[Congressional Record Volume 142, Number 130 (Thursday, September 19, 1996)]
[Extensions of Remarks]
[Pages E1654-E1656]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




     DISCOMFITTING DETAILS OF LATE-TERM ABORTIONS INTENSIFY DISPUTE

                                 ______
                                 

                            HON. DAVE WELDON

                               of florida

                    in the house of representatives

                      Thursday, September 19, 1996

  Mr. WELDON of Florida. Mr. Speaker, I submit the following for the 
Record.

              Harsh Details Shift Tenor of Abortion Fight

       From the moment the medical paper arrived anonymously at 
     the offices of the National Right to Life Committee three 
     years ago, antiabortion activists knew they had been handed a 
     powerful weapon.
       The eight-page, double-spaced document described in 
     precise, straightforward language an abortion procedure 
     sometimes used during the second half of pregnancy, at 20 
     weeks and beyond. A copy of a medical paper that had been 
     delivered at a recent seminar, it was written by an Ohio 
     doctor who had performed the procedure hundreds of times.
       It provide what abortion foes had long believed was crucial 
     in turning public opinion their way: a graphic description of 
     one type of abortion they felt would offend many, perhaps 
     most, Americans. In this procedure, the doctor delivered the 
     body of the fetus--feet first and sometimes still alive--into 
     the birth canal before collapsing the skull so that the head 
     could be drawn through the opening of the uterus. The medical 
     world called the procedure ``intact dilation and 
     evacuation,'' but antiabortion activists soon coined a new 
     name for it: ``partial-birth'' abortion.
       The activists believed that publicizing the details of the 
     procedure would fuel a national debate, pull many abortion 
     rights liberals to their side and prompt Congress for the 
     first time to ban a specific abortion procedure.
       They were right.
       President Clinton vetoed the legislation last April. But 
     Congress is gearing up to vote on it again before adjourning 
     at the end of next week. Although proponents of the ban 
     believe they may have the necessary two-thirds vote in the 
     House to override the veto, they acknowledge they still are 
     at least a dozen short in the Senate.
       Ongoing efforts to enact the ban have been aided by the 
     considerable weight of leading Catholic clerics, who visited 
     members of Congress last week to lobby for an override, and 
     whose followers have deluged Capitol Hill with millions of 
     postcards.
       The issue also has played a role in the presidential 
     campaign. Robert J. Dole, the Republican nominee who supports 
     a constitutional amendment banning nearly all abortions, has 
     said that Clinton's veto ``pushed the limits of decency too 
     far.'' Ten days ago, he told an audience of Catholics, 
     ``whether you're pro-life or pro-choice, there is one thing 
     everyone can agree on: Partial-birth abortion is wrong.''
       Whatever the bill's ultimate fate, the clash over late-term 
     abortions will be remembered as a benchmark in the decades-
     old abortion debate.
       It has forced members of Congress and the general public to 
     confront what happens during abortion--and most people find 
     such details grisly, no matter what surgical method is used. 
     It also has ignited a discussion of the ethical 
     justifications for abortions performed when a pregnancy is 
     more than half over. Such procedures--of which the procedure 
     banned by the legislation is only one of several--make up 
     only 1.3 percent of the 1.3 million abortions done in the 
     United States each year, but they provoke ambivalence and 
     discomfort even among abortion rights supporters.
       ``This legislation has so mobilized pro-lifers, that the 
     effect of it . . . will strengthen them for a very long 
     time,'' said Helen Alvare, spokeswoman for the National 
     Conference of Catholic Bishops. ``For years, the best we've 
     been able to do in Congress is preserve some funding 
     restrictions. To get from that into the question of abortion 
     itself was a huge leap.''
       Those on the other side of the debate view the bill's 
     success in Congress as an ominous precedent, and suggest 
     that, if it were law, abortion opponents would try to expand 
     or broadly interpret the ban to cover other kinds of 
     abortions.
       ``This is the first time Congress has ever attempted to 
     regulate the practice of medicine and abortion,'' said 
     Kathryn Kolbert, vice president of the Center for 
     Reproductive

[[Page E1655]]

     Law and Policy in New York, an abortion rights group.
       Said Lewis Koplik, a New Mexico physician who performs 
     late-stage abortions using a different method: ``They don't 
     want less than 1 percent of abortions stopped. . . .They want 
     all abortions stopped.''


                        estimates and anecdotes

       There are no reliable statistics on how many abortions are 
     done each year using the technique that would be banned. Nor 
     is there much information about the women who undergo the 
     procedure or about the condition of the fetuses they carry. 
     As a result, both sides of the debate have selectively used 
     estimates and anecdotes to support their positions.
       The National Abortion Federation, an organization of 
     abortion providers, believes 400 to 600 cases of ``intact 
     D&E,'' as the procedure is often called, may be done each 
     year. The National Right to Life Committee, which supports 
     the ban, believes it may be several thousand.
       Similarly, there are no reliable estimates on how many 
     American doctors use the technique. Interviews with abortion 
     providers suggest that they are fewer than 20, and perhaps 
     fewer than 10.
       Opponents of the ban, including President Clinton, have 
     used patients and data drawn chiefly from the practice of one 
     abortion doctor to portray the procedure as an extremely rare 
     one, used almost exclusively in cases where a woman discovers 
     that her pregnancy threatens her own life or that the fetus 
     is severely deformed. They also have implied that in some 
     cases, it is the only abortion technique that can safely be 
     used.
       Interviews with physicians, as well as information gleaned 
     from published documents and congressional testimony, paint a 
     different picture of these late-term abortions.
       It is possible--and maybe even likely--that the majority of 
     these abortions are performed on normal fetuses, not on 
     fetuses suffering genetic or developmental abnormalities. 
     Furthermore, in most cases where the procedure is used, the 
     physical health of the woman whose pregnancy is being 
     terminated is not in jeopardy. In virtually all cases, there 
     are alternative ways to perform the abortion safely, through 
     perhaps not as safely as when intact D&E is used.
       Instead, the ``typical'' patients tend to be young, low-
     income women, often poorly educated or naive, whose reasons 
     for waiting so long to end their pregnancies are rarely 
     medical. Only in the small subgroup of women whose abortions 
     are done extremely late-in the last one-third of gestation--
     are most of the fetuses malformed, and most of the 
     pregnancies initially desired.
       But if abortion rights advocates have painted a misleading 
     picture of intact D&E, so have proponents of banning the 
     procedure.
       Much of their campaign has led people to believe that 
     normal, viable fetuses are regularly being aborted very late 
     in pregnancy--in the eighth or ninth month--using this 
     technique. ``Virtually every pro-choice American and every 
     pro-life American agrees that aborting a child in the eighth 
     or ninth month the way a partial-birth abortion does is 
     wrong,'' House Speaker Newt Gingrich (R-Ga.) said in 
     supporting a veto override on ``Meet the Press'' Sunday.
       Most fetuses aborted by the ``intact D&E'' method are less 
     than 24 weeks gestation; the number done later, when the 
     chances of viability are greater, is very small.
       There is no clear-cut moment in pregnancy when a fetus 
     becomes ``viable,'' or capable of surviving outside the womb. 
     Of infants born at 24 weeks gestation, about one-third 
     survive; at 23 weeks, fewer than one-quarter. Most abortion 
     providers will not perform abortions of any type on a normal 
     fetus, carried by a healthy woman, beyond the 24th week of 
     pregnancy; many practitioners set the boundary even earlier.
       Antiabortion groups also have cited the fact that the 
     fetus, in some cases, is still alive when part of its body is 
     outside the womb during the procedure. ``The difference 
     between the partial-birth abortion procedure and homicide is 
     a mere three inches,'' Rep. Charles T. Canady (R-Fla.) said 
     last year. Proponents also have argued that fetuses may 
     suffer pain during the procedure.
       The usual alternative to intact D&E is ``dismemberment 
     D&E,'' in which the fetal limbs are pulled off the body in 
     utero, sometimes while the fetus is still alive. Proponents 
     of the ``partial-birth'' abortion ban have not made clear why 
     intact D&E should be outlawed, while ``dismemberment D&E''--
     used to abort a fetus of similar age while still inside the 
     uterus--is not. And, if the fetus has sensation--which is far 
     from certain--then arguably dismemberment D&E is the more 
     painful procedure.
       What's indisputable is that public discussion of this 
     method of ending pregnancy has thrown a spotlight on the 
     anguish and ambivalence that lurks below many--if not all--
     abortions. It has forced doctors, patients and the public to 
     face the ``livingness'' of the fetus in a way that abortion 
     techniques used early in pregnancy do not.


                             visual imagery

       Abortion opponents have always relied on visual imagery. 
     They have carried posters depicting the tiny feet of aborted 
     fetuses, and jars with the fetuses themselves. A 1986 
     antiabortion film, ``The Silent Scream,'' showed an 
     ultrasound image of the supposed agony of a 12-week fetus 
     being aborted. But it was not until they provided drawings of 
     the intact D&E procedure that were descriptive enough to make 
     the point, but not so graphic they couldn't appear in the 
     mass media, that they reached a wider audience.
       Within weeks of Martin Haskell's description of the intact 
     D&E procedure at a 1992 National Abortion Federation seminar 
     in Dallas, his paper had been sent to the National Right to 
     Life Committee, said its legislative director, Douglas 
     Johnson. The committee took Haskell's paper, along with some 
     rough sketches of the procedure that had appeared in an 
     antiabortion publication, to an artist who produced more 
     sophisticated drawings. These were circulated within the 
     antiabortion community.
       ``I was horrified that such a procedure existed,'' said 
     Canady, who was sent a copy of the paper and later introduced 
     the ban. ``It occurred to me that this was something the 
     American people would overwhelmingly oppose if they were 
     aware of it.''
       In 1993, Haskell said in interviews in two medical 
     publications that he had discovered the procedure by 
     accident, and had performed it more than 700 times. In most 
     cases, he said, the abortions were not done because of a 
     birth defect or a severe maternal illness.
       Haskell is no longer granting interviews, ``given the 
     harassment he's under,'' said his lawyer, Kolbert.
       The issue landed on Capitol Hill as Congress was debating 
     the 1993 Freedom of Choice Act, a bill that would have 
     prohibited many state restrictions on abortion. Canady argued 
     that the bill would prevent states from banning even late-
     term abortion techniques, like the procedure described by 
     Haskell, and offered an amendment banning the intact D&E 
     method. But abortion rights supporters had long outnumbered 
     abortion foes in Congress, and Canady's amendment failed by a 
     narrow margin. A procedural fight kept the bill from ever 
     coming up for a vote.
       With Republican victories in the 1994 elections, however, 
     more than 40 new antiabortion legislators arrived on Capitol 
     Hill, and the abortion balance changed. And proponents of the 
     ``partial-birth'' abortion ban believed their chances for a 
     major antiabortion victory were further enhanced by the 
     distastefulness of the late-term procedure.
       Antiabortion leaders correctly suspected the issue could 
     split the abortion rights opposition. Sen. Daniel Patrick 
     Moynihan (D-N.Y.), who traditionally had voted for abortion 
     rights, called the procedure ``as close to infanticide as 
     anything I have come upon in our judiciary.'' Previously 
     dependable abortion rights supporters like House Minority 
     Leader Richard A. Gephardt (D-Mo.) and Rep. Susan Molinari 
     (R-N.Y.), similarly decided to support the ban.
       It passed 286 to 129 in the House, and 54 to 44 in the 
     Senate.
       The emotion that marked the congressional debate has 
     accompanied the issue into the presidential campaign. Dole 
     has pledged that, as president, he would sign the ban on 
     ``partial-birth'' abortion. He has attacked Clinton's veto, 
     charging it represented his lack of ``moral vision.''
       Clinton has countercharged that his decision was based on 
     defending the health of women whose babies were seriously 
     deformed. ``I fail to see why [Dole's] moral position is 
     superior to the one that I took,'' he said.
       Polls suggest that, while Americans generally support a 
     women's right to an abortion, there is also considerable 
     support for the ban on the ``partial-birth'' procedure.
       Respondents to a Gallup Poll last July were asked if they 
     would favor ``a law which would make it illegal to perform a 
     specific abortion procedure conducted in the last six months 
     of pregnancy known as a `partial-birth abortion,' except in 
     cases necessary to save the life of the mother.'' Seventy-one 
     percent said yes.
       Supporters of the ban argue that public opinion is shifting 
     as they continue to place advertisements describing the 
     procedure in newspapers and on television. Among the ads is 
     one from a new group of 300 physicians, including former 
     surgeon general C. Everett Koop, which argues that the 
     procedure is never medically necessary.
       The quest for public support has shaped strategies on both 
     sides. Abortion opponents focus on the fetus and on the 
     medical details of the procedure. Abortion rights supporters 
     emphasize the rights and health of women and portray the 
     proposed ban as an unwarranted government invasion of 
     privacy.


                           shaping strategies

       A contentious subtext in this war of images has been the 
     question of why women seek late-term abortions.
       ``The anti-choice community has done a very good job at 
     painting a picture of a woman who has an abortion as 
     frivolous, irresponsible, one who engages in sex without 
     responsibility,'' said Kate Michelman, president of the 
     National Abortion and Reproductive Rights Action League.
       She and others cited an advertisement run by the National 
     Conference of Catholic Bishops listing examples of reasons a 
     woman could use to obtain a ``partial-birth'' abortion if the 
     legislation made an exception to preserve the health of the 
     mother. The list included such examples as ``won't fit into 
     prom dress,'' ``hates being fat'', and ``can't afford a baby 
     and a new car.''
       But the women who have spoken out publicly about their 
     experiences with the procedure have told a different story.
       ``We are not women popping up in the eighth month saying, 
     `I don't think I'll be a mom,' '' Claudia Ades told a 
     congressional hearing last November. Ades said she learned

[[Page E1656]]

     from a sonogram when she was 26 weeks pregnant that her fetus 
     had a severely malformed brain and numerous other serious 
     defects.
       ``These were desperately wanted children, where something 
     went terribly wrong,'' she said.
       In a recent interview, Ades said she and her husband, 
     Richard, who live in Los Angeles, ``begged for . . . someone 
     that could fix my baby's brain or the hole in his heart,'' 
     but were told their child had no chance of survival. She 
     opted for abortion, she said, because she believed her fetus 
     was in pain.
       Four different doctors told her intact D&E was the safest 
     way, Ades said. ``We knew other options existed,'' including 
     a Caesarean section, ``but they were not considered as safe, 
     as healthy or as appropriate for us. . . . What bothers me is 
     that we have to defend what we did. We believe it was such a 
     humane thing.''
       Johnson, of the National Right to Life Committee, and 
     others argue that even in the case of severe developmental 
     defects like the Ades fetus, the baby should be allowed to be 
     born. ``The premise that in some cases it is necessary to 
     kill the baby to complete a delivery . . . there are no such 
     cases,'' he said.
       Clinton said he would have signed the legislation if it had 
     included an exception for women who faced serious health 
     risks without the procedure. But foes of such an exception 
     argued that it ``would gut the bill,'' in Johnson's words.
       While the immediate future of the abortion debate clearly 
     hangs on the November elections, it seems likely that this 
     will not be the last time Congress focuses on a specific 
     procedure.
       Rep. Christopher H. Smith (R-N.J.), a leading abortion 
     opponent in the House, said after the House approved the ban 
     late last year that antiabortion lawmakers ``would begin to 
     focus on the methods and declare them to be illegal.''
       For abortion rights supporters, that is a daunting 
     prospect.
       ``There is no abortion procedure when described that is 
     aesthetically comforting, whether at six weeks or 32 weeks,'' 
     said Frances Kissling, president of Catholics for a Free 
     Choice. ``This is exactly the kind of abortion issue that 
     people don't want to think about. . . . They want women to be 
     able to have this option in such extreme and terrible 
     circumstances, but they know it's not pretty. It has to 
     happen, but it shouldn't be in the newspaper.''


                         viability and the law

       The normal length of human gestation is 266 days, or 38 
     weeks. This is roughly 40 weeks from a women's last menstrual 
     period. Pregnancy is often divided into three parts, or 
     ``trimesters.'' Both legally and medically, however, this 
     division has little meaning. For one thing, there is little 
     precise agreement about when one trimester ends and another 
     begins. Some authorities describe the first trimester as 
     going through the end of the 12th week of gestation. Others 
     say the 13th week. Often the third trimester is defined as 
     beginning after 24 weeks of fetal development.
       Nevertheless, the trimester concept--and particularly the 
     division between the second and third ones--commonly arises 
     in discussion of late-stage abortion.
       Contrary to a widely held public impression, third-
     trimester abortion is not outlawed in the United States. The 
     landmark Supreme Court decisions, Roe v. Wade abortion on 
     demand up until the time of fetal ``viability.'' After that 
     point, states can limit a women's access to abortion. The 
     court did not specify when viability begins.
       In Doe v. Bolton the court ruled that abortion could be 
     performed after fetal viability if the operating physician 
     judged the procedure necessary to protect the life or health 
     of the woman. ``Health'' was broadly defined.
       ``Medical judgment may be exercised in the light of all 
     factos--physical, emotional psychological familial and the 
     women's age--relevant to the well-being of the patient.'' the 
     court wrote. ``All these factors may relate to health. This 
     allows the attending physician the room he needs to make his 
     best medical judgment.''
       Because of this definition, life-threatening conditions 
     need not exist in order for a women to get a third-trimester 
     abortion.
       For most of the century, however, viability was confined to 
     the third trimester because neonatal intensive care medicine 
     was unable to keep fetuses younger than that alive. This is 
     not longer the case.
       In an article published in the journal Pediatrics in 1991, 
     physicians reported the experience of 1,765 infants born with 
     a very low birth weight at seven hospitals. About 20 percent 
     of those babies were considered to be at 25 weeks' gestation 
     or less. Of those that had completed 23 weeks' development, 
     23 percent survived. At 24 weeks 34 percent survived. None of 
     those infants was yet in the third trimester.

                          ____________________