A Texas law banning second-trimester abortions on living fetuses requires doctors to use untested, complicated and riskier procedures that have no medical benefit to the woman, an Oregon doctor who teaches and performs abortions testified Thursday.
Kicking off a five-day federal court trial on a bid by abortion providers to overturn the law, Dr. Mark Nichols said the regulation would force Texas physicians to choose from several methods of inducing “fetal demise” that carry increased risks of infection and injury for what is otherwise the safest and most common form of second-trimester abortion — dilation and evacuation, or D&E.
Two methods of injecting toxins into the fetus require special skills and equipment and are not guaranteed to work, forcing doctors to consider a second injection — adding to the health risks for women — or face prosecution for violating the law, he said.
“I would be very nervous about being able to provide this service and not violate the law,” said Nichols, who teaches at the Oregon Health and Science University in Portland.
Darren McCarty with the Texas attorney general’s office challenged Nichols, noting that some Texas doctors prefer to induce fetal demise before a D&E abortion because they believe there are medical benefits, including making it easier to complete the procedure.
McCarty also scoffed at claims that the differences between the 17th and 18th week of pregnancy would be great enough to raise the risks faced by women.
But Nichols said the smaller size of the fetus, coupled with the larger amount of amniotic fluid, makes fetal demise procedures more difficult “the earlier you are in the pregnancy.”
In addition, Nichols and two other abortion providers testified, D&E abortions are usually performed beginning in the 15th week of pregnancy, but the injection procedures are not used before the 18th week, requiring doctors to use untested methods to meet the fetal demise requirement.
“I think it would be inappropriate, and it would be experimenting on my patients unnecessarily,” said Dr. Robin Wallace, medical director of the Southwestern Women’s Surgery Center in Dallas.
A third method of fetal demise, cutting the umbilical cord, can be difficult if not impossible for some women based on the placement of the placenta or scarring in the uterus, Wallace said. A doctor might have to grope around in search of the cord, significantly increasing the risk of infection or of perforating the uterus, she added.
The Texas law, approved by the Legislature in May as part of a sweeping set of abortion regulations in Senate Bill 8, was blocked from taking effect on Sept. 1, leading to the trial scheduled to end Wednesday before U.S. District Judge Lee Yeakel.
Texas Attorney General Ken Paxton, who attended the last two hours of Thursday’s trial in downtown Austin, said the proceedings were a historic step in the fight “for the dignity of the unborn.”
“Senate Bill 8 prohibits the live dismemberment of babies still in the womb,” Paxton said outside the federal courthouse. “In live dismemberment, the abortionist literally tears a fully formed child apart limb by limb. … By defending SB 8, Texas is protecting the dignity of everyone involved.”
Wallace will remain on the stand when the trial resumes Friday, with abortion providers expected to call several more doctors to testify before Paxton’s lawyers begin presenting their witnesses.
When the trial ends, Yeakel is expected to take the matter under advisement, issuing a written ruling later on whether the law improperly blocks access to abortion.