the claim that a "born-alive" fetus is a common event and reject laws that would mandate resuscitation against the wishes of the parents.[2]

Only 1.3% of abortions occur after 21 weeks of pregnancy.[3] Although it is very uncommon, women undergoing surgical abortion after this gestational age sometimes give birth to a fetus that may survive briefly.[4][5][6] The periviable period is considered to be between 20 to 25 weeks gestation.[7] Long-term survival is possible after 22 weeks.[8] However, odds of long-term survival between 22 and 23 weeks are 2-3 percent and odds of survival between 23 and 24 weeks are 20 percent.[9] "Intact survival", which means survival of a neonate without subsequent damage to organs such as the brain or bowel is 1% at 22 weeks and 13% at 23 weeks.[9] Survival odds increase with increasing gestational age.[9]

If medical staff observe signs of life, they may be required to provide care: emergency medical care if the child has a good chance of survival and palliative care if not.[10][11][12] Induced fetal demise before termination of pregnancy after 20–21 weeks gestation is recommended by some sources to avoid this and to comply with the US Partial Birth Abortion Ban.[13][14][15][16][17] Induced fetal demise does not improve the safety of an abortion procedure and may incur risks to the health of the woman having the abortion.[14]

  1. ^ a b Robertson, Lori (2019-03-04). "The Facts on the Born-Alive Debate". FactCheck.org. Retrieved 2019-08-05.
  2. ^ a b c Grady, Denise (2019-02-26). "'Executing Babies': Here Are the Facts Behind Trump's Misleading Abortion Tweet". The New York Times. ISSN 0362-4331. Retrieved 2019-08-05.
  3. ^ Jatlaoui, Tara C. (2018). "Abortion Surveillance — United States, 2015". MMWR. Surveillance Summaries. 67 (13): 1–45. doi:10.15585/mmwr.ss6713a1. ISSN 1546-0738. S2CID 53741145.
  4. ^ "The Care of Women Requesting Induced Abortion. Evidence-Based Clinical Guideline no. 7" (PDF). Royal College of Obstetricians and Gynaecologists. November 2011. Archived (PDF) from the original on 14 November 2015. Retrieved 31 October 2015. Recommendation 6.21 Feticide should be performed before medical abortion after 21 weeks and 6 days of gestation to ensure that there is no risk of a live birth.
  5. ^ Society of Family Planning (February 2011). "Clinical Guidelines, Labor induction abortion in the second trimester". Contraception. 84 (1): 4–18. doi:10.1016/j.contraception.2011.02.005. PMID 21664506. Transient survival with misoprostol for labor induction abortion at greater than 18 weeks ranges from 0% to 50% and has been observed in up to 13% of abortions performed with high-dose oxytocin.
  6. ^ Fletcher; Isada; Johnson; Evans (August 1992). "Fetal intracardiac potassium chloride injection to avoid the hopeless resuscitation of an abnormal abortus: II. Ethical issues". Obstetrics and Gynecology. 80 (2): 310–13. PMID 1635751. following later abortions at greater than 20 weeks, the rare but catastrophic occurrence of live births can lead to fractious controversy over neonatal management.
  7. ^ "Periviable Birth - ACOG". www.acog.org. Retrieved 2019-07-14.
  8. ^ "Termination of Pregnancy for Fetal Abnormality" (PDF). Royal College of Obstetricians and Gynaecologists: 29–31. May 2010. Archived (PDF) from the original on 22 December 2015. Retrieved 26 October 2015.
  9. ^ a b c Younge, Noelle; Goldstein, Ricki F.; Bann, Carla M.; Hintz, Susan R.; Patel, Ravi M.; Smith, P. Brian; Bell, Edward F.; Rysavy, Matthew A.; Duncan, Andrea F. (2017-02-16). "Survival and Neurodevelopmental Outcomes among Periviable Infants". New England Journal of Medicine. 376 (7): 617–628. doi:10.1056/NEJMoa1605566. ISSN 0028-4793. PMC 5456289. PMID 28199816.
  10. ^ Nuffield Council on Bioethics (2007). "Critical care decisions in fetal and neonatal medicine: a guide to the report" (PDF). Archived (PDF) from the original on 4 March 2016. Retrieved 29 October 2015. Under English law, fetuses have no independent legal status. Once born, babies have the same rights to life as other people. {{cite journal}}: Cite journal requires |journal= (help)
  11. ^ Gerri R. Baer; Robert M. Nelson (2007). "Preterm Birth: Causes, Consequences, and Prevention. C: A Review of Ethical Issues Involved in Premature Birth". Institute of Medicine (US) Committee on Understanding Premature Birth and Assuring Healthy Outcomes. Archived from the original on 31 December 2015. In 2002, the 107th U.S. Congress passed the Born-Alive Infants Protection Act of 2001. This law established personhood for all infants who are born "at any stage of development" who breathe, have a heartbeat, or "definite movement of voluntary muscles", regardless of whether the birth was due to labor or induced abortion.
  12. ^ Chabot, Steve (5 August 2002). "H.R. 2175 (107th): Born-Alive Infants Protection Act of 2002". govtrack.us. Archived from the original on 14 November 2015. Retrieved 30 October 2015. The term "born alive" is defined as the complete expulsion or extraction from its mother of that member, at any stage of development, who after such expulsion or extraction breathes or has a beating heart, pulsation of the umbilical cord, or definite movement of the voluntary muscles, regardless of whether the umbilical cord has been cut, and regardless of whether the expulsion or extraction occurs as a result of natural or induced labor, cesarean section, or induced abortion.
  13. ^ "Practice Bulletin: Second-Trimester Abortion" (PDF). Obstetrics & Gynecology. 121 (6): 1394–1406. June 2013. doi:10.1097/01.AOG.0000431056.79334.cc. PMID 23812485. S2CID 205384119. Archived (PDF) from the original on 14 November 2015. Retrieved 30 October 2015. With medical abortion after 20 weeks of gestation, induced fetal demise may be preferable to the woman or provider in order to avoid transient fetal survival after expulsion.
  14. ^ a b Higginbotham Susan (January 2010). "Clinical Guidelines: Induction of fetal demise before abortion" (PDF). Contraception: A Publication of Society of Family Planning. 81 (6): 462–73. doi:10.1016/j.contraception.2010.01.018. PMID 20472112. Archived (PDF) from the original on 23 November 2015. Retrieved 26 October 2015. Inducing fetal demise before induction termination avoids signs of live birth that may have beneficial emotional, ethical and legal consequences.
  15. ^ Committee on Health Care for Underserved Women (November 2014). "Committee Opinion 613: Increasing Access to Abortion". Obstetrics & Gynecology. 124: 1060–65. doi:10.1097/01.aog.0000456326.88857.31. PMID 25437742. Archived from the original on 28 October 2015. Retrieved 28 October 2015. "Partial-birth" abortion bans – The federal Partial-Birth Abortion Ban Act of 2003 (upheld by the Supreme Court in 2007) makes it a federal crime to perform procedures that fall within the definition of so-called "partial-birth abortion" contained in the statute, with no exception for procedures necessary to preserve the health of the woman...physicians and lawyers have interpreted the banned procedures as including intact dilation and evacuation unless fetal demise occurs before surgery.
  16. ^ "2015 Clinical Policy Guidelines" (PDF). National Abortion Federation. 2015. Archived (PDF) from the original on 12 August 2015. Retrieved 30 October 2015. Policy Statement: Medical induction abortion is a safe and effective method for termination of pregnancies beyond the first trimester when performed by trained clinicians in medical offices, freestanding clinics, ambulatory surgery centers, and hospitals. Feticidal agents may be particularly important when issues of viability arise.
  17. ^ Milliez Jacques (2008). "FIGO Committee Report: Ethical aspects concerning termination of pregnancy following prenatal diagnosis". International Journal of Gynecology and Obstetrics. 102 (1): 97–98. doi:10.1016/j.ijgo.2008.03.002. PMID 18423641. S2CID 39838077. Termination of pregnancy following prenatal diagnosis after 22 weeks must be preceded by a feticide.
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