HOUSTON -- In the latest of a series of new techniques that blur the line between contraception and abortion, a growing number of clinics are offering abortions to women as early as eight or 10 days after conception, before they have missed a menstrual period.
The new technique, pioneered by Dr. Jerry Edwards, the medical director at Planned Parenthood here, is not available everywhere and is relatively new in most clinics where it is offered.
Nonetheless, many reproductive-health experts say it may move the timing of a large number of abortions.
"With some of the ultra-sensitive pregnancy tests now on the market, women can pick up a pregnancy even before they've missed their period," said Dr. Michael Burnhill, vice president for medical affairs at the Planned Parenthood Federation of America.
"For most women, the sooner they know they're pregnant, and the sooner they decide what they're going to do, the better.
"With these very early abortions, we're talking about a whole gestational sac that's the size of a matchstick head. It's nobody's picture of a little baby sucking its thumb."
Though polls show that most Americans are more comfortable with early abortions than late ones, the National Right to Life Committee says there is no moral difference because a unique human being begins to develop the moment an egg is fertilized and anything meant to stop that development is an abortion.
Twenty-three Planned Parenthood affiliates have begun offering very early abortions, many just in the past few months.
Vicki Saporta, executive director of the National Abortion Federation, said that she did not know exact numbers but her group had trained doctors to perform such abortions, and the technique was spreading to other clinics.
What has made the new technique possible is a combination of " better ultrasound imaging, which shows the gestational sac in its earliest stages, and more sensitive pregnancy tests, some of which can detect pregnancy as soon as the embryo is implanted in the womb, a week to 10 days after fertilization.
The technique uses a hand-held syringe that avoids the noise and cost of the vacuum pump used for later abortions -- and is popular in developing countries where electricity is not always available.
In theory, contraception is what prevents a pregnancy and abortion is what terminates a pregnancy. But just when pregnancy begins depends on who is doing the defining.
Medically and legally, abortion-rights advocates say, pregnancy starts with implantation.
The Roman Catholic Church and the National Right to Life Committee, however, believe that pregnancy begins with the union of a sperm and egg.
"As soon as an egg is fertilized, it starts growing into a human being with its own individual DNA, different from its parents," said Laura Echevarria, the committee's director of media relations.
"Scientifically speaking, there's no difference between a fertilized egg and what you have three weeks later.
"Saying it's OK to kill it in the early stages because you're more comfortable with that is completely arbitrary."
These philosophical differences remain as sharp and bitterly debated as ever. But as a practical matter, the possibilities available to women who want to avoid child-bearing come close to erasing the line between contraception and abortion.
"Medically and legally, there's a difference between contraception and abortion," said Janet Benshoof, president of the Center for Reproductive Law and Policy.
"But for women who do not want to have a baby, it's now a seamless web."
Up to 72 hours after unprotected sex, women can get emergency contraception, using a high dose of oral contraceptive pills to prevent pregnancy.
Though these "morning after" pills have been quietly available for decades, especially at college health clinics, they have been widely offered only this year, after the Food and Drug Administration announced in February that such emergency contraception was safe and effective.
Other emergency contraceptive possibilities exist.
For about a week after unprotected sex, the insertion of the Copper-T intrauterine device both stops any immediate pregnancy and serves as a long-lasting contraceptive.
Pub Date: 12/21/97