The rhetoric in Initiative 694 is less than subtle. It refers to partial-birth "infanticide" rather than "abortion"—upping the ante on an issue that had already

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Fetal stealth

Is 'partial-birth' I-694 a covert attack on all abortions?

The rhetoric in Initiative 694 is less than subtle. It refers to partial-birth "infanticide" rather than "abortion"—upping the ante on an issue that had already turned into a rhetorical war over the non-medical and emotionally charged term "partial birth."

Opponents, on the other hand, insist that the initiative's language is vague—so much so that it would effectively ban all abortion. The argument has considerable credence, given that courts have cited vague language in striking down similarly written laws in many of the 28 states where they have been passed.

Yet I-694 opponents remain frustratingly vague themselves when it comes to arguing their case. Those who aren't intimately familiar with the scope of abortion procedures have to guess at why this initiative might apply. Ask retired Planned Parenthood of Western Washington medical director Sheldon Biback about the specifics of a second-trimester procedure called "dilation and evacuation," for example, and you are met with, "It's not relevant. The uterus is emptied. It is emptied by whatever technological method the physician chooses to use."

The main reason for such reticence is obvious. Even most abortion supporters admit that "the techniques of abortion are gross," as one local doctor puts it. In addition, abortion providers are reluctant to talk on the record out of fear for their safety. Says one, "My wife actually says that every time she goes out and starts the car, she wonders if it's going to blow up."

On- and off-the-record comments about abortion procedures, however, furnish a close look at the likely effect of I-694. This in turn raises a fascinating but gruesome question: At what point during the course of an abortion does the fetus die? It's a question almost as thorny as "When does life begin?"

Consider the initiative's description of what it would ban: "the killing of a live infant who is in the process of birth, that is, who has exited by any means, at least in part, the vagina or birth canal" (emphasis added). Initiative supporters say the wording is narrowly intended for partial- birth abortions, a second- or third-trimester procedure in which the doctor induces labor, compresses the fetus' skull, suctions out its brain and extracts the otherwise intact fetus.

But consider also the first-trimester method called "suction curettage," used in 89 percent of the 26,138 abortions performed in Washington state in 1996—the latest year for which state statistics are available. The doctor inserts a tube into the uterus and suctions the fetus out. Initiative opponents argue that the fetus in this method also travels through the birth canal and vagina, albeit through a tube. As Dr. Biback points out, the initiative specifies "by any means"—which could include, possibly, "with the use of a tube."

But is the fetus alive, as the initiative also specifies? (Ignore for the moment the initiative's loaded use of the word "infant.") Dr. Leslie Miller, an ob-gyn who teaches at the University of Washington, explains that the fetus "probably gets torn apart" in the process of being suctioned. Yet, like many doctors, she says it's impossible to tell at what point the fetus dies, particularly since the entire process takes just two minutes. Even in the tube, she says, "the cells are alive."

While this seems to stretch the meaning of a "living" fetus, Tom Easterling, another UW professor and practicing ob-gyn, puts forward a more compelling definition of "living": the state in which a fetus's heart is beating.

Hard as it is to believe, there may be a heartbeat even as a fetus is being suctioned or extracted in the second-most-common type of abortion: a dilation and evacuation procedure. In a D&E, the doctor pulls a second-trimester fetus out with forceps because it is too large to be suctioned through a tube (yet small enough to make unnecessary the compressing of its skull or the induction of labor). Here, too, the fetus usually comes out in pieces.

Easterling's analysis is more than academic, since the initiative holds the threat of felony prosecution over the heads of abortion providers. "I would not perform an abortion until I know that the heart has stopped," he declares. Abortion clinics in Wisconsin made a similar decision when they shut down for a few days in May after the state enacted a vaguely worded ban on partial birth; most opened again when prosecutors agreed to not prosecute those performing first-trimester abortions, and a court decision has since enjoined the law. Easterling goes on to explain that it is possible to stop a fetus's heart in the womb before an abortion by means of an injection. It's a complicated and expensive procedure, however, entailing the use of an ultrasound for guiding the injection into a fetus so small it is measured in millimeters. Most abortion providers don't have the skills to do it.

Initiative supporters deride these kinds of analyses. "We're only talking about the process where natural birth begins," says Christian Coalition director Rick Forcier. "The public knows the difference [between partial-birth and other kinds of abortions]. The only ones that really don't know what we're dealing with is abortion providers."

But is it any more "natural" to deliver a fetus with a compressed skull than to suction one out in pieces? And is a fetus in either case any more alive?

Whatever the ultimate fate of I-694, there's no question that opponents of all types of abortion are eager to have this conversation—a circumstance, no doubt, that accounts for the initiative's lack of a medical definition for "partial birth" and its failure to define it in terms of a particular stage of pregnancy. This initiative and laws like it, Forcier says, are "one step towards increasing the national dialogue on abortion. For us it's a good opportunity."

 
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