No Limit on 'Choice'? Here's the Ugly Result : Abortion: The newest late-term methods horrify even the medical professionals.

New York columnist Nat Hentoff specializes in Bill of Rights issues.

Through the years I have known nurses who refused to take part in second-trimester abortions. Most were not pro-lifers and had participated in many first-trimester abortions. But, they told me, they could not bear seeing the dismemberment of the fetus in the uterus during D & E (dilation and evacuation).

There is now a new approach to second- and third-trimester abortions. It is D & X (dilation and extraction) and has led pro-lifers to use this development in an attempt to kill the Freedom of Choice Act. In American Medical News (a publication of the American Medical Assn.), reporter Diane Gianelli notes that "scores of calls from congressional staffers and others" have been received by the National Abortion Federation asking about the pro-lifers' brochures and ads illustrating D & X.

The anti-abortion forces had obtained a copy of a description of D & X at a National Abortion Federation seminar in Dallas last September. Dr. Martin Haskell, who has performed the procedure more than 700 times on patients from 20 to 24 weeks--and some up to 26 weeks--explained that he takes a large grasping forcep to grab hold of a "lower extremity" which he pulls into the vagina. Then, with his fingers, he removes the rest of the fetus except for the head. In most cases, the fetus is still alive.

Then, the seminar report said, "the surgeon takes a pair of blunt curved Metzenbaum scissors" and "forces the scissors into the base of the skull," spreading it to enlarge the opening. With a suction catheter, he "evacuates the skull contents." The fetus is now dead, and the skull joins the rest of the fetus.

Dr. James McMahon of Los Angeles, one of the few physicians who, so far, perform D & X, told American Medical News: "If I see a case . . . after 20 weeks, where it frankly is a child to me, I really agonize over it because the potential is so imminently there. . . . On the other hand, I have another position, which I think is superior in the hierarchy of questions, and that is: 'Who owns the child?' It's got to be the mother."

I reminded Jesse Jackson, a while ago, that when he was a spellbinding pro-lifer, he used to liken the claim of ownership of the unborn child to the slave-owning plantation owner who said he could do anything he liked with his property. Jackson did not deny having said that, but, looking uncomfortable, he said nothing more to me.

Anyway, say the pro-choicers, there are so few second-trimester abortions that all this fuss over D & X is a tactic to end all abortions.

That is true for the activists, but many onlookers wonder about the definition of "few." Gianelli quotes the Guttmacher Institute as estimating that in 1988--the last year for which figures are available--there were close to 168,000 second- and third-trimester abortions. Of these, according to Haskell, probably 4,000 are done in the third trimester.

But Gianelli notes, "Accurate figures on second- and third-trimester abortions are elusive because a number of states don't require doctors to report abortion statistics. For example, one-third of all abortions are said to occur in California, but the state has no reporting requirements."

The National Right to Life Committee has been running ads around the country showing how D & X works. It hopes that reaction to those ads will reach those members of Congress who are already ambivalent about how far, if at all, the Freedom of Choice Act should go in removing the ability of the individual states to place restrictions on abortion.

Whether or not the FOCA allows a waiting period, or parental notification when a teen-ager decides to have an abortion, a basic element of the proposed federal law is that abortion will be permitted--for any reason--until viability. But--and this is where D & X comes in--the definition of viability will not be determined any longer in any state legislatures. Viability will be defined by the physician performing the abortion--not always a disinterested authority. So there will be more second-trimester abortions.

Barbara Radford, executive director of the National Abortion Federation, says that there is no need to apologize for D & X. It's legal. And "there are many reasons why women have late abortions: life endangerment, fetal indications, lack of money or health insurance, social-psychological crises, lack of knowledge about human reproduction, etc."

And another reason not to apologize is that the target of the Metzenbaum scissors is--according to a majority of the Supreme Court--not yet a "person," not yet human enough to be protected by the Constitution. After all, as Richard John Neuhaus reminds us: "We need never fear the charge of crimes against humanity so long as we hold the power to define who does and who does not belong to 'humanity.' "

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