[Congressional Record Volume 142, Number 136 (Friday, September 27, 1996)]
[Extensions of Remarks]
[Pages E1743-E1748]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




[[Page E1743]]



                A CLOSER LOOK AT PARTIAL-BIRTH ABORTIONS

                                 ______
                                 

                         HON. ROBERT K. DORNAN

                             of california

                    in the house of representatives

                      Thursday, September 26, 1996

  Mr. DORNAN. Mr. Speaker, even liberal newspapers such as the 
Washington Post agree that abortion advocates have been fast and loose 
with the facts concerning H.R. 1833, the Partial-Birth Abortion Act. 
It's time to set the record straight. Here is an in-depth, factual 
analysis of this important, life-saving bill.

   [From the National Right to Life Committee, Inc., Sept. 11, 1996]

                 Partial-Birth Abortions: A Closer Look

        (By Douglas Johnson, NRLC Federal Legislative Director)

       The final version of the Partial-Birth Abortion Ban Act (HR 
     1833) was approved by the U.S. Senate by a vote of 54-44 on 
     December 7, 1995, and by the U.S. House of Representatives on 
     March 27, 1996, by a vote of 286-129. On April 10, 1996, 
     President Clinton vetoed the bill. The House is expected to 
     vote on whether to override the veto on or about September 
     19, 1996. If two-thirds of the House votes to override, the 
     Senate also will vote on whether to override.
       Opponents of the bill, including President Clinton and his 
     subordinates, have propagated a number of myths regarding the 
     partial-birth abortion procedure and the bill. These myths 
     include the assertions that partial-birth abortions are very 
     rare and are performed only in extreme circumstances 
     involving serious fetal deformities or threat to the life of 
     the mother; that the bill would jeopardize the lives or 
     health of some women; and that anesthesia given to the mother 
     kills the fetus/baby or renders her pain-free before the 
     procedure is performed. Some of this misinformation--
     especially the claim that the procedure is used mostly in 
     cases of severe ``fetal deformity''--has been uncritically 
     adopted as factual by some journalists, columnists, and 
     editorialists.
       Yet, these claims are contradicted by the past writings and 
     recorded statements of doctors who have performed thousands 
     of partial-birth abortions, and by other available 
     documentation, including authoritative medical information 
     gathered by the House Judiciary Committee and the Senate 
     Judiciary Committee. This factsheet relies heavily upon such 
     primary sources. For copies of documents cited here, contact 
     the NRLC Federal Legislative Office at (202) 626-8820, fax 
     (202) 347-3668.


    What is a partial-birth abortion, and what is the Partial-Birth 
                      Abortion Ban Act (HR 1833)?

       The Partial-Birth Abortion Ban Act (HR 1833) would prohibit 
     performance of a partial-birth abortion, except in cases (if 
     there are many) in which the procedure is necessary to save 
     the life of a mother. The complete text of the bill is 
     attached to this factsheet.
       The bill defines a ``partial-birth abortion'' as ``an 
     abortion in which the person performing the abortion 
     partially vaginally delivers a long fetus before killing the 
     fetus and completing the delivery.'' Abortionists who 
     violates the law would be subject to both criminal and civil 
     penalties, but no penalty would be applied to the woman who 
     obtained such an abortion.
       This procedure is generally beginning at 20 weeks (4\1/2\ 
     months) in pregnacy, and ``routinely'' at least 24 weeks 
     (5\1/2\ months). It has often used much later--even into the 
     ninth month. The Los Angeles Times accurately and succinctly 
     described this abortion method in a June 16, 1995 news story: 
     The procedure requires a physician to extract a fetus, feet 
     first, from the womb and through the birth canal until all 
     but its head is exposed. Then the tips of surgical scissors 
     are thrust into the base of the fetus' skull, and a suction 
     catheter is inserted through the opening and the brain is 
     removed.
       In 1992, Dr. Martin Haskell of Dayton, Ohio, wrote a paper 
     that described in detail, step-by-step, how to preform the 
     procedure. [``Dilation and Extraction for Late Second 
     Trimester Abortion.''] Dr. Haskell is a family practitioner 
     who has performed over 1,000 such procedures in his walk-in 
     abortion clinics. Anyone who is seriously seeking the truth 
     behind the conflicting claims regarding partial-birth 
     abortions would do well to start by reading Dr. Haskell's 
     paper, and the transcripts of the explanatory interviews that 
     Dr. Haskell gave in 1993 to two medical publications, 
     American Medical News (the official AMA newspaper) and 
     Cincinnati Medicine. [All are available from NRLC.]
       Here is how Dr. Haskell explained a key part of the 
     abortion method: With a lower [fetal] extremity in the 
     vagina, the surgeon uses his fingers to deliver the opposite 
     lower extremity, then the torso, the shoulders and upper 
     extremities. The skull lodges at the internal cervical os[the 
     opening to the uterus]. Usually there is not enough dilation 
     for it to pass through. The fetus is oriented dorsum or 
     spineup. 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) * * * [T]he 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 * * * [T]he 
     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.'' [``Dilation and Extraction for Late Second 
     Trimester abortion,'' pages 30-31.]
       Dr. Haskell also wrote that he ``routinely performs this 
     procedure on all patients 20 through 24 weeks LMP [i.e., from 
     4\1/2\ to 5\1/2\ months after the last menstrual period] with 
     certain exceptions,'' these ``exceptions'' involving 
     complicating factors such as being more than 20 pounds 
     overweight. Dr. Haskell also wrote that he used the procedure 
     through 26 weeks [six months] ``on selected patients.'' 
     [p.28] He added, ``Among its advantages are that it is a 
     quick, surgical outpatient method that can be performed on a 
     scheduled basis under local anesthesia.'' (p. 33).
       In sworn testimony in an Ohio lawsuit on Nov. 8, 1995, Dr. 
     Haskell explained that he first learned of the method when a 
     colleague described very briefly over the phone to me a 
     technique that I later learned came from Dr. [James] McMahon 
     where they internally grab the fetus and rotate it and 
     accomplish--be somewhat equivalent to a breech type of 
     delivery.
       Dr. James McMahon, who died in 1995, used essentially the 
     same procedure thousands of times, and to a much later point 
     in pregnancy--even into the ninth month. Other abortionists 
     also employ the procedure, as discussed below.


 Aren't ``third trimester'' abortions rare? At what stage in pregnancy 
     do partial-birth abortions occur? Are these babies ``viable''?

       It appears that the substantial majority of partial-birth 
     abortions are performed late in the second trimester--that 
     is, before the 27-week mark--but usually after 20 weeks (4\1/
     2\ months). There is compelling evidence that the 
     overwhelming majority of these pre-week-27 partial-birth 
     abortions are performed for purely ``social'' reasons.
       In an attempt to ``filter out'' this documentation, many 
     opponents of the bill attempt to narrow the debate to only 
     third-trimester partial-birth abortions procedures--that is, 
     to abortions performed beginning in the 27th week [seventh 
     month] of pregnancy. Some journalists and commentators have 
     readily adopted this ``filter.'' However, there is really no 
     non-ideological justification for adopting this ``third 
     trimester'' demarcation. It has no basis in the text of 
     the Partial-Birth Abortion Ban Act (HR 1833), which bans 
     partial-birth abortion at any point in pregnancy. Nor, 
     contrary to some popular misconceptions, is there any 
     basis in current Supreme Court constitutional doctrine or 
     in neo-natal medical practice for adopting a ``third 
     trimester'' demarcation.
       Under the Supreme Court's doctrine, ``viability'' is 
     regarded as the constitutionally significant demarcation. In 
     Planned Parenthood v. Casey (1992), the Supreme Court 
     explicitly disavowed the ``trimester framework'' of Roe v. 
     Wade (1973), and reaffirmed that ``viability'' is (in the 
     Court's view) the constitutionally significant demarcation. 
     ``Viability'' is the point at which a baby born prematurely 
     can be sustained by good medical assistance. Currently, many 
     babies are ``viable'' a full three weeks before the ``third 
     trimester.'' Therefore, most partial-birth abortions kill 
     babies who are already ``viable,'' or who are at most a few 
     days or weeks short of viability.\1\
---------------------------------------------------------------------------
     \1\ According to the landmark survey of neonatal units in the 
     National Institute of Child Health and Human Development 
     Neonatal Research Network, conducted in 1987 and 1988 by Dr. 
     Maureen Heck, et al, babies born at 23 weeks had on average a 
     23% chance of survival, rising to 34% at 24 weeks, and 54% at 
     25 weeks. See ``Very Low Birth Weight Outcomes of the 
     National Institute of Child Health and Human Development 
     Neonatal Network,'' Pediatrics, May 1991.
---------------------------------------------------------------------------
       (Even at 20 weeks, the baby is seven inches long on 
     average. And, as discussed below, at a March 21 congressional 
     hearing leading medical authorities testified that the baby 
     by this point is very sensitive to painful stimuli.)
       At least one partial-birth abortion specialist, the late 
     Dr. James McMahon, regularly performed the procedure even 
     after 26 weeks--even into the ninth month. In 1995, Dr. 
     McMahon submitted to the House Judiciary Constitution 
     Subcommittee a graph and explanation that explicitly showed 
     that he aborted healthy (``not flawed'') babies even in the 
     third trimester (after 26 weeks of pregnancy). Dr. McMahon's 
     own graph showed, for example, that at 29 or 30 weeks, one-
     fourth of the aborted babies had no ``flaw'' however slight. 
     Underneath the graph, Dr. McMahon offered this explanation: 
     After 26 weeks, those pregnancies that are not flawed are 
     still non-elective. They are interrupted because of maternal 
     risk, rape, incest, psychiatric or pediatric indications. 
     [chart and caption reproduced in June 15 hearing record, page 
     109]
       In an interview with Constitution Subcommittee Counsel Keri 
     Harrison, Dr. McMahon explained that ``pediatric indication'' 
     referred to underage mothers, not to any medical condition 
     of the mother or the baby.

[[Page E1744]]

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

       American Medical News reported in 1993, after conducting 
     interviews with Drs. Haskell and McMahon, that the doctors 
     ``told AM News that the majority of fetuses aborted this way 
     are alive until the end of the procedure.'' On July 11, 1995, 
     American Medical News submitted the transcript of the tape-
     recorded interview with Dr. Haskell to the House Judiciary 
     Committee. The transcript contains the following exchange:
       American Medical News: Let's talk first about whether or 
     not the fetus is dead beforehand.
       Dr. Haskell: No it's not. No, it's really not. A percentage 
     are for various numbers of reasons. Some just because of the 
     stress--intrauterine stress during, you know, the two days 
     that the cervix is being dilated [to permit extraction of the 
     fetus]. Sometimes the membranes rupture and it takes a very 
     small superficial infection to kill a fetus in utero when the 
     membranes are broken. And so in my case, I would think 
     probably about a third of those are definitely are [sic] dead 
     before I actually start to remove the fetus. And probably the 
     other two-thirds are not.
       In an interview quoted in the Dec. 10, 1989 Dayton News, 
     Dr. Haskell conveyed that the scissors thrust is usually the 
     lethal act: ``When I do the instrumentation on the skull * * 
     * it destroys the brain tissue sufficiently so that even if 
     it (the fetus) falls out at that point, it's definitely not 
     alive,'' Dr. Haskell said. [For further evidence on this 
     issue, see the next section.]
       Brenda Pratt Shafer, a registered nurse from Dayton, Ohio, 
     stood at Dr. Haskell's side while he performed three partial-
     birth abortions in 1993. In testimony before the Senate 
     Judiciary Committee (Nov. 17, 1995), Shafer described in 
     detail the first of the three procedures--which involved, she 
     said, a baby boy at 26\1/2\ weeks (over 6 months). According 
     to Mrs. Shafer, the baby was alive and moving as the 
     abortionist delivered the baby's body and the arms--
     everything but the head. The doctor kept the baby's head just 
     inside the uterus. The baby's little fingers were clasping 
     and unclasping, and his feet were kicking. Then the doctor 
     stuck the scissors through the back of his head, and the 
     baby's arms jerked out in a flinch, a startle reaction, like 
     a baby does when he thinks that he might fall. The doctor 
     opened up the scissors, stuck a high-powered suction tube 
     into the opening and sucked the baby's brains out. Now the 
     baby was completely limp.
       Under HR 1833, in any case in which a baby dies before 
     being partly removed from the uterus--whether of natural 
     causes or by an action of an abortionist--the subsequent 
     removal of that baby is not a partial-birth abortion as 
     defined by the bill.


           does anesthesia given to the mother kill the baby?

       Many prominent defenders of partial-birth abortion have 
     publicly insisted that the unborn babies are killed by 
     anesthesia given to the mother, prior to being ``extracted'' 
     from the womb. For example, syndicated columnist Ellen 
     Goodman wrote in November, 1995, that if you listened to 
     supports of the ban, ``You wouldn't even know that anesthesia 
     ends the life of such a fetus before it comes down the birth 
     canal.'' NARAL President Kate Michelman said, ``The fetus, 
     is, before the procedure begins, the anesthesia that they 
     give the woman already causes the demise of the fetus. That 
     is, it is not true that they're born partially. That is a 
     gross distortion, and it's really a disservice to the public 
     to say this.'' [KMOX-AM, St. Louis, Nov. 2, 1995]
       Likewise, Planned Parenthood distributed to Congress a 
     ``fact sheet'' signed by Dr. Mary Campbell, Medical Director 
     of Planned Parenthood of Metropolitan Washington, which 
     stated, ``The fetus dies of an overdose of anesthesia given 
     to the mother intravenously * * * This induces brain death in 
     a fetus in a matter of minutes. Fetal demise therefore occurs 
     at the beginning of the procedure while the fetus is still in 
     the womb.''
       However, when this statement was read to Dr. Norig Ellison, 
     the president of the 34,000-member American Society of 
     Anesthesiologists (ASA), he testified, ``There is absolutely 
     no basis in scientific fact for that statement * * * think 
     the suggestion that the anesthesia given to the mother, be it 
     regional or general, is going to cause brain death of fetus 
     is without basis fact.'' [Senate Judiciary Committee hearing 
     record J-104-54, Nov. 17, 1995, p. 153]
       Subsequently, in attempting to defend their ``fetal 
     demise'' claims, pro-abortion advocacy groups disseminated 
     new claims that the late Dr. James McMahon had utilized 
     exceptionally massive doses of narcotic anesthesia before 
     performing his abortions, and that these massive doses would 
     indeed kill a fetus. But in the testimony before the House 
     Judiciary Constitution Subcommittee on March 21, 1996, Dr. 
     David J. Birnbach, president-elect of the Society for 
     Obstetric Anesthesia and Perinatology, testified: In order to 
     cause fetal demise, it would be necessary to give the mother 
     dangerous and life-threatening doses of anesthesia.'' [* * *] 
     Although there is no evidence that this massive dose will 
     cause fetal demise, there is clear evidence that this 
     excessive dose could cause maternal death. [House Judiciary 
     Committee hearing record no. 73, pages 140, 142]


 Since the baby is still alive when ``extracted'' from the womb, does 
                             she feel pain?

       Dr. Norig Ellison, president of the American Society of 
     Anesthesiologists (ASA), wrote to the Senate Judiciary 
     Committee: Drugs administered to the mother, either local 
     anesthesia administered in the paracervical area or 
     sedatives/analgesics administered intramuscularly or 
     intravenously, will provide little-to-no analgesia [pain 
     relief] to the fetus. [Senate Judiciary Committee, Nov. 17, 
     1995 hearing record, page 226]
       On March 21, 1996, the House Judiciary Subcommittee on the 
     Constitution conducted a public hearing on ``The Effects of 
     Anesthesia During a Partial-Birth Abortion.'' Four leading 
     experts in the field testified that the fetuses/babies who 
     are old enough to be ``candidates'' for partial-birth 
     abortion possess the neurological equipment to respond to 
     painful stimuli, whether or not the mother has been 
     anesthetized. Opponents of the bill were unable to produce a 
     single medical witness willing to testify in support of the 
     claims that anesthesia kills the fetus or renders the fetus 
     insensible to pain. [See House Judiciary Committee Hearing 
     Record No. 73, March 21, 1996.)
       Dr. Jean A. Wright, associate professor of pediatrics and 
     anesthesia at the Emory University School of Medicine in 
     Atlanta, testified that recent research shows that by the 
     stage of development that a fetus could be a ``candidate'' 
     for a partial-birth abortion (20 weeks), the fetus ``is more 
     sensitive to pain than a full-term infant would be if 
     subjected to the same procedures,'' Prof. Wright testified. 
     These fetuses have ``the anatomical and functional processes 
     responsible for the perception of pain,'' and have ``a much 
     higher density of Opioid (pain) receptors'' than older 
     humans, she said.
       Dr. David Birnbach, president-elect of the Society for 
     Obstetric Anesthesia and Perinatology, testified, ``Having 
     administered anesthesia for fetal surgery, I know that on 
     occasion we need to administer anesthesia directly to the 
     fetus because even at these early ages the fetus moves away 
     from the pain of the stimulation.'' [hearing record, page 
     288]
       At a hearing before the same panel on June 15, 1995, 
     Professor Robert White, Director of the Division of 
     Neurosurgery and Brain Research Laboratory at Case Western 
     Reserve School of Medicine, testified, ``The fetus within 
     this time frame of gestation, 20 weeks and beyond, is fully 
     capable of experiencing pain.'' After analyzing the partial-
     birth procedure step-by-step for the subcommittee, Prof. 
     White concluded: ``Without question, all of this is a 
     dreadfully painful experience for any infant subjected to 
     such a surgical procedure.'' [House Judiciary Committee 
     hearing No. 31, June 15, 1995, page 70.] Prof. Jean Wright 
     concluded, ``This 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.'' [hearing record, page 286]


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

       HR 1833 explicitly provides that the ban ``shall not apply 
     to a partial-birth abortion that is necessary to save the 
     life of a mother whose life is endangered by a physical 
     disorder, illness, or injury,'' if ``no other medical 
     procedure would suffice for that purpose.''
       [Some pro-abortion advocacy groups have insisted that 
     exception does not apply to disorders associated with 
     pregnancy, since ``pregnancy'' per se is not a disorder or 
     disease. House Judiciary Committee Chairman Henry J. Hyde (R-
     11.) commented that this reading ``is absurdly convoluted, 
     and violates standard principles of statutory construction.'' 
     In a June 7 letter, even President Clinton has acknowledged 
     that the bill ``provides an exception to the ban on this 
     procedure only when a doctor is convinced that a woman's life 
     is at risk.'']
       Under HR 1833, an abortionist could not be convicted of a 
     violation of the law unless the government proved, beyond a 
     reasonable doubt, that the abortion was not covered by this 
     exception. (In addition, of course, the government would have 
     to prove, beyond a reasonable doubt, all of the other 
     elements of the offense--that the abortionist ``knowingly'' 
     partly removed a baby from the womb, that the baby was still 
     alive, and that the abortionist then killed the baby.)
       It is noteworthy that none of the five women who appeared 
     with President Clinton at his April 10 veto ceremony required 
     a partial-birth abortion because of danger to her life. As 
     one of the women, Claudia Crown Ades, said in a tape-recorded 
     April 12 radio interview on WNTM (Mobile, AL): ``My procedure 
     was elective. That is considered an elective procedure, as 
     were the procedures of Coreen Costello and Tammy Watts and 
     Mary-Dorothy Line and all the other women who were at the 
     White House yesterday. All of our procedures were considered 
     elective.'' [Complete tape recording available on request.]
       [Two of the women said that if their babies had died 
     natural deaths within their wombs, it could have placed them 
     at risk. But the removal of a baby who dies a natural death, 
     whether by foot-first extraction or in any other manner, is 
     not an abortion and has nothing to do with the bill. 
     Professor Watson Bowes, Jr., of the University of North 
     Carolina, co-editor of the Obstetrical and Gynecological 
     Survey, has stated that weeks would pass between the baby's 
     natural demise and the development of any resulting risk to 
     the mother.]

[[Page E1745]]

     What reasons has President Clinton given for vetoing HR 1833?

       On December 7, 1995, before the Senate had even voted on 
     final passage of the bill, chief opponent Sen. Barbara Boxer 
     (D-Cal.) took the floor to make an unqualified statement that 
     President Clinton would veto the bill. On December 8, White 
     House Press Secretary Michael McCurry said unequivocally that 
     the President would veto the bill because ``it would 
     represent an erosion of a woman's right to choose.''
       However, when President Clinton next publicly addressed the 
     issue in a February 28 letter to key members of Congress 
     (after a national poll found 71% support for the ban), he 
     took different tone, although the legal bottom line was 
     unchanged. Mr. Clinton wrote of having ``studied and prayed 
     about this issue * * * for many months,'' of finding the 
     procedure ``very disturbing,'' and of seeking ``common ground 
     * * * that respects the views of those--including myself--who 
     object to this particular procedure,'' while defending Roe v. 
     Wade. But the ``common ground'' that Mr. Clinton proposed 
     tracked the language offered by Sen. Boxer on December 7, and 
     endorsed by the National Abortion and Reproductive Rights 
     Action League (NARAL) as a ``pro-choice vote.'' The Boxer/
     NARAL amendment would have allowed partial-birth abortion to 
     be performed without any limitation whatever until 
     ``viability,'' and also ``after viability where, in the 
     medical judgment of the attending physician, the abortion is 
     necessary to preserve the life of the woman or avert serious 
     adverse health consequences to the woman.'' (The Senate 
     rejected this gutting amendment.)
       The Boxer/Clinton language must be read in the light of Doe 
     v. Bolton, the 1973 companion case to Roe v. Wade, in which 
     the Supreme Court said that ``health'' must encompass ``all 
     factors--physical, emotional, psychological, familial and the 
     woman's age--relevant to the well-being of the patient.'' 
     Given this expansive definition of ``health,'' adding the 
     word ``serious'' has no legal effect, since Mr. Clinton 
     proposes to leave entirely up to each abortionist to decide 
     whether ``depression'' or some other ``health'' concern is 
     ``serious.''
       In a June 7 letter to leaders of the Southern Baptist 
     Convention, Mr. Clinton said that he favored banning the 
     procedure with an exception for ``cases where a woman risks 
     death or serious damage to her health,'' but not for cases 
     involving ``youth'' or ``emotional stress.'' But in his 
     formal veto message on the bill, Mr. Clinton referred to a 
     ``health'' exception as required by Roe v. Wade. Mr. Clinton, 
     a former teacher of constitutional law, knows full well that 
     these two positions are inconsistent, because if Roe/Doe 
     applies to partial-birth abortions, then even after 
     ``viability,'' the exception must indeed cover ``emotional'' 
     health.
       In his June 7 letter, President Clinton asserted that ``the 
     medical community * * * broadly supports the continued 
     availability of this procedure where a woman's serious health 
     interests are at stake.'' However, the American Medical 
     Association (AMA) Legislative Council voted unanimously to 
     recommend endorsement of the bill, with one member explaining 
     that the procedure was ``not a recognized medical 
     technique.'' (The full AMA Board of Trustees was divided 
     on the bill and ultimately took ``no position.'') Of the 
     five medical doctors who serve in Congress, four voted for 
     the bill, including the only family practitioner/
     gynecologist.


            How often are partial-birth abortions performed?

       There are at least 164,000 abortions a year after the first 
     three months of pregnancy, and 13,000 abortions annually 
     after 4\1/2\ months, according to the Alan Guttmacher 
     Institute (New York Times, July 5 and November 6, 1995), 
     which is an arm of Planned Parenthood. These numbers should 
     be regarded as minimums, since they are based on voluntary 
     reporting to the AGI. (The Centers for Disease Control 
     reported that in 1993, over 17,000 abortions were performed 
     at 21 weeks and later--and the CDC acknowledges that the 
     reports that it receives are incomplete.)
       No one really knows how many late abortions are done by the 
     partial-birth procedure. The Center for Reproductive Law and 
     Policy told The New York Times, ``The number of procedures 
     that clearly meet the definition of partial birth abortion is 
     very small, probably only 500 to 1,000 a year.'' (March 28, 
     1996) Even if such figures were accurate, the legislation 
     would be urgently needed. If a new virus swept through neo-
     natal units and killed 500 or 1,000 premature babies, it 
     would be a top news story--not dismissed as too ``rare'' to 
     be of consequence. For each human being at the pointed end of 
     the scissors, a partial-birth abortion is a 100% proposition.
       Moreover, the numbers may be considerably higher--perhaps 
     thousands per year. Dr. Martin Haskell and the late Dr. James 
     McMahon spend years trying to convince other abortionists of 
     the merits of the procedure--that was the purpose of Dr. 
     Haskell's 1992 instructional paper (see page 3) which was 
     distributed by the National Abortion Federation, a lobbying 
     group for abortion clinics. For years, Dr. McMahon was 
     director of abortion instruction at the Cedar-Sinai Medical 
     Center in Los Angeles. In addition, he invited other doctors 
     to visit his abortion clinic for a period of days to learn 
     the procedure. Also, The New York Times reported on Nov. 6, 
     1995: ``Of course I use it, and I've taught it for the last 
     10 years,'' said a gynecologist at a New York teaching 
     hospital who spoke on condition of anonymity. ``So do doctors 
     in other cities.''
       It is not known how many other abortionists have adopted 
     the method, but a few have made themselves known. On March 
     19, 1996, Dr. William Rashbaum of New York City wrote a 
     letter to Congressman Charles Canady (R-FL), stating that he 
     has performed 19,000 late-term ``procedures,'' and that he 
     has performed the procedure that HR 1833 would ban 
     ``routinely since 1979. This procedure is only performed 
     in cases of later gestational age.''
       In 1995, Dr. Martin Haskell filed a lawsuit challenging a 
     state abortion-regulation law. In that proceeding, two other 
     doctors filed affidavits affirming that they perform the same 
     procedure as Dr. Haskell--and that's just in Ohio.


      For what reasons are late-term abortions usually performed?

       There is no evidence that the reasons for which late-term 
     abortions are performed by the partial-birth abortion method 
     are any different, in general, than the reasons for which 
     late-term abortions are performed by other methods--and it is 
     well established that the great majority of late-term 
     abortions do not involve any illness of the mother or the 
     baby. They are purely ``elective'' procedures--that is, they 
     are performed for purely ``social'' reasons.
       In 1987, the Alan Guttmacher Institute (AGI), an affiliate 
     of the Planned Parenthood Federation of America (PPFA), 
     collected questionnaires from 1,900 women who were at 
     abortion clinics procuring abortions. Of the 1,900, ``420 had 
     been pregnant for 16 or more weeks.'' These 420 women were 
     asked to choose among a menu of reasons why they had not 
     obtained the abortions earlier in their pregnancies. Only two 
     percent (2%) said ``a fetal problem was diagnosed late in 
     pregnancy,'' compared to 71% who responded ``did not 
     recognize that she was pregnant or misjudged gestation,'' 48% 
     who said ``found it hard to make arrangements,'' and 33% who 
     said ``was afraid to tell her partner or parents.'' The 
     report did not indicate that any of the 420 late abortions 
     were performed because of maternal health problems. [``Why Do 
     Women Have Abortions?,'' Family Planning Perspectives, July/
     August 1988.]
       Also illuminating is an 1993 internal memo by Barbara 
     Radford, then the executive director of the National Abortion 
     Federation, a ``trade association'' for abortion clinics: 
     There are many reasons why women have late abortions: life 
     endangerment, fetal indications, lack of money or health 
     insurance, social-psychological crises, lack of knowledge 
     about human reproduction, etc.''
       Likewise, a June 12, 1995, National Abortion Federation 
     letter to members of the House of Representatives noted that 
     late abortions are sought by, among others, ``very young 
     teenagers * * * who have not recognized the signs of their 
     pregnancies until too late,'' and by ``women in poverty, who 
     have tried desperately to act responsibly and to end an 
     unplanned pregnancy in the early stages, only to face 
     insurmountable financial barriers.''
       In her article about late-term abortions, based in part on 
     extensive interviews with Dr. McMahon and on direct 
     observation of his practice (Los Angeles Times Magazine, 
     January 7, 1990), reporter Karen Tumulty concluded: If there 
     is any other single factor that inflates the number of late 
     abortions, it is youth. Often, teen-agers do not recognize 
     the first signs of pregnancy. Just as frequently, they put 
     off telling anyone as long as they can.
       According to Peggy Jarman, spokeswoman for Dr. George 
     Tiller, who specializes in late-term abortions in Wichita, 
     Kansas: About three-fourths of Tiller's late-term patients, 
     Jarman said, are teen-agers who have denied to themselves or 
     their families they were pregnant until it was too late to 
     hide it. [Kansas City Star]


    for what reasons are partial-birth abortions usually performed?

       Some opponents of HR 1833, such as NARAL and the Planned 
     Parenthood Federation of America (PPFA), have persistently 
     disseminated claims that the partial-birth abortion procedure 
     is employed only in cases involving extraordinary threats to 
     the mother or grave fetal disorders. For example, NARAL 
     President Kate Michelman wrote in a Scripps Howard News 
     Service op ed published June 16, 1996, ``Late-term abortions 
     are only used under the most compelling of circumstances--to 
     protect a woman's health or life or because of grave fetal 
     abnormality * * * nearly all abortions are performed in the 
     first trimester.'' PPFA said in a press release that the 
     partial-birth abortion procedure is ``done only in cases when 
     the woman's life is in danger or in cases of extreme fetal 
     abnormality.'' (Nov. 1, 1995)
       However, claims such as these are inconsistent with the 
     writings and recorded statements of the three doctors who are 
     most closely identified with the procedure: Dr. Martin 
     Haskell, Dr. James McMahon, and Dr. David Grundmann.
     Reasons for Partial-Birth Abortions: Dr. Martin Haskell
       In his 1992 paper, Dr. Martin Haskell, who has performed 
     over 1,000 partial-birth abortions, described the procedure 
     as ``a quick, surgical outpatient method that can be 
     performed on a scheduled basis under local anesthesia.'' Dr. 
     Haskell, a family practitioner who operates three abortion 
     clinics, wrote that he ``routinely performs this procedure on 
     all patients 20 through 24 weeks'' (4\1/2\ to

[[Page E1746]]

     5\1/2\ months) pregnant, except on women who are more than 20 
     pounds overweight, have twins, or have certain other 
     complicating factors.
       For information on why Dr. Haskell adopted the method, the 
     1993 interview in Cincinnati Medicine is very instructive. 
     Dr. Haskell explained that he had been performing 
     dismemberment abortions (D&Es) to 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. * * * 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.
       In 1993, the American Medical News--the official newspaper 
     of the AMA--conducted a tape-recorded interview with Dr. 
     Haskell concerning this specific abortion method, in which he 
     said: And I'll be quite frank: most of my abortions are 
     elective in that 20-24 week range. * * * In my particular 
     case, probably 20% [of this procedure] are for genetic 
     reasons. And the other 80% are purely elective.
       In a lawsuit in 1995, Dr. Haskell testified that women come 
     to him for partial-birth abortions with ``a variety of 
     conditions. Some medical, some not so medical.'' Among the 
     ``medical'' examples he cited was ``agoraphobia'' (fear of 
     open places). Moreover, in testimony presented to the Senate 
     Judiciary Committee on November 17, 1995, ob/gyn Dr. Nancy 
     Romer of Dayton (the city in which Dr. Haskell operates one 
     of his abortion clinics) testified that three of her own 
     patients had gone to Haskell's clinic for abortions ``well 
     beyond'' 4\1/2\ months into pregnancy, and that ``none of 
     these women had any medical illness, and all three had normal 
     fetuses.''
       Brenda Pratt Shafer, a registered nurse who observed Dr. 
     Haskell use the procedure to abort three babies in 1993, 
     testified that one little boy had Down Syndrome, while the 
     other two babies were completely normal and their mothers 
     were healthy. [Nurse Shafer's testimony before the House 
     Judiciary subcommittee, with associated documentation, is 
     available on request to NRLC.]
     Reasons for Partial-Birth Abortions: Dr. James McMahon
       The late Dr. James McMahon performed thousands of partial-
     birth abortions, including the third-trimester abortions 
     performed on the five women who appeared with President 
     Clinton at his April 10 veto ceremony. Dr. McMahon's general 
     approach is illustrated by this illuminating statement in 
     the July 5, 1993 edition of American Medical News: 
     ``[A]fter 20 weeks where it frankly is a child to me, I 
     really agonize over it because the potential is so 
     imminently there. I think, `Gee, it's too bad that this 
     child couldn't be adopted.' On the other hand, I have 
     another position, which I think is superior in the 
     hierarchy of questions, and that is: `Who owns the child?' 
     It's got to be the mother.''
       In June, 1995, Dr. McMahon submitted to Congress a detailed 
     breakdown of a ``series'' of over 2,000 of these abortions 
     that he had performed. He classified only 9% (175 cases) as 
     involving ``maternal [health] indications,'' of which the 
     most common was ``depression.''
       Dr. Pamela E. Smith, director of Medical Education, 
     Department of Obstetrics and Gynecology, Mt. Sinai Hospital, 
     Chicago, gave the Senate Judiciary Committee her analysis of 
     Dr. McMahon's 175 ``maternal indication'' cases. Of this 
     sample, 39 cases (22%) were for maternal ``depression,'' 
     while another 16% were ``for conditions consistent with the 
     birth of a normal child (e.g., sickle cell trait, prolapsed 
     uterus, small pelvis),'' Dr. Smith noted. She added that in 
     one-third of the cases, the conditions listed as ``maternal 
     indications'' by Dr. McMahon really indicated that the 
     procedure itself would be seriously risky to the mother.
       Of Dr. McMahon's series, another 1,183 cases (about 56%) 
     were for ``fetal flaws,'' but these included a great many 
     non-lethal disorders, such as cleft palate and Down Syndrome. 
     In an op ed piece written for the Los Angeles Times, Dr. 
     Katherine Dowling, a family physician at the University of 
     Southern California School of Medicine, examined Dr. 
     McMahon's report on this ``fetal flaws'' group. She wrote: 
     Twenty-four were done for cystic hydroma (a benign lymphatic 
     mass, usually treatable in a child of normal intelligence). 
     Nine were done for cleft lip-palate syndrome (a friend of 
     mine, mother of five, and a colleague who is a pulmonary 
     specialist were born with this problem). Other reasons 
     included cystic fibrosis (my daughter went through high 
     school with a classmate with cystic fibrosis) and duodenal 
     atresia (surgically correctable, but many children with this 
     problem are moderately mentally retarded). Guess they can't 
     enjoy life, can they? In fact, most of the partial-birth 
     abortions in that [McMahon] survey were done for problems 
     that were either surgically correctable or would result in 
     some degree of neurologic or mental impairment, but would not 
     harm the mother. Or they were done for reasons that were 
     pretty skimpy: depression, chicken pox, diabetes, vomiting. 
     [``What Constitutes A Quality Life?,'' Los Angeles Times, 
     Aug. 28, 1996]
       Over one-third of McMahon's 2,000-abortion ``series'' 
     involved neither fetal nor maternal health problems, however 
     trivial.
       In Dr. McMahon's interviews with American Medical News and 
     with Keri Harrison, counsel to the House Judiciary 
     Subcommittee on the Constitution, Dr. McMahon freely 
     acknowledged that he performed late second trimester 
     procedures that were ``elective'' even by his definition 
     (``elective'' meaning without fetal or maternal medical 
     justification).
       After 26 weeks, Dr. McMahon claimed that all of his 
     abortions were ``non-elective''--but his definition of ``non-
     elective'' was very expansive. His written submission stated: 
     ``After 26 weeks [six months], those pregnancies that are not 
     flawed are still non-elective. They are interrupted because 
     of maternal risk, rape, incest, psychiatric or pediatric 
     indications.'' [``Pediatric indications'' was Dr. McMahon's 
     terminology for young teenagers.]
     Reasons for Partial-Birth Abortions: Dr. David Grundmann
       Dr. David Grundmann, the medical director for Planned 
     Parenthood of Australia, has written a paper in which he 
     explicitly states that he uses the partial-birth abortion 
     procedure (he calls it ``dilatation and extraction'') as his 
     ``method of choice'' for abortions done after 20 weeks (4\1/
     2\ months), and that he performs such abortions for a broad 
     variety of social reasons. [This paper, ``Abortion After 
     Twenty Weeks in Clinical Practice: Practical, Ethical and 
     Legal Issues,'' and associated documentation, is available 
     from NRLC.]
       Dr. Grundmann himself described the procedure in a 
     television interview as ``essentially a breech delivery where 
     the fetus is delivered feet first and then when the head of 
     the fetus is brought down into the top of the cervical canal, 
     it is decompressed with a puncturing instrument so that it 
     fits through the cervical opening.''
       In the 1994 paper, Dr. Grundmann listed several 
     ``advantages'' of this method, such as that it ``can be 
     performed under local and/or twi-light anesthetic'' with ``no 
     need for narcotic analgesics,'' ``can be performed as an 
     ambulatory out-patient procedure,'' and there is ``no chance 
     of delivering a live fetus.'' Among the ``disadvantages,'' 
     Dr. Grundmann wrote, is `'the aesthetics of the procedure are 
     difficult for some people; and therefore it may be difficult 
     to get staff.'' (Dr. Grundmann also wrote that ``abortion is 
     an integral part of family planning. Theoretically this means 
     abortions at any stage of gestation. Therefore I favor the 
     availability of abortion beyond 20 weeks.'')
       Dr. Grundmann wrote that in Australia, late-second-
     trimester abortion is available ``in many major hospitals, in 
     most capital cities and large provincial centres'' in case 
     of ``lethal fetal abnormalities'' or ``gross fetal 
     abnormalities,'' or ``risk to maternal life,'' including 
     ``psychotic/suicidal behavior.'' However, Dr. Grundmann 
     said, his Planned Parenthood clinic also offers the 
     procedure after 20 weeks for women who fall into five 
     additional ``categories'': (1) ``minor or doubtful fetal 
     abnormalities,'' (2) ``extreme maternal immaturity i.e. 
     girls in the 11 to 14 year age group,'' (3) women ``who do 
     not know they are pregnant,'' for example because of 
     amenorrhea [irregular menstruation] ``in women who are 
     very active such as athletes of those under extreme forms 
     of stress i.e. exam stress, relationship breakup * * *,'' 
     (4) ``intellectually impaired women, who are unaware of 
     basic biology * * *,'' (5) ``major life crises or major 
     changes in socio-economic circumstances. The most common 
     example of this is a planned or wanted pregnancy followed 
     by the sudden death or desertion of the partner who is in 
     all probability the bread winner.''


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

       President Clinton and pro-abortion advocacy groups have 
     made strenuous efforts to persuade the public that partial-
     birth abortions are necessary to protect the lives or health 
     of pregnant women, and many journalists have uncritically 
     accepted this claim at face value. However, these claims are 
     coming under increasingly sharp challenge from prestigious 
     medical experts, and from women who have given birth to 
     babies in circumstances such as those cited by President 
     Clinton.
       The sort of cases highlighted by President Clinton third-
     trimester abortions of babies with disorders incompatible 
     with sustained life outside the womb--account for a small 
     fraction of all the partial-birth abortions. Confronted with 
     identical cases, most specialists would never consider 
     executing a breech extraction and puncturing the skull. 
     Instead, most would deliver the baby alive, sometimes early, 
     without jeopardy to the mother--usually viginally--and make 
     the baby as comfortable as possible for whatever time the 
     child has allotted to her.
       In an interview published in the August 19 edition of 
     American Medical News, former Surgeon General C. Everett Koop 
     said, ``I believe that Mr. Clinton was misled by his medical 
     advisors on what is fact and what is fiction in reference to 
     late-term abortions. Because in no way can I twist my mind to 
     see that the later-term abortions as described--you know, 
     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.''
       Dr. Koop, a world-renown pediatric surgeon, was asked by 
     the American Medical

[[Page E1747]]

     News reporters whether he had ever ``treated children with 
     any of the disabilities cited in this debate? For example, 
     have you operated on children born with organs outside of 
     their bodies?'' Dr. Koop replied, ``Oh, yes indeed. I've done 
     that many times. The prognosis usually is good. There are two 
     common ways that children are born with organs outside of 
     their body. One is an omphalocele, where the organs are out 
     but sill contained in the sac * * * the first child I ever 
     did, with a hug omphalocele much bigger than her head, went 
     on to develop well and become the head nurse in my intensive 
     care until many years later.''
       In addition, in the summer of 1996, an organization called 
     Physicians' Ad Hoc Coalition for Truth (PHACT) began 
     circulating material directly challenging President Clinton's 
     claims. As of early September, PHACT reportedly consisted of 
     over 230 physicians, mostly professors and other specialists 
     in obstetrics, gynecology, and fetal medicine. In an 
     advertisement published in August, the PHACT physicians said: 
     Congress, the public--but most importantly women--need to 
     know that partial-birth abortion is never medically indicated 
     to protect a mother's health or her future fertility.
       The PHACT doctors also referred directly to the specific 
     medical conditions that affected some of the women who 
     appeared with President Clinton at his April 10 veto 
     ceremony, such as hydrocephalus (excessive fluid in the 
     head), and commented: We, and many other doctors across the 
     United States, regularly treat women whose unborn children 
     suffer these and other serious conditions. Never is the 
     partial-birth procedure medically indicated. Rather, such 
     infants are regularly and safely delivered live, vaginally, 
     with no threat to the mother's health or fertility.
       At a July 24 briefing on Capitol Hill, PHACT member Dr. 
     Curtis Cook, and ob/gyn perinatologist with the West Michigan 
     Perinatal and Genetic Diagnostic Center (616-391-3681), said 
     that partial-birth abortion is never necessary to preserve 
     the life or the fertility of the mother, and may in fact 
     threaten her health or well-being or future fertility. In my 
     practice, I see these rare, unusual cases that come to most 
     generalists' offices once in a lifetime--they all come into 
     our office. We see these every day * * * The presence of 
     fetal disabilities or fetal anomalies are not a reason to 
     have a termination of pregnancy to preserve the life of the 
     mother--they do not threaten the life of the mother in any 
     way * * * [and] where these rare instances do occur, they do 
     not require the death of the baby or the fetus prior to the 
     completion of the delivery.
       Also present at the July 24 briefing were several women 
     who, while pregnant, had learned that their unborn babies 
     were afflicted with conditions similar or identical to 
     those cited by President Clinton, but who gave birth to 
     their babies alive. One of the women, Jeannie French of 
     Oak Park, Illinois, distributed a July 17 letter that she 
     and several other women sent to President Clinton, asking 
     for a meeting so that he could learn about the medical 
     alternatives to partial-birth abortion. Ms. French wrote: 
     In recent months, I have had the opportunity to get to 
     know many women who've carried and given birth to children 
     with fatal conditions from anacephaly, encepaloceles, 
     Trisomy 18, hydrocephaly, and even a rare disease called 
     body stalk anomaly, in which internal organs develop 
     outside a baby's body. We gave birth to our children 
     knowing that their serious physical disabilities might not 
     allow them to live long. * * * You say that partial-birth 
     abortion has to be legal for cases like ours, because 
     women's bodies would be `ripped to shreds' by carrying 
     their very sick children to term. By your repeated 
     statements, you imply that partial-birth abortion is the 
     only or the most desirable response to children suffering 
     severe disabilities like our children. * * * This message 
     is so wrong! * * * Will you meet with us personally, and 
     hear our stories?
       Ms. French got a brief letter of response from two White 
     House scheduling aides, who said that ``the tremendous 
     demands on the President will not give him the opportunity to 
     speak with you and your group. * * * Your continued interest 
     and support are deeply appreciated.''


What about President Clinton's statement that for some women, the only 
    alternative to partial-birth abortion is to ``rip your body to 
                               shreds''?

       President Clinton has repeatedly justified his veto by 
     referring to cases in which the baby suffers from advanced 
     hydrocephaly (head enlargement). Speaking in Milwaukee on May 
     23, President Clinton suggested that Bob Dole or others who 
     would deny a partial-birth abortion in such cases are saying 
     ``it's okay with me if they ripped your body to shreds and 
     you could never have another baby.''
       But this is medical nonsense. Medical specialists commonly 
     deal with cases of severe hydrocephaly by a procedure called 
     cephalocentesis, in which a needle is used to withdraw the 
     excess fluid (but not the brain), reducing the head size so 
     that normal delivery of a live baby can occur. An eminent 
     authority on such matters, Dr. Watson A. Bowes, Jr., 
     professor of ob/gyn (maternal and fetal medicine) at the 
     University of North Carolina, who is co-editor of the 
     Obstetrical and Gynecological Survey, wrote to Congressman 
     Charles Canady: Critics of your bill who say that this 
     legislation will prevent doctors from performing certain 
     procedures which are standard of care, such as 
     cephalocentesis (removal of fluid from the enlarged head 
     of a fetus with the most severe form of hydrocephalus) are 
     mistaken. In such a procedure a needle is inserted with 
     ultrasound guidance through the mother's abdomen into the 
     uterus and then into the enlarged ventricle of the brain 
     (the space containing cerebrospinal fluid). Fluid is then 
     withdrawn which results in reduction of the size of the 
     head so that delivery can occur. This procedure is not 
     intended to kill the fetus, and, in fact, is usually 
     associated with the birth of a live infant.
       (Note: Cases of hydrocephaly accounted for less than 4% of 
     Dr. McMahon's partial-birth abortions, according to his 
     submission to the House Judiciary Committee.)


What about the small minority of cases that do involve ``serious fetal 
                              deformity''?

       It is true that some partial-birth abortions--a small 
     minority--involve babies who have grave disorders that will 
     result in death soon after birth. But these unfortunate 
     members of the human family deserve compassion and the best 
     comfort-care that medical science can offer--not a scissors 
     in the back of the head. In some such situations there are 
     good medical reasons to deliver such a child early, after 
     which natural death will follow quickly.
       Dr. Harlan Giles, a professor of ``high-risk'' obstetrics 
     and perinatology at the Medical College of Pennsylvania, 
     performs abortions by a variety of procedures up until 
     ``viability.'' However, in sworn testimony in the U.S. 
     Federal District Court for the Southern District of Ohio 
     (Nov. 13, 1995), Prof. Giles said: [After 23 weeks] I do not 
     think there are any maternal conditions that I'm aware of 
     that mandate ending the pregnancy that also require that the 
     fetus be dead or that the fetal life be terminated. In my 
     experience for 20 years, one can deliver these fetuses either 
     vaginally, or by Cesarean section for that matter, depending 
     on the choice of the parents with informed consent. * * * But 
     there's no reason these fetuses cannot be delivered intact 
     vaginally after a miniature labor, if you will, and be at 
     least assessed at birth and given the benefit of the doubt. 
     [transcript, page 240]
       In a partial-birth abortion, the abortionist dilates a 
     woman's cervix for three days, until it is open enough to 
     deliver the entire baby breech, except for the head. When 
     American Medical News asked Dr. Martin Haskell why he could 
     not simply dilate the woman a little more and remove the baby 
     without killing him, Dr. Haskell responded: The point here is 
     you're attempting to do an abortion * * * not to see how do I 
     manipulate the situation so that I get a live birth instead. 
     [American Medical News transcript]
       Under closer examination, it becomes clear that in some 
     cases, the primary reason for performing the procedure is not 
     concern that the baby will die in utero, but rather, that he/
     she will be born alive, either with disorders incompatible 
     with sustained life outside the womb, or with a non-lethal 
     disability. (Again, in Dr. McMahon's table of partial-birth 
     abortions performed for ``fetal indications,'' the largest 
     category was for Down Syndrome.)
       Viki Wilson, whose daughter Abigail died at the hands of 
     Dr. McMahon at 38 weeks, said: I knew that I could go ahead 
     and carry the baby until full term, but knowing, you know, 
     that this was futile, you know, that she was going to die * * 
     * I felt like I needed to be a little more in control in 
     terms of her life and my life, instead of just sort of 
     leaving it up to nature, because look where nature had gotten 
     me up to this point. [NAF video transcript, page 4.]
       Tammy Watts, whose baby was aborted by Dr. McMahon in the 
     7th month, said: I had a choice. I could have carried this 
     pregnancy to term, knowing everything that was wrong. 
     [Testimony before Senate Judiciary Committee, Nov. 17, 1995]
       Claudia Crown Ades, who appeared with President Clinton at 
     the April 10 veto, said: My procedure was elective. That is 
     considered an elective procedure, as were the procedures of 
     Coreen Costello and Tammy Watts and Mary Dorothy-Line and all 
     the other women who were at the White House yesterday. All of 
     our procedures were considered elective. [Quotes from taped 
     appearance on WNTM, April 12, 1996]
       In a letter opposing HR 1833, one of Dr. McMahon's 
     colleagues at Cedar-Sinai Medical Center, Dr. Jeffrey S. 
     Greenspoon, wrote: As a volunteer speaker to the National 
     Spina Bifida Association of America and the Canadian National 
     Spina Bifida Organization, I am familiar with the burden of 
     raising a significantly handicapped child * * * The burden of 
     raising one or two abnormal children is realistically 
     unbearable. [Letter to Rep. Hyde, July 19, 1995]


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

       Some opponents of the Partial-Birth Abortion Ban Act (HR 
     1833) insist that anyone writing about the bill should say 
     that it bans a procedure ``known medically as intact dilation 
     and evacuation.'' But when journalists comply with this 
     demand, they do so at the expense of accuracy. The bill 
     itself makes no reference whatever to ``intact dilation and 
     evacuation'' abortions. More importantly, the term ``intact 
     dilation and evacuation'' is not equivalent to the class of 
     procedures banned by the bill.
       The bill would make it a criminal offense (except to save 
     woman's life) to perform a ``partial-birth abortion,'' which 
     the bill

[[Page E1748]]

     would define--as a matter of law--as ``an abortion in which 
     the person performing the abortion partially vaginally 
     delivers a living fetus before killing the fetus and 
     completing the delivery.''
       In contrast, the term ``intact dilation and evacuation'' 
     was invented by the late Dr. James McMahon, and until 
     recently, was idiosyncratic to him. It appeared in no 
     standard medical textbook or database, nor anywhere in the 
     standard textbook on abortion methods, Abortion Practice by 
     Dr. Warren Hern. Because ``intact dilation and evacuation'' 
     \2\ is not a standard, clearly defined medical term, the 
     House Judiciary Constitution Subcommittee staff (which 
     drafted the bill under Congressman Canady's supervision) 
     rejected it as useless for purposes of defining a criminal 
     offense. Indeed, it is worse than useless--a criminal statute 
     that relied on such a term would be stricken by the federal 
     courts as `'void for vagueness.''
---------------------------------------------------------------------------
     \2\ The term ``intact dilation and evacuation'' should not be 
     confused with ``dilation and evacuation,'' which is a 
     procedure commonly sued in second-trimester abortions, 
     involving dismemberment of the fetus/baby while still in the 
     uterus. The bill does not apply to ``dilation and 
     evacuation'' abortions at all.
---------------------------------------------------------------------------
       Although there is no clear definition of the term, we know 
     enough to say that it is inaccurate to equate ``intact 
     dilation and evacuation'' abortions with the procedures 
     banned by HR 1833, since in his writings Dr. McMahon clearly 
     used the term ``intact dilation and evacuation'' so broadly 
     as to cover certain procedures which would not be affected at 
     all by HR 1833 (e.g., removal of babies who are killed 
     entirely in utero, and removal of babies who have died 
     entirely natural deaths in utero). Indeed, at least one of 
     the specific women highlighted by opponents of HR 1833 had 
     various types of ``intact D&E'' abortion procedures that were 
     not covered by HR 1833's definition of ``partial-birth 
     abortion.''
       [In his 1992 instructional paper, Dr. Haskell referred to 
     the method as ``dilation and extraction'' or ``D&X''--noting 
     that he ``coined the term.'' When the bill was drafted, the 
     term ``dilation and extraction'' did not appear in medical 
     dictionaries or databases.]
       The term chosen by Congress, partial-birth abortion, is in 
     no sense misleading. In sworn testimony in an Ohio lawsuit on 
     Nov. 8, 1995, Dr. Martin Haskell--who has done over 1,000 
     partial-birth abortions, and who authored the instructional 
     paper that touched off the controversy over the procedure--
     explained that he first learned of the method when a 
     colleague described very briefly over the phone to me a 
     technique that I later learned came from Dr. McMahon where 
     they internally grab the fetus and rotate it and accomplish--
     be somewhat equivalent to a breech type of delivery.


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

       The AMA newspaper American Medical News (July 5, 1993) 
     interviewed Dr. Martin Haskell and reported: Dr. Haskell said 
     the drawings were accurate ``from a technical point of 
     view.'' But he took issue with the implication that the 
     fetuses were ``aware and resisting.''
       Professor Watson Bowes of the University of North Carolina 
     at Chapel Hill, co-editor of the Obstetrical and 
     Gynecological Survey, wrote in a letter to Congressman 
     Canady: Having read Dr. Haskell's paper, I can assure you 
     that these drawings accurately represent the procedure 
     described therein. * * * Firsthand renditions by a 
     professional medical illustrator, or photographs or a video 
     recording of the procedure would no doubt be more vivid, but 
     not necessarily more instructive for a non-medical person who 
     is trying to understand how the procedure is performed.
       On Nov. 1, 1995, Congresswoman Patricia Schroeder and her 
     allies actually tried to prevent Congressman Canady from 
     displaying the line drawings during the debate on HR 1833 on 
     the floor of the House of Representatives. But the House 
     voted by nearly a 4-to-1 margin (332 to 86) to permit the 
     drawings to be used.


         Does the bill contradict U.S. Supreme Court decisions?

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


 THE PARTIAL-BIRTH ABORTION BAN ACT (H.R. 1833) AS PASSED BY THE U.S. 
SENATE ON DECEMBER 7, 1995 AND BY THE U.S. HOUSE OF REPRESENTATIVES ON 
                             MARCH 27, 1996

     Section 1. Short Title.
       This Act may be cited as the ``Partial-Birth Abortion Ban 
     Act of 1995.''
     Sec. 2. Prohibition on Partial-Birth Abortions
       (a) In General.--Title 18, United States Code, is amended 
     by inserting after Chapter 73 the following: ``Chapter 74--
     Partial-Birth Abortions.
       Sec. 1531. Partial-birth abortions prohibited.
       (a) Any physician who, in or affecting interstate or 
     foreign commerce, knowingly performs a partial-birth abortion 
     and thereby kills a human fetus shall be fined under this 
     title or imprisoned not more than two years, or both. This 
     paragraph shall not apply to a partial-birth abortion that is 
     necessary to save the life of a mother whose life is 
     endangered by a physical disorder, illness, or injury: 
     Provided, That no other medical procedure would suffice for 
     that purpose. This paragraph shall become effective one day 
     after enactment.
       (b)(1) As used in this section, the term `partial-birth 
     abortion' means an abortion in which the person performing 
     the abortion partially vaginally delivers a living fetus 
     before killing the fetus and completing the delivery.
       (2) As used in this section, the term `physician' means a 
     doctor of medicine or osteopathy legally authorized to 
     practice medicine and surgery by the State in which the 
     doctor performs such activity, or any other individual 
     legally authorized by the State to perform abortions: 
     Provided, however, That any individual who is not a physician 
     or not otherwise legally authorized by the State to perform 
     abortions, but who nevertheless directly performs a partial-
     birth abortion, shall be subject to the provisions of this 
     section.
       (c)(1) The father, if married to the mother at the time she 
     receives a partial-birth abortion procedure, and if the 
     mother has not attained the age of 18 years at the time of 
     the abortion, the maternal grandparents of the fetus, may in 
     a civil action obtain appropriate relief, unless the 
     pregnancy resulted from the plaintiff's criminal conduct or 
     the plaintiff consented to the abortion.
       (2) Such relief shall include--
       (A) money damages for all injuries, psychological and 
     physical, occasioned by the violation of this section; and
       (B) statutory damages equal to three times the cost of the 
     partial-birth abortion.
       (d) A woman upon whom a partial-birth abortion is performed 
     may not be prosecuted under this section, for a conspiracy to 
     violate this section, or for an offense under section 2, 3, 
     or 4 of this title based on a violation of this section.


                                 STEP 5

       ``[T]he surgeon then forces the scissors into the base of 
     the skull * * * [H]e 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.'' Text from Martin Haskell, M.D., Dilation and 
     Extraction for Late Second Trimester Abortion.

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