A Kinder, Gentler D&X
by Jay Johansen
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
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
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,
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.
Copyright 1996 by Ohio Right to Life