A Medical Doctor describes the Dilation and Evacuation
-- 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
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
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