[Congressional Record Volume 142, Number 130 (Thursday, September 19, 1996)]
[House]
[Pages H10608-H10620]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
DISCHARGING THE COMMITTEE ON THE JUDICIARY FROM FURTHER CONSIDERATION
OF THE PRESIDENT'S VETO OF H.R. 1833, PARTIAL-BIRTH ABORTION BAN ACT OF
1995
Mr. CANADY of Florida. Mr. Speaker, I offer a privileged motion.
The SPEAKER pro tempore (Mr. LaHood). The clerk will report the
motion.
The clerk read as follows:
Mr. Canady of Florida moves to discharge the Committee on
the Judiciary from the further consideration of the
President's veto of the bill, H.R. 1833.
The SPEAKER pro tempore. The gentleman from Florida [Mr. Canady] is
recognized for 1 hour.
{time} 1100
Mr. CANADY of Florida. Mr. Speaker, I yield the customary 30 minutes
to the gentlewoman from Colorado [Mrs. Schroeder], pending which I
yield myself such time as I may consume.
(Mr. CANADY of Florida asked and was given permission to revise and
extend his remarks.)
Mr. CANADY of Florida. Mr. Speaker, on April 15 this year President
Bill Clinton vetoed H.R. 1833, the Partial Birth Abortion Ban Act.
As a result, the President is the one person standing in the way of
Congress saving thousands of children from being partially delivered
and then killed with an abortion procedure that has shocked the
conscience of the American people.
The drawings here describe the procedure called partial-birth
abortion. These drawings describe this horrible procedure step by step.
Mr. Speaker, in the partial-birth abortion procedure, the physician or
the abortionist begins in this way. Guided by ultrasound, he grabs the
live baby's leg with forceps. Then the abortionist pulls the baby's leg
out into the birth canal. The abortionist delivers the living baby's
entire body except for the head, which is deliberately kept lodged just
within the uterus, as is depicted in this drawing.
Then the abortionist jams scissors into the baby's skull. The
scissors are opened to enlarge the hole. This is the step in this
procedure which kills a living human child.
Next, in completing this horrible procedure, the abortionist removes
the scissors and inserts a suction catheter into the baby's skull. The
child's brains are removed, causing the skull to collapse, and the
delivery of a dead child is completed. This tells the truth about
partial-birth abortion. This is the truth that the proponents of
partial-birth abortion have tried to conceal from the very day that the
debate over this bill began. These are the drawings that the supporters
of partial-birth abortion tried to censor and tried to prevent this
House from even seeing and tried to prevent the American people from
even seeing, but this is the truth that cannot be concealed.
After the President vetoed this bill, which was passed with strong
bipartisan support here in this House and in
[[Page H10609]]
the Senate, Senator Daniel Patrick Moynihan of New York said, and I
quote, ``I think this is just too close to infanticide. A child has
been born and it has exited the uterus, and what on earth is this
procedure?''
Senator Moynihan is right. The only difference between the partial-
birth abortion procedure and homicide is a mere 3 inches. President
Clinton and the abortion lobby have tried to defend this indefensible
procedure by propagating a number of myths to mislead the press and the
public.
Supporters of partial-birth abortion have repeatedly denied or
misrepresented the facts about partial-birth abortion. But the truth
cries out against them. Despite their relentless effort to misrepresent
and confuse the issue, the evidence continues to mount against this
horrible practice. Both the National Abortion Federation and the
National Abortion Rights Action League claim that anesthesia
administered to the mother before a partial-birth abortion is performed
kills the child, and therefore the child feels no pain when those
scissors are being inserted into the child's head. Norig Ellison, the
President of the American Society of Anesthesiologists, unequivocally
stated that those claims had absolutely no basis in scientific fact.
Dr. David Birnbach, the President-elect of the Society for Obstetric
Anesthesia and Perinatology, said the claims were crazy, but despite
these and other authoritative statements to the contrary, the abortion
lobby continued to assert the falsehood concerning anesthesia.
Dr. Ellison said that he was deeply concerned 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.
Consequently, I held a hearing in the Subcommittee on the
Constitution to put to rest the anesthesia myth. The facts were clear:
Anesthesia administered to the mother during a partial-birth abortion
does not kill the child, nor does the anesthesia alleviate the child's
pain. Dr. Jean Wright, a professor of pediatrics and anesthesia at the
Emory University School of Medicine in Atlanta, concluded that the
partial-birth abortion procedure, if it were done on an animal in my
institution, would not make it through the institutional review
process. The animal would be more protected than this child is.
The National Abortion Federation, a lobbying group that represents
abortion providers, also claims that partial-birth abortion was
inconsequential because only 500 children per year were being aborted
using the method. This myth exploded when the Record, a daily newspaper
published in northern New Jersey, documented that doctors at a single
abortion clinic in Englewood, NJ, performed 1,500 partial-birth
abortions per year on women who are 20 to 24 weeks pregnant. That is
three times the number the abortion lobby claims nationwide.
The paper also reported that the New Jersey doctors say only a
minuscule amount are for medical reasons. That is very interesting that
the National Abortion Federation, which represents abortion providers,
did not know about this. The people who are doing this are represented
by that organization. Yet they claim such a small number of these
procedures were being performed. It simply was not true. I would
suggest it is very likely they knew it was not true.
The admission of these New Jersey doctors that only a minuscule
amount of the 1,500 partial-birth abortions they perform every year are
for medical reasons brings me to the most pervasive myth promulgated by
the abortion lobby. The abortion lobby claims that partial-birth
abortion is only used in cases where a mother needs the procedure to
spare her health or future fertility. President Clinton used this claim
when he vetoed the Partial Birth Abortion Ban Act, asserting that the
procedure is necessary for women's health.
Unfortunately, for the most part this claim has been reported
uncritically, although the evidence is overwhelmingly against it.
Former Surgeon General C. Everett Koop insists that the President is
misinformed about partial-birth abortion. Dr. Koop explains:
In no way can I twist my mind to see that the late-term
abortion as described, partial-birth, and then destruction of
the unborn child before the head is born, is a medical
necessity for the mother. It certainly can't be a necessity
for the baby. So I'm opposed to partial-birth abortions.
Dr. Martin Haskell, who has performed over 1,000 partial-birth
abortions, wrote that he routinely performs this procedure on all
patients 20 through 24 weeks; that is, 4\1/2\ to 5\1/2\ months into
pregnancy. Haskell told the American Medical News.
I will be quite frank: Most of my abortions are elective in
that 20- to 24-week range. In my particular case, probably 20
percent are for genetic reasons. And the other 80 percent are
purely elective.
Another abortionist, Dr. James McMahon, who performed partial-birth
abortions in the third trimester on five women who appeared with
President Clinton at his April 15 veto event, submitted to Congress a
detailed breakdown of a series of over 2,000 partial-birth abortions.
He classified only 9 percent as involving maternal health indications,
of which the most common was depression. Other health reasons included
spousal drug exposure and the youth of the mother. That is what they
are talking about when they talk about health.
Another 56 percent of these abortions were for fetal flaws, but these
included a great many nonlethal disorders such as cleft lip and Down's
syndrome.
Most strikingly, Dr. McMahon did not list reasons, not even
depression or cleft lip, for more than one-third of the partial-birth
abortions he performed. McMahon candidly admitted that he used the
procedure for elective abortions, explaining ``after 20 weeks, where it
frankly is a child to me, I really agonize over it,'' but he added,
``Who owns the child? Who owns the child? It's got to be the mother.''
Property can be disposed of in such a heinous manner.
Just this week the Washington Post described the real circumstances
behind most partial-birth abortions. Dr. David Brown, a staff writer,
wrote:
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.
Clearly, most partial-birth abortions are performed on the healthy
children of healthy mothers. But let me address the small percentage of
partial-birth abortions that are performed on children with conditions
that may be incompatible with life outside the womb. The President of
the United States used his bully pulpit to tell women throughout the
country that the gruesome partial-birth abortion procedure must remain
available because the only alternative is to allow doctors to ``* * *
rip your bodies to shreds, and you could never have another baby even
though the baby you were carrying couldn't live.''
In response to this statement, this outrageous statement, Dr. Nancy
Romer, a practicing high-risk obstetrician-gynecologist who is also a
professor of medicine, said, this is totally untrue. There is no basis
in fact for what the President has claimed. There is no scientific
evidence, there is no medical evidence, to support that.
The President has relied on a campaign of misinformation. The
supporters of partial-birth abortion have relied on a campaign of
misinformation. But it is time that we put a stop to the misinformation
about partial-birth abortion.
We have had women who have come forward who have had similar
circumstances to the women who were there at the White House at the
veto ceremony. They went forward with their pregnancies. They delivered
the babies without the use of this procedure, and there was no harm
done to them. They have stood and given witness to that fact.
These brave women took it upon themselves to request that the
President give them the same opportunity to meet with him that he
extended to families who have had partial-birth abortions. On behalf of
the women, Mrs. Jeannie French wrote to the President.
Perhaps inadvertently, you sent a message of hopelessness
to women and families who anticipate the birth of children
with serious or fatal disabilities. This message is so wrong.
Unfortunately, the President flatly refused to meet with them.
When asked about vetoing the Partial-Birth Abortion Ban Act, Bill
Clinton said:
[[Page H10610]]
The President is the only place in this system of ours
where there is one person who can stand up for the people
with no voice, no power, who are going to be eviscerated.
Eviscerate has a medical meaning; that is, to remove the contents of
a body organ.
Mr. Speaker, partially born children are being eviscerated. You can
see it right here. Instead of standing up for these tiny, defenseless
people, Bill Clinton stood in their way and stands in their way. I urge
my colleagues to take this opportunity today to stand up for children
with no voice, no power; children who are going to be eviscerated in
the future unless we pass this bill over the President's veto.
Vote yes on the motion to discharge, and then vote yes to override
President Clinton's veto of the Partial-Birth Abortion Ban Act. Let us
put a stop to this horrendous procedure. Let us stop partial-birth
abortion in America.
Mr. Speaker, I reserve the balance of my time.
Announcement by the Speaker Pro Tempore
The SPEAKER (Mr. LaHood). The Chair will remind all persons in the
gallery that they are guests of the House, and that any manifestation
of approval or disapproval of proceedings is a violation of the House
rules.
Mrs. SCHROEDER. Mr. Speaker, I yield 3 minutes to the distinguished
gentleman from Massachusetts [Mr. Frank], chairman of the subcommittee.
{time} 1115
Mr. FRANK of Massachusetts. It is the chairman in exile, Mr. Speaker.
The gentleman who just spoke acknowledged that there are cases where
there are health reasons. He said they are a small number. This bill is
controversial for one reason and one reason only. The majority
absolutely, in both branches, refused to allow an amendment that would
have provided an exception where the health of the mother was at stake.
In the other body, such an amendment was put forward and it was
defeated. In this House, we went to the Committee on Rules and asked
for the right to present it, and we were not allowed to do it.
If the majority feels that the health-generated abortions of this
sort are such a minuscule portion of the total, why have they adamantly
refused to allow us to vote on such an amendment? We are talking here
when we talk about health, about cases where the child to be born is
unfortunately so severely deformed as to have no chance of life
whatsoever, and the question is, if a doctor decides late in a
pregnancy when this is dicovered that the child will not survive if
born and that this is the method of abortion that minimizes risk to the
mother, this bill makes that a crime. We were not even allowed to vote
on that.
Members have said that on the other side, ``Well, if you just say
health, it will be too vague.'' Well, they have got the votes. They
could have defined health. They could have said physical health. They
could have said significant physical health.
Understand that this bill would outlaw, as it is presented to us, and
this is what the President justifiably discussed when he vetoed it,
this would outlaw the doctor deciding in his or her judgment what is
the best procedure for a fetus that has no chance of life outside the
mother and the doctor says this is the safest way.
We have had people who have said, ``Look, the doctor said to me if I
didn't use this procedure, my ability to have children in the future
would have been wiped out.''
This bill says no. If in fact they believe that medical-generated
cases are a small number, why did they not allow us to vote on this?
The reason is, this is part of an effort by people who conscientiously
believe that all abortion is wrong. The people pushing for this bill do
not really differentiate in their own minds, morally, philosophically,
any other way, between this particular form of abortion and any other
form performed in the second or third month. They do not like the whole
notion. No one does. It is not a pleasant thing to describe in any
form. But the question is, if a doctor says to a woman in her sixth or
seventh month, ``Look, we have sad news, the child you will give birth
to will have no chance whatsoever of life and in fact if you give birth
in the normal fashion, this could damage your health, and I want to use
this procedure''; the doctor says, ``I advise that we follow this
procedure, because in my medical judgment any other action would
threaten your health,'' that doctor has just proposed the commission of
a crime.
Send this back to conference, give us an amendment that says
significant physical health effects would be a reason to allow this,
and you would not have a controversy because the President would have
signed the bill.
So that is the whole story. This bill refuses to allow a doctor and
the pregnant woman to decide that in the case of a fetus that has no
chance to live this is the best procedure and you would make that a
crime.
Mr. CANADY of Florida. Mr. Speaker, I yield 2\1/2\ minutes to the
gentleman from Indiana [Mr. Roemer].
Mr. ROEMER. Mr. Speaker, we are talking today about a procedure that
is defined as the following: ``Partially delivers a living fetus before
killing the fetus and completing the delivery.'' And we are talking
about doing this with a pair of scissors inserted into the back of this
baby's skull.
Now, let me gently try to contrast that image that you have right now
with one that is given in a very popular book today on the bestseller
list, ``What To Expect When You're Expecting,'' when people are ready
for the joy of a new birth in their family. In the fifth and the sixth
month when many of these gruesome procedures are performed, here is
what is happening to this baby:
By the end of the sixth month, the fetus is about 13 inches
long and weighs about a pound and a quarter. Its skin is thin
and shiny with no underlying fat. Its finger and toe prints
are visible. Eyelids begin to part. The eyes are opening.
With intensive care, the fetus may survive now outside the
womb.
So we are now contrasting a procedure that is brutal and gruesome and
abominable with what we could put into care and technology and love and
commitment to have that baby survive.
Let me say, Mr. Speaker, that in this body we spend billions of
dollars on satellites in space that can pick up a license plate on
Earth. We spend billions on defense, for F-117's to deliver cruise
missiles. Can we not find a measure to ban these procedures?
Mr. Speaker, pro-life, pro-choice people, this is not a question of
one's philosophy. We all agree abortion should be rare. This procedure
should be banned. Let us vote today in a bipartisan way to save our
children, to be bipartisan, and to permanently ban the procedure that
takes these precious lives that might and could be saved.
Mrs. SCHROEDER. Mr. Speaker, I yield 2\1/2\ minutes to the
gentlewoman from Texas [Ms. Jackson-Lee], a distinguished member of the
Committee on the Judiciary.
(Ms. JACKSON-LEE of Texas asked and was given permission to revise
and extend her remarks.)
Ms. JACKSON-LEE of Texas. Mr. Speaker, with great emotion I rise this
morning really to speak to the American people, for giving birth, as I
have done, is not a pretty picture. But, oh, what a wonderful sight
when that bouncing and wonderfully larger than life human being comes
into your arms.
So as a member of the House Committee on the Judiciary, it was with
great trepidation and tears and emotion that I listened to women come
and not talk about death but talk about life, the kind of life that you
see in these families.
I am pained now to be on the floor of the House because Republicans
have made a medical procedure now a political cause. I am pained
because I personally know the pain of praying for a fetus to survive
and it did not. I am glad I had the support of my God, my doctor, and
my family. I believe Americans are praying people, who believe in the
right to privacy in this most difficult and private matter.
This is a medical procedure that is only done to save the life of the
mother and to give a family the opportunity to bear children again.
Note that I say a family, for this is a significant decision that must
be made with the significant partner, the husband, the wife, the
family, and, yes, the physician and their spiritual leader and their
God.
Listening to the testimony about a woman who had a child that could
not be viable, the doctors told this woman
[[Page H10611]]
who testified that there was no hope, she asked about utero surgery,
about shunts to remove the fluid that was on the brain. Nothing would
work. There was pain. And the only thing that could work would be this
procedure.
In trying to seek some relief, this particular woman who testified at
the Judiciary Committee went to several specialists, looking for an
opportunity to preserve life. I ask for mercy today that we would be
allowed to go back to committee to address the question of life.
Birth is not pretty, but we want it to occur. This procedure is not
pretty, and it should not be on the floor of the House, but God help us
that we not take this time to deny American women and families the
opportunity for life. Sustain the President. Allow us to fix it to
provide life for Americans.
Mr. CANADY of Florida. Mr. Speaker, I would inquire of the Chair
concerning the amount of time remaining on both sides.
The SPEAKER pro tempore (Mr. LaHood). The gentleman from Florida [Mr.
Canady] has 13\1/2\ minutes remaining and the gentlewoman from Colorado
[Mrs. Schroeder] has 24 minutes remaining.
Mr. CANADY of Florida. Mr. Speaker, I reserve the balance of my time.
Mrs. SCHROEDER. Mr. Speaker, I yield 2 minutes to the distinguished
gentleman from Florida [Mr. Deutsch].
Mr. DEUTSCH. Mr. Speaker, I would like to speak in the short time
that I have for the people who are not in this Chamber today, who
cannot speak for themselves but have spoken in other settings.
This is a picture of Coreen Costello and her family. I am going to
quote from a letter that she has written. If anyone wants it, they can
ask their Member of Congress for the complete letter.
Those who want to ban a controversial late-term abortion
technique might think I would be an ally. I was raised in a
conservative, religious family. My parents are Rush Limbaugh
fans. I'm a Republican who always believed that abortion was
wrong.
Then I had one.
Disaster struck in my seventh month. Ultrasound testing
showed that something was terribly wrong with my baby.
Because of a lethal neuromuscular disease, her body had
stiffened up inside my uterus.
Our doctors told us that Katherine Grace could not survive,
and that her condition made giving birth dangerous for me--
possibly even life threatening. Because she could not absorb
amniotic fluid, it had gathered in my uterus to such
dangerous levels that I weighed as much as if I were at full
term.
At first I wanted the doctors to induce labor, but they
told me that Katherine was wedged so tightly in my pelvis
that there was a good chance my uterus would rupture. We
talked about a caesarean section. But they said this, too,
would have been too dangerous for me.
Finally we confronted the painful reality: Our only real
option was to terminate the pregnancy.
She goes on to mention that ``I'm pregnant again and due in June.''
There are health issues that this procedure protects that would be
banned and made criminal by this bill. That is a fact. The gentleman
from Florida [Mr. Canady] might want to ignore that, but it is a fact.
I do not think there is any person that would want this.
The gentleman from Florida [Mr. Canady], our colleague, we have got
great news that he is engaged now, just got engaged, I guess, recently.
Hopefully he is going to have children. I have a daughter who is 4
years old. Some day hopefully she will have children.
I pray that no one would ever have to face the choice that some of
these women faced, but in the real world people will have those choices
and they will have to make that choice of their own health or not, as
to the best procedure that is available. I just do not think that it is
the right thing for the U.S. Congress to do, to tell Mrs. Costello or
other women that they should put their lives at risk in this type of
situation.
Mrs. SCHROEDER. Mr. Speaker, I yield 2\1/2\ minutes to the
gentlewoman from California [Ms. Pelosi].
Ms. PELOSI. I thank the gentlewoman from Colorado for her leadership
and for yielding me this time.
Mr. Speaker, I rise in opposition to this legislation and to the veto
override of H.R. 1833. I believe it is unconstitutional and interferes
directly with the practice of medicine. It is an unwarranted and
unneeded government intrusion into medicine and into the family. The
bill destroys the family's right to face a devastating circumstance
with safety and dignity. But don't listen to me. I think that nothing
speaks more eloquently to this issue than the voice of some of the
families who have been through these very, very sad circumstances.
{time} 1130
Many women who have undergone this procedure have bravely shared
their stories with Members of Congress and the country, because of
their great fear that other women facing tragic circumstances late in
pregnancy will not have access to the safest possible procedures.
One such women is Vikki Stella, whose beautiful family is shown here.
Vikki writes that her husband Archer and she live in Illinois, in a
western suburb of Chicago. They have three children, Lindsay, Natalie,
and Nicholas.
A little less than 2 years ago Vikki had a procedure that this
legislation would ban. She was in the third trimester of pregnancy for
a much-wanted son. She was diabetic and therefore her health was of
particular concern. During the pregnancy she had to inject herself many
times a day with insulin, et cetera.
She had prenatal tests showing her pregnancy was normal, but at 32
weeks she says her world was turned upside down. She went in for
another ultrasound which found grave problems that had not been
detected before. ``Ultimately,'' she said, ``my son was diagnosed with
at least nine major anomalies that included a fluid-filled cranium with
no brain tissue at all.''
Vikki said never in the lives of her family would they have imagined
a disaster like this could happen to them. Their options were extremely
limited because of her diabetic situation. A C-section or a normal
labor were not options available to her without having potentially
severe health consequences.
The best option was a highly specialized surgical abortion procedure
developed for women with similar difficult conditions, called an intact
D&E. ``This procedure was gentle,'' says Vikki. ``Our baby was
delivered intact. We held him in our arms and said our goodbyes. We
named him Anthony.''
Losing Anthony was a great tragedy for her, which she so generously,
the Stella family has so generously shared with this Congress so that
other women will have the best possible options available to them.
Mr. Speaker, I include for the Record the letter from Vikki Stella
referred to above:
July 29, 1996.
Member of Congress,
U.S. House of Representatives,
Washington, DC.
Dear Member of Congress: My name is Vikki Stella. My
husband Archer and I live in Naperville, Illinois, in the
western suburbs of Chicago. We have three children, Lindsay,
who is twelve; Natalie, who is seven; and Nicholas Archer,
who is seven months old. I am one of the women who stood with
President Clinton as he vetoed H.R. 1833, the so-called
``Partial Birth Abortion'' Ban Act.
A little less than two years ago I had a procedure that the
legislation would ban. I was in my third trimester of
pregnancy with a much-wanted son. I am diabetic and,
therefore, my health is of particular concern. During the
pregnancy, I injected myself twice a day with insulin and
checked my blood sugars eight times a day by pricking my
finger and using a glucose meter. I had more prenatal tests
than most women including an amniocentesis and five
ultrasounds. Our doctor had pronounced my pregnancy
``disgustingly normal.'' But then at 32 weeks, our world
turned upside-down. I went in for another ultrasound, which
found grave problems that had not been detected before.
Ultimately, my son was diagnosed with at least nine major
anomalies: these included a fluid-filled cranium with no
brain tissue at all; compacted, flattened vertebrae;
congenital hip dysplasia; skeletal dysplasia; and
hypertoloric eyes. He would never have survived outside my
womb.
Never in our lives had we imagined that a disaster like
this could happen to us. We went home to our house in
Naperville, to the bedroom prepared for out little boy--tiny
clothes folded, crib assembled, walls painted--and we cried.
Our options were extremely limited because of my diabetes:
I don't heal as well as other people so waiting for normal
labor to occur, inducing labor early, or having a C-section
would have had potentially severe health consequences for me.
The best option was a highly specialized, surgical abortion
[[Page H10612]]
procedure developed for women with similar difficult
conditions called an intact D&E.
The procedure was gentle and our baby boy was delivered
intact. We held him and said our goodbyes. We named him
Anthony.
Losing Anthony was the most difficult thing we have gone
through. When I was asked to come to Washington to share this
personal grief, I agonized over the decision to come forward.
This is not an easy story to tell. It's very private and very
painful. But I know there will be other women after me who
will need this procedure. Contrary to the image that is
portrayed by supporters of this bill, we are not mothers who
want ``perfect babies'' or mothers who are having third-
trimester abortions because of cleft palates and missing
fingers. Well, yes, Anthony had a cleft palate. I wish to God
that was his only problem! He wasn't just imperfect--his
anomalies were incompatible with life. The only thing that
was keeping him alive was my body. He could never have
survived outside my womb, so I did the kindest thing, the
most loving thing I know to do. I took my son off life
support.
When I went to Washington to tell Congress the truth about
this procedure, my oldest daughter asked me why I was going.
I told her that I was going because of Anthony. Lindsay who
was eleven at the time and very smart for her age, wanted to
know why I had to go to Washington because her baby brother
died. So I told her the whole story. When I finished she
looked up at me with her great big eyes and said, without
hesitation, ``Mommy, you did the right thing.'' It's a sad
thing when an eleven-year-old is wiser than some Members of
Congress.
Fortunately President Clinton listened to my story and the
stories of families like mine and the tragedies we faced. He
took the time to meet with me and hear how important it was
for me to have the compassionate procedure. Holding Nicky in
his arms, the President understood that that beautiful baby
boy would not have been possible if it were not for the
safety of the surgical procedure that protected my
reproductive health.
Please stand with the President and vote to sustain his
veto.
Sincerely,
Vikki Stella,
Naperville, Illinois.
Mrs. SCHROEDER. Mr. Speaker, I yield 2 minutes to the gentleman from
Illinois [Mr. Durbin].
Mr. DURBIN. Mr. Speaker, in the 14 years that I have served in
Congress I have faced many votes on this issue. Not one of these votes
has been an easy one. I have tried to make a decision of conscience in
each case.
When I took a look at the drawings which the Republicans bring
forward about this procedure, it troubled me. And I am sure as we hear
this procedure described, it troubles us all, as it would most
Americans.
But then one day a woman walked into my office whom I had never met
before, from Naperville, IL. Her name was Vikki Stella. She said to me,
``Congressman, let me tell you my story. We had several children in our
family and our baby was on the way. We had named the child. We had
painted the nursery. We had the baby shower. And we were told late in
the pregnancy that a sonogram disclosed that this poor new baby of ours
would never survive because of tragic deformities.''
Because Vikki was also diabetic and had her own medical conditions to
be concerned about, the doctors warned her that if she went through a
normal pregnancy at that point she ran the risk of never having another
child. A double tragedy: Losing this baby and never being able to bear
another.
She and her husband laid awake at night crying over this decision. It
was no frivolous, easy decision for selfish reasons, and they decided
that it was best for them and their family to terminate that pregnancy
with the procedure that would be prohibited and criminalized by this
bill.
She cried as she told me this story, and I started to have a little
tear in my eye too, as anyone would. And then she brightened up and she
said, ``You know what, Congressman? I'm pregnant again. We are going to
have another baby. We will never forget our baby that we left and lost
in this procedure, but our family is going to have another chance.''
Think about that for a minute. Not one of us, not one of us would
have wanted to face this tragedy with our family. But think of this
possibility. If we override the President's veto, we would eliminate
the medical procedure that gave Vikki Stella of Naperville, IL another
chance to have a baby.
Mrs. SCHROEDER. Mr. Speaker, I yield 2 minutes to the distinguished
gentlewoman from Florida [Mrs. Thurman].
Mrs. THURMAN. Mr. Speaker, I thank the gentlewoman from Colorado for
yielding this time and for her leadership.
Mr. Speaker, I have only one thing to say today. I want to ask in
this forum what one of the women who has had this procedure has been
asking for weeks: Who are we to judge her and her family's heartache?
I want this body to know that I listened closely to Vikki Stella's
story of her family tragedy. I saw the anguish in her eyes, but I
marveled at her willingness to retell the story of her heartache, of
learning in the third trimester of fatal fetal abnormalities and the
tremendous threat her diabetes presented if she were to deliver such a
child.
The Stella family's decision was not easy, and it has not been easy
for her to spend the last year fighting against this legislation, but
she has done it. She told me and she has told others so families faced
with this personal tragedy have options.
I want my colleagues to think about us who have had critical family
health emergencies. We know that it is important that the medical
community has the opportunity to tell us what will best preserve and
protect the health and safety of our families. Intact D&E gave the
Stella family the chance to protect Vikki's health so she could
continue to be a good healthy mother for her two daughters. It also
allowed Vikki and her husband, Archer, to have a beautiful son,
Nicholas, who is now 8 months old.
I do not support third trimester abortions except for in severe
health situations. Vikki's story shows us why American families need
this severe health exception, and this legislation does not contain it.
Mr. CANADY of Florida. Mr. Speaker, I yield 1 minute to the
gentlewoman from California [Mrs. Seastrand].
Mrs. SEASTRAND. Mr. Speaker, today this body of Representatives
decides one of the most profound moral debates in the history of our
Nation. Our children will look upon this day to see if we stood for
principle. Will we vote to defend and protect the women and future
children of this Nation? Will we vote for principle over political
party? Will we defend our children or the President's veto?
Almost as shameless as the President's veto were his efforts to paint
himself as the defender of the health of women. According to Mr.
Clinton, the life and health of women depend on the employment of this
brutal procedure.
No less an authority than former Surgeon General C. Everett Koop has
made it clear that a partial birth abortion is never necessary under
any circumstance.
I commend Democrat leaders, the gentleman from Missouri [Mr.
Gephardt] and the gentleman from Michigan [Mr. Bonior], for their vote
to ban partial birth abortions. And just as these two leaders stood up
to their President, I hope all will follow their consciences and vote
to override the President's veto.
Mrs. SCHROEDER. Mr. Speaker, I yield 2 minutes to the distinguished
gentleman from West Virginia [Mr. Wise].
Mr. WISE. Mr. Speaker, there is no issue that I agonize over, and I
suspect many Members here agonize over, more than abortion. Except for
the most committed on either side, the issues are not clear-cut and
they are not easily resolved.
I also believe that reasonable limitations can be placed upon
abortions performed late in pregnancy. But this legislation goes too
far because it says doctors performing abortion using this procedure
can be fined or jailed for 2 years.
The tragedy of this debate is not what is being said, it is what is
not being said. Supporters say they want to prevent abortion. Yet the
mothers who have this procedure, such as the women who have visited my
office, did not want an abortion. They had to have this procedure to
safeguard their health, their life, or because there was such a gross
deformity of the fetus it was not likely to live.
It is important to note also what is not in this bill, Mr. Speaker:
Any language that would permit the doctor to perform this procedure if
the mother's health was seriously endangered. That is right. Even when
a mother's health is seriously endangered a doctor performing this
procedure can be jailed.
The supporters of this bill show dramatic pictures, artist's
drawings, to make a case. Let me show a real photo
[[Page H10613]]
to make my case. This is Coreen Costello, who visited my office, and
this is her family. Late in her pregnancy she learned the child she was
carrying had a severe and fatal disability. Her doctors recommended
this procedure because her child could not live and her health was
seriously endangered. She had this procedure.
Mr. Speaker, she has now had another child, Tucker, and so this photo
becomes even more complete with Tucker being added to it. There are
other photos, Mr. Speaker, and other real families: Vikki Stella;
Claudia Ades and her family.
Mr. Speaker, I cannot believe that when a mother's health is
seriously endangered this Congress would stand between the mother, her
family, and her God. There can be reasonable limitations, yes, on
abortion, but I cannot support, Mr. Speaker, any legislation that is
going to tell a doctor that if he or she performs the procedure that
they feel necessary because a mother's health is seriously endangered,
they can go to jail. I do not believe the American people want that
either.
Mr. CANADY of Florida. Mr. Speaker, I yield 2 minutes to my
colleague, the gentleman from Florida [Mr. Stearns].
Mr. STEARNS. Mr. Speaker, I thank my colleague for yielding me this
time.
Mr. Speaker, it is difficult to comprehend an act that takes away the
life of an infant just moments before his or her first breath. It is
just as difficult to comprehend the veto of the bill that would halt
this life-ending procedure by a President who claims to promote family
values and respect for human life.
I have received over 8,000 letters and postcards from my constituents
urging me on to vote to override President Clinton's veto of the
partial birth abortion ban. I completely agree with these people. This
procedure is a violation of the sixth Commandment: Thou shalt not
murder.
In fact, hundreds of doctors, including Dr. Karrer, from
Jacksonville, FL, a practicing obstetrician-gynecologist with 30 years'
experience, all of them have come forward to say that partial birth
abortions are never, never needed to preserve the life or fertility of
the mother.
As we may recall, President Clinton's argument for vetoing this
legislation was that this procedure is needed to prevent a serious
adverse health consequence. However, the Supreme Court's definition of
the term ``health'' includes all factors: physical, emotional,
psychological. Using these definitions, partial birth abortions are
justified for reasons ranging from the mother's depression to a baby's
cleft palate.
Perhaps the President was misinformed, perhaps he turned a deaf ear
to those who tried to give him these facts, or maybe he did not hear
that 80 percent of partial birth abortions are performed for purely
elective reasons. Whatever the case, President Clinton's arguments are
flat-out wrong.
If President Clinton hears nothing else in all of these arguments, I
urge him to listen to the words of Mother Teresa who said, ``The
greatest destroyer of peace is abortion. Because if a mother can kill
her own child, what is left? For me to kill you and you to kill me.
There is nothing in between.''
I strenuously object to President Clinton's veto of this ban, and I
urge my colleagues today to vote to override this shameful veto.
Mrs. SCHROEDER. Mr. Speaker, I yield 2\1/2\ minutes to the
distinguished gentleman from Texas [Mr. Doggett].
Mr. DOGGETT. Mr. Speaker, this debate has nothing to do with
murdering babies; it has everything to do with murdering the truth.
It is a deplorable and cynical move that the sponsors of this measure
engage in to exploit the very deeply held and genuine religious
convictions of millions of Americans.
{time} 1145
If anyone, no matter how religious and how committed on this issue,
really believes the opening statement of the gentleman from Florida
[Mr. Canady] that there are thousands of babies across this country
that are being stabbed to death moments before they are born into this
world, then I would say to all these antichoice Republican militants,
``The blood is on your hands this year, gentlemen, because you sat here
after President Clinton wisely vetoed your bill on April 10.''
They sat here at the scene of these alleged scissors murders. They
sat here through April; they sat here through May; they sat here
through June; they sat here through July; they sat here through August
doing little or nothing as these supposed thousands of murders took
place. They sat here until election eve because they were not concerned
about these procedures; you were concerned about gaining political
advantage with the millions of Americans who are genuinely concerned
about the question of abortion.
And, of course, my colleagues and their Republican antichoice
militants, they have a broader pledge. Their pledge is to end every
abortion, even when it results from rape, even when it results from
incest. By golly, in Texas they even went a little further. They said
even when a teenage father who will not marry the mother objects, there
is not going to be any abortion. And this is the first step, not the
last step, in addressing that agenda that mandates motherhood, whether
the mother wants to or not.
This same crowd will then come to this Congress and begin talking
about scissor murders which are not occurring in America today; this
same crowd will be here then telling the American people what kind of
birth control, if any, they can use. Today is the first time that
American women, facing a troubling health decision, are told: Do not
ask your doctor; ask your Congressman.
We are not going to follow that troubled path. It is time to stop
meddling in the personal lives, in the most personal decision that
American people face, that American women face.
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 to strongly urge Members to vote to
override the President's veto on this legislation.
This legislation is much-needed if we are going to save the thousands
of children who are killed unnecessarily each year by this procedure.
There is a provision in this bill that exempts those procedures where
it is necessary in order to save the life of the mother. So all other
procedures not necessary to save the life of the mother are just for
the purpose of killing a baby, because the mother feels, or the doctor
feels, that it is not appropriate to have this baby at this time.
It is a procedure that I feel, the scissors issues and the procedure
is when this baby is at the moment of being born, taking its first
breath and ready to live a life just like all of us, and then a moment
comes where the doctor kills the baby, sucks it out and takes it out,
and that is the end of it.
I say, let us vote to override the President's veto.
Mrs. SCHROEDER. Mr. Speaker, I yield 3 minutes to the distinguished
gentleman from Texas [Mr. Edwards].
Mr. EDWARDS. Mr. Speaker, when this bill first came to the House
floor, my wife was 8 months pregnant with our very first child. We were
soon blessed to have a healthy baby who turned 9 months old yesterday.
Our son is love of my wife's life and my life. He is the fulfillment of
our hopes and dreams and prayers.
Yesterday, I met another little child named Nicholas Stella. Because
Nicholas was born within 8 days of our own child, I could understand
the joy of his mother as he playfully strode across my office floor.
Had this bill been law 2 years ago, Nicholas might not be alive
today. As a new father, that is all the reason I need to vote to
sustain this bill's veto.
This bill is not about saving baby's lives; it is about politics in
an election year. This bill risks the fertility and health of women in
order to make a political statement in a 30-second TV ad or 8-second
sound bite.
What most citizens are not being told in America is that this bill
will not outlaw late-term abortions; rather, it prohibits only one
procedure that many physicians believe is needed to protect the health
and fertility of a pregnant woman in tragic cases where her fetus has
no chance of survival.
All other late-term abortion procedures under this bill would be
perfectly
[[Page H10614]]
legal, even if those procedures pose a greater threat to a woman's
health or fertility.
For anyone, for anyone here or elsewhere to suggest that I as a new
father or anyone else in this House would want to allow the abortion of
a healthy baby just moments before normal childbirth is ludicrous, it
is deceptive, and it is totally dishonest.
Mr. DORNAN. And it happens.
Mr. EDWARDS. It does not happen.
announcement by the speaker pro tempore
The SPEAKER pro tempore (Mr. LaHood). The gentleman from Texas has
the time.
Mrs. SCHROEDER. Regular order.
The SPEAKER pro tempore. The Chair would ask the gentleman from
California [Mr. Dornan] to please be seated. The Chair would ask the
gentleman from California to abide by the rules of the House. The
gentleman from Texas [Mr. Edwards] has the time.
Mr. DORNAN. I will, Mr. Speaker, but it happens. It happens.
Mrs. SCHROEDER. Regular order.
The SPEAKER pro tempore. The Chair would ask the gentleman from
California to abide by the rules of the House. The gentleman from Texas
[Mr. Edwards] has the time.
Mr. DORNAN. I will, Mr. Speaker, but it happens.
The SPEAKER pro tempore. The Chair would ask all Members to abide by
the rules. The gentleman from Texas has the time.
Mr. EDWARDS. Mr. Speaker, if that happens anywhere at any time, if
these Members of the House, including the one that just spoke, would
work with us to pass a bill, we could put into law in the next few
weeks, we could stop it from happening.
But for anyone to suggest, as they have in fliers and ads, that we
want to allow the abortion of a healthy baby just moments before
childbirth is, as I said before and say again, totally dishonest and
disgusting.
I helped pass a bill that outlawed not one late-term-abortion
procedure in Texas; we outlawed all late-term-abortion procedures in
Texas. But in that bill that is now law in Texas we did what this bill
should do. We said if the life or the health or the fertility of a
woman is at risk, that moral and medical decisions should be made by a
woman, her family and her doctor, and not by politicians and not by the
government.
Mr. Speaker, I urge the Members of this House to support the veto of
this ill-fated, ill-designed legislation.
Mr. CANADY of Florida. Mr. Speaker, I yield such time as he may
consume to the gentleman from California [Mr. Dornan].
(Mr. DORNAN asked and was given permission to revise and extend his
remarks.)
Mr. DORNAN. Mr. Speaker, I rise in support of this bill and against
infanticide and I will do a 1 hour special order tonight continuing the
debate. I say to my colleagues, please join me tonight.
Mr. CANADY of Florida. Mr. Speaker, I yield 2\1/2\ minutes to the
gentlewoman from Utah [Ms. Greene].
Ms. GREENE of Utah. Mr. Speaker, I first learned about the partial-
birth-abortion practice about a year-and-a-half ago when I was pregnant
with my daughter. At that time, I was asked to be a part of the
original cosponsors of that bill and, frankly, I did not want to be
involved.
At that point, I felt that if, as a pregnant women, I stepped forward
to engage in this debate, that the abortion supporters would pillory me
as the poster child of the right. I did not want to tarnish the
excitement and the joy of my pregnancy with this gruesome debate.
But, Mr. Speaker, I had to change my mind after I read this. It is
the Medical Journal article prepared by the doctor who pioneered this
so-called practice, this so-called procedure. I read it through. I
tried to forget what I had read. It haunted me for 2 weeks. I daily
thought about what I had read here about a procedure that is, in fact,
infanticide. And I decided that I had to step forward.
Mr. Speaker, this so-called procedure has been defended as an
emergency procedure when, in fact, this procedure takes 3 days to
complete because the practitioner has to induce labor for 2 days before
the person who is receiving the abortion can go in to partially deliver
the child.
It has been defended as being painless for the fetus, and yet
anesthesiologists say, if they are using anesthetics for the mother
appropriately, quote, ``Then it has little or no effect on the fetus.
From a clinical point of view, you cannot depend on the fetus being
asleep.'' That from the president of the Society for Obstetric
Anesthesia and Perinatology.
Mr. Speaker, we have provided an exception where the life of the
mother is at stake. This gruesome horrific practice is opposed by the
American Medical Association legislative counsel. It has been opposed
by C. Everett Koop, our former Surgeon General, who says he believes
the President has been misled as to the medical facts behind this so-
called procedure.
Mr. Speaker, I believe that the highest calling of this body is to
protect the rights and interests of those who are too weak to protect
themselves. Protect these children. Vote to override the President's
veto and establish some civilized approach to a heinous practice that
should not be allowed to continue in our Nation.
Mr. Speaker, today I will vote in favor of overriding President
Clinton's veto of H.R. 1833, a bill to eliminate an abortion procedure
commonly called a partial-birth abortion. I believe it is important for
my colleagues to read a paper prepared by Dr. W. Martin Haskell
describing the partial-birth abortion procedure, and to read an
interview with Dr. Haskell in the Cincinnati Medicine. I would like to
insert the interview and paper into the Congressional Record.
[From Cincinnati Medicine, Fall 1993]
Second 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 make much of a
contribution. I'd be just another good surgeon. While I was
in family practice, I got a parttime 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 pro-choice?
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 level 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 realize 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
[[Page H10615]]
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 times they
don't have adult minds. So their reaction to problems tends
to get 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 up on 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 its 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 that 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 up 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.
The D & X Procedure
Dilation and Extraction (D & X), a method for second
trimester abortion up to 26 weeks, was developed in 1992 by
Cincinnati physician W. Martin Haskell, MD. It is a
modification of Dismemberment and Extraction (D & E) which
has been used in the US since the 1970s. Haskel has performed
more than 700 D & X procedures in his office.
Step One--The patient's cervix is dilated to 9-11 mm over a
period of two days using Dilapan hydroscopic dilators. The
patient remains at home during the dilation period.
Step Two--In the operating room, patients are given Valium,
the Dilapan are removed and the cervix is scrubbed,
anesthetized and grasped with a tenaculum. Membranes are
ruptured.
Step Three--The surgical assistant scans the fetus with
ultrasound, locating the lower extremities.
Step Four--Using a large forcep, the surgeon opens and
closes its jaws to firmly grasp a lower extremity. The
surgeon turns the fetus if necessary and pulls the extremity
into the vagina.
Step Five--The surgeon uses his fingers to deliver the
opposite lower extremity, then the torso, shoulders, and
upper extremities.
Step Six--The skull lodges at the intemal cervical os.
Usually there is not enough dilation for it to pass through.
The fetus is spine up.
Step Seven--A right-handed surgeon slides the fingers of
his left hand along the back of the fetus and hooks the
shoulders of the fetus with the index and ring fingers (palm
down). He slides the tip of his middle finger along the spine
towards the skull while applying traction to the shoulder and
lower extremities. The middle finger lifts and pushes the
anterior cervical lip out of the way.
Step Eight--While maintaining this tension, the surgeon
takes a pair of blunt curved scissors in the right hand. He
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. The surgeon forces the
scissors into the base of the skull and spreads the scissors
to enlarge the opening.
Step Nine--The surgeon removes the scissors and introduces
a suction catheter into this hole and evacuates the skull
contents.
Step Ten--With the catheter still in place, he applies
traction to the fetus, removing it completely from the
patient, then removes the placenta.
____
Dilation and Extraction for Late Second Trimester Abortion
(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 are at the 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.
[[Page H10616]]
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 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 place 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, anesthesized
and dilated to 9-11mm. Five, six or seven large Dilapan
hydroscopic dilators are placed in the cervix. The patient
goes home or to a motel overnight.
Day 2--More Dilation
The patient returns to the operating room where the
previous day's Dilapan are removed. The cervix is scrubbed
and anesthesized. 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, anesthesized 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 tranducer 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 hand 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 analgesia 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
proplylactic 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.
references
\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.
\10\ McMahon, J., personal communications, 1992.
Mrs. SCHROEDER. Mr. Speaker, I yield 2 minutes to the distinguished
gentlewoman from California [Ms. Lofgren], a member of the committee.
Ms. LOFGREN. Mr. Speaker, this vote today regrettably has more to do
with politics than it has to do with medicine or what families need. We
know that the 30-second ads are running throughout the country--the hit
pieces and mailers are going forward. It is a political issue for this
Congress, but it is a real life issue for families that need this
procedure.
I saw Viki Wilson, my friend, yesterday. I was friends with her
mother-in-law, Suzy, for 20 years, and I remember April 8, 1994 when
they lost their daughter, Abigail.
Abigail was a much-wanted child. They had two baby showers for her.
The nursery was garnished with pink ribbons, but they found out in the
eighth month that Abigail's brain had formed outside of the cranium and
there was no way that Abigail could survive.
They sought medical help to see whether some medical procedure could
[[Page H10617]]
be done to cure the defect in Abigail. They wanted her to live. But
instead, their doctor advised that this procedure should be used so
that Viki's uterus would not burst, so that they might have an
opportunity to have another child, which they wanted to do.
I remember the tears and the prayers of the friends of the Wilson
family at that time. They needed friendship. They needed the Lord's
help and guidance. They did not need the Congress of the United States
to be involved in political wedge issues.
This is about politics. Although I disagree with the gentleman from
Illinois [Mr. Hyde], the chairman of the Committee on the Judiciary, I
do respect him. He has announced publicly that his goal is to have a
constitutional amendment to preclude all abortions in America. I do not
agree with him, but I respect his honesty in saying that.
This is the first step toward that. It is about politics, and I hope
that the American people understand that.
In closing, I got a call from my late mother's very best friend, a
devout Catholic who goes to Mass every single morning, and she told me
that the priest had asked her to distribute cards against this
procedure and she refused to do so.
Mr. CANADY of Florida. Mr. Speaker, I yield 2 minutes to the
gentleman from Florida [Mr. Weldon].
Mr. WELDON of Florida. Mr. Speaker, I thank the gentleman for
yielding and I rise in strong support of this veto override. And I want
to address one very important issue in this debate. I remember reading
the original American Medical News article back in 1993 when it came
across my desk, when I was still practicing medicine, describing this
procedure. And the people on the other side keep talking about these
particular cases where we may, on an emotional basis, be able to
justify doing such a gruesome procedure, but those doctors, Haskell and
McMahon, admitted that in 85 percent of the cases these were in
perfectly normal, healthy babies.
{time} 1200
Partially delivering the baby, arms and legs moving, putting a
scissors in the back of the head and then sucking the brains out in a
perfectly normal healthy baby, 58 percent of the cases. In the 15
percent of cases where there was birth defects, the majority of them
were nonlethal birth defects, cleft lip, cleft palate.
What kind of a nation are we, what kind of people are we where we
would allow this procedure to be done on not only a healthy baby but a
baby that simply has a cleft lip and a cleft palate? Where is our soul?
Mr. Speaker, I personally believe that when the President vetoed this
bill, it was the most cynical and despicable thing that he has ever
done in his 4 years in the White House. I urge all my colleagues to
vote in support of this veto override.
Mrs. SCHROEDER. Mr. Speaker, I yield 2 minutes to the distinguished
gentlewoman from New York [Ms. Slaughter].
Ms. SLAUGHTER. Mr. Speaker, everything about this debate is
heartbreaking. It is heartbreaking the misinformation that has been
disseminated. The thing that hurts me most hurt me back in the days
before abortion was legal for women. And that is that women have no
rights or abilities to choose. They are not bright enough. They are not
nurturing enough. They do not have enough sense. It is only up to men
in suits and ties to tell them what is good for them and how to think.
Imagine a scene in a doctor's office where a doctor, a woman, her
husband, awaiting a baby, desperately excited about it. The doctor
says, I have bad news for you. Something seriously has gone wrong and
we need to discuss our options. Now, they have some options. If this
Congress has its ways, they will not.
I remember as I grew up, young girls, knew that their future at the
point of giving birth, if there was to be a choice between their lives
or the baby would die. I remember kids, when I was growing up, who had
no mother. She had died in childbirth. The woman who would have been my
mother-in-law died in childbirth. My husband had a very difficult time
ever finding out anything about her. No one wanted to talk about her.
Before I gave birth to my first child, I worried terribly about that.
I wondered, if my husband would be married again, would he marry a
woman, as my father-in-law had, someone who would never discuss who I
was or what I meant. Now, fewer women die in childbirth. There are
options.
How in the world can we make these kinds of decisions? It is the
height of hypocrisy for Congress to decide. These babies that are
aborted are desperately wanted. If they were not wanted, if the woman
did not want this baby, she would have had the abortion early. There
would have been no question about it. After waiting this long, carrying
that child, you may believe me that child is wanted. The tragedy of a
woman who said she could feel life and learned later that this was only
seizures because the baby's brain was outside its body, the tragedy of
a woman whose fetus had no lungs and yet people on radio programs said
to her, why could you not give it the chance to live. How could it
live?
Can we please be sensible here and determine that American men and
women really want what is best for their families. If we talk family
values and family love, we have to say that families have some right to
make some choices without an infallible Congress interfering.
Mr. CANADY of Florida. Mr. Speaker, I yield 1 minute to the gentleman
from Ohio [Mr. Hall].
Mr. HALL of Ohio. Mr. Speaker, this procedure is simply wrong. A
compassionate society should not promote a procedure that is gruesome
and inflicts pain on the victim. We have humane methods of capital
punishment, and 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.
This procedure is only performed in a few places around the country.
Unfortunately one of those places is in my district. A local city
council in Kettering, OH, took the rare step and passed a resolution
supporting the override of the President's veto. I submit that in the
Record at this time:
City of Kettering, OH, Statement of Personal Intent Supporting an
Override of the Presidential Veto of the Partial-Birth Abortion Ban Act
of 1995
Whereas: the partial birth abortion method has been the
subject of action by both the U.S. Senate through SB 939 and
the U.S. House of Representatives through HB 1833 both of
which pieces of legislation amend Title 18 of the United
States Code; and
Whereas: this legislation received bi-partisan support and
passed by sizeable majorities; and
Whereas: President Clinton vetoed that legislation on April
10, 1996; and
Whereas: the members of Council feel that the partial birth
abortion procedure should not be permitted.
Now, therefore, be it made known:
Section 1. The members of the Council of the City of
Kettering who are present urge the U.S. House of
Representatives and the U.S. Senate to overrride President
Clinton's veto of the legislation referred to in the
introductory paragraphs of this resolution.
Section 2. The residents of Kettering are encouraged to
become informed about this issue and then to contact Senator
DeWine, Senator Glenn and Representative Hall, as well as
other congressional representatives, to make their opinions
known.
Mayor Richard P. Hartman, Vice Mayor Marilou W. Smith,
Councilmember John J. Adams, Councilmember Keith Thompson,
Councilmember Raymond P. Wasky, Councilmember John J. White.
July 23, 1996.
Finally, I do not want to discuss a bill relating to abortion without
saying that I also have a deep moral obligation to improving the
quality of life for children after they are born. 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 working on childhood hunger and trying
to help families achieve a just life.
I urge my colleagues to vote for this bill.
Mrs. SCHROEDER. Mr. Speaker, I yield 2 minutes to the gentleman from
California [Mr. Campbell].
(Mr. CAMPBELL asked and was given permission to revise and extend his
remarks.)
Mr. CAMPBELL. Mr. Speaker, some of us are called to the ministry.
Some of us are called to the priesthood or the rabbinate. We are called
to be Members of Congress. When we take our obligation, we swear an
oath to uphold and defend the Constitution of the United States.
This bill is unconstitutional. Our highest obligation is to uphold
and defend the Constitution because that is
[[Page H10618]]
the oath that we take. Hence, we should vote no.
Many conservative legal scholars applauded the Supreme Court's
opinion in 1995, United States versus Lopez; so did I. In that case,
the Supreme Court struck down the attempt by Congress to restrict the
possession of handguns in schools. Not because it was a bad idea; I
happen to think it is a great idea to restrict handguns in schools. But
because it was beyond the ability of Congress; because it had nothing
to do with interstate commerce. The Supreme Court said:
The Constitution mandates * * * withholding from Congress a
plenary police power that would authorize enactment of every
type of legislation.
The Supreme Court ruled that, in order for the Federal Government to
have authority, the subject matter of the bill there had to be control
over a means of interstate commerce, or interstate commerce itself, or
something which had a substantial effect upon interstate commerce. None
of those premises was present in that instance.
The Supreme Court then gave examples of the kinds of things that the
Federal Government constitutionally could not regulate. The examples
they gave were ``family law,'' ``marriage,'' ``divorce,'' ``child
custody,'' ``criminal law enforcement,'' ``child rearing.'' I am
quoting each of those phrases from the Supreme Court opinion.
What we have today is an attempt to regulate beyond the ability of
Congress to regulate. Conservatives, who are so careful to protect the
rights of the individual States against the intrusion of the Federal
Government, should listen to the words of James Madison in the
Federalist No. 45 and agree that this is an unconstitutional act.
Madison's words were, ``The powers delegated by the proposed
Constitution to the Federal Government are few and defined. Those which
are to remain in the State governments are numerous and indefinite.''
Please obey your oath of office. Do not allow this unconstitutional
law to become law.
Mr. CANADY of Florida. Mr. Speaker, I yield myself such time as I may
consume.
I would point out to the gentleman from California that the language
of the bill specifically provides that any physician who in or
affecting interstate or foreign commerce knowingly performs a partial
birth abortion. The provisions of the bill, specifically, only govern
those circumstances in or affecting interstate commerce.
Mr. Speaker, I yield 1 minute to the gentleman from South Carolina
[Mr. Inglis].
Mr. INGLIS of South Carolina. Mr. Speaker, there are a lot of victims
of abortion walking around today, people who now realize what they did.
In fact, it is almost in all of our families, somebody had an abortion
that now they know what it was.
I cannot believe the Orwellian language on this floor today, that
Members actually defend this procedure. The gentlewoman from Texas in
the back of the Chamber said earlier, this is only about life of the
mother. It is not. The guy who does this says that 80 percent of his
cases are solely for convenience. So why did she say that? Why did the
gentleman from Texas say things like, this is only about life? Why did
the gentleman from California say it is about interstate commerce?
Let me tell my colleagues what this is about: This is about a
procedure where an abortionist delivers all but the head of a child. It
does not deal with interstate commerce. That is not the essence of
this. It is about sucking the brains of the child out. That is amazing
that we would rely on that.
Mrs. SCHROEDER. Mr. Speaker, I yield myself such time as I may
consume.
I include for the Record letters from the American Nurses
Association, the American College of Obstetricians and Gynecologists,
and the American Medical Women's Association.
American Nurses Association,
Washington, DC, July 30, 1996.
The President,
The White House, Washington, DC.
Dear Mr. President: As the Congress prepares to reconsider
vetoed legislation which would prohibit health care providers
from performing a certain type of late-term abortions, I am
writing to commend you for your veto of H.R. 1833 and to
reiterate the opposition of the American Nurses Association
to this legislation.
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, and they are necessary either to protect
the health 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 members
of Congress to uphold your veto when H.R. 1833 is considered
again.
Sincerely,
Geri Marullo, MNS, RN
Executive Director.
____
The American College of Obstetricians and Gynecologists,
Albany, NY, August 1, 1996.
William Jefferson Clinton,
The President of the United States of America, The White
House, Washington, DC.
Dear Mr. President: The American College of Obstetricians
and Gynecologists (ACOG), District II, an organization
representing more than 3,000 physicians practicing in New
York State, does not support HR 1833, the ``Partial-Birth
Abortion Ban Act of 1995.'' As an organization dedicated to
improving women's health care, ACOG, District II is disturbed
that Congress would take any action that would supersede the
medical judgment of trained physicians and would criminalize
medical procedures that may be necessary to save the life of
a woman. Further, this legislation employs terminology that
is not even recognized in the medical community to define
what procedures doctors may or may not perform. This clearly
demonstrates why Congressional opinion should never be
substituted for professional medical judgment. For these
reasons, ACOG, District II supports your decision to veto
this legislation.
Thank you for considering our views on this important
matter.
Sincerely,
John G. Boyce, MD,
Chairperson.
____
The American College of
Obstetricians and Gynecologists,
Burlington, MA, August 1, 1996.
William Jefferson Clinton,
The President of the United States of America, The White
House, Washington, DC.
Dear Mr. President: The American College of Obstetricians
and Gynecologists (ACOG), an organization representing more
than 37,000 physicians dedicated to improving women's health
care, does not support H.R. 1833, the Partial-Birth Abortion
Ban Act of 1995. The College finds it very disturbing that
Congress would take any action that would supersede the
medical judgment of trained physicians and 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, H.R. 1833 employs terminology
that is not even recognized in the medical community--thus
demonstrating that Congressional opinion should never be
substituted for professional medical judgment. Accordingly,
ACOG supports your decision to veto this legislation.
Thank you for considering our views on this important
matter.
Sincerely,
Joseph K. Hurd, Jr., M.D.,
Chairman, Massachusetts Section.
____
The American College of
Obstetricians and Gynecologists,
Harrisburg, PA, August 1, 1996.
William Jefferson Clinton,
The President of the United States of America, The White
House, Washington, DC.
Dear Mr. President: The Pennsylvania Section of the
American College of Obstetricians and Gynecologists (ACOG),
an organization representing more than 1,700 physicians
dedicated to improving women's health care in the state of
Pennsylvania, does not support H.R. 1833, the Partial-Birth
Abortion Ban Act of 1995.
The PA Section of ACOG finds it very disturbing that
Congress would take any action that would supersede the
medical judgment of trained physicians and 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, H.R. 1833, employs
terminology that is not even recognized in the
[[Page H10619]]
medical community--demonstrating why Congressional opinion
should never be substituted for professional and medical
judgment.
Accordingly, the PA Section of ACOG supports your decision
to veto this legislation.
Thank you for considering our views on this important
matter.
Sincerely,
Own C. Montgomery, MD,
Section Chairman.
Kristi Wasson,
Executive Director.
____
The American College of
Obstetricians and Gynecologists,
Albuquerque, NM, August 2, 1996.
William Jefferson Clinton,
The President of the United States of America, The White
House, Washington, DC.
Dear Mr. President: The New Mexico section of ACOG fully
supports your decision to veto H.R. 1833, the Partial-Birth
Abortion Ban Act of 1995. We find it very disturbing that
Congress would take any action that would supersede the
medical judgment of trained physicians and criminalize
medical procedures that may be necessary to save the life of
a woman.
I am sending a copy of this letter to the New Mexico
members of Congress hoping that you all will consider our
views in this matter.
Respectfully,
Luis B. Curet, M.D.,
Chairman, NM ACOG.
____
The American College of
Obstetricians and Gynecologists,
Lincoln, NE, August 5, 1996.
William Jefferson Clinton,
The President of the United States of America, The White
House, Washington, DC.
Dear Mr. President: The American College of Obstetricians
and Gynecologists (ACOG), an organization representing more
than 37,000 physicians dedicated to improving women's health
care, does not support H.R. 1833, the Partial-Birth Abortion
Ban Act of 1995. The College finds very disturbing that
Congress would take any action that would supersede the
medical judgment of trained physicians and 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, H.R. 1833 employs terminology
that is not even recognized in the medical community--
demonstrating why congressional opinion should never be
substituted for professional medical judgment. Accordingly,
ACOG supports your decision to veto this legislation.
Thank you for considering our views on this important
matter.
Sincerely,
Joseph G. Rogers, M.D.,
Chairman, Nebraska Section.
____
The American College of
Obstetricians and Gynecologists,
Memphis, TN, August 6, 1996.
William Jefferson Clinton,
The President of the United States of America, The White
House, Washington, DC.
Dear Mr. President: I write in support of your veto of H.R.
1833. The Tennessee Section of the American College of
Obstetricians and Gynecologists similarly does not support
any governmental action that would intervene in a Physician's
ability to apply his or her best medical judgment. Similarly,
we do not support any legislation which would criminalize
medical procedures that may be necessary to save the life of
a woman. Our particular concern is the terminology used in
H.R. 1833. The term ``partial-birth abortion'' is not one
which is an accepted or defined medical term. We fully
support your decision to veto this legislation.
We appreciate your consideration in this matter.
Sincerely,
Frank W. Ling, M.D.,
Faculty Professor and Chair, Department of Obstetrics and
Gynecology, University of Tennessee College of
Medicine.
____
American Medical Women's
Association, Inc.,
Alexandria, VA, July 31, 1996.
Hon. Herbert H. Kohl,
U.S. Senate,
Washington, DC.
Dear Senator Kohl: On behalf of the American Medical
Women's Association, a national organization representing
more than 11,000 women physicians and medical students, and
several of our branches, we are writing to urge your
opposition to H.R. 1833, which would outlaw a particular
abortion procedure--the D and E (dilation and extraction)
technique, referred to as the ``partial-birth'' abortion
method by those opposed to abortion. Although this bill was
vetoed by President Clinton, we understand that efforts are
under way to override his veto.
As physicians, we oppose any laws and court rulings that
interfere with the doctor-patient relationship, either in
requiring or proscribing specific medical advice to pregnant
women. Further, we oppose any measures that limit access to
medical care for pregnant women, particularly the poor or
underserved, and measures that involve spousal or parental
interference with a woman's personal decision to terminate
pregnancy. This bill would not only restrict the reproductive
rights of American women but also impose legal requirements
for medical care decisions.
Our organization strongly oppose H.R. 1833 on several
grounds. We support a woman's right to determine whether to
continue or terminate her pregnancy without government
restrictions placed on her physicians' medical judgment and
without spousal or parental interference. This bill would
subject physicians to civil action and criminal prosecution
for making a particular medical decision. We do not believe
that the federal government should dictate the decisions of
physicians and feel that passage of H.R. 1833 would in effect
prescribe the medical procedures to be used by physicians
rather than allow physicians to use their medical judgment in
determining the most appropriate treatment for their
patients. The passage of this bill would set a dangerous
precedent--undermining the ability of physicians to make
medical decisions. It is medical professionals, not the
President or Congress, who should determine appropriate
medical options.
Sincerely,
Jean Fourcroy, MD, PhD, President, American Medical
Women's Association; Robin Oshman, MD, President, AMWA
Branch 100, Fairfield County, Connecticut; Jill
Braverman Panza, MD, President, AMWA Branch 102,
Albany, New York; Rosalinda Rubenstein, MD, President,
AMWA Branch 14, New York City, NY; Kathryn Budzack, MD,
Co-President, AMWA Branch 86, Madison, Wisconsin.
Mr. Speaker, I yield the balance of my time, 2 minutes, to the very
distinguished gentlewoman from Michigan [Ms. Rivers].
Ms. RIVERS. Mr. Speaker, this debate is not about abortion on demand
in the 7th, 8th, or 9th month. Roe versus Wade and the law of the land
allows for States to make that procedure illegal. So the specter of
perfect babies being killed moments before they draw their first
breaths is irrelevant to the discussion here today and are being used
as a way to inflame the rhetoric and cloud the debate.
What we are fighting about today is whether or not we should have a
specific provision in the law allowing when the mother's life or health
is threatened, that this procedure be available.
We have started this debate with a picture. I wonder about some other
pictures. Where is the picture of these moms who are for the most part
older, married, have other children, are in the pregnancy that is
desperately wanted, celebrated, with babies' rooms already decorated,
tiny little clothes already purchased? Where is the picture of the
agony that these families go through, cry through, pray through over
the promise of a pregnancy that will never be fulfilled?
Where is the picture of the horrible second guessing, the terrible
hoping against hope that some sort of miracle is going to save this
baby that can never live, all the while the mother knows that her
health or her ability to have another baby could very much be in
jeopardy? Where is the picture of mothers like Tammi Watts who weeped
when asked the question, do you have any other children? She said,
well, I have one baby in heaven. That is not a woman who would
cheerfully end a baby's life moments before it would draw its first
breath.
Do not believe the discussion we are hearing today. Look at the
pictures. Look at the facts. The debate is whether or not we will allow
a woman's health to be an exemption from this law. One side says no,
our side says yes. Get the real picture.
Mr. CANADY of Florida. Mr. Speaker, I yield the balance of my time to
the gentleman from New Jersey [Mr. Smith].
The SPEAKER pro tempore (Mr. LaHood). The gentleman from New Jersey
[Mr. Smith] is recognized for 3 minutes.
Mr. SMITH of New Jersey. Mr. Speaker, let us stop kidding ourselves.
Partial birth abortion is child abuse. That some otherwise smart and
even brilliant people have been so thoroughly fooled by the abortion
industry's outrageous lies and distortions and half-truths and those
surface appeal arguments is at best disappointing and unsettling.
How can anyone in this Chamber or in the White House defend sticking
a pair of scissors into a partially born child's head so as to puncture
the child's skull and then a suction catheter is inserted to suck out
the child's brains? How can anybody defend that?
My wife Marie is a former elementary schoolteacher. This morning she
said that, if a child or a student were to do that to her doll, stick
the doll in the back of the head with scissors, we
[[Page H10620]]
would think the child needed psychological counseling and would
immediately call for that kind of help. Yet the abortion President,
Bill Clinton, seeks to continue legal sanction of this gruesome assault
on children, with real scissors and real babies.
Finally, we are seeing what the right to choose really means
executing untold thousands of children by stabbing them and sucking out
their brains. I guess we now know how far the so-called prochoice
movement will go to sustain the Orwellian supermyth that abortion is
somehow sane, somehow compassionate, and even prochild.
Americans will now see that the real extremists are not the people
who insist on calling attention to the grisly details of abortion,
dismemberment of the baby's fragile body, brain-sucking abortions or
chemical injections. They will see that the people who actually
dismember, poison, or hold the scissors at the base of the skull, they
are the dangerous people.
Mr. Speaker, there are a lot of myths that the abortion lobby has
circulated about partial-birth abortion. This past Sunday in the Sunday
Record (of Bergen), a proabortion newspaper in my State, again exposed
the lie that there are 500 partial-birth abortions in the country each
year. The proabortion lobby seeks to trivialize the issue by grossly
undercounting the actual number. The article, however, points out that
in one New Jersey abortion mill alone, each year 1,500 partial-birth
abortions are performed.
{time} 1215
The Record article also points out that the indicators for most of
those abortions are nonmedical in that abortion clinic. Just like Dr.
Haskill, one of the pioneers in this gruesome procedure, who has said
that 80 percent of those who he sees are doing it for purely elective
reasons. The Sunday Record pointed out, and I quote:
Interviews with physicians who use the method reveal that
in New Jersey alone at least 1,500 partial-birth abortions
are performed each year, three times the supposed national
rate. Moreover, doctors say that only a minuscule amount are
for medical reasons.
Mr. Speaker, it is time to begin to stand up for these unborn
children and these partially born children and these newly born
children. This is a matter of human rights. The abortion side, the
abortion lobby, has sanitized these killings, they have kept people in
the dark. But, the dirty secret of the abortion rights movement is
finally out: Abortion kills babies, it is child abuse and we can stop
some of that abuse by overriding Bill Clinton's antichild veto.
The SPEAKER pro tempore (Mr. LaHood). Without objection, the previous
question is ordered.
There was no objection.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from Florida [Mr. Canady] to discharge the Committee on the
Judiciary from the further consideration of the veto message on H.R.
1833.
The question was taken; and the Speaker pro tempore announced that
the ayes appeared 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 288,
nays 133, not voting 12, as follows:
[Roll No. 421]
YEAS--288
Allard
Archer
Armey
Bachus
Baesler
Baker (CA)
Baker (LA)
Baldacci
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
Dornan
Doyle
Dreier
Duncan
Dunn
Ehlers
Ehrlich
English
Ensign
Eshoo
Everett
Ewing
Fawell
Flanagan
Foley
Forbes
Fowler
Fox
Franks (NJ)
Frisa
Funderburk
Gallegly
Gekas
Gephardt
Geren
Gilchrest
Gillmor
Goodlatte
Goodling
Gordon
Goss
Graham
Greene (UT)
Gunderson
Gutknecht
Hall (OH)
Hall (TX)
Hamilton
Hancock
Hansen
Hastert
Hastings (WA)
Hayworth
Hefley
Hefner
Herger
Hilleary
Hobson
Hoekstra
Hoke
Holden
Hostettler
Houghton
Hunter
Hutchinson
Hyde
Inglis
Istook
Jacobs
Johnson (SD)
Johnson, Sam
Jones
Kanjorski
Kaptur
Kasich
Kennedy (MA)
Kennedy (RI)
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
Lucas
Manton
Manzullo
Martinez
Martini
Mascara
McCollum
McCrery
McDade
McHale
McHugh
McInnis
McIntosh
McKeon
McNulty
Metcalf
Meyers
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
Richardson
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)
Smith (WA)
Solomon
Souder
Spence
Spratt
Stearns
Stenholm
Stockman
Stump
Stupak
Talent
Tanner
Tate
Tauzin
Taylor (MS)
Taylor (NC)
Tejeda
Thomas
Thornberry
Tiahrt
Traficant
Upton
Visclosky
Volkmer
Vucanovich
Walker
Walsh
Wamp
Watts (OK)
Weldon (FL)
Weldon (PA)
Weller
White
Whitfield
Wicker
Williams
Wolf
Young (AK)
Young (FL)
Zeliff
NAYS--133
Abercrombie
Ackerman
Andrews
Becerra
Beilenson
Bentsen
Berman
Bishop
Blumenauer
Boehlert
Boucher
Brown (CA)
Brown (FL)
Brown (OH)
Bryant (TX)
Campbell
Cardin
Chapman
Clay
Clayton
Clyburn
Coleman
Collins (IL)
Collins (MI)
Conyers
Coyne
Cummings
DeFazio
DeLauro
Dellums
Deutsch
Dixon
Doggett
Dooley
Durbin
Edwards
Engel
Evans
Farr
Fattah
Fazio
Filner
Flake
Foglietta
Ford
Frank (MA)
Franks (CT)
Frelinghuysen
Frost
Gejdenson
Gibbons
Gilman
Gonzalez
Green (TX)
Greenwood
Gutierrez
Harman
Hastings (FL)
Hilliard
Hinchey
Horn
Hoyer
Jackson (IL)
Jackson-Lee (TX)
Jefferson
Johnson (CT)
Johnson, E. B.
Kelly
Kennelly
Lantos
Levin
Lewis (GA)
Lofgren
Lowey
Luther
Maloney
Markey
Matsui
McCarthy
McDermott
McKinney
Meehan
Meek
Menendez
Millender-McDonald
Miller (CA)
Mink
Morella
Nadler
Olver
Owens
Pallone
Pastor
Payne (NJ)
Pelosi
Pickett
Rangel
Reed
Rivers
Rose
Roybal-Allard
Rush
Sabo
Sanders
Sawyer
Schroeder
Schumer
Scott
Serrano
Shays
Skaggs
Slaughter
Stark
Stokes
Studds
Thompson
Thurman
Torkildsen
Torres
Torricelli
Towns
Velazquez
Vento
Ward
Waters
Watt (NC)
Waxman
Wilson
Wise
Woolsey
Wynn
Yates
Zimmer
NOT VOTING--12
Dicks
Fields (LA)
Fields (TX)
Furse
Ganske
Hayes
Heineman
Johnston
Lincoln
Longley
Peterson (FL)
Thornton
{time} 1236
The Clerk announced the following pair: On this vote:
Mr. Hayes for, with Ms. Furse against.
Mr. TORKILDSEN changed his vote from ``yea'' to ``nay.''
Ms. ESHOO and Mr. WILLIAMS changed their 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.
____________________