Congressional Record, Volume 142 Issue 44 (Wednesday, March 27, 1996)

[Congressional Record Volume 142, Number 44 (Wednesday, March 27, 1996)]
[House]
[Pages H2895-H2929]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

SENATE AMENDMENTS TO H.R. 1833, PARTIAL-BIRTH ABORTION BAN ACT

Mrs. WALDHOLTZ. Mr. Speaker, by direction of the Committee on Rules,
I call up House Resolution 389 and ask for its immediate consideration.
The Clerk read the resolution, as follows:

Resolved, That upon adoption of this resolution it shall be
in order to take from the Speaker's table the bill (H.R.
1833) to amend title 18, United States Code, to ban partial-
birth abortions, with Senate amendments thereto, and to
consider in the House a single motion to concur in each of
the Senate amendments. The Senate amendments and the motion
shall be considered as read. The motion shall be debatable
for one hour equally divided and controlled by the chairman
and ranking minority member of the Committee on the
Judiciary. The previous question shall be considered as
ordered on the motion to final adoption without intervening
motion or demand for division of the question.

The SPEAKER pro tempore. The gentlewoman from Utah [Mrs. Waldholtz]
is recognized for 1 hour.
Mrs. WALDHOLTZ. Mr. Speaker, for purposes of debate only, I yield the
customary 30 minutes to the gentleman from California [Mr. Beilenson]
pending which I yield myself such time as I may consume. During
consideration of this resolution, all time yielded is for the purpose
of debate only.
Mr. Speaker, House Resolution 389 provides for consideration of the
Senate amendments to the Partial-Birth Abortion Ban Act, H.R. 1833. The
rule provides for 1 hour of debate on a single motion to concur in each
and all of the Senate amendments. The rule further provides that the
previous question is considered as ordered on the motion for final
adoption.
Mr. Speaker, this rule will allow the House to consider amendments
adopted by the Senate to the partial-birth abortion ban including an
amendment offered by Senator Dole that ensures doctors will be able to
use this procedure when the life of a woman is in danger.
During consideration of this bill by the House last fall, serious
concerns were raised about the affirmative defense provision included
in the House bill that said that a doctor could not be convicted of
using the partial-birth abortion procedure if the doctor can prove that
the procedure was necessary to protect a woman's life. The affirmative
defense, however, would not have protected a doctor from being arrested
and prosecuted for using the procedure.
The Dole amendment adopted by the Senate addresses and ameliorates
this concern. It clearly states that, without fear of prosecution, a
doctor may use this procedure, when no other procedure is adequate, in
order to protect the life of a woman.
Mr. Speaker, the rule is narrowly drawn so that we can adequately
work with the Senate on changes that they have adopted to the bill and
to expeditiously move the bill for final action. It is appropriate, Mr.
Speaker, to limit debate on the measure to amendments that have been
adopted in the Senate and not to use this bill as a vehicle for
debating the enormous range of contentious issues relating to abortion.
Abortion is clearly one of the most emotionally charged issues that
our Nation faces. People with the best of intentions who have carefully
considered this issue come to opposite conclusions, and it is difficult
to find areas of common ground. I would hope that this particular bill
is an area where we can find that elusive common ground and prohibit a
procedure that partially delivers a live child before killing it and
completing the procedure, a procedure that one practitioner admits he
uses for purely elective abortions about 80 percent of the time he uses
this procedure.
Mr. Speaker, the procedure that we are talking about today is one
that is gruesome and horrific. Without wishing to offend other Members
or the people who may be watching these proceedings, I think it is
critical, Mr. Speaker, that we describe exactly what it is we mean by a
partial-birth abortion so that people will understand that we are not
talking about a series of other issues that are related to the abortion
debate, but we are talking in this bill about one very clearly
described procedure that should be banned.
In this procedure, which is used during the second and third
trimesters of a pregnancy, the practitioner takes 3 days to accomplish
the death of the child. For the first 2 days the woman's cervix is
dilated so as to promote the ease with which the doctor will perform
the abortion. On the third day the woman goes into the doctor's office
and through the use of ultrasound the physician locates the legs of the
child. Using a pair of forceps, the physician then seizes one of those
legs and drags that leg through the birth canal. The doctor then
delivers the rest of the child, legs, torso, arms, and stops when the
head is still in the birth canal. One practitioner who uses this
procedure says the child's head usually stops before being delivered
because, of course, the cervix has not been dilated to the point that a
regular vaginal delivery would occur because that is not the point of
this exercise.
So, once the child's head is stopped in the birth canal, the doctor
reaches down to the base of the child's skull, inserts a pair of
scissors, ending the child's life, yanks those scissors open to enlarge
the hole and uses a vacuum catheter to suck out the contents of the
child's cranium.
That is the procedure that we are talking about in this bill, Mr.
Speaker, the partial delivery of a living fetus whose life is ended
with its head still in the birth canal by the deliberate insertion of a
pair of surgical scissors so that an abortion may be accomplished.
That is what we are talking about in this bill, Mr. Speaker. We are
not talking about any other type of abortion. We are not dealing with
Federal funding. We are not talking about any of the other issues with
which we have to grapple in the abortion debate. But we are talking
about a so-called procedure that measures life in inches, and we need
to agree with the Senate amendments and move this legislation forward,
hopefully for signature by the President.
Mr. Speaker, the rule that this bill has attached to it allows for
fair consideration of the amendments adopted in the Senate, and I urge
my colleagues to support this rule.
Mr. Speaker, I reserve the balance of my time.
Mr. BEILENSON. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, I thank the gentlewoman from Utah [Mrs. Waldholtz] for
yielding to me the customary half hour of debate time.
Mr. Speaker, we oppose the closed process that would make in order
consideration of the Senate amendments to H.R. 1833, the so-called and
misnamed partial-birth abortion ban. This is a bill that on the
pretense of seeking to ban certain vaguely defined abortion procedures
is, in reality, an assault on the constitutionally guaranteed right of
women to reproductive freedom and on the freedom of physicians to
practice medicine without Government intrusion.
Those of us, Mr. Speaker, who fought for many, many years to secure,
and then to preserve and protect, the right of every woman to choose a
safe medical procedure to terminate a wanted pregnancy that has gone
tragically wrong, and when her life or health are endangered, are
deeply troubled by the legislation before us today and by the rule
under which it is being considered.
We say at the outset that the other body improved the bill by
agreeing to the Smith-Dole amendment which does shield doctors from
prosecution if they perform the procedure when the life of the mother
was in danger, but only under certain circumstances. However, this is
an extremely narrow so-called life exception that requires that the
woman's life be endangered by, quote, a ``physical disorder, illness or
injury,'' end of quote, and it requires, further, that no other medical
procedure would suffice.
It appears that if the mother's life is threatened by the pregnancy
itself, then the procedure would still be illegal. And it does not take
into account the fact that doctors do not use other procedures because
they pose greater risks than does this method of serious health
consequences to the mother, including the loss of future fertility.

[[Page H2896]]

And of course the Senate amendment does not provide an exception to
preserve the mother's health no matter how seriously or permanently it
might be damaged.
For those reasons, Mr. Speaker, we feel strongly that a true life and
health exception amendment should have been made in order.
It is bad enough, we feel, that we are being asked to vote on this
irresponsible piece of legislation. To make matters worse, we are being
required to consider it under an unfair rule, and it is one that should
be defeated. Once again the majority has brought this most
controversial of bills to the floor under a totally closed rule. That
we would again be forced to consider a bill of this importance and of
this complexity under these restrictions is offensive, to begin with.
Once again, Members are being denied a vote on an amendment that
would allow an exception to protect a woman's life under all
circumstances or to prevent serious adverse consequences to her health
and future fertility.
The Committee on Rules heard very compelling testimony from the
gentlewoman from New York [Mrs. Lowey], the gentleman from
Massachusetts [Mr. Frank], and the gentlewoman from Colorado [Mrs.
Schroeder] on their request to offer a true life and adverse health
exception amendment to the Senate language.
We believe Members should have had the opportunity to vote on
allowing those exceptions to the ban.
This is obviously a basic and fundamental concern to women and to
their families. Without that exception, the bill will force a woman and
her physician to resort to procedures that may be more dangerous to the
woman's health and to her very life and that may be more threatening to
her ability to bear other children than the method that we seek to ban.
Making this amendment in order would have meant that Members could cast
a vote that shows respect for the importance of a woman's life, health,
and future fertility.
Mr. Speaker, the truth is we have absolutely no business considering
this prohibition and criminalization of a constitutionally protected
medical procedure. This is, we believe, a dangerous piece of
legislation. We oppose it not only because it is the first time the
Federal Government would ban a particular form of abortion, but also
because it is part of an effort to make it virtually impossible for any
abortion to be performed late in the pregnancy, no matter how
endangered the mother's life or health might be.
What is at stake here is whether or not it will be compassionate
enough to recognize that none of us in this legislative body has all
the answers to every tragic situation which confronts a woman and her
family. We are debating not merely whether to outlaw a procedure but
under what terms.
If we must insist on passing legislation that is unprecedented and
telling physicians which medical procedures they may use despite their
own best judgment, then we must also, it seems to us, permit a life or
adverse health exception. It is the only way we can ensure that the
bill might possibly meet the requirements that have been handed down by
the U.S. Supreme Court.
Mr. Speaker, this is a very personal matter to the people involved. I
would hope that everyone can, but obviously not everyone has had the
chance to, read the very moving testimony of one of my own
constituents, Mrs. Coreen Costello of Agoura, CA, in opposition to this
bill. Mrs. Costello described herself as a conservative pro-life
Republican who always believed abortion was wrong until she was faced
with the choice that she was in this case faced with.
She recounts in detail the events that have led to confronting the
painful reality that her only real option was to terminate her
pregnancy. The bill before us would ban the surgical procedure Mrs.
Costello had about which she wrote, and I quote her:
``I had one of the safest, gentlest, most compassionate ways of
ending a pregnancy that had no hope. Other women, other families, will
receive devastating news and have to make decisions like mine. Congress
has no place in our tragedies.''
Mr. Speaker, if I may add a personal note, in 1967, then-Governor
Ronald Reagan signed California's Therapeutic Abortion Act, which I
authored and which was one of the first laws in the Nation to protect
the lives and the health of our women.

{time} 1715

When the U.S. Supreme Court subsequently ruled in Roe versus Wade
that the government cannot restrict abortion in cases where it is
necessary to preserve a woman's life or health, I thought that we have
come to at least accept the precept that every woman should have the
right to choose with her family and her physician, but without
government interference, and when her life and health are endangered,
how to deal with this most personal and difficult decision.
I see now that obviously I was wrong, and that this Congress is
willing even to criminalize for the first time a safe medical procedure
that is used only rarely, and almost always to end the most tragic of
pregnancies.
Mr. Speaker, as I said, we believe this legislation is unwise, it is
unconstitutional, and it is bad public policy to return to the
dangerous situation that existed about 30 years ago and more. This
legislation is not a moderate measure, as its proponents argue. It is,
instead, likely the first step in an ambitious strategy to overturn Roe
versus Wade, and we believe it would be a tragedy for all women and
their families.
Mr. Speaker, it should be emphasized that what we are talking about
making a crime is a medical procedure that is used only in very rare
cases, fewer than 500 per year. It is a procedure that is needed only
as a last resort, in cases where pregnancies that were planned and are
wanted have gone tragically wrong. Adoption of the bill would have
these results.
In cases where it is determined that an abortion is necessary to save
the life of the women, the Senate amendment would force her to choose a
method that may leave her unable to bear children in the future. The
language of the Senate amendment will not protect women whose lives are
threatened by their pregnancies, and doctors will be forced to choose
other procedures, even if they are more dangerous.
Mr. Speaker, choosing to have an abortion is always a terribly
difficult and awful decision for a family to make, but we are dealing
here with particularly wrenching decisions in particularly tragic
circumstances. It seems to us that it would be fitting if we showed
some restraint and compassion for women who are facing those
devastating decisions.
Let me end, Mr. Speaker, by quoting again, if I may, from Mrs.
Costello's testimony before the Senate Committee on the Judiciary, just
a very brief amount:

Due to the safety of this procedure, I am again pregnant
now. Fortunately, most of you will never have to walk through
the valley we have walked. It deeply saddens me that you are
making a decision having never walked in our shoes. When
families like ours are given this kind of tragic news, the
last people we want to seek advice from are politicians. We
talk to our doctors, lost of doctors. We talk to our families
and other loved ones, and we ponder long and hard into the
night with God.
What happened to our family is heartbreaking and it is
private, but we have chosen to share our story with you
because we hope it will help you act with wisdom and
compassion. I hope you can put aside your political
differences, your positions on abortion, and your party
affiliations and just try to remember us. We are the ones who
know. We are the families that ache to hold our babies, to
love them, to nurture them. We are the families who will
forever have a hole in our hearts. We are the families that
had to choose how our babies would die. Each one of you
should be grateful that you and your families have not had to
face such a choice. I pray that no one you love ever does.
Please put a stop to this terrible bill. Families like mine
are counting on you.

Mr. Speaker, we do, as I have said before, strongly oppose the rule
before us and the bill that it makes in order. We urge defeat of the
rule so we can sent it back to the Committee on Rules and at least ask
for a rule that would allow us to vote on an amendment to preserve the
life, under all circumstances, and the health of the mother.
Mr. Speaker, I reserve the balance of my time.
Mrs. WALDHOLTZ. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, before I yield to the next speaker, I think it is
important that we recognize that the procedure

[[Page H2897]]

that we are talking about today is not a legitimate medical procedure
recognized by experts of the American Medical Association. With all
respect to my colleague on the Committee on Rules, for whom I have
great respect and affection, there is no question but that the
experience that his constituent had is one that none of us hope we have
to share. But, Mr. Speaker, the American Medical Association's Council
on Legislation, made up of 12 physicians, voted unanimously to
recommend that the American Medical Association board of trustees
endorse this partial birth abortion ban.
A member of the council, after they had discussed this procedure,
said that they felt that this was not a recognized medical technique,
and that the council members had agreed that the procedure was
basically repulsive. We are not criminalizing an accepted medical
technique, Mr. Speaker. It is unfortunate that we are having to debate
what has become medicalized infanticide.
Mr. Speaker, I yield 3 minutes to the gentleman from Florida (Mr.
Weldon).
Mr. WELDON of Florida. Mr. Speaker, I thank the gentlewoman for
yielding time to me, and I commend her and the Committee on Rules for
bringing forth this rule, and the members of the Committee on the
Judiciary for originally introducing this legislation.
Mr. Speaker, I was sitting in my office at the time, still practicing
medicine in 1993, when I got my copy of the American Medical News in
which this procedure was first described where a baby is identified
under ultrasound, the abortionist, using a forcep, reaches up into the
birth canal and grabs the baby by the feet, dragging the baby out of
the birth canal up to the level of its head, and then there, dangling
outside the mother, typically with its arms and legs moving, a forcep
is inserted into the back of the skull, an opening is created, the
brains are sucked out, and the dead baby is then delivered.
I was amazed to read in this article that somebody could actually
concoct a procedure this gruesome, and I was further shocked to read
that the physicians who developed the procedure then went on to report
that in 85 percent of the cases within which they do this procedure,
there are no significant birth defects, and some of the defects that
they cited, where they justified doing this procedure, included cleft
lip and cleft palate.
Mr. Speaker, I was shocked, and frankly I was amazed that I could
live in a country where a procedure as gruesome and awful as this could
be legalized. Some would call this a safe medical procedure. I would
contend that there was a party involved in this procedure where it was
anything but safe. Indeed, it was lethal, and it was lethal in a most
horrific way.
We in the United States, contrary to the contention of many people,
have the most liberal left-wing abortion laws. In Europe, most of
Europe that legalized abortion far before we did in this country, this
type of procedure is not legal. They have restrictions on how you can
do these procedures and when you can do them. Specifically, they are
not legalized in late trimester, in late second trimester, and in the
third trimester.
My colleague on the other side of the aisle I thought encapsulated
the whole issue very well. There are some people who would like the
mother to be able to choose how her baby will die. The majority of this
body voted once before, and will vote again, that there is a place
where the Government of the United States has to draw the line and say,
``This is beyond the pale.'' This is a total repudiation of the
principles upon which our Nation was founded. I support the rule. I
encourage all my colleagues to vote for the rule.
Mr. BEILENSON. Mr. Speaker, I yield 5 minutes to my good friend, the
gentleman from Ohio [Mr. Hall], a fellow member of the Committee on
Rules.
Mr. HALL of Ohio. Mr. Speaker, I thank the gentleman for yielding
time to me.
Mr. Speaker, I rise in support of the Senate amendments to this
legislation and was proud to be an original cosponsor of the House-
passed bill.
While abortions, except to save the mother's life, are wrong for
those of us who believe in life, this particular procedure is doubly
wrong. It requires a partial delivery and involves pain to the baby.
Mr. Speaker, you will hear the medical details of these abortions
from other witnesses, but I simply lend my support to the bill as one
who tries to ascribe to a moral code and commonsense. A compassionate
society should not promote a procedure that is gruesome and inflicts
pain on the victim. We have humane methods of capital punishment. We
have humane treatment of prisoners. We even have laws to protect
animals. It seems to me we should have some standards for abortion as
well.
Many years ago surgery was performed on newborns with the thought
that they did not feel pain. Now we know they do feel pain. According
to Dr. Paul Ranalli, a neurologist at the University of Toronto, at 20
weeks a human fetus is covered by pain receptors and has 1 billion
nerve cells--more than us, since ours start dying off with adolescence.
Regardless of the arguments surrounding the ethics of the procedure, it
does seem that pain is inflicted.
Finally, Mr. Speaker, I do not want to discuss a bill relating to
abortion without saying that we have a deep moral obligation to
improving the quality of life for children after they are born. I am a
Member of Congress who is opposed to abortion. But, I could not sit
here and honestly debate this subject with a clear conscience if I did
not spend a good portion of my time on hunger and trying to help
children and their families achieve a just life once they are born.
We need to promote social policies that ensure the mother and child
will receive adequate health care, training and other assistance that
will, in turn, enable them to become productive members of society. We
have not done a good job so far, and I am afraid to say, this House has
been unraveling social programs all too easily. Until our Nation makes
a commitment to offering pregnant women and their children a promising
future, I am afraid the demand for abortion will not subside.
Enough is enough. If there's one thing this Congress ought to do this
year is stop this very reprehensible and gruesome technique of
abortion. We treat dogs better than this. Vote yes on this bill.
Mrs. WALDHOLTZ. Mr. Speaker, I yield 2 minutes to the gentleman from
Ohio [Mr. Chabot].
(Mr. CHABOT asked and was given permission to revise and extend his
remarks.)
Mr. CHABOT. Mr. Speaker, today we will again vote on whether or not
it should be lawful for an abortionist to kill a baby that already has
been partially delivered in circumstances where the mother's life is
not at risk. Remember, the doctor must grasp two kicking, healthy legs
to secure the baby so that he can insert into the child's skull a
scissor-like device that causes the brain to collapse, and it kills the
child. Even those who advocate this type of abortion shudder to
describe it. Only the most extreme ideologue could favor such a
gruesome procedure where the mother's life is not in jeopardy.
This whole debate is over whether thinking, feeling, healthy little
babies who are within weeks or sometimes even days of natural delivery
should be robbed of the opportunity to breathe the same air you and I
share. These babies, only inches away from being fully born, are no
different from mildly premature babies. They deserve to live.
I celebrate the fact that today we will take a step in representing
those who cannot represent themselves by passing the partial birth
abortion bill, and I strongly, strongly urge Members to vote for its
passage.
Mr. BEILENSON. Mr. Speaker, I yield 2 minutes to the gentleman from
California [Mr. Farr].
Mr. FARR of California. Mr. Speaker, this is not a bill about life,
this is a bill about politics. Think about it. The House passed this
bill in its original version to ban partial birth abortions. The Senate
changed it. The Senate said, ``You can make an exception to the ban in
the case of the life of the mother.'' What is going on here? Congress
is trying to be your doctor.
I though this was the era of getting Government off our backs, not
the era of getting Government more into your personal issues.

{time} 1730

Now it seems that we are imposing more Government regulations on a
woman's personal life.

[[Page H2898]]

It is ironic that this Congress honors this month of March as Women's
History Month. We celebrate women overcoming obstacles in their lives,
women having liberties, and women having freedom of choice. Now here
tonight, in a male-dominated Congress, they want to take away a woman's
right to decide what is right for her and for her baby.
I have talked to constituents who have been forced to have this
procedure to protect future fertility. I think we are foolish to think
that we can handle this issue with our lawmaking process better than
women can handle it in the medical arena.
Everyone knows that we cannot save life or make life by ordering it.
Do not pass laws that may prevent healthy women from ever, ever
becoming loving mothers. Support women. Support womanhood. Reject this
rule. Reject this bill. Honor women. Honor medicine. Honor choice. Do
not make bad law.
Mrs. WALDHOLTZ. Mr. Speaker, I yield 3 minutes to the gentleman from
Tennessee [Mr. Bryant].
(Mr. BRYANT of Tennessee asked and was given permission to revise and
extend his remarks.)
Mr. BRYANT of Tennessee. Mr. Speaker, I rise in support of this rule
which I think is a very good one. It allows the Senate amendments that
were made to this bill to be accepted by this House, and I believe that
the Senate amendments are reasonable and, as I said before, acceptable.
This rule continues to focus on the matter at hand, only the Senate
amendments, and for that reason I do not think we need any extraneous
amendments to this bill.
When this House considered the bill in the past, the recent past, it
passed it by 288 people voting for it, which showed wide bipartisan
support for this bill. Now, under the guise of protecting the mother's
health, efforts are being made to change this rule or ask for
amendments to allow this exception.
The Supreme Court has considered in the case of Roe versus Bolton
that to protect the mother's health, that definition of health can
encompass all factors, physical, emotional, psychological, familial,
and the woman's age, all relevant to the patient's well-being. This
type of exception, as we found in California, would open the door wide
open to the humane device of this partial-birth abortion, and certainly
would be unacceptable.
Even many of the people that voted in the House earlier for this bill
which outlawed this particularly terrible procedure would call
themselves pro-choice.
I find it somewhat ironic, too, as we are taking up the Endangered
Species Act on this Hill and we are talking about preservation of
animals in particular, that we actually protect the American eagle and
its preborn, the egg of that eagle, more than we protect the preborn of
a human being. It is actually a fine of $500 to $5,000, up to 1 year in
prison, for destroying an eagle egg, a preborn eagle.
But this issue here is not about the big issue of abortion, but
simply outlawing a particularly egregious and terrible procedure that
is used. As I argued on the floor before, were we to transfer this type
of procedure over to a way of executing people who have committed
murder, on death row, there would be many in this body that would be
the first to stand up or encourage people to go to court to stop this
type of procedure as in violation of the eighth amendment to our
Constitution which prohibits cruel and unusual punishment. Were we to
take someone, instead of electrocuting them or using the gas chamber
or, as in Utah, using the firing squad, and take a screwdriver and
crack their skull and suck out their brain, which is this procedure
that is used in this particular type of abortion, again we would be in
court very quickly to defend that particularly terrible procedure, and
I would agree on that.

The example that we used in our earlier debate occurred in Washington
State, where a man on death row actually went to court and was able to
set aside temporarily his death row conviction or the execution of the
death penalty because he was so heavy, over 400 pounds, that he would
be decapitated were he hung as was the procedure in Washington.
We have precedent for this, and I would simply say that the American
Medical Association Council on Legislation has voted unanimously to
recommend that the AMA endorse this bill. I think their opinion would
carry an awful lot of weight.
Mr. Speaker, I was very pleased when this body passed H.R. 1833, the
Partial-Birth Abortion Ban Act, by an overwhelming 288-to-139 margin.
Today we consider the Senate's amendments to the bill and the rule.
The Senate passed the Partial-Birth Abortion Ban Act with similar
bipartisan support. And that body's amendments are reasonable and
acceptable. Furthermore, the rule simply addresses the matter at hand--
the Senate amendments. There is no reason to consider extraneous
amendments.
Unfortunately, the President and proabortion extremists continue to
oppose this modest, widely supported bill. The President has threatened
to veto this bill because it doesn't have amendments that would allow
this gruesome procedure for virtually any reason. Under the guise of
protecting the mother's health, the radical abortionists want to add a
health-of-the-mother exception. The bill already would allow the
partial-birth abortion procedure if the abortion was necessary to save
the woman's life, and this procedure was the only method of doing so.
However, to add ``health'' would be tantamount to writing in a
loophole through which a Mack truck could be driven. While protecting a
mother's health may sound reasonable on its face, the Supreme Court has
defined ``health'' as anything that relates to one's well-being. Does
that mean that being depressed or having a cold or allergies or a
headache could qualify as jeopardizing health under such an open-ended
definition? Certainly. In fact, the Court held in Doe versus Bolton
that ``health'' encompasses ``all factors--physical, emotional,
psychological, familial, and the woman's age--relevant to the well-
being of the patient.'' Therefore, to add ``health'' to this
legislation would gut the bill.
The fact is, according to the doctors who perform most of this type
of abortion, 80 percent of partial-birth abortions are elective. That
means they are for almost any reason.
Mr. Speaker, let's be completely clear about the procedure that this
bill would ban. The opponents of this bill would direct the debate to
side issues, and for good reason: If the American people know the
facts, they'll want this horrible abortion procedure banned.
While all methods of abortion are repulsive, barbaric, and
nauseating, this abortion method reaches depths of inhumanity that only
a calloused conscience could approve of.
Remember that this abortion procedure takes place during the second
trimester or later. That's after the baby's heart is beating, which
occurs at about 3 weeks after conception. That's after the baby's brain
waves can be measured, which happens at 6 weeks. That's after morning
sickness has usually subsided, after 3 months.
First, the abortionist uses ultrasound--an amazing, high-technology
medical tool that gives doctors and parents-to-be a look at the baby
inside the womb--the abortionist uses this tool of life as a tool of
death. He uses ultrasound to guide his forceps to grab the unborn
baby's leg.
Second, the abortionist pulls the baby by his leg into the birth
canal and proceeds to deliver the baby's entire body, except for the
head.
Next, the abortionist jams scissors into the base of the baby's
skull. That's the usual point when the baby dies. Let me interject here
that the only thing that separates this act from murder is the fact
that the baby's head is still in the birth canal.
Finally, the abortionist removes the scissors and inserts a suction
catheter. The baby's brains are sucked out, collapsing the skull. The
dead baby is then fully delivered. That's a partial-birth abortion.
Some of the so-called antichoice extremists who support this bill
include the American Medical Association's Council on Legislation,
which voted unanimously to recommend that the AMA endorse H.R. 1833.
The council made that recommendation because its members concluded that
partial-birth abortion is not a legitimate medical procedure. This
statement begs the question, if partial-birth abortion isn't an
acceptable medical procedure according to a professional body in the
field of medicine, then what is this procedure? It certainly doesn't
reflect the Hippocratic oath, which says doctors should first do no
harm.
It is ironic that we wouldn't treat convicted capital offenders this
way. The ACLU would be up in arms and in court and crying ``cruel and
unusual punishment'' if a State tried to stab scissors in the base of
the prisoner's skull and then suck out his brains with a vacuum
cleaner.
In fact, a court in Washington State ruled that hanging convicted
murderer Mitchell Rupe, who weighted 400 pounds, would be cruel and
unusual punishment. Rupe had appealed his death penalty by arguing that
because of his excessive body weight, the noose would decapitate him,
and that would be cruel

[[Page H2899]]

and unusual punishment. The appellate judge agreed with this man, who
had been convicted on two counts of first-degree murder.
Mr. Speaker, H.R. 1833 bans the performance of partial-birth
abortions, the gruesome procedure that I have described.
As medical technology continues to develop to the point where surgery
can be performed on unborn babies, where more and more premature babies
survive, where doctors can perform increasingly sophisticated
techniques that just 10 or 20 years ago we would have thought of as
medical miracles, it's time to take a hard look at biological and
medical facts.
H.R. 1833 bans a single abortion technique that even many people who
call themselves pro-choice support the banning of. But what are the
ethical and moral questions we as a society need to confront? Do the
medical facts we have today support the ignorant bliss on which Roe
versus Wade and Doe versus Bolton were decided? Is this country still a
civilized society? What kind of a people would allow the partial
birthing of a half-gestated baby, only to be stabbed with surgical
scissors and his brains sucked out, knowing the biological facts we
have in 1996?
It is also ironic that this Nation protects unborn eagles more
vigorously than it protects unborn human beings. We punish people under
three different acts--the Migratory Bird Treaty Act (16 U.S.C. 703),
the Bald Eagle Protection Act (16 U.S.C. 668), and the Endangered
Species Act (16 U.S.C. 1538 and 1540)--for destroying an eagle egg. The
Migratory Bird Treaty Act provides for penalties up to $500 in fines
and 6 months in prison for destroying an eagle egg. The penalty under
the Bald Eagle Protection Act is a fine up to $5,000 and a year in
prison. The Endangered Species Act provides for civil and criminal
penalties; the criminal penalties for knowingly destroying an eagle
egg, depending on the location where the egg is found, range to $50,000
in fines and 1 year in prison. Unborn eagles have that much protection
under law. However, unborn human babies may be aborted at any time
throughout the pregnancy. And in the case of partial-birth abortion,
the baby can even be forcibly, partially delivered in order for the
abortionist to destroy that baby's life.
Mr. Speaker, I have faith that the American people will make the
right decision. Give the American people the facts, as has been done
regarding partial-birth abortion, and they will arrive at the
civilized, decent conclusion that this procedure should be outlawed. I
believe the American people will remain true to our Nation's core
values, that we are all endowed by our Creator with certain unalienable
rights, foremost being the right to life.
I conclude with these verses from Psalm 139: ``For you created my
inmost being; you knit me together in my mother's womb. * * * My
frame was not hidden from you when I was made in the secret place. When
I was woven together in the depths of the earth, your eyes saw my
unformed body.''
Mr. Speaker, I urge that we accede to the Senate's amendments. I
urge that we adopt this rule. And I urge the President to reconsider
his veto threat.
Mr. BEILENSON. Mr. Speaker, I yield 5 minutes to the gentleman from
Massachusetts [Mr. Frank], who serves on the Committee on the
Judiciary.
Mr. FRANK of Massachusetts. Mr. Speaker, we will get to debate the
substance of the bill, although very briefly. The gentlewoman from Utah
[Mrs. Waldholtz] said that this rule provides adequate time to discuss
the Senate amendments. This rule, in fact, provides quite deliberately
the minimum time that it is legally possible to give a bill on the
floor of the House.
The rule gives 1 hour. That is the minimum that is allowed under the
basic rules, so this is part of an effort to suppress debate and
discussion on this bill. We will get to the substance, but I want to
talk here about the outrageous procedure. It is one more example of
this majority running absolutely roughshod over the notion of open
debate and democracy and fairness. This is, once again, a rule as we
say in previous weeks where to achieve their political purpose, to make
sure that their political message is unadulterated, the majority
sacrifices the right of the American people to have free debate.
For example, the gentlewoman from Utah talked about the amendment
that was adopted in the Senate. She said people felt that the life
exception for the mother was not done right so the Senate straightened
it out. Many of us raised that same point here in the House, and why
did we not straighten it out here in the House? Because they had the
same rules the last time. The rule did not allow that amendment. It is
an amendment that we in the House were prevented from considering
because of the close-fisted rule of the majority on this bill.
The Senate did adopt the amendment, so they are giving in and they
say, ``OK, we will do it''. They are almost taking credit for the
improvement the Senate made when they refused to allow us to vote on
such an amendment here. Now we have another amendment that we want to
offer, and I understand here that we cannot even offer a motion to
recommit this.
It is a very cleverly crafted procedure they have. This is not a
bill. It is a concurrence with the Senate amendment because, by making
it that way, we cannot even recommit it and no amendments are in order.
We can do nothing in the House to alter this. We can vote up or down.
We have twice been asked by the majority, not asked, directed by the
majority to vote on this very important issue with no amendment and
with the minimum time for debate allowed under the rules of this House.
They want to do it. They want to do it quickly and have as little
conversation as possible because it will not stand up, apparently, they
believe, to greater scrutiny. They are afraid to allow an amendment.

We have an amendment that we offered, the gentlewoman from Colorado
and I. It is an amendment that was offered in the Senate. The Senate
adopted one amendment and then the Senate rejected another but it got
47 votes. We are hardly talking about some fringe position; 47 votes,
including Republican votes, in the Senate, and we are not being allowed
to offer it here.
We cannot do it on the motion to recommit because there is no
committee to which it can be recommitted. This is simply a motion to
concur in the Senate amendment, and what is the amendment that the
majority is afraid to allow the House to vote on?
They cannot plead time. We are less busy than the guys in ``Marty,''
standing around on the corner. ``What do you want to do tonight?'' ``I
don't know. What do you want to do tonight?''
Voting is not one of the things, because the majority cannot get
itself organized. We have hardly overvoted ourselves this week, but the
majority is afraid to allow the amendment.
The amendment says the doctor will not be considered a criminal and
sent to prison if he performs this procedure to prevent damage to the
health of the mother. If a doctor were to decide that this procedure
was necessary to avoid damage to the mother's ability to give birth in
the future, he would be committing a crime if he did it because the
majority will not even let us vote on an amendment that would say to
avoid damage to her ability in the future to bear children. We are
talking about serious adverse health effects.
At the Committee on Rules, the majority allowed a debate in the
Committee on Rules. They did not want to but they cannot shut us up.
They are probably working on a way to do that in the Rules Committee.
The gentlewoman from Colorado said this is so broad. What do we mean
by health? My answer is simple. I think serious adverse health is good
enough, and I am prepared to put the doctor's opinion up.
But if you think that is too broad, then amend the amendment. My
colleagues on the other side of the aisle are afraid of open debate. If
you think serious adverse health is too broad, why do you not put very,
very, really serious adverse health? Or if you are afraid of
psychological, put physical health. I do not agree with that. I would
vote against that, but if you want to avoid serious physical damage to
the mother but do not want to let in depression, then allow us to vote
on it.
But your preferred procedure which you are imposing successfully on
this House, I am afraid, I reemphasize this, that procedure requires us
to vote and will not allow an amendment that would say to a doctor if
you perform this procedure, and by the way it is called a procedure by
the American College of Obstetricians and Gynecologists. I will put
their letter in opposition to this in the Record. You are saying that
we cannot even offer an amendment that would say to avoid serious
damage to the mother's physical health. Our amendment does not say
that, but you could amend the amendment and make that in order.

[[Page H2900]]

I know that democracy seems complicated to people who have so little
practice with it. You are instead going to demand that we vote to make
it criminal even if a doctor wanted to prevent serious physical damange
to the health of the mother.
Mr. Speaker, I include the following letter for the Record:

The American College of

Obstetricians and Gynecologists,

Washington, DC, November 1, 1995.

statement on H.R. 1833: the partial-birth abortion ban act of 1995

The American College of Obstetricians and Gynecologists is
disappointed that the U.S. House of Representatives has
attempted to regulate medical decision-making today by
passing a bill on so-called ``partial-birth'' abortion.
The College finds very disturbing any action by Congress
that would supersede the medical judgment of trained
physicians and that would criminalize medical procedures that
may be necessary to save the life of a woman. Moreover, in
defining what medical procedures doctors may or may not
perform, the bill employs terminology that is not even
recognized in the medical community--demonstrating why
congressional opinion should never be substituted for
professional medical judgment.
The College does not support H.R. 1833, or the companion
Senate bill, S. 939.

Mrs. WALDHOLTZ. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, I would like to simply respond quickly. The gentleman
from Massachusetts is an excellent student of the rules of the House,
and as such an excellent student of the rules of the House the
gentleman knows that the minority had an opportunity to offer a motion
to recommit when the House originally considered this bill. At that
time the gentleman could have offered his amendment. He chose not to.
The minority chose to not offer a motion to recommit. This bill went
over to the Senate. It is back now for our concurrence.
Mr. Speaker, I yield 2 minutes to the gentleman from Michigan [Mr.
Barcia].
Mr. BARCIA. Mr. Speaker, I rise today in support of House Resolution
1833, the Partial-Birth Abortion Ban Act, and I urge my colleagues to
vote in favor of the rule and the final passage of this important
legislation.
As a pro-life advocate I am committed to protecting the rights of
unborn children. My primary concern is that abortion should not be
treated like a routine medical procedure. Although some consider
partial-birth abortions routine medical procedures, this could not be
further from the truth. Partial-birth abortions are neither routine,
legitimate or necessary.
Partial-birth abortions are most often performed in the second or
third trimester. I am particularly troubled by the horrifying prospect
of late term abortions. Even in Roe versus Wade, abortions are limited
to the first trimester. Today we are considering continuing to allow
abortions through the third trimester of fetal viability.
House Resolution 1833 not only bans the performance of this type of
inhuman abortion but it imposes fines and a maximum of 2 years of
imprisonment for any person who administered a partial-birth abortion.
This gruesome and brutal procedure should not be permitted.
I strongly believe in the sanctity of life, and if 80 percent of the
abortions are elective, we have to reconsider and reevaluate the value
our society places on human life. This decision is not made in the case
of rape or incest, not if the mother's life is in danger, and not if
there are birth defects. In many cases this is a cold, calculated, and
selfish decision.
This is not a choice issue. This is a life or death issue for an
innocent child. Please join me in making this heinous procedure
illegal.
Mr. BEILENSON. Mr. Speaker, I yield 3 minutes to the gentlewoman from
New York [Ms. Slaughter].
Mrs. SLAUGHTER. Mr. Speaker, in every way this debate today is a
tragedy.
First, I want to make it very clear, as clear as I can to people who
are interested in knowing the truth, that the third trimester
abortions, and the partial-birth abortions are very rare and they are
not done as elective surgery at all. They are done in the case of a
severely deformed fetus, a dead fetus, or a mother who will not survive
until the birth is completed.
It is not a case of grabbing hold of two kicking legs and delivering
a child that will be able to grow and respond to life. It is not a case
of that at all. Why do we add to the awful tragedy of the families that
desperately want the children that they are carrying and lose? Why do
we say that the Congress of the United States knows better than the
parents do and better than their doctor does, and we are going to
require that they continue this pregnancy.
I am scared about the precedent that this legislation sets. To say
that the procedure, practice and procedure, should be left to the
Congress of the United States and not to medical people is a dangerous
idea. A physician cannot choose this procedure even if other procedures
would have serious health consequences, and we have talked about that,
the possibility of loss of fertility.

{time} 1745

But the underlying thing that last bothered me ever since I have been
in the Congress of the United States is there is another underlying
piece here, and that is that women do not have the right to choose,
maybe they are not smart enough, we cannot let them decide what is the
best thing in the world for them to do. Some men have to sit around and
decide what is best, usually deciding that in legislatures all over the
country and this Congress what it is that we can say is appropriate for
them.
It is not original with me, but if women were that dumb, how in the
world does anybody here expect that they had had a mother who bore them
and raised them to extraordinary lengths that they are today? Had a
Member of the Congress of the United States. Just like any other
patient, a woman deserves the best care based on the best circumstances
and the knowledge that it fits her situation. It should not be tailored
to fit the needs of Members of Congress or any ideas that they may
have. Women should not be considered second-class citizens and that
needs a big brother to tell her what is permissible and what is not.
Unfortunately, I think this is only a beginning. The bill's sponsors
have consistently stated this is a first step and, if they have the
votes, they will prevent all abortion. I think many of them would also
prohibit birth control. They want Government intrusion into every
doctor's office and eventually into every bedroom. We should not start
down this road. We should not prohibit medical procedures by Government
fiat. We should not prohibit physicians and patients from making
informed decisions based on the individual facts of the particular
case.
Mr. Speaker, I ask defeat of this rule, which prohibits this House
from modifying the draconian antiwoman provisions of this bill. I then
ask my colleagues to preserve the right of women to the most
appropriate medical procedure based on the best medical advice by
defeating this underlying bill.
Mrs. WALDHOLTZ. Mr. Speaker, I yield myself such time as I may
consume.
I think it is important to point out the definition of elective and
nonelective abortion regarding third-trimester abortions. In this
particular situation, it depends on the definition of the person
expressing it. One of the doctors who pioneered the partial-birth
abortion procedure, as he called it, said the third trimester abortions
he performed this way are nonelective, but he said that these abortions
also are caused by factors such as maternal risk, rape, incest,
psychiatric or pediatric indications. This doctor's definition of
nonelective are extremely broad. He went on to tell the Subcommittee on
the Constitution that he had performed more than 2,000 of these
partial-birth abortions and that he attributed over 1,300 of them to
what he called fetal indications or maternal indications.
Of those indications, the most common maternal indication was
depression. Other maternal indications included what he called
pediatric pelvis, their youth, spousal drug exposure, and substance
abuse. Clearly, Mr. Speaker, what is elective or nonelective varies
widely depending on the purpose of the person offering the definition.
Mr. Speaker, I yield 1 minute to the gentleman from Indiana [Mr.
Souder].
Mr. SOUDER. Mr. Speaker, first I want to agree with the earlier
speaker

[[Page H2901]]

that this amendment is actually not needed. We in the House had already
protected life of the mother, but in the new language, ``necessary to
save the life of the mother whose life is endangered by a physical
disorder, illness, or injury, provided that no other medical procedure
would suffice for that purpose,'' makes it clear this has nothing to do
with life of the mother.
I would also like to address the question of whether we men are
trying to regulate women. I think one of the tragedies of this country
are men who beat their spouses, mothers and fathers who treat their
children as though they are objects to abuse. The question here is
whether it is human life. If it is human life, it has nothing to do
with whether it is the right of the woman or the right of the man to
kill this child.
If we disagree over life, that is one thing. But to act like we are
trying to do anything other than protect an innocent life is unfair. In
this case, the life is a life. If its head pops out a little bit
further but if the legs are out and the heart is beating and the head
is inside, then you jab it, it is not a human life. This is a debate
over human life, not the rights of women and men.
Mr. BEILENSON. Mr. Speaker, I yield 2 minutes to the gentleman from
West Virginia [Mr. Wise].
Mr. WISE. Mr. Speaker, abortion is a tough debate under any
circumstances, and an emotional one. But I think the reason I oppose
this rule and oppose this measure is because in this one this debate is
wrongly directed. This is not an issue about whether or not a woman
should have a right to choose or what state a fetus is viable or when
life begins. The tragic situation in this case is that overwhelmingly
the women affected do not want an abortion. They wanted to have this
child. But it is being performed in the last trimester because of
medical necessities. There are less than 500 of these procedures
performed a year. And, yes, what are some of the situations? This has
been a pretty graphic debate. Some of the situations, such as brains
that have developed outside the fetus's skull, a situation where the
woman's health, the mother's health is significantly endangered, once
again, this woman, this couple having their child, want to have this
child in the overwhelming number of cases I have been able to find, yet
they are not able to. They find this out in the last trimester. I have
got problems with Congress, a lot of people have problems getting
involved in different areas. A lot of people have problems with
Congress making important medical decisions, particularly when a
woman's life is possibly endangered.
Under this amendment, it is improved a little bit from leaving the
House. The prosecution has to show beyond a reasonable doubt the doctor
performed this procedure improperly except the only way you get to that
point is you charge the doctor and bring that physician to trial. For
exercising medical judgment, a physician goes to trial. He or she
cannot perform this procedure even to safeguard the severe adverse
health effects to the mother, only for the life of the mother.
I guess what concerns me the most is that in this legislation they
would permit the doctor to be charged but the woman who requested that
understood that something has to be done, requested something be done,
she is not charged. This whole thing does not belong in the Congress,
and Congress should not start down this road.
Mrs. WALDHOLTZ. Mr. Speaker, I yield 7 minutes to the gentleman from
New Jersey [Mr. Smith].
Mr. SMITH of New Jersey. Mr. Speaker, I thank the gentlewoman for
yielding me this time.
Mr. Speaker, for more than two decades the multimillion-dollar
abortion industry has sanitized abortion methods by aggressively
employing the most clever and most benign of euphemisms market research
can buy. Until today they succeeded in a massive coverup about the
sickening truth about abortion methods, including chemical poisoning of
the child by highly concentrated salt water or some other potion,
dismemberment of the baby's fragile body by a knife connected to a
suction machine that is 20 to 30 times more powerful than the average
vacuum cleaner, and now brain extraction, the method at issue today, as
if the child's brain were a diseased tooth in need of extraction or a
tumor to be excised. Make no mistake about it, Mr. Speaker, partial-
birth abortion is child abuse. And those who do it today have an
unfettered right to kill. We can revoke that license to kill, Mr.
Speaker, and we must. If the President vetoes this legislation, then he
alone will have empowered the abortionist to kill babies in this way.
If he vetoes this bill, he renews this license to kill. He bears the
responsibility for the thousands of kids who will die from this hideous
method of abortion. Veto this bill, and there is no doubt whatsoever in
my mind that Bill Clinton will go down in history as the abortion
President.
Mr. Speaker, the abortion lobby lies to women and they lie to society
at large, and they usually get away with it. But not this time. On this
issue, they have said that partial-birth abortion is used primarily to
save the life of the mother, an exception included in the bill, or for
the deformity of the child. Leaving aside the inhumane notion that
handicapped kids are throw-aways or are to be construed as so much
garbage, I thought we took care of that with passage of the Americans
with Disabilities Act, which said that handicapped people have rights
and they have inherent value, and we need to respect that.
Nevertheless, the fact of the matter is then, perhaps most of the
partial-birth abortions procured in the United States are elective; in
other words, they are abortions on demand. Dr. Martin Haskell, an
abortionist who alone has performed over 1,000 partial-birth abortions,
said in a tape recorded interview with the American Medical News that
of the procedures he does, from 20 to 24 weeks, 80 percent are,
``purely elective.''
Mr. Speaker, the abortion lobby has also said that anesthesia kills
the babies before they are removed from the womb. Even if that excuse
were true, even if that rationalization were true, it would still mean
that a baby dies. But again it is another lie. The American Society of
Anesthesiologists, the ASA, has testified that such an assertion by the
abortion lobby has, and I quote, ``absolutely no basis in scientific
fact,'' and is, ``misleading and potentially dangerous to pregnant
women.'' According to the ASA general anesthesia given to a pregnant
woman does not kill nor does it injure an unborn baby or even provide
the baby with protection from pain. And Dr. Haskell himself has said
that local anesthesia he uses has no effect on the baby.
Mr. Speaker, to my left is a chart, one of a series of charts,
medically correct, a diagram of what the actual procedure is all about.
In a paper given by Dr. Haskell to the National Abortion Federation in
1992, entitled ``Second Trimester Abortion From Every Angle,'' in
September Dr. Haskell describes the partial birth abortion this way.
Remember, this man, one of the pioneers who is trying to promote the
use of this despicable form of child abuse, and he says, and I quote,

With the instrument, when the instrument appears on the
sonogram screen, the surgeon is able to open and close its
jaws and firmly and reliably grasp a lower extremity of the
child. The surgeon then applies firm traction to the
instrument, causing a version of the fetus and pulls the
extremity into the vagina.

He then goes on to say that,

With a lower extremity in the vagina, the surgeon uses his
fingers to deliver the lower extremity, then the torso, the
shoulders, and then the upper extremities, the skull lodges
in the internal cervical os. Usually there is not enough
dilation for it to pass through. At this point, the right-
handed surgeon slides the fingers of the left hand along the
back of the fetus and hooks the shoulders of the fetus with
the index and ring fingers palm down, while maintaining
tension, lifting the cervix and applying traction to the
shoulders with the fingers of the left hand. The surgeon
takes a pair of blunt curved Metzenbaum scissors in the right
hand. He carefully advances its tip curved down along the
spine and under his middle finger until he feels it contact
the base of the skull.

Mr. Speaker, according to Dr. Haskell, the surgeon then forces the
scissors into the skull, right into the skull of that baby. And then he
introduces a, suction catheter, holds it and excavates the skull
contents.
Mr. Speaker, one nurse, a registered nurse by the name of Brenda
Pratt Schaefer, witnessed several of these partial-birth abortions
while working for Dr. Haskell. She said, in describing the process
that,

The baby's body was moving, his little fingers were
clasping together, he was kicking

[[Page H2902]]

his feet. All the while his little head was still stuck
inside. Dr. Haskell took a pair of scissors, inserted them
into the back of the baby's head. Then he opened the scissors
up. Then he stuck a high-powered suction tube into the hole
and sucked the baby's brains out.

This is child abuse, Mr. Speaker, let us face reality. And we can
stop it.
Finally, just let me say, Mr. Speaker, I want to commend the
distinguished gentleman from Florida, Mr. Canady, the chairman of the
subcommittee, for his courage in bringing this very important human
rights legislation to the floor. The other side hates him for it. The
abortion, lobby certainly does. They hate many others who fight for
unborn kids.
But just let me say, protecting children and protecting human rights
is always difficult. I serve as the chairman of the Subcommittee on
International Operations and Human Rights. For 16 years I have been
promoting human rights abroad. This, I would say, and submit to my
distinguished colleagues, is a human rights abuse. Children are being
slaughtered, some say 500, as if 500 is a small number of executions.
That is, I think, a very conservative estimate; it is very likely many,
many more than that. And it is being promoted as a method of choice.

{time} 1800

I would submit that we have the opportunity today to stop this kind
of child abuse and to protect little children from this kind of
killing. We ought to do it. Support the rule and support the bill.
Mr. BEILENSON. Mr. Speaker, I yield 1\1/2\ minutes to the gentlewoman
from New York [Mrs. Maloney].
(Mrs. MALONEY asked and was given permission to revise and extend her
remarks.)
Mrs. MALONEY. Mr. Speaker, I rise in strong opposition to this rule.
The bill in question presents a direct challenge to Roe versus Wade. As
one member of the majority boasted, ``We intend to ban a woman's right
to choose, procedure by procedure.'' I take him at his word, because
this legislation will do just that.
I would like to put a human face on this debate and talk about Coreen
Costello, who is pictured here. Coreen Costello would have taken any
child that God would have given her, regardless of any handicap. But
this child, the child that she was expecting, was not a child that
could live. The Dole amendment would not have allowed Coreen Costello
to use the procedure that now allows her to have other children. She is
currently expecting yet another child. The Committee on Rules denied an
amendment that would keep Coreen Costello's doctor out of jail.
I urge Members to have a heart. Vote humanitarian, vote for children,
vote for women, vote for families, vote against this rule.
Mr. BEILENSON. Mr. Speaker, I yield the balance of my time to the
gentlewoman from Colorado [Mrs. Schroeder].
The SPEAKER pro tempore (Mr. Rogers). The gentlewoman from Colorado
is recognized for 4 minutes.
(Mrs. SCHROEDER asked and was given permission to revise and extend
her remarks.)
Mrs. SCHROEDER. Mr. Speaker, I thank the gentleman from California
for yielding me time.
Mr. Speaker, I eagerly, eagerly ask Members to vote against this
rule. This rule is one more gag rule put on doctors dealing with women
and their families in the most difficult situations that any family
would ever have to face. I think it is unbelievable that we are gagging
Members of Congress from being able to deal with the severe and adverse
health conditions a woman can have, and that is what is being done. We
are not being allowed to present that amendment.
The reason we are doing this today is really all political. Let us be
honest. We have a letter from the President pointing out he will veto
this bill in this form because it violates Roe versus Wade. We now have
a new decision, a 100-page decision in Ohio, where the same kind of
procedure was tested and the court said no, that is violative of Roe
versus Wade.
We have heard so many statements made here that were incorrect, that
you do not even know what to say.
People get up and they obsess on this, they obsess on this procedure
and they obsess on all this stuff. The real issue is, show me an
obstetrician and gynecologist that is going to do something terrible
and evil and awful. We try to make this into a witch trial. Show me
parents that would want this.

These are crisis situations, where everything has gone wrong. We are
only talking here about late, late abortions, where people were
clinging to that child trying to go as far as possible. If we deny this
kind of procedure, we are going to be denying to young parents their
chance to have another shot at being a parent, which is probably one of
the most driving desires anyone has.
Why do I say that? Because there are other procedures available.
Sure, you could have a hysterectomy. There are other procedures
available. But, guess what? You lose your reproductive organs. This
procedure has been put together so that the reproductive system can
remain whole and they get another shot at parenthood.
Should that not be okay? You hear people talk about how these are
elective. Elective? These are not elective. Who in the world would sign
up for a process like this, unless it was absolutely essential.
This bill does not do anything about early abortions in the first
trimester. Remember what Roe versus Wade said? In the first trimester,
you could do whatever. That is the elective part. We are talking about
the late part, where Roe versus Wade said States can regulate this
except in the case of life and severe health consequences to the
mother.
Here is a mother that is happy we did not interfere in that, because
she has gone on to be able to have another child, and she lived to see
these two children grow to adulthood.
Is it the position of this Congress that other women in the future
cannot have that opportunity? Are we going to move in and tell the
doctors that would look at her health rather than this law, guess what,
they go to prison for 2 years? Are we going to start criminalizing
these medical procedures?
This is the first medical procedure we will ever have criminalized.
Is that not interesting?
Mr. Speaker, I will put in the Record a letter from the American
Nurses Association speaking clearly that they are opposed to this bill,
and the American College of Gynecologists and Obstetricians, who are
the ones that are the specialists who deal with this. They are opposed
to this bill.
Mr. Speaker, we ought to be listening to the specialists and to the
people who are talking about this. If we really think our medical
profession is so badly trained in America, so against life that they
are out doing these grizzly, terrible things, then we better look at
the whole medical profession. But I do not think so. I hear this
obsessing that you are hearing, which is wrong.
Vote ``no'' against this rule. Allow women to have their severe
health consequences taken into consideration.

The American College of Obstetricians and Gynecologists Does Not
Support H.R. 1833

Dear Colleague: I thought you might be interested in the
following statement released by the American College of
Obstetricians and Gynecologists. Protect women's health by
voting ``No'' on H.R. 1833.
Pat.

The American College of

Obstetricians and Gynecologists,

November 1, 1995.

Statement of H.R. 1833--The Partial-Birth Abortion Ban Act of 1995

American Nurses Association,

Washington, DC, November 8, 1995.
Hon. Barbara Boxer,
U.S. Senate,
Washington, DC.
Dear Senator Boxer: I am writing to express the opposition
of the American Nurses Association to H.R. 1833, the
``Partial-Birth Abortion Ban Act of 1995'', which is
scheduled to be considered by the Senate this

[[Page H2903]]

week. This legislation would impose Federal criminal
penalties and provide for civil actions against health care
providers who perform certain late-term abortions.
It is the view of the American Nurses Association that this
proposal would involve an inappropriate intrusion of the
federal government into a therapeutic decision that should be
left in the hands of a pregnant woman and her health care
provider. ANA has long supported freedom of choice and
equitable access of all women to basic health services,
including services related to reproductive health. This
legislation would impose a significant barrier to those
principles.
Furthermore, very few of those late-term abortions are
performed each year they are usually necessary either to
protect the life of the mother or because of severe fetal
abnormalities. It is inappropriate for Congress to mandate a
course of action for a woman who is already faced with an
intensely personal and difficult decision. This procedure can
mean the difference between life and death for a woman.
The American Nurses Association is the only full-service
professional organization representing the nation's 2.2
million Registered Nurses through its 53 constituent
associations. ANA advances the nursing profession by
fostering high standards of nursing practice, promoting the
economic and general welfare of nurses in the workplace,
projecting a positive and realistic view of nursing, and by
lobbying the Congress and regulatory agencies on health care
issues affecting nurses and the public.
The American Nurses Association respectfully urges you to
vote against H.R. 1833 when it is brought before the Senate.
Geri Marullo,
Executive Director.

Mr. BEILENSON. Mr. Speaker, I yield such time as she may consume to
the gentlewoman from Texas [Ms. Jackson-Lee].
(Ms. JACKSON-LEE of Texas asked and was given permission to revise
and extend her remarks.)
Ms. JACKSON-LEE of Texas. Mr. Speaker, I rise in opposition to the
rule and legislation of H.R. 1833, for the dastardly impact on the life
and health of the mother and the fetus and the physicians.
Mr. Speaker, I rise in opposition to the rule for H.R. 1833. We must
be allowed to offer amendments to H.R. 1833, specifically, those which
would provide for a true exception to save a woman's life, or for
serious, adverse health consequences to the woman, including her future
fertility, or where there exists severe or potentially fatal fetal
abnormalities.
In 1973, and more recently in 1992, the Supreme Court held that a
woman has a constitutional right to choose whether or not to have an
abortion. H.R. 1833 is a direct attack on the principles established in
both Roe versus Wade and Planned Parenthood versus Casey.
H.R. 1833 is a dangerous piece of legislation which would ban a range
of late term abortion procedures that are used when a woman's health or
life is threatened or when a fetus is diagnosed with severe
abnormalities incompatible with life.
Because H.R. 1833 does not use medical terminology, it fails to
clearly identify which abortion procedures it seeks to prohibit, and as
a result could prohibit physicians from using a range of abortion
techniques, including those safest for the woman.
H.R. 1833 is a direct challenge to Roe versus Wade--1973. This
legislation would make it a crime to perform a particular abortion
method utilized primarily after the 20th week of pregnancy. This
legislation represents an unprecedented and unconstitutional attempt to
ban abortion and interfere with physicians' ability to provide the best
medical care for their patients.
If enacted, such a law would have a devastating effect on women who
learn late in their pregnancies that their lives or health are at risk
or that the fetuses they are carrying have severe, often fatal,
anomalies.
Women like Coreen Costello, a loyal Republican and former abortion
protester whose baby had a lethal neurological disease; Mary-Dorothy
Lines, a conservative Republican who discovered her baby had severe
hydrocephalus; Claudia Ades, who terminated her pregnancy in the sixth
month because her baby was riddled with fetal anomalies due to a fatal
chromosomal disorder, Vicki Wilson, who discovered at 36 weeks that her
baby's brain was growing outside his head; Tammy Watts, whose baby had
no eyes, and intestines developing outside the body; and Vikki Stella,
who discovered at 34 weeks that her baby had nine severe anomalies that
would lead to certain death. All these children were wanted but could
not survive. These are the women who would be hurt by H.R. 1833--women
and their families who face a terrible tragedy--the loss of a wanted
pregnancy.

In Roe, the Supreme Court established that after viability, abortion
may be banned by States as long as an exception is provided in cases in
which the woman's life or health is at risk. H.R. 1833 provides no true
exceptions for cases in which a banned procedure would be necessary to
preserve a women's life or health.
The Dole amendment does not cover all cases where a woman's life is
in danger. This narrow life exception applies only when a woman's life
is threatened by a physical disorder, illness or injury and when no
other medical procedure would suffice. By limiting the life exception
in this way, the bill would omit the most direct threat to a woman's
life in cases involving severe fetal anomalies--the pregnancy itself.
In fact, none of the women who submitted testimony during the Senate
and House hearings on this bill would have qualified for the procedure
under the Dole life exception. Instead, this bill would require
physicians to use an alternative life-saving procedure, even if the
alternative renders the woman infertile, or increases her risk of
infection, shock, or bleeding. Thus, the result of this provision is
that women's lives would be jeopardized, not saved.
This bill unravels the fundamental constitutional rights that
American women have to receive medical treatment that they and their
doctors have determined are safest and medically best for them. By
seeking to ban a safe and accepted medical technique, Members of
Congress are intruding directly into the practice of medicine and
interfering with the ability of physicians and patients to determine
the best course of treatment. The creation of felony penalties and
Federal tort claims for the performance of a specific medical procedure
would mark a dramatic and unprecedented expansion of congressional
regulation of health care.
This bill is bad medicine, bad law, and bad policy. Women facing late
term abortions due to risks to their lives, health, or severe fetal
abnormalities incompatible with life must be able to make this decision
in consultation with their families, their physicians, and their god.
Women do not need medical instruction from the government. To
criminalize a physician for using a procedure which he or she deems to
be safest for the mother is tantamount to legislating malpractice.
I urge my colleagues to vote against this rule so that we can offer
amendments which would create true life and health exceptions to the
bill. These amendments would allow doctors to continue to perform the
procedure which they feel is safest for the mother without risk of
prosecution.
True life and health amendments would ensure that mothers, and
families, facing tragic circumstances would continue to receive the
best possible, and safest medical care available.
Mr. BEILENSON. Mr. Speaker, I yield such time as he may consume to
the gentleman from California [Mr. Becerra]
(Mr. BECERRA asked and was given permission to revise and extend his
remarks.)
Mr. BECERRA. Mr. Speaker, I rise in opposition to the rule and the
bill. It is wrong-headed and should fail.
Mr. BEILENSON. Mr. Speaker, I yield such time as she may consume to
the gentlewoman from California [Ms. Pelosi].
(Ms. PELOSI asked and was given permission to revise and extend her
remarks.)
Ms. PELOSI. Mr. Speaker, I rise in opposition to this legislation,
which would prevent doctors from performing a lifesaving medical
procedure. This is a direct threat to the health and lives of American
women.
Mr. Speaker, we all hope that the number of abortions in this country
can be decreased. But this debate is not about abortion. Restricting
medical options that endangers the health of women is unconstitutional.
The Supreme Court has stated that the Government may ban post-viability
abortions, but it cannot restrict abortion when the procedure may be
necessary to save the health and life of the mother.
The life exception included in this legislation is far too narrow to
protect women's lives effectively. The exception would allow this
procedure only as a last resort when a women's life is threatened by
physical disorder, illness, and injury--when who other medical
procedure would suffice. It does not consider that this may be the
safest procedure to protect the health and life of the mother. This so-
called life exception would have a women rendered sterile or face
critical health risks rather than the use the safe and rare procedure
that this legislation is attempting to outlaw.
Families faced with this difficult decision often go on to have
successful pregnancies. Yet this legislation does nothing to protect
health or future fertility of the mother--in fact, it puts a mother's
future fertility at risk.
Mr. Speaker, the so-called partial-birth abortion ban is
unconstitutional and inhumane. I urge my colleagues to vote against
this legislation.

[[Page H2904]]

Mr. BEILENSON. Mr. Speaker, I yield such time as he may consume to
the gentleman from California [Mr. Fazio].
(Mr. FAZIO of California asked and was given permission to revise and
extend his remarks.)
Mr. FAZIO of California. Mr. Speaker, I rise in opposition to the
rule and the underlying legislation.
Mrs. WALDHOLTZ. Mr. Speaker, I yield myself the balance of my time.
The SPEAKER pro tempore. The gentlewoman from Utah is recognized for
3\1/2\ minutes.
Mrs. WALDHOTZ. Mr. Speaker, let me address first the question that
has been raised regarding this rule and the procedure by which this
bill is brought to the floor.
We have heard complaints, Mr. Speaker, that there was not an
opportunity to consider an amendment regarding the health consequences
to the mother. But in fact, Mr. Speaker, as I pointed out earlier, the
minority chose not to exercise its right to offer a motion to recommit
when this bill first came to the floor. That was the opportunity, Mr.
Speaker, that the minority had to offer whatever it felt was
appropriate to change this bill. They decided not to do that. It is a
bit disingenuous to complain about that now after the Senate has
already taken up the bill, after the House had completed its debate.
In fact, Mr. Speaker, that particular amendment was offered in the
Senate and it failed. We know what the definition of health of the
mother is, because the Supreme Court provided us that definition in Doe
versus Bolton, the companion case to Roe versus Wade, in which the
Supreme Court defined health in the abortion context to include ``all
factors, physical, emotional, psychological, familial and the woman's
age relevant to the well-being of the patient.''

This is an extraordinary broadening of this bill. This bill was
debated by the House, Mr. Speaker. It was debated by the Senate. We are
back now to consider whether we should concur in the amendments that
the other side has already stated improve the bill, a change that will
allow doctors to exercise their best judgment in performing this
procedure when it is necessary to save the life of the mother.
The gentlewoman from Colorado said though, Mr. Speaker, that we ought
to look to the specialists, to the physicians, in determining whether
this is an appropriate piece of legislation. So I wish to close, Mr.
Speaker, by referring to the specialists.
First, Mr. Speaker, I would quote from Dr. Martin Haskell, a
practitioner of the partial birth abortion method. When Dr. Haskell was
asked about the advantages of this particular procedure he did not talk
about the life of the mother. He did not talk about the sensation of
the fetus. He did not talk about the health risk to the mother. He said
this: ``Among its advantages are that it is a quick, surgical,
outpatient method that can be performed on a scheduled basis under
local anesthesia.'' Those are not emergency measures, Mr. Speaker.
When Dr. Haskell was asked in an interview with Cincinnati Medicine
in the fall of 1993, Dr. Haskell said when asked about the impact to
the fetus of this procedure, the question, ``Does the fetus feel
pain?'' This is what Dr. Haskell said: ``I am not an expert, but my
understanding is that fetal development is insufficient for
consciousness.'' He continued, ``It is a lot like pets. We like to
think they think like we do. We ascribe humanlike feelings to them, but
they are not capable of the same level of awareness we are. It is the
same with fetuses.''
Mr. Speaker, that is what one specialist, a practitioner of partial
birth abortion, says about this procedure. But let us turn to another
specialist, Dr. Pamela Smith, Director of Medical Education at the
Department of ob-gyn at Mount Sinai Hospital in Chicago. Dr. Smith
said, ``There is absolutely no obstetrical situations encountered in
this country that would require this procedure.''
Mr. Speaker, I ask for support on this rule.
Mr. Speaker, I move the previous question on the resolution.
The previous question was ordered.
The SPEAKER pro tempore. The question is on the resolution.
The question was taken; and the Speaker pro tempore announced that
the noes appeared to have it.
Mrs. WALDHOLTZ. Mr. Speaker, I object to the vote on the ground that
a quorum is not present and make the point of order that a quorum is
not present.
The SPEAKER pro tempore. Evidently a quorum is not present.
The Sergeant at Arms will notify absent Members.
The vote was taken by electronic device, and there were--yeas 269,
nays 148, not voting 14, as follows:

[Roll No. 93]

YEAS--269

Allard
Archer
Armey
Bachus
Baesler
Baker (CA)
Baker (LA)
Ballenger
Barcia
Barr
Barrett (NE)
Bartlett
Barton
Bass
Bateman
Bereuter
Bevill
Bilbray
Bilirakis
Bliley
Blute
Boehner
Bonilla
Bonior
Bono
Borski
Brewster
Browder
Brownback
Bryant (TN)
Bunn
Bunning
Burr
Burton
Buyer
Callahan
Calvert
Camp
Campbell
Canady
Castle
Chabot
Chambliss
Chenoweth
Christensen
Chrysler
Clement
Clinger
Coble
Coburn
Collins (GA)
Combest
Cooley
Costello
Cox
Cramer
Crane
Crapo
Cremeans
Cubin
Cunningham
Danner
Davis
de la Garza
Deal
DeLay
Diaz-Balart
Dickey
Dingell
Doolittle
Doyle
Dreier
Duncan
Dunn
Ehlers
Ehrlich
Emerson
English
Ensign
Everett
Ewing
Fawell
Fields (TX)
Flanagan
Foley
Forbes
Fox
Franks (NJ)
Frisa
Frost
Funderburk
Gallegly
Ganske
Gekas
Geren
Gilchrest
Gillmor
Goodlatte
Goodling
Gordon
Goss
Graham
Gunderson
Gutknecht
Hall (OH)
Hall (TX)
Hamilton
Hancock
Hansen
Hastert
Hastings (WA)
Hayes
Hayworth
Hefley
Hefner
Heineman
Herger
Hilleary
Hobson
Hoekstra
Hoke
Holden
Hostettler
Hunter
Hutchinson
Hyde
Inglis
Istook
Johnson, Sam
Jones
Kanjorski
Kasich
Kelly
Kildee
Kim
King
Kingston
Kleczka
Klink
Klug
Knollenberg
Kolbe
LaFalce
LaHood
Largent
Latham
LaTourette
Laughlin
Lazio
Leach
Lewis (CA)
Lewis (KY)
Lightfoot
Linder
Lipinski
Livingston
LoBiondo
Longley
Lucas
Manton
Manzullo
Martini
Mascara
McCollum
McCrery
McDade
McHugh
McInnis
McIntosh
McKeon
McNulty
Metcalf
Mica
Miller (FL)
Molinari
Mollohan
Montgomery
Moorhead
Moran
Murtha
Myers
Myrick
Nethercutt
Neumann
Ney
Norwood
Nussle
Oberstar
Ortiz
Orton
Oxley
Packard
Parker
Paxon
Payne (VA)
Peterson (MN)
Petri
Pombo
Porter
Portman
Poshard
Pryce
Quillen
Quinn
Radanovich
Rahall
Ramstad
Regula
Riggs
Roberts
Roemer
Rogers
Rohrabacher
Ros-Lehtinen
Roth
Roukema
Royce
Salmon
Sanford
Saxton
Scarborough
Schaefer
Schiff
Seastrand
Sensenbrenner
Shadegg
Shaw
Shuster
Sisisky
Skeen
Skelton
Smith (MI)
Smith (NJ)
Smith (TX)
Solomon
Souder
Spence
Stearns
Stenholm
Stockman
Stump
Stupak
Talent
Tanner
Tate
Tauzin
Taylor (MS)
Taylor (NC)
Tejeda
Thornberry
Thornton
Tiahrt
Upton
Volkmer
Vucanovich
Waldholtz
Walker
Walsh
Wamp
Watts (OK)
Weldon (FL)
Weller
White
Whitfield
Wicker
Wolf
Young (AK)
Young (FL)
Zeliff

NAYS--148

Abercrombie
Ackerman
Andrews
Baldacci
Barrett (WI)
Becerra
Beilenson
Bentsen
Berman
Bishop
Boehlert
Boucher
Brown (CA)
Brown (FL)
Brown (OH)
Cardin
Chapman
Clay
Clayton
Clyburn
Coleman
Collins (MI)
Condit
Conyers
Coyne
DeFazio
DeLauro
Dellums
Deutsch
Dicks
Dixon
Doggett
Durbin
Edwards
Engel
Eshoo
Evans
Farr
Fattah
Fazio
Fields (LA)
Flake
Foglietta
Frank (MA)
Franks (CT)
Frelinghuysen
Furse
Gejdenson
Gephardt
Gilman
Gonzalez
Green
Greenwood
Gutierrez
Hastings (FL)
Hilliard
Hinchey
Horn
Houghton
Hoyer
Jackson (IL)
Jackson-Lee (TX)
Jacobs
Jefferson
Johnson (CT)
Johnson (SD)
Johnson, E. B.
Johnston
Kaptur
Kennedy (MA)
Kennedy (RI)
Kennelly
Lantos
Levin
Lewis (GA)
Lincoln
Lofgren
Lowey
Luther
Maloney
Markey
Martinez
Matsui
McCarthy
McDermott
McHale
McKinney
Meehan
Meek
Menendez
Meyers
Miller (CA)
Minge
Mink
Moakley
Morella
Nadler
Neal
Obey
Olver
Owens
Pallone
Pastor
Payne (NJ)

[[Page H2905]]

Pelosi
Peterson (FL)
Pickett
Pomeroy
Rangel
Reed
Richardson
Rivers
Rose
Roybal-Allard
Rush
Sabo
Sanders
Sawyer
Schroeder
Schumer
Scott
Serrano
Shays
Skaggs
Slaughter
Spratt
Stark
Studds
Thompson
Thurman
Torkildsen
Torres
Towns
Traficant
Velazquez
Vento
Visclosky
Ward
Waters
Watt (NC)
Waxman
Williams
Wilson
Wise
Woolsey
Wynn
Yates
Zimmer

NOT VOTING--14

Bryant (TX)
Collins (IL)
Dooley
Dornan
Filner
Ford
Fowler
Gibbons
Harman
Smith (WA)
Stokes
Thomas
Torricelli
Weldon (PA)

{time} 1832

The Clerk announced the following pairs:
On this vote:

Mr. Thomas for, with Ms. Harman against.
Mrs. Fowler for, with Mr. Stokes against.

Ms. FURSE and Mr. GILMAN changed their vote from ``yea'' to ``nay.''
Mrs. KELLY changed her vote from ``nay'' to ``yea.''
So the resolution was agreed to.
The result of the vote was announced as above recorded.
A motion to reconsider was laid on the table.
Mr. CANADY of Florida. Mr. Speaker, pursuant to House Resolution 389,
I move to take from the Speaker's table the bill (H.R. 1833), to amend
title 18, United States Code, to ban partial-birth abortions with the
Senate amendments thereto, and concur in the Senate amendments.
The Clerk read the title of the bill.
The text of the Senate amendments is as follows:

Page 2, line 9, strike out [Whoever] and insert: Any
physician who
Page 2, line 12, after ``both.'' insert: This paragraph
shall not apply to a partial-birth abortion that is necessary
to save the life of a mother whose life is endangered by a
physical disorder, illness, or injury: Provided, That no
other medical procedure would suffice for that purpose. This
paragraph shall become effective one day after enactment.
Page 2, line 13, strike out [As] and insert: (1) As
Page 2, after line 16, insert:
``(2) As used in this section, the term `physician' means a
doctor of medicine or osteopathy legally authorized to
practice medicine and surgery by the State in which the
doctor performs such activity, or any other individual
legally authorized by the State to perform abortions:
Provided, however, That any individual who is not a physician
or not otherwise legally authorized by the State to perform
abortions, but who nevertheless directly performs a partial-
birth abortion, shall be subject to the provision of this
section.
Page 2, line 17, strike out [(c)(1) The father,] and
insert: (c)(1) The father, if married to the mother at the
time she receives a partial-birth abortion procedure,
Page 3, strike out lines 12 through 20.

motion offered by mr. canady

Mr. CANADY of Florida. Mr. Speaker, I offer a motion.
The SPEAKER pro tempore (Mr. Rogers). The Clerk will designate the
motion.
The Clerk read the motion.
Mr. CANADY of Florida moves to concur in each of the six Senate
amendments to H.R. 1833.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Florida [Mr. Canady] and the gentlewoman from Colorado [Mrs. Schroeder]
each will be recognized for 30 minutes.
The Chair recognizes the gentleman from Florida [Mr. Canady].

general leave

Mr. CANADY of Florida. Mr. Speaker, I ask unanimous consent that all
Members have 5 legislative days to revise and extend their remarks on
H.R. 1833.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Florida?
There was no objection.
Mr. CANADY of Florida. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, I rise to express my support for the motion to concur
in the Senate amendments to H.R. 1833, the Partial-Birth Abortion Ban
Act. H.R. 1833 bans a particularly heinous late-term abortion procedure
unless that procedure is necessary to save the life of the mother.
This is partial-birth abortion:
Guided by ultrasound, the abortionist grabs the live baby's leg with
forceps.
Mr. Speaker, then the baby's leg is pulled out into the birth canal
by the abortionist.
The abortionist delivers the living baby's entire body, except for
the head, which is deliberately kept lodged just within the uterus.
Then the abortionist jams scissors into the baby's skull.
The scissors are then opened to enlarge the hold in the baby's skull.
The scissors are than removed, and a suction catheter is inserted.
The child's brains are sucked out, causing the skull to collapse so
that the delivery of the child can be completed.
Clearly, the only difference between partial-birth abortion, the
procedure which my colleagues have just seen described, and homicide is
a mere 3 inches.
The supporters of partial-birth abortion seek to defend the
indefensible, but today the hard truth cries out against them. Despite
their relentless effort to misrepresent and confuse the issue, the
opponents of this bill can no longer conceal the uncomfortable facts
about this horrible procedure.
The ugly reality of partial birth abortion is revealed here in these
drawings for all to see.
The Senate amendment to H.R. 1833 makes three acceptable changes to
the House passed version of the bill:
First, the Senate amendment clarifies that H.R. 1833 allows a
partial-birth abortion to be performed if it is necessary to save the
life of the mother. Instead of a life exception in the form of an
affirmative defense as passed by the House, the amendment inserts the
life exception in the first paragraph of the bill. The effect of the
amendment is to force the prosecution to prove beyond a reasonable
doubt that the partial-birth abortion was performed to save the life of
the mother or that another procedure would have saved her life.

Second, the Senate amendment restricts civil liability under the bill
to physicians who perform partial-birth abortions or anyone who
directly performs a partial-birth abortion. In other words, the
amendment does not allow anyone who assists in a partial-birth abortion
to be liable under H.R. 1833.
Third, the Senate amendment allows fathers to sue for damages only if
the father was married to the mother at the time the partial-birth
abortion was performed.
I believe that if H.R. 1833 is enacted into law with the Senate
amendments, it will deter abortionists from partially delivering, and
then killing, unborn children.
Unfortunately, Mr. Speaker, President Clinton has threatened to veto
H.R. 1833 unless we make gutting changes to the bill. The President
does not want to openly defend a procedure that 71 percent of the
public says should be banned. Therefore, he is trying to deceive the
American people by claiming he supports banning this, as he calls it,
disturbing procedure while he has at the same time proposed an
amendment that would gut H.R. 1833, making it totally meaningless.
Mr. Speaker, the President wants a bill that allows an abortionist to
perform a partial-birth abortion whenever the abortionist says it is to
prevent a serious adverse health consequence. The President wants to
explicitly leave the definition of serious adverse health up to the
abortionist. In Doe versus Bolton, the companion cause to Roe versus
Wade, the Supreme Court defined health in the abortion context to
include, and I quote, ``all factors: physical, emotional,
psychological, familial, and the woman's age, relevant to the well-
being of the patient.'' Partial-birth abortions are currently being
performed for such health reasons as the mother's depression or young
age.
While Dr. Martin Haskell, a prominent practitioner of partial-birth
abortion, stated that 80 percent of the partial-birth abortions that he
performed from 20 to 24 weeks are purely elective, Dr. James McMahon
called the partial-birth abortions he performed in the third trimester
non-elective or health related. In documents submitted to the House
Subcommittee on the Constitution, Dr. McMahon asserted: after 26 weeks,
that is, 6 months, those pregnancies that are not flawed are still non-
elective. They are interrupted because of maternal risk, rape, incest,
psychiatric or pediatric indications. Dr. McMahon's definition of non-
elective is extremely broad.
Accordingly, if President Clinton had his way, even third trimester
partial-

[[Page H2906]]

birth abortions performed because of a mother's youth or depression
would be justified to preserve the mother's health. This is simply
unacceptable.
Furthermore, Dr. McMahon told the subcommittee that he had performed
more than 2000 of what he called intact dilation and evacuation
abortions. He attributed more than 1300 of these late-term abortions to
fetal indications or maternal indications. The most common maternal
indication was depression. Other maternal indications included
pediatric pelvis, that is, youth, spousal drug exposure, and substance
abuse.

{time} 1845

It is never necessary to partially vaginally deliver a living infant
at 20 weeks, that is, 4\1/2\ months or later, before killing the infant
and completing the delivery in order to protect a mother's life or even
her health.
During two extensive hearings in the Committee on the Judiciary on
H.R. 1833, not one of the medical experts invited to testify by the
bill's opponents could point to a single circumstance that would
require the use an abortion technique in which the infant was partially
delivered alive and then killed. On the contrary, several physicians,
including one well-known abortionist, have stated that partial birth
abortion poses risks to the health of the mother.
Dr. Pamela Smith, the director of medical education for the
Department of Obstetrics and Gynecology at Mr. Sinai Hospital in
Chicago, has written:

There are absolutely no obstetrical situations encountered
in this country which require a partially delivered human
fetus to be destroyed to preserve the health of the mother.
Partial birth abortion is a technique devised by abortionists
for their own convenience, ignoring the known health risks to
the mother. The health status of women in this country will
only be enhanced by the banning of this procedure.

Dr. Martin Haskell, himself, said of a partial birth abortion,
``Among its advantages are that it is a quick surgical outpatient
method that can be performed on a scheduled basis under local
anesthesia.''
The President and other proponents of partial birth abortion know
that adding an exception for health of the mother to H.R. 1833 is
unnecessary and would gut the bill, allowing partial birth abortion on
demand.
This is the question I would raise to the President and my colleagues
who support abortion on demand: Is there ever an instance when abortion
or a particular type of abortion is inappropriate? The vehement
opposition of abortion rights supporters to H.R. 1833 makes their
answer to my question clear. For them there is never an instance when
abortion is inappropriate. For them the right to abortion is absolute,
and the termination of an unborn child's life is acceptable at whatever
time, for whatever reason, and in whatever way a woman or an
abortionist so chooses.
To all my colleagues, I say this, Mr. Speaker: Look at this drawing.
Open your eyes wide and see what is being done to innocent, defenseless
babies. What we see here in this drawing is an offense to the
conscience of humankind. Put an end to this detestable practice. Vote
in favor of the motion to concur in the Senate amendments to H.R. 1833.
Mr. Speaker, I reserve the balance of my time.
Mrs. SCHROEDER. Mr. Speaker, I yield 2 minutes to the gentleman from
Michigan [Mr. Conyers], the esteemed ranking member of the committee.
Mr. CONYERS. Mr. Speaker, I rise to make observations about two
members of the Committee on the Judiciary, and I respect all of the
members on the committee. First, I have asked the gentlewoman from
Colorado, Patricia Schroeder, to manage this bill, because she will
long be remembered for her sensitivity and dedication on a subject that
is so difficult for all of us to deal with.
The other Member whose attention I would draw the membership to is
the gentleman from Florida [Mr. Canady], the author of this measure.
Mr. Canady is not a doctor, has never been to medical school, and has
created a misnomer in the title of this bill. There is no medical term
called ``partial birth abortion.'' It is not in the medical dictionary,
the American College of Obstetricians and Gynecologists do not use the
term and in fact, has come out very strongly against the bill.
Mr. Speaker, assuming that we are not doctors, let us just talk about
the law that we have a responsibility to deal with. Since the measure
of the Gentleman from Florida was introduced, a Federal court in Ohio
has spoken on a very similar measure and the Ohio Federal court has
said very, very clearly that this procedure, the dilation and
extraction, or D and X procedure, which was banned by an Ohio statute,
is unconstitutional. Similarly, this bill is unconstitutional.
I urge my colleagues to consider that Roe versus Wade, through the
constitutional process, has protected a woman's right to choose, for
over 20 years. This attempt to ban a class of medically appropriate
abortions is not only very discouraging, it is unconstitutional.
Mr. CANADY of Florida. Mr. Speaker, I yield 3 minutes to the
gentleman from Oklahoma [Mr. Coburn].
(Mr. COBURN asked and was given permission to revise and extend his
remarks.)
Mr. COBURN. Mr. Speaker, I think it is important that we talk about
what this bill is and what it is not. The term abortion is used rather
loosely around this body. Abortion, by definition, occurs before 20
weeks. This procedure is not used before 20 weeks. This procedure is
used on viable infants, infants who are viable outside of the womb. So
as we hear all the confusing dialogue tonight, it is important that
everybody realize that infants, 22 weeks gestation, from the time of
conception 22 weeks forward, which is actually less than 21 weeks, by
normal count, those are viable infants by definition. Today if a baby
is born at 22 weeks we do everything we can to save that baby.
So this bill is not about abortion, this bill is about eliminating
the murdering of infants who are otherwise viable outside of the womb.
What is this bill? This bill eliminates a procedure that has been
designed to be of benefit only to the abortionist. Every complicated
pregnancy that might have an adverse outcome in terms of an indication
under the present utilization of this procedure can in fact be
delivered in a much more humane, much less traumatic, and much more
beneficial way to both the infant and the mother. What this bill
provides is the respect that a viable fetus deserves, an infant of 22
weeks.

Let us make no mistake about this, this procedure is utilized to
terminate otherwise normal infants the vast majority of the time. We
are going to hear otherwise on that, but if you think an infant with a
cleft palate is someone who needs to be terminated, if you think
adolescent females, because they are pregnant. should qualify under
this bill, as the President would have us say, because of their
adolescence or because of their age, should otherwise be an exception
under this bill, then you do not in fact understand what this procedure
is all about.
I would urge my colleagues to think about what this bill really is.
This is not an abortion. This procedure is a convenient method for some
practitioners to terminate the lives of otherwise viable infants.
Mrs. SCHROEDER. Mr. Speaker, I yield myself 2 minutes.
(Mrs. SCHROEDER asked and was given permission to revise and extend
her remarks.)
Mrs. SCHROEDER. Mr. Speaker, first of all, let me answer the
gentleman who was just in the well. I think it is terribly important to
say we were trying to offer the amendment that is the law of the land,
which is severe adverse health consequences to the mother. I resent
very much hearing that this is about cleft palates and these are
designer things and so forth, because this is not, and there is no one
in this body trying to make it that way.
Now let me tell you why I hate this debate. I hate this debate
because this debate reminds me of my 30th birthday, and let me bring
you to my 30th birthday. My 30th birthday was spent in intensive care,
an intensive care in which I had been given last rites. I had a 15-day-
old baby girl I had not seen and a 4-year-old boy that I was terrified
I would not see again. I want to tell the Members, that is scrambling,
man. We had doctors, we had everybody running around figuring out what
in the world can happen.
I just want to say to people in this Chamber, if you really think
families in that situation want you, the U.S. Congress, to come in and
tell them

[[Page H2907]]

which procedures their doctors may use and which ones they may not use,
I think you are wrong. I think doctors think this is a zone of privacy
and families think this is a zone of privacy, and that we should trust
our doctors, although I understand there are some Members here who
trust Hamas more than they trust the Government. But I happen to trust
my doctor in that instance a whole lot more than I trust you Members of
Congress. I want you to know it.
I want you to know I also looked at your drawings. You know what it
said on the bottom? It said, ``Drawing commissioned by the National
Conference of Catholic Bishops.'' Maybe they deliver babies, and maybe
they practice medicine, but I go with the American College of
Gynecologists and Obstetricians, because those are the ones I know that
deliver babies. I am tired of the playing politics on this. I think
America's families are tired of playing politics on this, and I really
think that that is all this is about.
I wish there were some way to bring some sanity to this. My time has
expired. I have thousands more I could say, but I only want to tell
you, my 30th birthday was hell, and because of people like you, I could
be dead, and I resent that very much.
Mr. Speaker, I rise to urge my colleagues to oppose the motion that
would send to the President an abortion ban that does not have an
exception for the life or health of the woman.
When the House first voted on this bill, we fought hard, but
unsuccessfully, for an opportunity to debate and vote on an amendment
that would provide an exception to the ban in cases where the woman's
life or health is at risk. Since the original House vote on this bill,
two noteworthy events have occurred.
First, an Ohio court has issued a 100-page opinion setting forth,
with great detail and care, the unconstitutionality of a similar
provision passed by the Ohio legislature. Central to the court's
analysis is the fact that under Roe versus Wade and later cases, the
government cannot ban abortions that are necessary to preserve the life
or health of the woman.
Second, on February 28, President Clinton sent a letter to the
chairman of the Judiciary Committee clearly stating that he will veto
the legislation unless it contains a true exception for the life and
health of the woman, as required by Roe versus Wade.
Because H.R. 1833, both in its original form and as amended by the
Senate, fail to include any exception for the health of the woman, and
because the life exception is too narrowly framed to constitute a true
life exception, the bill before us today is unconstitutional. It
clearly violates Roe versus Wade, and most importantly, it sends an
unacceptable message to American women that their lives and health are
not worthy of full protection.
In the course of our committee's hearings on this bill, we heard
heart-rending stories from four women whose families benefited from the
procedure this bill would ban, all in cases where terrible tragedies
occurred late in the woman's pregnancy. As I listened to these women's
stories, it became obvious to me that, in many respects, this bill is
not about abortion at all. These pregnancies were wanted pregnancies,
and the women told us that their families loved and cherished the
babies that God was giving to them, no matter what disabilities those
babies might have.
Unfortunately, these families had to confront the terrible tragedy
that life was not to be for these babies, and they had to make
decisions about how to manage the medical crises that confronted them
in the way that best safeguarded the woman's life, health, and her
ability to have another chance at motherhood. They chose this procedure
based on advice from multiple medical specialists, knowing that it
posed the least risk to them and their future fertility. Some of these
women told us that they were pro-life before they had this procedure,
and they remain pro-life today. But they oppose this bill because it
bans a medical procedure that preserved their health and their future
fertility. Several of these women are pregnant again today, thanks to
this procedure that safeguarded their reproductive capacity.
So, in truth, the bill before us today is as much about safe
motherhood as it is about abortion. In 1920, 800 women died for every
100,000 live births. In 1990, 10 women died for every 100,000 births.
While the maternal mortality ratio in the United States has decreased
dramatically, pregnancy-related complications and deaths remain an
important public health concern.
We cannot get complacent about safe motherhood. And an adjunct of
safe motherhood is that when something goes terribly wrong with a
pregnancy, the woman, her family, and her doctor have every right to do
everything possible to preserve her future reproductive capacity, so
that she can have another chance at motherhood.
So many times when we say the words ``life and health of the woman''
people react as if it's some kind of tricky legal technicality. That
women don't die anymore because of pregnancy or childbirth. As a woman
who almost died after childbirth, let me assure you, it can happen. And
the CDC statistics I am citing are a reminder that the life and the
health of the woman can indeed be placed in jeopardy during pregnancies
today. The leading causes of pregnancy-related death are hemorrhage,
embolism, and hypertensive disorders. Combined, they account for over
70 percent of pregnancy-related deaths. That's why options that reduce
the risk of excess bleeding, such as the procedure we are considering
today, can in many cases save the life or health of the woman.
You would think that Congress would have the sense to leave the
practice of medicine to doctors. You would think that Congress would
respect the privacy of the families who confront these terrible
tragedies, and their intelligence in deciding how best to manage the
life and health risks these tragedies bring with them. Instead, this
bill tells these families that Congress would put the doctors who
preserved the woman's life, her health, and her future fertility in
prison for 2 years.
Look Coreen Costello in the eye, and tell her that the second chance
at safe motherhood that this procedure afforded her is something that
Congress is taking away. Sit down with her children and explain to them
that Congress would subordinate their mother's health to a political
agenda, so that supporters of this bill can run sensational 30-second
ads to advance their political ambitions.
If this committee were serious about passing a bill that would pass
constitutional muster, we would be voting on amendments to cure the
constitutional problems that are so carefully detailed in the Ohio
court decision and the President's letter. The President's letter makes
it clear that he would quickly sign a bill that contained an exception
for procedures necessary for the life of the woman or to avert serious
adverse health consequences to the woman.
Without altering the bill to cure the vagueness problem, the undue
burden on previability abortions, and to add a true life or health
exception, everyone in this Chamber knows that this bill would be
enjoined immediately by the courts. That being the case, what can the
purpose be in forcing this bill to the President's desk without a life
or health exception? I am afraid I cannot see one other than political
gamesmanship, and it is distressing in the extreme to see that game
being played at the expense of the lives and health of very real women
in this country, women like Coreen Costello and Mary-Dorothy Line.
Don't play a political game with the lives and health of the women of
this country. Don't vote to send this bill to the President without a
health exception and without a true life exception.
Mr. Speaker, I include for the Record the following:

The Issue Is Not Abortion

(By Mary-Dorothy Line)

My husband and I are extremely offended by the ad sponsored
by the National Conference of Catholic Bishops that appeared
in the March 26, 1996 edition of the Washington Post. A bill
pending before the House (H.R. 1833) would ban intact
dilation and evacuation (intact D&E) procedures used in some
late-term abortions; late term abortions which are provided
to protect the mother's life or health when there is no hope
for the baby. This legislation is wrong, and it would hurt a
lot of American families. We know. We are one of those
families.
I am a registered Republican and we are practicing
Catholics. Last April, we found out I was pregnant with our
first child and were extremely happy. 19 weeks into my
pregnancy, an ultrasound indicated that there was something
wrong with our baby. The doctor noticed that his head was too
large and contained excessive fluid. This problem is called
hydrocephalus. Every person's head contains fluid to protect
and cushion the brain, but if there is too much fluid, the
brain cannot develop.
As practicing Catholics, when we have problems and worries,
we turn to prayer. So, our whole family prayed. We were
scared, but we are strong people and believe that God would
not give us a problem if we couldn't handle it. This was our
baby; everything would be fine. We never thought about
abortion.
A few weeks later we had two more ultrasounds. We consulted
with five specialists, who all told us the same thing. Our
little baby had an advanced, textbook case of hydrocephaly.
We asked what we could do. They all told us there was no hope
and recommended that we terminate the pregnancy. We asked
about in utero operations and shunts to remove the fluid, but
were again told there was nothing we could do. We were
devastated. I can't express the pain we still feel--this was
our precious little baby, and he was being taken from us
before we even had him.
My doctors, some of the best in the country, recommended
the intact D&E procedure.

[[Page H2908]]

No scissors were used and no one sucked out our baby's brain
as is depicted in the inflammatory ads supporting H.R. 1833.
A simple needle was used to remove the fluid--the same fluid
that killed our son--to allow his head to pass through the
birth canal undamaged. This was not our choice--this was
God's will.
My doctor knew that we would want to have children in the
future, even though it was the furthest thing from my mind at
the time. They recommended the best procedure for me and our
baby. Because the trauma to my body was minimized by this
procedure, I was able to become pregnant again. We are
expecting another baby in September.
I pray every day that this will never happen to anyone
again, but it will, and those of us unfortunate enough to
have to live this nightmare need a procedure which will give
us hope for the future.
Congress needs to hear the truth. The truth does make a
difference--when people listen. Last week, I testified at a
hearing held in the Maryland legislature. A committee there
was considering a bill similar to the one Congress in
prepared to pass this week. In Maryland, they listened. And
in Maryland, several conservative legislators joined in the
15-6 committee vote to reject this bill.
After seeing the callous way our tragedies are regarded by
the proponents of H.R. 1833, I know the only hope to protect
families lies with the President of the United States. I am
told he is a good man. I am told he listens to people. I hope
he listens to us, to the truth, and not to the political
propaganda. I pray he shows love and compassion for women
like me and families like mine. I pray he vetoes this bill.
Many people do not understand the real issue--it is women's
health; not abortion and certainly not choice. We must leave
decisions about the type of medical procedure to employ with
the experts in the medical community and with the families
they affect. It is not the place for government.
Mr. CANADY of Florida. Mr. Speaker, I yield 3\1/2\ minutes to the
gentlewoman from California [Mrs. Seastrand].
Mrs. SEASTRAND. Mr. Speaker, I thank the gentleman from Florida for
yielding time to me.
Mr. Speaker, I rise this evening in support of the amended version of
H.R. 1833. The practice of partial-birth abortions should spark outrage
in all of us. We, of this Congress, have a duty, a duty to protect
children who might otherwise fall victim to this procedure. I believe
we also have a duty to protect women from the scandalous falsehoods
perpetrated by the opponents of this bill.
Those desperate to obscure the true nature of partial-birth abortions
claim that the anesthesia given to the mother prior to the procedure
results in the death of the child in utero. Based upon this myth they
argue that it is misleading to call the procedure a partial-birth
abortion, and any concerns that the child experiences pain are
misplaced. Extreme abortion advocates have trumpeted this mistaken
notion with the complicity of the unquestioning media.
Mr. Speaker, I rely upon the authority of Dr. Norig Ellison,
president of the American Society of Anesthesiologists, who says this
claim has ``absolutely no basis in scientific fact.''
Dr. David Birnbach, the president-elect of the Society for Obstetric
Anesthesia and Perinatology, says it is crazy. The American Medical
News reported in a January 1 article that ``Medical experts contend the
claim is scientifically unsound and irresponsible, unnecessarily
worrying pregnant women who need anesthesia.''
During the House and Senate debates over this measure, we heard
several of the opponents piously express concern for the health of
women. Yet, they willingly propagate the mistaken rhetoric of the
extreme pro-abortionists, and undoubtedly frighten pregnant women in
need of anesthesia for other medical reasons.
In Dr. Ellison's words:

I am deeply concerned that the widespread publicity may
cause pregnant women to delay necessary and perhaps life-
saving medical procedures totally unrelated to the birthing
process, due to misinformation regarding the effects of
anesthetics on the fetus.

Mr. Speaker, the Senate amendments to the bill clearly make an
exception should the life of the mother depend on the employment of
this procedure. I am satisfied that no woman will be harmed as a result
of this legislation, and many children will be spared a particularly
gruesome fate. To oppose this bill is to display the extremism in the
defense of abortion rights that is beyond reason and without
compassion.
In the immortal words of Abraham Lincoln:

Fellow Citizens, we cannot escape history . . . The fiery
trial through which we will pass will light us down, in honor
or dishonor, to the latest generation.

Let it be recorded by history that this Congress took a stand, not
only against cruel medical practice, but for the life and death of
women.

{time} 1900

Mrs. SCHROEDER. Mr. Speaker, I yield 2 minutes to the gentlewoman
from New York [Mrs. Lowey], the distinguished cochair of the Caucus on
Women's Issues.
(Mrs. LOWEY asked and was given permission to revise and extend her
remarks.)
Mrs. LOWEY. Mr. Speaker, I rise in opposition to H.R. 1833.
Mr. Speaker, we are here today debating this extreme bill because the
Republican leadership is absolutely committed to eliminating the right
to choose. The pro-life majority in this House has restricted abortion
rights throughout the last year--and this bill is yet another step on
the road to the back alley. This legislation will criminalize abortion,
harass doctors, and prevent women from getting the medical care they
need.
Families facing a late-term abortion are families that want to have a
child. These couples have chosen to become parents, and only face
terminating the pregnancy due to tragic circumstances. Terminating a
wanted pregnancy at this stage is agonizing and deeply personal.
This procedure is not about choice, It is about necessity.
Let me tell you about Claudia Ades, who lives in Sanata Monica, CA.
She heard about this bill, and called to ask me if there was anything
she could do to defeat it. As Claudia said so passionately, ``This
procedure saved my life and my family.''
Three years ago, Claudia was pregnant and happier than she had ever
been. However, 6 months into her pregnancy she discovered that the
child she was carrying had severe fetal anomalies that made its
survival impossible, and placed Claudia's own life at risk.
After speaking to a number of doctors, Claudia and her husband
finally concluded that there was no way to save the pregnancy. ``This
was a desperately wanted pregnancy,'' Claudia said, ``But my child was
not meant to be in this world.''
Those of us with healthy children can only imagine the horror that
Claudia felt when she received the news about her condition. It is the
news that all mothers pray every day they will never hear.
But, in those tragic cases where families do hear this horrible news,
who should decide? The one thing that I know for sure is that the
decision should not be made by Congress. At that horrible, tragic
moment, the Government has no place.
Now, the Republican leadership could have made this a better bill by
including real life and health exceptions. Not the sham life exception
that's included in this bill--written by the Republican presidential
candidate from Kansas who never met an abortion restriction that he
didn't support. President Clinton even indicated that he would sign the
bill if it contained real exceptions. But the Republican leadership
doesn't want the President to sign this bill--they want him to veto it.
This entire debate is a pay-off to the Christian Coalition and an
exercise in election year political theatre.
Mr. Speaker, President Clinton's veto pen is the only thing
protecting American women from the back alley. H.R. 1833 is an extreme
bill that will put the lives of American women at risk. I urge its
defeat.
Mr. CANADY of Florida. Mr. Speaker, I yield 2 minutes to the
gentleman from Virginia [Mr. Goodlatte], a member of the Committee on
the Judiciary.
Mr. GOODLATTE. Mr. Speaker, I thank the chairman for his fine work.
Mr. Speaker, today I rise in support of an eminently reasonable bill
to ban a heinous procedure to partially deliver fully formed babies,
and then kill them. Again, I repeat, this is a very reasonable bill
which the majority of Americans wholeheartedly support. Those who
oppose this bill are the excessive ones.
Already, 288 of the Members of this House have voted to ban partial
birth abortions. The bill before us today is identical except for three
minor changes--all of which I support:

[[Page H2909]]

It still allows an exception to the ban in order to save the life of
the mother, and now provides in those cases that the prosecution must
prove that there was no other alternative available to save the
mother's life, rather than placing the burden on the physician.
It clarifies that only the physician who performs the abortion may
incur civil liability under the bill.
It allows fathers to sue a physician for damages only if the father
and mother of the child were married when the abortion was performed.
We must put an end to this barbaric procedure where the difference
between abortion and murder is literally a few inches. This is
effective legislation to ban an unbelievably gruesome act. I urge my
colleagues to support it.
Mrs. SCHROEDER. Mr. Speaker, I yield 2 minutes to the gentleman from
Massachusetts [Mr. Frank], the ranking member of the subcommittee.
Mr. FRANK of Massachusetts. Mr. Speaker, I salute the courage of the
gentlewoman from Colorado [Mrs. Schroeder] and her willingness to take
this issue on.
Mr. Speaker, we are clearly here dealing with a political issue. We
heard one of the previous speakers say the purpose of it is to give the
President something to veto. The President has said, amend this bill
and he will sign it. Amend it to say that if the particular procedure
is deemed necessary by a doctor to avoid serious adverse health
consequences, he can do it.
Understand that this bill would say to a doctor, if in his judgment
performing the abortion in this way is necessary to prevent severe
physical damage to the mother, as long it is not life-threatening, he
cannot do it. He can do it if it will save her life, but if it will
destroy forever her chances of having a child, if it will cause her
serious, long-lasting physical pain and disability, this bill says it
is a crime to do it.
Mrs. SCHROEDER. Mr. Speaker, will the gentleman yield?
Mr. FRANK of Massachusetts. I yield to the gentlewoman from Colorado.
Mrs. SCHROEDER. Mr. Speaker, I think the gentleman is absolutely
correct. They are saying that there is a life exception, but it is very
cosmetic because the way I read the bill, it is that the doctor would
have to prove there was no other medical procedure that would suffice,
and maybe there is another medical procedure but it would not be as
good for her outcome.
Mr. FRANK of Massachusetts. Mr. Speaker, reclaiming my time, and of
course that is only life. It does not deal with health. The majority
refused to allow an amendment. Be very clear about it. We have twice
asked them let us vote, as the Senate did, and the amendment in the
Senate got 46 votes and lost narrowly.
Members have said, ``Your health exception is too broad.'' My
colleagues on the other side of the aisle can narrow it if they want
to. But they cannot, however, object that we have one that is too broad
when they have none at all; when they are asking the House to vote for
a bill that will make it a crime for a doctor to perform this procedure
even if he believes that performing it is necessary to prevent serious
physical, long-lasting, permanent damage to the mother. That is not a
reason for going forward under this outrageous bill.
Mrs. SCHROEDER. Mr. Chairman, I yield 2 minutes to the distinguished
gentleman from New York [Mr. Schumer].
Mr. SCHUMER. Mr. Speaker, I salute the gentlewoman from Colorado for
her leadership, and I want to reiterate some of the points that have
been made before.
Mr. Speaker, it all boils down to this: A doctor is in an operating
room, an obstetrician-gynecologist. There is a serious problem that
evolves and the doctor has to make a judgment. Does it make any sense
for this body, or for any body, to impose the threat of a crime, a
criminal penalty and a jail sentence, on that doctor while he or she is
making the decision about what is best for health or for life?
Then let us say that we even go with the narrow amendment of life.
What is the doctor going to do? Is a doctor not supposed to worry that
maybe his or her judgment is different than what a jury might determine
2 years later, not under the glare of the operating room lights?
This amendment is regrettable. It is unfortunate. I have some
sympathy with those that disagree with my view on the issue of choice,
about the idea that it should not be easy and it should not be a quick
decision, and abortion should not be a method of birth control. We are
not talking about that here because in these cases the mother, the
parents, wanted to have the baby but something happened and an
emergency may occur. We, again without a bit of knowledge of what is
actually the best medical procedure, are imposing something here, and
that is simply wrong.
I would say to my colleagues, resist this amendment. It is not going
to be an issue in political campaigns, believe me. It is too arcane and
too gruesome. Do the right thing. Rise to the occasion and vote down
this awful amendment.
Mr. CANADY of Florida. Mr. Speaker, I yield 2 minutes to the
gentleman from Indiana [Mr. Roemer].
(Mr. ROEMER asked and was given permission to revise and extend his
remarks.)
Mr. ROEMER. Mr. Speaker, we hear now today from some of our
colleagues that this is an issue of privacy and the U.S. Congress
should not vote on it. We vote on issues of speech, and that is very
private. We vote on issues of prayer, and that is very private. We vote
on issues of guns, and that is everywhere private. Certainly we should
vote to ban this kind of procedure that takes the life of a partially
delivered baby.
I hear some of my colleagues on this side of the aisle even say that
this is a regrettable procedure, an unfortunate procedure. This is a
gruesome and brutal procedure, and as we spend billions of dollars
every single year on medicine and technology, certainly there is no
room in our society for this kind of procedure to continue to take
place in 1996, no matter what your view is as a pro-life or a pro-
choice Member of Congress.
What are we voting on? A partial birth abortion is defined as a
procedure in which a doctor partially delivers a living fetus before
killing the fetus and completing the delivery. That is what we are
voting on.
What have we added to this in chapter 74, section 1531? ``This
paragraph shall not apply to a partial-birth abortion that is necessary
to save the life of the mother whose life is endangered by a physical
disorder, illness or injury.''
Finally, let me conclude by saying this issue should not divide pro-
choice and pro-life. It should not divide women and men. It should not
divide Democrats and Republicans. It is a brutal and inhumane procedure
that should be banned, and I urge my colleagues to support this bill.
Mrs. SCHROEDER. Mr. Speaker, I yield 2 minutes to the gentlewoman
from California [Mrs. Lofgren], a distinguished Member of the Committee
on the Judiciary.
Ms. LOFGREN. Mr. Speaker, politicians in Congress have issues. We
have wedge issues, we have issues we put in direct mail and we have
rhetoric. I have heard a lot of partial discussions, selected comments
that are meant to inflame, meant to persuade, and I think in some cases
meant to mislead. But the people who will be hurt by this bill do not
have issues. They have tragedies, and they do not need this bill to
pass.
Mr. Speaker, I want to talk about people I really know, my friend
Suzie Wilson's son and daughter-in-law, Bill and Vicki Wilson, and
their wonderful children, Jon and Kaitlyn, because 2 years ago this
April 8th they lost Abigail.
They were very much looking forward to Abigail. They had had two baby
showers. The nursery was full of pink ribbons waiting for Abigail, and
in the eighth month they found out that all of Abigail's brains had
formed outside of her cranium and that there was no way that this child
could survive. It was a tragedy.
They took their case to the doctor, who was able to save Vicki's life
and to save her fertility. The question that faced them was not whether
Abigail could live, but how would Abigail die and whether Vicki's
uterus would burst while Abigail was dying.
I am glad that Vicki and Bill had the chance they did to keep their
family intact. I know because we had a lot of tears, we friends of the
family. They did not need the Congress of the United States to help
them at that moment. They needed a doctor. They needed the

[[Page H2910]]

love of their friends and their family. They needed the guidance of
God.
Mr. Speaker, I have talked to Members in this body who have told me
privately that if it were their wife, they would want this procedure,
and then gone ahead and voted for this bill. I would ask all of you, do
your politics with some other issues. Hurt someone else. Search your
conscience and look at my friends, the Wilson family. Think of them and
put politics aside.
Mrs. SCHROEDER. Mr. Speaker, I yield 2 minutes to the distinguished
gentlewoman from Georgia [Ms. McKinney].
Ms. McKINNEY. Mr. Speaker, on Friday this House voted to repeal the
assault weapons ban as a payoff to the NRA. Today we are voting to ban
a rare but sometimes medically necessary procedure as a payoff to
certain right-wing elements within the Republican party.
Mr. Speaker, we need to be honest with each other. Anti-choice forces
see this ban as the first step toward ending a woman's right to choose
in America. As far as the anti-choice forces are concerned, there is no
difference between the procedure we are debating today and abortions in
the cases of rape and incest.

{time} 1915

Yet these same radicals believe that properly manipulated, this late-
term procedure can be the wedge issue to divide the overwhelmingly pro-
choice American public. Today, it is this procedure. Tomorrow, it is
family planning.
Mr. Speaker, no one in this body likes this procedure. And, yes, it
is unpleasant. But this rarely used medical procedure remains necessary
to ensure that women who must have an abortion are still able to bear
children afterwards.
Mr. CANADY of Florida. Mr. Speaker, I yield 2 minutes to the
gentlewoman from Idaho [Mrs. Chenoweth].
Mrs. CHENOWETH. Mr. Speaker, I rise today in absolute support of H.R.
1833.
As I walked to the floor this evening, it struck me how ridiculous
and sad it is that in this great Chamber in this great Nation, we
should even be debating this issue.
What we are talking about today is not the issue of abortion per se.
That is a discussion for another time, and that time will come.
What we are talking about is a procedure that is positively medieval.
The issue of abortion is very emotional and I try to avoid using
inflammatory rhetoric on the issue, because I have felt it didn't
further the debate.
But in this case murder is not too strong a term.
Partial birth abortion is murder, cold, grisly, and premeditated.
Partial birth is used on babies who are up to 9 months in the womb.
The ninth and final month.
At 9 months, what is the difference between a baby in the womb or a
baby in the crib? One is just as helpless as the other.
And yet this procedure exists and is used at will.
We have seen statements from abortionists that not only have they
frequently performed this procedure, but they have often performed it
in purely elective circumstances.
Can anyone argue that this chilling act is medically necessary?
The American Medical Association's Council on Legislation voted
unanimously to recommend that the AMA board of trustees endorse H.R.
1833.
Many council members agreed that, ``the procedure is basically
repulsive.''
To condone the practice of partial birth abortion is to discard and
disgrace every shred of morality that we as human beings should
embrace.
Mr. Speaker, I strongly urge my colleagues to take a stand against
this evil procedure known as partial birth abortion and vote for H.R.
1833.
Mrs. SCHROEDER. Mr. Speaker, I yield 2 minutes to the distinguished
gentlewoman from Kansas [Mrs. Meyers].
Mrs. MEYERS of Kansas. Mr. Speaker, we know that after the 24th week,
only .01 percent of all abortions are performed, .01 percent. There are
two or three procedures that are used, meaning that this particular
procedure is used in only a portion of that .01 percent. Of these
procedures, all are more terrifying and unpleasant than this one. But
if a woman is carrying a fetus which has a severe abnormality or if the
woman has a severe health condition which threatens her health if she
continues to carry the fetus, one of these procedures must be used. The
bill itself states that there are circumstances in which no other
procedure will suffice.
The Senate amendments improved the bill only marginally, and I must
still vote ``no'' because, one, I believe strongly that we should not
remove a medical option that might preserve the health of a woman or
preserve the ability of a woman to have future children. Second, I
believe strongly that we should not decide medical procedures on the
floor of this House and am deeply concerned about where this might
lead. And, third, I believe strongly that we should not criminalize a
medical procedure. For these three reasons, I must vote ``no.''
Mrs. SCHROEDER. Mr. Speaker, I yield 2 minutes to the gentlewoman
from California [Ms. Woolsey].
Ms. WOOLSEY. Mr. Speaker, I rise in opposition to H.R. 1833 and
criminalizing late-term abortions.
First of all, this conference report is a cruel, a very cruel attempt
to make a political point. Make no mistake about it, ladies and
gentleman, this conference report, with all of the emotional rhetoric
and the exaggerated testimony, is a frontal attack on Roe versus Wade
by the Gingrich majority, plain and simple. With the Gingrich majority,
what they want is to do away with Roe. The radical rights wants to do
away with Roe, and H.R. 183 is a good first step as far as they are
concerned. So let us be honest about what this debate is really about.
This legislation seeks to prohibit the wide array of medical
techniques which are rarely used but are sometimes required in the late
stages of pregnancy, like with the Wilson family, in extreme and tragic
cases when the life of the mother is in danger, or the fetus is so
malformed that it has absolutely no chance of survival; for example,
when the fetus has no brain, or the fetus is missing organs or the
fetus's spine has grown outside of its body, when the fetus has zero
chance of life, when women are forced to carry these malformed fetuses
to term, they are in danger of chronic hemorrhaging, permanent
infertility, or death.
Woman and their doctors need to make these decisions, not the
Congress. Like the Wilsons, the family needs to make this decision with
their doctors, not the Congress.
I urge my colleagues to oppose the conference report on H.R. 1833.
Mr. CANADY of Florida. Mr. Speaker, I yield 2 minutes to the
gentleman from New Jersey [Mr. Smith].
Mr. SMITH of New Jersey. Mr. Speaker, children, however dependent,
are not property and no child is ever a throw-away. A pregnancy is not
a disease. Yet partial-birth abortions treat a partially delivered
child as a tumor, as a wart, as a disease to be destroyed.
Even if you have a doubt, I say to my colleagues concerning the
humanity of an unborn child, can you not resolve that doubt in the
baby's favor when the infant is half delivered?
Mr. Speaker, for the first time ever, Democrats and Republicans will
send to the President a bill that says ``no'' to the horrific procedure
that literally sucks the brains out of a baby's head. This poster to my
left is not some kind of fiction. It is the reality of this horrendous
child abuse.
A registered nurse, Brenda Pratt Shafer, said after seeing some of
these partial-birth abortions, and I quote, ``The baby's body was
moving, his little fingers were clasping together, he was kicking his
feet. All the while, his little head was stuck inside.'' Dr. Haskell
took a pair of scissors and inserted them into the back of the baby's
head. Then he opened up the scissors. Then he stuck a high-powered
suction tube into the hole and sucked the baby's brains out.
Mr. Speaker, for the first time ever, despite the extraordinary
ability of the pro-abortion lobby to obfuscate and confuse, the reality
of abortion is finally getting the scrutiny it deserves. By addressing
this particular kind of abortion, this legislation compels us to face
the dark secret, the cold fact that an unborn baby dies in every
abortion.
I am astonished that Members can support this kind of abortion. Two
decades of cover up are over. I would say to colleagues that the brutal
methods,

[[Page H2911]]

whether it be chemical poisoning or suction, dismemberment of a baby,
in this case a partially delivered baby killed with brain suction, this
must be brought to the forefront so the people know exactly what is
going on.
I hope the President says to the bill that he will sign it. I hope he
signs it. It is not likely. He will have earned the legacy of being the
abortion President. What a tragic, what a pathetic legacy to be the
abortion President, especially a man who once in his past used to be
pro-life.
Mrs. SCHROEDER. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, I am sorry the gentleman would not yield. I wanted to
point out it does say it was the Conference of Catholic Bishops that
created that poster.
Mr. Speaker, I yield 2 minutes to the gentlewoman from Hawaii [Mrs.
Mink].
(Mrs. MINK of Hawaii asked and was given permission to revise and
extend her remarks.)
Mrs. MINK of Hawaii. Mr. Speaker, it is really tragic, tragic that
the personal problems and the anxieties of women who face these very,
very difficult decisions that must be made with respect to their health
and their safety and the integrity of their family and to have those
tragic circumstances of a person's life be used under these
circumstances to advance this political goal of trying to do away with
abortion.
But I think that the debate clearly points out that what is being
attempted here is a denunciation of the rights of women that have been
created by the U.S. Supreme Court. That is what is at stake here.
It is not this procedure that is used so few times out of necessity,
but it is the principle of interfering with the doctor and the women
that require this procedure, taking away that right of a woman to make
this difficult decision, taking away the right of a woman to consult
with her physician about what needs to be done, allowing the Congress
of the United States to make these decisions. I think that is the most
reprehensible thing we could even think of.
We talk about getting big government off of the backs of people.
Well, let us concentrate about what we are trying to do today. We are
trying to take away the rights of reproductive freedom that the Supreme
Court has established, which the courts have said we must not
interfere, and this is what is before us today, and that is why this
Congress must oppose it. That is why this bill must never become law.
It is trying to dictate to the doctors how to practice and criminalize
their profession. I think it is outrageous.
Mrs. SCHROEDER. Mr. Speaker, I yield 1 minute to the gentlewoman from
Texas [Ms. Jackson-Lee], a distinguished member of the Committee on the
Judiciary.
Ms. JACKSON-LEE of Texas. Mr. Speaker, I thank the gentlewoman for
yielding this time to me.
I am not a criminal, Mr. Speaker. And I am ashamed that what we are
doing today may, in fact, makes innocent women, women who love
children, criminals. Coreen Costello, Mary-Dorothy Lines, Claudia Ades,
Viki Wilson, Tammy Watts, and Vikki Stella, all women who offered their
most personal stories about wanting to conceive and to have a loving
child and yet coming upon a physical and debilitating need to have a
medical procedure.
Today we have legislation that will not cover all cases where a
woman's life is in danger. The bill will not provide a health
exception. H.R. 1833 creates obstacles to medical research, and
tragically the life exception will not protect women. Criminals, we are
making. Women, their families, their physicians. This is not the way to
go.
In order to suggest that those of us who rise to support the rights
of women do not have a love of a higher authority, how shameful. This
is a bad bill. It does not help this country. It does not help women,
and it certainly does not help the love we have for our children.
Mr. CANADY of Florida. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, I want to respond to a point that was made a few moments
ago about this bill criminalizing the activities of women and making
criminals of women. That is simply not true.
I would suggest that before Members come to the floor to speak about
the bill, they might want to read the bill. The bill says clearly a
woman upon whom a partial-birth abortion is performed may not be
prosecuted under this section.
Mr. Speaker, I reserve the balance of my time.

{time} 1930

Mrs. SCHROEDER. Mr. Speaker, I yield 2 minutes to the distinguished
gentlewoman from New York [Mrs. Maloney].
Mrs. MALONEY. Mr. Speaker, I rise in opposition to H.R. 1833. In yet
another attempt to roll back a woman's right to choose, to roll back
Roe versus Wade, and make all abortions illegal, choice opponents are
putting forward legislation which could endanger a woman's life and her
ability to have children in the future.
How odd that the majority party would describe itself as family
friendly. Plain and simple, the supporters of this bill feel it is more
important to save a doomed fetus than the life of a mother and her
ability to have children in the future.
Coreen Costello is the mother of two. The Dole amendment would not
have allowed her to use this procedure. Coreen Costello said in front
of the Senate in her testimony that she would have taken any child that
God gave her, regardless of any handicap. But her child was a child
that could not live. Fortunately for Coreen and her family, her doctor
was able to save her life and her fertility. She is now expecting her
next child.
But what about the women who come after Coreen? What will happen to
them, their health, their lives, their families, if this life-saving
procedure is outlawed? Congress has no place in their decisions and no
place in their tragedies.
Mrs. SCHROEDER. Mr. Speaker, I yield 3 minutes to the gentlewoman
from Connecticut [Mrs. Johnson].
Mrs. JOHNSON of Connecticut. Mr. Speaker, I thank the gentlewoman
from Colorado for yielding me time.
If your daughter and son-in-law were faced with the extraordinary
tragedy of discovering extreme fetal deformity late in pregnancy or a
life threatening development with abortion being the only alternative,
would you, would you, each individual Member of this body, want her to
have available to her the procedure that was the least threatening to
her life and the most protective of her future reproductive capability
and the most respectful of the need for the parents to be and their
living children to mourn their tragic loss?
Consider the experience of Coreen Costello. Mrs. Costello and her
husband hold strong pro-life views, but were suddenly faced with the
terrible and painful truth of the problems with her pregnancy.
Specialists had determined that the baby had a lethal neurological
disorder. Doctors at Cedars-Sinai told the Costellos that their
daughter would not live, and due to the amniotic fluid pooling in Mrs.
Costello's uterus, as well as the baby's position, there was a serious
risk of a ruptured uterus. Natural birth or an induced labor were
impossible. Coreen Costello then considered a caesarean section, but
the doctors at her hospital were adamant that the risk to her health
and life were simply too great.
She and her husband chose not to risk leaving their other children
motherless by opting for a D&E procedure. Because of the safety of the
procedure, Coreen is now pregnant again.
What right have we here in Congress on this floor to say to this
family that you should have risked mom's life and ignored your doctor's
advice? By what authority do we tell these women that we know more in
each of their cases than their own physicians?
It is ironic that some of you here are advocating legislation that
would assure that managed care plans guaranteed physicians the right to
tell women all the medical possibilities for treatment, and yet you
will legislate here tonight the denial to women of America who face
terribly tragic, painful, personal circumstances of the right to have
the medical procedure that in truth is safest for them and most
protective of their reproductive capability, assures them to the
maximum extent possible that they will have more children in their
future.
Men of the House of Representatives, women who are Members of
Congress,

[[Page H2912]]

if it were your daughter, would you not want her life and reproductive
hopes and dreams protected? Of course you would. Do not do this
shortsighted, mean-spirited, terrible thing to women in our Nation.
Mr. CANADY of Florida. Mr. Speaker, I yield 1 minute to the
gentlewoman from North Carolina [Mrs. Myrick].
Mrs. MYRICK. Mr. Speaker, I honestly believe that a lot of the
problems we have today in society stem from the fact that we have no
regard for human life. You can call me old-fashioned, but I believe
every individual born into this world is special, needed and important.
You know, our forefathers shared this philosophy when they wrote in
our Declaration of Independence that we are endowed by our Creator with
certain unalienable rights, that among these are life, liberty, and the
pursuit of happiness.
I ask that we consider the difference. A doctor performs a painful,
cruel, partial abortion one day, and it is accepted. And then the next
day, if that same mother gave birth to the same age child and then she
killed her child, she would be charged with murder. Only a few hours
separates these two acts, but one is considered justified and accepted,
even promoted, and the other is considered unjust. There is something
wrong with our society today if we continue to justify such an unjust
procedure.
Mrs. SCHROEDER. Mr. Speaker, I yield 1 minute to the distinguished
gentleman from Vermont [Mr. Sanders].
Mr. SANDERS. Mr. Speaker, I know that there are some Members of
Congress who believe they know everything about everything, but maybe
once in awhile Members of this body might want to show a little
humility. We are discussing a procedure which, as I understand it, is
used in .01 of 1 percent of abortions, a situation which occurs only
under the most tragic circumstances.
Day after day we hear from our conservative friends about how the
big, bad Government should leave people alone and get off of the backs
of people. I would urge our conservative friends to heed that advice on
this occasion.
This is a tragic circumstance. Let the woman, let her family, let the
physician make that decision, not the politicians in Congress.
Mr. CANADY of Florida. Mr. Speaker, I yield 1 minute to the gentleman
from Missouri [Mr. Volkmer].
(Mr. VOLKMER asked and was given permission to revise and extend his
remarks.)
Mr. VOLKMER. Mr. Speaker, I rise today in strong support of H.R.
1833, the Partial Birth Abortion Ban Act. Today's battle for the rights
of the unborn differ from previous prolife and proabortion debates.
Yes, this debate today will not stop all abortions. It will only stop
one procedure, the partial birth abortion. It brings to light the fact
that when a woman and her unborn child have this type of procedure,
that only the woman leaves the operating room.
Mr. Speaker, I think we are all forgetting one thing: A third
trimester baby has a very good chance of living, if it was allowed to
be born without interference. I urge my colleagues who might otherwise
not support a prolife piece of legislation to support this legislation,
which simply and narrowly protects against partial birth abortions.
This debate is not about a woman's right to choose, because there are
other options. This debate today is about putting an end to a procedure
that kills a child just a few inches from full birth.
Mrs. SCHROEDER. Mr. Speaker, I yield 2 minutes to the gentleman from
California [Mr. Becerra] a distinguished member of the Committee on the
Judiciary and also the spouse of a distinguished physician.
Mr. BECERRA. Mr. Speaker, I thank the gentlewoman for yielding me
time.
Mr. Speaker, I am confused. The debate I am hearing from that side
has nothing to do with the medical procedure that it seems we are
trying to ban. I continue to hear people talk about how we are
conducting abortions on babies that otherwise would be able to survive;
if the pregnancy were to go to term, we would have a living baby. When
in fact, as my wife who happens to be a high-risk obstetrician-
gynecologist who deals specifically with women who have difficult
pregnancies, has said, this is not a procedure where you are talking
about a fetus that will go to term and where you will have a healthy
baby born. This is a procedure that is used when it is fairly clear
that the baby has no chance to live, and to allow the pregnancy to go
to term would jeopardize the health and perhaps the life of the woman.
So it seems like the debate is not really on point.
Now, let me read something that came from the American College of
Obstetricians and Gynecologists, those doctors that are asked to
perform these types of procedures and to protect the women involved.
They state:

The college finds very disturbing any action by Congress
that would supersede the medical judgment of trained
physicians and that would criminalize medical procedures that
may be necessary to save the life of a woman. Moreover, in
defining what medical procedures doctors may or may not
perform, the bill employs terminology that is not even
recognized in the medical community, demonstrating why
congressional opinion should never be substituted for
professional medical judgment.

Mr. Speaker, I think that states it best. We have people here who are
trying to impose their opinion on a medical profession where technical,
highly sophisticated, highly trained individuals are being asked to
perform lifesaving procedures.
It does not make sense. We should stay out of this. We should let a
woman make that very difficult choice of what type of procedure she
would need to preserve her health and her life, and perhaps have a
chance to have a pregnancy that will be able to go to term.
Mr. Speaker, I would urge Members to seriously consider voting
strongly against this particular bill, because it does not do what the
proponents say.
Mrs. SCHROEDER. Mr. Speaker, I yield myself the balance of my time.
The SPEAKER pro tempore (Mr. Rogers). The gentlewoman from Colorado
is recognized for 2\1/2\ minutes.
Mrs. SCHROEDER. Mr. Speaker, as a woman, when I am with my doctor, I
want that doctor focused on my health, and not on their criminal
liability. What this bill does is it will focus any doctor on steering
away from what they think might be best for the patient, because they
could serve 2 years in prison or they could have a criminal record, or
on and on and on.
Mr. Speaker, I think every citizen thinks that that is a zone of
privacy. This Congress has never interfered in that zone of privacy
between a family and their physician. Today, for the first time, if
this bill becomes law, we will be moving to make an act criminal by a
doctor. I much more trust my doctor than I do Members of this body, I
am sorry to say, so I get very angry when I hear some of the things
that have been said here.
I have heard people talk about ``inhumane, brutal, gruesome,
terrible.'' We have seen the drawings. The drawings were not done by
the American College of Gynecologists and Obstetricians. They do not
support this bill. They were done, as they say rightfully, by the
Catholic Conference of Bishops. Now, they have the right to make their
case here, but, please, again, I think most Americans trust their
doctors to make those difficult decisions.
We have heard about pain, we have heard about everything. I sat
through those hearings. The anesthesiologists who testified said that
there is pain in everything. There is pain in birth. So if we are just
going to outlaw anything that is painful, we are going to be a very
busy Congress. What they were saying is what happened, some of the
advocates were misstating anesthesiology procedures. That is possible,
because people here are not doctors.

{time} 1945

But they were not supporting the bill. They were just trying to set
the record straight. Bottom line, as the gentlewoman from Kansas said,
these are in very tragic circumstances. Only .01 percent of all
abortions would be affected by this. These are basically a handful of
doctors, and thank goodness a handful of families. But I must say as
one who has been there, one who almost lost her life, I would be
terribly resentful of this happening, and I never thought it could
happen to me, so I say to people, please, please, I know this is a
difficult issue.
Anything you cannot explain, anything that is difficult to explain,
people hesitate to vote against. But please

[[Page H2913]]

be willing to make this explanation. It is much too important for
America's families.
Mr. CANADY of Florida. Mr. Speaker, I yield such time as she may
consume to the gentlewoman from Nevada [Mrs. Vucanovich].
(Mrs. VUCANOVICH asked and was given permission to revise and extend
her remarks.)
Mrs. VUCANOVICH. Mr. Speaker, I strongly urge my colleagues to
support H.R. 1833 with the Senate amendments which would ban this
brutal procedure know as partial-birth abortion.
Mr. Speaker, as many of you know, I have 15 grandchildren. Two of my
grandchildren, the miracle twins as I call them, were born prematurely
at 7 months. They were so tiny that they could fit in your hands but
they were perfectly formed little human beings and they are now 14
years old.
It makes me shudder to think that somewhere, perhaps even today, in
this country that there are other little preborn human beings 7 months
old in their mothers womb that are going to be subject to this brutal,
horrible procedure known as a partial birth abortion.
I am not the only one who finds this procedure horrifying. The
American Medical Association's Legislative Council unanimously decided
that this procedure was not ``a recognized medical technique'' and that
``this procedure is basically repulsive.'' This is especially true when
you realize that 80 percent of these types of abortion are done as a
purely elective procedure. It is important to note that this bill does
make exception for this type of abortion if it is necessary to save the
life of the mother, however, this is an exception that will have to be
used rarely.
I think we can all agree that it is inhuman to begin the birthing
process and nearly complete the delivery of the baby, only to suck the
life out of the child.
I strongly urge my colleagues to support H.R. 1833, with the Senate
amendments, which would ban this brutal procedure known as partial
birth abortion.
Mr. CANADY of Florida. Mr. Speaker, I yield the balance of my time to
the gentleman from Illinois [Mr. Hyde], chairman of the Committee on
the Judiciary.
The SPEAKER pro tempore (Mr. Rogers). The gentleman from Illinois is
recognized for 5 minutes.
(Mr. HYDE asked and was given permission to revise and extend his
remarks.)
Mr. HYDE. Mr. Speaker, I listened with great intensity to the debate
this evening. It is an important debate. I heard the gentleman from
Vermont talk about humility, and he is absolutely right. You do not
deal with people's lives in a sense of arrogance at all. But at the
same time, if you believe you are right, if you are convinced that you
possess the truth and you remain silent, you become the accomplice of
liars and forgers. I just ascribe the failure to consider the unborn,
and I listened to all of the impassioned remarks of my friends on the
other side, they never talk about the unborn. It is the woman, it is
her family, it is her doctor, but the little tiny infant in the
shadows, the absent person, the invisible person is the unborn, and
that is a failure of imagination. That is a compassion deficit.
Mr. Speaker, I guess you have to be healthy to be born. I guess our
Declaration of Independence, when it talked about the right to life
being inalienable should have said if you are healthy, if you are
healthy. God help you if you are handicapped before you are born. But
if you make it through the birth canal, we will give you a preferred
parking place. That is the way we deal with those situations. No, the
partial birth abortion, which is just what it is. It is not an exercise
of reproductive rights, and it is not a fetus. It is an abortion. It is
not a termination of a pregnancy. It is an extermination of a
defenseless little life whose little arms and little legs are wiggling
until that scissors gets shoved in his neck and then they stiffen. We
heard that testimony. Some of you heard that testimony. There is a
coursening of our national conscience when you tolerate this form of
torture.

Catholic bishops. Thank God somebody cares about this grotesquery.
Thank God, I do not think that invalidates those charts. A political
goal? If defending human dignity is political, then I plead guilty. But
somebody has to speak up for that little defenseless child almost born,
three-quarters born, just the little head left, and they brutally kill
that little child, and you do it in the name of compassion. I am sorry,
I think that is a coursening, a desensitizing of our conscience.
This bill outlaws a uniquely barbaric method of abortion. Even to
describe it is painful, but it is not as painful as the pain that
little unborn child feels. If steel traps are too brutal for wild
animals, what is too brutal for a tiny member of the human family, an
almost-born infant? Have you heard of PETA, People for the Ethical
Treatment of Animals? We need a PETA for humans, people for the ethical
treatment of tiny, defenseless, cannot rise up in the streets, cannot
vote, cannot escape members of the human family. You would not treat a
coyote like you treat this little almost-born baby.
Members keep insisting the Government should not intervene. Well, I
know some Members are for Government intervention in everything but
abortion. I understand that. But who will speak for the baby if the
Government does not? What is the purpose of law to protect the weak
from the strong? What is weaker than a little child almost born and you
destroy that child in a barbaric way? No, I am glad the Government is
there. I am not that libertarian that I do not think that Government
should not protect the weak from the strong.
The only thing Members consider is the autonomy of the woman, the
woman. Well, God bless the woman, and she needs help and care and love
and nurturing. But what about the little baby? Why do you leave that
out of your equation, our of your calculus?
We had four anesthesiologists tell us those little babies feel pain.
That is why they get anesthesia. One of the head of the anesthesiology
department at Emory University says the pre-term baby feels pain more
that when it is born. That validates the title ``silent scream.'' What
about the pain felt by the little baby? Not a word, not a word.
Is there anything, is there anything we say no to? Is everything
permitted? God help us if that is true. Let us draw the line here. This
should not be tolerated.
Mr. DICKEY. Mr. Speaker, I submit the following material for
enclosure in the Record:

Dilation and Extraction for Late Second Trimester Abortion--Presented
at the National Abortion Federation Risk Management Seminar, September
13, 1992

(By Martin Haskell, M.D.)

introduction

The surgical method described in this paper differs from
classic D&E in that it does not rely upon dismemberment to
remove the fetus. Nor are inductions or infusions used to
expel the intact fetus.
Rather, the surgeon grasps and removes a nearly intact
fetus through an adequately dilated cervix. The author has
coined the term Dilation and Extraction or D&X to distinguish
it from dismemberment-type D&E's.
This procedure can be performed in a properly equipped
physician's office under local anesthesia. It can be used
successfully in patients 20-26 weeks in pregnancy.
The author has performed over 700 of these procedures with
a low rate of complications.

background

D&E evolved as an alternative to induction or instillation
methods for second trimester abortion in the mid 1970's. This
happened in part because of lack of hospital facilities
allowing second trimester abortions in some geographic areas,
in part because surgeons needed a ``right now'' solution to
complete suction abortions inadvertently started in the
second trimester and in part to provide a means of early
second trimester abortion to avoid necessary delays for
instillation methods.\1\ The North Carolina Conference in
1978 established D&E as the preferred method for early second
trimester abortions in the U.S.\2\, \3\, \4\
---------------------------------------------------------------------------
Footnotes at end of article.
---------------------------------------------------------------------------
Classic D&E is accomplished by dismembering the fetus
inside the uterus with instruments and removing the pieces
through an adequately dilated cervix.\5\
However, most surgeons find dismemberment at twenty weeks
and beyond to be difficult due to the toughness of fetal
tissues at this stage of development. Consequently, most late
second trimester abortions are performed by an induction
method.\6\, \7\, \8\
Two techniques of late second trimester D&E's have been
described at previous NAF meetings. The first relies on
sterile urea intra-amniotic infusion to cause fetal demise
and lysis (or softening) of fetal tissues prior to
surgery.\9\
The second technique is to rupture the membranes 24 hours
prior to surgery and cut the umbilical cord. Fetal death and
ensuing autolysis soften the tissues. There are attendant
risks of infection with this method.
In summary, approaches to late second trimester D&E's rely
upon some means to induce early fetal demise to soften the
fetal tissues making dismemberment easier.

patient selection

The author routinely performs this procedure on all
patients 20 through 24 weeks LMP

[[Page H2914]]

with certain exceptions. The author performs the procedure on
selected patients 25 through 26 weeks LMP.
The author refers for induction patients falling into the
following categories: previous C-section over 22 weeks; obese
patients (more than 20 pounds over large frame ideal weight);
twin pregnancy over 21 weeks; patients 26 weeks and over.

DESCRIPTION OF DILATION AND EXTRACTION METHOD

Dilation and extraction takes over three days. In a
nutshell, D&X can be described as follows: dilation; more
dilation; real-time ultrasound visualization; version (as
needed); intact extraction; fetal skull decompression;
removal; clean-up; recovery.

Day 1--Dilation

The patient is evaluated with an ultrasound, hemoglobin and
Rh. Hadlock scales are used to interpret all ultrasound
measurements.
In the operating room, the cervix is prepped, anesthetized
and dilated to 9-11 mm. Five, six or seven large Dilapan
hydroscopic dilators are placed in the cervix. The patient
goes home or to a motel overnight.

Day 2--Dilation

The patient returns to the operating room where the
previous day's Dilapan are removed. The cervix is scrubbed
and anesthetized. Between 15 and 25 Dilapan are placed in the
cervical canal. The patient returns home or to a motel
overnight.

Day 3--The Operation

The patient returns to the operating room where the
previous day's Dilapan are removed. The surgical assistant
administers 10 IU Pitocin intramuscularly. The cervix is
scrubbed, anesthetized and grasped with a tenaculum. The
membranes are ruptured, if they are not already.
The surgical assistant places an ultrasound probe on the
patient's abdomen and scans the fetus, locating the lower
extremities. This scan provides the surgeon information about
the orientation of the fetus and approximate location of the
lower extremities. The transducer is then held in position
over the lower extremities.
The surgeon introduces a large grasping forcep, such as a
Bierer or Hern, through the vaginal and cervical canals into
the corpus of the uterus. Based upon his knowledge of fetal
orientation, he moves the tip of the instrument carefully
towards the fetal lower extremities. When the instrument
appears on the sonogram screen, the surgeon is able to open
and close its jaws to firmly and reliably grasp a lower
extremity. The surgeon then applies firm traction to the
instrument causing a version of the fetus (if necessary) and
pulls the extremity into the vagina.
By observing the movement of the lower extremity and
version of the fetus on the ultrasound screen, the surgeon is
assured that his instrument has not inappropriately grasped a
maternal structure.
With a lower extremity in the vagina, the surgeon uses his
fingers to deliver the opposite lower extremity, then the
torso, the shoulders and the upper extremities.
The skull lodges at the internal cervical os. Usually there
is not enough dilation for it to pass through. The fetus is
oriented dorsum or spine up.
At this point, the right-handed surgeon slides the fingers
of the left had along the back of the fetus and ``hooks'' the
shoulders of the fetus with the index and ring fingers (palm
down). Next he slides the tip of the middle finger along the
spine towards the skull while applying traction to the
shoulders and lower extremities. The middle finger lifts and
pushes the anterior cervical lip out of the way.
While maintaining this tension, lifting the cervix and
applying traction to the shoulders with the fingers of the
left hand, the surgeon takes a pair of blunt curved
Metzenbaum scissors in the right hand. He carefully advances
the tip, curved down, along the spine and under his middle
finger until he feels it contact the base of the skull under
the tip of his middle finger.
Reassessing proper placement of the closed scissors tip and
safe elevation of the cervix, the surgeon then forces the
scissors into the base of the skull or into the foramen
magnum. Having safely entered the skull, he spreads the
scissors to enlarge the opening.
The surgeon removes the scissors and introduces a suction
catheter into this hole and evacuates the skull contents.
With the catheter still in place, he applies traction to the
fetus, removing it completely from the patient.
The surgeon finally removes the placenta with forceps and
scrapes the uterine walls with a large Evans and a 14 mm
suction curette. The procedure ends.

Recovery

Patients are observed a minimum of 2 hours following
surgery. A pad check and vital signs are performed every 30
minutes. Patients with minimal bleeding after 30 minutes are
encouraged to walk about the building or outside between
checks.
Intravenous fluids, pitocin and antibiotics are available
for the exceptional times they are needed.

ANESTHESIA

Lidocaine 1% with epinephrine administered intra-cervically
is the standard anesthesia. Nitrous-oxide/oxygen analgesic is
administered nasally as an adjunct. For the Dilapan insert
and Dilapan change, 12cc's is used in 3 equidistant locations
around the cervix. For the surgery, 24cc's is used at 6
equidistant spots.
Carbocaine 1% is substituted for lidocaine for patients who
expressed lidocaine sensitivity.

medications

All patients not allergic to tetracycline analogues receive
doxycycline 200 mgm by mouth daily for 3 days beginning Day
1.
Patients with any history of gonorrhea, chlamydia or pelvic
inflammatory disease receive additional doxycycline, 100 mgm
by mouth twice daily for six additional days.
Patients allergic to tetracyclines are not given
prophylactic antibiotics.
Ergotrate 0.2 mgm by mouth four times daily for three days
is dispensed to each patient.
Pitocin 10 IU intramuscularly is administered upon removal
of the Dilapan on Day 3.
Rhogam intramuscularly is provided to all Rh negative
patients on Day 3.
Ibuprofen orally is provided liberally at a rate of 100 mgm
per hour from Day 1 onward.
Patients with severe cramps with Dilapan dilation are
provided Phenergan 25 mgm suppositories rectally every 4
hours as needed.
Rare patients require Synalogos DC in order to sleep during
Dilapan dilation.
Patients with a hemoglobin less than 10 g/dl prior to
surgery receive packed red blood cell transfusions.

follow-up

All patients are given a 24 hour physician's number to call
in case of a problem or concern.
At least three attempts to contact each patient by phone
one week after surgery are made by the office staff.
All patients are asked to return for check-up three weeks
following their surgery.

third trimester

The author is aware of one other surgeon who uses a
conceptually similar technique. He adds additional changes of
Dilapan and/or lamineria in the 48 hour dilation period.
Coupled with other refinements and a slower operating time,
he performs these procedures up to 32 weeks or more.\10\

summary

In conclusion, Dilation and Extraction is an alternative
method for achieving late second trimester abortions to 26
weeks. It can be used in the third trimester.
Among its advantages are that it is a quick, surgical
outpatient method that can be performed on a scheduled basis
under local anesthesia
Among its disadvantages are that it requires a high degree
of surgical skill, and may not be appropriate for a few
patients.

footnotes

\1\ Cates, W. Jr., Schulz, K.F., Grimes D.A., et al: The
Effects of Delay and Method of Choice on the Risk of Abortion
Morbidity, Family Planning Perspectives, 9:266, 1977.
\2\ Borell, U., Emberey, M.P., Bygdeman, M., et al:
Midtrimester Abortion by Dilation and Evacuation (Letter),
American Journal of Obstetrics and Gynecology, 131:232, 1978.
\3\ Centers for Disease Control: Abortion Surveillance 1978,
p. 30, November, 1980.
\4\ Grimes, D.A., Cates, W. Jr. (Berger, G.S., et al, ed):
Dilation and Evacuation, Second Trimester Abortion--
Perspectives After a Decade of Experience, Boston, John
Wright--PSG, 1981, p. 132.
\5\ Ibid, p. 121-128.
\6\ Ibid, p. 121.
\7\ Kerenyi, T.D. (Bergen, G.S., et al, ed): Hypertonic
Saline Instillation, Second Trimester Abortion--Perspectives
After a Decade of Experience, Boston, John Wright--PSG, 1981,
p. 79.
\8\ Hanson, M.S. (Zatuchni, G. I., et al, ed): Midtrimester
Abortion: Dilation and Extraction Preceded by Laminaria,
Pregnancy Termination Procedures, Safety and New
Developments, Hagerstown, Harper and Row, 1979, p. 192.
\9\ Hern, W.M., Abortion Practice, Philadelphia, J.B.
Lippincott, 1990, p. 127, 144-6.

Mr. TIAHRT. Mr. Speaker, I believe my colleagues will be interested
in Dr. Birnbach's testimony related to partial birth abortions.
Mr. Chairman, members of the subcommittee, my name is David Birnbach,
M.D., and I am presently the director of obstetric anesthesiology at
St. Luke's-Roosevelt Hospital Center, a teaching hospital of Columbia
University College of Physicians and Surgeons in New York City. I am
also president-elect of the Society for Obstetric Anesthesia and
Perinatology, the society which represents my subspecialty.
I am here today to take issue with the previous testimony before
committees of the Congress that suggests that anesthesia causes fetal
demise. I believe that I am qualified to address this issue because I
am a practicing obstetric anesthesiologist. Since completing my
anesthesiology and obstetric anesthesiology training at Harvard
University, I have administered analgesia to more than 5,000 women in
labor and anesthesia to over 1,000 women undergoing caesarean section.
Although the majority of these cases were at full term gestation, I
have provided anesthesia to approximately 200 patients who were
carrying fetuses of less than 30 weeks gestation and who needed
emergency nonobstetric surgery during pregnancy. These operations have
included appendectomies, gall bladder surgeries, numerous orthopedic
procedures such as fractured ankles, uterine and ovarian procedures,
including malignant tumor removal, breast surgery, neurosurgery, and
cardiac surgery.
The anesthetics which I have administered have included general,
epidural, spinal, and local. The patients have included healthy as well
as very sick pregnant patients. Although

[[Page H2915]]

I often use spinal and epidural anesthesia in pregnant patients, I also
administer general anesthesia to these patients and, on occasion, have
needed to administer huge doses of general anesthesia in order to allow
surgeons to perform cardiac surgery or neurosurgery.
In addition, I believe that I am also especially qualified to discuss
the effect of maternally administered anesthesia on the fetus, because
I am one of only a handful of anesthesiologists who has administered
anesthesia to a pregnant patient undergoing in-utero fetal surgery,
thus allowing me to watch the fetus as I administered general
anesthesia to the mother. A review of the experiences that my
associates and I had while administering general anesthesia to a mother
while a surgeon operated on her unborn fetus was published in the
Journal of Clinical Anesthesia vol. 1, 1989, pp. 363-367. In this
paper, we suggested that general anesthesia provides several advantages
to the fetus who will undergo surgery and then be replaced in the womb
to continue to grow until mature enough to be delivered. Safe doses of
anesthesia to the mother most certainly did not cause fetal demise when
used for these operations.
Despite my extensive experience with providing anesthesia to the
pregnant patient, I have never witnessed a case of fetal demise that
could be attributed to an anesthetic. Although some drugs which we
administer to the mother may cross the placenta and affect the fetus,
in my medical judgment fetal demise is definitely not a consequence of
a properly administered anesthetic. In order to cause fetal demise it
would be necessary to give the mother dangerous and life-threatening
doses of anesthetics. This is not the way we practice anesthesiology in
the United States.
Mr. Chairman, I am deeply concerned that the previous congressional
testimony and the widespread publicity that has been given this issue
will cause unnecessary fear and anxiety in pregnant patients and may
cause some to unnecessarily delay emergency surgery. As an example,
several newspapers across the United States have stated that anesthesia
causes fetal demise. Because this issue has been allowed to become a
``controversy'' several of my patients have recently expressed concerns
about anesthesia, having seen newspaper or heard radio or television
coverage of this issue. Evidence that patients are still receiving
misinformation regarding the fetal effects of maternally administered
anesthesia can be seen by review of an article that a pregnant patient
recently brought with her to the labor and delivery floor. In last
month's edition of Marie Claire, a magazine which many of my pregnant
patients read, an article about partial birth abortion states: ``The
mother is put under general anesthetic, which reaches the fetus through
her bloodstream. By the time the cervix is sufficiently dilated, the
fetus has overdosed on the anesthetic and is brain-dead.'' These
incorrect statements continue to find their way into newspapers and
magazines around the country. Despite the previous testimony of Dr.
Ellison, I have yet to see an article that states, in no uncertain
terms, that anesthesia when used property does not harm the fetus. This
supposed controversy regarding the effects of anesthesia on the fetus
must be finally and definitively put to rest.

In order to address this complex issue, I believe that it is
necessary to comment on three of the statements which have recently
been made to the Congress.
First, Dr. James McMahon, now deceased, testified that anesthesia
causes neurologic fetal demise.
Second, Dr. Lewis Koplick supported Dr. McMahon and stated: ``I am
certain that anyone who would call Dr. McMahon a liar is speaking from
ignorance of abortions in later pregnancy and of Dr. McMahon's
technique and integrity.''
Third, Dr. Mary Campbell of Planned Parenthood has addressed this
issue by writing the following: ``Though these does are high, the
incremental administration of the drugs minimizes the probability of
negative outcomes for the mother. In the fetus these dosage levels may
lead to fetal demise--death--in a fetus weakened by its own
developmental anomalies.''
My responses to these statements are as follows:
One, there is absolutely no scientific or clinical evidence that a
properly administered maternal anesthetic causes fetal demise. To the
contrary, there are hundreds of scientific articles which demonstrate
the fetal safety of currently used anesthetics.
Two, Dr. Koplick has stated that the ``massive'' doses used by Dr.
McMahon are responsible for fetal demise. This again, is incorrect and
there is not scientific or clinical data to support this allegation. I
have personally administered ``massive'' doses of narcotics to
intubated critically ill pregnant patients who are being treated in an
intensive care unit. I am pleased to say that the fetuses were born
alive and did well.
Three, Dr. Campbell has described the narcotic protocol which Dr.
McMahon had used during his D&X procedures: it includes the
administration of Midazolam (10-40 mg) and Fetanyl (900-2,500
g). Although there is no evidence that this dose will cause
fetal demise, there is clear evidence that this excessive dose could
cause maternal death. These doses are far in excess of any anesthetic
that would be used by an anesthesiologist and even if they are
incrementally given over a 2 to 3 hour period these doses would in all
probability cause enough respiratory depression of the mother, to
necessitate intubation and/or assisted respiration. Since Dr. McMahon
cannot be questioned regarding his ``heavy handed'' anesthetic
practice. I am unable to explain why we would willingly administer such
huge amounts of drugs if he did indeed administer 2,500 g of
fentanyl and 40 mg of midazolam to a patient in a clinic, without an
anesthesiologist present, he has definitely placing the mother's life
at great risk.
In conclusion, I would like to say that I believe that I have a
responsibility as a practicing obstetric anesthesiologist to refute any
and all testimony that suggests that maternally administered anesthesia
causes fetal demise. It is my opinion that in order to achieve that
goal one would need to administer such huge doses of anesthetic to the
mother as to place her life at jeopardy. Pregnant women must get the
message that should they need anesthesia for surgery or analgesia for
labor, they may do so without worrying about the effects on their
unborn child.
Thank you for your attention. I am happy to respond to your
questions.
Mr. VOLKMER. Mr. Speaker, I submit the following material for
inclusion in the Record:

[From the American Medical News, Nov. 20, 1995]

Outlawing Abortion Method: Veto-Proof Majority in House Votes To
Prohibit Late-Term Procedure

(By Diane M. Gianelli)

Washington.--His strategy was simple: Find an abortion
procedure that almost anyone would describe as ``gruesome,''
and force the opposition to defend it.
When Rep. Charles T. Canady (R. Fla.) learned about
``partial birth'' abortions, he was set.
He and other anti-abortion lawmakers launched a
congressional campaign to outlaw the procedure.
Following a contentious and emotional debate, the bill
passed by an overwhelming--and veto-proof--margin: 288-139.
It marks the first time the House of Representatives has
voted to forbid a method of abortion. And although the
November elections yielded a ``pro-life'' infusion in both
the House and Senate, massive crossover voting occurred, with
a significant number of ``pro-choice'' representatives voting
to pass the measure.
The controversial procedure, done in second- and third-
trimester pregnancies, involves an abortion in which the
provider, according to the bill, ``partially vaginally
delivers a living fetus before killing the fetus and
completing the delivery.''
``Partial birth'' abortions, also called ``intact D&E''
(for dilation and evacuation), or ``D&X'' (dilation and
extraction) are done by only a handful of U.S. physicians,
including Martin Haskell, MD, of Dayton Ohio, and, until his
recent death, James T. McMahon, MD of the Los Angeles area.
Dr. McMahon said in a 1993 AM/News interview that he had
trained about a half-dozen physicians to do the procedure.
The procedure usually involves the extraction of an intact
fetus, feet first, through the birth canal, with all but the
head delivered. The surgeon forces scissors into the base of
the skull, spreads them to enlarge the opening, and uses
suction to remove the brain.
The procedure gained notoriety two years ago, when abortion
opponents started running newspaper ads that described and
illustrated the method. Their goal was to defeat an abortion
rights bill then before Congress on grounds it was so extreme
that states would have no ability to restrict even late-term
abortions on viable fetuses. The bill went nowhere, but
strong reaction to the campaign prompted anti-abortion
activists to use it again.
They drafted a bill that would ban the procedure, after
considering a number of other options. An Ohio law passed
earlier this year, for instance, bans ``brain suction''
abortions, except when all other methods would pose a
greater risk to the pregnant woman. It has been enjoined
pending a challenge.

Mixed feelings in medicine

The procedure is controversial in the medical community. On
the one hand, organized medicine bristles at the notion of
Congress attempting to ban or regulate any procedures or
practices. On the other hand, even some in the abortion
provider community find the procedure difficult to defend.
``I have very serious reservations about this procedure,''
said Colorado physician Warren Hern. MD. The author of
``Abortion Practice,'' the nation's most widely used textbook
on abortion standards and procedures. Dr. Hern specializes in
late-term procedures.
He opposes the bill, he said, because he thinks Congress
has no business dabbling in the practice of medicine and
because he thinks this signifies just the beginning of a

[[Page H2916]]

series of legislative attempts to chip away at abortion
rights. But of the procedure in question he says. ``You
really can't defend it. I'm not going to tell somebody else
that they should not do this procedure. But I'm not going to
do it.''
Dr. Hern's concerns center on claims that the procedure in
late-term pregnancy can be safest for the pregnant women, and
that without this procedure women would have died. ``I would
dispute any statement that this is the safest procedure to
use,'' he said.
Turning the fetus to a breech position is ``potentially
dangerous,'' he added. ``You have to be concerned about
causing amniotic fluid embolism or placental abruption if you
do that.''
Pamela Smith, MD, director of medical education, Dept. of
Ob-Gyn at Mt. Sinai Hospital in Chicago, added two more
concerns: cervical incompetence in subsequent pregnancies
caused by three days of forceful dilation of the cervix and
uterine rupture caused by rotating the fetus within the womb.
``There are absolutely no obstetrical situations
encountered in this country which require a partially
delivered human fetus to be destroyed to preserve the life of
the mother.'' Dr. Smith wrote in letter to Canady.
The procedure also has its defenders. The procedure is a
``well-recognize and safe technique by those who provide
abortion care,'' Lewis H. Koplik, MD, an Albuquerque, N.M.,
abortion provider, said in a statement that appeared in the
Congressional Record.
``The risk of severe cervical laceration and the
possibility of damage to the uterine artery by a sharp
fragment of calvarium is virtually eliminated. Without the
release of thromboplastic material from the fetal central
nervous system into the maternal circulation, the risk of
coagulation problems, DIC [disseminated intravascular
coagulation], does not occur. In skilled hands, uterine
perforation is almost unknown,'' Dr. Koplik said.
Bruce Ferguson, MD, another Albuquerque abortion provider,
said in a letter released to Congress that the ban could
impact physicians performing late-term abortions by other
techniques. He noted that there were ``many abortions in
which a portion of the fetus may pass into the vaginal canal
and there is no clarification of what is meant by `a living
fetus.' Does the doctor have to do some kind of
electrocardiogram and brain wave test to be able to prove
their fetus was not living before he allows a foot or hand to
pass through the cervix?''
Apart from medical and legal concerns, the bill's focus on
late-term abortion also raises troubling ethical issues. In
fact, the whole strategy, according to Rep. Chris Smith (R,
N.J.), is to force citizens and elected officials to move
beyond a philosophical discussion of ``a woman's right to
choose,'' and focus on the reality of abortion. And, he said,
to expose those who support ``abortion on demand'' as ``the
real extremists.''
Another point of contention is the reason the procedure is
performed. During the Nov. 1 debate before the House,
opponents of the bill repeatedly stated that the procedure
was used only to save the life of the mother or when the
fetus had serious anomalies.
Rep. Vic Fazio (D, Calif.) said, ``Despite the other side's
spin doctors--real doctors know that the late-term abortions
this bill seeks to ban are rare and they're done only when
there is no better alternative to save the woman, and, if
possible, preserve her ability to have children.''
Dr. Hern said he could not imagine a circumstance in which
this procedure would be safest. He did acknowledge that some
doctors use skull-decompression techniques, but he added that
in those cases fetal death has been induced and the fetus
would not purposely be rotated into a breech position.
Even some physicians who specialize in this procedure do
not claim the majority are performed to save the life of the
pregnant woman.
In his 1993 interview with AMNews, Dr. Haskell conceded
that 80 percent of his late-term abortions were elective. Dr.
McMahon said he would not do an elective abortion after 26
weeks. But in a chart he released to the House Judiciary
Committee, ``depression'' was listed most often as the reason
for late-term nonelective abortions with maternal
indications. ``Cleft lip'' was listed nine times under fetal
indications.
The accuracy of the article was challenged, two years after
publication, by Dr. Haskell and the National Abortion
Federation, who told Congress the doctors were quoted ``out
of context.'' AMNews Editor Barbara Bolsen defended the
article, saying AMNews ``had full documentation of the
interviews, including tape recordings and transcripts.''
Bolsen gave the committee a transcript of the contested
quotes, including the following, in which Dr. Haskell was
asked if the fetus was dead before the end of the procedure.
``No, it's not. No, it's really not. A percentage are for
various numbers of reasons. Some just because of the stress--
intrauterine stress during, you know, the two days that the
cervix is being dilated. Sometimes the membranes rupture and
it takes a very small superficial infection to kill a fetus
in utero when the membranes are broken.
``So in my case, I would say probably about a third of
those are definitely dead before I actually start to remove
the fetus. And probably the other two-thirds are not,'' said
Dr. Haskell.
In a letter to Congress before his death, Dr. McMahon
stated that medications given to the mother induce ``a
medical coma'' in the fetus, and ``there is neurological
fetal demise.''
But Watson Bowes, MD, a maternal-fetus specialist at the
University of North Carolina, Chapel Hill, said in a letter
to Canady that Dr. McMahon's statement ``suggests a lack
of understanding of maternal-fetal pharmacology. * * *
Having cared for pregnant women who for one reason or
another required surgical procedures in the second
trimester, I know they were often heavily sedated or
anesthesized for the procedures, and the fetuses did not
die.''

next move in the senate

At AMNews press time, the Senate was scheduled to debate
the bill. Opponents were lining up to tack on amendments,
hoping to gut the measure or send it back to a committee
where it could be watered down or rejected.
In a statement about the bill, President Clinton did not
use the word ``veto.'' But he said he ``cannot support'' a
bill that did not provide an exception to protect the life
and health of the mother. Senate opponents of the bill say
they will focus on the fact that it does not provide such an
exception.
The bill does provide an affirmative defense to a physician
who provides this type of abortion if he or she reasonably
believes the procedure was necessary to save the life of the
mother and no other method would suffice.
But Rep. Patricia Schroeder (D, Colo.) says that's not
sufficient. ``This means that it is available to the doctor
after the handcuffs have snapped around his or her wrists,
bond has been posted, and the criminal trial is under way,''
she said during the House debate.
Canady disagrees. ``No physician is going to be prosecuted
and convicted under this law if he or she reasonably believes
the procedure is necessary to save the life of the mother.''

organized medicine positions vary

The physician community is split on the bill. The
California Medical Assn., which says it does not advocate
elective abortions in later pregnancy, opposes it as ``an
unwarranted intrusion into the physician-patient
relationship.'' The American College of Obstetricians and
Gynecologists also opposes it on grounds it would ``supersede
the medical judgment of trained physicians and * * * would
criminalize medical procedures that may be necessary to save
the life of a woman,'' said spokeswoman Alice Kirkman.
The AMA has chosen to take no position on the bill,
although its Council on Legislation unanimously recommended
support. AMA Trustee Nancy W. Dickey, MD, noted that although
the board considered seriously the council's recommendations,
it ultimately decided to take no position, because it had
concerns about some of the bill's language and about Congress
legislating medical procedures.
Meanwhile, each side in the abortion debate is calling news
conferences to announce how necessary or how ominous the bill
is. Opponents highlight poignant stories of women who have
elected to terminate wanted pregnancies because of major
fetal anomalies.
Rep. Nita Lowey (D, N.Y.) told the story of Claudia Ames, a
Santa Monica woman who said the procedure had saved her life
and saved her family.
Ames told Lowey that six months into her pregnancy, she
discovered the child suffered from severe anomalies that made
its survival impossible and placed Ames' life at risk.
The bill's backers were ``attempting to exploit one of the
greatest tragedies any family can ever face by using graphic
pictures and sensationalized language and distortions,'' Ames
said.
Proponents focus on the procedure's cruelty. Frequently
quoted is testimony of a nurse. Brenda Shafer, RN, who
witnessed three of these procedures in Dr. Haskell's clinic
and called it ``the most horrifying experience of my life.
``The baby's body was moving. His little fingers were
clasping together. He was kicking his feet.'' Afterwards, she
said, ``he threw the baby in a pan.'' She said she saw the
baby move. ``I still have nightmares about what I saw.''
Dr. Hern says if the bill becomes law, he expects it to
have ``virtually no significance'' clinically. But on a
political level, ``it is very, very significant.''
``This bill's about politics,'' he said, ``it's not about
medicine.''
Mrs. VUCANOVICH. Mr. Speaker, I submit the following material for
inclusion in the Record:

[From Cincinnati Medicine, Fall 1993]

2nd Trimester Abortion

(An interview with W. Martin Haskell, MD)

Last summer, American Medical News ran a story on abortion
specialists. Included was W. Martin Haskell, MD, a Cincinnati
physician who introduced the D&X procedure for second
trimester abortions. The Academy received several calls
requesting information about D&X. The following interview
provides an overview.
Q: What motivated you to become an abortion specialist?
A: I stumbled into it by accident. I did an internship in
anesthesia. I worked for a year in general practice in
Alabama. I did two years in general surgery, then switched
into family practice to get board certified. My intentions at
that time were to go into emergency medicine. I enjoyed
surgery, but I realized there was an abundance of really good
surgeons here in Cincinnati. I didn't feel I'd

[[Page H2917]]

make much of a contribution. I'd be just another good
surgeon. While I was in family practice, I got a part-time
job in the Women's Center. Over the course of several months,
I recognized things there could be run a lot better, with a
much more professional level of service--not necessarily in
terms of medical care--in terms of counseling, the physical
facility, patient flow, and in the quality of people who
provided support services. The typical abortion patient
spends less than ten minutes with the physician who performs
the surgery. Yet, that patient might be in the facility for
three hours. When I talked to other physicians whose patients
were referred here, I saw problems that could be easily
corrected. I realized there was an opportunity to improve
overall quality of care, and make a contribution. I own the
center now.
Q: Back in 1979 when you were making these decisions, did
you consider yourself prochoice?
A: I've never been an activist. I've always felt that no
matter what the issue, you prove your convictions by your
hard work--not by yelling and screaming.
Q: Have there been threats against you?
A: Not directly. Pro-life activist Randall Terry recently
said to me that he was going to do everything within his
power to have me tried like a Nazi war criminal.
Q: A recent American Medical News article stated that the
medical community hadn't really established a point of fetal
viability. Why not?
A: Probably because it can't be established with uniform
certainty. Biological systems are highly variable. The
generally accepted point of fetal viability is around 24-26
weeks. But you can't take a given point in fetal development
and apply that 100 percent of the time. It just doesn't
happen that way. If you look at premature deliveries and
survival percentages at different weeks of gestation, you'll
get 24-week fetuses with some survival rate. The fact that
you get some survivors demonstrates the difficulty in
defining a point.
Q: Most women who get abortions end pregnancies during the
first trimester. Who is the typical second-trimester patient?
A: I don't know that there is a typical second-trimester
abortion. But if you look at the spectrum of abortions (most
women are between the ages of 19 and 29) they tend to be
younger. Some are older. The typical thing that happens with
older women is that they never realized they were pregnant
because they were continuing to bleed during the pregnancy.
The other thing we see with older women is fetal
malformations or Down's Syndrome. These are being diagnosed
much earlier now than they used to be. We're seeing a lot of
genetic diagnoses with ultrasound and amniocentesis at 17-18
weeks instead of 22-24 weeks. With the teenagers, anybody who
has ever worked with or had teenagers can appreciate how
unpredictable they can be at times. They have adult bodies,
but a lot of time they don't have adult minds. So their
reaction to problems tends to be much more emotional than an
adult's might be. It's a question of maturity. So even though
they may have been educated about all kinds of issues in
reproductive health, when a teenager becomes pregnant,
depending upon her relationship with her family, the amount
of peer support she has--every one is a highly-individual
case--sometimes they delay until they can no longer contain
their problem and it finally comes out. Sometimes it's money:
It takes them a while to get the money. Sometimes it's just
denial.
Q: Do you think more information on abstinence and
contraceptives would decrease the number of teenage
pregnancies?
A: I grew up in the sixties and nobody talked about
contraception with teenagers in the sixties. But today,
though it may be controversial in some areas, there's a lot
being taught about reproductive health in the high school
curricula. I think a lot more is being done, but the bottom
line is we're all still just human--with human emotions, and
particularly with teenagers, a sense of invulnerability; it
can't happen to me. So education helps a lot, but it's not
going to eliminate the problem. You can teach a person the
skills, but you can't make them use them.
Q: Does it bother you that a second trimester fetus so
closely resembles a baby?
A: I really don't think about it. I don't have a problem
with believing the fetus is a fertilized egg. Sure it becomes
more physically developed but it lacks emotional development.
It doesn't have the mental capacity for self-awareness. It's
never been an ethical dilemma for me. For people for whom
that is an ethical dilemma, this certainly wouldn't be a
field they'd want to go into. Many of our patients have
ethical dilemmas about abortion. I don't feel it's my role as
a physician to tell her she should not have an abortion
because of her ethical feelings. As individuals grow and
mature, learn more, feel more, experience more, their
perspective about themselves and life, morality and ethics
change. Facing the situation of abortion is a part of that
passage through life for some women--how they resolve that is
their decision. I can be their advisor much as a lawyer can
be; he can tell you your options, but he can't make you file
a suit or tell you not to file a suit. My role is to provide
a service and, to a limited degree, help women understand
themselves when they make their decision. I'm not to tell
them what's right or wrong.
Q: Do your patients ever reconsider?
A: Between our two centers, that happens maybe once a week.
There's a patient who changes her mind or becomes truly
ambivalent and goes home to reconsider, then might come back
a week or two later. I feel that's one of the strengths of
how we approach things here. We try not to create pressure to
have an abortion. Our view has always been that there are
enough women who want abortions that we don't have to coerce
anyone to have one. We've always been strongly against
pressure on our patients to go ahead with an abortion.
Q: How expensive is a second trimester abortion?
A: Fees range from $1,200-1,600 depending on length of
pregnancy. More insurance companies cover abortion than don't
cover it. About 15 percent of our patients won't use
insurance because they want to maintain privacy. About 10-20
percent use insurance. The rest pay out of pocket.
Q: What led you to develop D&X?
A: D & E's, the procedure typically used for later
abortions, have always been somewhat problematic because of
the toughness and development of the fetal tissues. Most
physicians do terminations after 20 weeks by saline infusion
or prosteglandin induction, which terminates the fetus and
allows tissue to soften. Here in Cincinnati, I never really
explored it, but I didn't think I had that option. There
certainly weren't hospitals willing to allow inductions past
18 weeks--even Jewish, when they did abortions, their limit
was 18 weeks. I don't know about University. What I saw here
in my practice, because we did D & Es, was that we had
patients who needed terminations at a later date. So we
learned the skills. The later we did them, the more we saw
patients who needed them still later. But I just kept doing D
& Es because that was what I was comfortable with, up until
24 weeks. But they were very tough. Sometimes it was a 45-
minute operation. I noticed that some of the later D & Es
were very, very easy. So I asked myself why can't they all
happen this way. You see the easy ones would have a foot
length presentation, you'd reach in and grab the foot of the
fetus, pull the fetus down and the head would hang up and
then you would collapse the head and take it out. It was
easy. At first, I would reach around trying to identify a
lower extremity blindly with the tip of my instrument. I'd
get it right about 30-50 percent of the time. Then I said,
``Well gee, if I just put the ultrasound up there I could see
it all and I wouldn't have to feel around for it. I did that
and sure enough, I found it 99 percent of the time. Kind of
serendipity.
Q: Does the fetus feel pain?
A: Neurological pain and perception of pain are not the
same. Abortion stimulates fibers, but the perception of pain,
the memory of pain that we fear and dread are not there. I'm
not an expert, but my understanding is that fetal development
is insufficient for consciousness. It's a lot like pets. We
like to think they think like we do. We ascribe human-like
feelings to them, but they are not capable of the same self-
awareness we are. It's the same with fetuses. It's natural to
project what we feel for babies to a 24-week old fetus.
____

[From the American Medical News, Jan. 1, 1996]

Anesthesiologists Question Claims in Abortion Debate

(By Diane M. Gianelli)

Washington.--When he saw an article in the St. Louis Post-
Dispatch that claimed anesthesia caused fetal death in some
late-term abortion procedures. David Birnbach, MD, was
``shocked.''
``I thought, `This is crazy,' '' said Dr. Birnbach, who is
director of obstetric anesthesiology at New York's St.
Luke's-Roosevelt Hospital Center, and vice president of the
Society for Obstetric Anesthesia and Perinatology.
``Everyday we have pregnant patients who get anesthesia--
women who break their ankles, need knee surgery, have
appendectomies, gallbladder removals, breast biopsies, and so
on. Anesthetics done safely by an anesthesiologist do not do
harm to either the mother or the baby,'' he said.
The anesthesia-causes-fetal-death claim was made by one of
the two U.S. physicians who specialized in a particular type
of late-term abortion that opponents call ``partial birth''
abortions. The contention has been repeated by other
proponents of the procedure, who refer to it as ``intact
D&E'' (for dilation and evacuation) or ``D&X'' (dilation and
extraction).
Medical experts contend the claim is scientifically unsound
and irresponsible, unnecessarily worrying pregnant women who
need anesthesia. But while some are now qualifying their
assertion that anesthesia induces fetal death, they are not
backing away from it.
When Rep. Charles T. Canady (R, Fla.) introduced a bill to
ban the procedure, James T. McMahon, MD, a Los Angeles area
family physician who specialized in this procedure before his
recent death, responded. Dr. McMahon wrote that the
anesthesia given to the mother before the abortion causes
``neurological fetal demise.''
The bill to ban the procedure, passed late last year by
both the House and the Senate, defines it as one in which the
provider ``partially vaginally delivers a living fetus before
killing the fetus and completing the delivery.''
The procedure was recently banned in Ohio, where its other
main practitioner, Martin Haskell, MD, lives. But a federal

[[Page H2918]]

judge declared the law there unconstitutional in a
preliminary injunction last month.
On the federal level, the bill faces a presidential veto
threat, and while the measure passed the House by a 2-to-1
ratio, proponents do not have enough Senate votes to override
a veto.
The claim about anesthesia causing fetal death has been
repeated by many of the bill's opponents, including the
National Abortion Federation, the National Abortion and
Reproductive Rights Action League, and members of Congress. A
recent Planned Parenthood ``fact sheet'' on these late-term
abortions claims that ``the fetus dies from an overdose of
anesthesia given to the mother intravenously.''
The distinction of when fetal death occurs is critical,
because the bill would ban only procedures in which the fetus
was killed after being partially delivered alive through the
birth canal. If it could be proved that the fetuses died
inside the womb--from anesthesia or any other cause--the
abortion would not fall under the proposed law.
After reading the anesthesia-kills-fetuses claim in the St.
Louis paper, the American Society of Anesthesiologists issued
a press release denouncing it. And in testimony before the
Senate, Norig Ellison, MD, president of the society--which
did not take a position on the bill--called Dr. McMahon's
statements ``entirely inaccurate.''
He added that he was ``deeply concerned'' that the
widespread publicity given to Dr. McMahon's claims ``may
cause pregnant women to delay necessary and perhaps even
life-saving medical procedures, totally unrelated to the
birthing process, due to misinformation regarding the effect
of anesthetics on the fetus.''
In fact, cases of maternal concern have already surfaced.
Dr. Birnbach said he has already had patents raise questions.
And Rep. Tom Coburn, MD, an Oklahoma Republican who still
delivers babies when he goes home on weekends, said he just
had a patient refuse epidural anesthesia during childbirth
after hearing those claims. Dr. Coburn is a co-sponsor of the
bill.
Dr. Ellison, vice chair of the Dept. of Anesthesiology at
the University of Pennsylvania School of Medicine in
Philadelphia, testified that very little of the anesthetic
given the mother ever reaches, the fetus. He added that ``in
my medical judgment, it would be necessary--in order to
achieve `neurological demise' of a fetus in a `partial birth'
abortion--to anesthetize the mother to such a degree as to
place her own health in serious jeopardy.''
Planned Parenthood's Mary Campbell, MD, who wrote the fact
sheet claiming anesthesia cases fetal death, was grilled
during the Senate Judiciary Committee hearing Nov. 17, 1995,
by Sen. Spence Abraham (R, Mich.).
When prodded, she conceded ``I do not know what causes the
fetus to die.'' When asked why her fact sheet attributes the
cause to anesthesia, she replied, ``I simplified that for
Congress.''
Afer the hearing, Dr. Campbell wrote to Sen. Barbara Boxer,
(D, Calif.), who led the movement against the bill in the
Senate. In her letter, Dr. Campbell repeated that
anesthesia caused fetal death, but added some caveats. She
said it ``may lead to fetal demise (death) in a fetus
weakened by its own developmental anomalies.''
``In other cases,'' she wrote, ``these drugs prevent the
perception of pain by the fetus; they cause depression of
fetal respiration before the extraction procedure and
preclude fetal respiration afterward.''
Dr. Birnbach disputes her contention. Even in the very
high-end doses she mentioned, he said--10 mg to 40 mg of
Versed, given in 1 mg to 2 mg increments, and 900 ug to 2,500
ug of fentanyl, given in 100 ug to 150 ug increments--
``anesthesia does not kill an infant if you don't kill the
mother.''
He added that when patients receive the high-end dosage
range specified by Dr. Campbell, the mother was in fact at
risk for depressed breathing. ``You can't give those high
doses without harming the mother unless the mother is
assisted in her breathing,'' he said.
Dr. Birnbach said that, on occasion, he has given even
larger doses than the high-end ones cited by Dr. Campbell and
has never caused any harm to either the mother or the fetus.
He also said that Dr. Campbell's claims that the
medications depress fetal respiration before the abortion
takes place were ``immaterial'' because fetuses don't breathe
in the womb.
Dr. Birnbach added, however, that an infant born alive with
depressed respiration can still survive normally. ``The
narcotics are not a problem. We can reverse the narcotics and
we can breathe for the baby.''
Another recurring theme at both the hearings and during the
ensuing debate about the procedure centers around fetal pain.
Specialists in this procedure claim the fetus feels no pain
for a variety of reasons, but usually because they say
fetuses lack the neural development necessary to perceive
pain, or if they are capable of feeling pain, anesthesia
given to the mother prevents the preception of pain in the
fetus.
Robert J. White, MD, PhD, professor of neurosurgery at Case
Western University in Cleveland, testified on the topic
before Congress last summer. ``There are published scientific
studies that demonstrate that by the 20th week, many of the
neuronal pathways that sense pain have already started to
develop,'' he said. ``By the 24th week, the connections of
the cortex and the thalamus are well under way. . . . There
is no way to argue with impunity that pain reception is not
possible.''
Michael J. Murray, MD, an anesthesiologist at the Mayo
Clinic in Rochester, Minn., and president of the Minnesota
Medical Assn., agrees.
In fact, he said, physicians doing fetal surgery inject
narcotic fentanyl and muscle relaxants into the umbilical
cord to provide pain relief, even though the mother is
already anesthetized, ``because what they get from the mom is
not enough.'' He added that studies on neonates getting
surgery right after birth indicate that those who were given
opioids had much better outcomes than those who were just
given muscle relaxants.
The bottom line for many anesthesiologists, regardless of
their position on abortion: Women should not be concerned
about questionable claims thrown out in the heat of the
debate.
``Women who need anesthesia for emergency surgery during
pregnancy or who request analgesia for labor should take
heart that both they and their babies will do just fine,''
Dr. Birnbach said.
Mr. CANADY of Florida. Mr. Speaker, I submit the following material
for inclusion in the Record.
March 27, 1996.

The Smith-Dole Senate Amendment Protects the Life of the Mother

Dear Colleague: This is in response to a March 26 ``Dear
Colleague'' from Reps. Nita Lowey and Nancy Johnson, which
ran under the very misleading headline, ``The Dole Amendment
Endangers Women's Lives.''
As initially passed by the House on Nov. 1, 1995--with 288
votes--HR 1833 contained an ``affirmative defense'' provision
that protected a doctor if he showed that he ``reasonable
believed'' that a partial-birth abortion procedure was
necessary to save a mother's life. These sorts of
``affirmative defense'' exceptions are found in literally
dozens of federal criminal statutes. However, opponents of HR
1833 distorted the legal effect of the ``affirmative
defense'' mechanism. Therefore, the prime sponsor of the
Senate bill, Sen. Bob Smith (who for some curious reason is
not mentioned in the Lowey-Johnson letter) and Sen. Dole
offered an amendment that says the ban ``shall not apply to a
partial-birth abortion that is necessary to save the life of
a mother whose life is endangered by a physical disorder,
illness, or injury: Provided, That no other medical procedure
would suffice for that purpose.''
Senator Barbara Boxer--the leading Senate opponent of HR
1833--immediately endorsed the Smith-Dole Amendment, which
was adopted 98-0. Here is what Senator Boxer said on the
floor of the Senate: ``And now here we have it. Here we have
it, an exception now for life of the mother. I think that is
progress. I think that is progress, because when we started,
there was no exception. It was an affirmative defense.''
[Congressional Record, Dec. 5, 1995, p. S 18005]
Moreover, in a Jan. 31 letter to Cardinal Anthony
Bevilacqua of Philadelphia, President Clinton himself
recognized that the Senate had added a life-of-mother
exception (but the President continues to demand the addition
of the gutting ``health exception'' endorsed by the National
Abortion and Reproductive Rights Action League.)
Reps. Lowey and Johnson write, ``It is unclear whether
pregnancy would legally constitute a physical disorder.'' A
normal pregnancy does not constitute a life-threatening
condition--but in those rare cases in which a ``physical
disorder, illness, or injury'' causes the pregnancy to
threaten a mother's life, the Senate exception obviously
applies. With respect, our colleagues' reading of the Senate
language is absurdly convoluted, and violates standard
principles of statutory construction.
As to our colleagues' other objections: let's keep in mind
that a partial-birth abortion involves the almost complete
delivery of a living baby, who is then killed. Now, if the
entire baby has been delivered alive, except for the head,
supposedly without jeopardy to the mother, why can't the
doctor simply deliver the head as well, without killing the
baby?
When the American Medical News put essentially that very
question to Dr. Martin Haskell (who has done over 1,000
partial-birth abortions) in a tape-recorded interview, Dr.
Haskell's answer was both candid and chilling: ``The point
here is you're attempting to do an abortion . . . not to see
how do I manipulate the situation so that I get a live birth
instead,'' he said.
(There are rare cases in which a baby suffers from such
severe hydrocephaly--head enlargement caused by excess fluid
in the skull--so that without intervention, both vaginal
delivery and a Caesarian could pose risks to the mother. In
those cases, according to Prof. Watson Bowes, a nationally
eminent authority on fetal and maternal medicine who is co-
editor of the Obstetrical and Gynecological Survey, the
standard treatment is cephalocentesis--removal of excess
fluid through a needle. ``Fluid is then withdrawn which
results in reduction of the size in the head so that delivery
can occur,'' wrote Prof. Bowes. ``This procedure is not
intended to kill the fetus, and, in fact, is usually
associated with the birth of a live infant.'')
Attempts by HR 1833 opponents to ``revive'' the life-of-
mother issue are merely another reflection of their refusal
to come to grips

[[Page H2919]]

with the uncomfortable fact--which is amply documented in the
writings and validated statements of partial-birth abortion
practitioners--that the overwhelming majority of partial-
birth abortions have nothing whatever to do with life-
threatening complications of pregnancy, but are (in the words
of Dr. Martin Haskell) ``purely elective.''
Sincerely,
Henry J. Hyde,
Chairman.
____

``Fetal Death'' or Dangerous Deception? The Effects of Anesthesia
During a Partial-Birth Abortion

The claim that anesthesia given to a pregnant woman kills
her fetus/baby before a partial-birth abortion is performed
has ``absolutely no basis in scientific fact,'' according to
Dr. Norig Ellison, the president of the American Society of
Anesthesiologists. It is ``crazy,'' says Dr. David Birnbach,
the president-elect of the Society for Obstetric Anesthesia
and Perinatology.
Despite such authoritative statements, this medical
misinformation is still being disseminated. Here are a few
examples:

Abortion Advocates

kate michelman of the national abortion rights action league (naral)

One of the leading proponents of the ``anesthesia myth'' is
Kate Michelman, president of the National Abortion Rights
Action League (NARAL). For example, in an interview on
``Newsmakers,'' KMOX-AM in St. Louis on Nov. 2, 1995, Ms.
Michelman said: The other side grossly distorted the
procedure. There is no such thing as a ``partial-birth.''
That's, that's a term made up by people like these anti-
choice folks that you had on the radio. The fetus--I mean, it
is a termination of the fetal life, there's no question about
that. And the fetus, is, before the procedure begins, the
anesthesia that they give the woman already causes the demise
of the fetus. That is, it is not true that they're born
partially. That is a gross distortion, and it's really a
disservice to the public to say this.

dr. mary campbell of planned parenthood

Prior to the November 1, 1995, House vote on the bill,
Planned Parenthood circulated to lawmakers a ``fact sheet''
titled, ``H.R. 1833, Medical Questions and Answers,'' which
includes this statement:
``Q: When does the fetus die?
``A: The fetus dies of an overdose of anesthesia given to
the mother intravenously. A dose is calculated for the
mother's weight which is 50 to 100 times the weight of the
fetus. The mother gets the anesthesia for each insertion of
the dilators, twice a day. This induces brain death in a
fetus in a matter of minutes. Fetal demise therefore occurs
at the beginning of the procedure while the fetus is still in
the womb.''

the new york daily news

The fetus is partially removed from the womb, its head
collapsed and brain suctioned out so it will fit through the
birth canal. The anesthesia given to the woman kills the
fetus before the full procedure takes place. But you won't
hear that from the anti-abortion extreme. It would have
everybody believe the fetus is dragged alive from the womb of
a woman just weeks away from birth. Not true. (Editorial,
Dec. 15, 1995)

usa today

``The fetus dies from an overdose of anesthesia given to
its mother.'' (Editorial, Nov. 3, 1995)

the st. louis post-dispatch

``The fetus usually dies from the anesthesia administered
to the mother before the procedure begins.'' (News story,
Nov. 3, 1995)

syndicated columnist ellen goodman

Syndicated columnist Ellen Goodman wrote in mid-November
that, if one relied on statements by supporters of the bill,
``You wouldn't even know that anesthesia ends the life of
such a fetus before it comes down the birth canal.''

The Truth

``Medical experts contend the claim is scientifically
unsound and irresponsible, unnecessarily worrying pregnant
women who need anesthesia.'' (American Medical News, January
1, 1996)
``[A]nesthesia does not kill an infant if you don't kill
the mother.'' (Dr. David Birnbach quoted in American Medical
News, January 1, 1996)
``I am deeply concerned, moreover, that widespread
publicity . . . may cause pregnant women to delay necessary
and perhaps life-saving medical procedures, totally unrelated
to the birthing process, due to misinformation regarding the
effect of anesthetics on the fetus.'' (Dr. Norig Ellison,
Nov. 17, 1995, testimony before Senate Judiciary Committee)
``Drugs administered to the mother, either local anesthesia
administered in the paracervical area or sedatives/analgesics
administered intramuscularly or intravenously, will provide
no-to-little analgesia [relief from pain] to the fetus.''
(Dr. Norig Ellison, November 22, 1995, letter to Senate
Judiciary Committee)
Mr. SALMON. Mr. Speaker, I submit the following material for
inclusion in the Record:

American Medical News,

Published by the AMA,

Chicago, IL, July 11, 1995.
Hon. Charles T. Canady,
Chairman, Subcommittee on the Constitution, Committee on the
Judiciary, U.S. House of Representatives, Rayburn House
Office Bldg., Washington, DC
Dear Representative Canady: We have received your July 7
letter outlining allegations of inaccuracies in a July 5,
1993, story in American Medical News, ``Shock-tactic ads
target late-term abortion procedure.''
You noted that in public testimony before your committee,
AMNews is alleged to have quoted physicians out of context.
You also noted that one such physician submitted testimony
contending that AMNews misrepresented his statements. We
appreciate your offer of the opportunity to respond to these
accusations, which now are part of the permanent subcommittee
record.
AMNews stands behind the accuracy of the report cited in
the testimony. The report was complete, fair, and balanced.
The comments and positions expressed by those interviewed and
quoted were reported accurately and in context. The report
was based on extensive research and interviews with experts
on both sides of the abortion debate, including interviews
with two physicians who perform the procedure in questions.
We have full documentation of these interviews, including
tape recordings and transcripts. Enclosed is a transcript of
the contested quotes that relate to the allegations of
inaccuracies made against AMNews.
Let me also note that in the two years since publication of
our story, neither the organization nor the physician who
complained about the report in testimony to your committee
has contacted the reporter or any editor at AMNews to
complain about it. AMNews has a longstanding reputation for
balance, fairness and accuracy in reporting, including
reporting on abortion, an issue that is as divisive within
medicine as it is within society in general. We believe that
the story in question comports entirely with that reputation.
Thank you for your letter and the opportunity to clarify
this matter.
Respectfully yours,
Barbara Bolsen,
Editor.
Attachment.
____

American Medical News Transcript

Relevant portions of recorded interview with Martin
Haskell, M.D.
AMN. Let's talk first about whether or not the fetus is
dead beforehand . . .
Haskell. No it's not. No, it's really not. A percentage are
for various numbers of reasons. Some just because of the
stress--intrauterine stress during, you know, the two days
that the cervix is being dilated. Sometimes the membranes
rupture and it takes a very small superficial infection to
kill a fetus in utero when the membranes are broken. And so
in my case, I would think probably about a third of those are
definitely are (sic) dead before I actually start to remove
the fetus. And probably the other two-thirds are not.
AMN. Is the skull procedure also done to make sure that the
fetus is dead so you're not going to have the problem of a
live birth?
Haskell. It's immaterial. If you can't get it out, you
can't get it out.
AMN. I mean, you couldn't dilate further? Or is that
riskier?
Haskell. Well, you could dilate further over a period of
days.
AMN. would that just make it . . . would it go from a 3-day
procedure to a 4- or a 5-?
Haskell. Exactly. The point here is to effect a safe legal
abortion. I mean, you could say the same thing about the D&E
procedure. You know, why do you do the D&E procedure? Why do
you crush the fetus up inside the womb? To kill it before you
take it out?
Well, that happens, yes. But that's not why you do it. YOu
do it to get it out. I could do the same thing with a D&E
procedure. I could put dilapan in for four or five days and
say I'm doing a D&E procedure and the fetus could just fall
out. But that's not really the point. The point here is
you're attempting to do an abortion. And that's the goal of
your work, is to complete an abortion. Not to see how do I
manipulate the situation so that I get a live birth instead.
AMN, wrapping up the interview. I wanted to make sure I
have both you and (Dr.) McMahon saying `No' then. That this
is misinformation, these letters to the editor saying it's
only done when the baby's already dead, in case of fetal
demise and you have to do an autopsy. But some of them are
saying they're getting that information from NAF. Have you
talked to Barbara Radford or anyone over there? I called
Barbara and she called back, but I haven't gotten back to
her.
Haskell. Well, I had heard that they were giving that
information, somebody over there might be giving information
like that out. The people that staff the NAF office are not
medical people. And many of them when I gave my paper, many
of them came in, I learned later, to watch my paper because
many of them have never seen an abortion performed of any
kind.
AMN. Did you also show a video when you did that?
Haskell. Yeah. I taped a procedure a couple of years ago, a
very brief video, that simply showed the technique. The old
story about a picture's worth a thousand words.
AMN. As National Right to Life will tell you.
Haskell. Afterwards they were just amazed. They just had no
idea. And here they're rabid supporters of abortion. They
work in the office there. And . . . some of them have never
seen one performed . . .
Comments on elective vs. non-elective abortions:
Haskell. And I'll be quite frank: most of my abortions are
elective in that 20-24 week range . . . In my particular
case, probably

[[Page H2920]]

20% are for genetic reasons. And the other 80% are purely
elective.
____

[From the American Medical News, July 5, 1993]

Shock-Tactic Ads Target Late-Term Abortion Procedure

foes hope campaign will sink federal abortion rights legislation

(By Diana M. Gianelli)

Washington.--In an attempt to derail an abortion-rights
bill maneuvering toward a congressional showdown, opponents
have launched a full-scale campaign against late-term
abortions.
The centerpieces of the effort are newspaper advertisements
and brochures that graphically illustrate a technique used in
some second- and third-trimester abortions. A handful of
newspapers have run the ads so far, and the National Right to
Life Committee has distributed 4 million of the brochures,
which were inserted into about a dozen other papers.
By depicting a procedure expected to make most readers
squeamish, campaign sponsors hope to convince voters and
elected officials that a proposed federal abortion-rights
bill is so extreme that states would have no authority to
limit abortions--even on potentially viable fetuses.
According to the Alan Guttmacher Institute, a research
group affiliated with Planned Parenthood, about 10% of the
estimated 1.6 million abortions done each year are in the
second and third trimesters.
Barbara Radford of the National Abortion Federation
denounced the ad campaign as disingenuous, saying its ``real
agenda is to outlaw virtually all abortions, not just late-
term ones.'' But she acknowledged it is having an impact,
reporting scores of calls from congressional staffers and
others who have seen the ads and brochures and are asking
pointed questions about the procedure depicted.
The Minneapolis Star-Tribune ran the ad May 12, on its op-
ed page. The anti-abortion group Minnesota Citizens Concerned
for Life paid for it.
In a series of drawings, the ad illustrates a procedure
called ``dilation and extraction,'' or D&X, in which forceps
are used to remove second- and third-trimester fetuses from
the uterus intact, with only the head remaining inside the
uterus.
The surgeon is then shown jamming scissors into the skull.
The ad says this is done to create an opening large enough to
insert a catheter that suctions the brain, while at the same
time making the skull small enough to pull through the
cervix.
``Do these drawings shock you?'' the ad reads. ``We're
sorry, but we think you should know the truth.''
The ad quotes Martin Haskell, MD, who described the
procedure at a September 1992 abortion-federation meeting, as
saying he personally has performed 700 of them. It then
states that the proposed ``Freedom of Choice Act'' now moving
through Congress would ``protect the practice of abortion at
all stages and would lead to an increase in the use of this
grisly procedure.''

accuracy questioned

Some abortion-rights advocates have questioned the ad's
accuracy.
A letter to the Star-Tribune said the procedure shown ``is
only performed after fetal death when an autopsy is necessary
or to save the life of the mother.'' And the Morrisville,
Vt., Transcript, which said in an editorial that it allowed
the brochure to be inserted in its paper only because it
feared legal action if it refused, quoted the abortion
federation as providing similar information. ``The fetus is
dead 24 hours before the pictured procedure is undertaken,''
the editorial stated.
But Dr. Haskell and another doctor who routinely use the
procedure for late-term abortions told AMNews that the
majority of fetuses aborted this way are alive until the end
of the procedure.
Dr. Haskell said the drawing were accurate ``from a
technical point of view.'' But he took issue with the
implication that the fetuses were ``aware and resisting.''
Radford also acknowledged that the information her group
was quoted as providing was inaccurate. She has since sent a
letter to federation members, outlining guidelines for
discussing the matter. Among the points:
Don't apologize; this is a legal procedure.
No abortion method is acceptable to abortion opponents.
The language and graphics in the ads are disturbing to some
readers. ``Much of the negative reaction, however, is the
same reaction that might be invoked if one were to listen to
a surgeon describing step-by-step almost any other surgical
procedure involving blood, human tissue, etc.''

Late-abortion specialists

Only Dr. Haskell, James T. McMahon, MD, of Los Angeles, and
a handful of other doctors perform the D&X procedure, which
Dr. McMahon refers to as ``intact D&E.'' The more common
late-term abortion methods are the classic D&E and induction,
which usually involves injecting digoxin or another substance
into the fetal heart to kill it, then dilating the cervix and
inducing labor.
Dr. Haskell, who owns abortion clinics in Cincinnati and
Dayton, said he started performing D&Es for late abortions
out of necessity. Local hospitals did not allow inductions
past 18 weeks, and he had no place to keep patients overnight
while doing the procedure.
But the classic D&E, in which the fetus is broken apart
inside the womb, carries the risk of perforation, tearing and
hemorrhaging, he said. So he turned to the D&X, which he says
is far less risky to the mother.
Dr. McMahon acknowledged that the procedure he, Dr. Haskell
and a handful of other doctors use makes some people queasy.
But he defends it. ``Once you decide the uterus must be
emptied, you then have to have 100% allegiance to maternal
risk. There's no justification to doing a more dangerous
procedure because somehow this doesn't offend your
sensibilities as much.''

brochure cites n.y. case

The four-page anti-abortion brochures also include a
graphic depiction of the D&X procedure. But the cover
features a photograph of 16-month-old Ana Rosa Rodriquez,
whose right arm was severed during an abortion attempt when
her mother was 7 months pregnant.
The child was born two days later, at 32 to 34 weeks'
gestation. Abu Hayat, MD, of New York, was convicted of
assault and performing an illegal abortion. He was sentenced
to up to 29 years in prison for this and another related
offense.
New York law bans abortions after 24 weeks, except to save
the mother's life. The brochure states that Dr. Hayat never
would have been prosecuted if the federal ``Freedom of Choice
Act'' were in effect, because the act would invalidate the
New York statute.
The proposed law would allow abortion for any reason until
viability. But it would leave it up to individual
practitioners--not the state--to define that point.
Postviability abortions, however, could not be restricted if
done to save a woman's life or health, including emotional
health.
The abortion federation's Radford called the Hayat case
``an aberration'' and stressed that the vast majority of
abortions occur within the first trimester. She also said
that later abortions usually are done for reasons of fetal
abnormality or maternal health.
But Douglas Johnson of the National Right to Life Committee
called that suggestion ``blatantly false.''
``The abortion practitioners themselves will admit the
majority of their late-term abortions are elective,'' he
said. ``People like Dr. Haskell are just trying to teach
others how to do it more efficiently.''

numbers game

Accurate figures on second- and third-trimester abortions
are elusive because a number of states don't require doctors
to report abortion statistics. For example, one-third of all
abortions are said to occur in California, but the state has
no reporting requirements. The Guttmacher Institute estimates
there were nearly 168,000 second- and third-trimester
abortions in 1988, the last year for which figures are
available.
About 60,000 of those occurred in the 16- to 20-week
period, with 10,660 at week 21 and beyond, the institute
says. Estimates were based on actual gestational age, as
opposed to last menstrual period.
There is particular debate over the number of third-
trimester abortions. Former Surgeon General C. Everett Koop,
MD, estimated in 1984 that 4,000 are performed annually. The
abortion federation puts the number at 300 to 500. Dr.
Haskell says that ``probably Koop's numbers are more
correct.''
Dr. Haskell said he performs abortions ``up until about 25
weeks' ``gestation, most of them elective. Dr. McMahon does
abortions through all 40 weeks of pregnancy, but said he
won't do an elective procedure after 26 weeks. About 80% of
those he does after 21 weeks are nonelective, he said.

mixed feelings

Dr. McMahon admits having mixed feelings about the
procedure in which he has chosen to specialize.
``I have two positions that may be internally inconsistent,
and that's probably why I fight with this all the time,'' he
said.
``I do have moral compunctions. And if I see a case that's
later, like after 20 weeks where it frankly is a child to me,
I really agonize over it because the potential is so
imminently there. I think, `Gee, it's too bad that this child
couldn't be adopted.'
``On the other hand, I have another position, which I think
is superior in the hierarchy of questions, and that is: `Who
owns the child?' It's got to be the mother.''
Dr. McMahon says he doesn't want to ``hold patients hostage
to my technical skill. I can say, `No, I won't do that,' and
then they're stuck with either some criminal solution or some
other desperate maneuver.''
Dr. Haskell, however, says whatever qualms he has about
third-trimester abortions are ``only for technical reasons,
not for emotional reasons of fetal development.''
``I think it's important to distinguish the two,'' he says,
adding that his cutoff point is within the viability
threshold noted in Roe v. Wade, the Supreme Court decision
that legalized abortion. The decision said that point usually
occurred at 28 weeks ``but may occur earlier, even at 24
weeks.''
Viability is generally accepted to be ``somewhere between
25 and 26 weeks,'' said Dr. Haskell. ``It just depends on who
you talk to.
``We don't have a viability law in Ohio. In New York they
have a 24-week limitation. That's how Dr. Hayat got in
trouble. If somebody tells me I have to use 22 weeks, that's
fine . . . . I'm not a trailblazer or activist trying to
constantly press the limits.''

campaign's impact debated

Whether the ad and brochures will have the full impact
abortion opponents intend is yet to be seen.

[[Page H2921]]

Congress has yet to schedule a final showdown on the bill.
Although it has already passed through the necessary
committees, supporters are reluctant to move it for a full
House and Senate vote until they are sure they can win.
In fact, House Speaker Tom Foley (D, Wash.) has said he
wants to bring the bill for a vote under a ``closed rule''
procedure, which would prohibit consideration of amendments.
But opponents are lobbying heavily against Foley's plan.
Among the amendments they wish to offer is one that would
allow, but not require, states to restrict abortion--except
to save the mother's life--after 24 weeks.
Mr. SMITH of New Jersey. Mr. Speaker, I submit the following material
for inclusion in the Record:

Partial-Birth Abortions: Behind the Misinformation

(By Douglas Johnson, NRLC Federal Legislative Director)

Note: The Partial-Birth Abortion Ban Act (HR 1833) has been
approved in slightly different versions by the U.S. House of
Representatives (Nov. 1, 1995, on a vote of 288-139) and by
the U.S. Senate (Dec. 7, 1995, on a vote of 54-44). It is
expected that the House will approve the Senate-passed bill
on March 27 and send it to President Clinton soon thereafter.
President Clinton will veto the bill because ``the President
shares the view of many that it would represent an erosion of
a woman's right to choose,'' White House Press Secretary Mike
McCurry said on December 20, 1995.
Opponents of the bill have disseminated an extraordinary
amount of misinformation regarding the partial-birth abortion
procedure and the legislation--much of it starkly
contradicted by the past writings and recorded statements of
doctors who have performed thousands of partial-birth
abortions. Some of this misinformation has been adopted and
widely disseminated by some journalists, columnists,
editorialists, and lawmakers. This factsheet addresses some
of these issues.

What is the Partial-Birth Abortion Ban Act (HR 1833)?

The Partial-Birth Abortion Ban Act (HR 1833) would place a
national ban on use of the partial-birth abortion procedure,
except in cases (if there are any) in which the procedure is
necessary to save the life of a mother.
The bill specifically defines a ``partial-birth abortion''
as ``an abortion in which the person performing the abortion
partially vaginally delivers a living fetus before killing
the fetus and completing the delivery.'' [emphasis added]
Abortionists who violate the law would be subject to both
criminal and civil penalties, but no penalty could be applied
to the woman who obtained such an abortion.
The bill is aimed at a procedure that has often been
utilized by Dr. Martin Haskell of Dayton, Ohio; by the late
Dr. James McMahon of Los Angeles; and by others. This
procedure is generally used beginning at 20 weeks (4\1/2\
months) into the pregnancy, is ``routinely'' used to 5\1/2\
months, and has often been used even during the final three
months of pregnancy.
The Los Angeles Times accurately and succinctly described
this abortion method in a June 16, 1995 news story:
The procedure requires a physician to extract a fetus, feet
first, from the womb and through the birth canal until all
but its head is exposed. Then the tips of surgical scissors
are thrust into the base of the fetus' skull, and a suction
catheter is inserted through the opening and the brain is
removed.
In 1992, Dr. Haskell wrote a paper (``Dilation and
Extraction for Late Second Trimester Abortion'') that
described in detail, step-by-step, how to perform the
procedure. Anyone who is seriously seeking the truth behind
the conflicting claims regarding partial-birth abortions
would do well to start by reading Dr. Haskell's paper, and
the transcripts of the explanatory interviews that Dr.
Haskell gave in 1993 to the publications American Medical
News (the official AMA newspaper) and Cincinnati Medicine.
Regarding the procedure, Dr. Haskell wrote, ``Among its
advantages are that it is a quick, surgical outpatient method
that can be performed on a scheduled basis under local
anesthesia.'' (p. 33). Dr. Haskell also wrote that he
``routinely performs this procedure on all patients 20
through 24 weeks LMP [i.e., from last menstrual period] with
certain exceptions'' [i.e., from 4\1/2\ to 5\1/2\ months],
these ``exceptions'' involving complicating factors such as
being more than 20 pounds overweight.
Dr. Haskell also wrote that he used the procedure through
26 weeks [six months] ``on selected patients.'' [p.28]
Dr. James McMahon used essentially the same procedure to a
much later point--even into the ninth month. (Dr. McMahon
died of cancer on Oct. 28, 1995.)
In a letter to Congressman Charles Canady dated March 19,
1996, Dr. William Rashbaum of New York City wrote that he has
performed the procedure ``routinely since 1979. This
procedure is performed only in cases of later gestational
age.''

does the bill contain an exception for life-of-the-mother cases?

As originally passed by the House on November 1, 1995, HR
1833 contained an ``affirmative defense'' provision, which
would have shielded an abortionist from civil and criminal
liability if he showed that he had ``reasonably believed''
that utilization of the partial-birth abortion procedure was
necessary to save the life of a mother.
Similar ``affirmative defense'' exceptions are found in
literally dozens of federal criminal laws. Nevertheless,
after bill opponents distorted this provision, NRLC endorsed
and the Senate unanimously adopted the Smith-Dole Amendment,
which provides that the ban ``shall not apply to a partial-
birth abortion that is necessary to save the life of a mother
whose life is endangered by a physical disorder, illness, or
injury.''
Senator Barbara Boxer (D-Ca.), the lead Senate opponent of
the HR 1833, immediately endorsed the Smith-Dole Amendment,
saying:
And now here we have it. Here we have it, an exception now
for life of the mother. I think that is progress, because
when we started there was no exception. It was an affirmative
defense. [Congressional Record, Dec. 5, 1995, p. S 18005]
Under the Smith-Dole Amendment, an abortionist could not be
convicted of a violation of the law unless the government
proved, beyond a reasonable doubt, that the abortion was not
covered by this exception. (In addition, of course, the
government would have to prove, beyond a reasonable doubt,
all of the other elements of the offense--that the
abortionist ``knowingly'' partly removed a baby from the
womb, that the baby was still alive, and that the abortionist
then killed the baby.)
In a Jan. 31 letter to Cardinal Anthony Bevilacqua of
Philadelphia, President Clinton acknowledged that the Senate
had added a life-of-mother exception.

what further changes does president clinton demand in the bill?

In a February 28, 1996 letter to certain Members of
Congress, the President insisted that abortionists must be
permitted to use the procedure, not only to save a mother's
life, but also whenever they assert that the procedure is
necessary to prevent unspecified ``serious health
consequences.''
The President's letter proposed precisely the language of
an amendment offered on the Senate floor by Sen. Barbara
Boxer (D-Ca.), which was endorsed by the National Abortion
and Reproductive Rights Action League (NARAL) as a ``pro-
choice vote.''
NARAL and other pro-abortion advocacy groups clearly
recognized that the Boxer Amendment amounted to a re-
statement of the status quo. After the Boxer Amendment was
defeated by only a two-vote margin (51 to 47), a spokeswoman
for the pro-abortion Alan Guttmacher Institute said, ``We
were almost able to kill the bill.'' (Congressional Quarterly
Weekly Report, Dec. 9, 1995, page 3738)
President Clinton--a Yale Law School graduate who once
taught constitutional law--understands very well that with
respect to abortion, ``health'' is a legal term of art. In
Doe v. Bolton (the companion case to Roe v. Wade), the
Supreme Court defined ``health'' (in the abortion context) to
include ``all factors--physical, emotional, psychological,
familial, and the woman's age--relevant to the well-being of
the patient.''
Thus, the Boxer Amendment (demanded by President Clinton)
would allow abortionists to continue to perform partial-birth
abortions, even during the seventh, eighth, and ninth months,
for reasons such as ``depression.'' This is not a far-fetched
hypothetical, as discussed below under ``For What Reasons Are
Partial-Birth Abortions Usually Performed?''
Senator Boxer has added the word ``serious'' before
``health,'' for optical effect, but adding the word does not
legally narrow the scope of ``health,'' since the amendment
confers on the abortionist himself the unlimited power to
define whether the ``depression'' or other ``health'' concern
is ``serious.'' No partial-birth abortion would ever be
blocked by the law, because the Boxer Amendment confers on
the abortionist absolute authority to decide what the law
means (``in the medical judgment of the attending
physician'').
Thus, a ``life'' exception and a ``health'' exception are
two vastly different things. For example: Prior to enactment
of the Hyde Amendment in 1976, the federal Medicaid program
paid for 300,000 ``health'' or ``medically necessary''
abortions a year; the term was construed to cover any
physician-performed abortion. The Hyde Amendment limited
reimbursement to ``life'' cases, which have been on the order
of 100 to 200 annually. In other words, the ratio of
``health'' cases to ``life'' cases, under Medicaid, was more
than 1,000 to 1.

how many partial-birth abortions are performed?

Nobody knows. Pro-abortion groups have claimed that
``only'' 450 such procedures are performed every year. But
the combined practices of Dr. Martin Haskell and the late Dr.
James McMahon alone would have approximated that figure.
In a letter to Congressman Canady dated March 19, 1996, New
York doctor William K. Rashbaum wrote that he has performed
the procedure that would be banned by HR 1833 ``routinely
since 1979. This procedure is performed only in cases of
later gestational age.'' Moreover, The New York Times
reported in a Nov. 6, 1995 news story about the bill:
``Of course I use it, and I've taught it for the last 10
years,'' said a gynecologist at a New York teaching hospital,
who spoke on the condition of anonymity. ``So do doctors in
other cities.''

[[Page H2922]]

It is impossible to know how many other abortionists have
adopted the procedure, without choosing to write articles or
grant interviews on the subject. Both Haskell and McMahon
spent years trying to convince other abortionists of the
merits of the procedure. That is why Haskell wrote his 1992
instructional paper. For years, Mr. McMahon was director of
abortion instruction at the Cedar Sinai Medical Center in Los
Angeles.
There are at least 164,000 abortions a year after the first
three months of pregnancy, and 13,000 abortions annually
after 4\1/2\ months, according to the Alan Guttmacher
Institute (New York Times, July 5 and November 6, 1995),
which is an arm of Planned Parenthood. These numbers should
be regarded as minimums, since they are based on voluntary
reporting to the AGI.

For what reasons are partial-birth abortions typically performed?

Some opponents of HR 1833, such as NARAL and the Planned
Parenthood Federation of America (PPFA), have persistently
disseminated claimed that the procedure is employed only in
cases involving extraordinary threats to the mother of grave
fetal disorders. Regrettably, more than a few reporters,
commentators, and members of Congress have uncritically
embraced such claims and disseminated them as ``facts.''
For example, PPFA said in a press release that the
procedure is ``done only in cases when the woman's life is in
danger or in cases of extreme fetal abnormality.'' (Nov. 1,
1995) But (as PPFA well knows), this claim is inconsistent
with the writings and recorded statements of doctors who have
performed thousands of these procedures, or with documents
gathered by the House and Senate judiciary committees.
Dayton abortionist Dr. Martin Haskell, who wrote a paper
describing step-by-step how to perform the procedure (he's
done over 1,000), described it as ``a quick, surgical
outpatient method that can be performed on a scheduled basis
under local anesthesia.''
Dr. Haskell wrote that he ``routinely performs this
procedure on all patients 20 through 24 weeks'' (4\1/2\ to
5\1/2\ months) pregnant [emphasis added], except on women who
are more than 20 pounds overweight, have twins, or have
certain other complicating factors.
In 1993, after NRLC's publicizing of Dr. Haskell's paper
engendered considerable controversy, the American Medical
News--the official newspaper of the AMA--conducted a tape-
recorded interview with Dr. Haskell concerning this specific
abortion method, in which he said:
And I'll be quite frank: most of my abortions are elective
in that 20-24 week range * * * In my particular case,
probably 20% [of this procedure] are for genetic reasons. And
the other 80% are purely elective.
In testimony in a lawsuit in 1995, Dr. Haskell testified
that women come to him for partial-birth abortions with ``a
variety of conditions. Some medical, some not so medical''
Among the ``medical'' examples he cited was ``agoraphobia''
(fear of open places).
Moreover, in testimony presented to the Senate Judiciary
Committee on November 17, 1995, ob/gyn Dr. Nancy Romer of
Dayton (the city in which Dr. Haskell operates one of his
abortion clinics) testified that three of her own patients
had gone to Haskell's clinic for abortions ``well beyond''
4\1/2\ months into pregnancy, and that ``none of these women
had any medical illness, and all three had normal fetuses.''
Brenda Pratt Shafer, a registered nurse who observed Dr.
Haskell use the procedure to abort three babies in 1993,
testified that one little boy had Down Syndrome, while the
other two babies were completely normal and their mothers
were healthy. [Nurse Shafer's testimony before the House
Judiciary subcommittee, with associated documentation, is
available on request to NRLC.]
Dr. James McMahon voluntarily submitted to the House
Judiciary Constitution subcommittee a breakdown of a self-
selected sample of 175 partial-birth abortions that he
performed for what he called ``maternal indications.'' Of
these,the largest single category of ``maternal
indication''--39 cases, or 22% of the total sample--were for
``depression.'' (Other ``maternal indications'' included
``spousal drug exposure'' and ``substance abuse.'') Dr.
McMahon's self-selected sample of ``fetal indications'' cases
showed he had performed nine of these procedures for ``cleft
plate.'' Even though this data is cited in the official
report of the committee, when NARAL President Kate Michelman
was asked at a November 7, 1995 press conference about
``arguments . . . that these procedures . . . are given
for depression or cleft palate,'' Ms. Michelman responded,
``That is . . . not only a myth, it's a lie.''
Dr. McMahon also wrote: After 26 weeks [six months], those
pregnancies that are not flawed are still nonelective. They
are interrupted because of maternal risk, rape, incest,
psychiatric or pediatric indications. [Emphasis added.]
[``Pediatric indications'' was Dr. McMahon's terminology for
young teenagers.]
Dr. Pamela E. Smith, director of Medical Education,
Department of Obstetrics and Gynecology, Mt. Sinai Hospital,
Chicago, gave the Senate Judiciary Committee her analysis of
Dr. McMahon's sample of 175 cases in which he said he had
used the procedure because of maternal health indications. Of
this sample, 39 cases (22%) were for maternal ``depression,''
while another 16% were ``for conditions consistent with the
birth of a normal child (e.g., sickle cell trait, prolapsed
uterus, small pelvis),'' Dr. Smith noted. She added that in
one-third of the cases, the conditions listed as ``maternal
indications'' by Dr. McMahon really indicated that the
procedure itself would be seriously risky.
Reporter Karen Tumulty wrote an article about late-term
abortions, based in large part on extensive interviews with
Dr. McMahon and on direct observation of his practice, which
appeared in the Los Angeles Times Magazine (January 7, 1990).
She concluded: If there is any other single factor that
inflates the number of late abortions, it is youth. Often,
teen-agers do not recognize the first signs of pregnancy.
Just as frequently, they put off telling anyone as long as
they can.
Dr. George Tiller of Wichita, Kansas, specializes in late-
term abortions, including third-trimester abortions. Dr.
Tiller's spokeswoman, Peggy Jarman, told the Kansas City
Star: About three-fourths of Tiller's late-term patients,
Jarman said, are teenagers who have denied to themselves or
their families they were pregnant until it was too late to
hide it.
In 1993, the then-executive director of the National
Abortion Federation (NAF) distributed an internal memorandum
to the members of that organization which acknowledged that
such abortions are performed for ``many reasons'': There are
many reasons why women have late abortions: life
endangerment, fetal indications, lack of money or health
insurance, social-psychological crises, lack of knowledge
about human reproduction, etc.''
Likewise, a June 12, 1995, letter from NAF to members of
the House of Representatives noted that late abortions are
sought by, among others, ``very young teenagers . . . who
have not recognized the signs of their pregnancies until too
late,'' and by ``women in poverty, who have tried desperately
to act responsibly and to end an unplanned pregnancy in the
early stages, only to face insurmountable financial
barriers.''
It is true, of course, that some partial-birth abortions
involve babies who have grave disorders that will result in
death soon after birth. But these unfortunate members of the
human family deserve compassion and the best comfort-care
that medical science can offer--not a scissors in the back of
the head. In some such situations there are good medical
reasons to deliver such a child early, after which natural
death will follow quickly.

is a partial-birth abortion ever the only way to preserve a mother's
physical health?

Dr. Pamela E. Smith, Director of Medical Education,
Department of Obstetrics and Gynecology, Mt. Sinai Hospital,
Chicago, testified, ``There are absolutely no obstetrical
situations encountered in this country which require a
partially delivered human fetus to be destroyed to preserve
the life or health of the mother.''
Dr. Harlan R. Giles, a professor of ``high-risk''
obstetrics and perinatology at the Medical College of
Pennsylvania, performs abortions by a variety of procedures
up until ``viability.'' In sworn testimony in the U.S.
Federal District Court for the Southern District of Ohio
(Nov. 13, 1995), Prof. Giles said:
After 23 weeks I do not think there are any maternal
conditions that I'm aware of that mandate ending the
pregnancy that also require that the fetus be dead or that
the fetal life be terminated. In my experience for 20 years,
one can deliver these fetuses either vaginally, or by
Caesarean section for that matter, depending on the choice of
the parents with informed consent . . . But there's no reason
these fetuses cannot be delivered intact vaginally after a
miniature labor, if you will, and be at least assessed at
birth and given the benefit of the doubt. [transcript, page
240]
Opponents of H.R. 1833 have publicized the cases of several
women whose babies suffered from severe hydrocephalus
(enlargement of the head). But an eminent authority on such
matters, Dr. Watson A. Bowes, Jr., professor of ob/gyn
(maternal and fetal medicine) at the University of North
Carolina, who is co-editor of the Obstetrical and
Gynecological Survey, wrote to Congressman Canady:
Critics of your bill who say that this legislation will
prevent doctors from performing certain procedures which are
standard of care, such as cephalocentesis (removal of fluid
from the enlarged head of a fetus with the most severe form
of hydrocephalus) are mistaken. In such a procedure a needle
is inserted with ultrasound guidance through the mother's
abdomen into the uterus and then into the enlarged ventricle
of the brain (the space containing cerebrospinal fluid).
Fluid is then withdrawn which results in reduction of the
size in the head so that delivery can occur. This procedure
is not intended to kill the fetus, and, in fact, is usually
associated with the birth of a live infant.

is the baby alive when she is pulled feet-first from the womb?

Yes, in most cases the baby is alive until the end of the
procedure. American Medical News reported in 1993, after
conducting interviews with Drs. Haskell and McMahon, that the
doctors ``told AM News that the majority of fetuses aborted
this way are alive until the end of the procedure.'' On July
11, 1995, American Medical News submitted the transcript of
the tape-recorded interview with Haskell to the House
Judiciary Committee. The transcript contains the following
exchange:
American Medical News: Let's talk first about whether or
not the fetus is dead beforehand.

[[Page H2923]]

Dr. Haskell: No it's not. No, it's really not. A percentage
are for various numbers of reasons. Some just because of the
stress--intrauterine stress during, you know, the two days
that the cervix is being dilated [to permit extraction of the
fetus]. Sometimes the membranes rupture and it takes a very
small superficial infection to kill a fetus in utero when the
membranes are broken. And so in my case, I would think
probably about a third of those are definitely are [sic] dead
before I actually start to remove the fetus. And probably the
other two-thirds are not.
In an interview quoted in the Dec. 10, 1989 Dayton News,
Dr. Haskell again conveyed that the scissors thrust is
usually the lethal act: ``When I do the instrumentation on
the skull . . . it destroys the brain tissue sufficiently so
that even if it (the Fetus) falls out at that point, it's
definitely not alive,'' Dr. Haskell said.

Does anesthesia given to the mother kill the baby? Does the baby feel
pain during the procedure?

In Dr. Haskell's 1992 instructional paper, he lists among
the ``advantages'' of the procedure that ``it is a quick,
surgical outpatient method that can be performed on a
scheduled basis under local anesthesia.'' [emphasis added]
According to Prof. David H. Chestnut, editor of Obstetric
Anesthesia: Principles and Practice, ``Rational use of local
anesthetic drugs does not affect the fetus.'' (Testimony to
House Judiciary Constitution Subcommittee, March 21, 1996).
Dr. James McMahon utilized general anesthesia, at least in
some cases, but anesthesiologists say that these drugs do not
harm the fetus/baby unless given in amounts that would kill
the mother or place her in grave danger. (See below.)
Nevertheless, many critics of the bill have insisted that
the unborn babies are killed by anesthesia given to the
mother, prior to being ``extracted'' from the womb. For
example, syndicated columnist Ellen Goodman wrote in November
that, based on her review of statements by supporters of the
bill, ``You wouldn't even know that anesthesia ends the life
of such a fetus before it comes down the birth canal.''
The Planned Parenthood Federation of America (PPFA) has
been among the most persistent purveyors of this mythology.
Another leading proponent of the ``anesthesia myth'' has been
Kate Michelman, president of the National Abortion and
Reproductive Rights Act League (NARAL). For example, in an
interview on ``Newsmakers,'' KMOX-AM in St. Louis on Nov. 2,
1995, Ms. Michelman explained that she thinks it is wrong to
call the procedure a ``partial birth'' because (she claimed)
the baby is already dead. Kate Michelman's verbatim statement
follows:
The other side grossly distorted the procedure. There is no
such thing as a `partial birth'. That's, that's a term made
up by people like these anti-choice folks that you had on the
radio. The fetus-- I mean, it is a termination of the fetal
life, there's no question about that. And the fetus, is,
before, the procedure begins, the anesthesia that they give
the woman already causes the demise of the fetus. That is, it
is not true that they're born partially. That is a gross
distortion, and it's really a disservice to the public to say
this.
However, the claim that anesthesia can kill an unborn fetus
has been emphatically refuted in congressional testimony by
the heads of the leading professional societies of
anesthesiologists. These exports have criticized both pro-
abortion leaders and certain journalists and commentators,
for disseminating these bogus claims, while failing to
publicize the authoritative statements of experts that these
claims are entirely bogus.
In testimony before the Senate Judiciary Committee on
November 17, 1995, Dr. Norig Ellison, president of the
34,000-member American Society of Anesthesiologists (ASA),
said that such claims have ``absolutely no basis in
scientific fact.'' On behalf of the ASA, Dr. Ellison
testified that regional anesthesia (used in many partial-
birth abortions and most normal deliveries) has virtually no
effect on the fetus. General anesthesia has some sedating
effect on the fetus, but much less than on the mother; even
pain relief for the fetus is doubtful, and certainly
anesthesia would not kill the baby, Dr. Ellison testified.
(In March 1996, Dr. Ellison said that his testimony had been
reported in the medical press and that not one
anesthesiologist had contacted ASA to express any
disagreement.)
In testimony before the House Judiciary Constitution
Subcommittee on March 21, 1996, Dr. David J. Birnbach,
president-elect of the Society for Obstetric Anesthesia and
Perinatology, testified, ``I have never witnessed a case of
fetal demise that could be attributed to an anesthetic. . . .
In order to cause fetal demise, it would be necessary to give
the mother dangerous and life-threatening doses of
anesthesia.''
Recently, the Planned Parenthood Federation of America
(PPFA) and NARAL have tried to ``explain'' that they were
really just referring to the practice of the late Dr. James
McMahon--who, they claimed, used massive doses of narcotic
anesthesia. But Dr. Birnbach said, ``Although there is no
evidence that this massive dose will cause fetal demise,
there is clear evidence that this excessive dose could cause
maternal death.''
Brenda Pratt Shafer, a registered nurse from Dayton, Ohio,
stood at Haskell's side while he performed three partial-
birth abortions in 1993. In testimony before the Senate
Judiciary Committee (Nov. 17), Shafer described in detail the
first of the three procedures--which involved, she said, a
baby boy at 26\1/2\ weeks (over 6 months). According to Mrs.
Shafer, the abortionist delivered the baby's body and the
arms--everything but the head. The doctor kept the baby's
head just inside the uterus. The baby's little fingers were
clasping and unclasping, and his feet were kicking. Then the
doctor stuck the scissors through the back of his head, and
the baby's arms jerked out in a flinch, a startle reaction,
like a baby does when he thinks that he might fall. The
doctor opened up the scissors, stuck a high-powered suction
tube into the opening and sucked the baby's brains out. Now
the baby was completely limp.
Since the baby is usually not dead before being removed
from the womb, does the baby experience pain? Yes, according
to experts such as Professor Robert White, Director of the
Division of Neurosurgery and Brain Research Laboratory at
Case Western Reserve School of Medicine, who testified before
the House Judiciary Constitution Subcommittee: ``The fetus
within this time frame of gestation, 20 weeks and beyond, is
fully capable of experiencing pain.'' After analyzing the
partial-birth procedure step-by-step for the subcommittee,
Prof. White concluded: ``Without question, all of this is a
dreadfully painful experience for any infant subjected to
such a surgical procedure.''
Similar testimony was presented to the subcommittee on
March 21, 1996, by Dr. Jean A. Wright, associate professor of
pediatrics and anesthesia at the Emory University School of
Medicine in Atlanta. Recent research shows that by the stage
of development that a fetus could be a ``candidate'' for a
partial-birth abortion (20 weeks), the fetus ``is more
sensitive to pain than a full-term infant would be if
subjected to the same procedures,'' Prof. Wright testified.
These fetuses have ``the anatomical and functional processes
responsible for the perception of pain,'' and have ``a much
higher density of Opioid (pain) receptors'' than older
humans, she said.

is there a more ``objective'' term for the procedure than ``partial-
birth abortion''?

Congressman Charles Canady (R-FL), the author of H.R. 1833
and the chairman of the subcommittee that conducted hearings
on the bill, said on March 23, ``It it time for some in the
media to stop editing or denigrating the legal terminology
that has been adopted by the U.S. House and the U.S. Senate,
which is partial-birth abortion.''
(When Congress defined certain firefarms as ``assault
weapons,'' that terminology was readily accepted by most
journalists and editors--even though manufacturers of such
devices utilize other terms.)
Some opponents of the Partial-Birth Abortion Ban Act (H.R.
1833) insist that anyone writing about the bill should say
that it bans a procedure ``known medically as intact dilation
and evacuation.'' But when journalists comply with this
demand, they do so at the expense of accuracy. The bill
itself makes no reference whatever to ``intact dilation and
evacuation'' abortions. More importantly, the term ``intact
dilation and evacuation'' is not equivalent to the class of
procedures banned by the bill.
The bill would make it a criminal offense (except to save a
woman's life) to perform a ``partial-birth abortion,'' which
the bill would define--as a matter of law--as ``an abortion
in which the person performing the abortion partially
vaginally delivers a living fetus before killing the fetus
and completing the delivery.'' [emphasis added]
In contrast, the term ``intact dilation and evacuation''
was invented by the late Dr. James McMahon, and until
recently, was idiosyncratic to him. It appears in no standard
medical textbook or database, nor does it appear anywhere in
the standard textbook on abortion methods, Abortion Practice
by Dr. Warren Hern.
Because ``intact dilation and evacuation'' is not a
standard, clearly defined medical term, the House Judiciary
Constitution Subcommittee staff (which drafted the bill under
Congressman Canady's supervision) rejected it as useless for
purposes of defining a criminal offense. Indeed, it is worse
than useless--a criminal statute that relied on such a term
would be stricken by the federal courts as ``void for
vagueness.''
Although there is no clear definition of the term, we know
enough to say that it is inaccurate to equate ``intact
dilation and evacuation'' abortions with the procedures
banned by HR 1833, since in his writings Dr. McMahon clearly
used the term so broadly as to cover certain procedures which
would not be affected at all by HR 1833 (e.g., removal of
babies who are killed entirely in utero, and removal of
babies who have died entirely natural deaths in utero).
Indeed, some of the specific women highlighted by opponents
of HR 1833 had various types of ``intact D&E'' abortion
procedures that were not covered by HR 1833's definition of
``partial-birth abortion.''
The term chosen by Congress is in no sense misleading. In
sworn testimony in an Ohio lawsuit on Nov. 8, 1995, Dr.
Martin Haskell--who has done over 1,000 partial-birth
abortions, and who authored the instructional paper that
touched off the controversy over the procedure--explained
that he first learned of the method when a colleague
described very briefly over the phone to me a technique that
I later learned came from Dr. McMahon where they internally
grab the fetus and rotate it and accomplish--be somewhat
equivalent to a breach type of delivery.

[[Page H2924]]

In short, it is a misguided notion of objectivity for the
any journalist to denigrate the term for a criminal offense
that has been adopted and explicitly defined by the U.S.
House and the U.S. Senate, in favor of a undefined term
recently manufactured by the very special-interest that would
be ``regulated'' by the legislation.
[In his 1992 instructional paper, Dr. Haskell referred to
the method as ``dilation and extraction'' or ``D&X''--noting
that he ``coined the term.'' The term ``dilation and
extraction'' does not appear in medical dictionaries or
databases.]

are the five line drawings of the procedure circulated by NRLC
accurate, or are they misleading?

American Medical News (July 5, 1993) interviewed Dr. Martin
Haskell and reported: Dr. Haskell said the drawings were
accurate ``from a technical point of view.'' But he took
issue with the implication that the fetuses were ``aware and
resisting.''
Moreover, at a June 15, 1995, public hearing before the
House Judiciary Subcommittee on the Constitution, Dr. J.
Courtland Robinson, a self-described ``abortionist'' who
testified on behalf of the National Abortion Federation, was
questioned about the drawings by Congressman Charles Canady
(R-Fl.). Mr. Canady directed Dr. Robinson's attention to the
drawings, which were displayed in poster size next to the
witness table, and asked Dr. Robinson if they were
``technically correct.'' Dr. Robinson responded:
That is exactly probably what is occurring in the hands of
the two physicians involved. [Hearing record, page 89.]
Professor Watson Bowes of the University of North Carolina
at Chapel Hill, co-editor of the Obstetrical and
Gynecological Survey, wrote in a letter to Congressman
Canady:
Having read Dr. Haskell's paper, I can assure you that
these drawings accurately represent the procedure described
therein. . . . Firsthand renditions by a professional medical
illustrator, or photographs or a video recording of the
procedure would no doubt be more vivid but not necessarily
more instructive for a non-medical person who is trying to
understand how the procedure is performed.
On Nov. 1, 1995, Congresswoman Patricia Schroeder and her
allies actually tried to prevent Congressman Canady from
displaying the line drawings during the debate on HR 1833 on
the floor of the House of Representatives. But the House
voted by nearly a 4-to-1 margin (332 to 86) to permit the
drawings to be used.

does the bill contradict u.s. supreme court decisions?

The Supreme Court has never said that there is a
constitutional right to kill human beings who are mostly
born.
In its official report on HR 1833, the House Judiciary
Committee makes the very plausible argument that HR 1833
could be upheld by the Supreme Court without disturbing Roe.
In Roe, the Supreme Court said that ``the word `person,' as
used in the Fourteenth Amendment, does not include the
unborn.'' Thus, under the Supreme Court's doctrine, a
human being becomes a legal ``person'' upon emerging from
the uterus.
But a partial-birth abortion does not involve an ``unborn
fetus.'' A partial-birth abortion, by the very definition in
the bill, kills a human being who is partly born. Indeed, a
partial-birth abortion kills a human being who is four-fifths
across the `line-of-personhood' established by the Supreme
Court.
Moreover, in Roe v. Wade itself, the Supreme Court took
note of a Texas law that made it a felony to kill a baby ``in
a state of being born and before actual birth,'' and the
Court did not disturb that law.
Thus, the Supreme Court could very well decide that the
killing of a mostly born baby, even if done by a physician,
is not protected by Roe v. Wade.

should congress ever ban specific ``surgical procedures''?

Some prominent congressional opponents of the bill to ban
partial-birth abortions, including Rep. Schroeder (D-Co.),
argue that Congress should not attempt to ban a specific
surgical procedure. But Rep. Schroeder is the prime sponsor
of HR 941, the ``Federal Prohibition of Female Genital
Mutilation Act.'' (The Senate companion bill is S. 1030.)
This bill generally would ban anyone (including a licensed
physician) from performing the procedure known medically as
``infibulation,'' or ``female circumcision.'' (Some
physicians perform the procedure in response to requests from
immigrants from certain countries, based on the rationale
that those involved otherwise will probably obtain the
procedure from persons without medical training.) The bill
provides a penalty of up to five years in federal prison.
Supporters of this bill argue, persuasively, that subjecting
a little girl to infibulation is a form of child abuse. But
then, so too is subjecting a baby to the partial-birth
abortion procedure.
Mr. WELDON of Florida. Mr. Speaker, I submit the following material
for inclusion in the Record:
Mount Sinai Hospital

Medical Center

Chicago, IL, October 28, 1995.
Hon. Charles Canady,
Chairman, Subcommittee on the Constitution, House Committee
on the Judiciary, Longworth House Office Building,
Washington, DC
Dear Congressman Canady: It has recently been brought to my
attention that opponents of HR 1833 have stated that this
particular abortion technique should maintain its legality
because it is sometimes employed by physicians in the
interest of maternal health. Such an assertion not only runs
contrary to facts but ignores the reality of the risks to
maternal health that are associated with this procedure which
include the following:
1. Since the procedures entails 3 days of forceful
dilatation of the cervix the mother could develop cervical
incompetence in subsequent pregnancies resulting in
spontaneous second trimester pregnancy losses and
necessitating the placement of a cerclage (stitch around the
cervix) to enable her to carry a fetus to term.
2. Uterine rupture is a well known complication associated
with this procedure. In fact, partial birth abortion is a
``variant'' of internal podalic version . . . a technique
sometimes used by obstetricians in this country with the
intent of delivering a live child. However, internal podalic
version, in this country, has been gradually replaced by
Cesarean section in the interest of maternal as well as fetal
well being (see excerpts from the standard text Williams
Obstetrics pages 520, 521, 865 and 866).
Furthermore, obstetrical emergencies (such as entrapment of
the head of a hydrocephalic fetus or of a footling breech
that has partially delivered on its own) are never handled by
employing this abortion technique. Cephalocentesis, (drainage
of fluid from the head of a hydrocephalic fetus) frequently
results in the birth of a living child. Relaxing the uterus
with anesthesia, cutting the cervix (Duhrssen's incision) and
Cesarean section are the standard of care for a normal, head
entrapped breech fetus.
There are absolutely no obstetrical situations encountered
in this country which require a partially delivered human
fetus to be destroyed to preserve the health of the mother.
Partial birth abortion is a technique devised by abortionists
for their own convenience . . . ignoring the known health
risks to the mother. The health status of women in this
country will thereby only be enhanced by the banning of this
procedure.
Sincerely,
Pamela E. Smith, MD,
Director of Medical Education, Department of Obstetrics and
Gynecology.
____

The University

North Carolina,

Chapel Hill, July 11, 1995.
Hon. Charles Canady,
Chairman, Subcommittee on the Constitution,
House Committee on the Judiciary, Washington, DC.
Dear Congressman Canady: I have reviewed the Partial-Birth
Abortion Ban Act (HR 1833, S. 939) and the related materials
that you submitted to me.
Your bill would ban the use of the ``partial-birth
abortion'' method, which you define as ``an abortion in which
the person performing the abortion partially vaginally
delivers a living fetus before killing the fetus and
completing the delivery.''
As regards the use of the term ``partial-birth abortion''
to describe the procedure: The term ``partial-birth
abortion'' is accurate as applied to the procedure described
by Dr. Martin Haskell in his 1992 paper entitled ``Dilation
and Extraction for Late Second Trimester Abortion,''
distributed by the National Abortion Federation.\1\ Dr.
Haskell himself refers to that procedure as dilation and
extraction,'' but that is only a term, as he wrote, he
``coined.'' Another practitioner, Dr. James McMahon, who uses
a similar technique, uses the term ``intact dilation and
evacuation.'' \2\
---------------------------------------------------------------------------
Footnotes follow at end of Article.
---------------------------------------------------------------------------
There is no standard medical term for this period. The
method, as described by Dr. Haskell in his paper, involves
dilatation of the uterine cervix followed by breech delivery
of the fetus up to the point at which only the head of the
fetus remains undelivered. At this point surgical scissors
are inserted into the brain through the base of the skull,
after which a suction catheter is inserted to remove the
brain of the fetus. This results in collapse of the fetal
skull to facilitate delivery of the fetus. From
this description there is nothing misleading about
describing this procedure as a ``partial-birth abortion,''
because in most of the cases the fetus is partially born
while alive and then dies as a direct result of the
procedure (brain aspiration) which allows completion of
the birth.
As regards when fetal death occurs during this procedure:
Although I have never witnessed this procedure, it seems
likely from the description of the procedure by Dr. Haskell
that many if not all of the fetuses involved in this
procedure are alive until the scissors and the suction
catheter are used to remove brain tissue.\1\ Dr. Haskell,
explicitly contrasts his procedure with two other late
abortion methods that do induce fetal death prior to removal
of the fetus (these alternative methods being intra-amniotic
infusion of urea, and rupture of the membranes and severing
of the umbilical cord).\1\ Also, Doctor Haskell, in an
interview with Diane Gianelli of American Medical News that
the majority of the fetuses aborted this way are alive until
the end of the procedure.'' \2\ This is consistent with the
observations of Brenda Shafer, R.N. who, in a letter to
Congressman Tony Hall, described partial-birth abortions
performed by Dr. Haskell which she observed.\3\

[[Page H2925]]

Moreover, in a document entitled ``Testimony Before the
House Subcommittee on the Constitution'', June 23, 1995, Dr.
James McMahon states that narcotic analgesic medications
given to the mother induce ``a medical coma'' in the fetus,
and he implies that this causes ``a neurological fetal
demise.'' \4\ This statement suggests a lack of understanding
of maternal/fetal pharmacology. It is a fact that the
distribution of analgesic medications given to a pregnant
woman result in blood levels of the drugs which are less than
those in the mother. Having cared for pregnant women who for
one reason or another required surgical procedures in the
second trimester, I know that they were often heavily sedated
or anesthetized for the procedures, and the fetuses did not
die.
Dr. Dru Carlson, a maternal/fetal medicine specialist from
Cedars-Sinai Medical Center in Los Angeles, writes that she
has personally observed Dr. McMahon perform this procedure.
In a letter to Congressman Henry Hyde she described the
procedure and wrote that after the fetal body is delivered,
it is removal of cerebrospinal fluid from the brain that
causes instant brain herniation and death.\5\ This statement
clearly suggests that the fetus is alive until the suction
device is inserted into the brain.
As regards whether the fetus experiences pain during this
procedure: Dr. McMahon states that the fetus feels no pain
through the entire series of procedures.\4\ Although it is
true that analgesic medications given to the mother will
reach in the fetus and presumably provide some degree of pain
relief, the extent to which this renders this procedure pain
free would be very difficult to document. I have performed
in-utero procedures on fetuses in the second trimester, and
in these situations the response of the fetuses to painful
stimuli, such as needle sticks, suggest that they are capable
of experiencing pain. Further evidence that the fetus is
capable of feeling fetal pain is the response of extremely
preterm infants to painful stimuli.
As regards the accuracy of the illustrations of this
procedure which have been distributed by the National Right
to Life Committee: I have read the letters dated June 12,
1995 and June 27, 1995 sent to members of Congress by the
National Abortion Federation, which state that the drawings
of the partial-birth abortion procedure that have been
distributed by you and by the National Right to Life
Committee are ``highly imaginative . . . with little
relationship to the truth'' and ``misleading.'' \7\
Having read Dr. Haskell's paper \1\, I can assure you that
these drawings accurately represent the procedure described
therein. Furthermore, Dr. Haskell is reported as saying that
the illustrations were accurate ``from a technical point of
view.'' \2\ First hand renditions by a professional medical
illustrator, or photographs or a video recording of the
procedure would no doubt be more vivid, but not necessarily
more instructive for a non-medical person who is trying to
understand how the procedure is performed.
As regards the impact of the banning of the procedure on
other indicated standard medical procedures: Critics of your
bill who say that this legislation will prevent doctors from
performing certain procedures which are standard of care,
such as cephalocentesis (removal of fluid from the enlarged
head of a fetus with the most severe form of hydrocephalus)
are mistaken. In such a procedure a needle is inserted with
ultrasound guidance through the mother's abdomen into the
uterus and then into the enlarged ventricle of the brain (the
space containing cerebrospinal fluid).
Fluid is then withdrawn which results in reduction in the
size of the head so that delivery can occur. This procedure
is not intended to kill the fetus, and, in fact, is usually
associated with the birth of a live infant. This is an
important distinction between a needle cephalocentesis which
is intended to facilitate the birth of a living fetus as
contrasted with the procedure described by Doctors Haskell
and McMahon, which is intended to kill a living fetus which
has been partially delivered.
The technique of the partial-birth abortion could be used
to remove the fetus that had died in utero of natural causes
or accident. Such a procedure would not be covered by the
definition in your bill, because it would not involve
partially delivering a live fetus and then killing it.
As regards viability of preterm infants in the second
trimester of pregnancy: I have reviewed a ``fact sheet''
distributed by the National Abortion and Reproductive Rights
Action League (NARAL) in opposition to your legislation.\8\
This document states, ``Very few premature infants born at 24
weeks' gestation actually survive. The chance for survival at
25 weeks' gestation is 10-15%; one week later--at 26 weeks--
the chances of survival double to 24-45%. A survival rate of
50% is achieved only in live births at 27 or more weeks
gestation.'' These figures are outdated and misleading. In a
recent study from the National Institute of Child Health and
Human Development Neonatal Network, survival was documented
in a large number of premature infants born at the seven
participating institutions.\9\ At 23 weeks gestation the
neonatal survival was 23 percent and at 24 weeks' gestation
survival was 34 percent. As you can see in Figure 3 in the
enclosed article by Maureen Hack et al., there are wide
inter-institutional variations in neonatal survival at east
gestational age. For example, at 24 weeks' gestation neonatal
survival varied from a low of 10 percent to a high of 57
percent. This data applies to infants born without major
congenital defects.
I trust this information will be helpful.
Respectfully,
Watson A. Bowes, Jr., M.D.
Professor.

footnotes
\1\ Haskell M. Dilation and extraction for late second
trimester abortion. Presented at the National Abortion
Federation Risk Management Seminar, Dallas, Texas, September
13, 1992.
\2\ Gianelli D.M. Shock-tactic ads target late-term abortion
procedures. American Medical News, July 5, 1993, p 3 ff.
\3\ Shafer B. Letter written to Congressman Tony Hall, July
9, 1995.
\4\ McMahon JT. Written submission to the House Subcommittee
on the Constitution, Washington, D.C., June 23, 1995.
\5\ Carlson DE. Letter to the Honorable Henry Hyde, Chairman,
House Judiciary Committee, June 27, 1995.
\6\ Saporta V, Prohaska G. Letter to Members of Congress,
U.S. House of Representatives, June 12, 1995.
\7\ Saporta V. Letter to Members of Congress, U.S. House of
Representatives, June 27, 1995.
\8\ National Abortion and Reproductive Rights Action League.
Third-Trimester Abortion: The Myth of ``Abortion on Demand''.
(Date not listed)
\9\ Hack M, Hobar JD, Malloy MH, et al. Very low birth weight
outcomes of the National Institute of Child Health and Human
Development Neonatal Network. Pediatrics. 1991; 87:587-597.
Mr. ABERCROMBIE. Mr. Speaker, today I rise to discuss H.R. 1833, the
Partial-Birth Abortion Ban Act. During the course of the debate, gory
and graphic descriptions are going to be used to exaggerate and
manipulate emotions to obscure the real issues. In fact, the title
itself is misleading. This is not about abortion on demand, the issue
is about women and their families facing a tragic situation. Women who
chose to have a dilation and extraction or a dilatation and evacuation
preformed late in their pregnancy, do so only as a last resort. These
surgical procedures are rarely ever utilized. Fewer than 500 a year are
performed. These procedures are used in the case of desired pregnancies
gone tragically wrong due to severe fetal anomaly or severe risk to the
health or life of the mother.
I have read the personal testimony of Coreen Costello and Mary-
Dorothy Line.These women and others like them wanted their child and
were willing to have a child with disabilities. However, once they
realized that the baby could not survive outside of the womb, they had
to make a soul searching decision. This was a very difficult decision
made by the women and their husbands, but because they chose to have a
late term abortion procedure they saved their lives and preserved their
ability to have more children. Without the surgical procedures H.R.
1833 outlaws, neither of these women would be pregnant today or even
healthy.
Under H.R. 1833, Congress would intrude into the lives of Coreen
Costello, Mary-Dorothy Line and other women by denying them surgical
procedures which ensure their ability to conceive more children. H.R.
1833 says to American women: your health and fertility mean nothing to
us.This bill flagrantly violates women's rights and demotes them to
second class citizenry.
The Supreme Court ruled in the cases of Roe v. Wade, and Planned
Parenthood v. Casey that if a woman's life or health is endangered,
late term abortions can not be banned. Yet even as amended by the
Senate, H.R. 1833 does not have a genuine life exception. Pregnancy
does not qualify as a physical disorder, illness or injury. In
addition, H.R. 1833 also does not provide an exception for when the
mother's health is at serious risk. The language in H.R. 1833, under
legal scrutiny, clearly violates the Supreme Court's rulings since it
does not provide life or health exemptions. This bill prevents women
from receiving the safest possible medical care in the rare instances
when such care is called for in the most trying of personal
circumstances and anguish.
The bill is an example of the impossibility of writing a law of
general application for situations which clearly demand individualized
professional judgement in consultation with the parties personnely
effected. To interfere in such conditions is an affront to moral
sensibility and it disregards the profound consequences both physicians
and their patients must resolve.
Mr. POSHARD. Mr. Speaker, I rise today in strong support of the ban
on partial birth abortions, and urge my colleagues to follow suit in
passing this important legislation.
I sincerely believe this late-term abortion procedure goes beyond the
usual scope of debate we in the House have heard on the issue of
abortion. This ban is not only about respecting life, it's about using
humane and ethical medical practices. In fact, a number of historically
pro-choice Members of this body joined in supporting this ban when it
first was conducted by the House because of the nature of the
procedure.
As amended by the Senate, this bill continues to allow for such a
procedure should the life of the mother be endangered by a physical
disorder, illness, or injury. So let us not argue today about the
health and well-being of our prospective mothers, because this bill
protects

[[Page H2926]]

those very rights. To include an exception for the health of a mother
versus her life, does nothing more than allow this procedure to
continue to be used as an elective form of abortion.
For this reason, the Partial Birth Abortion Ban Act deserves the
support of every Member of Congress, regardless of your stance on the
issue of abortion.
Ms. JACKSON-LEE of Texas. Mr. Speaker, I rise in opposition to H.R.
1833. In 1973, and more recently in 1992, the Supreme Court held that a
woman has a constitutional right to choose whether or not to have an
abortion. H.R. 1833 is a direct attack on the principles established in
both Roe versus Wade and Planned Parenthood versus Casey.
H.R. 1833 is a dangerous piece of legislation which would ban a range
of late-term abortion procedures that are used when a woman's health or
life is threatened or when a fetus is diagnosed with severe
abnormalities incompatible with life. Because H.R. 1833 does not use
medical terminology, it fails to clearly identify which abortion
procedures it seeks to prohibit, and as a result could prohibit
physicians from using a range of abortion techniques, including those
safest for the woman.
H.R. 1833 is a direct challenge to Roe versus Wade (1973). This
legislation would make it a crime to perform a particular abortion
method utilized primarily after the 20 week of pregnancy. This
legislation represents an unprecedented and unconstitutional attempt to
ban abortion and interfere with physicians' ability to provide the best
medical care for their patients.
If enacted, such a law would have a devastating effect on women who
learn late in their pregnancies that they are carrying have severe,
often fatal, anomalies.
Woman like Coreen Castello, a loyal Republican and former abortion
protester whose baby had a lethal neurological disease; Mary-Dorothy
Lines, a conservative Republican who discovered her baby had severe
hydrocephalus; Claudia Ades, who had to terminate her pregnancy in the
sixth month because her baby was riddled with fetal anomalies due to a
fatal chromosomal disorder; Vicki Wison, who discovered at 36 weeks
that her baby's brain was growing outside his head; Tammy Watts, whose
baby had no eyes, and intestines developing outside the body; and Vikki
Stella, who discovered at 34 weeks that her baby had nine severe
anomalies that would lead to certain death. These are not elective
procedures. These are the women who would be hurt by H.R. 1833--women
and their families who face a terrible tragedy--the loss of a wanted
pregnancy.
In Roe, the Supreme Court established that after viability, abortion
may be banned by States as long as an exception is provided in cases in
which the woman's life or health is at risk. H.R. 1833 provides no true
exceptions for cases in which a banned procedure would be necessary to
preserve a women's life or health.
The Dole amendment does not cover all cases where a woman's life is
in danger. This narrow life exception applies only when a woman's life
is threatened by a physical disorder, illness or injury and when no
other medical procedure would suffice. By limiting the life exception
in this way, the bill would omit the most direct threat to a woman's
life in cases involving severe fetal anomalies--the pregnancy itself.
In fact, none of the women who submitted testimony during the Senate
and House hearings on this bill would have qualified for the procedure
under the Dole life exception. Instead, this bill would require
physicians to use an alternative life-saving procedure, even if the
alternative renders the woman infertile, or increases her risk of
infection, shock or bleeding. Thus, the result of this provision is
that women's lives would be jeopardized not saved.
This bill would create an unwarranted intrusion into the physician-
patient relationship by preventing physicians from providing necessary
medical care to their patients. Furthermore, it would impose a
horrendous burden on families who are already facing a crushing
personal situation.
Furthermore, the term ``Partial birth abortion'' is not found in any
medical dictionaries, textbooks or coding manuals. It is a term made up
by the author of H.R. 1833 to suggest that a living baby is partially
delivered and then killed. The definition in H.R. 1833 is so vague as
to be uninterpretable, yet chilling. Many OB/GYNs fear that this
language could be interpreted to ban all abortions where the fetus
remains intact. The supporters of this bill want to intimidate doctors
into refusing to do abortions. Given the bill's vagueness, few doctors
will risk going to jail in order to perform this procedure. As a
result, women and their families will find it even more difficult, if
not impossible, to find a doctor who will perform a late-term abortion,
and women's lives will be put in even more jeopardy.
Late term abortions are not common; 95.5 percent of abortions take
place before 15 weeks. Only a little more than one-half of 1 percent
take place at or after 20 weeks. Fewer than 600 abortions per year are
done in the third trimester and all are done for reasons of life or
health of the mother, severe heart disease, kidney failure, or rapidly
advancing cancer, and in the case of severe fetal abnormalities
incompatible with the life--no eyes,no kidneys, a heart with one
chamber instead of four or large amounts of brain tissue missing or
positioned outside of the skull, which itself may be missing.
An abortion performed in the late second trimester or in the third
trimester of pregnancy is extremely difficult for everyone involved.
However, when serious fetal anomalies are discovered late in a
pregnancy, or the mother develops a life-threatening medical condition
that is inconsistent with the continuation of the pregnancy, abortion--
however heart-wrenching--may be medically necessary.
In such cases, the intact dilation and extraction procedure [IDE]--
which would be outlawed by this bill--may provide substantial medical
benefits. It is safer in several respects than the alternatives,
maintaining uterine integrity, and reducing blood loss and other
potential complications. In addition, the procedure permits the
performance of a careful autopsy and therefore a more accurate
diagnosis of the fetal anomaly. Intact delivery allows geneticists,
pathologists, and perinatalogists to determine what exactly the fetus's
problems were. As a result, these families, who are extremely desirous
of having more children, can receive appropriate genetic counseling and
more focused prenatal care and testing in future pregnancies. Often, in
these cases, the knowledge that a woman can have another child in the
future is the only thing that keeps families going in their time of
tragedy.

Political concerns and religious beliefs should not be permitted to
take precedence over the health and safety of patients. The
determination of the medical need for, and effectiveness of, particular
medical procedures must be left to the medical profession, to be
reflected in the standard of care.
In passing H.R. 1833, this Congress would set an undesirable
precedent which goes way beyond the scope of the abortion debate. Will
we someday be standing here debating the validity of a triple bypass or
hip replacement procedure? Aren't these dangerous and unpleasant
procedures?
The legislative process is ill-suited to evaluate complex medical
procedures whose importance may vary with a particular patient's case
and with the state of scientific knowledge. The mothers and families
who seek late term abortions are already severely distressed. They do
not want an abortion--they want a child. Tammy Watts told us that she
would have done anything to save her child. She said, ``If I could have
given my life for my child's I would have done it in a second.''
Unfortunately, however, there was nothing she could do. For Tammy,
and women like her, a late term abortion is not a choice it is a
necessity. We must not compound the physical and emotional trauma
facing these women by denying them the safest medical procedure
available.
This bill unravels the fundamental constitutional rights that
American women have to receive medical treatment that they and their
doctors have determined are safest and medically best for them. By
seeking to ban a safe and accepted medical technique, members of
Congress are intruding directly into the practice of medicine and
interfering with the ability of physicians and patients to determine
the best course of treatment. The creation of felony penalties and
Federal tort claims for the performance of a specific medical procedure
would mark a dramatic and unprecedented expansion of congressional
regulation of health care.
H.R. 1833 contains no exception for adverse health consequences and
no true life exception. The Dole amendment is dangerously narrow and it
would force doctors to forgo the safest choice for a woman whose life
is at risk.
This bill is bad medicine, bad law, and bad policy. Women facing late
term abortions due to risks to their lives, health or severe fetal
abnormalities incompatible with life must be able to make this decision
in consultation with their families, their physicians, and their God.
Women do not need medical instruction from the Government. To
criminalize a physician for using a procedure which he or she deems to
be safest for the mother is tantamount to legislating malpractice. I
urge my colleagues to defeat this dangerous legislation.
Mrs. SMITH of Washington. Mr. Speaker, this evening the House will be
voting on the partial birth abortion ban legislation. As a nation, we
have created a veil of silence when it comes to the reality of abortion
procedures. It is easy to be pro-choice when one can claim ignorance
about the ways and means of abortion: whether it is a saline abortion,
dilation and extraction, or suction, just to name a few.
Tonight, we are talking about a particular procedure commonly
referred to as the ``partial

[[Page H2927]]

birth abortion.'' The very use of the word ``birth'' should be a clue
as to how this procedure is performed. By inducing a ``breech'' birth,
and I would like to note that I was a ``breech'' baby, a doctor is able
to deliver a baby feet first and while the child's head is still in the
birth canal, insert surgical scissors into the base of the baby's skull
and remove the brain tissue, thus collapsing the skull and then
finishing the delivery of a now dead baby. We are tantalizing a young
life as it enters the world, only to collapse its skull and end its
life.
I used to be pro-choice, but I am confident that I would have changed
my views years earlier had I been aware of the truly horrid nature of
abortion. Had I known that this procedure was being performed, my
decision to choose life would have been that much simpler. As a mother
and grandmother, it is mind boggling to imagine having labor induced,
to be giving birth, only to have the opportunity to be a mother stopped
in midstream. One mother, Brenda Pratt Shafer, is a nurse who witnessed
this procedure. In her own words, she has stated that she ``had often
expressed strong pro-choice views to my two teenage daughters.''
However, upon witnessing the partial delivery and death of a baby, she
realized that it is easy to be pro-choice when one does not now what
abortion is all about.
Some will say that this procedure is only used on children who would
otherwise have serious birth defects or other abnormalities. The
testimony of the doctors who have performed this procedure say
otherwise. One such doctor, Martin Haskell of Ohio, has stated that 80
percent of abortions he has performed using this procedure were
elective. Furthermore, as Americans, what is our life ethic if we
continue down this slippery slope of wanting only the ``perfect''
child? I am fearful that as we increasingly hear terms like ``gender
selection'' and the like, we will be banishing more innocent lives to a
grisly death. As a mother, I know that there are no ``perfect
children.'' Health alone does not make the perfect child. If nothing
else, the parents of a child whose life may only last a few hours or
days or weeks have the opportunity to bond with their child and then
say ``goodbye.''
Banning this procedure does not mean that other forms of abortion are
acceptable. However, I challenge my colleagues in the House and
Americans everywhere to justify the partial birth abortion. I ask my
colleagues tonight to face the facts and accept this procedure for what
it is. Many of us would like to turn the other way and have found
ourselves angry that we are being ``forced'' to look at first hand the
graphic nature of this act. I can only respond by saying that man's
inhumanity to man is never pleasant. It is necessary to understand what
we are up against.
I ask my colleagues in the House to accept the reality of the
partially birth abortion and join with me in banning this procedure. It
is just plan sick and does not reflect the values upon which this
Nation was founded and still embraces to be true today.
Thank you and please join with me in supporting H.R. 1833, the
Partial Birth Abortion Ban Act.
Ms. EDDIE BERNICE JOHNSON of Texas. Mr. Speaker, I rise in opposition
to this misguided and deceptive legislation before us known as H.R.
1833, the Partial Birth Abortion Ban Act. I believe this bill is both
bad politics and bad policy.
Mr. Speaker, it is critical to protect women's health and preserve
the ability of these women to have future healthy pregnancies. H.R.
1833 prevents women from receiving the safest medical care in the rare
cases when a wanted pregnancy has gone tragically wrong. Women need
access to the safest medical procedure. Under Roe versus Wade and later
reaffirmed in Planned Parenthood versus Casey the Supreme Court
explicitly declared that States can ban late term abortions, unless the
woman's life or health is endangered, and in fact 41 States have
already done so. As passed by the Senate, and earlier by the House,
H.R. 1833 is a direct constitutional challenge to both Roe and Casey
because it fails to provide a health exception.
Mr. Speaker, we must not be misled by the Senate's addition of
language purporting to be a ``life exception.'' As drafted, the ``life
exception'' language is so narrowly crafted that a doctor would still
risk criminal prosecution to perform this procedure. It is important to
note that the Senate, by a narrow margin, rejected a true ``life and
adverse health'' amendment that would have protected women who face
life and health threatening pregnancies.
Mr. Speaker, since the House has considered this bill, public debate
on the issue has shifted. The House acted to ban a specific abortion
procedure and jail doctors after only brief debate and a prohibition on
all amendments. When the far-reaching effects of this legislation were
more fully debated both in the Senate and in the news media the bill
passed the Senate by only a thin margin. The statements of the bill's
proponents both in Congress and in anti-choice movements make it clear
that H.R. 1833, far from being a moderate measure, is in fact the first
step in an ambitious strategy to use the new congressional anti-choice
majority to overturn Roe. I ask my colleagues to stop that from
happening.
Mrs. VUCANOVICH. Mr. Speaker, as many of you know, I have 15
grandchildren. Two of my grandchildren, the miracle twins as I call
them, were born prematurely at 7 months. They were so tiny that they
could fit in your hands but they were perfectly formed little human
beings and they are now 14 years old.
It makes me shudder to think that somewhere, perhaps even today, in
this country that there are other little pre-born human beings 7 months
old in their mothers womb that are going to be subject to this brutal,
horrible procedure known as a partial birth abortion.
I am not the only one who finds this procedure horrifying. The
American Medical Association's Legislative Council unanimously decided
that this procedure was not ``a recognized medical technique'' and that
``this procedure is basically repulsive''. This is especially true when
you realize that 80 percent of these types of abortion are done as a
purely elective procedure. It is important to note that this bill does
make exception for this type of abortion if it is necessary to save the
life of the mother however, this is an exception that will have to be
used rarely.
I think we can all agree that it is inhuman to begin the birthing
process and nearly complete the delivery of the baby, only to suck the
life out of the child.
I strongly urge my colleagues to support H.R. 1833, with the Senate
amendments, which would ban this brutal procedure known as partial
birth abortion.
Mr. ZELIFF. Mr. Speaker, I rise today in support of the conference
report to H.R. 1833, the Partial Birth Abortion Ban Act, which will
prohibit the use of a single medical procedure in the performance of
abortions. I do believe that this particular procedure is unnecessary
and a particularly cruel method of ending a late-term abortion. I
believe that saying no to one procedure (with exemptions for life-
threatening situations) in this case is appropriate, and does not
affect the reproductive rights of women with regard to the Roe v. Wade
decision, which I support. Enactment of this legislation will not in
itself have significant impact on those Constitutionally-guaranteed
rights.
But let me be clear, Mr. Speaker, that I will not support a strategy
in this body to slowly dismantle reproductive rights under Roe v. Wade
piece by piece, and I will oppose further measures that are part of
such a strategy. Having an abortion is a right as guaranteed under the
Constitution and upheld by the Supreme Court. To embark on a
congressional strategy aimed at slowly striking down that right is not
only wrong-headed, it is backhanded. The American people support the
right to choose and that fact would make any effort in this House to
further restrict the right to choose an effort without the support of
the American public.
In sum, Mr. Speaker, while I support this legislation today I will
not continue to support an effort by anti-choice forces to slowly
dismantle the constitutional rights of women in the country.
Mr. STOCKMAN. Mr. Speaker, I raise in support of the motion and ask
you insert this information into the Record.

``Fetal Death'' or Dangerous Deception? The Effects of Anesthesia
During a Partial-Birth Abortion

Abortion Advocates

Kate Michelman of the National Abortion Rights Action League (NARAL)

One of the leading proponents of the ``anesthesia myth' is
Kate Michelman, president of the National Abortion Rights
Action League (NARAL). For example, in an interview on
``Newsmakers,'' KMOX-AM in St. Louis on Nov. 2, 1995, Ms.
Michelman said:

The other side grossly distorted the procedure. There is no
such thing as a `partial-birth'. That's that's a term made up
by people like these anti-choice folks that you had on the
radio. The fetus--I mean, it is a termination of the fetal
life, there's no question about that. And the fetus, is,
before the procedure begins, the anesthesia that they give
the women already causes the demise of the fetus. That is, it
is not true that they're born partially. That is a gross
distortion, and it's really a disservice to the public to say
this.

Dr. Mary Campbell of Planned Parenthood

[[Page H2928]]

``A: The fetus dies of an overdose of anesthesia given to
the mother intravenously. A dose is calculated for the
mother's weight which is 50 to 100 times the weight of the
fetus. The mother gets the anesthesia for each insertion of
the dilators, twice a day. This induces brain death in a
fetus in a matter of minutes. Fetal demise therefore occurs
at the beginning of the procedure while the fetus is still in
the womb.''

The Press

the new york daily news

usa today

``The fetus dies from an overdose of anesthesia given to
its mother.''

the st. louis post-dispatch

``The fetus usually dies from the anesthesia administered
to the mother before the procedure begins.'' (News story,
Nov. 3, 1995)

syndicated columnist ellen goodman

The Truth

``Medical experts contend the claim is scientifically
unsound and irresponsible, unnecessarily worrying pregnant
women who need anesthesia.'' (American Medical News, January
1, 1996)
``[A]nesthesia does not kill an infant if you don't kill
the mother.'' (Dr. David Birnbach quoted in American Medical
News, January 1, 1996)
``I am deeply concerned, moreover, that widespread
publicity . . . may cause pregnant women to delay necessary
and perhaps life-saving medical procedures, totally unrelated
to the birthing process, due to misinformation regarding the
effect of anesthetics on the fetus.'' (Dr. Norig Elisson,
Nov. 17, 1995, testimony before Senate Judiciary Committee)
``Drugs administered to the mother, either local anesthesia
administered in the paracervical area or sedatives/analgesics
administered intramuscularly or intravenously, will provide
no-to-little analgesia [relief from pain] to the fetus.''
(Dr. Norig Ellison, November 22, 1995, letter to Senate
Judiciary Committee)

Statement of Norig Ellison, M.D., President, American Society of
Anesthesiologists

Chairman Canady, members of the Subcommittee. My name is
Norig Ellison, M.D., I am the President of the American
Society of Anesthesiologists [ASA], a national professional
society consisting of over 34,000 anesthesiologists and other
scientists engaged or specially interested in the medical
practice of anesthesiology. I am also Professor and Vice-
Chair of the Department of Anesthesiology at the University
of Pennsylvania School of Medicine in Philadelphia and a
staff anesthesiologists at the Hospital of the University of
Pennsylvania.
I appear here today for one purpose, and one purpose only;
to take issue with the testimony of James T. McMahon, M.D.,
before this Subcommittee last June. According to his written
testimony, of which I have a copy, Dr. McMahon stated that
anesthesia given to the mother as part of dilation and
extraction abortion procedure eliminates any pain to the
fetus and that a medical coma is induced in the fetus,
causing a ``neurological fetal demise'', or--in lay terms--
``brain death''.
I believe this statement to be entirely inaccurate. I am
deeply concerned, moreover, that the widespread publicity
given to Dr. McMahon's testimony may cause pregnant women to
delay necessary, even lifesaving, medical procedures, totally
unrelated to the birthing process, due to misinformation
regarding the effect of anesthetics on the fetus. Annually
over 50,000 pregnant women are anesthetized for such
necessary procedures.
Although it is certainly true that some general analgesic
medications given to the mother will reach the fetus and
perhaps provide some pain relief, it is equally true that
pregnant women are routinely heavily sedated during the
second or third trimester for the performance of a variety of
necessary surgical procedures with absolutely no adverse
effect on the fetus, let alone death or ``brain death''. In
my medical judgment, it would be necssary--in order to
achieve ``neurological demise'' of the fetus in a ``partial
birth'' abortion--to anesthetize the mother to such a degree
as to place her own health in serious jeopardy.
As you are aware, Mr. Chairman, I gave the same testimony
to a Senate committee 4 months ago. That testimony received
wide circulation in anesthesiology circles and to a lesser
extent in the lay press. You may be interested in the fact
that since my appearance, not one single anesthesiologist or
other physician has contacted me to dispute my stated
conclusions. Indeed, two eminent obstetric anesthesiologists
appear with me today, testifying on their own behalf and not
as ASA representatives. I am pleased to note that their
testimony reaches the same conclusions that I have expressed.
Thank you for your attention. I am happy to respond to your
questions.

Mr. GEJDENSON. Mr. Speaker, today I rise to express my opposition to
H.R. 1833, the so-called ``Partial-Birth'' Abortion bill. I voted
against this measure last year when it was first considered by the
House and I will do so again today because I do not believe that
Congress is the proper authority to decide the appropriateness of a
particular medical procedure. This decision should be made by a woman,
her family and her physician.
Further, in addition to being the first step in an all-out assault on
a woman's right to choose, this bill is also unconstitutional since it
fails to make an exception for the life and health of the mother as
required by Roe v. Wade. For that reason, President Clinton has
indicated that he will veto this measure.
Proponents of H.R. 1833 would like the public to believe that the
women who have third trimester abortions do so because after 6 months
of pregnancy, they suddenly decide that they do not want a baby. This
could not be further from the truth. The women I have heard speak about
their experiences--Mary-Dorothy Line, Tammy Watts, Coreen Costello--all
desperately wanted their babies, but severe fetal abnormalities left no
chance of the child surviving outside of the womb. Nevertheless, they
have all insisted that while their decision to have this procedure was
a painful one, it was their decision, not one forced upon them by the
Federal Government.
With this in mind, it is ironic that while the Republican majority in
Congress has spent much of the past year denouncing Government
intervention in an individual's private life, they are intent on
passing this bill which is the ultimate imposition of Government on a
woman's health care choices.
The SPEAKER pro tempore. Pursuant to the rule, the previous question
is ordered.
The question in on the motion offered by the gentleman from Florida
[Mr. Canady].
The question was taken; and the Speaker pro tempore announced that
the ayes appear to have it.
Mr. CANADY of Florida. Mr. Speaker, I object to the vote on the
ground that a quorum is not present and make the point of order that a
quorum is not present.
The SPEAKER pro tempore. Evidently a quorum is not present.
The Sergeant at Arms will notify absent Members.
The vote was taken by electronic device, and there were--yeas 286,
nays 129, answered ``present'' 1, not voting 15, as follows:

[Roll No 94]

YEAS--286

Allard
Archer
Armey
Bachus
Baesler
Baker (CA)
Baker (LA)
Ballenger
Barcia
Barr
Barrett (NE)
Barrett (WI)
Bartlett
Barton
Bass
Bateman
Bereuter
Bevill
Bilbray
Bilirakis
Bliley
Blute
Boehner
Bonilla
Bonior
Bono
Borski
Brewster
Browder
Brownback
Bryant (TN)
Bunn
Bunning
Burr
Burton
Buyer
Callahan
Calvert
Camp
Canady
Castle
Chabot
Chambliss
Chenoweth
Christensen
Chrysler
Clement
Clinger
Coble
Coburn
Collins (GA)
Combest
Condit
Cooley
Costello
Cox
Cramer
Crane
Crapo
Cremeans
Cubin
Cunningham
Danner
Davis
de la Garza
Deal
DeLay
Diaz-Balart
Dickey
Dingell
Doolittle
Doyle
Dreier
Duncan
Dunn
Ehlers
Ehrlich
Emerson
English
Ensign
Everett
Ewing
Fawell
Fields (TX)
Flake
Flanagan
Foglietta
Foley
Forbes
Fox
Franks (NJ)
Frisa
Frost
Funderburk
Gallegly
Ganske
Gekas
Gephardt
Geren
Gilchrest
Gillmor
Goodlatte
Goodling
Gordon
Goss
Graham
Gunderson
Gutknecht
Hall (OH)
Hall (TX)
Hamilton
Hancock
Hansen
Hastert
Hastings (WA)
Hayes
Hayworth
Hefley
Hefner
Heineman
Herger
Hilleary
Hobson
Hoekstra
Hoke
Holden
Hostettler
Houghton
Hunter
Hutchinson
Hyde
Inglis
Istook
Jacobs
Jefferson
Johnson (SD)
Johnson, Sam
Jones
Kanjorski
Kaptur
Kasich
Kennedy (RI)
Kildee
Kim
King
Kingston
Kleczka
Klink
Klug
Knollenberg
LaFalce
LaHood
Largent
Latham
LaTourette
Laughlin
Lazio
Leach
Lewis (CA)
Lewis (KY)
Lightfoot
Lincoln
Linder
Lipinski
Livingston
LoBiondo
Longley
Lucas
Manton
Manzullo
Martinez
Martini
Mascara
McCollum
McCrery
McDade
McHale
McHugh
McInnis
McIntosh
McKeon
McNulty
Metcalf

[[Page H2929]]

Mica
Miller (FL)
Minge
Moakley
Molinari
Mollohan
Montgomery
Moorhead
Moran
Murtha
Myers
Myrick
Neal
Nethercutt
Neumann
Ney
Norwood
Nussle
Oberstar
Obey
Ortiz
Orton
Oxley
Packard
Parker
Paxon
Payne (VA)
Peterson (MN)
Petri
Pombo
Pomeroy
Porter
Portman
Poshard
Pryce
Quillen
Quinn
Radanovich
Rahall
Ramstad
Regula
Riggs
Roberts
Roemer
Rogers
Rohrabacher
Ros-Lehtinen
Roth
Royce
Salmon
Sanford
Saxton
Scarborough
Schaefer
Schiff
Seastrand
Sensenbrenner
Shadegg
Shaw
Shuster
Sisisky
Skeen
Skelton
Smith (MI)
Smith (NJ)
Smith (TX)
Solomon
Souder
Spence
Spratt
Stearns
Stenholm
Stockman
Stump
Stupak
Talent
Tanner
Tate
Tauzin
Taylor (MS)
Taylor (NC)
Tejeda
Thornberry
Thornton
Tiahrt
Traficant
Upton
Volkmer
Vucanovich
Waldholtz
Walker
Walsh
Wamp
Watts (OK)
Weldon (FL)
Weller
White
Whitfield
Wicker
Wolf
Young (AK)
Young (FL)
Zeliff

NAYS--129

Abercrombie
Ackerman
Andrews
Baldacci
Becerra
Beilenson
Bentsen
Berman
Bishop
Boehlert
Boucher
Brown (CA)
Brown (FL)
Brown (OH)
Campbell
Cardin
Chapman
Clay
Clayton
Clyburn
Coleman
Collins (MI)
Conyers
Coyne
DeFazio
DeLauro
Dellums
Deutsch
Dicks
Dixon
Doggett
Dooley
Durbin
Edwards
Engel
Eshoo
Evans
Farr
Fattah
Fazio
Fields (LA)
Frank (MA)
Franks (CT)
Frelinghuysen
Furse
Gejdenson
Gilman
Gonzalez
Green
Greenwood
Gutierrez
Hastings (FL)
Hilliard
Hinchey
Horn
Hoyer
Jackson (IL)
Jackson-Lee (TX)
Johnson (CT)
Johnson, E. B.
Johnston
Kelly
Kennedy (MA)
Kennelly
Kolbe
Lantos
Levin
Lewis (GA)
Lofgren
Lowey
Luther
Maloney
Markey
Matsui
McCarthy
McDermott
McKinney
Meehan
Meek
Menendez
Meyers
Miller (CA)
Mink
Morella
Nadler
Olver
Owens
Pallone
Pastor
Payne (NJ)
Pelosi
Peterson (FL)
Pickett
Rangel
Reed
Rivers
Rose
Roybal-Allard
Rush
Sabo
Sanders
Sawyer
Schroeder
Schumer
Scott
Serrano
Shays
Skaggs
Slaughter
Stark
Studds
Thompson
Thurman
Torkildsen
Torres
Towns
Velazquez
Vento
Visclosky
Waters
Watt (NC)
Waxman
Williams
Wilson
Wise
Woolsey
Wynn
Yates
Zimmer

ANSWERED ``PRESENT''--1

Richardson

NOT VOTING--15

Bryant (TX)
Collins (IL)
Dornan
Filner
Ford
Fowler
Gibbons
Harman
Roukema
Smith (WA)
Stokes
Thomas
Torricelli
Ward
Weldon (PA)

{time} 2008

The Clerk announced the following pairs:
On this note:

Mr. Thomas of California for, with Ms. Harman against.
Mr. Fowler of Florida for, with Mr. Stokes against.

Mr. MYERS of Indiana changed his vote from ``nay'' to ``yea.''
So the motion was agreed to.
The result of the vote was announced as above recorded.
A motion to reconsider was laid on the table.

____________________