Late-term abortions unlikely to end Prohibition: If the Senate decides to override President Clinton's veto and enact a ban on "partial-birth abortions," women still will be able to get late-term abortions that use different, less gruesome techniques.

Sun Journal

September 26, 1996|By Jonathan Bor | Jonathan Bor,SUN STAFF

As early as today, the U.S. Senate will vote on whether to ban "partial-birth" abortions. To do so, it must join the House of Representatives in overriding a veto by President Clinton. But even if the Senate approves the ban, it is unlikely to end abortions performed in the late stages of pregnancy.

A congressional ban would end one particular procedure that voices on both sides of the abortion debate agree is the most gruesome and distasteful of all methods used to end pregnancies.

In this method, the fetus is usually delivered feet first until all but its head has emerged. Then a vacuum hose sucks brain tissue from the skull, collapsing the head so it too can be withdrawn.

Just about everything in this latest chapter of the abortion debate is in dispute, including the procedure's name.

Anti-abortion forces use the phrase "partial-birth" because it drives home their message that the fetus is "inches away" from being born alive. Abortion-rights activists use the term "intact dilation and evacuation" -- "intact D&E" -- because it is clinical, free of moral taint.

Whatever the name, the procedure is usually done after the 20th week -- that is, the second half of pregnancy. For some people, this makes the issue particularly wrenching because with modern medical techniques, physicians can now save a small fraction of premature babies born in the 23rd or 24th week. And for this reason, some people consider this the threshold of fetal viability.

The National Right to Life Committee estimates that there may be "thousands" of these "partial-birth" abortions performed each year in the United States. Most abortion-rights groups contend that the number is more likely in the hundreds.

Almost 90 percent of the 1.5 million abortions performed each year in the United States take place in the first trimester of pregnancy, according to the Alan Guttmacher Institute. These are performed using a suction device to remove the fetus.

Between 13 and 20 weeks, abortions may be done by the vacuum method. But doctors who believe the fetus is too large to withdraw this way can use surgical instruments to dismember the fetus, then draw its parts out of the birth canal. This method is often known as a "simple D&E."

Of the remaining abortions, about 13,000 occur in the 21st week or later. No more than 600 are done in the 26th week or later.

Although doctors are not required to report which methods they use, it is unlikely that many abortions in the second half of pregnancy are intact D&Es. In Baltimore, some obstetrician-gynecologists say they have never performed an intact D&E or referred a patient to anybody who has.

Dr. J. Courtland Robinson, the former medical director of Planned Parenthood of Maryland, says he had never heard of the "partial-birth" procedure until he was asked to testify before House and Senate committees considering the bill last year.

"I've never done one," says Robinson, a professor of obstetrics and gynecology at the Johns Hopkins School of Medicine. "I doubt anyone at Hopkins has done one. The reason the bill is bad is that micromanaging doctors in the [operating room] isn't such a smart idea."

"I've never seen it done," says Dr. Karin Blakemore, chief of maternal-fetal medicine at Hopkins. "I don't know of anyone who ever had to do one. It would be extraordinarily rare to ever have to do one."

Several Baltimore doctors say "induction" is the preferred method of aborting a fetus in the second half of pregnancy. A doctor injects a lethal dose of medication to the fetal heart, and then administers drugs to the mother that dilate her cervix and trigger contractions to deliver an intact fetus.

In Baltimore and many other communities, doctors refer women who want late abortions to Women's Health Care Services, a clinic in Wichita, Kan. Five years ago, the center seemed the center of the abortion debate, when anti-abortion demonstrators staged a 47-day protest against it.

Women's Health Care performed few late abortions before the demonstration, said Peggy Jarman, a spokeswoman for the clinic. But publicity brought a rush of business, including a significant number of patients in their second trimester and beyond.

Jarman says the owner, Dr. George Tiller, made a "personal decision" never to use the partial-birth procedure. Instead, he relies exclusively on "simple D&Es" in the second trimester and induction abortions in the third. Choosing her words carefully, she suggests that Tiller selected methods that he considered safe and that fulfilled his patients' wish not to bring pain to the fetus:

"Because the woman is concerned about that, he wanted to address the issue from her perspective," Jarman says. "Dr. Tiller makes it very very clear that his patient is the woman."

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