One of the hottest choice-related issues in this election year has been the attempt to ban late-term abortions by the intact D&E procedure -- dubbed "partial-birth abortions" by anti-choice forces. After President Clinton vetoed legislation to ban this procedure, the U.S. House of Representatives voted to override the veto, but the motion to override failed in the U.S. Senate. Although choice advocates won this battle, the issue has not gone away.
The debate on this issue was characterized by anti-choice rhetoric that falsely depicted the intact D&E procedure as horribly brutal and distorted the facts about the frequency of late-term abortions. Opponents of abortion claimed that the intact D&E procedure is used during third trimester pregnancy for "the convenience of the mother," that 80% of third-trimester abortions are "elective," and that late-term abortions are done much more often than the 600 times per year reported by abortion defenders.
Statistics compiled by the Alan Guttmacher Institute's research confirm the 600-per-year figure and indicate that abortions in the third trimester (the 7th, 8th and 9th months) of pregnancy are indeed very rare, accounting for fewer than 0.04% of abortions. Third trimester abortions are done when necessary to protect a woman's life or health, in many cases when there are severe fetal abnormalities that make it risky to continue the pregnancy. A large percentage of second trimester abortions, particularly those in the late second trimester, are performed for the same reasons.
Doctors can choose among several late-term abortion procedures. Intact D&E is one of the least-used procedures, but is selected when other procedures would present greater risk to the women's life, health, or future childbearing, usually when the fetus is severely deformed and other procedures would cause greater blood loss or greater risk of tearing the woman's cervix and uterus. In both the second and third trimester, the intact D&E procedure is often the method which can best protect a woman's health and future fertility. In this procedure, the woman's cervix is dilated over a period of time, and then the fetus is removed. In some cases, in order to remove the fetus without injuring the woman's cervix or uterus, a spinal needle is used to remove cerebrospinal fluid, decreasing the size of the head enough to bring it out safely.
Abortion opponents received wide publicity for their allegations that third-trimester intact D&E procedures are more common than reported, with some 1500 procedures per year in New Jersey alone. TFC asked Barbara Kavadias, executive director of the New Jersey chapter of the Religious Coalition for Reproductive Choice (RCRC), about these numbers. She said that state statistics confirm that there are no third-trimester abortions in New Jersey, but that 1500 second-trimester abortions are performed each year by the intact D&E procedure. Kavadias said the procedure is chosen in the second trimester to reduce health impacts and so that grieving parents will have an intact fetus to touch and hold as they mourn the loss of a wanted child that was doomed by severe abnormalities.
The Congressional ban on the intact D&E procedure would not have allowed its use to protect a woman's health or future fertility. The legislation included a very narrow "life exception" that would permit a physician to use the procedure only if a woman's life was endangered by a "physical disorder, illness or injury" and no other procedure would prevent her death. An amendment to permit the procedure when necessary to "avert serious adverse health consequences to the woman" was defeated in the Senate and was not even brought to a vote in the House.
Physicians who participated in Congressional hearings asked Congress to leave medical decisions with medical practitioners who are qualified to determine what is the best and safest procedure for their patients. In a letter to The Washington Post, Dr. Allan Rosenfeld, an ob-gyn and Dean of the Columbia School of Public Health in New York, also expressed the fear that vague language in the bill enacted by Congress would be interpreted by some doctors as banning all D&E procedures, not just the "intact" D&E procedure. His letter stated that "D&E procedures have been shown by data collected by the Centers for Disease Control and Prevention to be the safest abortion method for women between 12 and 18 weeks of gestation and is therefore the primary method used in the second trimester." It is the stories of women who came forward to tell of their experiences with late-term abortion, however, that form the most compelling testimony against the ban.
Coreen Costello, a Republican and full-time mother of two, told Congress "When I was seven months pregnant I was having premature contractions. . . . During an ultrasound, the physician became very silent. . . . My husband reassured me that we could deal with whatever was wrong. We had talked about raising a child with disabilities. We were willing to take whatever God gave us. . . . My doctor . . . informed me that they did not expect our baby to live. She was unable to absorb any amniotic fluid and it was puddling into my uterus. . . . This poor precious child had a lethal [neuromuscular disease] and had been unable to move for almost two months. The movements I had been feeling . . . had been nothing more than bubbles and fluid." For Coreen and her husband, who were both anti-choice, terminating the pregnancy was not an option. "I wanted her to come on God's time. I did not want to interfere." Later doctors discovered that the baby's body was stuck in a transverse position, wedged against her cervix. "Due to swelling, her head was already larger than that of a full-term baby. Natural birth or induced labor were not possible. I considered a caesarean section, but experts at Cedars-Sinai Hospital were adamant that the risks to my health . . . were too great. . . . The doctors all agreed that our only option was the intact D&E procedure. [Afterward] my husband and I held her tight and sobbed. . . We memorized every inch of her tiny body. . . She wasn't missing part of her brain. There was no hole from scissors. There was a needle hole covered with a regular band-aid on the back of her head. She looked peaceful. . . . I had one of the safest, gentlest, and most compassionate ways of ending a pregnancy that had no hope." Coreen became pregnant again, and recently gave birth to a healthy son.
Claudia Crown Ades was in the third trimester of a desperately wanted pregnancy when an ultrasound revealed trisomy 13. Her son had extensive brain damage, serious heart complications, and major organ malformations. His condition was incompatible with life, and carrying him to term would have been extremely risky for Claudia. "The religious right would have you believe that it was God's will that I give birth to this baby, but we believe that God gave me [the ability] to make a conscious and responsible decision to save this poor little soul from any more pain."
When Mary-Dorothy Line -- a devout Catholic very excited to begin a family -- was five months pregnant, she learned that her fetus might have a genetic problem. "My husband and I talked about what we would do if there was something 'abnormal.' We quickly decided that we are strong people . . . and, that while having a . . . disabled child would be hard, that it would not be too hard. . . . So, we prayed, as did our parents and grandparents. . . . We sat there and watched as she examined our baby . . . and then told us that in addition to [a] brain fluid problem, the baby's stomach had not developed and he could not swallow." After being told that in-utero surgery would not help, Mary-Dorothy Line and her husband decided to have an intact D&E abortion. The doctors said "the intact dilation and evacuation . . . was the best and safest procedure for me to have. The multiple days of dilation would not be traumatic to my cervix. This was important to preserve my body and protect my future fertility. [The doctors] knew that that was very important to my husband and I since we really wanted to have children in the future." The intact D&E procedure did protect Mary-Dorothy Line's fertility, as she recently gave birth to a healthy baby girl.
At 32 weeks into her much wanted pregnancy, Vikki Stella learned that her fetus had nine severe abnormalities - including a fluid-filled cranium with no brain tissue at all. For Vikki, the safest procedure to protect her health and preserve her fertility was an intact D&E abortion. "As a diabetic . . . this surgery was . . . safer for me than induced labor or a c-section, since I don't heal as well as other people. . . . I'v been told mothers like me all want perfect babies. . . [My son] wasn't just imperfect he was incompatible with life. The only thing that was keeping him alive was my body." After the abortion, she was able to have another child.
These and other personal stories that were told to Congress demonstrate that late-term intact D&E abortions are done for reasons of compassion, not because women or their doctors are brutal or uncaring. They show that the procedure does not deserve to be labeled "evil," "gruesome," "barbaric," or the other adjectives that have appeared in National Right-to-Life fund-raising appeals.
Polling for the National Abortion and Reproductive Rights Action League (NARAL) suggests that a majority of voters have not been taken in by the "partial birth" hyperbole. Asked "Does the fact that a Congressional candidate supports banning late-term abortion even in cases where the woman's health is endangered make you more or less likely to vote for that candidate?," 65% of the likely voters polled between July 29 and August 4 answered "somewhat less likely" or "much less likely."
--Compiled from several sources, including NARAL and RCRC reports
In October the American Academy of Pediatrics (AAP) announced that it supports the right of teenagers to receive legal abortions without a parent's knowledge or permission. The AAP's Marianne Felice said three out of five teens "voluntarily" tell their parents before an abortion. She stated that the "kids who don"t tell are more likely to already have problems at home or come from abusive families." This announcement pits the AAP against the recent wave of state laws mandating unmarried minors to notify or gain permission before obtaining abortions.
Last Modified February 19, 1997