A Kinder, Gentler D&X

by Jay Johansen

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As I write this, Congress has just passed a bill to outlaw Partial Birth abortions, such as D&X. Much of the momentum for this bill came from the particularly ugly nature of this type of abortion.


A key argument that pro-abortionists made is that pro-lifers are sensationalizing the nature of this abortion. As an editorial in the New York Daily News on December 15, 1995 put it:

The fetus is partially removed from the womb, its head collapsed and brain suctioned out so it will fit through the birth canal. The anesthesia given to the woman kills the fetus before the full procedure takes place. But you won't hear that from the anti-abortion extreme. It would have everybody believe that the fetus is dragged alive from the womb of a womb of a woman just weeks away from birth. Not true.
Similarly, syndicated columnist Ellen Goodman wrote in mid-November that if you listened to pro-lifers, "You wouldn't even know that anesthesia ends the life of such a fetus before it comes down the birth canal."

Who's Telling the Truth?

Are these claims true? Is the unborn baby really dead before he is stabbed in the back of the neck?

Not according to the American Society of Anesthesiologists and the American Medical Association.

The January 1, 1996 issue of American Medical News, the official newspaper of the AMA, contained an article which refuted the pro-aborts claim. They reported, "Medical experts contend the claim is scientifically unsound and irresponsible, unnecessarily worrying pregnant women who need anesthesia."

The AMA is concerned that pregnant women who hear that babies can be killed in the womb by an "overdose of anesthesia" given to the mother, may be reluctant to take anesthesia. "In fact", they said, "cases of maternal concern have already surfaced. ... [Dr] Tom Coburn ... just had a patient refuse epidural anesthesia during childbirth after hearing those claims."

James McMahon, an abortionist who used the D&X technique, wrote in a statement to Congress that he gave anesthesia to the mother and "due to the enormous weight difference, a medical coma is induced in the fetus. There is a neurological fetal demise".

But Dr Norig Ellison, president of the American Society of Anesthesiologists, replied, "I believe this statement to be entirely inaccurate. I am deeply concerned, moreover, that widespread publicity ... may cause pregnant women to delay necessary and perhaps life-saving medical procedures, totally unrelated to the birthing process, due to misinformation regarding the effect of anesthetics on the fetus."

Dr Mary Campbell, the medical director of Planned Parenthood of Metropolitan Washington DC, wrote a "fact sheet" for Congress in which she said, "the fetus dies of an overdose of anesthesia given to the mother intravenously ... This induces brain death in a matter of minutes. Fetal demise therefore occurs at the beginning of the procedure while the fetus is still in the womb." But when she was asked to defend that statement after Dr Ellison's rebuttal, she backtracked: "I simplified that for Congress ... I do not know what causes the fetus to die."

What's the Point?

Presumably the whole point of this debate was to make the procedure sound less brutal. Killing a baby who is half-born by ramming scissors in the back of his neck does, indeed, sound pretty ugly. Killing him with an overdose of anesthesia sounds like a fairly humane way to kill someone. (Pro-abortionists in America today freely concede that they defend the practice of killing an innocent baby in cold blood. The only point which they feel it necessary to debate is how painful a death they inflict.)

As this argument withered, they brought in a fall-back argument: that anesthesia prevented the fetus from feeling any pain during the procedure.

Dr Ellison wrote a ltter to Congress rebutting this also, and his reply to that point is also telling against the original claim. The entire letter is reproduced below.

American Society
of Anesthesiologists

November 22, 1995.

Re H.R. 1833, the Partial-Birth Abortion Ban Act of 1995.

Hon. Orrin G. Hatch,
Chairman, Committee on the Judiciary, U.S. Senate, Dirksen Office Building, Washington, DC.

Dear Senator Hatch:

Thank you for inviting my participation in your Committee's hearing on H.R. 1833.

I appreciate the opportunity to reply to the written questions of Senator Leahy. The only one of the six questions which falls within my area of expertise is number four:

4. Do analgesics and anesthetics given to a pregnant woman undergoing an abortion provide any pain relief to the fetus, even if the medication stops short of killing a fetus?

Drugs normally cross the placenta from mother to fetus according to a concentration gradient. The effect on the fetus of drugs administered to the mother will depend on (a) fetal condition, (b) the route of administration, and (c) the timing.

a. Fetal acidosis will facilitate transport of local anesthesia such as lidocaine, which is a weak base, into the fetus.

b. Drugs administered intramuscularly achieve peak concentrations lower than intravenous administration, with the resultant decrease in placenta transport of the former.

c. Drug administration intramuscularly will have no effect on infants born within one hour after administration; in contrast, birth 2-3 hours after intramuscular administration may result in depressed infants. Conversely, intravenous administration of drugs will have maximum depressed effect in babies born 1/2 - 1 hour after the administration.

d. Very little is known about fetal response and consciousness to pain prior to 24-25 weeks gestation. It is clear that a pregnant woman can receive an effective anesthetic for cesarean section, and the fetus when delivered within the next half hour will be exquisitely sensitive to pain stimulus and will respond by crying and avoiding the stimulus more than 95% of the time.

In direct answer to question number four, drugs administered to the mother, either local anesthesia administered in the paracervical area or sedatives/analgesics administered intramuscularly or intravenously, will provide no-to-little analgesia to the fetus.

In closing, I reiterate that the pregnant woman in need of urgent, even life-saving surgery, need not defer same due to misinformation regarding the effect of anesthetics on the fetus.


Norig Ellison, M.D.,


Posted 5 Sep 2000.

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