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Author Topic: Reproductive issues  (Read 14993 times)
JDN
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« Reply #50 on: December 03, 2008, 09:50:30 PM »

I'm sorry, maybe I wasn't clear.  If using your example, I patronized a prostitute in CA (prostitution is illegal in CA) and took a flight to Utah;
could they prosecute me?  In BOTH states the "act" is illegal therefore it seems to me one could be prosecuted or extradited from Utah to CA; yes?  I mean
if I kill someone in CA (illegal) and flee to Utah (murder is also illegal) I can and in most cases will be prosecuted and/or extradited to CA.  Using you analogy,
if one state permitted murder, and I crossed into that state, then you are right, they would not prosecute or extradite me.  But going back to the example, if most
states prohibit abortion, I guess the woman has a serious, maybe criminal problem?

Also, regarding searches; even leaving the US I can be subjected to a very invasive search.  And while it may be a "consent" search, even domestically,
if I want to travel, business or pleasure, I have no option, do I?  And I find it offensive that they want to search my computer files, yet given that I travel a
lot, I have not choice.  "Consent" perhaps, but in reality I have no choice.  And if some rent a cop found something on my computer, I miss my flight.  The same applies
to the woman in the above example.  Either one of us might need a lawyer for something innocuous.  I guess that is how they could catch criminals like women who have
abortions if it is illegal?
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G M
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« Reply #51 on: December 03, 2008, 10:35:18 PM »

I'm sorry, maybe I wasn't clear.  If using your example, I patronized a prostitute in CA (prostitution is illegal in CA) and took a flight to Utah;
could they prosecute me? 

**California would have jurisdiction. If you fled and were arrested in Utah, CA could have you extradited back to face trial in California. Neither CA or UT could charge you for patronizing a legal prostitute in NV.**

http://legal-dictionary.thefreedictionary.com/Extradition

The transfer of an accused from one state or country to another state or country that seeks to place the accused on trial.

Extradition comes into play when a person charged with a crime under state statutes flees the state. An individual charged with a federal crime may be moved from one state to another without any extradition procedures.

Article IV, Section 2, of the U.S. Constitution provides that upon the demand of the governor of the prosecuting state, a state to which a person charged with a crime has fled must remove the accused "to the State having Jurisdiction of the Crime." When extraditing an accused from one state to another, most states follow the procedures set forth in the Uniform Criminal Extradition Act, which has been adopted by most jurisdictions. A newer uniform act, the Uniform Extradition and Rendition Act, is designed to streamline the extradition process and provide additional protections for the person sought, but by 1995, it had been adopted by only one state.

Extradition from one state to another takes place on the order of the governor of the Asylum state (the state where the accused is located). The courts in the asylum state have a somewhat limited function in extraditing the accused to the state where she or he is charged with a crime. They determine only whether the extradition documents are in order (e.g., whether they allege that the accused has committed a crime and that she or he is a fugitive) and do not consider the merits of the charge, since the trial of the accused will take place in the state demanding extradition.

In some cases, courts considering extradition from one state to another may go beyond the procedural formalities and look at the merits of the criminal charge or at allegations by the accused that extradition will lead to harmful consequences beyond a prison term. These cases are rare because under the U.S. Constitution, states are not given the power to review the

underlying charge. This problem occurred in New Mexico ex rel. Ortiz v. Reed, 524 U.S. 151, 118 S. Ct. 1860, 141 L. Ed. 2d 131 (1998), in which the state of New Mexico refused to return a fugitive to the state of Ohio.

The Supreme Court has identified that a court considering an extradition case can only decide four issues: (1) whether the extradition documents on their face are in order, (2) whether the petitioner has been charged with a crime in the demanding state, (3) whether the petitioner is the person named in the request for the extradition, and (4) whether the petitioner is a fugitive. The New Mexico Supreme Court in Reed determined that the person subject to the extradition, Manuel Ortiz, was not a "fugitive," and refused to honor the extradition order from the state of Ohio. The Supreme Court found that New Mexico courts had overstepped their authority and ordered the New Mexico Supreme Court to return the fugitive.


In BOTH states the "act" is illegal therefore it seems to me one could be prosecuted or extradited from Utah to CA; yes?  I mean
if I kill someone in CA (illegal) and flee to Utah (murder is also illegal) I can and in most cases will be prosecuted and/or extradited to CA.  Using you analogy,
if one state permitted murder, and I crossed into that state, then you are right, they would not prosecute or extradite me.  But going back to the example, if most
states prohibit abortion, I guess the woman has a serious, maybe criminal problem?

**Again, you cannot charge/prosecute unless you have jurisdiction. If you legally possess marijuana in California, then cross into Nevada, NV law now applies. The legality ends once you cross out of California's legal jurisdiction. NV cannot charge you for marijuana you possess in CA, but can charge you for marijuana you do possess while in NV.**

Also, regarding searches; even leaving the US I can be subjected to a very invasive search.  And while it may be a "consent" search, even domestically,
if I want to travel, business or pleasure, I have no option, do I? 

**The courts have ruled that 4th Amnd. protections do not apply at border crossings. As far as consenting to security screening, you can charter a private plane, drive, take a bus, take a train or walk. They may not be your preferred options, but they are options.**


And I find it offensive that they want to search my computer files, yet given that I travel a
lot, I have not choice.  "Consent" perhaps, but in reality I have no choice.  And if some rent a cop found something on my computer, I miss my flight. 

**TSA does not inspect the contents of your hard drive. US Customs officers might at a border crossing. They are federal law enforcement officers, hardly "rent a cops".**

The same applies to the woman in the above example.  Either one of us might need a lawyer for something innocuous.  I guess that is how they could catch criminals like women who have abortions if it is illegal?


**Again, a state does not have jurisdiction to charge you for something you do that is legal in the state you do it in. California cannot charge you for patronizing a legal prostitute in Nevada.**
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JDN
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Posts: 2004


« Reply #52 on: December 04, 2008, 08:46:29 AM »

[
**Again, a state does not have jurisdiction to charge you for something you do that is legal in the state you do it in. California cannot charge you for patronizing a legal prostitute in Nevada.**

I understand; my point is that if you do something illegal in one state; prostitution or for example perform an illegal abortion, you may be arrested and held and returned to another state if prostitution or for example abortion is also illegal in the state to which you fled/traveled.

And I understand coercive and invasive searches are legal at the border, but since I often travel internationally, short of chartering a private plane (beyond my budget) I have few choices.  Even flying to NY is a very long walk, drive, or train ride.  Yet, if during this search, sticking to topic, if evidence was found in my luggage that I had committed an illegal abortion and it was illegal in the state I was traveling from and going to, I could be arrested and/or detained at either location; correct?

As for "rent a cop" I was thinking TSA employees; in contrast, I have the highest respect for the training and qualifications of Custom Officers and I know they are doing a difficult job.


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G M
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« Reply #53 on: December 04, 2008, 09:02:59 AM »

[
**Again, a state does not have jurisdiction to charge you for something you do that is legal in the state you do it in. California cannot charge you for patronizing a legal prostitute in Nevada.**

I understand; my point is that if you do something illegal in one state; prostitution or for example perform an illegal abortion, you may be arrested and held and returned to another state if prostitution or for example abortion is also illegal in the state to which you fled/traveled.

**It need not be illegal in the state you flee to. CA wants to charge you for patronizing a prostitute. You flee to NV. A NV state trooper stops for for an illegal lane change, runs your license and finds the CA warrant for your arrest. As long as CA will extradite you back for trial, the trooper will arrest you and take you to county pending extradition. NV's legal brothels have no effect on you being sent back to CA to face trial.**

And I understand coercive and invasive searches are legal at the border, but since I often travel internationally, short of chartering a private plane (beyond my budget) I have few choices. 

**Private plane or not, crossing an international border, you will face being searched by US Customs and Border Protection officers. The only border crossers that are immune are those with diplomatic immunity.**


Even flying to NY is a very long walk, drive, or train ride.  Yet, if during this search, sticking to topic, if evidence was found in my luggage that I had committed an illegal abortion and it was illegal in the state I was traveling from and going to, I could be arrested and/or detained at either location; correct?

**I have a hard time imagining what would constitute evidence of an illegal abortion that could be discovered by TSA security screening. They are trained (somewhat) to detect threats to aviation security. If in the process of searching you or your property, they discovered potential evidence of a crime, a sworn LEO would respond. If he/she then found probable cause that a crime, then indeed you would face arrest.**

As for "rent a cop" I was thinking TSA employees; in contrast, I have the highest respect for the training and qualifications of Custom Officers and I know they are doing a difficult job.



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rachelg
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« Reply #54 on: December 04, 2008, 10:19:37 PM »

http://www.newsweek.com/id/171975/output/print
 
 
 Jewish law is clear on the subject--- the fetus is only potential life. Jewish law  would not allow  a Jewish woman to have an abortion for birth control reasons. However   if the pregnancy  endangers  the mother life she is required to have an abortion.  Under Jewish Law  you are not allowed to kill another innocent person to save you own life let alone be required to take that action. 

   I have been pro-choice  since a young age like 10. I lived near a hospital  that performed abortions.  At one point there were regular protesters so it came up in conversation with my parents  pretty regularly.  I was smart enough not to share that information at recess.    A  young child's political views are often just parroting the parents ---it is not necessarily  a sign of great insight. 
 
The people surveyed  below  clearly don't see the embryos as identical to  4 year old or that would donate the embryos for others to be adopted.
 
Would you want it to be required that the embryos are implanted or are you against test tube babies period?

 http://www.newsweek.com/id/171975/output/print
 
Agonizing Dilemma

A psychologist on the complicated reasons couples are reluctant to donate or destroy stored embryos after their fertility treatments end.
Karen Springen
Newsweek Web Exclusive

Hundreds of thousands of human embryos are currently sitting in tiny cylinders and suspended in minus-340-degree Fahrenheit liquid-nitrogen tanks. What should happen to them? In the new issue of the journal Fertility and Sterility, researchers who surveyed 1,020 patients at nine American fertility clinics reported that 54 percent of respondents with cryopreserved embryos said they were "very likely" to use them for reproduction and 21 percent were "very likely" to donate them for research.

Only 7 percent of the respondents said they were "very likely" to donate the embryos to another couple trying to conceive and just 6 percent said they were "very likely" to thaw and dispose of the embryos. "They felt like thawing and discarding embryos was wasteful. There was also some sense that that was not respectful," says lead author Dr. Anne Drapkin Lyerly, associate professor of obstetrics and gynecology at the Duke University Medical Center's Trent Center for Bioethics, Humanities and History of Medicine. Unfortunately, thawing and discarding is often the only choice for many couples. Only four of nine of the reproduction clinics surveyed offered donation for research.

To find out more about the complex emotional dilemmas that couples face when making choices about stored embryos, NEWSWEEK's Karen Springen spoke with psychologist Sandra Leiblum, director of psychological services at the New Jersey Center for Sexual Wellness and editor of "Infertility: Psychological Issues and Counseling Strategies" (Wiley). Excerpts:

NEWSWEEK: Do these results surprise you—the lack of enthusiasm for thawing and discarding the embryos or for giving them to other couples?
Sandra Leiblum: It makes sense. To store and dispose of embryos, which are living genetic material, feels like a wanton disregard for the potential for life. To treat it like some cellular remains that have no genetic significance feels too cavalier and too disrespectful. To donate them [to another couple] is kind of like prenatal adoption. You don't have any choice as to who the embryo would go to. People really feel a huge level of uncertainty about what to do with frozen embryos.

Does donating the embryos for research make sense from a psychological standpoint?
Using [them] for research means you do want something useful to happen as a result of your commitment to going through the misery of infertility treatment. The embryos are precious in a sense in terms of what they represent, materially and financially and psychologically. You want to feel as though something important and significant is happening with them.

Do some people want to keep storing embryos because they're worried that they'll lose a child someday?
If a catastrophe occurs, you always want the possibility of having recourse. People who go through infertility have gone through years of trying to conceive. Years of the woman being on fertility drugs or having sex based on when ovulation occurs, having these huge disappointments of either miscarriage or inability to conceive. The amount of psychological devotion, angst, money, stress, trying to conceive is not trivial. So if you finally succeed in getting embryos, it's too precious to just destroy. There's a sense of you don't want to just let go of them. It's partly insurance against future catastrophe. Or if you have a divorce and remarry and you have a new partner, you may want to have options. Women these days are conceiving in their 40s.

Or even into their 60s?
Theoretically. Or you could get a surrogate. It's your egg, it's your material, and that of someone you love. You hear these stories where the male partner goes to Iraq. And then if you have his embryo, you can still kind of manage to recreate.

What's the problem with storing the embryos indefinitely?
It's a huge burden for these cryopreservation banks. It's expensive. It's a huge bioethical dilemma. Sometimes you lose touch with the women or couples who have preserved their embryos. What does the bank do? They can't discard the embryos themselves. What if the power is lost and they die. There are all kinds of issues. We have a situation where we have thousands of these embryos that are not doing anything.

What about an alternative like putting the embryos back in the woman's body at a time she's not likely to conceive or holding a ceremony at the time of disposal? (Seven percent of the respondents in the "fertility and sterility" survey said they were "very likely" to choose each of those options.)
That shows, I think, respect for the possibility of life. That this material is not like ordinary material.

In other words, it's not like thawing out and discarding an old pot roast?
Exactly. It's special. It's endowed. It has life potential. It's meaningful … It's important in some way. It's kind of like even when you have a stillbirth or you have a miscarriage, sometimes people want to name it and do a ceremony around that.

Is a ceremony a healthy thing to do?
Yes. Ceremonies and rituals help people kind of cope with meaningful events in their life. The ceremony makes sense to me. It's a commemoration.

Why don't centers offer more of these options?
I wonder if it's because they don't have personnel. You need someone who's trained in terms of the importance of this. Maybe having kind of a divinity person would make it more sensible than expecting a physician to do it. Have someone who knows about rituals.
URL: http://www.newsweek.com/id/171975
« Last Edit: December 05, 2008, 06:47:00 AM by rachelg » Logged
Crafty_Dog
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« Reply #55 on: December 06, 2008, 08:00:45 AM »


September 26, 2008 6:00 AM

Court Contradiction
Abortion on high.

By Sheila Liaugminas

For the first time in the 35 years, the Supreme Court has been asked to decide whether this statement is biological fact, or mere ideology: “Abortion terminates the life of a human being.”

Two U.S. courts disagree over what Roe v. Wade means for this issue, so there are now two Constitutions — one in New Jersey, the other in the Eighth Circuit’s six states. This kind of conflict increases the odds that the United States Supreme Court will step in, and a new case, Acuna v. Turkish, gives it the option to.

On September 29, the high Court will announce whether it plans to do so.

Acuna presents a compelling opportunity to address an issue that Roe sidestepped, and that now represents ground zero in the abortion culture. Roe considered only whether there was a state interest in protecting “the potentiality of human life” (yes, according to the court, but a very limited one that grows as the fetus ages) and whether the unborn were considered “persons” under the Fourteenth Amendment (no).

The new case began just prior to Rosa Acuna’s abortion in April 1996. She asked Dr. Sheldon Turkish if her “baby is already there.” She wanted to know whether the abortion would terminate the life of a whole, living human being, or whether the procedure prevented a human being from coming into existence in the first place. What was it that the abortionist proposed to “evacuate” from her? To her, the difference was crucial.

According to Acuna, Turkish said, “Don’t be stupid; it’s only some blood.” According to Turkish, he said, “It’s just some tissue.” Based on that, she consented to an abortion.

A month later, she had a massive hemorrhage. Bleeding profusely, she was rushed to a hospital. Heading into the operating room on a gurney, she asked a nurse what was wrong with her. “They left part of your baby in you,” the nurse told her. She’d had an incomplete abortion.

Acuna was devastated. What the nurse said clashed with what Turkish had said. She decided to find out for herself at the local library. In medical and scientific books, Acuna realized that Turkish had lied. She became severely depressed, and it got worse over time. She sued the doctor, claiming he’d had the duty to tell her she was carrying an already-existing human being.

New Jersey trial judges denied Acuna’s claim. Her case bounced from trial to appellate court and back again. One ruling argued that since Roe had found that unborn children are not persons, Acuna’s claims had no merit.
In September 2007, the New Jersey supreme court — the last court that could hear the case, besides the U.S. Supreme Court — decided 5-0 that Acuna was not entitled to a more accurate answer from Turkish, because “there is no consensus in the medical community” that embryos are living human beings at six to eight weeks of age, as a matter of scientific fact.

However, Mrs. Acuna had put into the record scientific proof from internationally renowned biologists, embryologists, and geneticists that the embryo is an independent, living human being from the instant of fertilization. Turkish’s lawyers presented no evidence that contradicted this.
 
========
Court Contradiction


Meanwhile, in 2005, the South Dakota legislature passed the nation’s most thorough “informed-consent” law, requiring abortion clinics to tell women “that the abortion will terminate the life of a whole, separate, unique, living human being.” The law required doctors to disclose that abortion may cause women psychological harm, and that the mother’s relationship with the human being she carries is protected by the Fourteenth Amendment.

Planned Parenthood asked for and received an immediate injunction in a U.S. District Court. The group convinced Judge Karen Schreier that the law infringes on the abortionist’s “right to free speech,” because the language of the informed consent was ideological and not biological.


An Eighth Circuit Court of Appeals panel upheld Schreier’s ruling 2-1, citing Roe. The majority said “the factual underpinning” of Roe was the “finding that there was no medical, scientific, or moral consensus about when life begins, making the question of when a fetus or embryo becomes a human being one of individual conscience and belief.”

But then, all eleven judges of the Eighth Circuit Court of Appeals considered the case. They vacated the three-judge panel’s decision: In June 2008, a 7-4 majority decision threw out Schreier’s order, clearing the way for the informed-consent law to take effect. The court found that the state of South Dakota’s “evidence suggests that the biological sense in which the embryo or fetus is whole, separate, unique and living should be clear in context to a physician.”

Furthermore:


While the State cannot compel an individual simply to speak the State’s ideological message, it can use its regulatory authority to require a physician to provide truthful, non-misleading information relevant to a patient’s decision to have an abortion, even if that information might also encourage the patient to choose childbirth over abortion. Therefore, Planned Parenthood cannot succeed on the merits of its claim that [the informed consent law] violates a physician’s right not to speak unless it can show that the disclosure is either untruthful, misleading or not relevant to the patient’s decision to have an abortion.

And Planned Parenthood, the court decided, could not show that.

We now have two major U.S. courts in direct conflict. The Eight Circuit Court of Appeals upheld as biological fact the same statement that the New Jersey supreme court decided was simple ideology. This is a key constitutional question, which may soon be settled in Washington.
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rachelg
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« Reply #56 on: January 10, 2009, 04:29:00 PM »

Coitus Interceptus
http://www.slate.com/blogs/blogs/humannature/archive/2009/01/05/coitus-interceptus.aspx
Posted Monday, January 05, 2009 10:15 AM | By William Saletan

I'm just back from vacation and trying to catch up on the war in Gaza. More on that later. But first, something I didn't have a chance to get to before the break: the Vatican's latest pronouncement on fertility technology. Apparently the men in Rome are having trouble understanding some nuances of the female reproductive system.

The pronouncement comes in the form of Dignitas Personae, an instruction from the Congregation for the Doctrine of the Faith, which articulates official Catholic positions. This document covers several interesting topics, which I hope to get to in the days ahead. But the one that calls for rebuttal right away is the section on "[n]ew forms of interception and contragestation." It says:

    Alongside methods of preventing pregnancy which are, properly speaking, contraceptive, that is, which prevent conception following from a sexual act, there are other technical means which act after fertilization, when the embryo is already constituted, either before or after implantation in the uterine wall. Such methods are interceptive if they interfere with the embryo before implantation and contragestative if they cause the elimination of the embryo once implanted.

This is an astute and useful set of distinctions. Unfortunately, the CDF immediately proceeds to violate them. Here's its next paragraph:

    In order to promote wider use of interceptive methods [a footnote here specifies "morning-after pills"], it is sometimes stated that the way in which they function is not sufficiently understood. It is true that there is not always complete knowledge of the way that different pharmaceuticals operate, but scientific studies indicate that the effect of inhibiting implantation is certainly present, even if this does not mean that such interceptives cause an abortion every time they are used. ...

Really? Is the effect of inhibiting implantation "certainly present"? Let's review the mechanics of morning-after pills, specifically levonorgestrel, marketed as Plan B. The problem with the CDF's statement is that this "interceptive" is chemically identical to the best-known contraceptive: the pill. And the risk that this drug

    will prevent implantation of an embryo is purely theoretical. There is no documented case of such a tragedy, since we have no way to verify conception inside a woman's body prior to implantation without causing the embryo's death. Even theoretically, the risk is vanishingly small, since the primary effect of oral contraception is to prevent ovulation, and the secondary effect is to prevent fertilization. To classify oral contraception as abortifacient, one would have to posit a scenario in which the drug fails to block ovulation, then fails to block fertilization, and yet somehow, having proved impotent at every other task, manages to prevent implantation.

So, the assertion of an anti-implantation effect is theoretically unsound. But what do the data show? Two years ago, the world's leading expert on levonorgestrel, James Trussell, co-authored an analysis of the available research in the Journal of the American Medical Association. The analysis confirmed that that anti-ovulation effects wipe out any data suggesting a possible anti-implantation effect. It concluded:

    Published evidence clearly indicates that Plan B can interfere with sperm migration by altering the cervical and uterine environment, and that preovulatory use of Plan B usually suppresses the LH surge either completely or partially, which in turn either prevents ovulation or leads to the release of ova that are resistant to fertilization. Epidemiological evidence rules strongly against interruption of fallopian tube function by Plan B. Evidence that would support direct involvement of endometrial damage or luteal dysfunction in Plan B's contraceptive mechanism is either weak or lacking altogether. Both epidemiologic and clinical studies of Plan B's efficacy in relation to the timing of ovulation are inconsistent with the hypothesis that Plan B acts to prevent implantation.

In fact:

    Progestational drugs, including levonorgestrel, are used therapeutically in assisted reproduction because they increase the rate of successful implantation and pregnancy. That observation a priori reduces the likelihood that Plan B interferes with implantation; it even raises the counterintuitive but undocumented possibility that Plan B used after ovulation might actually prevent the loss of at least some of the 40% of fertilized ova that ordinarily fail spontaneously to implant or to survive after implantation.

So, in summary:

    [T]he ability of Plan B to interfere with implantation remains speculative, since virtually no evidence supports that mechanism and some evidence contradicts it. ... [T]he best available evidence indicates that Plan B's ability to prevent pregnancy can be fully accounted for by mechanisms that do not involve interference with postfertilization events.

So much for the question of effect. But what about the other part of the moral equation: intent? The Vatican document, still referring to morning-after pills, says that "anyone who seeks to prevent the implantation of an embryo which may possibly have been conceived and who therefore either requests or prescribes such a pharmaceutical, generally intends abortion."

But a woman who requests a morning-after pill doesn't necessarily seek to prevent an embryo's implantation. In fact, as we just showed, it would be irrational of her to seek that effect, since no evidence supports it. In fact, given the evidence, it would make just as much sense for her to request the pill in order to prevent embryonic loss. And anyone who has ever taken a morning-after pill knows that at that moment, your actual intent is to avert pregnancy at the earliest possible stage of the process, which happens to be ovulation.

Bottom line: The perceptive analytical framework established by Dignitas Personae, combined with the best scientific evidence and analysis, clearly implies that morning-after pills are contraceptives, not interceptives. Therefore, from the standpoint of respecting embryonic life, you may take them in good conscience
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rachelg
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« Reply #57 on: January 10, 2009, 04:30:30 PM »

http://www.nytimes.com/2009/01/05/nyregion/05abortion.html?pagewanted=print
For Privacy's Sake, Taking Risks to End Pregnancy
 
 
January 5, 2009
For Privacy's Sake, Taking Risks to End Pregnancy
By JENNIFER 8. LEE and CARA BUCKLEY

Amalia Dominguez was 18 and desperate and knew exactly what to ask for at the small, family-run pharmacy in the heart of Washington Heights, the thriving Dominican enclave in northern Manhattan. "I need to bring down my period," she recalled saying in Spanish, using a euphemism that the pharmacist understood instantly.

It was 12 years ago, but the memory remains vivid: She was handed a packet of pills. They were small and white, $30 for 12. Ms. Dominguez, two or three months pregnant, went to a friend's apartment and swallowed the pills one by one, washing them down with malta, a molasseslike extract sold in nearly every bodega in the neighborhood.

The cramps began several hours later, doubling Ms. Dominguez over, building and building until, eight and a half hours later, she locked herself in the bathroom and passed a lifeless fetus, which she flushed.

The pills were misoprostol, a prescription drug that is approved by the Food and Drug Administration for reducing gastric ulcers and that researchers say is commonly, though illegally, used within the Dominican community to induce abortion. Two new studies by reproductive-health providers suggest that improper use of such drugs is one of myriad methods, including questionable homemade potions, frequently employed in attempts to end pregnancies by women from fervently anti-abortion cultures despite the widespread availability of safe, legal and inexpensive abortions in clinics and hospitals.

One study surveyed 1,200 women, mostly Latinas, in New York, Boston and San Francisco and is expected to be released in the spring; the other, by Planned Parenthood, involved a series of focus groups with 32 Dominican women in New York and Santo Domingo. Together, they found reports of women mixing malted beverages with aspirin, salt or nutmeg; throwing themselves down stairs or having people punch them in the stomach; and drinking teas of avocado leaf, pine wood, oak bark and mamon fruit peel.

Interviews with several community leaders and individual women in Washington Heights echoed the findings, and revealed even more unconventional methods like "juice de jeans," a noxious brew made by boiling denim hems.

"Some women prefer to have a more private experience with their abortion, which is certainly understandable," said Dr. Daniel Grossman, an obstetrician with Ibis Reproductive Health in San Francisco, which joined Gynuity Health Projects in New York in conducting the larger study. "The things they mention are, 'It is easier.' It was recommended to them by a friend or a family member."

Dr. Carolyn Westhoff, an obstetrician at NewYork-Presbyterian/Columbia University Medical Center, said the trend fits into a larger context of Dominicans seeking home remedies rather than the care of doctors or hospitals, partly because of a lack of insurance but mostly because of a lack of trust in the health care system. "This is not just a culture of self-inducted abortion," she said. "This is a culture of going to the pharmacy and getting the medicine you need."

Physicians say that women can obtain the pills either through pharmacies that are willing to bend the rules and provide the medicine without a prescription or by having the drugs shipped from overseas.

It is impossible to know how many women in New York or nationwide try to end their pregnancies themselves, but in the vibrant, socially conservative Dominican neighborhoods of Upper Manhattan, the various methods are passed like ancient cultural secrets. In a study of 610 women at three New York clinics in largely Dominican neighborhoods conducted eight years ago, 5 percent said they had taken misoprostol themselves, and 37 percent said they knew it was an abortion-inducing drug. Doctors and community leaders say they have not seen any signs of the phenomenon disappearing, which they find worrisome because of concerns about the drug's effectiveness and potential side effects.

Sold under the brand name Cytotec, misoprostol is approved to induce abortion when taken with mifepristone, or RU-486; doctors also sometimes use it to induce labor, though it is not approved for that use. A spokesman for Pfizer, which manufacturers Cytotec, declined to comment beyond saying that the company does not support the off-label use of its products and noting that the label includes "F.D.A.'s strongest warning against use in women who are pregnant."

That warning, in capital letters, also notes that the drug "can cause abortion."

But it does not always do so, not least because notions of how best to use it vary from inserting several pills into the vagina to letting them dissolve under the tongue. The side effects can be serious, and include rupture of the uterus, severe bleeding and shock.

"We do worry because we don't know where women are getting the instructions from," said Jessica Gonzalez-Rojas of the National Latina Institute for Reproductive Health, which was also a partner on the Ibis study. "We imagine that there is misinformation on how to take it, which is why it could be hit or miss."

In 2007 in Massachusetts, an 18-year-old Dominican immigrant named Amber Abreu took misoprostol in her 25th week of pregnancy and gave birth to a 1-pound baby girl who died four days later; a judge sentenced her in June to probation and ordered her into therapy. In South Carolina in February, a Mexican migrant farm worker, Gabriela Flores, pleaded guilty to illegally performing an abortion and was sentenced to 90 days in jail for taking misoprostol while four months pregnant in 2004. A Virginia man, Daniel Riase, is serving a five-year prison sentence after pleading guilty in 2007 to slipping the pills into his pregnant girlfriend's glass of milk.

Researchers studying the phenomenon cite several factors that lead Dominican and other immigrant women to experiment with abortifacients: mistrust of the health-care system, fear of surgery, worry about deportation, concern about clinic protesters, cost and shame.

"It turns an abortion into a natural process and makes it look like a miscarriage," said Dr. Mark Rosing, an obstetrician at St. Barnabas Hospital in the Bronx who led the 2000 study, which was published in the Journal of the American Medical Women's Association. "For people who don't have access to abortion for social reasons, financial reasons or immigration reasons, it doesn't seem like this horrible thing."

Ms. Dominguez, for her part, said she had no insurance or money to pay for an abortion, and could not fathom getting one for fear her mother would find out. One of her friends had spent $1,200 on an abortion that left her with a uterine infection, and another friend endured the procedure without anesthesia, she said. In addition, Washington Heights is a tightknit community where abortion — as well as birth control — is shunned; if Ms. Dominguez were spotted entering a clinic, rumors could fly.

"There are scary moments, and you got to have a friend right next to you," said Ms. Dominguez, now 30 and a mother of four. "It's cheap but dangerous. Certain people are more delicate than others. But afterwards, I felt relief."

A friend of Ms. Dominguez's said her stepsister took the pills last year because she was in the country illegally, and worried that a doctor might turn her in. "She was just scared," the woman said, speaking on the condition that her name not be published to protect the stepsister's privacy. "She had no papers, no insurance, no nothing."

The woman went to a free clinic afterward to make sure the pills had worked (they had). Health care workers and other community leaders say such visits are how they discovered widespread illicit use of the drug as well as homemade potions.

Dr. Rosing said he learned about Cytotec during his residency at NewYork-Presbyterian/Columbia hospital in Washington Heights, where he saw a lot of Dominican immigrants with incomplete abortions in the emergency room. They spoke of taking the "star pill," a nickname for the hexagonal shape of one form of misoprostol. He suspected "that has to be the tip of the iceberg," he said, "and it was."

The pills allow pregnant women a degree of denial over what is taking place. Like Ms. Dominguez, many women in the neighborhood talk about the need to bring on — or "down" — their periods, not abortion. Afterward, they might tell doctors or relatives they had lost the baby.

The Planned Parenthood study concluded that women in both nations "seemed to see inducing the termination of pregnancy, or abortions, as a part of the reality of their lives," in a community where, as one interview subject put it, "we are all doctors." The report noted that in a culture steeped in machismo, birth control is generally seen as the woman's responsibility.

"If I introduce the condom into a relationship, I'm basically saying I've had somebody else, and I've not been faithful to you," said Haydee Morales, a vice president at Planned Parenthood of New York.

Debralee Santos, program director at Casa Duarte, a community arts organization in Washington Heights, said that while she had never had reason to distrust medical professionals, she understood the apprehensions that kept other women from seeking them out. "I get it, I really do," she said.

"It's a community that, even as it comes of age, always relies on itself first," explained Ms. Santos, who was born in the United States to immigrant parents. "Women, in particular, continue to help each other in ways that speak to tradition and solidarity."

Ms. Dominguez, who volunteers at Casa Duarte and is known as Flaca, Spanish for skinny, did not want her name or photograph published at first. But after some thought, she decided to allow it so more people would learn about the trap many pregnant Dominican women feel they are in.

"It's a health risk," she said. "There's a lot of girls in situations like that, and they're overwhelmed."
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rachelg
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« Reply #58 on: January 10, 2009, 04:45:33 PM »

http://www.chabad.org/theJewishWoman/article_cdo/aid/537403/jewish/Do-You-Wish-Mazal-Tov-to-a-Pregnant-Woman.htm
I think this article  clarifies the Jewish idea of pregnancy being a potential life.

Question:
I just found out that a friend is pregnant. She is quite observant so I want to do the right thing. Is it appropriate to say Mazal Tov to a pregnant woman?

Answer:
Conceiving a child is like conceiving an idea. A new idea is very exciting, but until it has been brought into the concrete world and actualized, it is too early to celebrate. So too with pregnancy.

Becoming pregnant is an awesome and wonderful event. The miracle of conception is the most natural supernatural occurrence, the most normal paranormal experience in the universe. But as exciting as becoming pregnant is, nothing has really happened. Pregnancy is a potential that is yet to be fulfilled, a prelude to something yet to arrive, a step towards a new life that is yet to come, a spark of an idea that is yet to be implemented.

Pregnancy is a potential that is yet to be fulfilled We would not throw a party for someone who had a good idea but has not yet followed it through. So we don't celebrate a pregnancy as we would other happy occasions, and we do not wish Mazal Tov to a pregnant woman. Mazal Tov is only appropriate when referring to something that has already occurred, while pregnancy is the expectation of something yet to come.

Rather than saying Mazal Tov, the appropriate wish to expecting parents is Beshaah Tovah - all should proceed at the right time: the pregnancy should be smooth, the baby should be healthy and the birth should be without complication. These are wishes for the future rather than blessings for the past, more a prayer than a congratulation.

This is also why many have a custom not to buy things for an unborn baby. This is not superstition. Just as the baby is still concealed, so is our joy and our celebration. When the baby comes out in the open, so will the gifts and the joy. Until then, we remain in a state of quiet happiness and prayerful optimism.

Becoming pregnant is a fantastic idea. When someone conceives, we pray that with G-d's help they should be blessed to implement it; Beshaah Tovah - all in the right time.
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G M
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« Reply #59 on: January 11, 2009, 09:01:07 AM »

http://hotair.com/archives/2008/10/30/planned-parenthood-admits-infanticide-happens/

Infantacide by any other name smells just as foul. Call it "choice" or "womens' health" or any other Orwellian terminology, if you will.
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DougMacG
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« Reply #60 on: January 11, 2009, 11:43:28 AM »

Quoting Rachel's post from 'the Jewish woman': "Conceiving a child is like conceiving an idea." - Oops, bad idea - stab, stab, stab.  No. Conceiving a child is NOT like conceiving an idea.

"Apparently the men in Rome are having trouble understanding some nuances ..." - "the men in Rome" - Is that the level of respect you would like to see posted about your faith?


"I need to bring down my period, ...She was handed a packet of pills...Ms. Dominguez, two or three months pregnant...swallowed the pills one by one... passed a lifeless fetus, which she flushed..." - Curious how we know the fetus was lifeless before or after 'passing'.  How would a live 2 month fetus look different before flushing.  I assume the same pills wrongly administered in wrong dosage to a newborn would have the same affect, just harder to flush.
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G M
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« Reply #61 on: January 11, 2009, 11:54:45 AM »

**Watch this documentary and tell me if the fetuses look like people, or just "masses of tissue".**
 
4-D Ultrasound Gives Video View of Fetuses in the Womb
Brian Handwerk
for the National Geographic Channel
and National Geographic News
February 25, 2005
 
The new generation of three- and four-dimensional ultrasound imagery provides striking views of fetuses inside the womb. Parents-to-be appreciate the lifelike pictures, and doctors gain an improved understanding of fetal development and behavior.

"It's almost a new science, in a way. It's taught us so much about how the fetus develops at an early stage," said Professor Stuart Campbell of the Create Health Clinic in London. Campbell, one of the world's leading experts in obstetrics, has been working with ultrasound technology since its earliest days and with so-called four-dimensional images since their debut about four years ago.

Four-dimensional imagery shows objects in 3-D moving in something close to real time. Doctors have long known that fetuses move, but the physical behavior revealed by 4-D scans is expanding that knowledge exponentially.

"We see the earliest movements at 8 weeks," Campbell said. "By 12 weeks or so they are seen yawning and performing individual finger movements that are often more complex than you'll see in a newborn," he said. "It may be due to the effects of gravity after birth."

The images reveal facial expressions, like smiling, at 20 weeks. Beyond 24 weeks fetuses may suck their thumbs, stick their tongues out (perhaps using newly developed taste buds to sample amniotic fluid imbued with the flavors of the mother's food), and make apparently emotional faces.

Many of the reflexes seem designed to help the fetus with tasks it will need after birth, such as opening its eyes and sucking.

Campbell believes that ever improving imagery—particularly the 4-D scans, which are inching ever closer to displaying real-time movement—represents the tip of the iceberg for fetal-behavior study.

"I think we ought to study the behavior of the fetus prenatally," he said. "For example, we don't understand why cerebral palsy occurs in 90 percent of the cases it does, but we believe it occurs in the uterus. I think the future lies in first-trimester diagnosis. I can see diagnosing abnormalities in the first 12 weeks."

Computer Advances Drive Improving Imagery

Ultrasound images are made by sending high-frequency sound waves into the mother's body, where they penetrate fluids but bounce back off solids. The rebounding waves are collected to produce an image, traditionally seen as a two-dimensional "slice."

"As computers have gotten faster it's possible for them to process many 2-D slices over a very short period of time and then stitch them together. That's how we got from 2-D to 3-D," said Carol Benson, a radiologist specializing in ultrasound at Brigham and Women's Hospital in Boston, Massachusetts.

"With the 4-D, processing is fast enough that you can watch [movement] as it happens. When it gets faster it will eventually appear to be in real time."

But 2-D images aren't going anywhere in the near future. In fact, they usually offer better diagnostic information than their 3-D and 4-D counterparts.

"2-D lets you see inside of structures, because you can take slices within [the fetus's body]," Benson explained. "With 3-D you can do a surface rendering, but you can't see inside the baby any better than I can see inside you."

But because the new kinds of scans are created from many stitched-together 2-D images, the 3-D and 4-D imagery represent a valuable diagnostic resource.

The new processes collect data for the entire volume of the fetus and womb. From this imagery, a more conventional, 2-D image can be separated out and can depict any and all desirable angles.

"When we're looking at the fetus or at the uterus, the position of these structures may not be in the ideal plane to get the information that we want," said Barry B. Goldberg, director of the Jefferson Ultrasound Research and Education Institute in Philadelphia, Pennsylvania.

"With these [new processes] it's possible to reconstruct [2-D cross sections] in different planes," he continued. "We can collect a volume of information, decide what plane we want, and manipulate the image plane to get [the visual] that will give us the most information."

Because the data can be stored on a computer, new slices can be created and examined long after the patient has returned home—though computer capabilities are currently too slow to allow this process to become standard procedure.

Third Dimension Offers Doctors a New View

A three-dimensional view can, in some cases, provide its own diagnostic advantages.

"For the first time it is now possible to visualize fetal organs as more than flat images but rather as three-dimensional objects that can be rotated and examined from different angles," said Wesley Lee, of the Division of Fetal Imaging at William Beaumont Hospital in Royal Oak, Michigan.

Lee stresses that 3-D images are a complement to, rather than a replacement for, 2-D ultrasound.

"[This] technology allows doctors to visualize ultrasound images in different ways that may strengthen or refute an initial diagnostic impression using more conventional tests," he said.

Such images are useful at identifying cleft lip, spina bifida, and some genetic syndromes.

As computers become more powerful and processing speed increases, the technology will only improve.

"We're really at the beginning, 3-D and 4-D image quality appears to be improving every month," the Jefferson Institute's Goldberg noted.

Future advances may allow the digital transfer of complete fetus and uterus volume scans. Such transfers of imagery could enable remote consultation and diagnosis for patients in areas lacking advanced health care.

Everyone agrees that the new scans already provide dramatically better visualization for parents, which can result in an even stronger parent-child bond. High-risk obstetrician and gynecologist Jude Crino is the director of the Perinatal Ultrasound Unit at the Johns Hopkins University School of Medicine in Baltimore, Maryland.

"We can see better, but it's also important that the patient can see better," he explained. "When I give a patient a 2-D image, it's not uncommon for them to ask two or three times, 'What is this? Could you point this out?' If you give them a 3-D image, they are immediately able to recognize it, because it looks like a baby."

Campbell notes that in his clinic the effects of the moving, 4-D images are even greater.

"You just see the whoops of joy when the fetus does something like blink," he said. "That's a very powerful impact."
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G M
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« Reply #62 on: February 05, 2009, 10:54:54 PM »

**Choice! No excess in the pursuit of "womens' health" can be criticized, right?**

02/05/09 02:15 PM
Fla. doctor investigated in badly botched abortion

By CHRISTINE ARMARIO
Associated Press Writer
Eighteen and pregnant, Sycloria Williams went to an abortion clinic outside Miami and paid $1,200 for Dr. Pierre Jean-Jacque Renelique to terminate her 23-week pregnancy.

Three days later, she sat in a reclining chair, medicated to dilate her cervix and otherwise get her ready for the procedure.

Only Renelique didn't arrive in time. According to Williams and the Florida Department of Health, she went into labor and delivered a live baby girl.

What Williams and the Health Department say happened next has shocked people on both sides of the abortion debate: One of the clinic's owners, who has no medical license, cut the infant's umbilical cord. Williams says the woman placed the baby in a plastic biohazard bag and threw it out.

Police recovered the decomposing remains in a cardboard box a week later after getting anonymous tips.

"I don't care what your politics are, what your morals are, this should not be happening in our community," said Tom Pennekamp, a Miami attorney representing Williams in her lawsuit against Renelique (ren-uh-LEEK') and the clinic owners.

The state Board of Medicine is to hear Renelique's case in Tampa on Friday and determine whether to strip his license. The state attorney's homicide division is investigating, though no charges have been filed. Terry Chavez, a spokeswoman with the Miami-Dade County State Attorney's Office, said this week that prosecutors were nearing a decision.

Renelique's attorney, Joseph Harrison, called the allegations at best "misguided and incomplete" in an e-mail to The Associated Press. He didn't provide details.

The case has riled the anti-abortion community, which contends the clinic's actions constitute murder.

"The baby was just treated as a piece of garbage," said Tom Brejcha, president of The Thomas More Society, a law firm that is also representing Williams. "People all over the country are just aghast."

Even those who support abortion rights are concerned about the allegations.

"It really disturbed me," said Joanne Sterner, president of the Broward County chapter of the National Organization for Women, after reviewing the administrative complaint against Renelique. "I know that there are clinics out there like this. And I hope that we can keep (women) from going to these types of clinics."

According to state records, Renelique received his medical training at the State University of Haiti. In 1991, he completed a four-year residency in obstetrics and gynecology at Interfaith Medical Center in New York.

New York records show that Renelique has made at least five medical malpractice payments in the past decade, the circumstances of which were not detailed in the filings.

Several attempts to reach Renelique were unsuccessful. Some of his office numbers were disconnected, no home number could be found and he did not return messages left with his attorney.

Williams struggled with the decision to have an abortion, Pennekamp said. She declined an interview request made through him.

She concluded she didn't have the resources or maturity to raise a child, he said, and went to the Miramar Women's Center on July 17, 2006. Sonograms indicated she was 23 weeks pregnant, according to the Department of Health. She met Renelique at a second clinic two days later.

Renelique gave Williams laminaria, a drug that dilates the cervix, and prescribed three other medications, according to the administrative complaint filed by the Health Department. She was told to go to yet another clinic, A Gyn Diagnostic Center in Hialeah, where the procedure would be performed the next day, on July 20, 2006.

Williams arrived in the morning and was given more medication.

The Department of Health account continues as follows: Just before noon she began to feel ill. The clinic contacted Renelique. Two hours later, he still hadn't shown up. Williams went into labor and delivered the baby.

"She came face to face with a human being," Pennekamp said. "And that changed everything."

The complaint says one of the clinic owners, Belkis Gonzalez came in and cut the umbilical cord with scissors, then placed the baby in a plastic bag, and the bag in a trash can.

Williams' lawsuit offers a cruder account: She says Gonzalez knocked the baby off the recliner chair where she had given birth, onto the floor. The baby's umbilical cord was not clamped, allowing her to bleed out. Gonzalez scooped the baby, placenta and afterbirth into a red plastic biohazard bag and threw it out.

No working telephone number could be found for Gonzalez, and an attorney who has represented the clinic in the past did not return a message.

At 23 weeks, an otherwise healthy fetus would have a slim but legitimate chance of survival. Quadruplets born at 23 weeks last year at The Nebraska Medical Center survived.

An autopsy determined Williams' baby - she named her Shanice - had filled her lungs with air, meaning she had been born alive, according to the Department of Health. The cause of death was listed as extreme prematurity.

The Department of Health believes Renelique committed malpractice by failing to ensure that licensed personnel would be present when Williams was there, among other missteps.

The department wants the Board of Medicine, a separate agency, to permanently revoke Renelique's license, among other penalties. His license is currently restricted, permitting him to only perform abortions when another licensed physician is present and can review his medical records.

Should prosecutors file murder charges, they'd have to prove the baby was born alive, said Robert Batey, a professor of criminal law at Stetson University College of Law in Gulfport. The defense might contend that the child would have died anyway, but most courts would not allow that argument, he said.

"Hastening the death of an individual who is terminally ill is still considered causing the death of that individual," Batey said. "And I think a court would rule similarly in this type of case."


 

 
 
Find this article at:
http://www.buffalonews.com/260/story/570428.html
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G M
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« Reply #63 on: February 06, 2009, 08:45:35 AM »

http://hotair.com/archives/2009/02/06/president-obama-infanticide-happens/comment-page-1/#comments

Moral blindness, thy name is Obama.
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Chad
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« Reply #64 on: March 13, 2009, 05:21:03 PM »

 cheesy

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G M
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« Reply #65 on: April 11, 2009, 10:33:45 AM »

http://hotair.com/archives/2009/04/11/choosy-choicers-choose-back-alley-abortions-in-china/

Choosy choicers choose back-alley abortions in China
POSTED AT 11:15 AM ON APRIL 11, 2009 BY ED MORRISSEY   


Legal Insurrection notes an interesting contradiction at the Center for Reproductive Rights.  In response to the demographic distortion that China’s one-child policy has produced, the CPR has called for an end to forced abortions and government imposition of reproductive policy.  So far, so good; we can broadly agree on those goals.  However, CPR also opposes gender-selective abortion, which is astoundingly hypocritical (emphases mine):

Our shadow letter underlined many areas of concern, including: harmful effects of the one-child policy such as forced abortion, coerced sterilization, and increased trafficking and abduction of women; limited access to infertility treatment; maternal mortality; sex-selective abortions; and deficiencies in sex education. The Committee, through its Concluding Observations, expressed concern over rights violations ensuing from these practices. It advised the Chinese government to investigate and prosecute instances of forced sterilization and abortion and to strengthen and enforce existing laws outlawing sex-selective abortion and female infanticide.

First, why not just protest infanticide in general?  Is it only a problem when female infants are killed through direct action or purposeful neglect?  I understand that the problem in China is focused on female infants, but if infanticide’s the problem, then we shouldn’t have to get gender-specific about the objection. Their objection looks specifically outcome-based rather than principled.

It seems CPR has a problem with choice that disproportionately disfavors females.  They don’t object to abortion, unless the woman chooses to abort in order to avoid giving birth to a female. But how is that choice any less legitimate than any other reason to procure an abortion?  For some, the gender relates to economic status and potential, criteria which in other contexts pro-abortion groups hail as rational considerations.

And doesn’t this negate the knee-jerk argument against outlawing abortions in general?  If women want to abort because they carry female babies, then won’t they get back-alley abortions if CPR succeeds in keeping gender-specific abortions illegal?  Shall we round up and arrest the mothers?  The doctors?  And if we can justify doing that for gender-specific abortions, why not do it for all abortions and stop the wholesale slaughter of human life altogether?

If one argues for a pro-choice position, then one would support all reasons for the choice.  If CPR and its allies support abortion based on outcomes rather than the supposed ideal of choice, then it’s fair to argue what outcomes they’re really supporting.
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DougMacG
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« Reply #66 on: April 13, 2009, 10:01:47 AM »

GM,  Your post about gender selection in China raises pro-choice questions that can't be answered rationally by the pro-choice crowd.  It keeps coming back to black and white choices of life and death.  The gray areas just don't fit well with the right or choice to selectively kill your offspring.  If you should be able to kill safely, properly and legally for timing, for convenience, for money reasons, and to kill the runt of the litter (e.g. down syndrome) etc. etc. then what moral line have you crossed by killing for gender selection.  Either IMO you concede you don't have a moral line to cross or protect in the law or you falsely believe abortion by choice is not killing off one of God's creatures. 

What other protected 'rights', I ask again, do we want to be safe, legal and RARE?  If abortion is safe and legal and at times a good thing for society, then why the outrage at the next step when other places, fully populated, make it mandatory?
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rachelg
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« Reply #67 on: May 22, 2009, 10:00:58 PM »

I am currently not interested in discussing abortion and I don't see that changing .

http://www.scienceandsensibility.org/?p=189
The Soaring Cesarean Rate: It’s the Economics, Stupid


The Soaring Cesarean Rate: It’s the Economics, Stupid
May 22nd, 2009 by Henci Goer No comments I was reading a Los Angeles Times article on the overuse of cesarean surgery when one quote leapt off the page at me. Said Dr. Elliot Main, chief of obstetrics of a California hospital chain, “Cesarean birth ends up being a profit center in hospitals, so there’s not a lot of incentive to reduce them.” This was not news to me. Some years ago, Susan Hodges of Citizens for Midwifery and I gave a joint talk on “Economic Disincentives for Mother-Friendly Childbirth,” a talk Susan later expanded into an article, but I never thought I’d see the day when a system insider acknowledged this.

The L.A. Times article didn’t elaborate on Dr. Main’s statement, but let’s take a cold blooded look at the business side of cesarean surgery: From the hospital’s point of view, cesareans - especially scheduled cesareans - make staffing needs predictable and maximize patient throughput, essential elements of reducing costs. They also increase billing opportunities and lengthen postpartum stay, which enhance revenues. On the obstetrician’s side, she or he may be paid more, although this isn’t always the case, but the real savings is in time management—and time is money. Minimizing time spent in the hospital allows obstetricians to increase patient load and, what’s more, deliver those patients at times that don’t conflict with office hours or disrupt nights or weekends. And both hospital administrators and obstetricians believe that cesareans prevent malpractice suits. In short, cesareans are good for everybody, except, of course, mothers and babies.

When a system makes it financially disadvantageous to change obstetric practice, it is human nature to find reasons to maintain the status quo, which explains why we see so many obstetricians, prominent and otherwise, downplay or deny cesarean’s harms, tout benefits that are minimal or nonexistent and generally frame cesarean surgery versus vaginal birth as “chocolate versus vanilla.” According to the American College of Obstetricians and Gynecologists, all an ob/gyn has to do is “believe” a cesarean is a good idea—never mind the reality—to make it ethical to perform one on a healthy woman. Small wonder that one in three U.S. women now has her baby via major abdominal surgery, a rate approaching three times what it should be, with no end in sight, and no one trying to do anything about it.

Well, that’s not quite true. The L.A. Times article cites the Institute for Healthcare Improvement’s Strategic Partners program. Despite the impressive title, it is merely a garden hose solution for putting out a forest fire. The best its program director could come up with from its clinical guidelines were recommendations to use oxytocin more carefully and hold off on elective deliveries until 39 weeks. The program director called the latter a “tipping point” and “culture change.” This would be funny if it weren’t so pathetic. Even this feeble reform attempt hasn’t generated much enthusiasm. In four years, only 60 hospitals have signed on, and the article didn’t say whether the program has yielded any meaningful improvements.

It isn’t as if we don’t know what to do. We have Lamaze’s Healthy Birth Practices, the Coalition for Improving Maternity Service’s Ten Steps to Mother-Friendly Childbirth, and now, Childbirth Connection’s Eight Steps to Reform Maternity Care. But as the maternity care system is currently organized and with the current reimbursement structure, a hospital would find it difficult to implement them and still keep its maternity unit open. If we hope to do anything meaningful about the cesarean rate, we need real culture change, and the tipping point will come when we somehow make vaginal birth an economically viable option. Change starts with understanding the barriers. In this case, it starts with not confusing cost-effective for the greater society with cost-effective for hospitals and doctors, much less with revenue generating.

For an excellent analysis of economic and other system barriers to maternity care reform, and recommendations for how to overcome them, download the report: Sakala, C., & Corry, M. P. (2008). Evidence-based maternity care: What it is and what it can achieve. New York: Milbank Memorial Fund.
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DougMacG
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« Reply #68 on: May 24, 2009, 02:22:12 PM »

"I am currently not interested in discussing abortion and I don't see that changing." - Rachel


During your break from this divisive issue, I offer to switch sides of the issue with you.  You would make a WONDERFUL Pro-Life advocate for the unborn life and I can personally attest to the inconveniences of having to raise a child as a single parent in difficult circumstances. 

The unplanned pregnancy with an unable mother and canceled abortion has been disruptive to me in so many way. Financially in costs and I had to sacrifice my career path.  Parenting takes up otherwise valuable time everyday as I drive my daughter to her activities constantly and look after her every need.  Did I mention braces now and college soon! OTOH, I am a little bit proud as I helped this blob of cells develop into a healthy, beautiful, outgoing, blue-eyed, smiling, red-haired girl, with a large, supportive, extended family on both sides, completing her first year of high school with straight A's, 3 sports letters, second chair viola in the top orchestra, first place ski racer, USTA tennis champion, performed at Orchestra Hall - sold out, and completed the confirmation program within her religion.  And won't clean her room.  I could go on.

Let me know if you think the switch will work.  smiley   - Doug
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JDN
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« Reply #69 on: May 24, 2009, 04:23:27 PM »

"has been disruptive to me in so many way..."
"Parenting takes up otherwise valuable time everyday..."
 
Ha!

You sound very lucky indeed.
And have every right to be VERY proud.
And, it sounds like she is very lucky too.


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