Born Alive Abortion Survivors Protection 1 z 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 2 z 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 3 z 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 vit ...

1. Born Alive
Abortion Survivors Protection
1
z
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
2
z

2. 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
3
z
Problem Statement
Reporting
“Homicide is when one human being causes the death of
another” (Cornell Law School, n.d.). This is where situations

3. 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
4
z
Background
Currently there is some protection for a viable baby born alive.

4. 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.
5
z
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.

5. Healthcare Quality: S. 123 will improve the quality of
healthcare given to the neonate survivor, who possibly have no
healthcare
6
z
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.
7
z
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

6. 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.
8
z
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.
9
z
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.
10
z

7. 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.
11
z
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?Docume

8. ntID=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/abortio
n.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

9. ttps://downloads.frc.org/EF/EF19E62.pdf
12
z
Health Policy Analysis
1
Executive summary/Introduction
The proposal that will be discussed in this Health Policy
Analysis is called the IL- H.R. 136: Breath of Fresh Air Act.
Bill introduced to establish a grant program for nebulizers that
extends out to secondary school and elementary school.
The purpose was to secure the grant program mentioned in the
proposed bill. The bill explains the significant number of
individuals who have asthma and related deaths and the bill is
designed to address epidemic by securing the proposed grant
program that will allow the use of the nebulizers to help
improve health outcomes.
Asthma’s prevalence continues to grow nationwide: it is critical
to be addressing the potential health hazard this can have on the
community through funding of needed treatments.
My recommendation for action:
Support this proposed bill as by addressing the ongoing issue of
asthma related deaths and exacerbations we will be lowering
annual health care costs for the nation as well as potentially
preventing treatable deaths such as the asthma related deaths.
I would recommend funding the bill through the federal
government in hopes to reduce these associated costs and
asthma related deaths..
(H.R. 136: Breath of Fresh Air Act , 2021)

10. 2
Problem Statement
With the prevalence and growth of asthma as well as asthma
related deaths in addition to associated health care cost it is
imperative to take action to help not only reduce these costs
which often are associated with emergency room visits but also
to reduce the asthma related deaths that are occurring.
3
Background
Asthma prevalence is higher in high income countries
Asthma begins in childhood quite often.
In a number of developed countries (Dharmage, Perret, &
Custovic, 2019) discusses, since 1960’s there has been a sharp
increase in asthma prevalence and even in low-income countries
globally there still has been a statistically increase in asthma
prevalence since the early twentieth century as well.
(Dharmage, Perret, & Custovic, 2019)
4
Background
Dr. Gennaro D’Amato a doctor in the division of respiratory and
allergic diseases department of chest diseases in a highly
specialized hospital in United States.
Over 300 publications related to asthma.
Suggest that absence of asthma action plans nationwide as well
as under-prescription of preventor medication is of national
concernment. He states there is a deficiency when it comes to
the appropriate action needed to be taken during an acute

11. respiratory crisis related to asthma nationwide. (D'Amato et al.,
2016)
(D'Amato et al., 2016)
5
Background
Healthcare Access
(Enilari & Sinha, 2019) determined that trends suggest global
asthma levels are increasing with 100 million new cases being
anticipated within the next ten years, this was seen in study
done by (Dharmage, Perret, & Custovic, 2019) as well.
Providing nebulizer treatments to the nations schools will help
to increase healthcare access even if it is at the school.
Increasing availability of treatments is increasing availability of
healthcare access.
(Enilari & Sinha, 2019)
6
Background
Healthcare Quality
The mortality rate of asthma still remains a global issue (Enilari
& Sinha, 2019) notes and specifically to the U.S. as well that
needs to be addressed and that causes thousands of lives lost per
year that are entirely preventable.
No improvements in mortality rates for asthma have been
observed within the last decade.
Healthcare quality will be positively impacted:
Allowing for available treatments when necessary
Will help to prevent exacerbations that are currently suspected
of occurring

12. (Enilari & Sinha, 2019) ; (Naja, Permaul, & Phipatanakul, 2018)
7
Background
Health Care Cost
The cost of asthma care has increasing implications in health
care expenditures (Nunes, Pereira, & Almeida, 2017).
Leads to as many emergency room and hospital visits per year
as two million each of which cost an estimated $1,500 per visit.
Many of these trips could be prevented with proper knowledge
and accessibility of proper treatment.
Poor asthma control leads to higher levels of hospitalization and
directly proportionate to the direct costs associated with asthma
care but work and school loss accounted for the greatest
percentage of indirect costs that are associated with asthma
care.
Health Care cost decreased:
Due to decreased exacerbations, hospital and ER visits will also
decrease plummeting these associated costs
With less flare ups and exacerbations less school w ill be
missed, less medications may have to be taken, etc.
All factors considered in relation to this have implications in
the decreased health care cost
(Nunes, Pereira, & Almeida, 2017)
8
Landscape
The first interest group that will potentially support this
proposal would be the caregivers of the children with asthma:

13. Typically have uncontrolled bouts of asthma leading to:
ER visits
High healthcare costs
Poor child health
This group will support this bill to not only lower their
potential overall healthcare cost annually through decreased
hospital admission, but as well as allowed the children to live
healthier lives by providing necessary treatment when it is
needed.
9
Landscape
The second interest group would be the emergency department
nurses:
Interest group that will support this bill as this group is able to
see:
High admission rates for asthma exacerbations that are currently
ongoing and rising
Associated healthcare costs with these needless admissions
This interest group also has an interest in:
Wanting the population to be healthier as a whole
To keep the emergency room census decreased for those with
unpreventable life-threatening illnesses or diseases.
10
Landscape
The third interest group would be outpatient clinicians:
Also affected by the increasing asthma prevalence and
exacerbation rates that are occurring nationwide.
This group is affected similarly as the emergency department
group is and will have similar motivations:
Interest group that will support this bill as this group is able to
see:
High admission rates for asthma exacerbations that are currently

14. ongoing and rising
Associated healthcare costs with these needless admissions
11
Landscape
Interest groups that will be opposing this bill:
Those that may potentiall y be at liability to help pay for this
proposal
The recommendation is to get federal funding
Perhaps interest groups tied to those federal funds would be
interesting in opposing this issue as to afford more resources for
their own causes and needs.
12
Option 1
Utilization of asthma action plans nationwide could help to
provide the framework for standardized nebulizer treatments:
An asset related to this option is the implementation of action
plans for asthma related health incidences will not only
strengthen the likelihood of adopting this proposal but also it
will most likely serve as a general purpose to help decrease
asthma related deaths nationwide.
A negative aspect that comes from this particular option is the
amount of work and unlikelihood of actually reforming the
current standards of asthma action plans that the nation has
undergone, currently there is no movement to start this reform
and this is likely the biggest con this option will face.
13
Option 2
Providing upstream thinking and actions when it comes to

15. asthma prevention as a nation:
This mental shift may help to influence the legislative process
moving forward in regards to this proposal.
A major benefit of this particular option would be that upstream
thinking would help to prevent these high associated health care
costs as well as in general allowing for a healthier national
population.
Another benefit is there is no education required necessarily,
just a change in the way things are thought about and addressed.
A major negative aspect of this option is changing the current
stigma behind the view of the severity of asthma, as this is
viewed as a less severe disease then many and due to this there
is a lack of interest in providing efforts in upstream thinking.
14
Option 3
Educating the public and the health care community specifically
on the increase in prevalence of this disease and its related
deaths:
A major benefit of adopting this option is there is the
possibility to provide upstream thinking, education as well as
potentially impacting the future of the national asthma action
plans.
Education can take place and increase one’s knowledge without
requiring any kind of prerequisite as stated and this is a major
benefit of this option
A negative aspect of this option that is to be reviewed would be
obtaining platforms that allow for this information to be
effectively spread throughout the public in order to help
legitimize this proposal as well as in general just providing
good educating on this epidemic.
15

16. Recommendation
Educating the public and the health care community specifically
on the increase in prevalence of this disease and its related
deaths is the option that I personally would recommend for this
policy:
Option preferred due to fact there is required action to be taken
first prior to the options being able to be rolled out.
A major benefit of adopting this option is there is the
possibility to provide upstream thinking, education as well as
potentially impacting the future of the national asthma action
plans.
A negative aspect of this option that is to be reviewed would be
obtaining platforms that allow for this information to be
effectively spread throughout the public in order to help
legitimize this proposal as well as in general just providing
good educating on this epidemic.
Due to these reasons for all intents and purposes this option
would be the easiest to mobilize and to facilitate.
16
Recommendation
By spreading education and information to the school
community we can help to impact when the disease is caught
and how quickly steps can be taken to help prevent any further
exacerbations as well as potentially helping to catch any new
cases of occurrences that may happen to any undiagnosed
students.
It is crucial to understand that when educational actions are
taken against and for asthma there is a raised level of
knowledge of the disease among the participants in schools.
With school education it is proposed that issues, such as
external health causes, violence, alcohol, tobacco, and other
drugs and healthy eating, in addition to illnesses of public

17. interest, make up the general content as to what is beneficial to
be discussed and how asthma can be best avoided, to minimize
the risk.
(Coelho et al., 2016)
17
References
Carvalho, C., Barretto C., Souza-Machado, C., & Souza-
Machado, A. (2016). The Impacts of Educational Asthma
Interventions in Schools: A Systematic Review of the
Literature. Canadian respiratory journal, 2016,
8476206. https://doi.org/10.1155/2016/8476206
D'Amato, G., Vitale, C., Molino, A., Stanziola, A., Sanduzzi,
A., Vatrella, A., Mormile, M., Lanza, M., Calabrese, G.,
Antonicelli, L., & D'Amato, M. (2016). Asthma-related
deaths. Multidisciplinary respiratory medicine, 11, 37.
https://doi.org/10.1186/s40248-016-0073- 0
Dharmage, S. C., Perret, J. L., & Custovic, A. (2019).
Epidemiology of Asthma in Children and Adults. Frontiers in
pediatrics, 7, 246.
https://doi.org/10.3389/fped.2019.00246
Enilari, O., & Sinha, S. (2019). The Global Impact of Asthma in
Adult Populations. Annals of global health, 85(1), 2.
https://doi.org/10.5334/aogh.2412
H.R. 136: Breath of Fresh Air Act. (2021). Retrieved from
https://www.govtrack.us/congress/bills/117/hr136
Naja, A. S., Permaul, P., & Phipatanakul, W. (2018). Taming
Asthma in School-Aged Children: A Comprehensive
Review. The journal of allergy and clinical immunology. In
practice, 6(3), 726–735.
https://doi.org/10.1016/j.jaip.2018.01.023
Nunes, C., Pereira, A. M., & Morais-Almeida, M. (2017).

18. Asthma costs and social impact. Asthma research and
practice, 3, 1. https://doi.org/10.1186/s40733-016-0029-3
18