Alice sat on the padded examining table, her legs drawn up with knees beneath her chin and her arms and a white flannel blanket wrapped tightly about her. The table was the central feature of the small room. A sink and counter with cabinets above and below were the other furnishings.
Between stainless steel stirrups attached to the foot of the table was a removable rectangular basin draped in blue surgical towels.
On a small movable table to the right of the stirrups was a bundle of instruments, wrapped in similar toweling and taped shut, a large hypodermic needle and a shot-glass-like container holding 30 cc's of Xylocaine and a local anesthetic.
The time was 1:25 on a Tuesday afternoon, and Alice, who is 19, was talking quietly with Louise Klok, her counselor at the women's clinic of the Washington Hospital Center, waiting for the doctor to enter the room and begin her abortion.
Unlike the vast majority of women who have late or second trimester abortions - abortions performed during the second three months of pregnancy - Alice had an understandable reason for not having had her abortion before her 17th week of pregnancy. She had become pregnant while talking birth control pills and ignored signs of pregnancy because she did not believe she could be pregnant.
About 11 per cent of the 1 million legal abortions performed in the United States in 1975 were second trimester abortions, despite the fact that such operations are more complicated and more risky. The death rate from abortions jumps from 1.7 per 100,000 during the first 12 weeks of pregnancy to 13 per 100,000 in the second 12 weeks.
"I consider every second trimester abortion a social failure," said Dr. Christopher Tietze, a physician who is senior fellow with the Population Council and one of the world's leading experts on the statistics and demographics of abortion.
Tietze and other advocates of abortion feel that way not only because women undergoing second trimester abortion face greater chance of death or injury but also because their lateness indicates they were afraid, unwilling or unable to obtain an abortion earlier.
While there are few, if any, comprehensive studies of second trimester patients it is known that, compared to first trimester patients, they are younger, more likely to be Catholic or members of other religious groups opposed to abortion.
Dr. William Peterson, director of the Hospital Center clinic to which Alice went, has as good an understanding of the situation as anyone in the abortion business. The clinic accounted for about 1.5 per cent of all the "late" abortions in the United States in 1975.
Peterson believes procrastination is the major contributor to late abortions. "There's a lot of varying reasons you can put into categories and, when you add all those reasons together, you still have a majority left that don't fit those categories. That large remaining category is best labeled 'fantasy.' If you don't think about it, you aren't pregnant," he said.
Then there are women such as Alice, victims of birth control failures who have no reason to suspect that they may be pregnant and therefore postpone a pregnancy test. "I really wasn't expecting to be pregnant, and I didn't notice it early enough," Alice said, even though this was her second pregnancy.
When Alice first became pregnant two years ago - by the same boyfriend - she planned to have the child. "I was scared to have an abortion." explained Alice, the daughter of Christian fundamentalists. "I just couldn't make the decision. It seemed out of place. It wasn't that I was against abortion."
But she miscarried that pregnancy at 4 1/2 months, just about the point at which she now was seeking to abort the second pregnancy.
"I though having a baby would be a whole lot easier (than it would be)," she told Klok during her counseling session at the Hospital Center, explaining why she decided on abortion this time. "But I know it's not. Financially, I'm not ready for a child.
"I don't even have my own views on life straightened out, let alone knowing what I'd teach a child. I'm not prepared for that. And I know I couldn't give it up if I went through with the whole term."
Alice, who borrowed $350 for the abortion (the cost ranges from a low of about $125 during the first trimester to about $850 in the second), said she had spoken with several friends who had undergone abortions. "They said it was not as bad as they thought it would be and they really don't feel bad about it," she recalled. "They know that at that point they had to do it. I just hope I'll feel the best I can about it afterwards. I don't know . . ."
After talking with counselor Klok and being interviewed by a reporter, Alice went to Room 3. She took her place on the examining table and waited for Dr. William Peterson, who by his own estimation has delivered between 8,000 and 10,000 babies and performed more than 1,000 second trimester abortions.
At 1:26 p.m., Peterson strode briskly into the room, took off the white physician's coat worn over his green surgical outfit and hung it on the door. He peered over his steel gray half glasses at Alice, who was still clutching the blanket, and quipped: "What are you going to do when you get cold?"
Then he went to work.
"I think abortion is a lousy answer to a terrible problem." Peterson told a reporter during a recent interview. "But because it's a lousy answer doesn't mean you disregard it and throw it out . . . What it leaves behind is a far more serious problem.
"I like obstetries," said the former military physician, who in addition to his clinic duties is chief of the hospital's Department of Obstetries and Gynecology.
"I like prenatal care. I like to be part of the whole exercise. It's a fantastic experience to be part of a growing family and to watch children grow. My patients still send me pictures of babies that I delivered years ago . . . and it's a warm feeling," he said.
Then there are the other patients, like Alice - but Peterson said he sees no conflicts between his two roles.
"One's night and one's day," he said. When he performs an abortion. Peterson "terminates". It's alive, obviously, the fetus is alive, but I don't see it, as killing. It's really a parasite (at the time of the abortion). It's not alive in the sense that it's alive and can live on its own . . . I see this as potential and not actual . . .
"I feel an abortion is somewhat similar to taking out a uterus. You take out a woman's uterus because there's a tumor in it and, especially if she's on the young side, there's no great elation in it, there's no feeling for it."
During a lengthy discussion of his work. Peterson returned several times to the theme that "we shouldn't be wasting our time on 'abortion, right or wrong.' That isn't the issue. The issue is education to prevent as much abortion as possible.
"The bottom line is this: Your daughter or my daughter is going to get pregnant. They're not going to be able to afford to be pregnant . . . and they're going to have an abortion.
"Now, are you going to set the stage for her to have a safe abortion, or are you going to send her under the counter to the (illegal) abortionist . . .?"
Oppnents of abortion frequently argue there is no such thing as an unwanted pregnancy because there is such a huge demand for adoptable infants.
"This is another one I hear," said Peterson of that argument. "Why should that person, because she made a human error, is careless, dumb and all the other words, why should she carry a baby inside herself and deliver it for you/What's she owe you? Why should she go through the psychological trauma of giving up a child that she's felt move inside her?"
The debate about abortion is "a totally religious issue," Peterson said. "Completely." We run into people here who used to be anti-abortionist until they had to face the problem. It's very simple to be against something you're not facing and be very strongly against it on a moral issue - and this is a moral issue, an emotional issue - have the problem and then tell me about it."
During the 22 minutes required to end Alice's 17-week pregnancy, Peterson was confronted with the fact, as he had been at least 1,000 times previously, that he was taking some form of human life. Unlike a first trimester abortion, where the fetus generally is mauled beyond recognition by the abortion process, a second trimester abortion involves removing and inventorying clearly identifiable body parts, such as hands and feet.
The patient is unaware of what is happening to the fetus as the physician works. There are no mirrors, as in delivery suites, and only the staff can see what the doctor removes from the uterus.
As Peterson was beginning the procedure. Alice and Louise Klok, who remains with her during the abortion, were talking about places Alice had lived, and Peterson joined the conversation from time to time.
While he worked, Peterson talked to Alice about her previous miscarraige, explaining the importance of having an obstetrician carefully monitor any future, planned pregnancies in an attempt to avoid another miscarriage, explaining the importance of [WORD OMITTED]
By 1:32, only 6 minutes after he had entered the room, Peterson already was beginning to remove the placenta, the fetal life support system. Within another two minutes, he was removing recognizable fetal parts.
The conversation in the room continued as Peterson worked.
"I'm a Scorpio." said Alice, answering a question from Louise.
"What did you say about Scorpios?" asked Peterson, peering over his glasses at material he was removing from the utertus.
"She's a Scorpio," Louise told him.
By 1:45, as Alice started to feel cramps and Louise helped to control her breathing. Peterson was using the steel suction nozzle of a small machine called an Air Shield Uterine Aspirator to suck out the remaining contents of Alice's uterus. As he finished, a nurse measured a tiny fetal foot - it was 28 millimeters long - to help determine the age of the fetus.
By 1:50 p.m., the procedure was completed, and Alice's pregnancy had been terminated.
For Peterson, the task is purely technical. For counselor Louise Klok, however, the reaction to what is happening can be more emotional. Unlike the patient, she can see everything the doctor is doing during an abortion in stark detail.
"I feel like I appreciate the complexity of the situation, which I didn't before," said Klok, a counselor for a year and a half. "It was just a clear answer to me before . . . I still believe it's important for (abortion) to be legal and available. I feel very strongly that children who aren't wanted sometimes have pretty horrible existences and people who have children they're not ready or able to care for have pretty horrible existences.
"More and more I feel angry at flippancy about abortion," Klok said. "I mean, that was me, too, at one point. Sometimes I just want to shake (a flip patient) and say, 'Think more seriously about what you're doing.' One reason is that because of the flippancy they're more likely to come back a second time."
Klok, 30, who has a bachelor's degree in fine arts and a master's degree in early childhood education, had an abortion five years ago. "I was in grad school and teaching full-time. I'd just started living with the man I'm living with now. There was no question. I couldn't deal with a child. It was absolutely clear to me.
"At that point it was very easy for me. I didn't even have to think about it. I was very active in women's liberation at the time and having an abortion just went along with my attitudes. I wouldn't even consider having a child at that time. I didn't think I wanted a child. That's changed a lot for me."
Klok said she did not think about her abortion for several years. But "recently I've thought about it because I realize it would be very different circumstances if I were to get pregnant again and had to make that decision. I don't regret it. I don't feel I could have done anything else. I don't feel like I did the wrong thing, but I'm just aware of how I've changed my whole orientation toward abortion."
Klork said her reaction to abortion has evolved opposite to the way she thought it would.
"The first few months I was here the smell really got to me," she said, "just the smell of a surgical procedure, blood and body smells, but it really didn't affect me, it was almost unreal.
"It started to sink in for me after I'd been here several months or so. Now sometimes I feel more connected with what I see than I did.
"At first it almost seemed like I was seeing doll parts, very apart from me. And gradually I began to understand what I was seeing . . . I began to make a connection with my body . . .
"Basically," Klok said, "what it comes down to is I still believe in what I'm doing. It's just - what we see every day is fetal parts and it's very clear that it's something liviing. Now, what that means, I don't know."