Conservative attacks on Obama's old vote against Illinois' Born Alive Infant Protection Act (BAIPA) have been percolating online for months, and burst into the mainstream Saturday, when Rick Warren asked the candidate about his position on BAIPA at the Saddleback Church forum (see Sarah Posner's latest for more on that). Today the New York Times weighs in with a piece parsing the language of the two separate "born alive" bills that Obama opposed in the Illinois state senate: The first, which NARAL did not oppose and which has a federal antecedent, would have defined as a "child" any fetus "born alive" during either a birth or abortion, making it a crime for doctors to withhold medical care from such babies, regardless of their eventual viability outside of the womb. The second bill would have allowed legal action against hospitals, doctors, and nurses that did not provide such care, and is the one pro-choice groups were more concerned about. They worried it would create a climate of fear in which practitioners would not perform abortions or complicated births because of the legal risks.

I first wrote about Obama, the anti-choice movement, and BAIPA in March, for RH Reality Check. Undoubtedly, NARAL made a smart political move when it decided not to oppose BAIPA; nobody wants to be painted as the cold-hearted group or individual who opposes life-saving interventions for babies. But if you're scratching your head about the intent of these bills -- wouldn't any doctor be compelled to save the life of any baby? are fetuses really "born alive" during abortions? -- you're not alone. It's worth going into some detail to clarify how BAIPA operates as a classic anti-choice strategy, distorting the very nature of abortion in order to horrify the public and erode support for choice.

In order for a fetus to be "born alive" during an abortion, that fetus would have to be removed from the womb relatively intact. But 90 percent of abortions are performed through aspiration (usually in the first 16 weeks of pregnancy), in which a surgical vacuum is used to empty out a woman's uterus. The vast majority of the remaining 10 percent of abortions consist of dilation and evacuation, which is usually performed after 16 weeks of pregnancy, often when a woman's health or life is at risk. Under that procedure, the aspiration process is sometimes preceded by an injection into the abdomen that ensures fetal demise. 

The kind of abortion BAIPA really targets is so-called "partial birth abortion," or dilation and extraction, which accounts for less than one-fifth of one percent of all American abortions. It is used most often to end wanted pregnancies in which expectant parents learn their baby will not be viable outside of the womb. During the operation, the fetus' skull is collapsed inside of the woman, after which labor is induced and she delivers the fetus. Difficult stuff, and not a procedure any woman or doctor undergoes lightly or happily. That's why so few of these operations take place each year. But here the fetus is removed intact. Under BAIPA, this would open up doctors and nurses performing dilation and extraction to accusations of delivering "live" babies. It would be almost impossible to make such a claim when the result of an abortion is an aspirated mass of blood and tissue.

What is BAIPA? It's not a bill about babies at all -- doctors are already required to save babies' lives, and any ethical doctor would do so. BAIPA is a bill meant to reshape the language we use to talk about abortion and mislead the public about the possible outcomes of typical abortion procedures.

--Dana Goldstein

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