Surgical
Dilatation (Dilation) and Evacuation (D&E)
Used to abort unborn children as old as 24 weeks, this method is similar to the D&C. The difference is that forceps with sharp metal jaws are used to grasp parts of the developing baby, which are then twisted and torn away. This continues until the child’s entire body is removed from the womb. Because the baby’s skull has often hardened to bone by this time, the skull must sometimes be compressed or crushed to facilitate removal. If not carefully removed, sharp edges of the bones may cause cervical laceration. Bleeding from the procedure may be profuse. [50]
Dr. Warren Hern, a Boulder, Colorado abortionist who has performed a number of D&E abortions, says they can be particularly troubling to a clinic staff and worries that this may have an effect on the quality of care a woman receives. Hern also finds them traumatic for doctors too, saying "there is no possibility of denial of an act of destruction by the operator. It is before one's eyes. The sensation of dismemberment flow through the forceps like an electric current." [51]
Dilatation (Dilation) and Evacuation (D&E)
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Partial-Birth Abortion
Abortionists sometimes refer to these or similar types of abortions using obscure, clinical-sounding euphemisms such as "Dilation and Extraction" (D&X), or "intact D&E" (IDE) which mask the realities of how the abortions are actually performed. [69]
This procedure is used to abort women who are 20 to 32 weeks pregnant -- or even later into pregnancy.(* Babies born at 23 weeks or more often survive. This procedure eliminates that possibility.[70]) Guided by ultrasound, the abortionist reaches into the uterus, grabs the unborn baby’s leg with forceps, and pulls the baby into the birth canal, except for the head, which is deliberately kept just inside the womb. (At this point in a partial-birth abortion, the baby is alive.) Then the abortionist jams scissors into the back of the baby’s skull and spreads the tips of the scissors apart to enlarge the wound. After removing the scissors, a suction catheter is inserted into the skull and the baby’s brains are sucked out. The collapsed head is then removed from the uterus.[71]
Partial Birth Abortion
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This procedure simply allows the abortionist to suck out the baby's brains right up to the day of delivery.
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Guided by ultrasound, the abortionist grabs the baby's leg with forceps |
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The baby's leg is pulled out into the birth canal. |
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The abortionist delivers the baby's entire body, except for the head. |
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The abortionist jams scissors into the baby's skull. The scissors are then opened to enlarge the hole. |
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The scissors are removed and a suction catheter is inserted. The child's brains are sucked out, causing the skull to collapse. The dead baby is then removed. |
Hysterotomy
Similar to the Caesarean Section, this method is generally used if chemical methods such as salt poisoning or prostaglandins fail (see pp. 12-14). Incisions are made in the abdomen and uterus and the baby, placenta, and amniotic sac are removed. [72] Babies are sometimes born alive during this procedure, raising questions as to how and when these infants are killed and by whom.
This method offers the highest risk to the health of the mother, because the potential for rupture during subsequent pregnancies is appreciable. [73] In the first two years of legal abortion in New York State, the death rate from hysterotomy was 271.2 deaths per 100,000 cases. [74]
Chemical
These methods involve the injection of drugs or chemicals through the abdomen or cervix into the amniotic sac to cause the death of the child and his or her expulsion from the uterus. Several drugs have been tried, [52] but the most commonly used are hypertonic saline, urea, and prostaglandins.
Salt Poisoning
Otherwise known as "saline amniocentesis," "salting out," or a "hypertonic saline" abortion, this technique is used after 16 weeks of pregnancy, when enough fluid has accumulated in the amniotic fluid sac surrounding the baby.
A needle is inserted through the mother’s abdomen and 50-250 ml (as much as a cup) of amniotic fluid is withdrawn and replaced with a solution of concentrated salt. [53] The baby breathes in, swallowing the salt, and is poisoned.[54] The chemical solution also causes painful burning and deterioration of the baby’s skin. [55] Usually, after about an hour, the child dies. The mother goes into labor about 33 to 35 hours after instillation and delivers a dead, burned, and shriveled baby. [56] About 97% of mothers deliver their dead babies within 72 hours.[57]
Hypertonic saline may initiate a condition in the mother called "consumption coagulopathy" (uncontrolled blood clotting throughout the body) with severe hemorrhage as well as other serious side effects on the central nervous system. [58] Seizures, coma, or death may also result from saline inadvertently injected into the woman’s vascular system.[59]
Urea
Because of the dangers associated with saline methods, other instillation methods such as hypersomolar urea are sometimes employed, [60] though these are less effective and usually must be supplemented by oxytocin or a prostaglandin in order to achieve the desired result. [61] Incomplete or failed abortion remains a problem with urea methods, often precipitating the additional risk of surgery.
As with other instillation techniques, gastrointestinal side effects such as nausea or vomiting are frequent, but the most common problem with second trimester techniques is cervical injuries, which range from small lacerations to complete detachments of the anterior or posterior cervix. Between 1% and 2% of patients using urea must be hospitalized for treatment of endometritis, an infection of the lining oft he uterus.[62]
Prostaglandins
Prostaglandins are naturally produced chemical compounds which normally assist in the birthing process. The injection of concentrations of artificial prostaglandins prematurely into the amniotic sac induces violent labor and the birth of a child usually too young to survive. Often salt or another toxin is first injected to ensure that the baby will be delivered dead, [63] since some babies have survived the trauma of a prostaglandin birth and been born alive. [64] This method is used during the second trimester. [65]
In addition to risks of retained placenta, cervical trauma, infection, hemorrhage, [66] hyperthermia, bronchoconstriction, tachycardia, [67] more serious side effects and complications from the use of artificial prostaglandins, including cardiac arrest and rupture of the uterus, can be unpredictable and very severe. Death is not unheard of. [68]