Copyright 2000 The Omaha World-Herald Company
Omaha
World-Herald
April 20, 2000, Thursday SUNRISE EDITION
SECTION: NEWS; Pg. 6;
LENGTH: 496 words
HEADLINE:
Dilation and Extraction Procedure Surfaced in 1992
BYLINE: JUDITH NYGREN
SOURCE:
WORLD-HERALD STAFF WRITER
BODY:
At the heart of
Nebraska's "partial-birth" abortion ban is a procedure
pioneered by a Cincinnati doctor. Dr. Martin Haskell presented a paper in early
1992 detailing what he called dilation and extraction. The anti-abortion
movement has labeled it "partial-birth" abortion. As outlined
by Haskell, the procedure involves dilating a woman's cervix over a three-day
period. On the third day, the surgeon uses forceps to grab a leg of a living
fetus and pulls it into the vagina. The surgeon uses his finger to deliver the
opposite leg into the vagina, then the torso, the shoulders and the arms.
Usually there is not enough room for the head to pass into the vagina, so the
surgeon forces a pair of scissors into the base of the skull and spreads the
scissors to enlarge the opening. After the scissors are removed, the surgeon
inserts a suction catheter into the hole and sucks out the brain to reduce the
size of the head. The entire fetus then can be removed. Haskell said he used the
D&X procedure with all women who were 20 to 24 weeks pregnant and with
selected patients between 25 and 26 weeks of pregnancy. The State of Nebraska
considers a fetus born before 20 weeks to have no chance of survival, while a
fetus born at 24 weeks is considered to have about a 55 percent chance of
survival. Dr. LeRoy Carhart, the Bellevue abortion provider who challenged
Nebraska's ban as unconstitutional, testified in U.S. District Court that he
does not abort viable fetuses. With most of his patients who are between 16 and
20 weeks pregnant, he tries to perform a D&X. Carhart told the judge that he
strives to deliver a fetus intact during the second trimester because he
considers it a safe procedure that protects the woman's health. But his actual
success with a D&X through the 19th week is low - less than 5 percent to 10
percent. The tissue, Carhart testified, is so soft at this point that the fetus
is easily torn apart. Carhart also testified that, unlike Haskell, he doesn't
manipulate the fetus into a feet-first position. He removes it head first or
feet first depending on its natural position. In a head-first abortion, Carhart
uses dilation and evacuation - or D&E - dismembering the fetus rather than
delivering it intact. If it presents itself feet-first, Carhart will either
puncture the skull or crush it before completing the abortion. After the 20th
week, Carhart typically kills the fetus by injection 48 to 72 hours before
beginning the abortion. Thus, the judge ruled, the state's ban wouldn't apply to
his later abortions because the fetus is already dead when it enters the vagina.
Carhart doesn't use a lethal injection on the fetus between weeks 16 and 20
because the waiting time between injection and abortion is only 12 to 24 hours
and the fetal tissue doesn't change enough to make it the best procedural
choice. Carhart has said that he performs an average of 1,200 abortions a year,
about 20 of which are D&X procedures.
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April 20, 2000 
