Gosnell, Carhart, and the PBA Ban (Part 2)

In Part 1, I gave a bit of background to the whole practice of post-viability abortions, which were invented by the Supreme Court in 1973 and embraced wholeheartedly by a select group of intrepid abortion practitioners who weren't about to let a little thing like a baby thwart their ambitions.

Post-viability abortions are a subset of abortions past the midpoint in pregnancy, at which point the baby is too big and sturdy to easily dismember. It was for these abortions in general, and not post-viability abortions in particular, that a solution was sought.

Hysterotomy (delivering a baby via c-section and just letting it die) is a massively invasive procedure and can lead to unpleasant legal ramifications if somebody in the OR realizes that you're killing a viable baby and is enough of a retrograde throwback to have a problem with that.

The old-style instillation abortions (putting poison in the amniotic fluid) were, like hysterotomy, too dangerous to do outside a hospital. Not only was that prohibitively expensive, but in a hospital, the doctor didn't have as much control over who dealt with the patients, and thus he was risking the problem I mentioned before of buttinski nurses who would see a live baby and wouldn't just drop it in the bucket and stick it in the closet per instructions.

Once ultrasound machines became common, however, abortionists discovered that rather than just load the amniotic fluid down with poison and hope the baby swallows and inhales enough of it to die, they could jab a needle straight into the baby's heart or brain and deliver a lethal dose much more reliably.

Once the baby is dead, the abortionist can let it soften overnight -- "like meat in a crock pot" as LeRoy Carhart said -- and take it out in pieces the next day, or he can induce labor and let the mother deliver it into the toilet, as George Tiller preferred to do.

Some doctors, however, found the crock-put baby thing a bit troubling. Among them was Dr. James McMahon in California, who had two issues brewing.

First of all, he had a strange fascination with the idea of dilating the cervix as wide as he could. He quoted another abortionist as describing opening the cervix "like a lotus in the moonlight." Personally I find that creepy, but then I have a problem with dropping a live baby into a bucket and covering it with formaldehyde so I'm clearly an unenlightened busybody like those troublesome nurses that couldn't be trusted to deal appropriately with saline survivors.

Second of all, many of his patients were aborting wanted babies that had been diagnosed with some problem. These parents wanted to see the baby after it was dead. A macerated, mutilated fetus isn't a pretty sight.

McMahon came up with a solution, which he dubbed "intrauterine cranial decompression." He'd drag the living baby out feet-first, then stop just before delivering the head to suck out the brains, "decompressing" the "cranium." All he'd have to do was have a nurse stuff the collapsed head with cotton batting to round it out and he'd have a very presentable dead baby to show the parents.

"Intrauterine cranial decompression" doesn't exactly roll off the tongue, and perhaps because of this it didn't catch on very quickly. Then in 1992, Dr. Martin Haskell made a presentation to the National Abortion Federation Risk Management Seminar in Dallas. He tweaked McMahon's technique and dubbed it "D&X," for "dilation and extraction." With such a catchy name, how could it fail?

The method caught on, but the prolifers caught wind of it, and the proverbial shit hit the fan. The prolifers gave the procedure the name that finally stuck -- Partial Birth Abortion -- and managed to get it banned.

What a bunch of killjoys.

Gosnell, Carhart, and the PBA Ban (Part 1)

Abortionist Carhart

The Kermit Gosnell verdict and Live Action's release of the Carhart video offer us a chance to reflect on how the Partial Birth Abortion (PBA) Ban changed and didn't change abortion practice.

Let's have a brief refresher.

Before Roe: 

Post-viability abortions are at their core a nonsensical concept. Pick up any dictionary and you'll find that "abortion" is defined as the death of the fetus prior to viability. All pregnancies end. A pregnancy with an "abortive outcome" ended before the baby could survive outside the womb. This abortive outcome could be natural (a miscarriage) or induced by deliberately killing a living fetus. Once the fetus had passed the developmental age of viability, the outcome of the pregnancy is by definition a birth -- either a live birth or a stillbirth. But in 1973, a group of non-physicians handed down a decision called Roe vs. Wade which decreed that logic be damned, language be damned,  medicine be damned, if somebody wanted to kill a fetus at any point in the pregnancy, legally that act of killing would be lumped in under "abortion" and it would be enshrined as a right.

Tinkering Around

With this new permission to kill any fetus they wanted to kill, abortionists tinkered around. They took the two basic ways of getting a viable fetus out of the mother -- induced labor and a c-section -- and modified them to make sure that the end result would not be a live baby. Those who preferred to induce labor would do something prior to inducing labor to make sure the baby would come out dead. In the era before ultrasounds allowed an abortionist to guide a needle to the fetal heart or brain to do a lethal injection, this was done by injecting poison into the amniotic fluid. If labor induction failed, or if for some reason time was of the essence, a hysterotomy would be performed -- which is just a c-section with the intent of delivering a dead baby.

The Problem

Both of these approaches to the newly-minted post-viability abortion, however, had one serious drawback. Fetuses can be remarkably tenacious of life. You can want them dead, but they can thwart your plans by failing to die. This is known as the "dreaded complication." (Interesting that the "dreaded complication" isn't a dead mother but a live baby. What other medical procedure considers life itself to be both dreaded and a complication?)

There are two standard approaches to the dreaded complicaton:

1. The Obama Approach: Pronounce that since you'd made the decision to go ahead with an abortion, the fetus is by definition not viable regardless of his or her actual gestational age, size, health status, and condition upon delivery. He or she is to be stashed with the more cooperative -- and hence dead -- fetuses in the utility room or biohazard bag or wherever you choose to put them. Just pretend the whole ugly little business with the pulse and the breathing and the movement and the gasping and the crying never happened.
2. The Gosnell Approach: "Ensure fetal demise" after the baby is delivered. This is much quicker and more certain.

The problem with both of these approaches is that they leave you open to a third possibility:

• The Oh Shit I'm Gonna Get My Ass Sued Off Now Approach: Some idiot nurse rescues the baby and you curse the day you let that interfering bitch anywhere near your patient.

To most people, the How About We Don't Abort the Baby in the First Place Approach seems like an obvious solution. In fact, most abortionists decided that this is a good approach, at least for their own personal practices.* But some abortionists were more bold and intrepid. They weren't about to be cowed by some three-pound conglomeration of pregnancy tissue! And leading the charge was a stalwart fellow from Orange County, California. His name was James McMahon, and he was determined that if the person "who owns the child" wants it dead, then he would achieve that death, for a sizeable fee, whatever the great  personal cost to himself!

*I find it fascinating that although the abortion lobby fights to force all ob/gyns to perpetrate abortions whether they want to do them or not, there is no concerted effort to force existing abortion practitioners to do late abortions whether they want to do them or not. Bizarre, no?