2 peer review of the 2 attached PowerPoint 1200 words. due 5/2/21

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PoilicyPP1.pptx

Born Alive Abortion Survivors Protection

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S. 123 Born Alive Abortion Survivors Protection

This bill was first introduced to the House on January 28, 2021 by Benjamin Sasse who was the primary sponsor for this bill. The purpose of the bill was “to amend title 18 to prohibit a health care practitioner from failing to exercise the proper degree of care in the case of a child who survives an abortion or attempted abortion” (GovTrack.us., 2021). The language of the bill explains that if an abortion results in the live birth of a baby, the baby is a legal person according to the law of the United States. Any baby born in a hospital, clinic, or other places is considered a person and protected under law. This bill is designed to protect those babies who were unsuccessfully aborted. It also mandates reporting to state of federal law enforcements of any violations of not caring for these tiny humans by admitting them to the hospital. Anyone violating this law could suffer consequences for their actions. It is of my belief that there should be required documentation and reports of all abortion procedures as well as consequences for those medical professionals that do not admit those babies who survived into the hospital

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Problem Statement: Late Term Abortions

Late term abortions would be considered any pregnancy past 20 weeks gestation. There are not any mandates or regulations on reporting any abortion. “There is no national requirement for data submission or reporting” (Centers for Disease Control and Prevention, 2020). States and facilities voluntarily report their data to the CDC, making statistics inconsistent. According to the CDC, less than one percent of abortions are considered late term (CDC, 2020). Yet, reports do not specify the exact gestation age, so anything past 20 weeks is only voluntarily reported as late term. Advances in medicine have allowed babies born as early as 22 weeks to live. The survival rate at 22 weeks is 5.1%, 23.6% at 23 weeks, 54.9% at 24 weeks, 72.0% at 25 weeks, and 81.4% at 26 weeks (Johnston, 2019). As one can see, there is a major difference in the chances of survival for a baby born at 22 weeks compared to 26 weeks. I believe there should be a more accurate way to collect data across the states. If there was a unified process that details the specifics to each abortion, then certain policies and laws may be justifies and make more sense. Law makers need concrete evidence and statics before any regulations can be implemented

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Problem Statement Reporting

“Homicide is when one human being causes the death of another” (Cornell Law School, n.d.). This is where situations dealing with late term abortions may get complicated. A baby that was not expected to live but does, may not get lifesaving care. According to title 18, a baby is considered a legal person outside of the womb. The homicide law could apply in such cases as failed late term abortions, yet abortion documentation reports lack vital details. Only twenty-eight states require providers to report post abortion complication, while only six states require providers to report whether the fetus was viable (Guttmacher Institute, 2021). Without mandated reporting and streamlined documentation of procedures, homicide charges may be difficult to prove. As of 2019, nine states were required to report a live birth after a failed abortion (Semelsberger, 2020). This is where the amendment to title 18 comes in to protect those babies who may have a second chance at life. Consistency of documentation and reporting is not just for seeing the “bad” side of abortion but also create ways to improve upon abortion care and improved contraception. Statistics should especially be gathered for those late term abortions, not only for improvements, but also to ensure quality care. This reporting of such statistics and record keeping should fall under the non-maleficence principle of nursing. So while it may seem this record keeping and reporting is to condemn abortions, it could actually improve upon such hot topic situations. Then law makers can really evaluate all of the facts

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Background

Currently there is some protection for a viable baby born alive. A 2002 bill passes that defined born alive as “the complete expulsion or extraction from his or her mother of that member, at any stage of development, who after such expulsion or extraction breathes or has a beating heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, regardless of whether the umbilical cord has been cut, and regardless of whether the expulsion or extraction occurs as a result of natural or induced labor, cesarean section, or induced abortion” (Robertson, 2019). So why amend title 18? S.123 wants to go a step further and propose that not only is this infant a person, who is protected, but also maximize its protection of being a legal person. This amendment outlines legal consequences of snipping the spinal cords, not trying to keep them alive, doing nothing for these infants, or basically killing them. Yet, if these infant survivors are legally considered a person, there are already laws in place for acts of homicide. According to a law professor in Florida, “most criminal laws are at the state level not the federal” (Robertson, 2019). The S. 123 amendment would make the penalties uniform for those health care professionals violating title 18. At the same time, S.123 still seems redundant.

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S. 123 Impact

Healthcare Access: S. 123 will not have any impact on the current access to healthcare.

Healthcare Cost: S.123 does not address who will pay for the neonate, as treating a baby in the NICU can be very expensive. “Surviving infants born at 24 weeks were $297, 627” for a 109.6 day stay in the neonatal intensive care unit (Barry, 2018).This does not include the extensive amount of money for post discharge from the NICU procedures, therapies, follow up appointments, and so on.

Healthcare Quality: S. 123 will improve the quality of healthcare given to the neonate survivor, who possibly have no healthcare

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Landscape Stakeholders, Lobbyist, and Interest Groups

Nancy Pelosi refuses to allow the bill a chance to be voted on in the House of Representatives (Angelson, 2021). This extension to Title 18 has historically been supported by many Republicans and a few Democrats. This is most likely because the majority of Republicans are Pro-Life. Planned Parenthood, Center for Reproductive Rights, and Susan B Anthony List are among many that are lobbying the Born-Alive Abortion Survivors Protection Act (OpenSecrets.org, n.d.). This bill may be part of the abortion world, but it is beyond the typical pro-choice and pro-life debates.

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Option 1

If S. 123 passes, procedures and protocols will need to be created to implement this bill. This isn’t a black and white bill, but one that is suggesting the first steps to protect those who survive an abortion. Abortion data will need to be more accurate and reported upon in order to evaluate the quality of this bill. This could be a potentially be an expensive bill due to collecting the data, creating new policies and procedures, and most of all the care of these fragile neonates.

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Option 2

In order for this to pass, more accurate data is needed to make a final decision for amending Title 18. Only six states report their live abortion statistics. Is this bill worth passing when maybe mandated reporting and better record keeping should be implemented first to have a better picture of this particular topic. With more data, maybe this bill would be unnecessary, or it will prove there is a need for this bill in the healthcare. This would be a more neutral approach for both sides of this issue.

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Option 3

There is already a law in place and this amendment would be unnecessary. It would be extremely costly to implement and would be met with many more hurdles to overcome when it comes to caring for a neonate’s life. How is this neonate cared for? To what extremes? Who is the guardian? Who is responsible for paying for care? How is the mom notified? What paperwork and documentation is needed? What other specialties would be involved in such cases? How many neonates survive abortions or is this bill based upon a few exceptions to the rule? Between Title 18 and homicide laws, S. 123 would be redundant.

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Recommendation

Born-Alive Abortion Survivors Protection amendment to title 18 is a valuable policy that I believe should be put into place until improvements are made to gathering necessary and consistent data about abortions. This bill would clarify the current laws in place and a move in the right direction of addressing viable neonates born alive after an abortion. Not much is known about late term abortion in the sense that very few states report on live births after a failed abortion. The statistics reported from the CDC combine all abortions after 20 weeks gestation into the late term category when in actuality, the chances of living doubles between the 23 and 24 weeks gestation and climb exponentially thereafter. These babies born are legally and ethically a person and should be protected. Once better reporting and data gathering is implemented, S. 123 may not be needed as technically it falls under the homicide laws, but until then, this policy makes sense for those born living.

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References

Angelson, R. (2021, April 14). Latta Signs Discharge Petition to Force House Vote on Born-Alive Abortion Survivors Protection Act.Bab Latta. Retrieved from https://latta.house.gov/news/documentsingle.aspx?DocumentID=402446

Barry, M. B. (2018, April 30). Abortion At or Over 20 Weeks’ Gestation: Frequently Asked Questions. Congressional Research Service. Retrieved from https://fas.org/sgp/crs/misc/R45161.pdf

Centers for Disease Control and Prevention. (2020, November 25). Reproductive Health. Retrieved from https://www.cdc.gov/reproductivehealth/data_stats/abortion.htm

Cornell Law School. (n. d.) Homicide. Retrieved from https://www.law.cornell.edu/wex/homicide

GovTrack.us. (2021). S. 123 — 117th Congress: Born-Alive Abortion Survivors Protection Act. Retrieved from https://www.govtrack.us/congress/bills/116/s130

Guttmacher Institute. (2021, March 1). Abortion Reporting Requirements. Retrieved from https://www.guttmacher.org/state-policy/explore/abortion-reporting- requirements

Johnston, R. W. (2019, April 15). Data On Late-Term Abortions In the United States. Retrieved from http://www.johnstonsarchive.net/policy/abortion/late_term_abortion_usa.html

OpenSecrets.org. (n. d.). Clients Lobbying on H.R. 962: Born-Alive Aboertion Survivors Protection Act. Retrieved from http://www.opensecrets.org/federal- lobbying/bills/summary?cycle=2020&id=hr962-116

Robertosn, L. (2019, March 4). The Facts on the Born-Alive Debate. FactCheck.org. Retrieved from https://www.factcheck.org/2019/03/the-facts-on-the-born- alive-debate/

Sajadi-Eranazarova, K. R., Martinez, C. L. (2020, November 18). Abortion Complications. StatPearls. StatPearls Publishing: Treasure Island, FL. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430793/

Semelsberger, C. (2020, August). Born-Alive Abortion Survivors: Just the Facts. Retrieved from ttps://downloads.frc.org/EF/EF19E62.pdf

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