Dr. Martin Haskell, of Cincinnati, told U.S. District Judge John Shabaz that the intact dilation and extraction procedure (D&X) he pioneered and introduced at a National Abortion Federation conference in 1992 is the safest way to perform abortions on women who are 20 to 24 weeks pregnant.
Haskell said he has done about 2,000 D&X abortions in which he maneuvers the nonviable fetus so he can pull all but its head, feet first, from the uterus. He said he then cuts the umbilical cord and colapses the head so it can fit through the cervical opening.
Haskell testified on behalf of Planned Parenthood of Wisconsin and six doctors who have argued the state law is unconstitutional. They said it's flawed because its wording could stop all abortions and it doesn't have an exception for when the D&X procedure is used on nonviable fetuses and needed to preserve a woman's health.
Haskell said D&X is safer than the more commonly used dilation evacuation procedure, in which doctors pull out a fetus in pieces, because it doesn't require that a forceps be repeatedly inserted into the uterus.
He said D&X minimizes trauma, blood loss and operating time.
"It's an opportunity to provide an easier, less traumatic procedure for the woman." Haskell said.
But Dr. Harlan Giles, who primarily relies on inducing labor to perform late-term abortions in Pittsburgh, said he saw no need for D&X.
"I have never been faced with a situation where a D&X ... would be necessary or even preferable." Giles said.
He said he decided to testify in the Wisconsin case and in other states where such laws have been challenged because he was "emotionally and medically disturbed" by the procedure.
"I consider it cruel and unusual punishment that causes pain to the fetus when it is performed." Giles said.
Giles also said he thinks that only D&X is banned by the state law, which identifies "partial-birth abortion" as "an abortion in which a person partially vaginally delivers a living child, causes the death of the partially delivered child with the intent to kill the child, and then completes delivery of the child." Child is defined as "a human being from the time of fertilization until it is completely delivered from a pregnant woman."
The law has an exception for when the procedure is needed to save a woman's life. Doctors convicted of violating the law must be sentenced to life in prison.
Shabaz reached a conclusion similar to that of Giles last spring when he refused to bar enforcement of the law before trial. But Shabaz was overruled in November by the 7th U.S. Circuit Court of Appeals, which said in a 2-1 decision that, based on the facts before trial, the law is vague and irrational and can't be enforced.
Haskell and three of the doctors who challenged the law disagreed with Giles testimony Thursday and told Shabaz that it could be applied to other common abortion procedures.
Dr. Dennis Christensen, who does abortions at the Madison Abortion Clinic, said he regularly pulls part of the fetus out of the uterus before the fetus dies when he does dilation and evacuation abortions.
Christensen also said he always tries to pull as much of the fetus as possible from the uterus, and sometimes pulls out all but the head before collapsing it. He agreed with Haskell that it's best to avoid putting forceps into the uterus.
Christensen said he won't continue performing abortions if the law is enforced and he's subject to life imprisonment for violating it.
"In my mind, it's totally unclear what I could be prosecuted for under this act." Christensen said.
Shabaz scheduled closing arguments to start at 8:45 a.m. today and said he'll try to issue an opinion about two hours after the arguments are finished.
Guided by ultrasound, the abortionist grabs the baby's leg with forceps.
The baby's leg is pulled out into the birth canal.
The abortionist delivers the baby's entire body, except for the head.
The abortionist jams scissors into the baby's skull. The scissors are then opened to enlarge the hole.
The scissors are removed and a suction catheter is inserted. The child's brains are sucked out, causing the skull to collapse. The dead baby is then removed.