Senate split on abortion procedure Hearings open today on bill to ban late-term practice

November 17, 1995|By Sandy Banisky | Sandy Banisky,SUN NATIONAL STAFF

Political disputes over abortion aren't new. But with the Partial-Birth Abortion Ban Act, up for Senate hearings today, supporters and opponents disagree on everything but the bill's punctuation.

They argue over what, exactly, the term "partial-birth abortion" means; how often the procedure is done, and whether a ban is constitutional.

And they disagree on whether Congress, instead of doctors, should be regulating a medical procedure.

The bill would ban what both sides agree is a grim form of late-term abortion. Abortion opponents say the practice is unnecessary. Abortion-rights backers say it sometimes offers women the safest way to end a doomed pregnancy.

Doctors who do the procedure call it "intact dilation and evacuation," and it is used only in the last months of pregnancy. The doctor begins delivery of the fetus feet first. The physician then inserts an instrument into the fetus' skull to pull out the brain, making the skull collapse to allow easier passage through the birth canal and limiting the risks to the woman.

How often is the procedure used?

Rarely, according to abortion-rights backers. Too often, abortion opponents say.

Both sides concede there are no figures to back either position.

In 1992, the last year for which the Alan Guttmacher Institute has statistics, about 1.5 million abortions were performed in the United States. Nearly 90 percent of those were performed in the first trimester, the safest time for a woman to end a pregnancy.

Only .04 percent, or about 600, were performed in the third trimester, according to the Guttmacher statistics. It's not clear how many of those were intact dilation and evacuations, because doctors aren't required to report which procedure was used.

Abortion rights advocates say intact dilation and evacuation is used only in late-term pregnancies where the fetus has profound defects or the woman's health is in danger.

Dr. David Nagey, director of maternal-fetal medicine at the University of Maryland, said the procedure is so rare that he's seen it done only twice in his 20 years of practice -- both times "where the baby had horrible hydrocephalus and no brain we could identify."

In both cases, he said, a Caesarean section would have put the woman at higher risk of bleeding, infection and hysterectomy.

But Douglas Johnson, legislative director of the National Right to Life Committee, said he has evidence that the procedure is used more often than his opponents allow -- to end unwanted pregnancies as well as troubled ones.

"The fact that it's a small proportion of abortions is irrelevant to this argument," he said. "For each little girl who ends up at the pointed end of the scissors, it's a 100 percent proposition."

Besides the dispute over the procedure itself, the partial-birth abortion bill sets up another discussion: Who should decide which medical procedures are appropriate?

"One of the dangerous aspects of this debate is that Congress is stepping in to regulate the practice of medicine," said Arthur Caplan, director of the University of Pennsylvania Center for Bioethics.

Legislatures indeed have addressed medical issues, he said, setting limits on sterilization, for example, and banning euthanasia. But this measure is unique, Dr. Caplan said, in attempting to ban one kind of operation when the general practice, abortion, is legal.

"I understand why people object to this technique," he said. "It's awful, one heck of a last resort, used only under the most desperate circumstances. But the general precedent is you don't want your congressman coming into the operating theater and telling the surgeon, 'Do it this way, not that way.' "

Right to Life's Mr. Johnson, however, says he did not hear anyone raise the issue of congressional meddling when Rep. Patricia Schroeder, the Colorado Democrat who favors abortion rights, introduced a bill that would ban female circumcision.

Viki Wilson, a registered nurse in Fresno, Calif., said she had a dilation and evacuation in her ninth month of pregnancy because doctors assured her it was the safest way to end a doomed pregnancy.

In April 1994, she had a nursery stocked with gifts from two baby showers when prenatal tests showed the fetus she was carrying had two-thirds of her brain growing outside the skull and had no chance of survival.

"I wanted to end her suffering," said Ms. Wilson, wife of a doctor and mother of two.

Her doctors said that a Caesarean was risky and inducing labor was not an option because the fetus' head was so large it could not pass through the birth canal.

She was referred to a doctor who performed the intact dilation and evacuation, using not scissors but a spinal needle. The Wilsons named the child Abigail, baptized her and held a funeral.

"I'm not advocating every woman terminate her pregnancy when she's dealt this," Ms. Wilson said. "But if this is no longer available, God help those families who have to go through this."

Last month's House debate on the bill, to the dismay of abortion-rights groups, was accompanied by graphic illustrations and descriptions.

Mr. Johnson said he wants the public to hear partial-birth abortion described and to see what it involves. "This is going to be a revelation for many Americans and may well make them take another look at Roe vs. Wade," the 1972 Supreme Court decision that established the right to abortion.

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