"Imagine if you can that you are a pro-choice obstetrician/gynecologist like I once was. Your patient today is 24 weeks pregnant. At twenty-four weeks from last menstrual period, her uterus is two finger-breadths above the umbilicus.
If you could see her baby, which is quite easy on an ultrasound, she would be as long as your hand plus a half from the top of her head to the bottom of her rump not counting the legs. Your patient has been feeling her baby kick for the last 2 months or more but now she is asleep on an operating room table and you are there to help her with her problem pregnancy.
The first task is remove the laminaria that had earlier been placed in the cervix to dilate it sufficiently to allow the procedure you are about to perform. With that accomplished, direct your attention to the surgical instruments arranged on a small table to your right. The first instrument you reach for is a 14-French suction catheter. It is clear plastic and about nine inches long. It has a bore through the center approximately ¾ of an inch in diameter.Picture yourself introducing this catheter through the cervix and instructing the circulating nurse to turn on the suction machine which is connected through clear plastic tubing to the catheter. What you will see is a pale yellow fluid that looks a lot like urine coming through the catheter into a glass bottle on the suction machine. This is the amniotic fluid that surrounded the baby to protect her.
With suction complete, look for your Sopher clamp. This instrument is about thirteen inches long and made of stainless steel. At the end are located jaws about 2 ½ inches long and about ¾ of an inch wide with rows of sharp ridges or teeth. This instrument is for grasping and crushing tissue. When it gets hold of something, it does not let go. A second trimester D&E abortion is a blind procedure. The baby can be in any orientation or position inside the uterus. Picture yourself reaching in with the Sopher clamp and grasping anything you can.
At twenty-four weeks gestation, the uterus is thin and soft so be careful not to perforate or puncture the walls. Once you have grasped something inside, squeeze on the clamp to set the jaws and pull hard–really hard. You feel something let go and out pops a fully formed leg about six inches long. Reach in again and grasp whatever you can. Set the jaw and pull really hard once again and out pops an arm about the same length. Reach in again and again with that clamp and tear out the spine, intestines, heart and lungs.
The toughest part of a D&E abortion is extracting the baby’s head. The head of a baby that age is about the size of a large plum and is now free floating inside the uterine cavity. You can be pretty sure you have hold of it if the Sopher clamp is spread about as far as your fingers will allow. You will know you have it right when you crushed own on the clamp and see white gelatinous material coming through the cervix. That was the baby’s brains. You can then extract the skull pieces. Many times a little face will come out and stare back at you.
Congratulations! You have just successfully performed a second trimester Suction D&E abortion. You just affirmed her right to choose.
If you refuse to believe that this procedure inflicts severe pain on that unborn child, please think again.
Before I close, I want to make a comment on the necessity and usefulness of utilizing second and third trimester abortion to save women’s lives. I often hear the argument that we must keep abortion legal in order to save women’s lives in cases of life threatening conditions that can and do arise in pregnancy.
Albany Medical Center where I worked for over seven years is a tertiary referral center that accepts patients with life threatening conditions related to or caused by pregnancy. I personally treated hundreds of women with such conditions in my tenure there. There are several conditions that can arise or worsen typically during the late second or third trimester of pregnancy that require immediate care. In many of those cases, ending or “terminating” the pregnancy, if you prefer, can be life saving. But is abortion a viable treatment option in this setting? I maintain that it usually, if not always, is not."