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.
FP: Many different types.
AL: Many different
FP: But these are the two
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
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
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
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
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?
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
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
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
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
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 321-500-1000 and
visit us at www.gospeloflife.com.
for the Spanish translation of this transcript
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