Various states have proposed so-called “partial birth” abortion bans since President Clinton issued his initial veto of the federal legislation in 1996. Physicians have been responding to this intrusion on the practice of medicine in innumerable ways. In Illinois, House Bill 382 (HB 382) has been challenged in court by five physicians and a clinic. One of the doctors involved in the case is PRCH member Cassing Hammond, MD.
Dr. Hammond is an instructor in the Department of Ob/Gyn at Northwestern University, the director of Prentice Ambulatory Care and Surgery at Prentice Women’s Hospital and an ob/gyn consultant for the Rehabilitation Institute of Chicago. An American College of Obstetricians and Gynecologists fellow, Dr. Hammond has distinguished himself repeatedly during and after receiving his MD from the University of Missouri in 1988. In addition to being chosen for the Lemmon Award for Outstanding Medical Student in Obstetrics and Gynecology at the University of Missouri, he received the Residency Perinatology Award at the University of Rochester and the Excellence in Undergraduate Education Award from Northwestern University’s Department of Ob/Gyn.
Dr. Hammond became involved with HB 382 at the request of his colleague and PRCH Board member Dr. Marilynn Frederiksen. “Once I understood the nature of the legislation and how it would impact pregnancy-termination services, I agreed to submit an affidavit. In fact, I think that most gynecologists, even those uncomfortable with the types of procedures the law ostensibly prevents, would object to this legislation were they to actually read the bill,” he says. “If you read HB 382, you find that it outlaws far more than the procedure some have tried to label ‘partial birth’ abortion. Indeed, you not only outlaw the majority of abortions, but you outlaw many procedures necessary for safe obstetrics and gynecologic care.”
Dr. Hammond uses three examples to illustrate the potential impact of HB 382 on critical reproductive healthcare:
Case 1: A patient presents to labor and delivery at 22-weeks gestation with ruptured membranes. The fetus has delivered breech, the head is entrapped but the fetus still has a heartbeat. According to HB 382, if a physician assists in any way with the vaginal delivery and the infant dies (as a consequence of vaginal delivery), the physician has committed a Class Four felony.
Case 2: A patient experiences spontaneous rupture of membranes at 18-weeks gestation, three days post-amniocentesis. There is no fluid around the fetus and the patient wishes to terminate the pregnancy. The physician does a traditional D&E procedure, realizing the inevitable outcome of this pregnancy. The physician has committed a Class Four felony.
Case 3: A patient has a first-trimester pregnancy termination at ten weeks. Because fetal cardiac activity had been demonstrated prior to the procedure and because the procedure involved the “delivery” of fetal parts through the vagina resulting in the death of the fetus, the physician has violated the so-called “partial birth” abortion ban, despite having used traditional suction curettage techniques.
Dr. Hammond sees these potential outcomes as not only inevitable, but calculated. “As it has in Wisconsin, where a similar statute was upheld, you essentially outlaw all abortions, denying women their constitutional rights. I’m sure the political forces pushing this type of legislation have intended this result,” he says. “Ironically, if you circumvent vaginal delivery by performing a hysterotomy or hysterectomy you’re well within the law.”
Dr. Hammond encourages other physicians to participate in cases such as these. He says, “I think legislative involvement such as mine with HB 382 is an effective way to make use of our knowledge of medical issues and impact the system. I also support PRCH because they represent a more legitimate and authoritative way to approach the media. Eventually, the public has to learn the real implications of this type of legislation. I would prefer they learn those implications from informed discussions than as a result of experiencing the types of clinical tragedies that will arise should HB 382 be upheld.”