Is “IDX” Really That Hard to Write?

Elena Kagan’s confirmation hearing was held last week, and the event unfolded fairly predictably. Even though Orrin Hatch has stated that he’ll vote against Kagan, and Jeff Sessions has made noises about a possible filibuster, the general consensus is that she’ll be confirmed. One issue did spark some controversy, however: Kagan’s writings on abortion. As an associate White House counsel during the Clinton Administration, Kagan was one of the staffers involved in the discussions of a potential ban on so-called “partial-birth abortion”

Much has been reported and opined about Kagan’s work on this issue, but whether the subject comes up in mainstream media, conservative publications, or liberal websites, one piece of the story remains consistent: the use of the term “partial-birth abortion.” The casual and pervasive use of this term clearly represents how anti-choice language has gained acceptance in the mainstream, particularly as it is not an actual medical procedure. What the misnomer refers to is intact dilation and extraction (IDX), a rare procedure[1] used only in the later stages of pregnancy, which is generally defined as the beginning of the third trimester. IDX is performed by dilating the woman’s cervix with the aid of medications and removing the fetus through the birth canal. To safely remove the fetus, it is necessary to reduce the size of the head, which is done through the physician making an incision at the base of the skull and inserting a suction catheter to collapse the skull. 

IDX is performed only when the woman’s life is in danger or after a diagnosis of fetal abnormalities incompatible with life. Medical organizations such as the American Congress of Obstetricians and Gynecologists (ACOG) have maintained that IDX is the safest method by which to perform a late-term abortion, and the method of delivery results in an intact fetus, which allows for both a measure of emotional closure – expectant parents have the ability to see and hold the fetus – and, in certain cases, for an autopsy to help determine the causes of the abnormalities.

When questioned about her writings and viewpoint on abortion, Kagan re-affirmed her belief in a woman’s right to choose. Her answers were lucid and concise, though perhaps a bit more vague than Court-watchers would have preferred. But oh, how sweet it would have been if just once, she had pointed out that for a committee so stuck on exact answers and proper terminology, the senators were quite comfortable asking her about a procedure that doesn’t even exist.


[1] According to “Abortion Incidence and Services in the United States in 2000,” by Lawrence B. Finer and Stanley K. Henshaw, Perspectives on Sexual and Reproductive Health Vol. 35 No. 1, January/February 2003, pp 6-15, in 2000, only 0.17% of all abortions were performed using intact dilation and extraction.

About Sarah:
Sarah's first book, Generation Roe: Inside the Future of the Pro-Choice Movement, will be out March 2013. For more information, follow her on Twitter @saraherdreich, or check out saraherdreich.com.