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Transcript of "See for Yourself"

Next on Gospel Of Life watch an explanation of the most common surgical procedure in America, abortion.

FP: Hello, I'm Rev. Frank Pavone, director of Gospel of Life Ministries. Welcome to our program. Most of the American people realize that abortions occur everyday in our country, but at the same time, most of our fellow citizens have never seen an abortion. What you are about to see in this program is a descriptive illustration of what the abortion procedure is. I must warn you that what you are going to see in this program is very disturbing and yet every detail is factually verified. 

We are joined by our special guest, Doctor Anthony Levatino, a medical doctor who has done the abortion procedure many times, no longer does it because of his conviction that it is wrong, but nevertheless will illustrate for us using instruments and fetal models exactly how the most common abortion procedures are performed.  

Doctor Levatino, thank you for joining us. 

AL: Glad to be here, Father Frank.  FP: How many abortions have you performed in your career?

 

AL: I did several hundred probably while I was a resident, I never actually kept count. But in private practice over a five year period in my first five years of private practice, I performed over 1200 abortions. 1100 of them were first trimester suction D&C abortions, and over 100 were second trimester D&E abortions.  

FP: OK, so we're going to talk about those two procedures and of course we should put this in a wider context. There are many abortion procedures that are done. 

AL: Yes. 

FP: Many different types. 

AL: Many different techniques. 

FP: But these are the two most common.  

AL: Absolutely.  

FP: OK, and we have here the instruments that are used at various stages of each of these procedures as well as fetal models. Lets start with the first trimester suction curettage abortion and explain to us actually what happens in that procedure. 

AL: The model here gives us some idea of what we are talking about size-wise. Here's a baby that would measure roughly ... of course doctors count from last menstrual period, so this baby would be somewhere in the range of around ten weeks since last menstrual period. At twelve weeks the baby is the.. literally the width of your hand, this one just comes out a little bit less than that and that's why I'm figuring this one to be approximately ten weeks, a very typical time for a suction D&C abortion. D&C is dilatation and curettage, the two parts of the operation. Dilation or dilatation is the opening of the cervix and then curettage is the term we use for scraping inside of the uterus. D&Cs can be done for lots of reasons, not just abortion, but the standard D&C procedure that might be used for say bleeding has been adapted to abortion. 

What is done is as I said, first dilation. If the pregnancy is in ... many first trimester abortions are early enough that you don't have to take an additional step other than mechanically dilating the cervix using dilators.  

If a pregnancy is beyond nine or ten weeks, still in the first trimester suction D&C range, we might use a material called laminaria. Laminaria is actually a product of seaweed believe it or not, and they come in these very tightly rolled sterilized, as an instrument basically, that has a string on it so that it can be removed from the cervix later. But the laminaria would be introduced through the cervix and then it absorbs water over eight hours and slowly dilates, and this tends to make dilation of more advanced pregnancies safer. This is absolutely vital in a second trimester abortion, so we'll talk more about it then. If the laminaria has been used it's removed. The patient is then ready for the procedure and a series of dilators of different sizes this is somewhat bigger... this is about a, actually this is about a nine, I think this is a nine - ten Hegar dilator. And this is just the size that you'd use for a pregnancy this size as a matter of fact when you get to this point of the procedure the cervix is progressively dilated by using the Hegar dilators, the cervix would be held with an instrument called a tenaculum this has a couple of sharp teeth on it which is actually used to hold the cervix so it won't move. And then the dilators are used progressively. They are pushed through the cervix. You have to be very careful of course. If you use too much force, or if you lose control of the instrument, it can actually go right through the uterine wall, which is a perforation, which is one of the big risks that are associated with this type of abortion.  

The cervix is dilated progressively in this case up to... this would be a number ten Hegar, which would be an appropriate size for an abortion this size, and then a suction curette which would be matching for the size of gestation is used. This is a number twelve straight curette, so we would use one slightly smaller. The sizes on the dilators and the curettes correspond, so a 10 curette would fit through the opening that the 10 dilator makes. The curette is introduced into the uterine cavity and then the suction is turned on. Now of course you don't have a suction machine here but it sits a couple of feet off of the floor and there are a couple of bottles on top of it and its connected through clear plastic tubing from the end of the catheter to the machine. This is a very powerful suction machine and when its turned on the catheter in place in the uterus again making sure that you don't go so far that you perforate the uterus, and then the curette is rotated inside the uterus while that suction is being applied. Now babies of this size, they're fully formed, two arms, two legs, beating heart, functioning brain. Its all there, but the structures are very soft. The bones have not calcified. All the tissues are very soft. So the suction machine just literally, just rips this baby to pieces, because... and it comes by basically ground up or homogenized right into the tubing and then gets pulled through the tubing into the collection bottles on the machine. 

FP: Is the edge of that sharp? 

AL: It is not. This one is not sharp. There are other types you can get that do have some little ridges on them. Generally this is really not meant as a scraping instrument, mainly just for suction.  

After the suction is done, most of this tissue is going to be gone. Then the actual curettage part, the scraping, is performed. We have one curette here, this is a really small size, this would be too small for doing this type of abortion, but these come with bigger blades on them, right up to very large sizes that are available. There would be a set on the table. And then this is used to scrape the walls of the uterus out to make sure that all the tissue is removed. So the technique would be to dilate the cervix, get as much tissue out with the suction as you can, then scrape the lining, and then I would usually go back one more time with the suction kind of as a clean up. And of course as the uterus empties the uterus tends to contract down, you always have to keep that in mind because actually your area is getting smaller and smaller again keeping in mind not to do any injury if possible. And then the procedure is completed.  

FP: When this is being done, the person performing the procedure cannot see what he or she is doing.  

AL: Suction D&C is a blind procedure as is suction D&E. There is no visualization of any kind. The whole thing is done by feel.

FP: And if some of the parts of the baby's body are left inside at the conclusion of this procedure, what happens then? 

AL: That can be a potentially serious complication. If anything is left behind, either bits of the placenta or even bits of the baby, what can happen is what will sometimes happen, sometimes there is no bad result, the uterus will simply contract or cramp and the patient will report she is having maybe more than normal or the expected amount of cramping. And then literally pass this tissue and I mean just literally miscarriage style, literally at home. And sad to say, I once had a patient call up in a panic because she had passed an arm, and it just literally dropped down in her living room. But that can happen. You can cause increased bleeding even hemorraging if there is retained tissue, especially retained placenta. Also if there is retained tissue, this tissue is dead or is dying now at this point, and it can lead to an infection. It's definitely, there's a risk of infection anyway, just from the instrumentation, but the risk of infection goes up if there is any tissue left behind.  

FP: So the procedure you just described is done from what week of the pregnancy at the earliest until when at the latest? 

AL: Suction D&C abortion is done probably as early as six weeks up to about 12 to 13 weeks. As I said, at about 12 or 13 weeks now we are talking about the baby being as, from rump to the top of the head, as being the width of your hand. When the baby is bigger than that, this technique won't work. The tissues are getting, as I said, the tissues are not only getting bigger but they're strengthening as well, and there is a limit to just how much you can do with the suction in terms of tearing up and then pulling this material out. So beyond 12 to 13 weeks this simply won't work, partially because of the baby's size and then also because of the strength of the body.  

When we get past that stage, anticipating your next question, we have to really change the procedure over to something called suction D&E, or suction, dilatation, and evacuation. Days, years past when we were first doing abortions, the only methods we used for second trimester abortion were things like saline abortion, that isn't used anymore, or prostaglandin abortions, which would essentially induce labor. This was difficult for patients, expensive because of prolonged hospital stays, these women would have to go through labor. I saw them go through labor anywhere from 8 to 36 hours. And in the early 80's those of us in the abortion industry, me included, were looking for a better method of second trimester abortion, and we came up with the D&E method. Now in D&E, now this baby is much more, this baby is closer to, oh, I would guess about maybe sixteen or seventeen weeks of size. Now 20 week babies, see I'm holding this baby this way for a reason because a 20 week baby would literally be again head to rump, not counting the feet because they're curled up, would be the length of your hand, so looking at the size relationship, I'd guess that this baby's about 16 or 17 week size, very typical for a second trimester D&E abortion.  

Same procedure. Laminaria is used. Now multiple laminaria are used over a period of one or two days to get the cervix to dilate enough. Dilatation is one of the most dangerous parts of the procedure. If you're going to perforate the uterus your going to do it during the dilation phase when these dilators are being used to forcibly open the cervix. Using laminaria does the procedure over a prolonged period of time and makes it safer. Now you would dilate to a considerably... we were talking about a dilator this size earlier... now we have to get to progressively larger sizes. This is a 13 - 14 Hegar dilator and this is a 15 - 16. For a baby this size I would be shooting for a dilation of about at least this much, or this much. Again, to give me enough, its not enough room to bring the whole baby through the opening of the cervix, but enough that I can manipulate what's going on.  

The difference between the two procedures is this, in a D&E procedure you must use a grasping clamp. This particular one is called a sopher clamp. Its roughly 13 inches long, so it has a lot of mechanical advantage to it, and the business end of this clamp is up here where there's rows of teeth, and when this, and again this is blind, just like the suction D&C procedure. When this gets a hold of something it does not let go. Once that cervix is dilated and you've used the suction now strictly to empty out the bag of water, it doesn't really bring any parts out, the sopher clamp is reached inside blindly grabbing at parts of the baby, and then getting a hold and pulling, and you really pull. And we are talking about a baby up to 20, 22 weeks even, with D&E abortion, and when this thing lets go all of a sudden you pull out an arm or a leg that big, and put it down on the table next to you. And you go back with this instrument again and again, and using just this instrument as I said because you just grasp and pull hard. You tear out spine, intestines, heart and lungs. The tricky part of a procedure like that is the head though. And by the time... and usually these babies are breech in their position in the uterus, so the head is usually the last thing that you're going to get. Again, a blind procedure. You're reaching inside and trying to reach whatever you can and you know you've probably got the baby's head because the clamp will be extended about as far as your hands will go, and I always tell people you know you've got it right when you crush down on the clamp and some white material runs out of the cervix, because that was the baby's brains. And then you pull out skull pieces. And I'm dead serious, a lot of times you have a bad day and a little face comes back and stares back at you. But that's the difference between the two procedures. D&E is a riskier procedure because the uterus is bigger, softer, thinner, and it's very easy to run through and perforate the wall. Of course up here there's nothing here in the studio, but there's intestines and bladder and everything else. And I certainly had the experience once of not even realizing it, just reaching in and pulling out tissue, and when I pulled out came somebody's intestine right through the cervix, which is entirely possible, and that lady had to have a laporotomy and had to have that intestine repaired.  

FP: Up to what stage in pregnancy are these procedures performed? 

AL: Suction D&E can be performed up to roughly between 22, 23 weeks. 24 weeks, this is from the last menstrual period, is probably the outside for this procedure. When you get beyond that point, again the tissues are strengthening as the days go by, the bones are beginning to calcify, and the D&E procedure simply becomes too difficult and too dangerous to do beyond about between 22 and 24 weeks. When we are talking about abortions beyond 24 weeks, too, its very important, 24 weeks is a really critical stage. 24 weeks from beyond menstrual period, you are talking about babies that will live on their own with proper medical care. So you are talking about viable children when we go beyond 24 weeks. Also these techniques break down, they simply aren't usable beyond that time, and that's when you start talking about partial birth abortion, which of course is a totally different procedure.  

FP: What's the latest D&E procedure that you did, latest in terms of the stage of pregnancy? 

AL: The latest one I ever did was 22 weeks. 

FP: Now, you described reaching in and literally dismembering the child and I know that in the medical texts on abortion that word is used, dismemberment, as is the word decapitation. The child is fully alive at this point when this procedure begins, right?  

AL: Yes. 

FP: And, the child therefore dies in the process somewhere of the various pieces of the baby being taken out. The question has come up recently because there have been, as you know, court trials held in various parts of the nation in response to the ban on partial birth abortion, and in which doctors have taken the stand and testified about the very procedures that you have outlined for us here. And one of the questions that has come up in the course of those trials is the question of whether a baby like you just showed us feels pain when his or her legs or arms are torn off. Can you give us in summary fashion what the medical opinion is, if there is a prevalent medical opinion, on that question of whether these children feel pain?  

AL: I'm not an expert in that area, but babies are known to be sensitive and do feel pain to the best of our knowledge. There has been plenty of testimony at those very same trials that you spoke about with people who are expert in this area and have testified to that very fact. I know from practical experience, I mean we do amniocentesis for diagnosis of genetic disorders for instance at 15, 16 weeks of pregnancy, and again that's another procedure that's by feel, and I know there are times that I've stuck babies with needles and you can feel them pull away. There's plenty of scientific data to support the fact that these babies probably do feel pain in these later procedures.  

FP: Are there some other instruments here that we haven't talked about?

AL: There's a variety of instruments here. This one is a sound, its an instrument used in both of these procedures. Basically its a measuring device to tell you how far, the distance from the cervix to the top of the uterus will generally give you a good indication of exactly how far along the pregnancy is. The tenaculum we talked about earlier is used to hold the cervix so that it will not move and actually the uterus tends to curve up or down in the body and by pulling on it, it tends to straighten it out and make the procedure easier. This is a ring forceps, its actually used in many types of surgeries. It can be used when you don't need something this powerful a ring forceps or a Bozeman clamp, which is this other one, can be used simply to reach in and grab tissue, loose pieces of tissue and withdraw them. 

The Bozeman clamp is basically something called a Kelly clamp, its kind of a long Kelly clamp, which again in this instance could be used to pull tissue out though generally we wouldn't use this because the sharper the tip of the instrument, the more likely it is to perforate. So you tend to like blunt instruments like the sopher clamp or the ring forceps if you're looking to grab something. This is a different kind of dilator. This is called a Hank dilator. Its graduated a little differently but otherwise serves exactly the same function as the Hegars that we talked about earlier.  

FP: And the piece at the end? 

AL: This is a Graves speculum which is a standard speculum which every woman knows about from just a gynecologic exam. It fits through the vagina and the instrument is opened in such a way that allows us to see the cervix. So when we talk about both of these procedures all of these procedures, and you can see the kind of space we are working with here, the tenaculum would be sitting inside the instrument more or less in this fashion, and then all the other instruments have to be used through this opening to be able to accomplish what it is we are trying to accomplish. But that's how the speculum is used to visualize the cervix.  

FP: The baby in the case of the first trimester abortion that you described, the parts of the body end up going through the suction tube and into a collection jar. But in the case of the D&E, as you're pulling out one piece after another you're putting those pieces into a tray, is that right? And then what has to be done then afterwards, are the pieces inspected to make sure all the body is there? 

AL: That's exacly what you need to do. In describing a D&E abortion, we talk about arms, legs, spine, intestines, and that isn't to gross out the nice people in the TV audience. You have to literally keep inventory. And when it's over you, it sounds gruesome, but absolutely true, you almost essentially reassemble the baby. You have to make sure you have two arms, two legs, and all of the pieces, and as I said earlier, because if you leave something behind, that patient could come back infected, bleeding or worse.  

FP: What was done in the time that you were doing abortions with those body parts after the procedure was all over? How were they disposed of? 

AL: Properly disposed of, the body parts from an abortion need to go through pathologic examination, just like any other tissue removed from the body. There have been absolutely tragic cases that have been frankly malpractice where as a cost cutting measure some clinics have been known not to send parts from abortions. They'd simply discard them because they would save that expense. This is very dangerous for the woman because especially if an early D&C abortion is performed, and even with the tissue removed, it should be examined because there are cases of ectopic or tubal pregnancy. You'll get plenty of tissue just from the thickened lining of the uterus, and you'll think that you've got tissue from the baby, but if especially in an early pregnancy its very hard to identify parts in the very early ones, but if you don't have a pathologist look at that tissue, that woman could actually have a pregnancy in the tube, and if that goes undiscovered, normally it would be discovered because it doesn't show on the report, if its not discovered, that can rupture and we've seen patients die from this.   

FP: And final question, when you did these procedures did you have to fill out a death certificate for the fetus? 

AL: I was required by law to file death certificates. Now I will tell you with abortions in my office we simply didn't bother. Certainly in the hospital they were a little more stringent about making sure all the laws were complied with in that regard. I filed a fetal death certificate for every one. 

FP: I want to thank you for describing this procedure for us and God bless you for sharing your testimony and thanks be to God that you as well as I know the forgiveness of Jesus Christ, and we rejoice in that together. God bless you. 

AL: Thank you. 

FP: And God bless you brothers and sisters, for joining us for this very powerful, very disturbing segment, yet it's essential for us to know what is going on, because if we are to form an opinion about abortion, we first have to see exactly what it is, and that's what we have done for you today. Thank you for watching. Please stay with us now for our action segment.  

Welcome to our action segment. We are joined now by Janet Morana, our associate director. Well that was a very powerful presentation from Dr. Levatino. 

JM: Yes it was, and you know that's the reason why we had to give a presentation like that is because the media will not show what an abortion is, the most common surgical procedure here in the United States, and yet you can look on the medical channel and see heart surgery all kinds of different operations yet they will not show an abortion. And we know by proof that we have shown what an abortion is to people, we have images of these abortion procedures up on our web site which is Gospeloflife.com/images and we know it has changed people's minds about abortion. People who thought that abortion should remain legal or just had no idea what we were really talking about changed their minds when they see what abortion really is.  

FP: And in fact nothing that we have ever done has convinced more people more quickly and more readily than that, letting them simply see the images, as we say America will not reject abortion until America sees abortion. Therefore we want to give our people some practical action, you've already mentioned that at Gospeloflife.com/images they can see these images, tell us what they can do. 

JM: Well first of all they themselves should revisit the images. We have several things up there. We have images of first trimester abortion, of the actual procedure that Dr Levatino described, and the unborn child before the procedure and then what happens to that child after the abortion. They themselves should first of all go back and see the images, but then what we want to do is to have them challenge people that they know who are either neutral on the issue, they don't think it affects them, they don't care, or people who really think they are in favor of abortion and say well if you're in favor of this you should really see what you're talking about. That word abortion has lost all meaning in society. So we want to challenge them to look to see what an abortion is. And if they don't think that this is an activity that will change minds and hearts, we also want them to go to our website because we have testimonies of people who have seen these images and it has totally changed their mind. We've had people that came, that stumbled upon our website because they considered themselves pro choice, saw those images, and totally changed their opinion on abortion all because of the sight of these images. 

FP: We get e-mails like that all the time and as you say we've posted some of those e-mails there so people can see how powerful this is. In other words they have full permission to go to our site, download those images, print them, e-mail them to others, or simply email to others the link that they can then go and look at what an abortion is.  

JM: That's right and especially if they're in a chat room and they're discussing the issue with someone the best thing to do is challenging them by giving them the link to our site and say do you know what lets just first before we start this discussion lets see what we are talking about.  

FP: We've had students use these images for presentations in their school and it has converted not only their class but their teacher as well. And these images have saved lives. We've had people who were thinking of having an abortion and they went to the web site and saw this and changed their mind.  

JM: Now, we also have diagrams and those are actual diagrams done by Nucleus Medical Media which is a company that does diagrams for medical textbooks.  

FP: And the two procedures that Dr. Levatino described for us here with the instruments are the two procedures that these diagrams illustrate. We have one of the suction curettage abortion of a nine week fetus and the other of a dilation and evacuation of a 23 week baby, these are all babies, and we have these images there on the web site for viewing. Now if people want them in printed form then they need to contact us at Gospel of Life and right there on the web site obviously there will be the e-mail or they can call us or they can write to us. And these images, we'll be glad to send them print outs. Now we have here examples of the print outs and its four frames showing the various stages of the procedure. We'll be glad to send them as many copies as they want. We also make these available in large poster size for educational purposes 

JM: Again we want to caution them not to copy these two diagrams because they are copyright protected, and we do pay to have permission, and we actually have to pay per copy to use them. But they're actually medical drawings, so they're very good to really convince people.  

FP: And we also finally have on our web site transcripts we referred with the doctor earlier that in court proceedings, practicing abortionists have testified to what these procedures are. Those transcripts are on our web site and they can be downloaded and used in any way that people can use them, quote them in letters to the editor, share them with their friends, pastors, publicize them in anyway at all.  

So thank you Janet for all that you do, and thank you brothers and sisters for joining us at Gospel of Life. Lets work together to build a culture that rejects this kind of violence and that protects all life from its very beginning to its end. 

I'm Dr. Paul Schenck, executive director of Gospel of Life Ministries. Father Frank Pavone, Janet Morana, and I want to personally invite you to be a strategic part of this new exciting and challenging work. Jesus said, "I am the Way, the Truth, and the Life." The objective of Gospel of Life Ministries is to reach out to Christians of all denominations and churches and bring them together in practical ways to proclaim the gospel of life and to build a culture of life. If you are a committed Christian, a pastor, Sunday school teacher, church leader, pro-life volunteer, if you have a burden to see believers cooperate together we'd like to hear from you. To obtain our resources contact us at Gospel of Life Ministries, P.O. Box 60038, Staten Island, New York, 10306. Call us at (718) 980-4400 and visit us at www.gospeloflife.com.

Click here for the Spanish translation of this transcript

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