Court Ruling on Abortion May Change Doctor Practices

The Supreme Court Wednesday supported a ban on so-called partial-birth abortions. Anti-abortionist supporters hail the decision, but what does it mean for doctors faced with patients in life-threatening situations? Dr. Karen Lifford, director of the Planned Parenthood League of Massachusetts, talks with Madeleine Brand about the alternative procedures available to doctors.

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MADELEINE BRAND, host:

This is DAY TO DAY from NPR News. I'm Madeleine Brand.

ALEX CHADWICK, host:

I'm Alex Chadwick.

Abortion opponents are applauding yesterday's Supreme Court decision supporting a ban on the procedure that they call partial-birth abortion; the medical term is intact dilation and extraction. But what about the doctors who perform these procedures?

BRAND: Earlier, I spoke with Dr. Karen Lifford. She's a practicing OB/GYN who is also the medical director of Planned Parenthood in Massachusetts. Planned Parenthood was part of the suit that the Supreme Court ruled on yesterday. Some 90 percent of abortions are performed before 12 weeks in the first trimester. The banned procedure is done after 12 weeks, and it involves removing a fetus intact from the uterus.

I asked Dr. Lifford how often she personally performs that procedure.

Dr. KAREN LIFFORD (Medical Director, Planned Parenthood): It's really not a matter of how often any particular procedure on medicine is used. It's having a range of options that we all need to practice medicine safely and to offer our patients what's best for their health.

BRAND: Justice Anthony Kennedy in his majority decision yesterday said there was, quote, "medical uncertainty" over whether the procedure was ever necessary for the sake of the woman's health. What do you think of that?

Dr. LIFFORD: I think that that's disregarding. Experts in our field, as well as leading medical organizations, agree that this procedure is sometimes necessary and that this option should not be taken away from physicians.

BRAND: What is the alternative? So what will a woman receive now in the second trimester if she wants to terminate a pregnancy?

Dr. LIFFORD: The fallback is a D&E, a dilation and extraction, which is widely used across the country. But I think that this does not allow medicine to evolve to practices that may be safer.

BRAND: So the difference between the two procedures are that, in one instance, the fetus is extracted whole, if you will, and the other not?

Dr. LIFFORD: And the other difference is how much instrumentation is required, and that's why it felt that this banned procedure might be safer.

BRAND: What happens if a woman miscarries past the 12th week and does not expel the fetus on her own, does she have the D&E?

Dr. LIFFORD: This law does not apply to fetuses that are not living. So the restrictions on someone who has miscarried and the fetus is dead it doesn't apply to. However, many miscarriages involve labor that starts prior to when the fetus can survive outside a woman, and it would apply in those circumstances.

BRAND: So I'm just trying to get a sense, you know, for a woman who, you know, needs or wants to terminate a pregnancy in the second trimester. When she comes into your office, what would she now face and what restrictions would she now be under?

Dr. LIFFORD: Well, I think what women need to know is that abortion, including second trimester abortion, is still legal in the United States. Planned Parenthood and other providers have always followed the law. We will always continue to follow the law. And we will provide our patients with the options that are available. But we will be restricted now, and this restriction is based on politicians rather than physicians.

Medicine has always moved forward and changed according to physician's best judgment. This is really precedent-setting that politicians are making medical decisions.

BRAND: Does it also reflect the success in the tactics of the anti-abortion movement to shift the focus away from talking about the women's health to talking about the fetus?

Dr. LIFFORD: I think this is a major setback for women's health. There are more than 30 years of precedent that abortion bans cannot - must include protections for the women's health. This is the first time we've seen a ban upheld where we're willing to disregard the health of women.

BRAND: Dr. Karen Lifford is the medical director of the Planned Parenthood League of Massachusetts, also a practicing OB/GYN. Dr. Lifford, thanks for joining us.

Dr. LIFFORD: Thank you very much.

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