Monday, November 14, 2022

Stumbled Across: Had Nancy Been Fully Informed?

While looking for original source documents for the case of "Tamara" in Lime 5, I found the case of Nancy Sabot, who went to Fargo Women's Health Organization for an abortion on January 29, 1988. 

The primary issue of Nancy's case hinges upon informed consent. Had Nancy been adequately prepared for what she might experience? 

Reading the coverage of the trial puts me in mind of how the ACLU treats abortion-injured women. There's so much here to unpack, so let's go.

Nancy's Qualms

Nancy said that she had been very uncertain about the abortion. In her intake paperwork, choosing the statement that best captured her feelings about the abortion, she circled, "I have some conflicts with my decision, but feel abortion would be best."

Nancy's attorney, Michael DeMoss, described the pre-abortion counselor as "a woman whose sole credential for work in abortion counseling appears to be the fact that she has had an abortion." David Reardon noted in his book Aborted Women: Silent No More, that a lot of women trying to cope with distress about their abortions go through a phase of encouraging other women to abort because this reinforces in their minds that they'd made the right choice themselves. 

Nancy testified, "I expressed many, many times I was unsure of the decision and [the counselor] kept pushing, pushing, pushing."

The counselor noted in her deposition that Nancy did indeed express moral conflicts with her decision. 

Did this counselor help Nancy to sort out her moral qualms so that she'd be confident in her ability to live with her choice? Or did the counselor focus on pushing Nancy past her moral qualms?

What both sides agree on is that Nancy was morally conflicted about the abortion before she got onto the table. She was not the woman prochoicers describe -- firmly and confidently following her own beliefs and morals. She was not a woman who would willingly face possible death at the hands of a "back alley butcher" because of her certainty that an abortion was what she wanted.

Nancy's Abortion

Dr. George M. Miks estimated Nancy's pregnancy as 10 weeks. He said that he asked Nancy before inserting the dilator if she wanted to proceed and she said yes.

Nancy said, "Dr. Miks began the procedure almost immediately after he came into the room. I began to breathe rapidly and hyperventilate. He instructed me not to protest. He said I could take the pain. Finally when I screamed, they said that I became uncontrollable, he quit the procedure.... Dr. Miks' last words to me were, 'I don't have to take this,' and he quit the procedure."

Miks agreed that the abortion was an ordeal for both him and his patient. In a deposition, he described Nancy as "uncooperative" during the procedure. "She moved around quite a bit, making the procedure difficult. She screamed and carried on, or at least verbally was quite loud and carried on in such a way that she ... had difficulty in in listening to instructions." He disputed Nancy's assertion that he got fed up and decided not to finish the abortion. 

Nancy definitely was screaming. Clinic employee Susan Charon said, "I was sitting at my desk and I heard screaming and I thought I would go downstairs to see if I could help," but decided that there was no need for her help because "They had just finished."

Charon said that she spoke to Miks about the situation. "He was upset, a little upset. He had said to me that she was rather difficult and he didn't think he wanted to go in and see her again."

Clinic director Jane Bovard also heard Nancy screaming, and said in her deposition that she'd been told that Nancy had been screaming, thrashing around, and hyperventilating during the abortion. She didn't feel any need to discuss the situation with the doctor, though, because, "It happens enough that I wouldn't find it cause to ask him about it."

Both sides agree that Nancy was in so much pain that she couldn't stay still. The staff even indicated that women screaming in pain was not out of the ordinary. Was it Nancy's fault that she couldn't stay still, or the doctor's fault for not providing adequate pain control?

The Incomplete Abortion

A clinic employee notified Bovard that Miks hadn't removed the entire fetus. "I went and talked to Dr. Miks. I asked him what he was feeling about this. He said to me, 'I clearly identified all the significant parts. I saw the calvarium (part of the skull that contains the brain). I saw the spine. I saw extremities. She does not need to be resuctioned.'" Miks had, in short, examined what he'd suctioned from Nancy's uterus.

The clinic staff said that Nancy didn't remain in the waiting room for half an hour after the abortion as instructed, and thus she missed out on her medications and aftercare instructions. Miks said this meant that Nancy hadn't been told about the possibility of minor bleeding, passing of tissue, and needing to return to the clinic in two weeks for a follow-up visit. This conflicts with their later assertion that Nancy had been made fully aware of what might come out of her body after she got home.

What Nancy Saw

Two days after the abortion, Nancy had just gotten out of the shower and gone into her kitchen. "I noticed a loud splat. I heard something fall out. I reached down to examine it. I thought it would be a blood clot, and I found in my hand the face, shoulders and arms of my baby."

Nancy said she called the clinic and told Sabot and told her what had happened. Sabot, she said told her that since Miks said he'd gotten the entire fetus, either Nancy was seeing just uterine tissue or the remains of a twin. Nancy said Sabot told her, "You passed it. Take your antibiotics. Since your bleeding is normal there is no need to take it in. Just get rid of it. Put it behind you and be calm. You will be all right." Nancy said that Sabot was clearly trying to talk her out of going to the hospital.

Sabot agreed that Nancy had called her at 6:48 am on January 31, saying that she had passed a head an arm. "She was screaming and yelling at me," Sabot said in her deposition. She added that Nancy's husband got on the phone and said he was going to sue the doctor.

After calling the clinic, Nancy said, she called two friends. One of them came to her home and grabbed "the baby and the tissue paper in which the baby was wrapped from my husband Mark's hand and was crunching it up acting like she was going to flush it. Mark grabbed the tissue and my baby out of her hand.... She wanted to flush my baby down the toilet. She kept saying, 'Put it behind you.'"

What Had Nancy Seen?

Nancy took the tissue with her to Medcenter One emergency room. A hospital pathology report described it as "parts of the human fetus including the entire face, two arms, and a portion of rib cage and back."

Nancy underwent a D&C to remove any remaining tissue.

The clinic argued that since a 10 week fetus is only an inch long the doctors don't typically inspect the tissue to make sure they got all the "parts." This disagrees with the deposition testimony that Miks actually did look at the tissue and identified the upper part of the skull (calvarium), spine, and extremities. And since the calvarium is pretty much the skull minus the facial bones, Miks effectively admitted that he'd left behind the face of Nancy's unborn baby, complete with the bony structure. He said that he'd removed "extremities," but not that he'd gotten all four. He didn't say he'd removed the entire rib cage. 

Here's information from Baby Center about 10 weeks into pregnancy: "Your baby is about the size of a kumquat," which they say is about 1.22 inches. But the plot thickens. During the trial, though Miks testified that he calculated that Nancy was 10 weeks and five days into her pregnancy, he noted in her medical records that she might have been 12 weeks pregnant. If we go back to Baby Center, Nancy's baby would have been "the size of a lime," about 2.13 inches crown to rump. (GRAPHIC: Click to see the face and arms of an aborted 10 week fetus. This can give you an idea of what Nancy saw and whether or not this would be what one would be expect to see if warned that "some of the pregnancy" or "retained tissue" might be expelled.)

Going On the Offensive

The clinic and their attorneys went into full attack mode against Nancy. Jane Hodgsen, a prominent abortionist with more than 30,000 dead babies to her discredit (but 5,000 live ones, so that's a 6:1 dead-to-live babies ratio with her), said, "The expulsion of a small portion of fetus at plaintiff's home, although painless and relatively bloodless, was unfortunate in view of her now apparent history of chemical addiction and hysterical personality traits. Retained tissue is a well-recognized complication of early abortion."

Note the terminology. The consent form said, "Missing all or part of the pregnancy" was expected in about six of every 1,000 abortions. Would you, if told you might "expel tissue," or "all or part of the pregnancy," expect to see the face of your dead baby staring up at you?

Nancy reported severe trauma from that sight, including "frequent nightmares of holding a baby in my hands, having a complete face and looking up at me." According to the hospital pathology report, that was exactly what Nancy experienced. Not a bland passing of a few blobs of tissue or ill-defined "pregnancy" -- which, by the way, is a state, not an object or organism.

Had They Screened Nancy?

Now let's look at how the clinic admits that they didn't do a very good job of screening Nancy to determine that she'd cope well with seeing that "tissue" should she expel it at home -- especially since according to their own arguments its to be expected that you might see a limb or two, maybe a face or even the entire head. 

"The plaintiff's alleged injuries, if any, are grossly exaggerated and without any basis in fact or law." This despite the hospital pathology report confirming what Nancy said she found staring up at her from her kitchen floor: the face, shoulders, and arms of her aborted baby.

A psychiatrist who testified for the clinic essentially said that Nancy had already been such a drug-addled nutcase prior to the abortion that it hadn't made her any worse. All of her problems were due to physical and mental abuse from her husband and her mother, and she had a responsibility to tell the staff how emotionally fragile she was. "I got the picture of a woman who thought her own life was very interesting, very unique and extraordinary" and noted that Nancy had a pre-abortion diagnosis of "atypical personality disorder." 

Shouldn't they have been screening for emotional instability before sending the woman home knowing that she might end up with her dead fetus staring up at her from her kitchen floor?

Miks in particular held that the entire thing was Nancy's fault for writing in pain so much that he couldn't get the entire fetus out. Besides, he asserted, she'd been told she might pass "fetal tissue" and if she'd find it so disturbing it was her own fault for going through with the abortion after the informed consent.


In the end the jury sided with Miks and the clinic, that Nancy was a drug-addled lunatic who willingly consenting to an abortion after being made fully aware that she might expel a recognizable mangled fetus. They didn't even find that Miks had failed to provide sufficient anesthesia to enable Nancy to avoid flinching in pain during the abortion. 

Nancy appealed the decision on multiple grounds, but the clinic and Miks insisted that Nancy foot the bill for the entire court transcript (over $7,000 in 1993, which is nearly $14,000 in 2022) to pursue the appeal. She couldn't afford to do so, instead having her attorneys submit the limited portions of the transcript Nancy could afford. The appellate court basically threw Nancy's appeal out on the grounds that they had insufficient information to make a decision.

Your Thoughts

Who was responsible for the trauma Nancy went through? 

Was it the clinic's responsibility to let her know exactly what sort of "tissue" she might pass? Or was it Nancy's responsibility to understand ahead of time exactly what that "tissue" might look like? 

Was it the clinic's responsibility to inform Nancy that women who had existing mental health problems were at higher risk for emotional trauma after an abortion? If Nancy had provided an extensive mental health history, would the clinic have warned her? Or should she have known that her mental health history made her high risk, without the clinic having any duty to inform her of this? 

Was it the doctor's responsibility to provide sufficient anesthesia so that the procedure would be painless for Nancy? Or was it Nancy's responsibility to hold still, regardless of how much pain she was in? 

I admit to being of two minds. I feel sorry for Nancy because when she was in a lot of stress, she believed the abortion-rights movement's soothing words about "tissue" and "the pregnancy," and how women never feel any negative reactions after an abortion. But also I wonder how an adult human being could not understand that an abortion would involve the mangling of one's unborn baby. What did she think Miks was going to suction out? A hamster?

What are your thoughts?

Watch Nancy and the Pregnancy Tissue on YouTube.


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