PBA Trials: California

The following section consists of highlights of the partial birth abortion ban trial held in California. Partial birth (or D & X) abortions are usually done in the late second trimester but can be done in the third trimester as well. All pictures of unborn babies are in the late second trimester – candidates for this type of abortion.

Planned Parenthood v. Ashcroft
U.S. District Court, Northern District of California
The Honorable Phyllis J. Hamilton, Judge

DAY ONE: Monday, March 29, 2004.

Excerpts from direct examination of Dr. Maureen Paul:

Q. And when you begin the evacuation, is the fetus ever alive?

A. Yes.

Q. How do you know that?

A. Because I do many of my procedures especially at 16 weeks under an ultrasound guidance, so I will see a heartbeat.

16 weeks

Q. Do you pay attention to that while you are doing the abortion?

A. Not particularly. I just notice sometimes.


Q. Okay. Does it every come out completely without the head becoming lodged?

A. Rarely it does.


Q. And you had said that sometimes when you apply traction to the fetus it comes out intact up to point where the calvarium [skull] lodges; is that correct?

A. Yes.

Q. In that circumstance, what do you do to complete the procedure?

A. Well, there are two things you can do. You can disarticulate at the neck, or what I prefer to do is to just reach in with my forceps and collapse the skull and bring the fetus out intact.

Q. You testified earlier, Dr. Paul, that the fetus can be alive when the evacuation begins; is that correct?

A. That’s right.

Q. When in the course of the abortion does the fetus — does fetal demise occur?

A. I don’t know for sure. I certainly know that if I deliver intact and collapse the skull that demise occurs.

Excerpts from the Government’s cross-examination of Dr. Paul:

Q. In performing a D&E at 20 weeks gestational age and above, in your previous capacity, was there ever a time when you saw any indication that the fetus was experiencing pain?

A. I have no idea what that means.

DAY TWO: Tuesday, March 30, 2004.

Excerpts from PPFA’s direct examination of Dr. Katharine Sheehan:

Q. Okay. So after you have assessed the fetal presentation, what do you do next?

A. Then, a cervical block of local anesthetic is placed around the cervix, and the amniotic sac is ruptured, allowing the amniotic fluid to flow out. And, then, using the forceps, I begin the procedure if extracting the fetal parts.

Q. And how do you go about doing that?

A. I generally try using the ultrasound to find the small parts of the fetus, “small parts” being considered the extremities. I really prefer it if the lower extremities are presented first. I can grasp the lower extremities of the fetus, and using gentle traction, extract the tissue.

[This is another way of saying she grasps the arms and legs, then pulls them off]

Q. And after you have done that, what do you have? What happens next?

A. I continue to put traction on the fetus tissue. If the cervix is adequately dilated, then the fetus will generally slide down through the cervix, and I continue to extract the tissue until it is completely extracted. If the cervix is not so well dilated, then disarticulation and dismemberment happens.


Q. So do you ever use a chemical agent to cause fetal demise?

A. Yes.

Q. What is that agent?

A. The agent is Digoxin.

Q. What is Digoxin?

A. Digoxin is the name for Digitalis, which is a cardiac medicine that is typically used for specific cardiac conditions, most typically heart failure.

Q. And at what gestational age do you use Digoxin?

A. We start using it at 22 weeks.

Q. Why do you choose 22 weeks?

A. We like to prevent an eventuality of a live birth, and because it seems to make the procedure move along a little bit easier on the day of the procedure….We administer the Digoxin with a needle through the abdominal wall of the woman intro the uterus. We are aiming to get it into the fetal heart, or at least into the fetal thorax. However, we are not able to do that every time. If we are not able to do that, then we attempt to put the Diogoxin into the amniotic fluid. And it seems to work less often when it is just put into the amniotic fluid.

Injecting Digoxin into this 22-week-old baby’s heart prevents a live birth and lets the abortion ‘move along a little easier’

Q. What percentage of time are you successful in getting the Digoxin into the fetal heart?

A. I would say approximately 50 percent.

Q. And what about the term “living fetus,” what does that mean to you?

A. It would be a fetus that still has a heartbeat, and that would still apply to many of my cases.

Q. And in your practice do you bring the fetus to the point where the fetal trunk past the navel is outside the body of the woman?

A. Yes, I do. That’s what I mainly do.

Q. And that happens often?

A. Yes.


Q. You testified yesterday, I believe, that you have performed approximately 30,000 surgical abortions throughout your career?

A. That is my best guess.

Excerpts from the Government’s cross-examination Dr. Sheehan:

Q. Thank you. If I could read that to you, page 101 [of Dr. Sheehan’s deposition], starting on line 22.and I should say first this question refers to your expert report; is that correct?

A. Uh-huh.

Q. Question: Could you describe, doctor, what you mean in paragraph 4 by your “best efforts to remove the fetus intact?”

Answer: I think I already described that, but what I attempt to do is to grasp the fetal feet with the instrument, and putting gentle traction on that fetal extremity, I try to tease the tissue down so that the fetus comes down feet first through the cervix, the pelvis and the thorax, and I actually get the arms out and just use gentle traction, rather than using the kind of crushing and compressing gestures that one would use to do the disarticulation.

Is that what you said?

A. Yes.

Excerpts from direct examination of Dr. Eleanor Drey:

Q. And was there a time frame of when [Digoxin] was given?

A. When we first started giving it, we always gave it at the time that we were doing our preoperative evaluation, so that the patient would get the laminaria placed. And then, after that, she would have the Digoxin injection. At that time we were waiting two days with the laminaria in place. And, so, initially we were giving Digoxin two days before D&E.

Q. And did you ever change that procedure, that time schedule?

A. We did. What started happening was we had an unfortunate number of women who were spontaneously going into labor and delivering at hospitals sort of all over the bay area, and it was distressing to everyone.

23-week-old unborn baby

DAY THREE: Thursday, April 1, 2004:

Excerpts from direct examination of Dr. “Doe” (testifying under a pseudonym):

Q. Do some women deliver the fetus partially as a result of the misoprostol?

A.Yes, they can.

Q. And when that happens, could the fetus be outside the uterus past the navel of the fetus?

A. Outside the uterus, yes, and potentially even outside the vagina.

Q.. And could it be alive?

A. Yes. [He just admitted that babies are sometimes born alive]

Q.. And when that happens, how do you complete the procedure?

A. Usually, if the fetus is coming out, the easiest method is to try to do how we would do a breech. It often comes out in a breech presentation. And, again, that is feet first, head second. We do the similar maneuvers that we would do to do a breech delivery. However, sometimes the cervix is not dilated enough to allow the calvarium [head] to pass.

Q. And what do you then do?

A. I would separate the calvarium [head] from the body.

22 to 24 weeks – ideal age for this type of abortion


Q. And when during in induction does fetal demise occur; do you know?

A. I don’t know. It really depends on gestational age, and sometimes the fetus is born alive.


Q. And do you ever — do patients ever ask you whether there is something they could use to cause fetal demise?

A. Yes. I would — I don’t know what percentage of my patients, but a certainly small number of patients ask could there be fetal demise prior to the procedure. When I talk to them about what it would entail to do, most of them do not want to proceed with that. And I don’t think they are particularly worried about the effects. They don’t think — I think about the infection risk. They don’t think about the infection risk. They just don’t want to go through that procedure, to have a needle placed, and under ultrasound guidance maybe see the ultrasound and see the fetus again. The vast majority of the patients don’t want to have that done.

Excerpts from cross-examination of Dr. “Doe”:

Q. And I think you testified earlier that in about 15 percent of the D&Es you perform, the fetus is delivered partially intact so that the calvarium gets stuck in the cervix; is that correct?

A. It was – I think my testimony, I believe, is approximately 15 percent would be delivered intact. Not all of those that the calvarium would be stuck; some would deliver completely intact.

Q. Do you have a — can you give me an estimate of that 15 percent how many are delivered where the calvarium does get stuck in the cervix?

A. I would probably say at least 80 percent the calvarium would be stuck in the cervix.

Q. And just to be clear, the calvarium, again, is just the fetus’ head, correct?

A. Correct.

Q. In those cases in which you are doing a D&E and the fetus delivers partially intact except for the calvarium getting stuck in the cervix, you have to insert forceps and crush the calvarium; is that right?

A. I would separate the calvarium from the fetal — how I would perform the procedure is, I would separate the calvarium from the fetal body, thorax, and then insert the forceps to crush the calvarium to be able to deliver it.


Dr. Doe would kill a baby like this (22-244 weeks) by cutting the head from the body

Q. Let me just ask you. Can you describe for us how you get the forceps around the calvarium before crushing it?

A. In a situation where the fetus is delivered up until the calvarium?

Q. That’s right.

A. Again, as I testified, I would separate the calvarium from the fetus, so —

Q. Let me stop you right there. How would you separate the calvarium from the fetus?

A. Under direct visualization, I would use, seeing outside of the cervix within the vagina that I can see directly, I would use scissors to cut the neck and separate the — I am not in the uterus, I am in the vagina, separating the fetal calvarium from the fetal body.

Q. And after you’ve done that, the calvarium is still in the cervix?

A. Or in the lower uterine segment.

Q. Okay. Then what is the next step that you do?

A. The next step I would use is to put the bierer forceps — is what I most likely would be using in the situation – into the uterus, get around, open them wide, get around the calvarium, and crush the calvarium. Just as if it were higher up and not stuck in the cervix, I would be doing it just the same way.

Q. And is it fair to say that the calvarium is one of the largest parts of the fetus?

A. Yes.

Q. It is also one of the widest parts of the fetus?

A. Yes.

week 21

Q. Is it fair to say that when you are opening the forceps to get around the calvarium, you are opening them wider than you would if you were attempting to grasp a fetal limb?

A. Yes.

Q. Could there potentially be risks to the cervix when you are opening the forceps wide enough to get around the calvarium?

A. Yes.

Q. In fact, one of those risks might be a perforation or a laceration of the cervix, right?

A. Yes.

Q. And another risk might be a perforation or a laceration of the lower uterine segment?

A. Yes.

Q. And let’s talk about that a little bit. Are the — can the bones of the calvarium, can they be sharp?

A. Yes.

Q. Are they in any — are they sharper say than the bones of the fetal leg or are they roughly comparable?

A. It depends on how — if it’s a disarticulation of how it went. A calvarium could be crushed and there are not sharp edges and the femur, which is a leg bone, could be broken and be sharper. I think you can’t predict that. But I think any of the major long bones, certainly not ribs, but femur, humorous could be sharper than a calvarium that has been crushed.

Q. And when you are crushing the calvarium, there is the same risks that we talked about earlier, possible perforation or laceration of the cervix, the lower uterine segment, or the uterus; is that right?

A. Yes.

Q. And a cervical or uterine laceration, it can be relatively minor or it could be relatively severe; is that right?

A. Yes.

Q. If it’s severe enough, there are some cases where a woman might exsanguinate and die, right?

A. Yes.

Q. Can you tell us what exsanguinate means?

A. To bleed to death.

Excerpts from re-cross examination of Dr. “Doe”:

Q. And Ms. Parker asked you a question about why some of your patients don’t prefer a labor induction abortion. I think one of the reasons you gave was that your — the woman may not want to see the fetus; is that right?

A. Yes.

Q. Now, in a labor induction abortion you are not showing the fetus to the mother in every case, are you?

A. No, we are not. But with a labor induction, it is often kind of unpredictable when the fetus delivers. And it is probably a minority of times the physician is actually there at the time to deliver the fetus. Often you don’t have the normal kind of cervical dilation that you might have in a term labor. You have nothing, nothing, nothing. And then, all of a sudden, she goes: “I have got to push,” and the fetus kind of pops into the bed.

24 week-old unborn baby

DAY FOUR: Monday, April 5, 2004.

Excerpts from cross- examination of Dr. Fredrik Broekhuizen:

 Q. Usually in examining the fetal parts you don’t actually see the bones, do you? You usually see the limb and the actual bone is in the limb?

A. You can sometimes see bone. Sometimes you can see just the limb.

Q. But usually you just see the limb, and the actual bone is in the limb?

A. Actually, when disarticulation takes place in the joint one can certainly see the end of the bone on inspection.

Q. The end of the bone. But usually the rest of the bone is inside the limb?

A. There are situations where actually the bone is crushed in the middle of the limb. And under those circumstances one can see part of the bone.


Q. Doctor, you testified earlier that sometimes parents want an intact fetus for blessing or burial. Have you ever had the parent express that desire where you had compressed the head of the fetus to complete the delivery?

A. Yes.

Q. Was anything done in those instances, doctor, to improve the appearance of the fetus’ head after decompression?

A. Yes.

Q. What was done?

A. The fetus was — just like a newborn — it was dressed and kind of had a little hat placed on it so that only the face was visible.

From Dr. Tiller’s facility in Wichita, Kansas: A father  and aborted child

Q. You have seen the fetus’ legs move before crushing the head, haven’t you?

A. I have seen that before compressing/decompressing the head.

Q. And that is while the head is lodged in the internal os?

A. Correct.

Q. The rest of the body is outside the cervix?

A. Correct.

Excerpts from direct examination of Dr. Mitchell Creinin:

Q. If that happens and you remove the dilators and you find you have more than two, two and a half centimeters, is that a bad outcome?

A. No. — I want — I judge the number of Dilapan based on making sure I get the minimum amount without putting in so many that I make her uncomfortable or get more dilation than I absolutely need, which I have found at times can cause patients to go into labor or deliver.


Q. What do you do to evacuate the contents of the uterus?

A.. . . If it is head first, it’s very, very, very difficult to try and grasp the head as the very first thing. So, with every D&E, the way I have been taught, the way I have always done it, the way I have always taught it is to try and grab a lower limb to convert the position to breech and then proceed with the evacuation. If it’s already breech, or if it’s transverse, that’s easier to grab a lower extremity. After grabbing the lower extremity, I am going to pull the pregnancy or pull whatever part I have grasped through the open cervix until there is resistance from the lower uterine segment and the internal os. My goal is to try and remove the fetus as intact as possible. The fewer passes, the safer it is for the woman. So, as I pull down, the uterus is going to tell me how far I can go just by the resistance I get. So when I meet resistance, I will continue to pull, and it’s the pressure of the fetus against the lower uterine segment that actually results in dismemberment of the fetus. And where that is going to happen on the fetus will vary from patient to patient.

22 to 24 weeks

Q. So, moving along, once you’ve located and grasped the lower extremities and turn the fetus if you need to, what do you do next?

A. Pull with the instrument that I am using to remove the fetus with the attempt to remove the fetus in as few passes as possible. So until I meet resistance from the lower uterine segment, I will continue to pull.

Q. Why —

A. And once I meet resistance, I will then, while holding on to the fetus — minimal rotation, but just kind of try and ease those parts through the cervix to allow whatever’s meeting resistance to try and slowly get through the cervix. The fetus will either continue to come or will begin to break apart. It will break apart wherever or whatever it is. It may be in the middle of the leg, it may be at the abdomen, it may be at the chest, just depending on the dilation and the size of the fetus, et cetera, just on that individual case.


Q. Does it ever happen that in grasping the fetus you’re able to remove the fetus intact or relatively intact all the way up to the calvarium?

A. Yes, on occasion.

Q. If that happens, would you do anything differently to complete the procedure?

A. If the fetus is intact up to the calvarium, there’s two things I could do. One would be to continue to pull, and usually it comes apart at the level of the neck, or I can insert, what I would I have done is insert scissors through that part of the head under direct visualization, inserted the 11-millimeter cannula that I used before and drain the brain tissue and then the head comes through the opening.

DAY FIVE: Tuesday, April 6, 2004

Excerpts from Government’s cross-examination of Dr. Mitchell Creinin:

Q. Now, you have encountered situations in which you are performing a D&E and the fetus is removed intact except that the head of the fetus gets stuck at the internal cervical os, correct?

A. Correct.

Q. When that has happened you have proceeded with the D&E procedure in one of three ways, correct?

A. If you can tell me the three ways I would be happy to.

Q. One method would be to pull on the baby so that the head breaks off from the rest of the body; is that right?

A. Yes.

Q. And then, you will go inside the uterus with the forceps and remove the head?

A. Correct.

Q. The next method is that you would use scissors to puncture the base of the skull?

A. Correct.

Q. And the, you will stick a suction cannula into the opening and drain the brain tissue, and then you will have the head come out.

A. Did you say “Drain the brain tissue”?

Q. Then, you will drain the brain tissue?

A. Yes.


20 weeks

Q. And the third method is that you take a crushing instrument, put that instrument inside the cervical os, crush the baby’s head, and pull the head through the cervix, correct?

A. That would be the third possible, although physically that would virtually never be the case. It would be one of the first two. Those are my three options, but it would be one of the first two that I could realistically do.


Q. Doctor, if a woman’s cervix was so dilated the fetus could be delivered in intact it would not be necessary to collapse the skull because the fetus could pass through the cervix, right?

A. Correct.

Q. But you would not allow the fetus to pass intact if the fetus were at or about 24 weeks in gestation, correct?

A. Correct.

Q. Because if the fetus were close to 24 weeks, and you were performing a transvaginal surgical abortion you would be concerned about delivering the fetus entirely intact because that might result in a live baby that may survive, correct?

A. You said I was performing an abortion, so since the objective of the abortion is to not have a live fetus, then that would be correct.

[The doctor states that he must crush the skull to keep the baby from being born alive. If he didn’t crush the skull, there would be a live birth. The only thing preventing a live birth is the interference of the doctor, who is killing the baby rather than delivering him]

22 to 24 weeks

Q. In your opinion, if you were performing a surgical abortion at 23 or 24 weeks and the cervix was so dilated that the head could pass without compression, you would do whatever you needed to do in order to make sure that the live baby was not delivered, wouldn’t you?

A. Whatever I needed, meaning whatever surgical procedures I needed to do as part of the procedure? Yes. Then, the answer would be: Yes.

Q. And one step you would take to avoid delivery of a live baby would to be to deliver or hold the fetus’ head on the internal side of the cervical os in order to collapse the skull; is that right?

A. Yes, because the objective of my procedure is to perform an abortion.

Q. And that would ensure that you did not deliver a live baby?

A. Correct.

Excerpts from Planned Parenthood’s re-direct examination of Dr. Creinin:

The witness: There have been situations, most commonly if there is a multiple pregnancy and the first one is removed by D&E, and then the second one because the cervix is very pliable at that point will come out completely intact.

The Court: Have you had that experience?

The Witness: Yes. In all of those situations, though regardless of whether the fetus comes out completely intact, intact up to the head, and I do a procedure on the base of the skull, or I did – or it comes out completely at the level of the head, and I disarticulate it, all of those have at times gone intact or relatively intact to the level of the umbilicus or greater and would violate the law.

Excerpts from Planned Parenthood’s direct examination of Dr. Carolyn Westhoff:

Q. And in what way does it – looking at the reduction in the risk of injuring the woman with the sharp, boney fragments, if you can explain in a little more detail how that happens?

A. Well, I need to explain that by contrasting it to a D&E that involves disarticulating the fetus. When the fetus is disarticulated, the skin and soft tissue covering the bones is disrupted, so sharp fragments of bone are exposed. And in the process of exposing them, grasping them, and removing them from the uterus there is the possibility that those bony fragments can lacerate at any level of the uterus and the cervix itself during extraction.


Q. Can the bony parts perforate the uterus in addition to lacerating it?

A. Yes, they can.

Q. Have you ever observed uterine perforation or laceration or cervical laceration as a result of instrument passes in a D&E with disarticulation?

A. Yes.

Q. Have you ever observed that happening as a result of sharp fetal parts?

A. Yes, I have.

Q. Is there an advantage to intact D&E in terms of not having retained tissue in the uterus after the procedure?

A. Yes, there is.

Q. What is the – what is that – can you explain that advantage in a little more detail?

A. Yes. When the fetus is removed in parts we attempt to account for all the parts on the operating table at the completion of the case. But it is entirely possible that small fragments of soft tissue can remain inside the uterus that we can’t be sure of. And even with, for instance, the sonographic scan, we may not be able to detect those, and that can lead to subsequent infection or hemorrhage on the part of the patient. We have, in fact, on our service had a case with a small fragment of retained skull leading to those very difficulties and requiring a second procedure subsequently to relieve those symptoms.


A. … In contrast, when I am retrieving a fetal skull that is floating fee in the uterine cavity, I must pass instruments in an attempt to grasp it inside the uterus. And that is a blind use of instruments, which has more potential for perforation.


Q. And once you start the procedure with instruments, do you complete it with instruments? Or might you bring out a presenting part with an instrument, and then switch to your fingers?

A. Yes. Each procedure proceeds very individually, and so each step of the procedure will depend really on just what happened in the one step before it. And for each step of the procedure I want to do what is going to be safest at that moment. So, yes, in fact, I have had cases where I may bring down and extract a leg with an instrument and disarticulate that leg, but because the position of the fetus comes down in the uterus during that maneuver, I may then be able to bring down the next leg with my fingers. And, in fact, the rest of the fetus will follow. So, similarly, I could start with my fingers and then in addition need to use instruments. So the combination of maneuvers I use are determined one at a time on an individual basis to minimize the total number of passes and maximize patient safety at each step of the way.

DAY SEVEN: Friday, April 9, 2004

Excerpts from Government’s direct examination of Dr. M. Leroy Sprang:

Q. . . . Now, could you tell us, please, why it is your opinion that intact D&X presents a risk of infection?

A. Several reasons. One, that normally in the vagina, just like on the skin in the mouth we have numerous bacteria present. But particularly in the vagina there are generally five to nine organisms that occur in very large numbers, like 10 to the ninth. And that is where they belong, and they don’t do any harm there. If you add a foreign body, twigs, stick seaweed, you are going a get a certain amount of trauma to the tissue which enhances the bacterial growth. And the way the laminaria work, their length is such that you are taking them from the outside of the vagina, placing them through the cervical canal. For them to be effective, they have to cover the entire length of the cervical canal with a portion of them remaining in the vagina so you can retrieve them, and the other portion going right up against the amniotic sac. If you don’t do that, you are not going to completely dilate the cervix the entire length, and it will lead to major problems. So what happens in the first day, a certain amount of trauma from the little sticks, as they dilate, even more trauma. But then the bacteria in the vagina work their way up those little sticks and are then at the level of the internal os and sitting right next to the amniotic sac. So that it is moving them from the normal position to an abnormal position, which increases the risk of infection.

Q. Does the length of time over which the dilation for intact D&X occurs, do you think that also increases the risk of infection?

A. It increases the risk because the length of time a foreign body is there, the greater the risk of bringing bacteria from the vagina to the cervix, either on the first application or on the subsequent applications of the laminaria. Sometimes the actual little sticks will break the amniotic sac, too, which significantly increases the risk of infection because then you have the bacteria going from the vagina to the uterine cavity. And I know that happens just obviously intuitively it happens, but the different authors, including Haskell, describes it in his paper that sometimes it breaks and sometimes it doesn’t. And the next day when they remove them and proceed to the next step of the procedure, if it has — his comment is “if it hasn’t already ruptured,” which obviously tells you sometimes it does, then he ruptures the membranes. So you have another significant risk of infection there, especially if it broke. You inserted them on day two, and you waited to day three to do the procedure, you’ve got a ruptured bag of waters with foreign bodies sitting in the cervix for potentially 24 hours.

Q. Doctor, you said something a few minutes ago about the amount of bacteria in the vagina. What I think you said was: “10 to the ninth”?

A. Yes. It is a mathematical term. And you add 10, and add nine zeros. That is the number.

Q. Doctor, I think you also mentioned the internal podalic version as presenting a risk to the patient. Why is it your opinion that that maneuver presents a risk to the patient?

A. Having done it as well, there is a strong mechanical force in taking the fetus and basically forcing it to do a summersault within the uterine cavity. These are not little things that you just kind of push gently, and it just turns. It doesn’t work that way. You are using a great deal of force in turning it upside-down that does trauma to the uterine cavity and could disrupt the placenta and cause bleeding. And rarely things like amniotic fluid embolus. Those are not common things that could happen, but rarely they could. And, in fact, in Williams’ textbook of obstetrics, which is one of the most premiere, respected obstetrical textbooks for teaching medical students, when I was a student was the primary textbook, it specifically says that there are very few, if any, indications to do internal podalic version other than the second twin. And in various editions he actually says it is potentially harmful. He says that it is the most common cause of traumatic uterine rupture.

Q. Doctor, if I can ask a few follow-up questions on those things. You mentioned disrupting — the potential for disrupting the placenta. What can that lead to?

A. Again, these are rare situations, but there is potential trauma if you disrupt the placenta at that point. There will be bleeding. And you are also — you have got vernix parts, white stuff on the fetus. There is not as much that early in pregnancy. You have still got some amniotic fluid around. When you disrupt the placenta, some of that material can get into the maternal circulation, which could cause an amniotic fluid embolism in the mother, which is a very serious situation.

Q. Is there any risk in that internal podalic version of causing maternal bleeding?

A. Because if you do separate the placenta, all the blood supply to the uterus goes to the surface of the placenta and stops there. If the placenta starts to separate, you, in fact, have an abruption of a placenta, and there would be internal hemorrhage.


Q. So you have never encountered a situation where the pregnancy had to be terminated before viability because of a maternal health condition?

A. I have not.


Q. Doctor, are you aware of any maternal health conditions that would require terminating pregnancy by the intact D&X method?

A. And after careful review and after sitting on both the ACOG — correction — AMA task force, we could not find any medical conditions that would require an intact D&X. The ACOG panel could not come up with any situations that would require an intact D&X. And, in fact, in reading each of the numerous declarations and depositions I haven’t seen any physician [here a hearsay objection was sustained]

Q. Doctor, in your practice have you seen a need for the use of the intact D&X [partial birth] method?

A. I have never seen a situation where an intact D&X method was necessary to be performed.


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PBA Trial Transcripts: New York

National Abortion Federation, et. al. v. Ashcroft
U.S. District Court, Southern District of New York
The Honorable Richard Conway Casey, Judge

Partial birth abortions are usually done in the late second trimester. All pictures of babies were taken at this time, so they all would be potential candidates for this type of abortion

DAY TWO: Tuesday, March 30, 2004 (DAY ONE, opening statements only)

Excerpts from NAF’s re-direct examination of Dr. Amos Grunebaum:

THE COURT. Doctor, you mentioned earlier today that you believe in full disclosure to your patients as to the procedures and the various possibilities that are available.


THE COURT. And that you spell out for the woman just what is entailed in a D&E that involves dismemberment, correct.


THE COURT. You also spell out that if you are doing an intact D&E or D&X or partial-birth abortion, whichever term is used, that that entailed a partial delivery, and then the procedure you described of inserting the scissors in the base of the skull and using a suction device to remove the brain.


THE COURT. And that some of them desire that because after the procedure if they want to see or hold the dead fetus, is that correct?


Pictures: From Dr. Tiller’s abortion facility in Kansas, the mother and father of an aborted baby take pictures with their dead child.

THE COURT. I believe you mentioned also take pictures, is that correct?

THE WITNESS. Yes. That is part of our common policy — it changed about ten years ago — that we take pictures.

THE COURT. This is part of the grieving process?

THE WITNESS. Absolutely. We have been told by grieving counselors to take pictures of all dead fetuses and babies — specifically babies, but also fetuses — so there is a memory of the baby by the mother.

DAY THREE: Wednesday, March 31, 2004

Excerpts from NAF’s direct examination of Dr. Timothy Johnson:

Q. Do you have an opinion, Dr. Johnson, as to which of the two D&E variations, the intact or the dismemberment variation, may best facilitate the extraction of the fetal skull during an abortion procedure?

A. I think that the intact procedure is actually developed in part to deal with the problem of the fetal skull. When one does a D&E, technically one of the challenges is to remove the fetal skull, partly because it is relatively large, partly because it is relatively calcified, and it is difficult to grasp on occasion. So one of the common technical challenges of a dismemberment D&E is what is called a free-floating head or a head that has become disattached and needs to be removed. This can lead to more passages of instruments through the cervix. And technically it is difficult to grasp the head; it is round, it slips out of the instruments that we generally use. Either those instruments or the head can be extruded outside the uterus and cause perforation.


Q. Did you make any observation of the way the physician performing that intact D&E effected the incision into the skull?

A. In the situations that I have observed, they either — actually, the procedures that I have observed, they all used a crushing instrument to deliver the head, and they did it under direct vision.

24 week-old unborn baby

Q. Thank you, Doctor.

THE COURT: Can you explain to me what that means.

THE WITNESS: What they did was they delivered the fetus intact until the head was still trapped behind the cervix, and then they reached up and crushed the head in order to deliver it through the cervix.

THE COURT: What did they utilize to crush the head?

THE WITNESS: An instrument, a large pair of forceps that have a round, serrated edge at the end of it, so that they were able to bring them together and crush the head between the ends of the instrument.

THE COURT: Like the cracker they use to crack a lobster shell, serrated edge?


THE COURT: Describe it for me.

THE WITNESS: It would be like the end of tongs that are combined that you use to pick up salad. So they would be articulated in the center and you could move one end, and there would be a branch at the center. The instruments are thick enough and heavy enough that you can actually grasp and crush with those instruments as if you were picking up salad or picking up anything with —

THE COURT: Except here you are crushing the head of a baby.

23 weeks



THE COURT: Was the body outside the woman’s body to an extent?

THE WITNESS: Some of it. It can be or not. Some of it can be or — it depends on where the cervix is. It depends on where the uterus is. It depends how long the baby is. It depends how long the mother’s vagina is.

THE COURT: At some times that you observed it was?

THE WITNESS: Right. And sometimes during the procedure the cervix can actually be brought down so that — the cervix and the uterus can be moved up and down relative to the opening of the vagina.

THE COURT: An affidavit I saw earlier said sometimes, I take it, the fetus is alive until they crush the skull?

THE WITNESS: That’s correct, yes, sir.

22 to 24 week-old unborn baby

THE COURT: In one affidavit I saw attached earlier in this proceeding, were the fingers of the baby opening and closing?

THE WITNESS: It would depend where the hands were and whether or not you could see them.

THE COURT: Were they in some instances?

THE WITNESS: Not that I remember. I don’t think I have ever looked at the hands.

hands at 20 weeks

THE COURT: Were the feet moving?

THE WITNESS: Feet could be moving, yes.



THE COURT: If you are all finished let me just ask you a couple questions, Dr. Johnson. I heard you talk a lot today about dismemberment D&E procedure, second trimester; does the fetus feel pain?

THE WITNESS: I guess I —

THE COURT: There are studies, I’m told, that says they do. Is that correct?

THE WITNESS: I don’t know. I don’t know of any — I can’t answer your question. I don’t know of any scientific evidence one way or the other.

THE COURT: Have you heard that there are studies saying so?

THE WITNESS: I’m not aware of any. THE COURT: You never heard of any?

THE WITNESS: I’m aware of fetal behavioral studies that have looked at fetal responses to noxious stimuli.

THE COURT: Does it ever cross your mind when you are doing a dismemberment?

THE WITNESS: I guess whenever I —

THE COURT: Simple question, Doctor. Does it cross your mind?

THE WITNESS: Does the fetus having pain cross your mind?



THE COURT: Never crossed your mind.


THE COURT: When you have done D&Es or when you have done abortions, do you tell the woman various options that are available to her?

THE WITNESS: Yes, sir.

THE COURT: And do you explain what is involved like in D&E, the dismemberment variation? Do you tell her that?

THE WITNESS: We would describe the procedure, yes.

20 week-old unborn baby

THE COURT: So you tell her the arms and legs are pulled off. I mean, that’s what I want to know, do you tell her?

THE WITNESS: We tell her the baby, the fetus is dismembered as part of the procedure, yes.

THE COURT: You are going to remove parts of her baby.


THE COURT: Are you ever asked, Does it hurt?

THE WITNESS: Are we ever asked by the patient?


THE WITNESS: I don’t ever remember being asked.

THE COURT: And although you have never done an intact D&E, do you know whether or not the incision of the scissors in the base of the skull of the baby, whether that hurts?

THE WITNESS: Well, I guess my response would be I think that the baby feels it but I’m not sure how pain registers on the brain at that gestational age. I’m not sure how a fetus at 20 weeks or 22 weeks processes and understands pain.

THE COURT: You have never done one of these procedures but did you ever ask what — you say you know about it clinically, did you ever ask one of those who perform them whether it hurts the fetus?


THE COURT: When you describe the possibilities available to a woman do you describe in detail what the intact D&E or the partial birth abortion involves?

THE WITNESS: Since I don’t do that procedure I wouldn’t have described it.

THE COURT: Did you ever participate with another doctor describing it to a woman considering such an abortion?

THE WITNESS: Yes. And the description would be, I would think, descriptive of what was going to be, what was going to happen; the description.

20 week-old unborn baby

THE COURT: Including sucking the brain out of the skull?

THE WITNESS: I don’t think we would use those terms. I think we would probably use a term like decompression of the skull or reducing the contents of the skull.

THE COURT: Make it nice and palatable so that they wouldn’t understand what it’s all about?

THE WITNESS: No. I think we want them to understand what it’s all about but it’s — I think it’s — I guess I would say that whenever we describe medical procedures we try to do it in a way that’s not offensive or gruesome or overly graphic for patients.

THE COURT: Can they fully comprehend unless you do? Not all of these mothers are Rhodes scholars or highly educated, are they?

THE WITNESS: No, that’s true. But I’m also not exactly sure what using terminology like sucking the brains out would —

THE COURT: That’s what happens, doesn’t it?

THE WITNESS: Well, in some situations that might happen. There are different ways that an after-coming head could be dealt with but that is one way of describing it.

THE COURT: Isn’t that what actually happens? You do use a suction device, right?

THE WITNESS: Well, there are physicians who do that procedure who use a suction device to evacuate the intercranial contents; yes.

Excerpts from NAF’s direct examination of Dr. Cassing Hammond:

THE COURT: Do they give full disclosure as to the various procedures available and what is entailed, such as the dismemberment, in some forms of D&E?

THE WITNESS: If they do not and then the patient is referred to me for D&E, we do tell the patient what’s entailed in a D&E.

THE COURT: In simple, clear English?

THE WITNESS: I think so, your Honor, yes. Now, there are variations, depending on the patient’s own kind of psychological situation that we clearly take into consideration, but we actually have a large number of patients who look at us and say, let me get this straight. What you will be doing is dismembering the fetus. And we say, yes, that’s exactly what we are doing.

THE COURT: Do you tell them what happens when they do an intact D&E?

THE WITNESS: If the patient —

THE COURT: The brain is sucked out?

THE WITNESS: Well I don’t — as a point of fact, your Honor, I don’t usually do the suction part. I do compress the calvarium [head] and I do some other procedures. I don’t actually do suction so I don’t explain that part.

THE COURT: You don’t explain that to them?

THE WITNESS: Well I explain the method.

THE COURT: You explain what a compression of the calvarium is?

THE WITNESS: Yes, sir; that I do explain.

THE COURT: That that’s crushing the skull?

THE WITNESS: I explain that, yes.

DAY FOUR: Thursday, April 1, 2004.

Excerpts from direct examination of Dr. Cassing Hammond:

A. So when we do this procedure, I’ve got the patient asleep, I’ve got a device that I can hold on to the top of the cervix – So I can lift the cervix, look at the back of the neck, and then a scissors, which we have on our operating table, and make an incision in the back of the fetal neck. That whole time I can see what I am doing. And in the very rare cases where I can’t see what I am doing, I can usually put my finger, in fact always put my finger, on top of my scissors, which are against the back of the fetal neck, and I have complete control and feeling the entire time I do this. In those cases, feeling is just as good as seeing. I know exactly where the scissors are. They are not anywhere near the patient’s cervix or uterus. It is a completely visible, completely palpable in the sense of feeling operation. If you contrast that with a D&E that is by dismemberment -RGS the last part of the procedure usually involves trying to get the head or calvarium out. What I am having to do in one of those procedures is to try to feel with an instrument up inside the uterus with this skull that is bobbing at the end of my instrument, and I have to get around it.

22 to 24 weeks

Q. Dr. Hammond, do you always use scissors or other instruments to breech the fetal head or the fetal neck in the course of doing an intact D&E of this kind?

A. Not always. It depends on the fetus. If you’ve got a fetus that is earlier in gestation, the skull, or calvarium, it is soft. It isn’t as firmly formed. So in those cases you can often do this just with your finger, you can do this digitally. In some cases the scissors probably after 20 weeks I am more likely to use them. We actually have a number of instruments on the table that I can use, whatever seems like it is going to be most effective.


Excerpts from cross examination of Dr. Hammond:

Q. [Y]ou told the Judge that you explained to your patients what compressing the head means, correct?

A. Yes, we do.

Q. But in fact, you don’t explain to every patient that there is a possibility that you might remove the fetus intact up to the point where the head is stuck in the internal cervical os and you perform a procedure to compress the skull or puncture the skull, do you, Doctor?

A. Not to every patient, no.

Q. You only do it if the patient asks you, isn’t that right, Doctor?

A. In some cases, yes.


Q. And in fact, Dr. Hammond, no patient has ever asked you, has she?

A. I don’t know. Somebody might have. I don’t have an independent recollection at this point.

Q. Directing your attention to page 233, line 4 of your deposition in this case:

“Q has a patient ever asked that?

“A not to my knowledge, no.”


Q. In fact, the closest you have ever come to having this kind of conversation with any of your patients is when they’ve come in and they’ve said to you, Doctor, is the procedure similar to what we’ve been hearing about in the media as being encompassed by the partial-birth abortion ban act of 2003 or a similar statute? Isn’t that right, Doctor?

A. That is true.


A. So, if they choose to pursue this in any way or bring it up we will have this conversation with our patients.

THE COURT: With the technical language that you used here?

A. No. No. No. No. With patients I make the most, the best attempt I can not to use words like calvarium and to replace it with skull and so forth, but we don’t — we don’t sugar coat it too much, your Honor.

THE COURT: You use reduction rather than crushing the skull.

A. I will say crush, clamp and extract and I use those very words because those are what patients understand. We want them to know exactly what the procedure is going to entail and we actually try not to sugar coat this for them because they’re the ones who are going to undergo the procedure.

THE COURT: But only if they ask.

THE WITNESS: No. Occasionally a patient clearly wants more information and if we sense that we try to give what’s appropriate to the patient. Keep in mind, a lot of my patients are emotionally quite fragile so we don’t have to bring up the terms — we don’t have to go into gory detail about everything that we are doing. But does that mean that we don’t share with them, that this involves dismemberment or separation of parts of the fetus or taking the fetus apart? We do. And we use that term. We say we take the fetus apart. We say, it is coming out in pieces and we make sure that that’s clear with the patients. And they understand it. And given the circumstances that they confront and their alternatives, the majority of them want us to do the procedure.

THE COURT: Do you tell them whether or not it hurts the baby?

THE WITNESS: We have that conversation quite a bit with patients, your Honor.

THE COURT: And what’s your answer?

THE WITNESS: We say several things to the patient, your Honor. First of all, we tell the patient that it’s controversial what exactly — what the fetus experiences of pain at various gestational ages. We share with them the fact that even for normally developed fetuses people debate the beginning of sensation of the fetus.(Studies show that a baby at the latter part of the second trimester feels pain. See also Does the Baby Feel Pain?), They debate at what gestational age the fetus is able to interpret pain as we think about it. We share with the patients that even though there are speculations about these things among normal fetuses, when you start dealing with the kind of circumstances that we confront where a baby may not have its forebrain or may not have its brain or may have it which is in essence a completely disrupted and in some cases spinal cord, that there is no data that lead us to know what the baby feels.

THE COURT: How about when there is no anomaly instead of all these exceptions, how about when there is no anomaly.

18 week-old unborn baby

THE WITNESS: We say that there is a possibility and one of the things that we are doing with most of these patients after 16 to 18 weeks is they’re all under IV anesthesia, not just conscious sedation where it’s some IV administered medications that likely don’t reach the fetus in high concentrations but — and not an inhalational anesthesia where it less would reach the fetus by IV deeply sedating anesthetic which may confer some pain control to the fetus. We also share with them their alternatives and we share with them the fact that we really don’t know what the fetus feels and some of the other things that they can do for pain. For example, frankly, your Honor, I think we sugar coat some of the other option and we share this with patients. They might ask, well can you give intracardiac injections that we discussed or could you, could we do an induction termination and avoid this? But the honest truth is, how do we know that taking this huge instrument and poking it into the baby’s heart and injecting a poison hurts any less than my rapidly cutting the umbilical cord or transecting the spinal cord with my scissors? Or how do we know that poisoning the environment that the baby is in with digoxin is any more painful or less painful than my doing a very rapid D&E. And if the baby delivers and is living in the sense of a medical induction, we’re assuming because nature takes it course that it’s not painful. But if the baby slowly tires and stops breathing and dies by asphyxiation it is reasonable to assume that even for a normally born fetus a normally formed fetus that this may also involve pain. So what we are really asking the patients that I see is, which do you think is going to hurt worse for your fetus?


This 19 week old baby could die various ways in an abortion- and all of them could be painful

THE COURT: Excuse me. You don’t feel any obligation whatsoever to protect the life of the fetus?

THE WITNESS: We are seeing —

THE COURT: I am asking you something.

THE WITNESS: With many of my patients, yes, particularly post-viability, your Honor.

THE COURT: You don’t find any dual responsibility, your obligation is only to the woman?

THE WITNESS: In the circumstances in which I am doing terminations, that is correct. …..

Q. What do you do under those circumstances when you have delivered a fetus that is alive in the course of an induction termination?

A. The very first thing we do is to assess the viability of the fetus. By that, we perform a very rapid assessment of whether we think this fetus is of the gestational age where resuscitation is appropriate. If there is any question of in our minds at apprentice, we have a full — excuse me — a 24-hour in-house [neonatologist] whom we contact who does an immediate assessment and then would perform whatever resuscitative measures are necessary on behalf of the baby -PLT. Assuming, since we usually have very, very good data about gestational age and know that these are nonviable fetuses, assuming that that is not the case, we would then provide comfort and care to the baby. By that, we would place the baby under a radiant warmer to keep the baby warm. We might wrap the baby. Then depending on what the mother wishes to do, allow the mother to hold the baby at this point and simply [wait] for nature to take its course.


Q. You have seen a fetus born alive after induction abortion in the second trimester, haven’t you?

A. I’m sorry, can I just — you said after induction abortion in the second trimester? Am I correct?

Q. Yes. Doctor.

A. Yes, I have.

Q. And you have observed signs of life in the fetus, didn’t you?

A. That is correct.

Q. You have seen spontaneous respiratory activity, right?

A. Yes.

Q. Heartbeat?

A. Yes.

Q. Spontaneous movements?

A. Yes.

Q. And you have seen these signs at 24 weeks, right?

A. That is correct. Q. 23 weeks?

A. Yes. Q. 22 weeks?

A. Yes.

Q. Doctor, don’t you make an effort when you perform D&E by dismemberment to count the fetal parts after the procedure is over?

A. No. We look for sentinel parts. But we don’t count every single part that we’ve extracted after one of these procedures, no.

second trimester sonogram

Q. Well you make an effort to count the four extremities and the head, don’t you?

A. That we do, yes. …..

Q. You could use a combination of your hand and your instrument; not really grasping but helping and assisting the delivery of the infant to the point its head gets stuck, right?

A. That is correct.

Q. Sometimes you place an instrument in the uterus, grasp a lower extremity, deliver it into the vagina, take the instrument off, grasp the lower extremity with your right hand, feel with the fingers of your left hand beyond the external os to the opposing extremity, deliver that extremity to get a better grasp on the fetus and then continue the delivery, correct?

A. That is correct.

DAY FIVE: Friday, April 2, 2004.

Excerpts from direct examination of Dr. Carolyn Westhoff:

THE COURT: Doctor, that isn’t my question. Do you discuss dismemberment? Do you tell them about ripping or tearing a limb off the fetus?

THE WITNESS: I may very often discuss that I remove the fetus in pieces but that is not necessarily a uniform part of the discussion.

THE COURT: Well do you do it most of the time? I mean, do they really understand what are you doing when you tell them all these clinical terms?

THE WITNESS: I try to use everyday language and not use terms that are going to be confusing to the patient. We try to —

THE COURT: Do any of them ask you whether or not the fetus experiences pain when that limb is torn off?

20 to 22 weeks

THE WITNESS: I do have patient who ask about fetal pain during the procedure, yes.

THE COURT: And what do you tell them?

THE WITNESS: I, first of all, assess their feelings about this, but they of course even notwithstanding the abortion decision, would generally tell me they would like to avoid the fetus feeling pain. I explain to them that in conjunction with our anesthesiologists that the medication that we give to our patients during the procedure will cross the placenta so the fetus will have some of the same medications that the mother has.


THE WITNESS: Yes, that’s right.

THE COURT: What do you tell them, does the fetus feel pain or not when they ask?

THE WITNESS: What I tell them is that the subject of the fetal pain and whether a fetus can appreciate pain is a subject of some research and controversy and that I don’t know to what extent the fetus can feel pain but that its —

THE COURT: Do you tell them it feels some pain?

THE WITNESS: I do know that when we do, for instance an amniocentesis and put a needle through the abdomen into the amniotic cavity that the fetus withdraws so I certainly know based on my experience that the fetus with withdraw in response it a painful stimulus.


THE COURT: Don’t you make it simple for them and say yeah, they feel it?

THE WITNESS: I am not confident what the fetus feels with the anesthesia that we use and I don’t want to shy away from the possibility the fetus feels pain but I do not believe it’s fully determined what the fetus feels during this procedure.

THE COURT: Do you care?

THE WITNESS: Certainly.


THE COURT: Have you ever lacerated the cervix?

THE WITNESS: Yes. I have had patients experience cervical laceration under my care during D&E.


22 to 24 week-old unborn baby

THE COURT: I want to know whether that woman knows that you are going to take a pair of scissors and insert them into the base of the skull of her baby, of her fetus. Do you tell her?

THE WITNESS: I do not usually tell patients specific details of the operative approach. I’m completely —

THE COURT: Do you tell her that you are going to then, ultimately, suck the brain out of the skull?

THE WITNESS: In all of our D&Es the head is collapsed or crushed and the brains are definitely out of the skull but those are —

THE COURT: Do you tell them that?

THE WITNESS: Those are details that would be distressing to my patients and would not — information about that is not directly relevant to their safety.

THE COURT: Don’t — whether it’s relative to their safety or not don’t you think it’s since they’re giving authorization to you to do this act that they should know precisely what you’re going to do?

THE WITNESS: That’s actually not the practice I have of discussing surgical cases with patients.

THE COURT: I didn’t ask you that. I said don’t you think they ought to know?

THE WITNESS: No, sir, I don’t.


Q. Do you tell a woman who is considering a D&E that the fetal arms, legs, extremities may be dismembered is in the course of a dismemberment variation D&E, Dr. Westhoff?

week 20

A. I tell patients that we will remove all of the fetus and the uterus and membrane, the placenta and membranes from the uterus as safely as possible and that that proceeds somewhat differently for all patients.

Q. How often will it be necessary to collapse the fetal skull during D&E whether the D&E proceeds by a dismemberment or more relatively intact, Doctor?

A. For the vast majority of D&Es [it will] be necessary it either crush or collapse the fetal skull.

THE COURT: Do you tell the woman that? Do you use the word crush?

THE WITNESS: Your Honor, I do not.

THE COURT: I didn’t think so.


Q. Is there a difference, Dr. Westhoff, between the way a head, fetal head may be collapsed in a D&E by dismemberment and the way it may be collapsed during a D&E performed by the intact [method]?

A. Yes. The approaches are different. In the dismemberment D&E the fetal head will be up inside the uterus. It is necessary to insert our forceps, open them as wide as possible to try to capture the head within the opening of the forceps and then crush the head using external force applied against the head. With an intact D&E, when we have put a hole into the base of the skull we can generally do that under direct visualization because the base of the skull is, thanks to traction, held right in the cervical opening and so it is, in my experience and my opinion, less risky to put a hole in the base of the skull. Because the contents of the skull are liquid the skull contents may often drain out spontaneously as soon as there is a hole in the skull. In some cases it is necessary to use [suctioning].

hands at 24 weeks


Q. What have women told you as to reasons why they wish to terminate pregnancies after the first trimester?

A. There are several categories of. One is personal problems such as relationship problems and social problems. A much larger group in our practice is women who HIV abnormalities in the pregnancy itself. These may be chromosomal abnormalities that have been diagnosed or anatomical abnormalities of the fetus, and a smaller group are problems with maternal health. That is a smaller category than the other two.


Q. How do the contractions during induction [abortion] during the second trimester, Dr. Westhoff, compare to those typically experienced at term during labor?

A. The uterine contractions during an induction abortion are similar to the contractions that women experience during childbirth where labor is also induced using similar med situations. I believe based on my experience that contractions that are induced with medication are more painful than contractions that occur spontaneously.

THE COURT: How could you know that without feeling it yourself?

THE WITNESS: Your Honor, if it is appropriate, I have been through childbirth and have had an induction myself. But I have taken care of many, several thousand, patients in childbirth. Based on my observation of spontaneous labor and induced later, I have a very definite opinion that induced labor is more painful for my patients.


Q. Dr. Westhoff, can you state whether in your opinion the intact variation of D&E facilitates a grieving by the woman or parents with respect to the D&E abortion?

A. Yes. We have taken care of several patients who have availed themselves of the opportunity to hold the fetus after a termination done by the intact D&E meld. Because it is the back of the skull that collapsed, since this is not disfiguring, and the face, for instance, is intact. Several of my patients have wished to hold the fetus after the procedure and have expressed gratitude that they were able to do so.

THE COURT: Would any of those patients that have expressed that desire to assist them in grieving, and certainly grieving is a serious thing, in any of those instances did you tell those mothers that what they authorized you to do was to make an incision at the base of the skull of their baby and suck its brain out?

THE WITNESS: Your Honor, I definitely —

THE COURT: It is a simple question, Doctor. Did you in any of those cases?

THE WITNESS: I definitely in those cases discussed collapsing the skull. I definitely don’t recall exactly what words I used to communicate it.

22 to 24 weeks

THE COURT: But did you tell them that you would be sucking the brain out of the same baby that they desired to hold, for the grieving process? Did you tell them that is what you did?

THE WITNESS: I definitely tell them I collapsed skull.

THE COURT: How about [sucking] the brain out, did you tell them that before they wanted to hold that baby so they would know that is what they had authorized you to do?

THE WITNESS: They know that the head is empty. I do not use the term “sucking the brain out” with my patients. I don’t think that helps the grieving process.


Q. Dr. Westhoff, you mentioned a moment ago that the face may remain even though the head is collapsed and the intracranial content suctioned out. Can you explain how that occurs?

A. Yes. The fetus has a tiny face and a relatively large head. The bones of the back of the skull are very soft. When we make an incision in the base of the skull, we don’t disturb any of the skin covering the entire skull, we don’t disturb the scalp. So the top and back of the head itself just collapses and looks a little wrinkly and collapsed, but the facial structures are not disturbed at all by that procedure.

Q. Do you or the hospital take any other steps to help facilitate the grieving process in circumstances where parents may indicate they desire it?

A. Yes, sir. We have clergy available to meet with our patients during their pre-op visits or on the day of their surgery. We have social workers available. And we also have a variety of referrals available. We have arrangements to permit burial of the fetus if the patients want. Because the hospital also has small coffins present, both for stillbirths or for fetuses after a termination, and in the case of our D&E patients we actually have little hats available so we could in fact cover the back of the head where the incision had been made.


Q. When you perform an intact D&E, Dr. Westhoff, is the fetus living when you commence vaginal delivery?

A. Although I don’t always check for it, I believe there is usually a heartbeat and that the fetus is living.


Q. And at the time you either cut the umbilical cord or collapse the skull, is the fetus living?

A. Yes.

Q. Dr. Westhoff, do you make it a practice either to effect fetal demise by using potassium chloride, as we have heard about, or injecting a toxin into the amniotic sac prior to the time that you effect a surgical evacuation of the uterus?

A. No, Mr. Hut, I usually do not do so

Q. Why not?

A. The main reason that it is an additional procedure that does not offer any benefit to the woman that I am taking care of. The procedure itself is not trivial, it can be difficult to accomplish, can fail, and has some risks. Those are the main reasons I do not use this procedure.

THE COURT: As you said this morning, there is some dispute as to fetal pain. If you had done that, there wouldn’t be any pain, would there? To the fetus I’m talking about.

THE WITNESS: I don’t think we know whether intracardiac injection would cause fetal pain, your Honor.


THE COURT: I take it, then, the question of the infliction of pain to the fetus is not on the top of your list of concerns when doing your work?

THE WITNESS: While I wish to avoid fetal pain, I have no desire to inflict fetal pain- top of my list is the safety of the woman who is undergoing the procedure.

THE COURT: In fact, do you consider fetal pain at all?

THE WITNESS: Yes, your Honor. As I previously stated, I think one of the benefits of using general anesthesia with my patients, since I don’t know if there is fetal pain, is that the general anesthesia crosses the placenta and does circulate in the fetal circulation and may have a physiologic effect in the fetus, and I think that is a benefit.

THE COURT: That is the limit of your concern? OK. Next question.

DAY SIX: Monday, April 5, 2004

Excerpts from cross- examination of Dr. Carolyn Westhoff:

Q. Then assuming that you have sufficient dilation you will take two of your fingers, reach into the woman and attempt to grasp a fetal part and bring it down into the cervix, right?

A. Yes.

Q. And you like to grab the fetus’ foot if you can, right?

A. Yes.

Q. And if you can you bring down the fetus’ foot and then you break the amniotic sac with your forceps, right?

A. Yes.

Q. Then, because the fetus is wet you take a piece of gauze to help improve your grasp and you bring one foot down and if possible sweep the second foot through the cervix, right?

A. Yes.

Q. Then with gentle traction on both of the feet you pull the fetus through the cervix, right?

A. Yes.


18 weeks

Q. Well, you pass a finger up through the cervix to find the fetus’ arms, right?

A. Yes.

Q. And generally they’re extending into the uterus at that point, aren’t they?

A. Yes.

Q. And so you will move your finger along the shoulder to sweep the arm across the fetus’ chest, right?

A. I may do that, yes.

Q. And by doing that you sweep the arm down and around and the arm comes through the cervix, right?

A. Yes.

Q. And then you repeat that maneuver on the opposite side of the fetus’ body to sweep down the other arm, right?

A. Yes.

Q. And at that point the fetus’ body is below the cervix and the neck is in the cervix with the head still in the uterus, right?

A. Yes.

Q. And it’s at that point that you take a scissors and insert it into the woman and place an incision in the base of the fetus’ skull, right?

A. Yes.

Q. Now the contents of the fetus’ skull, just like the contents of my skull and your skull is liquid, right?

A. That’s right.

23 weeks

Q. And sometimes after you’ve made the incision the fetus’ brain will drain out on its own, right?

A. That’s right.

Q. Other times you must insert a suction tube to drain the skull, right?

A. That’s right.

Q. And then the skull will collapse immediately after its liquid contents have been removed and the head will pass easily through the dilated cervix, right?

A. That’s right.

Excerpts from direct examination of Dr. Marilynn Fredriksen:

Q. You mentioned that you perform a procedure known as dilation and evacuation, or D&E, is that correct?

A. Yes.

Q. Approximately how many D&E procedures have you performed throughout your career?

A. I really don’t know, but probably thousands.

THE COURT: Thousands, plural?

THE WITNESS: Thousands, plural.

THE COURT: Have you ever perforated a uterus or done any of these things?


THE COURT: Were you ever sued for malpractice?


THE COURT: Involving an abortion?



THE COURT: Just one – did in the malpractice suit against you, Doctor, did the plaintiff recover?


THE COURT: Was there settlement?

THE WITNESS: No. We won.


THE COURT: Doctor, do you make full disclosure to all your patients before you embark on a particular procedure?

THE WITNESS: I educate them in the process of an informed consent as to the risks of pregnancy termination and the relative difference of risks of the different procedures.

THE COURT: Well, when you tell them about pain and such that you were talking about before, do you also tell them about that you do the D&E, it involves dismemberment? Do you tell them that you tear the limbs off the fetus?

THE WITNESS: I don’t use that term, as I say it.

THE COURT: Do you use simple English words so they know what you are doing —


THE COURT: — and what they’re authorizing?


THE COURT: Well, how do you tell them that you are going to take the limb off?

THE WITNESS: I tell them that in the process.

THE COURT: Do you use “disarticulation”?


THE COURT: What word do you use?

THE WITNESS: I tell them that in the process of the termination we will attempt to get the fetus out as intact as possible but that is not a guarantee and sometimes a fetus comes out in parts.

THE COURT: Do you discuss with them whether or not there is any fetal pain?

THE WITNESS: I think that’s a concern. My approach has been to say that the cord usually comes down and severing of the cord means that the fetus sanguinates.

THE COURT: Do you think that a normal woman patient understands those words?

THE WITNESS: Well, bleed to death is the analogy on more lay terms.

THE COURT: Well, do you use sanguinate or do you say bleed to death?

THE WITNESS: I use the term that the fetus loses all of its blood when the cord is severed.

THE COURT: Do you tell them whether or not the fetus experiences pain?

THE WITNESS: Since I don’t know that I do say that most of the time the fetus may not experience anything. Because once the cord has been severed there is no blood supply to the central nervous system and therefore the fetus, for all intrinsic, purposes dies. Whether or not that is analogous to the end of the presence or absence of a fetal heartbeat I don’t know, but there is no fetus that has central nervous system activity once they have lost all oxygenation.

THE COURT: Do you use all of those words, “oxygenation,” and things like that? Or do you tell them in simple words?

THE WITNESS: I tell them in simple, understandable words, depending upon the particular patient that I am dealing with.

THE COURT: Oh, depending on the patient the words vary?


THE COURT: And when you do an intact D&E do you tell them that you are going to insert scissors in the base of the skull?


16 weeks: A younger candidate for a PBA

THE COURT: You don’t tell them that.

THE WITNESS: No, because I don’t always do that, number one.

THE COURT: You do that sometimes?


THE COURT: When you do, do you tell them?

THE WITNESS: Not ahead of time because I can’t predict who I’m going to do that with and who I can’t do that with.

THE COURT: Do you tell them you may be doing that?


THE COURT: Do you tell them whether or not it hurts?

THE WITNESS: Who am I — what am I —

THE COURT: The patient.

THE WITNESS: The patient?

THE COURT: The woman, the mother.

THE WITNESS: It doesn’t hurt her, no.

THE COURT: Do you tell whether or not it will hurt the fetus?

THE WITNESS: The intent of an [abortion is] that the fetus will die during the process of uterine evacuation.

THE COURT: Ma’am, I didn’t ask you that. Very simply I asked you whether or not do you tell the mother that one of the ways she may do this is that you will deliver the baby partially and then insert a pair of scissors in the base of the fetus’ skull?

THE WITNESS: I have not done that.

THE COURT: Do you ever tell them that after that is done you are going to suction or suck the brain out of the skull?

THE WITNESS: I don’t use suction.

THE COURT: Then how do you remove the brain from the skull?

THE WITNESS: I use my finger to disrupt the central nervous system, thereby the skull collapses and I can easily deliver the remainder of the fetus through the cervix.

THE COURT: Do you tell them that you are going to collapse the skull?


THE COURT: The mother?


THE COURT: Do you tell them whether or not that hurts the fetus?

THE WITNESS: I have never talked to a fetus about whether or not they experience pain.

THE COURT: I didn’t say that, Doctor. Do you tell the mother whether or not it hurts the fetus?

THE WITNESS: In a discussion of pain for the fetus it usually comes up in the context of how the fetus will die. I make an analogy between what we as human beings fear the most — a long protracted painful death.

THE COURT: Doctor, I didn’t ask you —

THE WITNESS: Excuse me, that’s what I tell my patients.

THE COURT: But I’m asking you the question.

THE WITNESS: I’m sorry.

THE COURT: And I’m asking you whether or not you tell them that.

THE WITNESS: I feel that fetus dies quickly and it’s over quickly. And I think from a standpoint of a human being our desire is that we have a quick death rather than a long protracted death —

THE COURT: That’s very interesting, Doctor but it’s not what I asked you. I asked you whether or not you tell them the fetus feels pain.

THE WITNESS: I don’t believe the fetus does feel pain at the gestational ages that we do, but I have no evidence to say one way or the other so I can’t answer that question.

THE COURT: Have you ever read any studies about fetal pain?

THE WITNESS: Fetal pain is best explored in the premature context of delivering premature babies beyond 24 or up to 28, at 28, 30 weeks. In those studies it’s much, much further in gestation than where I am dealing with the fetus.

THE COURT: Are you aware of any studies done on fetal pain in a shorter gestational period?


THE COURT: Next question.

DAY SEVEN: Tuesday, April 6, 2004.

Excerpts from direct examination of Dr. Marilynn Frederiksen: Q. Is it always necessary to make an incision at the base of the fetal head to facilitate delivery in an intact D&E?

A. No, it is not.

Q. Why not?

A. In certain circumstances it is easier to just use grasping forceps and deliver the head through the cervix.

Q. Dr. Frederiksen —

THE COURT: Excuse me. Grasping forceps, does that mean you crush the skull?

THE WITNESS: You compress the skull, yes.

16 week-old unborn baby

THE COURT: You crush it, right?


THE COURT: So you use your finger to get the contents of the skull out rather than sucking the contents of the skull out, is that correct?



Q. Have you ever injected KCl or digoxin into the fetal heart before beginning a pregnancy termination in the second trimester?

A. Yes, I have. …..

Q. Can a physician affect fetal demise by injecting KCl or digoxin anywhere other than in the fetal heart?

A. You can’t guarantee the process.

Q. Why not?

A. I have been unable in certain cases to actually put a needle into the heart for technical reasons or because the mother is obese or the fetus is in a particularly difficult position to gain access to the heart. When you put these agents not in the heart or near the heart, you can’t guarantee fetal death.

Q. Has it ever happened that you have attempted to inject a feticidal agent into the fetal heart but failed to do so and demise failed to occur?

A. Yes.

Q. Can you describe that for us, please.

A. Technically, we couldn’t get the needle into the heart. We chose to put digoxin into the muscle mass of the fetus. The fetus still had a heartbeat the next day.


Q. How did you learn to perform an intracardiac fetal injection?

A. It was an extension of my maternal fetal medicine training.

Q. In what context?

A. We initially started to do intracardiac injections of small fetuses in the end of the first trimester and the beginning of the second for the purpose of reducing multifetal pregnancies or multiple gestations, either with a twin gestation, where one twin is normal and the other is abnormal, or of a situation where we have too many fetuses within the uterus.

Excerpts from cross-examination of Dr. Marilynn Frederiksen:

Q. Doctor, you would never use a scissors to grasp for and extract fetal parts, would you?

A. No.

Q. In an intact D&E you use a scissors to puncture the fetus’s skull at the base of the neck, correct?

A. Yes.

Q. You would agree, Doctor, wouldn’t you, that a scissors is potentially more dangerous to the woman than a forceps if a mistake is made, right?

A. Yes.

Q. A scissors is more dangerous than a forceps because a scissors is a sharper instrument than a forceps, right?

A. Yes.

Q. In fact, Doctor, in your opinion, forceps do not pose a risk of cervical laceration, do they?

A. I don’t think so, no.


Q. Doctor, you offered the opinion in your expert report that one advantage to intact D&E is that you get an intact fetus for pathologic assessment, right?

A. Yes.

Q. In fact, with an intact D&E you don’t actually get a fully intact fetus, do you?

A. That’s correct.

Q. A fetus aborted by intact D&E has no brain contents, does it?

A. No, it does not.

Q. At the conclusion of the procedure, you examine the products of conception to ascertain that they have all been evacuated?

A. Correct.

Q. When you do a D&X or intact D&E, you either compress the fetal head with forceps or you make an incision into the back of the neck, into the skull, with a scissors, and then you cause disruption of the fetal brain?

A. Yes.


Q. To disrupt the fetal brain, you use your finger, and that compresses the contents of the head and allows it to pass through the cervix?

A. Yes.

Q. When you do a D&X in breech presentation, you grasp the fetal foot, and with careful manipulation of the fetus you deliver the fetus to the trunk, right?

A. Yes.

Q. Then you essentially do a breech delivery, where you are left with the fetal head inside the cervix, right?

A. Yes.

Q. Then you either compress the head or you enter the skull with scissors and disrupt the fetal brain, correct?

A. Correct.

DAY EIGHT: Wednesday, April 7, 2004

Excerpts from direct examination of Dr. Gerson Weiss:

THE COURT: Do you, when you tell them the various procedures available, say that in an intact D&E, if you choose to call it, or partial-birth abortion, that you take a pair of scissors and make an incision in the base of the skull?

THE WITNESS: I say that we take the fluid and material out of the skull.

THE COURT: No, Doctor. The question is simple. Don’t turn it around. Just do you tell them that if you do that procedure you’re going to take a pair of scissors and make an incision at the base of their baby’s skull?

THE WITNESS: I do not use that language.

THE COURT: Do you discuss with them whether or not this inflicts pain on the fetus or the baby?

THE WITNESS: No, I do not.

THE COURT: Do you tell them that you are going to use a suction device and suck the brain out of the baby?


THE COURT: You use simple words and tell them that?


THE COURT: Next question.


Q. Can you eliminate the risks of retained fetal tissue in a D&E involving dismemberment by counting the fetal parts at the end of the procedure?

. No, you can’t. You can count roughly. You can count there is a limb here, I can see feet and hands, I can see skull fragments, I can see trunk. But when you see little pieces, if there are small pieces left behind that are torn off, you can’t fully reconstruct and you cannot fully count the small pieces. Another way of looking at that is if you have a long bone that is broken into six parts, you are only going to say I see long bone parts. You will not be able to reconstruct to a point of that accuracy.


Q. Is your ability to bring the fetus out intact affected by the fetal tissue at that gestational age that you perform D&Es?

A. The earlier the pregnancy the more fragile the fetus. So, grasping a fetus early on is more likely to tear it and less likely to allow you to bring it out whole. If the fetus were older its condition would be tougher enough that it could take, you could move it into an appropriate position easier.

Q. And you also testified that you have, when you were speaking with the Judge, that you have used suction to remove the brain of the fetus, is that right?

A. Yes.

Q. Is there another way that you have removed the head in the D&E procedures that you have performed?

A. Yes.

Q. What is that?

17 weeks

A. You can in a, before 18 weeks, sometimes grab the head with one instrument, with a grasping instrument in one hand and use a grasping instrument in the other hand to grab the rest of the head. Usually with a twist you can deflate the head enough to bring it through. So, it’s a crush —

THE COURT: Do you crush the head?

THE WITNESS: Yes, it could be a crushing; yes, early on.


Q. What is it that you are using to bring the cervix down in your description?

A. You are using a grasping instrument called a tenaculum. Usually they have several opposing teeth which grasp the cervix and allow you to hold it without tearing.

Q. In the example you just gave, I think you said that there were several things you might do that would be an act that would kill the fetus. What might those things be?

A. One thing would be to simply pull the fetus out. Having done that, it is likely that the fetal head would remain inside, and in pulling it would have separated the head from the body, and that would have resulted in the fetal death and later delivery. Another possibility is that you would grasp the head under those circumstances and either crush it or hold it and then puncture it to deliver the head. In either case, you have done an overt act after delivering the fetus to the trunk.

Q. In the example you gave where you delivered the fetus up to the head, is any part of the trunk past the navel outside the woman’s body?

A. Yes, certainly.

Q. What part?

A. Depending on the anatomy of the woman, most of the cervix is dilated, so it is usually a good part of the fetus, probably from the navel down in the situation when the vagina and the cervix are in the same plane or close to the same vertical plane.

Q. In that example is any part of the trunk above the navel outside?

A. It is possible that, depending on the situation, a part of the fetus above the navel would be outside. It depends only on the geometry of the cervix and how far the cervix is brought down.

Q. In the example you gave where the head separates, is that an act that you know will kill the fetus?

A. It is.

Q. Is that an act that completes the delivery of the fetus.

A. No, it is not.

Q. Why not?

A. Because you would then have to remove the head.

Q. You would have to go back —

A. You would have to go back, grasp the head, and remove it.

Q. Dr. Weiss, what is your purpose, in the example you just gave, in delivering a fetus up to the head after removing an arm? What is your purpose in doing that?

A. Your purpose in doing the procedure is overall to terminate the pregnancy, to make the woman no longer pregnant

Excerpts from cross-examination of Dr. Weiss:

Q. You were on the board of directors of Planned Parenthood of Essex County from 1992 through 1997, is that right?

A. That is correct.

Q. You are still a member of Planned Parenthood?

A. I don’t know if I am a member.

Q. Would it surprise you to learn that your CV lists you as a member of Planned Parenthood?

A. No. I am not sure what the dates are. I would be continuing a member if I sent them a check this year, and I don’t recall doing so.

Q. As soon as the law on abortion changed in 1971, you were part of a group that established a Planned Parenthood-sponsored abortion facility in Pittsburgh, is that correct?

A. That is correct.

Q. And you have provided testimony —

THE COURT: What year was that?

MR. LANE: Excuse me, your Honor?

THE COURT: What year was that?

MR. LANE: 1971, your Honor.

THE WITNESS: Excuse me, sir. I misspoke. On recollection, it was after the law was changed, and that was January 22, 1973. So I believe it was 1973.

THE COURT: A date that sticks in your mind, is it, Doctor?



Q. Doctor, in your view, you don’t set out to do a specific abortion procedure, but instead set out to make a woman unpregnant, isn’t that right?

A. That’s correct.

Q. The word “unpregnant” is your term, right, Doctor?

A. That’s correct.

Q. That is a term you used here this morning as well as in your deposition?

A. Yes.

Q. That is not a medical term, is it, Doctor?

A. No. It is a term in English.

THE COURT: It is a what term?

THE WITNESS: A term in English.

DAY SEVEN: Thursday, April 8, 2004.

Excerpts from direct examination of Dr. Stephen T. Chasen:

THE COURT: Yes. Do you tell them straight out what you are doing? No sugar coating, just you tear it off and remove it in pieces?

THE WITNESS: There is nothing I can do to make this procedure palatable for the patients. There is no sugar coating.

THE COURT: I didn’t ask you that, Doctor. I know it is not pleasant. I want to know whether or not these people know, have a fully-educated discussion with you what you are going to do.

THE WITNESS: We have a full and complete discussion about the fact that in most cases the fetus will not pass intact through the cervix and in many cases —

THE COURT: No, let’s go back. I asked you a simple question. Do you tell them you are going to tear limbs off?

THE WITNESS: I don’t have simple discussions with my patients. I have involved discussions. I can share with you what I tell my patients.

THE COURT: Go ahead. I am asking you, do you tell them you tear it off?

THE WITNESS: I initiate the discussion in general terms, and they always include the possibility that destructive procedures will be done to facilitate removal of the fetus.

THE COURT: Do you do it in nice sugar-coated words like that?

[note the doctor’s inability to answer yes or no questions with a ‘yes’ or ‘no’] THE WITNESS: My patients are under no illusions and they don’t regard that as sugar-coating and they are usually devastated-

THE COURT: How do you know, Doctor, do you see into their minds?

THE WITNESS: These are patients most of whom I have cultivated a relationship, and I can tell.

THE COURT: Oh, you can tell. Do you ever use the word you are going to tear the limb off?

THE WITNESS: Yes, I do, I use that terms sometimes.

THE COURT: You do?

THE WITNESS: That is not an option I give them. Their option is to have a D&E or to continue the pregnancy or to have a medical induction of labor. When I am telling them D&E, again, in general terms that some destruction of the fetus will be necessary and —

THE COURT: No, Doctor, let’s get back. [Do you tell] them that if it comes to that procedure, you will take a pair of scissors and insert them in the base of the skull?

THE WITNESS: I don’t use those terms, but, again, they know that the brain has to be removed so allow —

THE COURT: You don’t use those terms?

THE WITNESS: I don’t talk about the specific instruments that I use to accomplish this.

THE COURT: Do you tell them that you’re going to suck the brain out of the skull?

THE WITNESS: I don’t use the term “suck” but I say the brain has to be removed so that the skull will fit through the cervix without injuring them.

THE COURT: Do you ever discuss with them whether or not in the D&E, the dismemberment, when you tear limbs off, do they ask you, does it hurt?

THE WITNESS: Patients have asked about if —

THE COURT: What do you tell them?

THE WITNESS: I tell them that neither I nor anybody knows for sure whether it does.


Q. Doctor, in earlier answer, again I think in response to a question put to you by his honor, you made reference to certain observations you have made concerning fetal response to stimuli and response to anesthesia; what were those observations?

A. In some cases prior to inserting [laminaria] and performing the abortion procedure I will do a procedure to effect fetal death. I will inject the fetus with potassium which will stop the heart. The most common way to do this is by injecting a fetal directly into the heart of the fetus under ultrasound guidance. New these cases the mothers are not anesthetized and the fetuses don’t receive any anesthesia by route of the mother. And in every one of these cases, upon contact of the needle with the fetal chest, I see a withdrawal response of the fetus, recoiling that I can see on the ultrasound.


Q. Yes. Just describe for us if you can how you perform a D&E?

A: Once they’re under anesthesia I do an examination and based on the dilation of the cervix, based on the proximity of the cervix to the opening of the vagina, based on the fetal position that I can determine by palpation or with ultrasound that I have there, I determine the, what I feel will be the most appropriate way to evacuate the fetus from the uterus.

Q. And what might those appropriate ways be?

A. ….And in most cases the degree of cervical dilation will not accommodate passage of the fetal head through the cervix. And in this case my practice is to make an incision at the base of the skull with the scissors which I can do really under direct visualization, place a suction device within the skull, the brain tissue is aspirate and typically the head then delivers easily.

Q. And what do you do in the event that you are not able to —

THE COURT: Excuse me. Does that mean because the skull collapsed?


THE COURT: That it delivers easily.

THE WITNESS: Once the skull has collapsed.


Q. In your experience, Dr. Chasen, are there ever cases in which, to your knowledge, the fetus dies during the course of an induction abortion?

A. Yes.

Q. Based on your experience, Dr. Chasen, how long does the process of fetal death [by] asphyxiation take from the onset of contractions and induction abortion?

A. It could take many minutes.


On the cusp of the third trimester- candidate for D&E

Q. Dr. Chasen, in your experience, how is the fetal head extracted in a dismemberment D&E?

Q. Dr. Chasen, in your experience, how is the fetal head extracted in a dismemberment D&E?

A. The fetal head is extracted by placing the forceps around it and crushing it.

Q. How readily is that — how easy is that to accomplish?

A. In some cases it is relatively easily accomplished and in other cases it is very difficult.

THE COURT: Does it hurt the baby?

THE WITNESS: I don’t know.

THE COURT: But you go ahead and do it anyway, is that right?

THE WITNESS: I am taking care of my patients, and in that process, yes, I go ahead and do it.

THE COURT: Does that mean you take care of your patient and the baby be damned, is that the approach you have?

THE WITNESS: These women who are having [abortions] at gestational ages they are legally entitled to it —

THE COURT: I didn’t ask you that, Doctor. I asked you if you had any caring or concern for the fetus whose head you were crushing.


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Former Clinic Worker: Nita Whitten

Nina Whitten, former clinic worker, discusses what she observed in an abortion clinic run by Dr. Curtis Boyd.

“I was hired by Curtis and Glenna Boyd in July 1980. The reason I went to work for Curtis and Glenna was sort of a long and complicated one. I grew up in a Christian home. My father was a preacher when I was a child. He retired from preaching and he became an engineer, and we lived a fairly normal life. I was, however, rather radical along the feminist lines. My mother was too, and to some extent I still am because I am a preacher, and there aren’t a lot of men who think women ought to be preaching, but I am preaching to you today.

When I went to work for Curtis and Glenna, they made really sure that I was all in favor of abortion. What was so funny was that I lied right through my teeth. I didn’t know anything about it, I really didn’t. I didn’t know anybody who had one; I had never seen one; I had never been around it. All I knew was the word “abortion” and that I was a liberal person. I was very liberal, and so therefore I could work there. I told them that it wouldn’t bother me and that if I got pregnant I’d probably have an abortion. That’s what I told them. They believed me and they hired me.

I was a competent secretary and still am pretty good at being a secretary. But the funny thing about it is when you’re involved in abortion, your whole perspective about life changes. At least mine did. I was really shocked at the reaction that my family and my friends had when they found out that I worked at an abortion clinic. I couldn’t tell my grandmother what I did, so I lied to her and I told her that I worked for a doctor who took care of women. She thought we delivered babies, I guess. She didn’t know and she didn’t find out until just a few weeks ago, and she sent me up here with her blessing. I think that’s wonderful.

Several of the people who I worked with were very unusual. The woman who was instrumental in hiring me, Elaine Clark, and I pray for Elaine every day… I really want the Lord to deliver Elaine because when I knew Elaine she was on her way to quitting the clinic. She wanted to leave and the reason she wanted to leave was she said, and I believe all of them will eventually say this, she couldn’t handle it any more. It was too much.


Elaine was hooked on Valium when I was there. I don’t know what she’s doing now; I’ve heard reports that she’s better now and, of course, she’s not working there so obviously she’s better. But she was really, really traumatized by what she saw every day. She was traumatized by the insensitivity to not just unborn babies’ lives, but to life in general. Because that’s how this clinic was run. It wasn’t good. It was hard to work there. It was hard to work for Curtis and Glenna, and it was hard to work in a place where there was no love, and there wasn’t any love. They’ll tell you that they’re doing this for the woman’s sake, and, you know, Curtis was involved in civil rights back when the black people received their liberation. He was all involved in that. But it’s a lie when they tell you that they’re doing it to help women, because they’re not. They’re doing it for the money.

Money was the big deal. We made a lot of money. Curtis and Glenna lived in a very nice home. They had another nice home in Santa Fe, New Mexico.

They owned expensive things and lived like rich people do. They wanted to live that way and they weren’t embarrassed to live that way. They made all their money on abortions. When I worked there, they did abortions up to 19 weeks, and we had babies bigger than 19 weeks (in Texas at the time, you could only go to 24 weeks), Robert Crist would fly in and do our big, big babies on Saturdays once in a while when we could get him in there.

24 weeks

One of the most interesting things that happened when I worked there was that I was trained by a professional marketing director how to sell abortions over the telephone. This man came into our clinic and he took every one of our receptionists, all of the nurses, anyone who would be on the phone, and he took us through an extensive training period where we learned how to sell abortions over the telephone so that when the girl called, we hooked a sale so she wouldn’t go down the street and get an abortion somewhere else, and so that she wouldn’t adopt out her baby or so that she wouldn’t change her mind. We were doing it to get her money. It was for the money.

One of the things that our clinic was very afraid of was bad press. Glenna had nightmares, and it’s interesting to hear about these dreams because I’m going to tell you about my dream in a few minutes. But Glenna had nightmares. There was a woman who had died at our clinic from amniotic embolism of the brain…The woman who died in the abortion clinic caused a lot of press coverage in Dallas. They descended on that clinic. Glenna even gave a big speech at the National Abortion Federation meeting about it; how she worked it out in psychological terms, and how she was so traumatized by this, but how we all were, etc. It won her great acclaim. It in no way saved that woman’s life, and it didn’t do anything for that woman’s husband or her family which she left behind. I think that it’s time that we call it what it was. That woman was murdered, not just that baby. Amniotic embolisms can happen at any given moment, but it certainly wouldn’t have happened if she hadn’t had the abortion.

I’m going to tell you some gory details that happened at the clinic that I remember specifically. There was a woman who came in the clinic who was forcing her daughter to have an abortion. This wasn’t uncommon at all; it happened all the time. Since I was on the front desk a lot of times, filling in for the receptionist, or if they were out sick, I got to see this firsthand. I wasn’t really as adept as some of the other girls because I wasn’t always up there. I was usually in the back typing, filling out papers, and basically paying the bills, doing the things that secretaries do.

14 weeks

This woman forced her daughter to come in there and she was a second trimester, probably about 15 weeks. They had inserted the laminaria the day before, and she was in there and quite miserable. The poor girl was really upset and she kept going to the bathroom, and obviously there was something wrong with her physically, and when she went into the bathroom the next time, all of a sudden she started screaming at the top of her lungs. “It’s a baby; it’s a baby; mama, mama, mama!” She was screaming in the middle of our clinic. So I’m freaking out and trying to figure out what’s going on. I called Holly, her counselor, and said, Holly, she’s aborted the baby in the bathroom and you need to get the doctor right now. Well, he was in a procedure and couldn’t come then. None of the nurses knew what to do, so they got her back there real quick and took care of her.


You see, when the girls come into these clinics, they don’t know, nine times out of ten, what’s going to happen to them. They get a package deal–it’s like going to get your teeth fixed or something. This is what we’re going to do to you; it won’t hurt very much; it’s going to cost this–pay cash. They don’t tell you what the baby looks like; they don’t tell you how long it’s going to take; they don’t tell you it’s going to hurt. And it hurts; it’s a baby; and it’s a waste of your money.

16 week old unborn twins

One of the things that happened a lot of times is that women would be referred by their doctor because they didn’t want to have that particular baby. There was one woman who came in and she was pregnant with twins. She had a family; she was a normal person; she could have that baby; there was no problem having babies; she got pregnant on purpose but when she found out it was twins she decided to have an abortion because there were twins. She did it on purpose. Her doctor referred her to us because there was twins. So she came into the clinic and I remember when they took the little fetuses, the little babies, back to the lab room and they were looking at them. Everybody came in to look. I went in to look. I wanted to see what twin babies looked like.

eight weeks sonogram

That was really the first time I really looked at the babies. I had never really looked; I hadn’t been in the procedure room; I didn’t know. I knew what they said. Curtis made films and stuff, but I didn’t pay much attention to that because I wasn’t a doctor and I wasn’t a nurse. I was a secretary, and I kind of wanted to avoid thinking about those little babies. Because you see, in my heart, I knew they were babies, and I knew it was murder, and I knew it was wrong.

One thing that happened at the clinic that I worked at that was incredibly devastating, right before I left. Dr. Boyd had made an agreement with a doctor, and I cannot name this doctor because I just don’t think it would be wise to name him today, but he was the Director of Fetal Research at the University of Texas Health Science Center at that time. He had made an agreement with this doctor to give him our large babies for him to do fetal research on. They did this, and I believe at the time, it was against the law. I don’t know if it is now, and I’m not familiar with the legal terms because I’m not a lawyer, but I remember we were told not to tell anyone, and they only came in secret to get the babies.

12 weeks

What happened in the clinic, though, was the thing that sort of made me start thinking about getting out of there. They brought their research assistant in because Curtis is so interested in technology and all these weird things he liked to do. He had them come in and they dissected a baby for us in our lab room so we could see what they were doing with the body parts. They did that right there and everybody filed in and looked. I looked at it. I pretended like I was being brave and walked out. It made me sick.

One of the things that happened as I worked at the clinic was that I became extremely depressed, extremely despondent, and basically hooked on drugs. I had done “fun” drugs before I started working at the clinic because, you know, when you’re that age, peer pressure, I thought it was fun and I enjoyed that. But when I worked there I had to take drugs to cope. I took drugs to wake up in the morning; I took speed while I was at work; and I smoked marijuana, drank lots of alcohol, and took anything else I could buy with the money that I made. This was a daily thing. I’m not talking about on weekends; I’m saying that this is the way that I coped with what I did. It was horrible to work there and there was no good in it.

In January, right before I left, I started having problems with my period, and I was on birth control pills and assumed that there was no way that I could get pregnant. Basically, what happened was that I developed amenorrhea, but I didn’t know that at the time. I thought I was pregnant. Now this nurse who I worked with was just a regular nurse; she wasn’t an OB nurse; she wasn’t trained. And the nurses did ultrasounds on the large babies before the doctor did the procedure, and he would look at the picture, and they thought they knew what they were doing. They had no idea what they were doing. You have to be a technician to really run an ultrasound machine the way you’re supposed to. They had no training in ultrasound machines other than what Glenna Boyd taught them. That was it. Glenna Boyd isn’t even a doctor or a nurse. They did an ultrasound on me and did pregnancy tests and couldn’t find out what was wrong. They decided I was pregnant and they inserted a laminaria in me. I went home with a bottle of valiums; I had 10, 10 mg. valiums, and my husband now but who I was living with at the time, said that I took the whole bottle that night. I took them one at a time. I started at 5:00 in the morning and by the time I got back to the clinic the next morning at about 9:00 1 had taken the whole bottle and don’t remember that very well because after you take a couple you don’t remember things. I was in such severe pain I could not think. It was the most excruciating pain I have ever felt in my life, and only by the grace of God can I even tell you about it. I went into the clinic the next morning and at our clinic they used nitrous oxide, pericervical blocks, and Sublimaze, and that’s how they did the procedures. So they hooked me up to all this and my counselor was one of the girls I worked with and she was there to help me cope with this situation. They were going to do this abortion on me. They got in there and discovered that I wasn’t even pregnant in the first place. I was just totally baffled by all this. Why did they do this to me if I wasn’t pregnant? I worked for them; they ought to know better; how come this happened? Well, when I went home that day I was still in a lot of pain, so they referred me to the little doctor that they always have on call. I went to him and he told me I had a severe pelvic infection and couldn’t believe that they did this to me. He gave me some antibiotics and told me I would be all right.

I wasn’t satisfied with his answer so I went to my mother’s doctor, and he said the same thing, that basically they did a terrible thing; they made a big mistake; I wasn’t pregnant. Why did they do this? They couldn’t imagine why and I was really sick with this pelvic inflammatory disease. They gave me some more medicine. I took the medicine and got over that, but I took off work for six weeks. While I was off of work, they still paid me and they had to call me to get the directions on how to pay the salaries. I was the only one who knew how to fill out the checks and do all the accounting part of it.

It’s funny, because the girl who was the director of the clinic at that time, named Marty, is a Catholic. I was sort of baffled by her. She was an unusual person. She called on the phone and I told her that I never wanted to talk to her again. You did this to me and I wasn’t even pregnant. Don’t you know any better? What’s wrong with you? Why would you do this to me? She just said, calm down, it’s not the end of the world. I was still taking my illegal drugs and my legal drugs, trying to cope.

I finally got back to work, and while I was there, in the spring, Marty and I were there. I came in about 9:00 and there were fire trucks all around our clinic and I couldn’t imagine why. The funny thing is that we were struck by lightning. I am serious. It burnt out every major electric appliance, including the abortion machines.

After they did this abortion on me when I wasn’t pregnant and after we got struck by lightning, my husband (who wasn’t my husband then) a mathematician, decided to go back to college and get his Master’s Degree, and I praise God because he was willing to say, okay, we’re moving. I really wanted to get out of the clinic and I said, I’m getting out of the rat race. I hated living in Dallas.

There were a lot of medical things that they did that I don’t agree with. Like Dr. McMillan brought out, if they’re such good doctors, how come they don’t report their complications? How come they don’t turn it in to pathology? I moved to Nacagdoches, Texas and God put me where I went. I got a job at the hospital there, at Nacagdoches Memorial Hospital, praise God! It’s funny because I told them where I worked and I had this funny notion that good patient care was what I had seen. There wasn’t good patient care, but I thought it was, sort of, in my mind. I couldn’t justify what they did to me, but I thought this was just the way it was.”

Q. If a girl had a problem and came back what would happen?

A. That’s the saddest thing you could have asked. Basically, if there was something really serious they sent them to the little doctor on call. But other than that, they didn’t do anything, and they certainly didn’t do anything to help her emotionally or mentally. There weren’t many cases of that happening because most of the women, like has been said, wanted to forget it. They didn’t want you to know that they had had an abortion, and they weren’t about to do anything about it. I believe Curtis was involved in some sort of litigation where he was being sued for some sort of malpractice deal. I don’t know whatever came of that, but I do remember filing the papers for it. There were always instances where something could happen because it was bad medical care, especially at that clinic. It was pretty pathetic.

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Former Clinic Worker: Lorraine LaNeve

LaNeve gives her testimony:

“I started my job functioning in all the duties of a nurse. First, by preparing the clients in the waiting room by medicating them with Valium and then influencing my captive audience to write letters to the elected officials pleading that abortion should remain a woman’s right.

seven week-old unborn baby

Then into the procedure room where I assisted the physician with the gory practice of killing the unborn child while demeaning the client. Upon completion of the procedure, I placed a sanitary napkin on the client and walked her to the recovery room where she sat in the chair, was given medication, and was timed to leave in approximately 40 minutes or sooner depending on the case load and the demand for the chair. As a surgical nurse I had the responsibility to prepare the room for the next client then take the fetal parts to the lab and check and count them. This was called a GROSS and afterwards I prepared them for disposal. I started working two days a week but became so engrossed with the feminist lie that abortion on demand was an entitlement, having been indoctrinated into my weakened psyche as “my body my choice”. I was sent to various seminars and conferences sponsored by NARAL, (The National Abortion Rights Action League) and NAF (National Abortion Federation).”

Soon afterwards. I graduated and added to my resume that of vigorously engaging in public relations with the help of the blossoming abortion industry. From there, I went on to lobbying elected officials in Washington and many states. I was sent to several states to set up new clinics and train personnel in the art of legally killing. Eventually I wound up with a full-time position in the management office in New York.

Having been employed in this malevolent industry for 5 1/2 years and sharing the responsibility to help to legitimize the abortion industry gives me the responsibility of bearing guilt for the deaths of many future citizens. We all are the losers because we will never know how greatly these murdered children would’ve contributed to the well-being of society.”

The full testimony can be found here. 

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Former Clinic Worker:Jennifer Eastberg

Jennifer Eastberg, who worked at one of the biggest abortion clinics in the country, Lovejoy Surgicenter, testified before a committee in favor of a proposed law requiring parental notification of minor’s abortions. Eastberg, who has seen many young women come in for abortions at Lovejoy and who also has a degree in mental health, is uniquely qualified to know about minors and abortion. Here is her testimony:

Mr. Chair, members of the committee, for the record my name is Jennifer Eastberg. I am a LCSW, been have been in the mental health field over twelve years and I am currently in private practice.

I truly appreciate this opportunity to share my experiences and repeated observations which will illustrate why I am a strong proponent of this parental notification bill. Because feelings run so deep on both sides, it has become extremely difficult to have rational discussions regarding these issues. Assuming that helping and protecting women, especially adolescents, is the ultimate goal for all of us, then we must be willing to listen to each other.

I am a former employee of Lovejoy Surgicenter, one of, if not the largest, abortion facility in the Northwest. I came to Lovejoy after graduating from college and after years of exposure to numerous circumstances, through which I developed an intense feminist perspective. One particular, horrific experience during college, solidified this conviction. I was determined that no man, and especially the government, was ever, ever going to tell me what I could and couldn’t do with my body!!! I was on a mission to do whatever I could, to change what I saw happening to women.

This is important for you to know, because when I say I’ve seen this issue from all sides, I really mean it. While working at Lovejoy, I was exposed to the truth – the grim realities of abortion – that broke through and shattered my belief that I was protecting and helping women. Over time, my conclusion was that I was not helping, but was actually participating in a deceptively, exploitive phenomenon of women today.

Let me qualify this statement, however. I am not implying some conspiracy against women is occurring in the abortion industry. I do believe that most people who work in the industry are genuinely caring, well-intended and genuinely committed individuals. My point is, however, as a front line mental health therapist, my original suspicions and conclusion about the short and long-term effects of abortion have been reconfirmed repeatedly. I continue to see an escalating number of women (especially adolescents) who are struggling with physical, emotional, spiritual, and relational repercussions of having an abortion. I don’t go looking for this stuff. On the contrary, this is an in-my-face reminder of the phenomenon I participated in, that has produced what I am now attempting to remedy.

No one told me to quit. There was no political change or religious conversion. I left the industry because of what I saw. I left because of the creeping realization to abortion’s insidious implications.

Let me address a few of the reasons why passing this bill is so important …. First of all, adolescents face much higher psychological risks than adult women tend to experience from receiving an abortion. To fully grasp the psychological and emotional implications of a young girl having an abortion, one must understand the specific developmental state the teen is working through. Adolescence is a time of intense change- a time of marked physical and internal development – internal development including emotional, intellectual, academic, social and psychological. It is also a time of massive cultural indoctrination. This cultural pressure comes from schools, magazines, music, television, advertisements, movies and peers. They are struggling with the critical challenge of forming their identity. They’re grappling with developing a healthy self-concept and of finding intrinsic value within themselves. Girls are making choices that will have implications for the rest of the lives.

Almost any references regarding adolescent development would include the emotional intensity and fluctuations of this stage. Given the likelihood of increasingly more volatile emotions, a major task is to gain an understanding and tolerance for one’s emotionality. This is a tremendous task in and of itself – not to mention superimposing a traumatic abortion experience onto this fragile period of development. Also, keep in mind, a child’s ability to process and integrate this experience is contingent on how successful she was in working through previous developmental tasks.

The probability of an adolescent internalizing feelings of guilt, shame, confusion and aloneness due to an abortion is overwhelmingly evident. In addition, many of these internalizations are left untouched, without any opportunity for appropriate intervention from family or professional counsel. This will likely lead to (at minimum) some degree of sadness and depression.

Other symptoms may include anger, flashbacks, delayed or long-term grief or anniversary reactions. They may experience memory repression, recurrent, intrusive distressing memories or dreams of the event. They may also struggle with feelings of detachment from others, difficulty keeping close relationships and even suicidal ideation and/or attempts. Pro-choice advocates often claim, as was stated in the April 16th hearing, that C. Everett Koop had issued a report there were no adverse psychological effects of abortion on women. This is simply not true! Dr. Koop stated after the report, that as a physician he knows abortions are dangerous to women’s mental health. What he said in the three page letter he sent to the president, was that the available studies were flawed because they did not examine the problem of the psychological consequences over a long enough period. Based on his own knowledge and personal experience, he said, any long-term studies will add more credibility to those people who say there are serious detrimental health effects of abortion. The realities often remain unnoticed by those not on the front lines.

It is also critical to consider that this adolescent girl will probably struggle with this experience in isolation. Our current laws contribute and actually sanction this. This isolation and secrecy lends credence to the adolescents’ feelings that they have done something wrong. Whether this comes from the mixed messages in society or from her intrinsic feelings about abortion – intervention must happen!!! I consistently hear, “I was all alone … I went through this all by myself … Telling a close friend or two didn’t even cut it … I can’t describe the loneliness I experienced.”

Without some help, ideally parental involvement, the loss of wholeness, self-confidence and self-direction can last well into adulthood. It is important to consider that adolescent’s surface behavior often conveys very little about the struggle within. In fact, these behaviors are often designed to obscure that struggle. Another statement made in the first round of testimony was that these PAS symptoms I just mentioned virtually do not exist. If there really isn’t the existence of PAS, then it would seem reasonable for the abortion industry to incorporate into their informed consent form, something like this: “In the event you experience at least three of these psychological symptoms within one to five or ten years of your abortion, then we will provide some type of appropriate professional counseling/intervention as needed.”

The schizophrenia about our current parental involvement laws has been presented repeatedly in the first Senate hearing. How can we expect any young girl, by herself, listening to adults who don’t even know her, make a good decision about this crisis?

Not to mention the likely possibility of not being fully informed about this procedure and without the guidance of parents who are generally far more sensitive to their child’s physical and emotional well-being. (Can you imagine your daughter, without your knowing, having a surgical procedure that even you may not be fully informed about?!)

These adults, of whom I used to be one, will talk to her for approximately 30-60 minutes prior to scheduling an abortion. In most cases which I observed, the adolescent will not meet the physician prior to the abortion. Most likely, the doctor will never have consulted with this child’s pediatrician – a standard and critical practice of performing good, quality medicine.

As our current laws reflect, we appear to understand how crucial parental involvement is in most areas of an adolescent’s life. Whether this child has shoplifted, received an M.I.P., skipped or is failing in school, has possession of a weapon or is dealing with a crisis pregnancy – in all these cases, we are talking about an adolescent in serious trouble. An adolescent in crisis. If we think about the need for parental involvement regarding abortion the same way we do with the other potentially damaging and destructive adolescent behaviors and activities just mentioned, then this bill would be a moot point- parents involvement would be an assumed expectation.

Conversely, if we are to follow the logic of our current abortion laws (not requiring parental involvement in adolescent antisocial behavior) then the absurdity becomes obvious. For example, the school would not contact you if your child had been absent for a week without your knowledge. The police would not notify you if your son or daughter had been arrested for burglarizing or driving while intoxicated. The legal right to secrecy regarding abortion reflects abortion is being treated as a unique circumstance of an adolescent in trouble/crisis. You can’t logically advocate this position without also including parental involvement in abortion issues as well. Parents who do not have sufficient information about their child cannot adequately know how to guide them.

Will there be parents who will potentially abuse their daughter as a result of finding out about this crisis pregnancy? Yes. (You can be sure, however, the abuse has gone on long before this crisis pregnancy.) Will a child experience more stress as a result of the parental involvement? Yes. However, the same reasons for which parents could be abusive in this abortion circumstance, are no different than how they could react to other adolescent troubles. I don’t deny the reality of increased stress a teenager would experience as a result of a parent knowing the truth. As I just mentioned, there are other situations that could create even more of a potentially abusive reaction from the parent finding out about the circumstances. Parents should have a negative reaction. However, they must intervene with love, adequate communication and, if need be, professional counsel.

Dr. Elizabeth Newhall testified that she had never seen nor heard of a death related to a safe and legal abortion. She had heard of two deaths as a result of parental involvement (parental notification laws). The death of Becky Bell and Spring Adams are horrible, tragic deaths.(Webmaster’s Note: The Becky Bell Story has been debunked- see article here- apparently Eastberg is not aware) They should have never happened! Neither should the deaths of hundreds of women who had safe and legal abortions (see here.) I have in my hand copies of numerous newspaper articles about women who have died from abortions. One death as a result of abortion is too many! It concerns me however, that apparently physicians aren’t aware of these deaths as well. This is crucial to know because this could provide the necessary opportunities, information for physicians to improve the quality of their medical procedures. Examining all these cases to understand what went wrong is good medical practice.

As was stated in the first round of testimony on April 16th, apparently 75% of adolescent girls do actually involve their parents. This was reported as the norm – which is great even if it was half that percentage. Therefore, we cannot allow the exceptions to this norm (the dysfunctional families) to dictate how we are going to shape/develop our laws. Laws need to be based on the norm of how families are supposed to function.

Because some parents are failing, are we going to maintain laws that can actually enable their dysfunction to continue? What brings dysfunctional families into counseling or to seek some appropriate type of intervention, is crises. It could be a crisis resulting from a mother’s alcoholism, a father’s unemployment, an acting out teenager or their daughter’s crisis pregnancy. The dysfunctional family needs to be given the opportunity to function as they should at least be given the chance to explore this crisis in an appropriate, safe forum. While the goal of not mandating parental involvement is to provide protection, this will most likely enable the dysfunction to continue. By not structuring abortion laws to be conducive to family or other appropriate involvement, we are also directly contributing to the potential impairment and fragility of the adolescent’s continued development.

There is so much more to be said that supports the passage of this bill. I do though, very much appreciate this opportunity to share my observations with you.

Credit: Eternal Perspectives Ministries Summer 1995 issue

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Former Clinic Worker: Joy Davis

Davis went from working at one abortion clinic to directing six clinics and eventually began to perform abortions without a license. She originally got into the abortion business to help women. Here is her story:


“Fourteen years ago, I was offered a job in an abortion clinic in Birmingham, Alabama. I thought about the offer for some time and came to the conclusion that it was a good opportunity to help women and the money was real good (keep in mind I was a single parent of two children, Jeff and Allen). So I accepted the job.

A very short time after working there, I realized one thing — we were not there to help women. We were a business — a money-making organization….The conditions in the clinic that I worked at were very, very poor. We had no life support systems. Our people were not very well trained — most of them did not even have a medical background. The doctors rotated in and out. We never had the same doctor…

It was a real bad experience. But because the money was good and because I had two children to take care of, I put it all out of my mind. I didn’t let it make me feel guilty. I met a doctor at the clinic. His name was Tommy Tucker, and he came up to me one day and said that he wanted to open his own clinic. He said he wanted to do things right. He wanted to have the best equipment possible. He wanted to have highly trained and qualified people working at the clinic. He wanted to do general anesthesia and have anesthetists come in and put these women to sleep so they wouldn’t suffer, because in the clinic we worked at they did suffer a great deal.

I thought that this was a wonderful idea and I accepted Dr. Tucker’s offer. I became the regional director of six abortion clinics in Mississippi and Alabama. We had the best equipment, a highly trained, qualified staff, and we would only see a very few women a day because we didn’t want to rush them through like cattle. We wanted to take time and give them the kind of medical attention that they needed.

But we still lied to the women, it was just something we had to do to make money.

But that didn’t last long. After just a few months, his greed took over. He wasn’t making enough money, so the first thing to go was the anesthetist, because they made a lot of money. Through just the few months of watching them put patients to sleep, we started putting patients to sleep ourselves and we had no idea what we were doing. We just knew what we had seen them do, so we started doing it.

Then our registered nurses that worked in our recovery room were the next people to go. Then our lab technician and on and on.

I started interviewing people that had no medical background at all, bringing them in to do the job of anesthetist, lab technicians, nurses and even physicians. The people that I looked for when I was interviewing would always be one thing and that was a single mother. If they had a husband that made a good living, I wasn’t interested in them. I wanted the women that needed us and needed the money. That way I knew that I would have their loyalty and that they would stick with it no matter how tough it got. So I brought in people off the street with no medical background and trained them.

We were seeing approximately ten women a day in the clinics, but that wasn’t enough. We started seeing as many as we could get in every clinic.

The doctor’s schedule would start out in Birmingham, Alabama, on Monday morning. Monday afternoon he was in our clinic in Montgomery. Monday night he was in our clinic in Tuscaloosa. Tuesday morning he was back in the Birmingham office, then he would catch a plane, fly to South Haven, Mississippi. He would see patients there, then fly to our clinic in Jackson, Mississippi. And it would just keep going on and on.

We soon ran into another problem: there was not an airline fast enough or efficient enough to get the doctor to all of the clinics. So he trained me to be a physician.

I never spent the first day in medical school. I was just an ultrasound technician. I really knew nothing about medicine, other than what I had seen other doctors do, but

I started doing abortions. I started actually performing surgery on women. I did norplants, cryosurgery, pap smears, pelvic exams — anything he did, I did.

And I was real proud of that because I felt I did it better than he did. All of the employees would say, “Oh you need to see Dr. Davis today,” because they felt that I was better than he was. I never had any problem patients. I never put a woman in the hospital, and he was putting them in the hospital almost every month, in very critical condition — hysterectomies, retained tissue, everything that could go wrong with his patients, did go wrong.

So I really had a big head. I thought I was great, because I didn’t have those problems. I took my time and I gave all this love to those patients. So they really loved me. But the truth is, I wasn’t giving those patients love. I was risking their lives very negligently. Out of the thousands and thousands of patients we saw, I couldn’t remember one name or a face because they were just a number to me. I would refer to them by how much money they paid, “Oh, that’s a $400 case,” or “Oh, that’s a $5000 case.”

Then one day a young girl came to us for a late second trimester abortion. You see, we did pregnancies all the way up to term. We’ve terminated up to 38 weeks of pregnancy. And this young girl came to us and she wanted an abortion. She was a single mother, working, going to school and she found herself pregnant again. She was ashamed of what had happened to her and she did not want to tell her family or her friends that she was pregnant again. So she came to us. I evaluated her and realized that she was very sick. She was running a fever. I didn’t know why. I didn’t know what was wrong with her, but one thing I did know was that she was not healthy enough to go through a late second trimester abortion.

So I turned her down. I told her that we couldn’t do it, that she needed to go to a hospital where they could take care of her and find out what was wrong with her. Dr. Tucker found out that I turned her down and came in and insisted that I put her through. He said she had paid an $1800 deposit and that he was not going to give her the money back.

I argued with him. I told him my reasons for turning her down, but it just wasn’t good enough. He insisted that I put her through.

Her procedure took two days and in those two days, I grew very close to her. Not because I really wanted to get to know her, but because I was mad at Dr. Tucker for overriding my decision. And I felt sorry for her. I found out that she was so much like me. She was struggling so hard, being a single parent, working a full-time job, going to school, trying so hard to make it in this life and she just couldn’t handle another child.

The doctor came in and did her abortion. I monitored on ultrasound while he was doing the abortion. And as soon as he was through he walked out of the room. She was still under general anesthesia, that a non-qualified person had administered As she started coming to, she started having difficulty breathing. Her blood pressure bottomed out. Everything was going wrong. I sent for the doctor to come back in the room. There was a lot of panic, a lot of confusion. We were running around, trying to resuscitate her, trying to do everything we could to stabilize her. And the other patients that were waiting to have abortions were in the very next room.

When the doctor walked in the room, he got angry, because we were making so much noise. He told me to get that patient out of the room and take her to the back recovery room so the other patients could not hear her or us.

I took her to the back recovery room. I stayed with her and did everything I could do to stabilize her, but then she started bleeding. She was bleeding uncontrollably, I couldn’t stop it. I ran back to the doctor and I said “You’ve got to help me. She’s bleeding and I don’t know what to do.” He said to take her to the examining room, examine her, find out why she’s bleeding and stop it. “It’s that simple.”

So I did. I took her to the examining room and tried to find out what was going wrong, but there was so much blood. I did everything I had been trained to do. I used petosin, petresin, I packed the uterus. I did everything that I knew to do, but she kept bleeding. I then called an ambulance so we could get her to the hospital and they could help her.

When the doctor found out that I called the ambulance, he was furious. He canceled the ambulance. He told me, “I’m the doctor here. I’ll make those decisions. We cannot send this patient to the hospital in this condition. They’ll hang us. Now try to stabilize her.”

And I did. I tried. At this point she couldn’t talk. She was in such serious condition that all she could do was just look at me with very frightened eyes — just look at me. And I tried so hard to help her. Blood was just pouring out of her like a faucet and I couldn’t stop it.

So I ran back to him and said, “Please help me. If you don’t help me she’s going to die.” He said, “Fine. Call the ambulance. I have a plane to catch.” And he left the building.

I called the ambulance. It took twenty minutes for them to get to the clinic. During that twenty minutes I realized that I was not a doctor and it scared me to death to realize that I was put in that position — that I let myself be put in that position — to try and save a life that I was not qualified to try and save.

The other thing that ran through my mind was the doctor. He was my hero. He brought me up from nothing to making approximately $100,000 a year and doing real well. But at that moment I finally saw him for who he really was. He was a coward and he had run out on a patient that needed him.

So they transported her to the hospital. I felt relieved that she was just gone and that the responsibility had been taken off of me. I then received a phone call from the hospital, which informed me that she had died. At that point I started having nightmares. Every time I would close my eyes I would see her face. The guilt and the anger that I was experiencing was overwhelming, it almost destroyed me.

The medical board then subpoenaed her records. Tucker went one step further and change her records to make it look like he was not as negligent as he really was. He gave me the original records and ordered me to go to the basement and burn them. He said, “We can’t go to court like this. They’ll hang us. We’ve got to cover this up. Go burn those records right now.”

I couldn’t do it, I couldn’t burn those records. I put them in my briefcase. I couldn’t lie for him on this one. I couldn’t cover for him any longer…I went to the medical board; I went to the D.A. — I turned over all the information of all the negligence that we had done. I turned myself in for practicing medicine without a license and gave them the proof that I was doing so.

They told me that they wanted me to stay employed with him. They wanted me to continue to gather information for them. They said they had a clear-cut case of negligent homicide, but they wanted more. So I continued to work for him and continued giving them information. But this kept going on and on, nothing was being done.

Then one day, Dr. Tucker came back to Alabama, where I was. He had been working in Mississippi. He said, “I had a real hard time in Mississippi, we had a problem and you need to go out and try to calm down the employees.”

I said, “What happened?”

He said, “There was a girl who came in for an abortion. I thought she was eighteen weeks. She ended up being closer to term. I inserted the laminaria and she went into labor. She went into labor and delivered a live, healthy baby.”

I said, “What did you do?”

He said, “What could I do? I killed the baby. But all the employees are really upset, so you need to go and take care of this.”

I caught a plane and went to Mississippi. But before I caught that plane, I called the District Attorney in Mississippi and told him what had happened. Before I could get to the clinic, he was there questioning the employees. The case went to the grand jury, but they couldn’t prove that Tucker had killed the baby, because they did not have a baby. The baby disappeared and they couldn’t prove it. So the case did not go on any further, even though the employees testified that it did happen. They still couldn’t prove the case.

I went back to the medical board in Alabama and I said, “Why aren’t you doing anything? Why haven’t you done something about the death of this girl?” They said abortion was a hot political issue and they really didn’t want to touch it…You see the abortionists don’t care about the women and they certainly don’t care about the baby. Women and babies are dying. Fr. Pavone showed me a list of women who had died in this country form abortions. And as I looked at that list, I couldn’t believe the names of hundreds of girls that have died.

And you know what I found right beside each name? It was a number. And that’s how we used to see them, as just numbers. The girl that died in our clinic. I will never, ever forget her. I’ll never forget her face, her smile. She was not a number. None of them are just numbers. I encourage you to get a copy of that list from Fr. Pavone and just read the names. And know that they were just like you and I.”

This is the story of just one abortion death due to negligence. There are many more. Read about a few here.

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Former Abortionist: McArthur Hill

Now I’m going to stand here and tell you that I am a murderer. I have taken the lives of innocent babies and I have ripped them from their mothers’ wombs with a powerful vacuum instrument. And when they were too big to do it in that way, I’ve injected a concentrated salt solution into the bag of waters to slowly and painfully poison them, and then to cause labor to follow.

seven week-old unborn baby

This is how I got involved–and I want you to listen to this because this is how many people get involved. I began my residency in July 1971, and on July 7, 1971, one and one-half years before Roe v. Wade, I went into the operating room where my chief resident sat down on a stool, he performed an abortion, and then he said that I could do the next one–there were several lined up for that day. In medical circles that’s called “see one, do one, and teach one.” Simply stated, I’d seen one, I did one, and then I taught others to do them later.

After I performed the abortion, here are the words which I dictated, and this is what I want you to listen carefully to:

“The patient was prepped and draped in a sterile fashion in the dorsal lithotomy position with an IV with 15 units of pitocin and 1,000 ccs of dehydrogenase lactate running. Under satisfactory general anesthesia, the cervix was grasped with a thyroid clamp and dilated to a #10 hanks dilator. After sounding to a depth of 4 inches, a #10 curved curette was introduced into the uterine cavity and utilized to empty the uterine contents. Five units of pitocin were given IV at this time. A large, sharp curette was then introduced into the uterine cavity and the small amount of remaining tissue was curetted from the anterior uterine wall. The total fluid and tissue obtained was 125 ccs. Estimated blood loss for the procedure was 50 ccs with 200 ccs of dehydrogenase replacement. After insuring that there was adequate hemostasis on the cervix at the site of the thyroid clamp application, the anesthesia was terminated and the patient taken to the recovery room in satisfactory condition.” (End of Dictation)

In about as little time as it took to read this operative report to you, I had become a murderer….I did not consciously select the words I used in dictating the operative report, but my subconscious mind was obviously at work trying to protect my conscience mind through denial. As you were listening to what I said, you heard me say the words “uterine contents,” you heard me say the word “tissue,” “fluid and tissue,” and “procedure.” They are all words which denied what really happened that day.

The pathology specimen that we sent down was labeled, “Products, of Conception.” The operation performed was called a vacuum curettage. But on the operation request and report, under special circumstances, were found the words “living fetus.” The gymnastics which my mind performed that day in dictating that report could not totally erase the fact that something living was killed that day.

When I was in medical school, abortion was illegal; it was criminal; it was regarded as murder. I graduated from medical school in 1968, and we already had in 1968, however, the beginnings of the erosion of that Pro-Life ethic. In 1967, the State of Colorado passed a law which made it legal to perform an abortion under some circumstances. New York and California followed, and since I was in California during my training, abortion was legal under conditions which threatened the mother’s health, mental health and her life. In our institution there was actually some confusion about what steps we should take to justify the abortions, since we clearly had not come to the point of legally, at least, abortion on demand. So we sent some patients to the psychiatrist before they were aborted; some we did not. But we finally settled on a terminology which we put in the chart, and it went something like this: “Continuation of this pregnancy would be detrimental to the physical and emotional well being of this patient.”

In spite of these words, it was clear that most, if not all, of the abortions which we performed were done so that the patient’s life would not be interrupted by the pregnancy and delivery of a baby.

Early in my training I also had an experience in which I became acutely aware of the fact that there were a lot of patients who came in holding stuffed animals. I began to refer to this as the “teddy bear sign.” As these active-duty officers and active-duty enlisted, and dependent wives and dependent daughters would arrive at our hospital, not just a few of them, but many of them would be carrying some stuffed animal with them. It was not difficult for me to associate this with insecurity and immaturity on the part of these patients. This was in sharp contrast to the patients who were coming to the hospital for other types of surgery.

Another observation was that many of them came back for their second and their third abortions. I can stand here and tell you that during my time in training I never did encounter a true therapeutic abortion situation. One patient who had a therapeutic abortion for kidney disease was aborted at about 32 weeks. The baby weighed over 3 lbs. and even in that day would have had about a 70% chance for survival if the labor had simply been induced and abortion not performed.

28 week unborn baby

In my training program we really made no attempt to counsel the patients concerning their abortions. Most of them had spent many hours and, in some cases, days being transported to the hospital. We limited our discussion with them to the medical aspects of the abortion procedure itself in order to obtain their consent. I recall one patient, however, who decided against having her abortion after she came. Somebody had talked her into having the abortion, and as we got her into surgery and the pentothal was injected, I was standing at the end of the table, and she raised her arm as she was going to sleep and waved it several times, and stated, I protest! At that point I ripped my gloves off, walked out of the room, and told them to wake her up. I wish I could stand here today and tell you that I decided to stop doing abortions in a single instant. But it didn’t happen that way. As you will see, my decision was, and perhaps still is, an evolving one, and we can get into a discussion about that. I did not feel right about doing abortions, but I made no effort to distinguish legal from moral at that time. My justification was that it was legal, the patients wanted it done, and they came from all over the world to Travis Air Force Base in California to have it done.

6 to 7 week unborn baby

It was easy for us to do the first trimester abortions because we were using the same procedure that you use if you remove the placental tissue after a woman has a miscarriage. The vacuum machine is used, and the vacuum tubing empties into a tidy little cheesecloth sack. That little cheesecloth sack is about this big and in it are the products of conception. That’s what we called it. We sent those down to pathology.

In my second year of residency I spent two months on a pathology rotation, which is an interesting thing, and I had to come face-to-face with the contents of those sacks. We were studying the embryology of the ovary. I was in an obstetrical gynecology residency and we were obviously interested in the embryology of the ovary. I, personally, then had to search through the jumbled-up mass of tissue to find the fetal gonads, to be sure to include them on the slide so that we could study them. The jumbled-up mass of tissue was easily identifiable as the torn and shredded body of a tiny human being. It was very obvious when we viewed the slides that we were also studying the embryology of the testes, because half of the aborted fetuses were males….Even though these discoveries made me uncomfortable, I continued to do abortions. There were times when I personally sat there and opened up containers, five, six, seven containers at a time, and would open them up and stand and look at the [contents].


Many of them [abortionists] had nightmares about their participation in the abortions. In my nightmares I would deliver a healthy newborn baby and I would take that healthy newborn baby and I would hold it up, and I would face a jury of faceless people and ask them to tell me what to do with this baby. They would go thumbs-up or thumbs-down and if they made a thumbs-down indication then I was to drop the baby into a bucket of water which was present. I never did reach the point of dropping the baby into the bucket because I’d always wake up at that point. But it was clear to me then that there was something going on in my mind, subconsciously.

second trimester – 16 weeks

I actually stopped doing the second trimester abortions at that time. There was no great clamor about my refusing to do the abortions, but it was interesting to me that there was a subtle understanding that my actions were causing the other residents to do more than their share.”


Dr. Hill eventually stopped doing abortions due to the influence of his wife. He later became a Christian and joined the pro-life movement.

This was from a speech at a conference sponsored by the Pro-Life Action League

Please also visit the Pro-Life Action League’s abortion providers page for more info. 

Leave a comment below. (note: Even though it says comments are disabled, comment box will still work).



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Former Clinic Worker: Kathy Sparks

This is the speech Kathy Sparks gave at the convention “Meet the Abortion Providers.”

“Right after the birth of Shannon, [her daughter] I knew that I needed to go back to work. We were in very bad financial shape and one of the people who lived in the apartment downstairs worked at the abortion clinic on the other side. At this particular abortion clinic there are two sides: the OB/GYN side where women go in to have babies, and on the other side they abort them. Let me tell you, it is very contradictory. She told me that there was an opening for a medical assistant on the abortion side of the clinic down at Hope and suggested I go down and apply for the job. I thought about it and talked to Mike about it, and when I asked her how much money they paid, she told me it was excellent. I thought this was great; I’d be in the medical field; I didn’t necessary have to have my degree.

So I went down and had a very intense interview. Let me tell you, as all of the former abortionists will tell you, that they really want to make sure that you are pro-choice before they hire you, and I really was. I did not have to convince them; it was obvious. They did put me through a second interview, however; they wanted to make doubly sure that they were hiring someone who was pro-choice.


eight week-old unborn baby

In the beginning, they trained me to answer the telephones and to make appointments…In this particular abortion clinic, when the girl set up her appointment, if the girl sounded even the least bit anxious to make the appointment for that day, they did not want her to have an opportunity to change her mind or to have someone talk her out of it, or the possibility of her going to another abortion clinic.

As you will see as I tell you about this clinic, I believe the love of money was the root of evil that happened at this particular abortion clinic (this is only my opinion).

We did between 40 and 60 a day at this one clinic; they were very busy and they did abortions approximately four days per week. We would just stay there late and work sometimes two hours overtime to get those extra girls in. Sometimes they were more than content to wait until the next day, or perhaps the next week; other times they had to have it done then, and, indeed, they would get their abortion that day.

So, I answered phones and set up trays in the morning. We would put the instruments in a big sterilizer and set them all up; about ten at a time; then we’d set more up.

Then I was trained to do all sorts of fun medical things, like take blood pressure. I just really loved it; I really liked it; I liked my job. I got to wear a white uniform. All the desires in my heart to be a nurse were being somewhat fulfilled, as evil as it was. I did not see how evil abortion was. It did not bother me at all. When I saw my first abortion procedure, I didn’t see it any differently than dissecting a frog in biology. I had blinders upon my eyes, as I believe many people involved in the abortion industry do. I believe that many of them, giving them the benefit of the doubt, didn’t really see the evil that they were partaking in.

In my opinion, the most important part of this particular abortion clinic was the counseling. I was able to sit in with one particular worker who had eight years of college; she was so very good. She could sit down with these girls during counseling and she could cry with them at the drop of a pin. She would immediately start drawing them out, asking them all kinds of good questions. She would find out what their pressure point was. What was driving them to want to abort that child, and whatever that pressure point was, she would magnify it. If it was the fact that her parents were going to “kill” her, and she didn’t know how she was going to be able to tell her parents; then the counselor would proceed by telling her, you don’t have to do this; that’s why abortion is here; we want to help you; this is the answer to your problems. Oftentimes, if it was money, she would tell them how much baby items cost. You know, it does cost $3,000 to have a baby now, and, you know, baby shoes are $28; sleepers are $15. You know, that’s what’s wonderful about abortion; we can take care of this problem and you don’t have to worry about it until you are financially prepared to have a child. So that’s what the counselors would do.

The counseling at this particular abortion clinic was so effective that 99 out of every 100 women would go ahead and abort. So that’s very effective counseling; a very important part of that abortion clinic.

After they were counseled, they were put back in the waiting area to wait for their turn to go and have the procedure.

I do want to interject here about sidewalk counseling because some people have talked about that. Dr. Hill said that he did not see picketers; we did have picketers. But back then, and this was ten years ago, we didn’t have very nice picketers. So I would like to share a little bit about what I believe might be a good and effective way to picket, because I believe picketing is very, very important; it’s essential; very important. The type of picketers we had did things like egg the cars and put garbage on the doorstep, and threw broken bottles in the parking lot. The people who worked inside the abortion clinic, as well as the women who were waiting to have the abortion, they all think they’re “nuts;” they think they’re “loony” because of this criminal damage they’re doing. A few times they would take a car key and scrape up the sides of the car; this was before they had security guards to protect the parking lot and all of our vehicles.

So I would suggest that is not a good form of picketing. It’s not very effective. At that time, abortion had only been legalized for approximately four or five years. It was relatively new and I think the Pro-Life Movement was just getting on its feet, and we didn’t hear a whole lot about the Pro-Lifers, other than the fact that they all thought that we were murderers. I’m just telling you how I felt about Pro-Life people back then.


After a while, I would sit in during the recovery room phase before I learned how to assist the doctor in the procedure room. The recovery room is an incredible place at this particular clinic. I don’t know how it is now, but back then they would do so many abortions. They had recliners, like most abortion clinics do, and some girls, if they were far along in their pregnancy, would be on a stretcher. But oftentimes, there were so many girls and not enough recliners that they would be sitting on the floor. After this medical procedure, here they are sitting on the floor with a blanket around them. They would be given a couple of cookies and perhaps a soda, and as soon as they were even somewhat ready, they were out the door because they had more patients to get through. It was really sad.

During that whole time, I didn’t think a thing about it. It didn’t bother me at all that they were sitting on the floor. We would keep moving out of the recliners and move more in, and just keep going.

I worked in the clean-up room, in my opinion the worst part of the clinic because it was so messy. You had to wear rubber gloves and it was like washing dishes. That’s where the babies were brought back. At the time I worked there, they only did first trimester abortions; they didn’t have facilities to do second trimester. But, oftentimes, second trimester abortions were performed and these babies we would not put in the little jar with the label to send off to the pathology lab. We would put them down a flushing toilet. They had a toilet that was mounted to the wall, and it was a continually flushing toilet; it didn’t have a lid or a handle. That’s where we would put these babies. They knew that they couldn’t turn them in or they were going to be found out that they were doing abortions which were too late term. This is what I participated in while I worked there

13 week-old unborn baby

The ones that were small enough, which would be 12-13 weeks or less, we would put in a jar, label them, and put them in a big box to go off to the pathology lab. I want to share this with you that this is the type of person that I was. As far as moral convictions, I might have had them way earlier in my life, maybe at 17 or 18. But here I was, 21 years old, and very much into the world. I did drugs, I drank; I was just a very, very bad sinner. When the babies would be put in the jars, we would hold them up and kind of twirl them around and look at the little arm and little leg float up, and we’d put them back in the box. As sick as that sounds, that’s the way it was, and that’s the way it is at a lot of places right now.

I think that there are two sets of people in these abortion clinics. We have the ones who have been there for a long time, since the first day, and they’re more like Dr. Brewer in the fact that they’ve just become hardened. After a while it doesn’t bother them at all. Then we have the other set who don’t stay there very long, and that was me. They stay for three or four months, and they can’t take it any more and they have to get away. That was basically the two types of people that I came in contact with during my short stay at that abortion clinic.

legs of an unborn baby at 12 weeks

Then, of course, I worked the procedure room where we assisted the doctors. We handed them their instruments, took the blood pressure, made sure that the girl was okay. They did have two registered nurses on staff there that would administer a drug called Sublimaze, which was kind of like a relaxing drug. This drug was given to the girls who were farther along, 12, 13, 14 and farther to help her become relaxed. But, oftentimes, it didn’t really help. A lot of times people think that these girls are put to sleep. I’ve never seen an abortion where the girl was put to sleep. I do know that they do take place, of course, but not at this particular abortion clinic.”


Sparks then describes how miserable she was, how she became suicidal, and how she went on to have a religious conversion.


The next day I went into the abortion clinic. It was so completely different than the very day before. It was freezing cold. I could not get warm. I was chilled all the way down to my bones. I just couldn’t get warm. I had a sweater on, and it was incredible because no one else seemed to notice. There was a smell, a stench in the air that I couldn’t get away from. I kept breathing it and breathing it and it was making me nauseous. One of the first abortions done that day was on a woman who was 23 weeks pregnant. This woman should have had a saline or a laminaria abortion, or even a hysterectomy. Anything would have been better than to try to do a D&C on a woman who was that far along.

22 to 24 weeks sonogram

You have to realize that in this particular abortion clinic, what would be done was she would be examined one side; a pelvic exam by one doctor; then she’d come over and go through all the blood work and sign a release paper, etc. Then, by the time it was time for her abortion, she would be examined a second time. So we’re talking about two different doctors doing a pelvic exam who knew this lady was farther than certainly 12 weeks along. She lay on the table. She was a regular-built person, and she had a belly. And I thought, no way! That couldn’t be the baby! So the doctor did the pelvic and sat down on his chair and mouths up to me, “very big.” I’m thinking, very big, what are you going to do this for? I was trembling and getting a little bit nervous. But he began the procedure. He started to dilate her with the dilating rods and the water broke. He began to do a procedure that normally would take five to eight minutes, and we were in there for an hour. This woman was in so much pain, she was coming off the table. Every medical assistant and nurse was in that room. The nurse had to give her three doses of Sublimaze to try to calm her down. She was screaming; the nurse was yelling at her because everybody else was getting quite upset in the waiting area, as you can imagine, from this woman who was screaming. The doctor was trying to do the abortion, and the baby’s bones were far too developed to rip them up with this curette, and so he had to try to pull the baby out with forceps, which he brought out three or four major pieces. Then he scraped and suctioned and scraped and suctioned. There this little baby boy was laying on the tray. I took the baby and I took him to the clean-up room, and I set him down, and I began weeping, uncontrollably sobbing for what I had been a part of because God showed me that was a baby, they were all babies, and I had been a part of murdering probably nearly 1,000 babies, and I cried and cried. His little face was perfectly formed, just like the sign you saw, perfectly formed; little eyes were closed, little ears and everything was perfect about this little boy.

unborn baby at 20 weeks

So the recovery nurse was wondering what was taking me so long and she walked in and looked at me. She left, didn’t say a word, shut the door, and went and got the director of the abortion clinic. This woman walked in, shut the door behind her, put her hands on my shoulders and grabbed me. She began to rebuke me; pull yourself together; you’re a professional. She shook me. I was a limp rag and crying and crying, this baby was 23 weeks. The doctor himself had told me how far along she was. She said, when did you get your medical degree? She took the baby boy over the toilet and put him down the toilet. I was crying and crying. Finally, when she was finished, I told her I couldn’t work procedure anymore, that I’d stay in cleanup. She said, fine. We worked it out and the other girls went in to work procedure for the rest of the day.

That night I went home and I told Mike about the entire experience. I said, Mike, I don’t know what to do. We had thousands of dollars worth of debt. We had all the debts from his first marriage, a new baby, so much financial debt. And at the time we were such new believers in Christ that we didn’t know that He was our God who would provide every need according to His riches and glory. We didn’t know that yet. Apparently, Mike must have skimmed over that in the Bible, we didn’t know that yet. He said, let’s just pray about it. Okay, Mike, let’s pray. He went to work that night and I lit two candles at the side of my bed and sat down and prayed a very childlike prayer: Lord, if you want me out, just speak to me, and if I know it’s going to be okay, I’ll leave, Lord. I will leave. Just tell me.

I went to sleep that night, got up, and went to the abortion clinic the next morning and experienced the same smell, the same cold chills. I worked the cleanup room and at 10:00 in the morning, the director, the same lady who rebuked me the very day before, walked in and closed the door behind her. Only this time, she’s very bothered. She’s very troubled. “Kathy, I had a dream last night and it was so real that I don’t know if I dreamed it or if you told me this, or what.” I’m kind of looking at her and said, “What did you dream?” She said, “I dreamed that you walked into my office and you told me that you had to quit this place because of your religion!” I had not told a single person that I had made a commitment to the Lord. You know how you have to grow in that before you tell anybody, and I just didn’t tell anybody yet. So I knew that God had given her a dream to come in and tell me to get out. So I told her, “You did have a dream; I did not tell you that, but I am going to quit. I do have to leave, and it is because of my religion. What you’re doing here is wrong and I must leave.” She left then. She thought I had lost my marbles the day before and now I was crying.

It’s amazing how Satan works, because if you don’t think he’s real, he sure is. She walked in later on that day and offered me $2.50 an hour more to stay and work tubal ligations. She said, “Certainly birth control isn’t against your religion.” I said, “Well birth control might not be against my religion, but this place is. I’ve got to leave. So I quit.”

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Former Clinic Worker: Jewels Green

Like many who work in abortion clinics, Jewels Green had an abortion herself, which had led to emotional trauma, including suicidal feelings and a psychiatric hospitalization. She worked in the abortion industry for five years, witnessing the aftermath of many abortions, before leaving her job.

Recently, she began speaking out about her experiences in the clinic. She says that a kind of “gallows humor” pervaded the clinic, in which the workers made jokes about the dead bodies of the babies they saw and the other distasteful aspects of abortion. For example:

“I vividly remember the cleaning lady who quit after finding a foot in the drain of the one of the sinks in the autoclave room (where the medical instruments were cleaned and sterilized after abortions) and how we all laughed and joked about it in the staff lounge for days and weeks afterward…”

She goes on to mention:

“But one thing about the clinic never sat well with me, and maybe this is because in my heart I always knew it was wrong. All of it was wrong. Especially this: the dead baby in the refrigerator in the lab. It was touted as a “teaching tool” and a “medical anomaly that this perfect 10-week-old fetus “survived” the suction abortion procedure perfectly intact. So he (I thought I could tell it was a he) was given the dubious honor of being preserved in formalin in a translucent plastic jar in the laboratory refrigerator. I think we called him Charlie, but I can’t really remember…. Occasionally I peeked in on him, fascinated by the bizarreness of it all, but also with a scientific curiosity—every other abortion resulted in parts, bits and pieces of human in the jar—but this miraculous little creature was perfectly formed and complete in every way, with the heartbreaking exception that he was dead. There was no amniotic sac, no placenta, just teeny-tiny perfect little baby. Floating in the jar. In the fridge. Forever silent witness to the march of death of his immature brethren. How I now pray his soul rests in peace, and that someday he is given decent burial—or at the very least tossed out with the rest of the bio-hazardous waste—for that would be far more merciful than where I knew him to be.”

10 week-old unborn baby – from a miscarriage

She also says of the abortions she participated

“Abortion ends life. Period. This is not in question nor should it be. This is a fundamental truth. I worked in the autoclave room where the “products of conception” (as so many pro-choice proponents—and abortion clinic counselors—call the fetus and placenta) were rearranged and counted to make sure “we got everything.”…. For abortions from about 8 1/2 – 12 weeks, this meant counting hands and feet, making sure the spine and ribcage and skull were present, you get the idea. For the abortions where the gestational age of the fetus was in question, especially if there was a chance it was an “oops,” meaning a pregnancy terminated beyond the clinic’s legal limit of 14 weeks LMP (from last menstrual period), the feet were measured to determine a more accurate gestational age.

14 week sonogram

Working in the autoclave room was never, ever easy. I saw my lost child in every jar of aborted baby parts. One night after working autoclave my nightmares about dead babies were so gruesome and terrifying and intense I met with the clinic’s director to talk about my feelings.

She was very understanding, open and honest, and painfully forthright when she told me, “What we do here is end a life. Pure and simple. There is no disputing this fact. You need to be OK with this to work here.” After a few days rotated out of the autoclave room, I felt I was OK with this, and God help me, I went back.”

Green eventually did leave and is now a pro-life activist.


Former abortion clinic worker breaks silence, speaks out for life” BY KRISTEN WALKER Lifesitenews.com Thu Jul 21, 2011

 Laughing at the baby’s foot in the sink: for us abortion clinic workers, the macabre was the normBY JEWELS GREEN LifeSiteNews.com Thu Sep 08, 2011


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Well Known Abortionist Discusses Abortions To Save a Woman’s Life

Abortionist Don Sloan, who has performed abortions for decades, says that a situation where the mother’s life is endangered by her pregnancy is extremely rare:

“If a woman with a serious illness- heart disease, say, or diabetes- gets pregnant, the abortion procedure may be as dangerous for her as going through pregnancy … with diseases like lupus, multiple sclerosis, even breast cancer, the chance that pregnancy will make the disease worse is no greater that the chance that the disease will either stay the same or improve. And medical technology has advanced to a point where even women with diabetes and kidney disease can be seen through a pregnancy safely by a doctor who knows what he’s doing. We’ve come a long way since my mother’s time….The idea of abortion to save the mothers’ life is something that people cling to because it sounds noble and pure- but medically speaking, it probably doesn’t exist. It’s a real stretch of our thinking.”

Don Sloan, M.D. and Paula Hartz. Choice: A Doctor’s Experience with the Abortion Dilemma. New York: International Publishers 2002 P 45-46

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