Late-Term Abortion


Also known as the “MOLD Technique”

The induction abortion with the use of digoxin injection was pioneered by late-term abortionist George R. Tiller of Wichita, Kansas, and is now widely used throughout the United States by the few abortionists who are willing to admit they do the late-term procedures. It has replaced the live partial birth abortion method since the Partial Birth Abortion Ban act was upheld by the U.S. Supreme Court in April, 2007.

In videos obtained by Operation Rescue, Tiller is seen describing this particular abortion method, known as the MOLD Technique, which is an acronym for the four products employed in the abortion process: Misoprostol, Oxytocin, Laminaria, and Digoxin.

Currently, this late-term abortion process is in use in pregnancies as late as 35 weeks by Shelley Sella and Susan Robinson at Southwestern Women’s Options in Albuquerque, New Mexico, LeRoy Carhart at Germantown Reproductive Health Services in Germantown, Maryland, Warren Hern at the Boulder Abortion Clinic in Boulder, Colorado, and Josepha Seletz at Pro-Choice Medical Center in Los Angeles, California. Other abortionists also use this process in the second and third trimesters but are less open about it.

“We think the process is safe. Nothing is perfect.” – George Tiller

The Induction abortion takes 3-4 days to complete. On the first day the woman is given an ultrasound to determine the gestational age of her baby. Then, with the aid of the ultrasound to guide the abortionist, a lethal dose of the heart medication Digoxin is injected into the baby’s heart or into the amniotic fluid directly through the woman’s abdomen. (Potassium chloride is infrequently substituted for Digoxin.) Digoxin gives the baby a fatal heart attack. This is an off-label application of the drug, which was originally developed and approved as a treatment for heart disease. In some cases, the injection can be made vaginally instead of through the abdomen.

In a video shown to abortion patients, Tiller discussed the fatal injection:

“Although you may find this a little difficult and a little uncomfortable, on the first day that you arrive at the clinic we will make an injection of a medication called digoxin into the fetus to initiate fetal demise.”

Tiller elaborates on his reasons for killing the baby before beginning the surgical abortion procedure.

“The first reason is so that there will be no fetal pain. We — we have learned with hundreds and hundreds and hundreds of patients that women have the question about, ‘Will this be painful for our baby? Will this be painful for my baby?’ And the answer to that is ‘no.’ We make an injection directly into the fetus with a medication called digoxin on the day that you arrive so that the baby will expire painlessly. The first reason is no fetal pain.”

However, those who have experienced massive heart attacks, describe them as extremely painful and frightening. It is well documented that babies in the later stages of pregnancy can feel pain, and at least one study indicates that babies as young as 6-8 weeks gestation may experience pain.

While the concept that a late-term baby can feel pain is often disputed in the press and by abortion supporters, it is obvious that Tiller believed that late second and third trimester pre-born babies can feel pain, and thus used his lethal fetal injection as a means of allaying the concerns of abortion patients.

But the most important reason for killing the baby first is to avoid a live birth. This prevents myriad of problems for the abortionists, including running afoul of state and federal laws protecting the life of the baby after a live birth, even if the birth is the result of an abortion.

After the Digoxin injection, the woman’s cervix is packed with laminaria, thin tampon-like sticks made of seaweed that expand the cervix gradually over the next day. The drug Misoprostol is also administered vaginally to “ripen” the cervix for the upcoming delivery of the dead baby.

Misoprostol is a drug that was originally manufactured to treat stomach ulcers. Its use in abortions is an off-label application not approved by the FDA. Misoprostol stimulates uterine contractions which are unpredictable and sometimes violent.

After the first day’s injection and cervical preparation, the patient is sent home or to a local hotel where she will remain unmonitored until her appointment at the clinic the following day.

On Day 2 of the procedure, the woman is repacked with larger laminaria sticks and given additional Misoprostol to prepare the woman for labor. The Misoprostol may be administered both vaginally or bucally (between the cheek and jaw), depending on whether delivery is expected on Day 3 or 4. If the woman is undergoing a later, 4 day process, she will return on Day 3 for additional laminaria and Misoprostol. Each day until delivery, she is sent back to her hotel where she remains unmonitored, even though active labor had begun or was in progress.

Sometimes, women cannot be able to get to the clinic in time and deliver their dead babies in the hotel, in vehicles, or other places were medical assistance is nonexistent. Tiller admitted so much in an video he produced for the purpose of introducing prospective abortion patients to the late-term abortion process.

“At Women’s Health Care Services, our late elective abortion program involves managing the pregnancy by the premature delivery of a stillborn.” – George Tiller

On the final day of the abortion, the woman is given the drug Oxytocin, which induces or augments contractions and the onset of labor. Women then are placed in a room where they endure the final stage of labor process. When it is determined that the labor has progressed to the point where the baby is about to be delivered, each woman is usually taken into a room with a toilet and told to lean on the nurse and push the baby into the toilet.

The toilet delivery method is used by a number of abortionists, including Florida abortionist James Pendergraft. Other abortionists may allow the woman to deliver on a delivery table. Still others, such as former Michigan abortionist Alberto Hodari, prefer to remove the dead baby through dismemberment.

Once the dead baby is delivered, the woman is given a procedure called Dilation and Curettage, or D&C. Here, a sharp edged spoon-shaped instrument is used to remove the remaining tissue, such as the afterbirth, from the uterus.

After the abortion, or the following day, the woman is given what Tiller’s employees called the “Party Pack,” which includes abortion aftercare instructions and a prescription for birth control pills. They are then released to return home.

Other abortionists have responded publicly to the increased use in the Induction abortion with digoxin injection method and its dangers.

Hodari prefered to dismember live babies between 18 and 24 weeks. He told the Detroit News on July 30, 2007, “It was much simpler and much less dangerous than what we are doing now. But this is now the law. It’s awful. It’s unnecessary. It’s dangerous. It’s more complicated. It makes the woman go through another procedure that’s not necessary. It impacts everything we do after 18 weeks.” Hodari began using the injections even though he considers them dangerous.

“We do not believe that our patients should take a risk for which the only clear benefit is a legal one to the physician,” abortionist Philip D. Darney, chief of obstetrics at San Francisco General Hospital told the Boston Globe on August 10, 2007. He has chosen not to use the injections.

Complications from lethal fetal injections are well known. In Orlando, Florida, the misuse of Digoxin resulted in the live birth of Baby Rowan, who died after abortion clinic workers denied him medical care. In Wichita, Kansas, Tiller’s needle slipped, and Baby Sarah was injected in the head with a toxic drug that was a precursor to digoxin. She survived and was later adopted, but suffered a malady of medical problems. She died five years later from complications to the injuries she received as a result of the injection.

“But frankly, debate over digoxin/dead baby abortions versus live baby abortions is absurd. The result is still a dead baby. Both procedures are barbaric and hold serious risks to women,” said Operation Rescue Senior Police Advisor Cheryl Sullenger. “The act of killing a pre-born baby is in itself immoral and until we can come to grips with that as a society, we never be able to value life as we should.”

Women also run additional risks when submitting to this abortion procedure.

One woman suffered a ruptured uterus during a 35-week abortion done by Shelley Sella in Albuquerque, who ignored the patient’s medical history of a previous Cesarean Section delivery for which the use of Misoprostol is contraindicated. Sella was charged by the New Mexico Medical Board for gross negligence in this case, but escaped punishment.

Christin Gilbert, 19, and Jennifer Morbelli, 29, died from complications to third-trimester abortions done by LeRoy Carhart. Both women suffered a complication known as disseminated intravascular coagulation (DIC), a blood clotting disorder that leads to massive hemorrhage. Gilbert may also have suffered from sepsis, a live-threatening blood infection. Morbelli’s complications included an amniotic embolism, which is a treatable condition if caught in time.

There is rising concern that the entire Induction process as practiced by Sella, Carhart, and their associates, is too dangerous for use in outpatient clinics since women who have begun the surgical abortion process are left unmonitored outside the clinic for long periods of time without access to immediate emergency care.

Dr. Gerald L. Bullock, a Texas Obstetrician and Gynecologist considered an expert in the field, has expressed his professional opinion that the process violates the standards of patient care because if fails to follow the accepted protocols set forth by the American Congress of Obstetricians and Gynecologists.

Related resources:

New Docs Reveal Horrific Details of Botched 35-Week Abortion, Gross Negligence in NM Disciplinary Case

New Mexico Medical Board Disciplinary Hearing Transcripts in the case of Shelley Sella, November 29-30, 2012:

  • Hearing Transcript, Nov. 29, 2012. Part 1
  • Hearing Transcript, Nov. 29, 2012. Part 2
  • Hearing Transcript, Nov. 30, 2012. Part 1
  • Hearing Transcript, Nov. 30, 2012. Part 2
  • Autopsy of Christin Gilbert

    More on Sella’s Background