OSV STORY FOR JAN. 19

Partial-birth abortion: A primer

By Mary Meehan

President Clinton recently said he doesn't like partial-birth abortion, and that if Congress "will help me with language here and do it in good faith, I will happily sign" a bill against it. Senate Minority Leader Thomas Daschle, D-S.D., who said he wants "to end this repulsive practice," is promoting a ban on third-trimester abortions, with exceptions for life and health of the mother.

Here's a guide to key issues involved:

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Q: Do the Clinton and Daschle statements mean that a compromise on the issue is in sight?

A: Not a chance. Most partial-birth abortions are done in the second tri-mester; Sen. Daschle's proposal wouldn't prevent the vast majority of them.

A bill to ban them at any stage, which President Clinton vetoed last year, did have a life-of-the-mother exception. But Clinton and Daschle demand a health exception. Abortion opponents fear it will be so broad that nearly any legal truck can be driven through it.

Q: How did the whole controversy start, anyway?

A: In September 1992, Dr. Martin Haskell of Dayton, Ohio, explained to other abortion doctors how he manipulates an unborn child for breech (feet-first) delivery, delivers everything except the head, punctures the skull with surgical scissors, "evacuates the skull contents" by suction, then delivers a dead child.

Life Advocate magazine ran a story on the Haskell abortion, accompanied by line drawings of it that shocked many people. After a long campaign, pro-life groups persuaded Congress to pass a bill banning partial-birth abortion. President Clinton vetoed the bill last year; the House overrode his veto, but the Senate did not.

Q: Defenders of the Haskell procedure don't like the term "partial-birth abortion." What do they call it?

A: They prefer detached, clinical terms. They usually say "intact dilation and evacuation" (intact D & E) or "dilation and extraction" (D & X). Some call it "intrauterine cranial decompression." The late Dr. James McMahon of Los Angeles, who did a variation of the Haskell procedure, sometimes called it "transcervical paracentesis capitis."

Q:Doesn't this get pretty confusing for lay people?

A: Even some medical people may be confused.

Q: Is the child still alive when the abortion begins?

A: In 1993, Haskell told American Medical News that about one-third of the children are dead before he starts the abortion, and "probably the other two-thirds are not" (excerpts of interview transcript, released in 1995).

Nurse Brenda Pratt Shafer, who watched Haskell abort a Down-syndrome baby at about six months, said the "baby's little fingers were clasping and unclasping, and his feet were kicking" after Haskell delivered the lower part of his body. "Then the doctor stuck the scissors through the back of his head, and the baby's arms jerked out in a flinch." After Haskell suctioned its brains out, "the baby went completely limp."

McMahon once said that anesthesia he gave to the mother produced "neurological fetal demise" (that is, killed the child) before the abortion. Leading anesthesiologists, however, disputed

this claim. Dr. Norig Ellison, president of the American Society of Anesthesi-ologists, called McMahon's statement "entirely inaccurate." Dr. David Chestnut, another anesthesiologist, called it "nonsense."

Q: Does anesthesia given to the mother at least provide some pain relief to the child?

A: It may, depending on type and dosage. But Chestnut, referring to the anesthesia reportedly used by McMahon, said "the extent to which this renders any procedure pain-free is unknown."

Q: Why do women have partial-birth abortions?

A: Haskell told American Medical News that "most of my abortions are elective in that 20-24-week

range. . . . Probably 20 percent are for genetic reasons, and the other 80 percent are purely elective."

A doctor at a New Jersey abortion clinic that does some 1,500 partial-birth abortions each year said that most are done on "Medicaid patients, black and white, and most are for elective, not medical, reasons -- people who didn't realize or didn't care how far along they were. Most are teenagers" (Bergen, N.J., Record, Sept. 15, 1996).

Q: Aren't some of these abortions done because the child is handicapped?

A: McMahon specialized in eugenic abortions, which some call "selective," or "genetic" or even "therapeutic" abortions.

Eugenics, the effort to breed a better human race, has a deep bias against the disabled -- a bias that has enormous influence on both genetics and obstetrics. Key figures in both medical fields have been officers or members of the American Eugenics Society, which still exists under the name of Society for the Study of Social Biology. Eugenicists promoted the system of prenatal testing and eugenic abortion, which is now a standard part of obstetrics.

Many doctors referred women to McMahon for second-trimester -- and even third-trimester -- eugenic abortions. The fetal handicaps ranged from Down syndrome and spina bifida to cleft palate, hydrocephalus and dwarfism.

Q: Some of the children aborted by McMahon had horrendous conditions, didn't they? Such as organs outside the body?

A: Yes, they did. But former Surgeon General C. Everett Koop, a noted pediatric surgeon, told American Medical News last year that he had repaired such conditions as early as 1946. One of the children, he said, became "the head nurse in my intensive-care unit many years later."

It's true, however, that some children are "born dying" and can survive only minutes, hours or weeks. Abortion supporters believe it's permissible to directly kill such children in the womb. Pro-life advocates say it is not.

Q: How about threats to the mother's life or health -- for example, when hydrocephalus has swollen the child's head so large that normal delivery is impossible?

A: Early cesarean delivery is often the best answer here, both to avoid danger to the mother and to allow placement of a shunt to drain fluid from the child's head.

Another possibility, although one very risky for the child, is cephalocentesis (withdrawal of fluid from the head) before delivery. The key ethical point here is whether cephalocentesis is done slowly and carefully to save the child, or rapidly and destructively to kill it. Often it's done with destructive intent because the doctor and parents fear the child will be retarded. (Early shunting can prevent many, but not all, cases of mental retardation due to hydrocephalus.)

Q: Will banning partial-birth abortion just result in more killing of children inside the womb -- for example, by dismemberment?

A: It may. On the other hand, the gruesomeness of a "D & E" dismemberment abortion, and the admission by many doctors that it can harm the mother, may produce much reaction against it as well.

Shafer, who described Haskell's partial-birth abortion, told Our Sunday Visitor last year that she had also watched him do dismemberments "while the baby's heart was beating." She saw him "yank off a leg, yank off an arm and just bring it outside."

"That was horrible," she said. "I'd never seen it before -- never really wanted to think about it before."

Meehan writes from Rockville, Md.

Copyright Our Sunday Visitor, 1997; from the 1-19-97 edition

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