Recent proposed federal legislation banning certain abortion procedures,
particularly intact dilatation and extraction, would modify the US Criminal
Code such that physicians performing these procedures would be liable for
monetary and statutory damages. Clarification of medical procedures is important
because some of the procedures used to induce abortion prior to viability
are identical or similar to postviability procedures. This article reviews
the scientific and medical information on late-term abortion and late-term
abortion techniques and includes data on the prevalence of late-term abortion,
abortion-related mortality and morbidity rates, and legal issues regarding
fetal viability and the balance of maternal and fetal interests. According
to enacted American Medical Association (AMA) policy, the use of appropriate
medical terminology is critical in defining late-term abortion procedures,
particularly intact dilatation and extraction, which is a variant of but distinct
from dilatation and evacuation. The AMA recommends that the intact dilatation
and extraction procedure not be used unless alternative procedures pose materially
greater risk to the woman and that abortions not be performed in the third
trimester except in cases of serious fetal anomalies incompatible with life.
Major medical societies are urged to collaborate on clinical guidelines on
late-term abortion techniques and circumstances that conform to standards
of good medical practice. More research on the advantages and disadvantages
of specific abortion procedures would help physicians make informed choices
about specific abortion procedures. Expanded ongoing data surveillance systems
estimating the prevalence of abortion are also needed.
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