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Abortion opponents across the country are pushing for new laws governing medical professionals who perform the procedure.
Alabama recently enacted what’s considered to be the most restrictive abortion ban in the country, while Georgia and Louisiana have advanced bills that would ban the procedure after about six weeks.
In North Carolina, the bill under consideration isn’t a ban but a new directive for medical professionals.
Modeled after the "Born Alive Abortion Survivors Act" introduced in the U.S. Senate, NC’s Senate Bill 359 would require medical professionals to provide life-saving care specifically to infants who survive an abortion and to report instances of such births. Medical professionals and hospital employees who don’t comply with the law could face felony charges, prison time and up to $250,000 in fines.
The GOP-controlled state House and Senate approved the bill in April. Democratic Gov. Roy Cooper vetoed it and Republicans are now attempting to override his veto. A vote in the state House is scheduled for June 5.
Generally speaking, Democrats have opposed the bill on grounds that it would bring more bureaucracy into complicated medical situations and may discourage abortions that are medically necessary. Republicans, meanwhile, believe more should be done to prevent infant deaths and hold doctors accountable.
Amid debate on the bill, two key questions stand out.
First: Do infants born alive through the course of an abortion have legal protection? Yes. Experts told PolitiFact that they do.
Second: How often are babies born during a planned abortion, but then killed or neglected to death?
Cooper said the practice "simply does not exist." But statements by some bill supporters give the impression that it’s a common occurrence.
"These babies are sometimes left to die without medical care or, worse, helped to die by the very physicians who deliver them into the world," Tami Fitzgerald, executive director of the anti-abortion NC Values Coalition, said in a newsletter.
We found that there’s some evidence suggesting that infants occasionally survive abortion attempts, but reports are rare. And there’s even less hard evidence to suggest that, when infants do survive those attempts, they’re viable but killed by medical professionals or allowed to die.
"It’s hard to get accurate statistics because it’s illegal. So people won’t be happy to report things that are illegal," said Mary Ziegler, an attorney and professor at Florida State University College of Law. Ziegler is an attorney and author of two books on abortion who spoke to PolitiFact in a telephone interview.
The types of deaths targeted by the NC bill occur "to the point of almost never," she said. "At the end of the day, we don’t know. It would be wrong to say 100 percent it doesn’t happen. We don’t know. But for a variety of reasons, it’s almost impossible" to measure.
The lack of data is part of the reason why the NC bill includes a requirement that medical professionals start reporting such cases.
North Carolina tracks infant deaths but doesn’t know how many infants died after being born alive during a failed abortion, said SarahLewis Peel, spokeswoman for the NC Department of Health and Human Services.
"In 2017, there were zero deaths with an underlying cause of death of "Termination of Pregnancy," Lewis wrote in an email.
The North Carolina Medical Board also failed to identify any cases in which a physician was disciplined for allowing an infant to die, said Jean Fisher Brinkley, the board’s communications director.
In fact, PolitiFact found no report that chronicled the number of times that medical professionals have been disciplined for not providing care to infants who’d been born during or after an abortion procedure.
There is, however, a report on infants who were born alive during an abortion. It was published by the Centers for Disease Control and Prevention and is likely the most-frequently cited report in the "born alive" debate.
The CDC examined infant death certificates between 2003 and 2014 and identified 143 cases where the infant was born alive during an attempt to terminate the pregnancy. To put that in perspective: there were more than 9.3 million abortion procedures performed in the United States during that same 12-year period, PolitiFact Texas reported.
The details of the 143 cases in the CDC report are sparse. The report was generated using death certificates, which included more than 40 terms for describing the cause.
Here’s what we do know: 97 reportedly involved a maternal complication or a congenital anomaly. About 42 percent of the deaths occurred within an hour of birth, 54 percent occurred between one and 23 hours after birth, and about 4 percent of the deaths occurred a day after birth.
PolitiFact asked the CDC for state-specific data from its report on the 143 infants born alive, but a CDC spokesman said the agency can’t provide it.
SOME STATES TRACK
Six states — Arizona, Florida, Michigan, Minnesota, Oklahoma and Texas — attempt to track cases of babies who survive an abortion, FactCheck.org reported in March.
Minnesota appears to offer the most detailed reports on infants born alive during an abortion.
A 2017 report by Minnesota’s health department found that three infants were born alive during the course of an abortion in 2017, but later died (page 27 of the report: nando.com/53-). In two of those cases, no care was given. In one of those two, the infant’s vital signs were already weak.
Further information about the cases isn’t immediately available from the Minnesota Health Department, spokesman Doug Schultz told PolitiFact in an email. It’s also unclear whether the medical professionals in those abortion cases acted within the limits of the law.
"Providing additional information on specific cases would have to be carefully reviewed and likely would not be possible as the information could be potentially identifying. Penalty and prosecution of physicians are outside of our jurisdiction and we don’t have any information on that," Schultz said.
Elsewhere, Arizona health authorities in 2017 found that 10 infants were born alive during an attempted abortion between August and December of that year (page 21 of the report: nando.com/53z). Physicians submitted statements about the level of care provided in each case, but those statements aren’t detailed in Arizona’s report.
In 2013, Texas started requiring medical professionals to report cases where an infant was born alive after a failed abortion. There have been zero reported instances, PolitiFact Texas found earlier this year.
On conservative news sites and blogs, there are unsubstantiated stories about abortion providers who killed infants who were born alive. There are also stories about abortion clinic employees and what they’ve said about their operating procedures.
When it comes to proven cases of infanticide, Philadelphia abortion doctor Kermit Gosnell is perhaps the most well-known example. Gosnell was sentenced to life in prison for killing infants, some of whom were born alive.
There’s also the case of Sycloria Williams, who in 2006 went to an abortion clinic to try to terminate her 23-week pregnancy. The abortion didn’t happen. She gave birth, but her baby was neglected and died, according to the Associated Press, CNN and other media outlets.
Overall, media outlets — the New York Times, the Associated Press, Vox and FactCheck.org — have interviewed multiple experts who have reported that the situation outlined in the "born alive" bills is extremely rare.
By practice and law, living infants receive care, PolitiFact reported in a recent fact check of President Donald Trump.
Arthur Caplan, a bioethicist at New York University Langone Medical Center, told PolitiFact he is unaware of examples of "medically active killing," and that while "allowing to die does happen," it occurs "very rarely — say, a baby born with no lungs at 20 weeks."
Dr. Kristyn Brandi, a New Jersey OB-GYN with fellowship training in family planning and a board member of Physicians for Reproductive Health, told Vox that the Partial-Birth Abortion Ban Act of 2003 aims to prevent the scenario addressed in the "born alive" bills.
"If we did what these politicians are claiming we’re doing, we’re already breaking the law. No one is actually doing that," Brandi told Vox. "At least, I should say, no credible doctor or practitioner is doing anything anywhere even close to what they’re suggesting."
This story was produced by the North Carolina Fact-Checking Project, a partnership of McClatchy Carolinas, the Duke University Reporters’ Lab and PolitiFact. The NC Local News Lab Fund and the International Center for Journalists provide support for the project, which shares fact-checks with newsrooms statewide. To offer ideas for fact checks, email email@example.com.
North Carolina Senate Bill 359, also known as the "Born-Alive Abortion Survivors Protection Act," on ncleg.gov.
Telephone interview with Mary Ziegler, an attorney and professor at Florida State University College of Law.
Email correspondence with SarahLewis Peel, spokeswoman for the NC Department of Health and Human Services.
Email correspondence with Minnesota Health Department spokesman Doug Schultz.
Email correspondence with Jeff Lancashire, a spokesman for the CDC’s National Center for Health Statistics.
NC Values Coalition newsletter emailed on April 16, 2019.
Statement issued by Gov. Roy Cooper on April 18, 2019.
FactCheck.org, "The Facts on the Born-Alive Debate," posted March 4, 2019.
Congress.gov, "Partial-Birth Abortion Ban Act of 2003."
Arizona Department of Health Services report, "Abortions in Arizona: 2017," published Sept. 21, 2018.
Florida Agency for Health Care Administration reports on Infants Born Alive.
Minnesota Department of Health report, "Induced Abortions in Minnesota, January-December 2017: Report to the Legislature," published July 1, 2018.
CNN, "Charges filed against clinic co-owner in abortion case," published March 4, 2009.
The Guardian, "Philadelphia abortion doctor sentenced to three life terms in jail," published May 15, 2013.
NPR, "Louisiana lawmakers approve strict abortion limit, Dem. governor says he will sign it," posted May 29, 2019.
News & Observer, "NC House schedules vote on 'born alive' abortion bill," posted May 29, 2019; "As abortion bills advance nationwide, where does NC's 'born alive' bill stand?" posted May 15, 2019; "Abortion laws are changing across the US. Here's a state-by-state guide, and what it means," posted May 15, 2019.
Centers for Disease Control and Prevention report, "Mortality Records with Mention of International Classification of Diseases-10 code P96.4 (Termination of Pregnancy): United States, 2003-2014," re-posted at CDC.gov on April 11, 2016.
PolitiFact, "Are abortion survivors covered by existing laws?" posted April 19, 2019; "No infant has been reported 'born alive' after an abortion in Texas," posted April 18, 2019; "Donald Trump repeats, falsely, that doctors, mothers decide to execute live babies after birth," posted April 29, 2019.
New York Times, "Trump repeats a false claim that doctors 'execute' newborns," published April 28, 2019; "'Executing babies:' Here are the facts behgind Trump's misleading abortion tweet," published Feb. 26, 2019.
Associated Press, "Trump fact check: babies executed after failed abortions. He's oversimplifying, AP finds," posted to USAToday.com on May 13, 2019; "Doctor investigated in badly botched abortion," posted by NBCNews.com on Feb. 5, 2009.
Vox, "What's missing from the coversation about later abortions, explained by a doctor," published April 29, 2019.