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A Medical Doctor describes the Dilation and Evacuation Procedure

-- Dr. Tony Levatino, M.D.

Imagine for a moment that you are a "pro-choice" obstetrician-gynecologist as I once was. Your patient today is seventeen years old and she is twenty weeks pregnant. At twenty weeks, her uterus is up to her umbilicus and she has been feeling her baby kick for the last two weeks. If you could see her baby, she would be as long as your hand from the top of her head to the bottom of her rump not counting the legs. Your patient is now asleep on an operating room table with her legs in stirrups. Upon entering the room after scrubbing, you dry your hands with a sterile towel and are gowned and gloved by the scrub nurse.

The first task is remove the laminaria that had earlier been placed in the cervix to dilate it sufficiently to allow the procedure you are about to perform. With that accomplished, direct your attention to the surgical instruments arranged on a small table to your right. The first instrument you reach for is a 14-French suction catheter. It is clear plastic and about nine inches long. It has a bore through the center approximately ¾ of an inch in diameter. Picture yourself introducing the catheter through the cervix and instructing the circulating nurse to turn on the suction machine which is connected through clear plastic tubing to the catheter. What you will see is a pale yellow fluid the looks a lot like urine coming through the catheter into a glass bottle on the suction machine. This amniotic fluid surrounded the baby to protect her.

With suction complete, look for your Sopher clamp. This instrument is about thirteen inches long and made of stainless steel. At one end are located jaws about 2 ½ inches long and about ¾ on an inch wide with rows of sharp ridges or teeth. This instrument is for grasping and crushing tissue. When it gets hold of something, it does not let go.

A second trimester D&E abortion is a blind procedure. The baby can be in any orientation or position inside the uterus. Picture yourself reaching in with the Sopher clamp and grasping anything you can. At twenty weeks gestation, the uterus is thin and soft so be careful not to perforate or puncture the walls. Once you have grasped something inside, squeeze on the clamp to set the jaws and pull hard – really hard. You feel something let go and out pops a fully formed leg about 4 to 5 inches long. Reach in again and grasp whatever you can. Set the jaw and pull really hard once again and out pops an arm about the same length. Reach in again and again with that clamp and tear out the spine, intestines, heart and lungs.

The toughest part of a D&E abortion is extracting the baby’s head. The head of a baby that age is about the size of a plum and is now free floating inside the uterine cavity. You can be pretty sure you have hold of it if the Sopher clamp is spread about as far as your fingers will allow. You will know you have it right when you crush down on the clamp and see a pure white gelatinous material issue from the cervix. That was the baby’s brains. You can then extract the skull pieces. If you have a really bad day like I often did, a little face may come out and stare back at you.

Congratulations! You have just successfully performed a Suction D&E abortion. You just affirmed her right to choose. You just made $600 cash in fifteen minutes.

(Click here to see a video explanation of the procedure.)

(Click here to see a medical diagram of the procedure.)

For more medical information on D&E abortion, see the following texts:

Abortion Practice, by Warren M. Hern, M.D., M.P.H. (1990: Alpenglo Graphics, Inc., 1130 Alpine, Boulder, CO 80304), ISBN 0-9625728-0-2.

Second Trimester Abortion: Perspectives After a Decade of Experience, Edited by Gary S. Berger, William E. Brenner, and Louis G. Keith (1981: Martinus Nijhoff Publishers, PO Box 566, 2501 CN The Hague, The Netherlands and John Wright, PSG, Inc., 545 Great Road, Littleton, MA 01460), ISBN 90-247-2487-2.

 

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