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First-degree murder and a charge of infanticide for “Baby Boy B” were thrown out. According to the grand jury report, Baby Boy B’s body was discovered at the clinic in the freezer during the raid in 2010. It was a 28-week-old male.http://www.cnsnews.com/news/article/gosnells-attorney-ludicrous-say-baby-born-alive-because-it-moves-one-time

 

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 Abortion Medications


1. Medication-Induced Fetal Demise (also known as “Feticide” or “Fetocide”): Generally used to refer to the use of medications, most commonly digoxin or concentrated potassium chloride (KCl) that are used to stop the fetal heart before doing an induction or surgical abortion. Fetal demise results in softening of fetal tissues and possibly facilitates extraction of the fetus. It is used before induction abortion to avoid the delivery of a live fetus. Potassium chloride injection can be used to reduce the number of fetuses in multiple gestations, such as reducing triplets to twins. In doing this to terminate an anomalous fetus, it is call “selective reduction” (SR) (see “multifetal pregnancy reduction” above).

2. Digoxin: Digoxin is a heart medication that sometimes is injected into the amniotic fluid or fetus to cause fetal demise before surgical or induction abortion (see Feticide). For both intra-amniotic and intra-fetal digoxin injection, a dose of 1 mg is common. Higher doses, up to 3 mg in the third trimester, are used by some clinicians, but the safety of larger doses has not been established in studies. Demise is less immediate than with KCl, but usually occurs within 24 hours.

3. Potassium Chloride (KCl): Potassium chloride (KCl) is a pharmacologic agent that is used to cause fetal demise before abortion. It also is used for multifetal pregnancy reduction (abortion of one or more fetuses while one or more are left viable in the uterus). KCl requires direct fetal intra-cardiac or intra-umbilical injection and is done under ultrasound guidance by specially trained physicians. KCl will not cause fetal demise when injected into the amniotic fluid, unlike digoxin. Injection of KCl into the fetal heart or umbilical cord typically stops fetal cardiac activity immediately.

4. Mifepristone: Mifepristone, a steroid related to progestin, works by blocking the activity of the body’s progesterone, a substance needed to continue pregnancy. (See Medical Abortion.)

5. Misoprostol: Misoprostol is a synthetic prostaglandin (PG E1) developed and manufactured in the U.S. for the treatment and prevention of stomach ulcers. Thousands of studies have evaluated its use in gynecology because it causes uterine contractions and cervical softening, or “ripening.” In the U.S., misoprostol is not FDA-approved for induction termination, but it is approved as part of the early medical abortion regimen with mifepristone. Misoprostol also is given to women before a surgical abortion or labor induction to achieve cervical ripening[1] and for treatment of excessive bleeding after an abortion or other uterine procedure. Misoprostol tablets are produced for oral use in doses of 100mcg and 200mcg, but have also been studied for various indications to be used vaginally, buccally (in the cheeks), sublingually (under the tongue) or rectally.

6. Vasopressin and Epinephrine: These medications cause constriction of blood vessels in the areas where injected. They sometimes are added to the cervical numbing medications. Vasopressin has been shown to reduce blood loss significantly from second-trimester dilation and evacuation abortions and decrease the need for reaspiration.

7. Oxytocin (Pitocin) and Methylergonovine Maleate (Methergine): These medications are uterotonic drugs that frequently are administered following second-trimester procedures to cause uterine contraction and decrease blood loss. They may be used either to prevent or to treat heavier bleeding.

G. Complications and Interventions

1. Post-Abortion Hemorrhage: A blood loss of 500 mL or bleeding requiring transfusion are commonly used definitions of post-abortion hemorrhage. Causes include incomplete abortion, uterine atony, placental abnormalities, perforation or uterine injury, cervical laceration, and bleeding disorders. Post-abortion hemorrhage occurs in approximately 0.8 per 100,000 abortions, with increased risk at more advanced gestations. Treatment depends upon the underlying cause of the hemorrhage, and may include uterine massage; re-aspiration; medications (such as prostaglandin F2a, oxytocin, misoprostol, methylergonovine, or vasopressin); a pressure balloon inside the uterus; surgery, including laparotomy for repair of perforation or hysterectomy; or uterine artery embolization by Interventional Radiology.

2. Cervical Laceration: A cervical tear most commonly resulting from the tenaculum, mechanical dilation or pressure on the cervix. Tears of the external cervix are the most common, are usually easy to repair and have little impact on the patient. Treatment options include observation alone; direct compression for 5-10 minutes; the application of silver nitrate, ferric subsulfate or other procoagulants (medications that cause blood clotting); or surgical repair using an absorbable suture. For higher cervical tears that extend inside the internal cervical os, or opening to the uterus, pressure with a balloon, uterine artery embolization or surgery may be needed. Although not entirely preventable, the risk of a cervical laceration can be lessened especially in later gestations by the use of osmotic dilators or cervical priming agents. The rate of occurrence is 0-1%.

3. Uterine Atony (or Uterine Hypotonous): Failure of the uterine musculature to contract normally after an abortion. This complication also is common after childbirth. The blood vessels supplying the pregnancy are severed when the placenta separates from the wall of the uterus. The bleeding that results from these severed vessels normally stops when the uterus contracts, compressing the vessels. However, if the uterus does not contract enough, bleeding can continue. Significant blood loss can result from a floppy, uncontracted uterus. Greater gestational age increases the risk of uterine atony. Treatment may include uterine massage, medications (uterotonics), placement of a pressure balloon or Foley catheter in the uterus, uterine artery embolization (temporary blockage of the uterine arteries by Interventional Radiologists) and surgery (most commonly hysterectomy).

4. Lower Uterine Segment Atony: The lower uterine segment is the inferior portion of the uterus that joins with the cervical canal and expands during pregnancy to become the lower part of the uterine cavity. This part of the uterus has less muscle tissue and is affected by scar tissue after a cesarean section. Even when the top of the uterus contracts well, atony of the lower segment can result in significant bleeding. Treatment is similar to that for all causes of uterine atony.

5. Placenta Accreta/Increta/Percreta

Placenta Accreta: Refers to the abnormally deep attachment of the placenta through the endometrium (inside lining of the uterus) and into the myometrium (the muscle layer of the uterus). It is present in 1-2 per 10,000 second-trimester abortions and usually produces hemorrhage during or after the procedure. It is rarely an issue before the second trimester. Placenta accreta frequently is associated with prior uterine surgery such as cesarean delivery and surgery to remove fibroids (myomectomy). When the condition is suspected before a procedure, preoperative planning helps to mobilize staff and have the proper equipment to handle treatment of hemorrhage, including uterine artery embolization or hysterectomy. “Accreta” often is used non-specifically to refer to any degree of abnormal placentation, but more strictly refers to the least deep invasion of the placenta, with deeper invasion becoming increasingly more difficult to treat.

Type

Invasion of placenta has occurred:
Accreta

Superficially onto the myometrium (uterine muscle)
Increta

Deep into the myometrium
Percreta

Through the myometrium
6. Endometritis/Post-Abortal Infection: Infection after abortion is uncommon. Studies demonstrate preventative antibiotics reduce infection risk after surgical abortion. Treatment with antibiotics may be done as an outpatient or in the hospital depending upon the severity of the infection. Sterile procedure is critical to prevent infection after surgical abortion but still does not completely prevent it.

7. Uterine Perforation: A hole usually caused by an instrument puncturing the uterine wall. Small holes caused by a smooth dilator may not require treatment other than observation or antibiotics. Holes that have been penetrated by forceps or suction usually require surgery to check for damage to other organs and to repair the hole and any other damaged organs.

8. Broad Ligament Hematoma: A blood clot collection (or hematoma) that results from a tear in the upper vagina, cervix, or uterus that disrupts the uterine or vaginal arteries. Blood collects in the limited yet expandable space to the side of the uterus.

9. Uterine Foley/Bakri Balloon: A balloon used to create pressure inside the uterus in cases of persistent bleeding when pharmacologic therapies have failed and before resorting to more invasive procedures, such as uterine artery embolization or surgery. An intrauterine pressure balloon also can serve to temporize before another surgical procedure or uterine artery embolization.

10. Uterine Artery Embolization: A procedure performed by a radiologist under X-ray guidance (fluoroscopy) where a small catheter is threaded through the largest artery in the groin to the uterine arteries and a substance is placed into the uterine arteries to block blood flow to the uterus. In the setting of post-abortion hemorrhage, the substance generally used is very temporary, so that it should be less likely to cause difficulties with future pregnancies.

11. Pregnancy Complications Seen During Abortion Care: Pregnancy complications seen during abortion care include ectopic pregnancy (pregnancy outside of the uterus, usually in the Fallopian tube) and molar pregnancy (an abnormal overgrowth of tissue that is supposed to develop into placenta, which may increase post-abortion bleeding and is associated with other medical risks).

http://californiaabortionlaw.com/wp/?page_id=135


                 

AUSTIN, Texas

Democrats block Texas abortion bill after senator’s 10-hour filibuster attempt

CORRIE MacLAGGAN

 

Published Wednesday, Jun. 26, 2013 01:49AM EDT

Last updated Wednesday, Jun. 26, 2013 07:38AM EDT

Texas state Democrats blocked a drive for new abortion restrictions on Wednesday after a marathon speech in the capitol in Austin caused some Republican backers of the bill to cast votes after a midnight deadline.

Democrat Senator Wendy Davis spoke for more than 10 hours in a bid to pull down the voting window on a measure that would place a ban on abortions after 20 weeks of pregnancy.

Her filibuster attempt stalled about two hours short of the deadline over a complaint that she violated rules, and the Republican-controlled Senate then began voting on the bill to cries of protests from spectators.

Republicans said they met the deadline but Lieutenant Governor David Dewhurst, after meeting with lawmakers, said some of their votes came in after midnight, the effective close for the 30-day special session.

Dewhurst also bemoaned the “unruly mob” at the capitol, according to the Dallas Morning News.

The bill called for stricter standards for abortion clinics.

Republican backers said it would protect women’s health and that the ban on late-term abortions would protect the fetus, based on disputed research that suggests pain is felt by 20 weeks of development.

Opponents said it would force nearly all Texas abortion clinics to close or be rebuilt.

Gilberto Hinojosa, chairman of the Texas Democratic party, said Davis displayed courage in her filibuster bid.

Davis, who began speaking at 11:15 a.m. local time, was prevented by procedural rules from deviating off-topic or taking a break by eating, leaning against her desk, sitting down or using the rest room.

Republicans tried to disrupt her by charging that she meandered off-topic and, at one point, received help adjusting a supportive back brace.

Davis whittled away chunks of time by reading testimony and messages from women and others decrying the legislation, reciting previously suggested changes to the bill and tapping into her own life history as a single mother at 19.

She said the bill would have choked off her own access to a local Planned Parenthood clinic.

“I was a poor, uninsured woman, whose only care was provided through that facility. It was my medical home,” said Davis, now 50, several hours into her speech.

Lieutenant Governor Dewhurst, who is Senate president, suspended the filibuster after roughly 10 hours, to cries of “let her speak” from supporters.

Democrats appealed the ruling, sparking a row over parliamentary rules.

After the session, Davis said on social media: “An incredible victory for Texas women and those who love them.”

But Republican Governor Rick Perry, a strong opponent of abortion, could still revive the proposal by calling the legislature into a new special session.

The U.S. Supreme Court legalized abortion nationwide in 1973, but conservative states have enacted laws in recent years that seek to place restrictions on the procedure, especially on abortions performed late in pregnancy.

Twelve states have passed 20-week bans, including two states where the bans take effect later this year, according to the Center for Reproductive Rights. Courts have blocked the bans in three of the 12 states – Arizona, Georgia and Idaho.

Earlier this month, the Republican-controlled U.S. House of Representatives passed a bill banning abortions 20 weeks after fertilization. The measure is extremely unlikely to become law because Democrats control the U.S. Senate and the White House.

The Texas proposal would allow exemptions for abortions to save a woman’s life and in cases of severe fetal abnormalities.

“In Texas, we value all life, and we’ve worked to cultivate a culture that supports the birth of every child,” Perry said.

The abortion debate simmers elsewhere in the United States.

North Dakota’s only abortion clinic on Tuesday filed a federal challenge to a new state law, the most restrictive in the country, one that would ban procedures to end pregnancy once a fetal heartbeat can be detected, as early as six weeks.

A Philadelphia jury last month convicted abortion doctor Kermit Gosnell of murdering three babies during abortions at a clinic in a high-profile case that focused national attention on late-term abortions.

 

http://www.theglobeandmail.com/news/world/texas-democrats-block-abortion-bill/article12821687/