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Thursday, July 24, 2008

The Current Practice of Abortion in South Dakota

Dakota Voice is reviewing the Report of the South Dakota Task Force to Study Abortion, in light of the upcoming November vote on Initiated Measure 11 to end most abortions in South Dakota.

Pertinent sections of the report will be reviewed each week for the next several weeks which may shed light on Initiated Measure 11.

First week: The Incorrect Assumptions of the Roe v. Wade Decision

Last Week: What Has Been Learned From the Practice of Abortion Since the Roe v. Wade

The following is from Section II.A.3 on the findings of the report:

Kate Looby, the Director of Planned Parenthood of South Dakota which operates an abortion facility in Sioux Falls, South Dakota, testified before the Task Force. Dr. Carol E. Ball, who performs abortions there, also testified before the Task Force. Both described how Planned Parenthood counsels women about abortions, what kind of information is disclosed, and the interaction between the abortion physician and the pregnant mother.

Based on their testimony, it is admitted that the Planned Parenthood facility in Sioux Falls does not disclose any information about the unborn child and that it does not disclose to the pregnant mother in any way that the child, the second patient, is already in existence. Planned Parenthood only discloses what the state requires them to disclose by statute. This does not adhere to the common law disclosure requirements discussed by Dr. Seger, Dr. Nathanson, Dr. Davis, and Dr. Ridder.

South Dakota Codified Law 34-23A-10.1(2), which appears as Exhibit B, requires that the abortion facility simply inform the women by telephone that they have the right to review printed material prepared by the state that provides information about fetal development.

Ms. Looby testified that their procedure includes having an assistant speak directly to the women over the phone. She states that in this part of the conversation, the woman has an opportunity to ask questions. However, Planned Parenthood still does not volunteer information about the unborn child.

The state's preprinted information does not make it clear that the procedure will terminate the life of a living human being. It only lists aspects of fetal development.

The South Dakota Department of Health publishes statistics about abortions performed at Planned Parenthood, and elsewhere in the State. The latest statistics, as contained in the 2003 report, were made part of the record.

In 2003, there were 819 abortions performed in South Dakota. The law requires the abortion facility to provide a form for the women to fill out concerning the information given to the women. In 819 forms filled out by these women, only five women requested that the written information be mailed to them. (See, 2003 South Dakota Vital Statistics Report, S.D. Department of Health, P. 71.) That means that 814 of the 819 women (99.4%) received no information about the development of the unborn child except the information required by SDCL 34-23A-10.1(1)(c): "The probable gestational age of the unborn child at the time the abortion is to be performed." In other words, the woman is only told how far along she is in the pregnancy, a fact she most often already knows from the date she missed her last menstrual period.

Further, the 2003 Vital Statistics Report of the South Dakota Department of Health states that:

"The data showed that of the 819 forms received, 813 of the patients reported receiving the medial information described in SDCL section 34-23A-10.1 during a telephone conversation and 6 in person." (Report, P. 71.)

The report indicates that in every instance the physician gave the disclosure concerning gestational age. (Report, P. 71.)

Additionally, according to Ms. Looby's testimony, a message given by the physician is pre-recorded. It is a four-minute recording designed to satisfy the statutory requirement of SDCL 34-23A-10.1 that the information contained in that section be imparted by the physician who will perform the abortion.

To summarize, in 814 out of 819 procedures, the only information given to the pregnant mother about the second patient was simply a gestational age. In 813 cases out of the 819, the physician in a taped statement gave resource information. The women had no way of asking the physician any questions since it is a recording.

Based upon the reporting of the women on the forms reviewed by the Department of Health, and the testimony of Ms. Looby and Dr. Ball, it appears that Planned Parenthood does not voluntarily convey other information about the fetus after women listen to the doctor's taped recording.

In fact, what is communicated to the women is misleading. Ms. Looby and Dr. Ball played a video for the Task Force illustrating what may be communicated to women about the abortion procedure. In this video, reference is made to the contents of the woman's uterus in dehumanizing and misleading language. For instance, the video never mentions that an unborn child, embryo, or fetus is even present. It never refers to the unborn child in any way that would imply the existence of a second patient. The language used in the video simply implies that something is removed but does not identify what it is except to claim it is only "tissue:"

1. "The uterus is then emptied by a gentle suction."

2. "As the uterus is emptied..."

3. "A spoon shaped curette may be used to feel the walls of the uterus to help ensure complete evacuation."

4. "Occasionally the contents of the uterus may not be completely emptied."

5. "To remove the tissue it may be necessary to repeat the vacuum aspiration."

6. "Very infrequently, the early abortion procedure will not end the pregnancy."

7. "If the pregnancy has not been ended, another abortion procedure is recommended."

We find first that Planned Parenthood fails to inform the pregnant mother in any language that her unborn child is in existence. It is impossible for a woman to give informed consent to an abortion if she does not fully understand that her child is in existence and that she is consenting to the termination of the life of her child.

Second, the doctor who in seeking consent to terminate the life of his or her second patient (the child) cannot, in a professional or moral sense, contend that proper authority has been obtained from the mother if she is not fully aware that she is giving such authority.

Dr. Ball and Ms. Looby testified that the women who come to Planned Parenthood sign a "consent" to have an abortion without first speaking to the doctor. These consent forms are filled out before the doctor sees the patient. A person designated as a "counselor" provides whatever information is told to the pregnant mother. However, Ms. Looby admitted that these "counselors" are not licensed and the only training they receive is from Planned Parenthood.

The video played recites:
"If you have not done so already, you will meet privately with a counselor. The counselor reviews your medical history, answers any questions you have about the abortion procedure, provides after-care instructions and talks with you about your birth control needs. The counselor also talks with you about your decision to have an abortion. It is important that this decision is yours and made of your own free will. At the end of the counseling session, you are asked to sign an informed consent indicating that you understand the medical risks of the abortion procedure." (Emphasis added).

Thus, the abortion doctor sees the pregnant mother for the first time in the procedure room, only after the consent form has been signed and the woman has made her commitment to undergo the abortion.

The video, Dr. Ball, and Ms. Looby all verify that the women are told that they may ask questions of the doctor who is to perform the abortion. However, we find that the process which results in the pregnant mother signing the consent form and making her decision before ever seeing or speaking to a abortion doctor is incompatible with the principles of a doctor's duty to see that the patient's decision is informed before she consents to an operative procedure. We find that there is no true physician-patient relationship in this process, and once the decision has been made, the woman is seeing the doctor, not for counseling, consultation, or help in reaching a decision, but rather, to submit to the medical procedure that she has already committed to, whether or not it was informed.

The abortion doctor, therefore, provides no counseling unless the pregnant mother initiates a discussion and asks questions in the procedure room. However, we find that even if a woman has the will to press the doctor for answers to questions, the answers that are given at Planned Parenthood concerning the most critical matters will not be helpful to her.

Following her testimony, Dr. Ball was asked what she would tell a woman who asked her "Is this a human life?" or "At what point in the process does human life begin?" or similar questions. Dr. Ball testified that she would refuse to answer these questions. When pressed on this point, Dr. Ball stated that it is a subjective matter for the woman to decide, and an answer from her is nothing but her subjective personal opinion.

Thus, a woman who goes to Planned Parenthood in Sioux Falls is not given scientific and factual information necessary for her to understand that the procedure will terminate the life of a human being, even when the woman asks precisely if the abortion is killing their baby.

We find that Planned Parenthood has confused the objective biological fact that the procedure terminates the life of a live human being with the moral, or value judgment of what respect or value should be placed upon the life of that human being. Under existing law, only the pregnant mother has the right to decide whether she should or should not submit to the abortion. But the pregnant mother can apply her own discrete personal, moral or religious values to her circumstance only after accurate biological facts concerning the existence and nature of her unborn child are disclosed.

By its own admissions, Planned Parenthood makes no such disclosures as required by common medical practice, it uses misleading language such as "contents of the uterus," and it refuses to make accurate disclosure of biological facts even when asked directly about the unborn child.

A policy that requires a patient to research the scientific facts on her own conflicts with all accepted notions of informed consent, and virtually ensures that South Dakota women will submit to a procedure without giving informed consent.

We find that the withholding of the biological information from women has the effect of imposing the personal philosophy of Planned Parenthood and its agents upon these women. To say that a human being, no matter how young or physically immature, is nothing but "tissue" or "contents of the uterus" is to already make and convey the judgment that this human being has less value than others. This precludes the mother from making the decision for herself about whether the life of the human being in question has value.

The testimony of Ms. Looby and Dr. Ball also made it clear that Planned Parenthood does not make accurate disclosures about the risks of abortion. These are discussed more fully in Section II-E. In the Planned Parenthood video referenced in this Report, the following statements were made which we find to be completely inaccurate based on the record and evidence discussed in Section II-E:

1. "Early abortion by vacuum aspiration is one of the safest procedures in all of

2. "A legal abortion, as it is performed in the United States today, is a very safe
procedure and complications are rare."

3. "The emotion most women experience after having had an abortion is relief."

4. "Women may have some mixed feelings at this time but emotional problems after abortion are uncommon, and when they happen, they usually go away quickly."

5. "Serious long-term disturbances after abortion appear to be less frequent than after childbirth."

6. "The risk of dying from a full-term pregnancy and childbirth is at least seven times greater than that from early abortion."

Dr. Ball testified that Minnesota is her state of residence and medical practice. Planned Parenthood of South Dakota schedules abortions about six days a month. On each of these six days, Dr. Ball, or one of three other out-of-state physicians, travels to Sioux Falls to perform, on average, twenty abortions per day, and then leaves the state the same day. One of these four out-of-state abortion doctors has hospital privileges in the Sioux Falls area. Dr. Ball testified: "we have a verbal agreement with an Ob/Gyn group in Sioux Falls who will help us with any complications that occur." Therefore, if any woman has complications, local doctors who are strangers to the patient and were in no way involved in the abortion procedure must see her.

The Task Force concludes that there is no traditional or healthy physician-patient relationship between an abortion doctor at Planned Parenthood in South Dakota and the pregnant mother. The only time the abortion doctor sees the patient is in the room where the procedure is to be performed, after the woman has already committed to submitting to the abortion by signing the consent form.

Further, we seriously question whether the practices of the doctors who provide abortion services at the Sioux Falls facility meet the standards set by the American College of Surgeons, particularly with respect to its principles concerning the relationship of the surgeon to the patient and its proscription against itinerant surgery.

It must be noted that the information regarding the practice of abortion in South Dakota is based entirely on the practices at Planned Parenthood of South Dakota where almost all abortions are performed. Doneen Hollingsworth, Secretary of the Department of Health, testified that there are four abortion providers in the state, but South Dakota Codified Law prohibits the disclosure and identification of these providers.

There have been two other significant developments in the past twenty years that have resulted in further understanding about the practice of abortion. First, pregnancy help centers have opened all over the country to offer counseling and support to women in crisis pregnancy situations. Second, women have begun to speak out about their abortion experiences.

The 2005 South Dakota Task Force to Study Abortion was created when the South Dakota legislature passed HB 1233 with a bipartisan majority in both houses. The purpose of the task force was "to study abortion and to provide for its composition, scope, and administration." The report was completed in December 2005 after several months of meetings.


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