Partial Birth Abortion:
As Described by its Inventor

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Inflammatory Language

Pro-lifers have been accused of using inflammatory language to describe partial-birth abortions. Here in Ohio, before the term "partial birth" was invented, we referred to this as "brain suction abortion". One state legislator with whom I spoke criticized us loudly for using such a term. She also condemned our descriptions of how the procedure was done. After all, she said, any medical procedure can sound unpleasant if described in graphic detail.

Pro-lifers reply that pro-abortionists use clinical terminology to hide the ugliness of what they are doing. A description of what abortinists do sounds violent and brutal because what abortionists do is violent and brutal.

Surely the real question is not, Does this description sound unpleasant? The real question is, Does it accurately describe what is happening? If it is inflammatory and false, that's propaganda. But if it's inflammatory and true, it is not the language that should be attacked, but the action it describes. Using pretty language to describe violence may make it sound nicer, but it does not make it cease to be violence.

The Horse's Mouth

So what is a "partial birth abortion", really? Let's turn to a source that cannot possibly be accused of anti-abortion bias. Let's turn to the abortionist who invented it. He wrote a paper describing how to do it for a conference of abortionists in 1992. This paper was presented to Congress during the debate on the partial-birth abortion ban bill, and so I take all the quotations I use here directly from the Congressional Record, September 19, 1996, pages H10631 and following.

The abortionist refers to the procedure as "Dilation and Extraction", or D&X for short.

Comparison to D&E

First, he compares this new procedure he has just invented with other procedures:
The surgical method described in this paper differs from classic D&E in that it does not rely upon dismemberment to remove the fetus.


Classic D&E is accomplished by dismembering the fetus inside the uterus with instruments and removing the pieces through an adequately dilated cervix.

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.


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.

Translations: "fetus" means "unborn child". "dismemberment" means "cutting or tearing off arms and legs". The gist of this section of his paper is that late D&E's are difficult because the baby's skin and bones have gotten tough enough that it's hard to tear them apart.

For Emergency Use Only

Defenders of this procedure routinely argue that pro-lifers are making a big deal about nothing, because this procedure is used only rarely, in special, emergency situations where it is necessary to save the live of the mother.

When does the inventor say it is used?

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.
(LMP means "since last menstrual period".)

How many is this?

The author has performed over 700 of these procedures with a low rate of complications.
As of 1992, when he wrote this paper, of course. Presumably he's done many more since then.

So is 26 weeks the latest this is done? Perhaps the inventor does not commit any abortions later than that, but he notes in a section entitled "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.

The Procedure Itself

But how do you do it? The apparent purpose of the paper was to tell other abortionists how they could use this procedure too. He gives a quick checklist of the steps:
In a nutshell, D&X can be described as follows:
Well, that doesn't sound too bad.

He gives details of each of these steps. For the fifth and six steps, he explains that an assistant will use ultrasound to determine which way the baby is facing and to find his feet ("lower extremities"). Then:

The surgeon introduces a large grasping forcep, such as 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 ... pulls the extremity into the vagina.


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 wit 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.

Perhaps you found some of the technical medical terminology in that quote confusing. But surely there can be no confusion about the statement, "The surgeon then forces the scissors into the base of the skull" and "he spreads the scissors to enlarge the opening".

Glob of Tissue

Pro-abortionists frequently say that what is aborted is not a baby, certainly not a person. Rather, it is simply a "glob of tissue" or a "product of conception".

One need only read this abortionist's paper to see that he certainly is not under any such delusion. He clearly refers to the unborn's "lower extremities", "torso", "shoulders", "upper extremities", and "skull". A glob of tissue does not have shoulders and a skull. A baby does.

It is clear that even when he tries to sugar-coat what he is doing with technical medical terms or convoluted phrases -- like saying "lower extremities" instead of "legs and feet" -- the abortionist finds it impossible to tell other abortionists how to perform this procedure without describing what he's really doing, like "force the scissors into the base of the skull".

Posted 5 Sep 2000.

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