His colleague, Dr. Frederic D. Frigoletto, vice chairman of obstetrics and gynecology at Massachusetts General and past president of the American College of Obstetricians and Gynecologists, agreed and called for a different kind of effort among people who want to preserve women’s right to abortion.
“We are not in favor of this act, but now that it is here, we should prevent further intrusions” by legislatures into medical practice, Dr. Frigoletto said, “rather than spending a lot of energy saying things that are not very accurate about the impact of the ban itself on women’s ability to have pregnancy terminations.”
Nonetheless, the political reverberations of the decision are leading to widely disparate pronouncements by groups on either side of the abortion debate, with continuing questions about what the ban means and how the Supreme Court could possibly regulate the practice of medicine. The law is perfectly clear, said Douglas Johnson, legal director for National Right to Life, which opposes most abortions. To violate it, Mr. Johnson said, a doctor has to plan to deliver vaginally a living fetus and then deliberately kill it when it is leaving the womb.
It is permissible to kill the fetus while it is in the womb, Mr. Johnson said, adding, “Anything goes inside the womb.”
It is also permissible to deliver a fetus so immature that it could not draw a breath or otherwise show clear signs of life. And it is permissible to use the banned method to save the pregnant woman’s life.
The Supreme Court decision is shameful and incomprehensible, said the American College of Obstetricians and Gynecologists, which issued a statement about the decision. The organization added that the procedure, which it calls intact dilation and extraction, or D and E, “is safest and offers significant benefits for women suffering from certain conditions that make non-intact D & E especially dangerous.”
The American Medical Association did not issue a statement. Its policy, which abbreviates dilation and extraction as D & X, states: “According to the scientific literature, there does not appear to be any identified situation in which intact D & X is the only appropriate procedure to induce abortion, and ethical concerns have been raised about intact D & X. The A.M.A. recommends that the procedure not be used unless alternative procedures pose materially greater risk to the woman.”
Dr. Schiff said, “Obviously, it’s a very emotionally charged situation,” but the new abortion law “is very clear and specific,” stating just what Mr. Johnson said it did.
Although some doctors may feel more comfortable with the banned method, Dr. Frigoletto said alternatives include dismembering the fetus before extracting it from the uterus or killing the fetus first with a lethal injection of a drug and then inducing an abortion.
The banned method, Dr. Frigoletto said, is typically used when a woman is 20 to 23 weeks pregnant and before the fetus is viable. Any earlier and it would be almost impossible to extract a live fetus and crush its head. The fetus would be so tiny that it would fall out of the uterus when the cervix is dilated, he explained.
About 5,000 women a year have abortions in the middle of the second trimester, but there are no figures on what proportion use the banned method. Dr. Frigoletto estimated that it was a minority, though, because with the partial-birth method the woman has to endure several hours of labor.
But some doctors prefer the banned method, he said, adding: “Just like any surgical procedure, there are variations, and some surgeons feel more comfortable with one procedure than another, based on training and experience.” |
