Did I Violate the Partial-Birth Abortion Ban?

SLATE ^ | October 22, 2003 | Warren M. Hern

[NYer]

As the misleadingly titled "Partial-Birth Abortion Ban" makes its way to the president's desk, anti-abortion groups are celebrating their public relations victory. But beneath the hoopla, the bill's medical consequences remain murky. Exactly which procedures will be banned, and which doctors prosecuted? Will the anti-abortion lobby be happier with the alternative methods to which doctors will resort? If not, which methods and doctors will be targeted next? Will this ban have a chilling effect on related procedures? If so, will it prevent abortions—or births?

I ask these questions because I am a potential target of this legislation. Almost exactly 30 years ago, shortly after Roe v. Wade, I started performing abortions on a full-time basis in Boulder, Colo., at the state's first free-standing nonprofit abortion clinic, where I was the founding medical director. In my private practice, I perform many abortions as late as the 26^th week of pregnancy, and some as late as the 34^th week.

I don't know the answers to the questions I've posed above, and neither does Congress. No physician expert on late abortion has ever testified in person before a congressional committee. No peer-reviewed articles or case reports have ever been published describing anything such as "partial-birth" abortion, "Intact D&E" (for "dilation and extraction"), or any of its synonyms. There have been no descriptions of its complication rates and no published studies comparing its complication rates with those of any other method of late abortion.

What I do know is that the political exploitation of this issue is confusing and frightening my patients. Recently, I received a call from a woman whose physician had discovered catastrophic genetic and developmental defects in the fetus she is carrying. The pregnancy was profoundly desired, and the diagnosis was devastating for her and her husband. She called me with great anxiety to find out whether passage of the "partial-birth" ban by the Senate would mean that she could not come to my office for help because my work would be illegal. She was also horrified by the images that she had seen and the terminology she had heard in the congressional debates.

I reassured her that I do not perform the "partial-birth" procedure and that there is no likelihood that the ban's passage would close my office and keep me from seeing her. The fetus cannot be delivered "alive" in my procedure—as the ban stipulates in defining prohibited procedures—because I begin by giving the fetus an injection that stops its heart immediately. I treat the woman's cervix to cause it to open during the next two days. On the third day, under anesthesia, the membranes are ruptured, allowing the amniotic fluid to escape. Medicine is given to make the uterus contract, and the dead fetus is delivered or removed with forceps. Many variations of this sequence are possible, depending on the woman's medical condition and surgical indications.

On the same day I got that call, I received a call from another woman who hoped to become pregnant but wanted to be reassured that, in spite of passage of the "partial-birth" ban, she would still be able to terminate the pregnancy if a serious genetic defect were discovered at, say, 20 weeks of pregnancy. Because of her history, she has an especially high risk of such a scenario. Without reassurance, she would avoid pregnancy entirely. Again, I reassured her that I would be here for her if she needs me.

But what if the people enforcing the "partial-birth" ban decide for some reason—because they doubt that my injection worked, for example—that it covers what I do? Or what if other doctors decide to follow the same procedure of causing fetal death by injection some time—even a day or two—before the extraction is performed? If the intact delivery of the living fetus (the "birth" imagery) is what bothers lawmakers, will they ban this method as well? Depending on the doctor, the alternative to intact extraction could be dismemberment of the fetus in the uterus, which may be more dangerous for the woman and no less troubling to look at. Is that what Congress wants? Who gets to decide what is safer for the woman: the expert physician or Congress?

Earlier this year, I began an abortion on a young woman who was 17 weeks pregnant. Because of the two days of prior treatment, the amniotic membranes were visible and bulging. I ruptured the membranes and released the fluid to reduce the risk of amniotic fluid embolism. Then I inserted my forceps into the uterus and applied them to the head of the fetus, which was still alive, since fetal injection is not done at that stage of pregnancy. I closed the forceps, crushing the skull of the fetus, and withdrew the forceps. The fetus, now dead, slid out more or less intact. With the next pass of the forceps, I grasped the placenta, and it came out in one piece. Within a few seconds, I had completed my routine exploration of the uterus and sharp curettage. The blood loss would just fill a tablespoon. The patient, who was awake, hardly felt the operation. She was relieved, grateful, and safe. She wants to have children in the future.

Did I do a "partial-birth" abortion? Will John Ashcroft prosecute me? Stay tuned.Warren M. Hern, a physician, is director of the Boulder Abortion Clinic in Boulder, Colo.

Article URL: http://slate.msn.com/id/2090215/

[William McKinley]

I fully support this guy's freedom of speech. I think he should get on every network and say exactly what he wrote for Slate. I think that before the Presidential debates, he should retell his story for all to hear.

I think more people need to hear him tell exactly what he does, how he does it, and why he does it.

How can anyone read this and not be completely repulsed?

[Fawnn]

How does this man sleep at night?

My thoughts exactly!

Somebody posted this verse on one of Terri's threads, but it's also appropriate here:

"Woe to those who call evil good, and good evil; Who substitute darkness for light and light for darkness; Who substitute bitter for sweet and sweet for bitter!"

[Lil'freeper]

Neither of the examples this monster cites are 'for the health of the mother' but rather 'for the convenience of the mother'. Sick.

[Fawnn]

...you committed pre-meditated, cold blooded murder on an innocent and helpless human being. You are a mass murdering butcher.

Exactly! (The absence of the Holy Spirit in peoples' lives certainly does distort their perceptions, doesn't it?)

[Caleb1411]

[mountaineer]

I received a call from another woman who hoped to become pregnant but wanted to be reassured that, in spite of passage of the "partial-birth" ban, she would still be able to terminate the pregnancy if a serious genetic defect were discovered

By all means, let's not get pregnant without a 100 percent guarantee the baby will be absolutely perfect in every way. (Let's just hope he or she isn't as morally deficient as this would-be mother and the proud abortionist who wrote this screed).

[Sarah]

He can't be serious!
There are so many holes in this guy's logic and justifications it seems like a set up.

[newgeezer]

anti-abortion groups are celebrating their public relations victory. But beneath the hoopla, ... will it prevent abortions...?

Anyone who thinks the answer is 'yes,' please tell me how.

Take away Jeffrey Dahmer's meat cleaver. Does anyone seriously believe he would hesitate to use his hatchet?

[finnman69]

Warren is a pretty cold individual. So was Hitler.

[newgeezer]

Warren M. Hern, a physician, is director of the Boulder Abortion Clinic in Boulder, Colo.

[Between the Lines]

What I do know is that the political exploitation of this issue is confusing and frightening my patients.

Good.

[Eagle Eye JR]

"Then I inserted my forceps into the uterus and applied them to the head of the fetus, which was still alive, since fetal injection is not done at that stage of pregnancy. I closed the forceps, crushing the skull of the fetus, and withdrew the forceps. The fetus, now dead..."

Congratulations, you are a murder and one sick bastard. I pity you for the heartless acts you perform, and how you seem so non chalant about it. How anyone could do this is beyond my comprehension.

[Verax]

and some as late as the 34th week.

I could not force myself to read anymore as I was overcome with the evil nature this person necessarily posseses to be able to murder a 34 week old baby with his bear hands.

[Not A Snowbird]

For the life of me I don't understand how anyone can so calmly discuss killing an unborn child, either by injection or by crushing its skull.

What you have described here is incredibly revolting to me. I just don't understand. At what point did you become so impassive toward the unborn?

[Samurai_Jack]

"Unless there is a medical threat to the mother or some gruesome genetic defect "

If these children are given the same kind of legal protection as a murderer... If you consider that child to be a living human being then he or she deserves a trial by jury before execution. Is that child really threatening mommas life? Is this really only a decision that can be made by an "abortion provider"?

Just my opinion

[nathanbedford]

We are experiencing evil in action. This is how it works, we see it before our ken. It comes not with horns and tails but with plausible rationalization, even justification, which you must accept or betray yourself to be dogmatic, intolerant, or worse, Christian.

The banality of evil.

Here it is folks. Will you stand against it here or stay cool, together, thoughtful, nuanced, compassionate, tolerant, progressive, non-judgmental and modern?

[biblewonk]

Good analogy.

[mvpel]

[m1-lightning]

You think 34 months is sick? Read this one:

Is a crying baby alive?

[Gorjus]

Any abortion which meets the criteria of partial-birth . . .
destroying life on a technicality

The abortionists' worries are justified. Incrementalism is a very likely future, and with time (we can hope) the loopholes he intends to use can be closed as well.

It's the same concern that gun owners face with incremental anti-gun-rights laws. The history of registration leading to confiscation (or outlawing possession altogether) is undeniable to any honest consideration. It's as much proof as anyone should need that controversial issues can be 'won' through incremental steps more readily than giant leaps. Of course, there is a critically important difference between gun rights - where no one else's rights are harmed by my gun ownership, and it might just save my life - and abortion-on-demand where the rights of mother and child are in irreconcilable conflict - and the death of one of them results if the 'rights' of the other are unchecked.

I don't think the Federal government has any business telling the States what to do on this - neither to mandate that abortions be legal nor to mandate that particular ones are illegal - but things are so screwed up now that I'll accept Federal intervention to undo the wrong that was done. I'd love for the socialist left to regret their generations-long tactic of incrementally increasing the power of the central government at the expense of the States and the people.

I hope and pray that this 'doctor's' fears are justified. For once, I'd like to see a trend that makes things better rather than worse. It's enough to make me accept this as an exception to my basic philosophy of government.