“[Constitutionally protected] abortion . . . has never been understood . . . to include taking the life of a partly born child."

—U.S. Catholic Conference

“A criminal statute banning any medically safe method of abortion unduly infringes upon women’s rights.”

—Abortion Access Project

Abortion is one of the most persistently controversial issues in American culture and politics today. Since the 1973 national legalization of abortion, competing groups have fought to either restrict or increase access to the procedure, leading to heated debates among political activists, religious organizations, state legislatures, and judges.

This conflict is perhaps reflective of the nation’s ambivalence over abortion. While it is often depicted as a two-sided debate, the abortion controversy is actually quite multifaceted, involving complex speculation on biology, ethics, and constitutional rights. Those who identify themselves as pro- life, for example, generally contend that abortion is wrong because it kills human life, which they believe begins at conception. However, some pro-lifers grant that abortion should be allowed in cases of rape or incest, or when the pregnancy threatens the life or health of the mother. Those who identify themselves as pro-choice often maintain that abortion must remain legal because a woman should have the right to control her body and her destiny. But some pro-choicers also believe that there should be certain restrictions on teen access to abortion and on abortions occurring after the first trimester of pregnancy. This mixture of opinions is probably why Gallup polls consistently show that 50 to 60 percent of Americans favor abortion “only under certain circumstances.”

The continuing debate over a relatively new form of second-trimester abortion called intact dilation and extraction (D&X) reveals the complexity of American opinion on the subject. Referred to as “partial-birth abortion” by its opponents, D&X is usually performed on women who are between twenty and twenty-four weeks pregnant, ostensibly when the fetus has severe defects or when the pregnancy endangers the mother’s health. During the procedure, the doctor delivers all but the head of the fetus from the uterus, then uses scissors to cut a hole in the base of the fetus’s skull so that its contents can be removed. This allows the fetus’s head to collapse so that it can more easily pass through the cervical opening.

Opponents of D&X maintain that it is a grisly and immoral procedure akin to infanticide. At twenty-four weeks, they contend, more than 50 percent of fetuses are potentially viable (able to survive outside of the womb). Moreover, as Illinois physicians M. LeRoy Sprang and Mark G. Neerhoff claim, the procedure is hardly ever performed as a result of a medical emergency: “The vast majority [are] done not in response to extreme medical conditions but on healthy mothers and healthy fetuses.” They point out that 56 percent of partial-birth abortions are done as a result of “fetal flaws . . . some as minor as a cleft lip,” while 9 percent involve maternal health problems, “of which the most common [is] depression.”

Abortion-rights supporters assert that the vast majority of abortions are performed in the first trimester, with only 1.4 percent occurring after twenty-one weeks of pregnancy: approximately two thousand per year. Some contend that the furor over a relatively rare procedure, which became a focal point for anti-abortion activism in the 1990s, was at heart an attempt to sway public opinion against the more common types of abortion. However, most of the physicians who perform D&X abortions grant that the majority of such procedures are elective and not medically necessary.

These revelations about the D&X procedure disquieted Americans on all sides of the debate. New York Times polls taken in 1997 concluded that between 54 and 71 percent of Americans opposed late-term abortions. However, another 1997 poll commissioned by the Republican Coalition for Choice found that 82 percent of the public believed that the D&X option is a “medical decision that should be made by a woman, her doctor, her family, and her clergy.” These seemingly contradictory poll results reflect public distaste over the procedure as well as a reluctance to cede individual rights, claims Coalition for Choice president Susan R. Cullman: “People say, ‘It’s an awful procedure. I can’t stand it. Get rid of it.’ But when you say, ‘If you’re in this predicament, do you want doctors to give you options"’ the answer is, ‘Of course.’”

The D&X procedure did not exist in 1973, when the Supreme Court’s Roe v. Wade decision held that a woman’s right to privacy—including the right to choose to end a pregnancy in the first two trimesters—was protected by the Fourteenth Amendment. However, the Court’s 1992 decision in Planned Parenthood v. Casey did allow states to set certain kinds of limits on access to abortions. Under Casey, as long as no “undue burden” is placed on women seeking abortions, states can regulate access to the procedure. As a result, many state legislatures enforced restrictions on abortion, including laws that significantly limited or banned the D&X procedure. In addition, between 1995 and 2000, Congress passed several bills attempting to impose a nationwide ban on D&X abortions—although each of these bills was vetoed by President Bill Clinton.

In June 2000, in a 5-to-4 decision, the U.S. Supreme Court struck down a Nebraska ban on partial-birth abortions. Justice Stephen Breyer argued that the state’s law was unconstitutional because it did not include any exceptions for protecting the health of the mother and because the overly vague language of the law could have been used to ban the more common types of second-trimester abortions. The ruling leaves open, however, the possibility that a more clearly defined D&X ban could some day gain the approval of the Court.

The complex ethical and legal debate over abortion shows no sign of abating as activists, legislators, and judges continue to ponder if and when the procedure should be regulated. Abortion: Opposing Viewpoints explores this and several other contentious issues in the following chapters: Is Abortion Immoral? Should Abortion Rights Be Restricted? Can Abortion Be Justified? Is Abortion Safe? The authors in this anthology present compelling arguments concerning the morality, accessibility, purpose, and effect of abortion.