[Congressional Record Volume 141, Number 190 (Thursday, November 30, 1995)]
[Senate]
[Page S17860]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                 PARTIAL-BIRTH ABORTION BAN ACT HEARING

  Mr. HATCH. Mr. President, I have had delivered to each Senator a copy 
of the transcript of the Judiciary Committee's November 17 hearing on 
H.R. 1833, the Partial Birth Abortion Ban Act, together with inserts 
and written submissions. Since the distribution of these materials, I 
have received answers to written questions from another one of the 
witnesses who testified at the hearing. I ask unanimous consent that a 
letter from Dr. Norig Ellison to me be included in the Record.
  There being no objection, the letter was ordered to be printed in the 
Record, as follows:

                                                  American Society


                                         of Anesthesiologists,

                                                November 22, 1995.
     Re  H.R. 1833, the Partial-Birth Abortion Ban Act of 1995.

     Hon. Orrin G. Hatch,
     Chairman, Committee on the Judiciary, U.S. Senate, Dirksen 
         Office Building, Washington, DC.
       Dear Senator Hatch: Thank you for inviting my participation 
     in your Committee's hearing on H.R. 1833.
       I appreciate the opportunity to reply to the written 
     questions of Senator Leahy. The only one of the six questions 
     which falls within my area of expertise is number four:
       4. Do analgesics and anesthetics given to a pregnant woman 
     undergoing an abortion provide any pain relief to the fetus, 
     even if the medication stops short of killing a fetus?
       Drugs normally cross the placenta from mother to fetus 
     according to a concentration gradient. The effect on the 
     fetus of drugs administered to the mother will depend on (a) 
     fetal condition, (b) the route of administration, and (c) the 
     timing.
       a. Fetal acidosis will facilitate transport of local 
     anesthesia such as lidocaine, which is a weak base, into the 
     fetus.
       b. Drugs administered intramuscularly achieve peak 
     concentrations lower than intravenous administration, with 
     the resultant decrease in placenta transport of the former.
       c. Drug administration intramuscularly will have no effect 
     on infants born within one hour after administration; in 
     contrast, birth 2-3 hours after intramuscular administration 
     may result in depressed infants. Conversely, intravenous 
     administration of drugs will have maximum depressed effect in 
     babies born \1/2\-1 hour after the administration.
       d. Very little is known about fetal response and 
     consciousness to pain prior to 24-25 weeks gestation. It is 
     clear that a pregnant woman can receive an effective 
     anesthetic for cesarean section, and the fetus when delivered 
     within the next half hour will be exquisitely sensitive to 
     pain stimulus and will respond by crying and avoiding the 
     stimulus more than 95% of the time.
       In direct answer to question number four, drugs 
     administered to the mother, either local anesthesia 
     administered in the paracervical area or sedatives/analgesics 
     administered intramuscularly or intravenously, will provide 
     not-to-little analgesia to the fetus.
       In closing, I reiterate that the pregnant woman in need of 
     urgent, even life-saving surgery, need not defer same due to 
     misinformation regarding the effect of anesthetics on the 
     fetus.
           Sincerely,
                                              Norig Ellison, M.D.,
     President.

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