[WikiEN-l] Major Correction

Eileen EileenE at gmx.net
Mon Oct 27 18:54:32 UTC 2003


As per a suggestion by Jimmy Wales <jwales at bomis.com>  I wish to bring this
matter to your attention.

I did try a correction earlier in the 'edit this entry' function but I
believe the edit I am suggesting is a little more than it can handle.

TIA Eileen

RE: 
http:/en.wikipedia.org/w/wiki.phtml?title=Intact_dilation_and_extraction

I am unsure of the procedure for making the type of changes that this page
requires in order to make it accurate.  This is obviously a subject which has
been subjected to a great deal of controversy and dare I say propaganda and
this has led to a great deal of erroneous information disseminated as fact.

There are a number of major errors in the Wikipedia entry describing the D&X
abortion procedure.  The most glaring error is the statement that this sis a
late term abortion.  While it might be described as a late abortion,
performed around the middle of the pregnancy, it is certainly almost never performed
"Late Term" which is the last third of the pregnancy or to be technically
correctly after 26.6 weeks.  This procedure would usually be impossible to
perform that late in the pregnancy.

I also note the use of "birth canal" to describe the vagina as if a woman
had an exit chute on her baby factory; and the use of "womb" in place of
'uterus'. Both these terms, and the misstatement of the time the procedure is
performed, lead me to believe the article was mainly written by somebody opposed
to abortion who was more interested in getting a subtle message out then
actually providing honest information.  Since we are describing a medical
procedure appropriate medical/biological terminology which is well understood by the
general population is the appropriate vocabulary.

May I suggest reading this article before using the term "PBA" as loosely as
it is used in your current entry.
http://womensenews.org/article.cfm/dyn/aid/499/

I have linked Dr. Haskell's paper on my web site.  To the best of my
knowledge since this was presented at a public forum and also was presented into
evidence at a Senate hearing it would be considered "public domain' so there
really is no reason you may not add it to your papers if you so desire.

I have redone your page and would be happy to discuss any corrections you
see needed.  You have my full permission to use the page as I have amended it
since much of the work on its creation had already been done by you.

Thank you for your consideration in this matter and I look forward to
hearing from you.  I would prefer to retain my anonymity, since I have been
subjected to threats in the past, but would suggest that if you are interested in
confirming the facts as I presented them Dr. Haskell would probably be your
best source,

Eileen E
EileenE at GMX.Net

Cada niño un niño querido.
Chaque enfant un enfant voulu.
Jedes Kind ein gewünschtes Kind.
Cada criança uma criança querida
Ogni bambino un bambino desiderato.
Every child a wanted child.

http://www.eileene.cjb.net

________________________________________________________________________
_________Amended Intact dilation and extraction - Wikipedia page_______
________________________________________________________________________
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<div id='article'><h1 class='pagetitle'>Intact dilation and
extraction</h1><p class='subtitle'>From Wikipedia, the free encyclopedia.
<br><small>Find out how you can help <a
href='http://wikimediafoundation.org/fundraising'
class='internal'>support</a> Wikipedia's phenomenal growth.</small>

<p><a name="top"></a><p><table border="0" id="toc"><tr><td align="center">
<b>Table of contents</b> <script
type='text/javascript'>showTocToggle("show","hide")</script></td></tr><tr id='tocinside'><td align="left">
<div style="margin-bottom:0px;">
<A CLASS="internal" HREF="#Definition">1 Definition</A><BR>
</div>
<div style="margin-bottom:0px;">
<A CLASS="internal"
HREF="#Circumstances_in_which_the_procedure_is_performed">2 Circumstances in which the procedure is performed</A><BR>
</div>
<div style="margin-bottom:0px;">
<A CLASS="internal"
HREF="#Legal_and_political_situation_in_the_United_States">3 Legal and political situation in the United States</A><BR>
</div>
<div style="margin-left:2em;">
<A CLASS="internal" HREF="#About_the_terminology">3.1 About the
terminology</A><BR>
<A CLASS="internal" HREF="#Efforts_to_ban_the_procedure">3.2 Efforts to ban
the procedure</A><BR>
</div>
<div style="margin-bottom:0px;">
<A CLASS="internal"
HREF="#Legal_and_political_situation_in_the_United_Kingdom">4 Legal and political situation in the United Kingdom</A><BR>
</div>
</td></tr></table><P>
<H2><a name="Definition">Definition</a></H2>
<p>
<strong>Intact dilation and extraction</strong> is a mid-term or second
trimester <a href="/wiki/Abortion" title="Abortion">abortion</a> technique in
which the patient's <a href="/wiki/Cervix" title="Womb">cervix</a> which is the
muscle ring that controls entry to the <a href="/wiki/Uterus"><b>  uterus
</b></a> is dilated and the <a href="/wiki/Fetus" title="Fetus">fetus</a>
extracted in substantially one piece.  The term <em>"dilation and extraction"</em>
or <em>"D&X"</em> was coined in 1992 by Dr. Martin Haskell to describe a
variation on the more common Dilation and Evacuation (D&E - see below).  At the
same time roughly Dr. James McMahon, since deceased, developed a similar but
substantially different procedure procedure which could be used later in the
pregnancy and he used the term <em>"intact dilation and evacuation"</em> to
identify it. Dr Haskell's procedure eventually became known by the term
<em>"intact D&X"</em> which was the name he used to describe it when he<a
href=http://eileen.undonet.com/Main/7_R_Eile/Haskell_Desc.html><b> presented a  paper
</b></a> on the procedure to his peers in 1992.
<p>
<H2><a
name="Circumstances_in_which_the_procedure_is_performed">Circumstances in which the procedure is performed</a></H2>
<p>
Intact D&X procedures are performed by only a small number of abortion
providers currently and for this reason they are much less common than the D&E
procedure which is the preferred second trimester method in the USA.  They are
most frequently used in the second trimester between weeks 18 and 21 of
pregnancy.  Only about 0.01% of abortions are performed after this point so this
makes the D&X even more rare after week 21.  They may be performed during the
third trimester of <a href="/wiki/Pregnancy" title="Pregnancy">pregnancy</a>
if they are possible and one of the requirements would be that the fetus be
small for gestational age (SGA). This is because the head, the largest part of
the fetus, must be made small enough to permit it to be extracted through the
minimally dilated cervix.  After the second trimester the head is normally
too large for such a procedure and further dilation of the cervix might damage
the cervix and compromise future pregnancies for the woman.

This procedure is chosen when the physician performing the abortion has the
skills needed and may be the procedure of choice when:
<ul><li>The fetus is <a href="/wiki/Dead" title="Dead">dead</a>. 
</li><li>The fetus is alive, but continued pregnancy would place the woman's
life in severe danger.
</li><li>The fetus is alive, but continued pregnancy would grievously damage
the woman's health and/or disable her.
</li><li>The fetus is so malformed that it can never gain consciousness and
will die shortly after birth.
</li><li>The fetus is alive, but the woman wishes to end her pregnancy for
non-medical/psychological reasons.
</li><li>The woman has for reasons of her own requested that her pregnancy
be terminated before the fetus is viable in states where this is legal. Most
states do not legally permit abortions past the point of viability, usually
considered to be 23/24 weeks today.
</li></ul><p>
One of the fetal defects which fall into this category is <a
href="/wiki/Hydrocephalus" title="Hydrocephalus">hydrocephalus</a> which physicians refer to
as a neuralk tube defect. Approximately 1 in 2,000 fetuses develop
hydrocephalus while in the uterus; this is about 5,000 a year in the <a
href="/wiki/United_States" title="United States">United States</a>. The defect is not
usually discovered until late in the second <a href="/wiki/Trimester"
title="Trimester">trimester</a> of pregnancy.
<p>
If a fetus develops hydrocephalus, the <a href="/wiki/Head"
title="Head">head</a> may expand to a size of up to 250% of the radius of a newborn <a
href="/wiki/Skull" title="Skull">skull</a>, making it impossible for it to perform
a removal through the  <a href="/wiki/Vagina" title="Vagina">vagina</a>. In
such a case, the <a href="/wiki/Physician" title="Physician">physician</a> may
elect to perform an intact D&X procedure by draining off the fluid from the
<a href="/wiki/Brain" title="Brain">brain</a> area, which permits the fetal
skull to collapse and the bones in the skull to slide over each other, then
withdrawing the dead fetus through the partly dilated cervix. You might think
of this as rtrying to remove an inflated baloon through a small hole in a
paper bag without tearing the bag.  Once the baloon is deflated the removal is
easy. A type of caesarian section delivery, called a hysterotomy, may allow the
delivery of a hydrocephalic fetus although such major surgery, with its
inherent dangers, is not always in the best interest of the woman.  Furthermore
the hysterotomy may leave a scar that is easily ruptured in future
pregnancies.
<p>
In the 2 to 3 day procedure, the <a href="/wiki/Cervix"
title="Cervix">cervix</a> is dilated. The fetus is delivered feet-first, facing toward the
woman's spine. The <a href="/wiki/Surgeon" title="Surgeon">surgeon</a> inserts a
sharp object into the soft opening at the bottom of the fetal head just above
the neck, and then inserts a vacuum tube through which the brains and its
fluids are extracted. The head of the fetus contracts at this point and allows
the fetus to be more easily removed from the <a href="/wiki/Uterus"
title="Uterus">womb</a>. The fetus can then be removed with less damage to the woman.
The technique was pioneered by Dr. <a
href="/w/wiki.phtml?title=Martin_Haskell&amp;action=edit" class='new' title="Martin Haskell">Martin Haskell</a> in <a
href="/wiki/1992" title="1992">1992</a>.
<p>
Intact D&X procedures are not performed during the first trimester, because
there are better ways to perform abortions. There is no need to follow such a
procedure because the fetus' head is quite small at this stage of gestation
and can be quite easily removed from the woman's uterus.
<p>
<H2><a name="Legal_and_political_situation_in_the_United_States">Legal and
political situation in the United States</a></H2>
<p>
<H3><a name="About_the_terminology">About the terminology</a></H3>
This procedure is often referred to as "<a
href="/wiki/Partial-birth_abortion" title="Partial-birth abortion">partial-birth abortion</a>" among the media
and among pro-life groups although there has never been a medical
description of this "partial birth abortion" procedure and such descriptions as have
been written into legislation have been continually found unconstitutional
because they can describe a number of different abortion procedures. In the
medical field intact dilation and extraction is sometimes referred to as a <em>D&X
procedure</em> (not to be confused with the much more common variation
<em>D&E procedure</em> (<a
href="/w/wiki.phtml?title=Dilation_and_evacuation&amp;action=edit" class='new' title="Dilation and evacuation">dilation and
evacuation</a>.)
<p>
<H3><a name="Efforts_to_ban_the_procedure">Efforts to ban the
procedure</a></H3>
Since <a href="/wiki/1995" title="1995">1995</a>, led by Congressional <a
href="/wiki/United_States_Republican_Party" title="United States Republican
Party">Republicans</a>, the <a
href="/wiki/United_States_House_of_Representatives" title="United States House of Representatives">U.S. House of
Representatives</a> and <a href="/wiki/United_States_Senate" title="United States
Senate">U.S. Senate</a> have moved several times to pass measures banning the
procedure.  After several long and emotional debates on the issue, such measures
passed twice by wide margins, but <a href="/wiki/United_States_President"
title="United States President">President</a> <a href="/wiki/Bill_Clinton"
title="Bill Clinton">Bill Clinton</a> <a href="/wiki/Veto" title="Veto">vetoed</a>
those bills in April 1996 and October 1997 on the grounds that they did not
include health exceptions.  Subsequent Congressional attempts at overriding the
veto were unsuccessful.
<p>
On <a href="/wiki/October_2" title="October 2">October 2</a>, <a
href="/wiki/2003" title="2003">2003</a>, with a vote of 281-142, the <a
href="/wiki/United_States_House_of_Representatives" title="United States House of
Representatives">House</a> again approved a measure banning the procedure. Through this
legislation, a doctor could face up to two years in prison and face civil
lawsuits for performing such an abortion. A woman who undergoes the procedure
cannot be prosecuted under the measure. On <a href="/wiki/October_21"
title="October 21">October 21</a>, <a href="/wiki/2003" title="2003">2003</a>, the <a
href="/wiki/United_States_Senate" title="United States Senate">United States
Senate</a> passed the same bill by a vote of 64-34.  The measure does not
contain health exemptions, just the same as previous ones considered by the US
Supreme Court.  It remains to be seen whether the Supreme Court will also find
the language in the bill (Called S3 in the Senate) too broad to actually
describe an identifiable medical procedure so that physicians who perform
abortions will know exactly what is being banned and what they may and may not do
when performing such surgery. Either or both grounds, health exception and
vague terminology, would permit an appeal to the Supreme Court eventually and if
found valid would render the legislation unconstitutional.
<p>
The <a href="/wiki/American_Civil_Liberties_Union" title="American Civil
Liberties Union">American Civil Liberties Union</a> and the <a
href="/w/wiki.phtml?title=National_Abortion_Federation&amp;action=edit" class='new'
title="National Abortion Federation">National Abortion Federation</a> planned to file a
lawsuit challenging the constitutionality of the October 2, S3, bill. Courts
have struck down several similar state statutes.
<p>
<H2><a name="Legal_and_political_situation_in_the_United_Kingdom">Legal and
political situation in the United Kingdom</a></H2>
<p>
Questioned about UK government policy on the issue in <a
href="/wiki/Parliament_of_the_United_Kingdom" title="Parliament of the United
Kingdom">Parliament</a>, ministers of the <a href="/wiki/British_government#Government"
title="British government">British government</a> have stated (for example, on <a
href="/wiki/May_12" title="May 12">May 12</a>, <a href="/wiki/2003"
title="2003">2003</a>) that although this method of abortion would be legal if judged
appropriate, "We are not aware of the procedure referred to as 'partial-birth
abortion' being used in Great Britain."
<p>
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