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Personal Stories to Join Debate Over Late-Term Abortion : Health: The House has voted to ban the procedure. But the Senate will hear from two women who say it was a dignified solution when their fetuses developed ‘catastrophic’ problems.

TIMES STAFF WRITER

Viki Wilson, a 37-year-old nurse from Fresno, was looking forward to the birth of her third child, a baby girl who was due on Mother’s Day, 1994.

But in the eighth month of her pregnancy, a final ultrasound test portrayed a tragedy.

“About two-thirds of Abigail’s brain had grown outside her skull. And what I had thought were strong baby movements were actually seizures,” Wilson said. “It wasn’t a question of whether our baby would die. It was only a question of when and how.”

She and her husband, a physician, consulted several specialists in Fresno, but were finally referred to a Los Angeles doctor, one of only three in the nation who regularly performed late-term abortions.

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Accompanied by her family, Wilson became one of about 450 women last year to undergo a medical procedure that the House voted last week to make a federal crime.

Abortion doctors call it a “dilation and extraction,” or “D & E.” House Republicans call it “a partial-birth abortion.” Either way, this rarely used method of ending a pregnancy has become the latest battle in the long war over abortion policy in the United States. Senate Majority Leader Bob Dole (R-Kan.) has indicated that the Senate will take up the bill Tuesday. And if passed there, the legislation will mark the first time Congress has ever voted to outlaw a specific medical procedure.

During last week’s House debate, which was limited to one hour, Republican leaders said they wanted to expose the “ugly reality” of the abortion business.

They did so most powerfully with a set of five drawings said to illustrate a partial-birth abortion. The drawings depict a baby being pulled from its mother’s body. When all but its head is removed, “the abortionist jams scissors into the baby’s skull,” the illustration states. “A suction catheter is inserted, [and] the child’s brains are sucked out.”

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“You would not take a coyote, a mangy raccoon, and treat that animal that way,” said House Judiciary Committee Chairman Henry J. Hyde (R-Ill.), a veteran anti-abortion leader. “It is too cruel, [more suited] to Dr. Joseph Mengele or Dr. Kevorkian.”

The gruesome drawings helped propel the bill to an overwhelming 288-139 victory, with even liberals such as Minority Leader Richard A. Gephardt (D-Mo.) voting yes.

But when the Senate takes up the measure, legislators will hear about Wilson and Claudia Crown Ades, a Santa Monica woman who underwent the same procedure. Their stories tell a quite different tale, one of a safe, dignified end to a tragic pregnancy.

On Saturday, Ades and her husband attended a memorial service for the Los Angeles abortionist at the center of the dispute, Dr. James McMahon, who died a week ago of cancer.

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“He is truly a hero for me. He saved my life and he helped save the possibility of us having a family,” said Ades, 36.

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About 95% of the 1.5 million abortions performed in the United States each year take place within the first 15 weeks of pregnancy. These are protected from government interference under the Supreme Court’s Roe vs. Wade ruling.

Late-term abortions are another matter, however, as both the court and common sense make clear. As a baby grows into a distinct and functioning being, the woman’s unilateral right to terminate the pregnancy diminishes.

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About 13,000 abortions occur after 4 1/2 months of pregnancy, according to the Alan Guttmacher Institute, which conducts reproductive research. Other estimates suggest that only about 600 abortions take place after 26 weeks, during the third trimester of pregnancy.

At this late stage, when a fetus is “viable” on its own, the government “may proscribe abortion except where it is necessary, in appropriate medical judgment, for the preservation of the life or health of the mother,” the court said in the Roe vs. Wade decision.

While that ruling appeared to permit bans on third-trimester abortions, it did not do so, abortion foes say.

“In reality, it has meant the physician has total discretion,” said Douglas Johnson, legislative director for the National Right to Life Committee. Every year, hundreds of late-term “elective” abortions are performed, he said.

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Abortion rights advocates dispute this. Laws in 32 states ban late-term abortions, according to the Center for Reproductive Law and Policy in New York.

While it is true that several hundred women “elect” each year to have late-term abortions, they do so only after learning their babies have severe abnormalities, abortion rights advocates say.

“They almost always have catastrophic complications,” Dr. Warren Hern, director of the Boulder (Colo.) Abortion Clinic, said of his patients. He is one of two remaining doctors who specialize in late-term abortions. “Sometimes [mothers] are suffering from an acute medical condition. More often the baby has a severe anomaly. A very small proportion [of late-term abortions] are rape or incest cases, usually very young.

“When you are talking about past 26 weeks [of pregnancy], there are no more than 400 or 500 in the whole country,” said Hern, who was also in Los Angeles for the memorial service for McMahon.

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The House bill targets just one method of performing late-term abortions. It says “the person performing the abortion [who] partially vaginally delivers a living fetus before killing the fetus and completing the delivery” is subject to two years in prison and civil damages.

An abortion after the sixth month of pregnancy can be complicated. At this stage, the baby and its head are too large to be removed easily. Further, the woman’s uterus is engorged with blood, and a tear can cause severe bleeding, doctors say.

During the House debate, sponsors of the bill said women needing a late-term abortion could get a Cesarean section, major surgery that can have complications and certainly requires a lengthy recovery.

In the past, some doctors were said to use forceps to dismember a dead fetus and remove it in pieces, a gruesome procedure that would be entirely legal under the House bill.

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More recently, obstetricians say, several methods are commonly used in late abortions. Some doctors kill the fetus with an injection and slowly remove it, a procedure that also would remain legal.

McMahon, who taught obstetrics and gynecology at Cedars-Sinai Medical Center, said he developed what he considered a safer method in 1983. In testimony supplied to the Judiciary Committee, he explained the procedure:

Over two days, the woman’s cervix is dilated. Then, she is given a heavy dose of anesthesia.

Because “the cervical diameter is always smaller than the head . . . [the head] must be reduced in size to accommodate intact passage,” he said. Using forceps, the doctor pulls the baby partly through the vagina. Then, “using a needle similar to that used in a spinal tap, fluid is removed” from the head, McMahon said, allowing the doctor “to bring the head through the cervix and out.”

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Medical experts apparently disagree on a key issue: whether babies aborted in the method pioneered by McMahon are alive and capable of feeling pain when they are partly removed from the uterus.

McMahon said “the fetus feels no pain through the entire series of procedures” because of the anesthesia. “There is a neurological fetal demise. There is never a live birth,” he said.

But Dr. Watson A. Bowes, professor of obstetrics at the University of North Carolina, questioned that conclusion.

“I have never witnessed this procedure,” he said, “but from the descriptions, it seems the baby would be still be alive at the time the instrument is put into the base of the skull.”

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An opponent of abortion, Bowes said he does not perform abortions, “but even if I were for it, I don’t think we need this procedure. It borders on infanticide.”

Hern, the abortion doctor from Boulder, said he also has reservations about the procedure used by McMahon. “I do a fetal injection two days in advance” of the procedure to ensure the fetus is not alive when the abortion is performed, he said.

Nonetheless, he praised McMahon and condemned the legislation as “a lurid exercise in public relations by the Republicans in Congress.”

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Wilson and Ades want their stories heard to counter what they say are blatantly sensationalized descriptions of the abortion procedure they underwent. They are especially angered by reports of live babies being “stabbed with scissors,” and their brains “suctioned” out of them.

Both say they contacted Sen. Barbara Boxer (D-Calif.) so their stories could be told to the Senate.

“This was not a choice. All the options were bad,” Wilson said of her abortion. “With Dr. McMahon, my baby was put gently to sleep so she could be delivered. . . . Because of the overdose of anesthesia, she was gone before the procedure began.

“If [McMahon] had not removed some fluid, her head would have crushed, and there would have tearing of the cervix during the delivery,” she continued. “We were able to hold Abigail afterward. Her brain was not ‘sucked’ out. She looked perfect, except there was small pinhole in the back where [the doctor] had aspirated the fluid.”

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In 1992, Ades said she and her husband, Richard, were happily preparing for the birth of their first child when they got devastating news. Six months into her pregnancy, she was told the baby had severe brain and heart damage, a condition known as trisomy 13 because it stems from an extra 13th chromosome.

“Women don’t go six months or seven months into their pregnancy and change their minds,” she said. “I wanted this pregnancy more than anything.”

Like Wilson, she and her husband consulted other specialists and concluded McMahon offered the safest and best end to a tragic pregnancy.

“This was not about getting rid of a kid. It was about having a family and a future,” she said. “You are given so much anesthesia, the baby is gone at the start.”

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Since then, Ades said she has had more failed pregnancies, but the couple are now looking forward to adoption. “I’m just very sad that Dr. McMahon won’t be here when we finally get a baby,” she said.


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