Byline: NATALIE CLARKE
THEY call it partial-birth abortion, and it is hard to imagine a more grisly or upsetting procedure. After around 24 weeks in the womb - two-thirds of a fullterm pregnancy - the baby is pulled out from the mother feet first, up to the neck.
The doctor then creates a hole in the baby's skull to take out the brain, making it easier to collapse the head. Finally, the now-dead baby is delivered.
In America, there are 2,200 of these partial-birth abortions a year. This week, a final debate will begin in the U.S. Senate to decide whether the practice should be banned. It follows years of argument, political wrangling and legal battles.
President Bush has promised to approve the legislation if it is passed by Congress, and his fellow Republicans seem poised to use their majority to force it through.
Such a ban would represent a hugely significant victory for the pro-life lobby. It symbolises a remarkable shift in American attitudes towards the whole issue of abortion, with profound implications for this side of the Atlantic.
For years, British public opinion has tended to see the antiabortion movement as the preserve of fanatical zealots bent on destroying women's hard-fought right to 'choose'. Among the young and politically active, it has been a deeply unfashionable cause.
Yet in America, all that is changing.
Millions of ordinary American women are picking up the antiabortion banner.
They include feminists and Left-wingers - political preserves once perceived as almost universally pro-choice. And they are increasingly drawn from the younger generation. One poll showed that among women aged 18 to 39, 53 per cent said they considered abortion an act of murder.
And while the pro-choice movement still had an overall majority of women as a whole, it had been reduced to just 49 per cent, as opposed to 45 per cent who were pro-life. The rest were undecided.
As one pro-life advocate puts it: 'If a women switches sides these days, it's always over to ours.' British campaigners believe that, as in so many areas, this country will follow where America has led.
And they point out that here, as in the States, the most fervent prolife campaigners are often women who have undergone terminations themselves and been deeply traumatised by the experience. They call themselves 'victims of abortion' and do not wish other women to suffer in the way they have.
Twenty-first century Britain, regarded abroad as the abortion capital of Europe, is currently firmly in the pro-choice camp.
BUT as we approach the 35th anniversary next month of legalised abortion in this country, the question is: will the momentous sea change in America take hold here, as women begin to see the effects of abortion on their friends, sisters and mothers?
One reason for the profound turnaround of ideology is that many women who have had abortions are speaking out to warn of the anguish and regret that has followed a termination.
There is also dismay at the vast numbers of women who seek terminations, not for medical or reasons or because their personal circumstances are dire, but because the time 'isn't right'.
There are growing health concerns too - notably, there is a link between breast cancer and abortion as well as a number of complications that can arise from the procedure itself.
THE new breed of American prolife campaigner is epitomised by Pia de Solenni. A successful career woman, with a hectic social life and a penchant for designer suits, she is dismissive of those who see abortion as 'liberating' women from the problems of unwanted pregnancies.
'Abortion has been portrayed as the responsible thing to do,' she says.
'In a problematic situation, in the eyes of everyone around her be it employer, parent or partner who does not want the child - it's easier for a woman to have an abortion than to take care of her child.
'Those who are pro-abortion say woman should not be forced to carry a child she does not want.
But the truth is that there are very few women who abhor the child they are carrying.
'There are women who have had abortions who are just devastated.
It's the situation around them that is the problem. A woman is made to think the baby is a chain around her neck, not what it really is - a blessing and a privilege.' De Solenni, who is a fellow at the Centre for Human Life and Bioethics, part of America's Family Research Council, which helps shape government policy, believes women have been conned by proabortion propaganda.
'Women feel they have no choice but to have an abortion. They are told it is a necessary evil. They have neglected what is uniquely feminine about them, that is being able to have children and raise families, and have focused on being like men, pursuing careers at the cost of all else.
'But there is a growing backlash against abortion and the movement has entered the mainstream across all sections of society.' The abortion laws in Britain are among the most liberal in Europe.
Since the procedure was legalised in 1968, the abortion rate has risen dramatically, from 23,641 in 1968 to 186,274 in 2001.
Over a thousand were undertaken on girls under 15 in 2001, and 2,777 were done at a gestation period of 20 weeks or over. In the States, there were 1.3million abortions in 2000, the lowest number since 1974, although this is partly attributable to fewer women becoming pregnant.
Women are told their right to choose is empowering, another freedom bestowed by the sexual revolution.
But is it? The conviction of the pro-life movement is that it is quite the opposite, that abortion is demeaning, humiliating and debilitating to women.
Listen to Olivia Gans, who had a termination at the age of 21 in 1981, when she was in her fourth year at college. Olivia is the director of American Victims of Abortion, a group of women who speak out on the trauma they suffered through abortion. 'I was a classic case for abortion,' she says.
'My boyfriend and I hadn't planned it and were overwhelmed. I was apprehensive but when I tried to talk about my doubts to abortion providers I was told I was selfish, childish, foolish and irrational.
'The sensible thing was to have the child aborted. That's what's so ironic about the so called pro-choice movement. That's the last thing you have: choice.
'My boyfriend felt nervous about the prospect of me having the baby and in the end I thought: what's the point in fighting this, so I had a termination.
'That night I went home and the Wizard Of Oz was on television and I felt so sad that my child would never enjoy the simple joys of childhood.
'After that I blocked the whole thing out of my mind, but a year later I started having panic and anxiety attacks. I dropped out of college and would weep through the night.
'As for my boyfriend and I, we split up three months after the abortion.
That's terribly common. Research shows that 70 per cent of couples who opt for abortion split up. Every time they look each other in the eye they see someone who isn't there.
'If I had the choice again, I would say yes to my child in a heartbeat.
With abortion the baby dies and the mother is psychologically damaged.
Who's the winner?' Pia de Solenni agrees. 'It's demeaning to a woman to suggest that if, for example, she is at college, she won't be able to continue her education if she's pregnant.
'What are we saying - that a woman dumbs down when she's pregnant? If help and support is available to the woman, then, of course, she can continue her studies and have a baby.
'Women suffer all sorts of anxieties and regret after abortion.
There was a study recently which showed that women who abort are four times more likely to die within a year of the abortion than are women who give birth. It suggests they don't take care of themselves, they no longer value their life.' AT the heart of this emotive issue is, of course, the unborn child. Pro-life supporters are unwavering in their belief that the unborn child is a human being deserving of dignity and respect and the right to live.
Pro-choice proponents are equally certain that a woman should not be forced to carry a child she does not want, or feels she cannot have.
Thirty years ago women facing the trauma of an unwanted pregnancy were reassured that the foetus was just a 'blob of tissue'.
Today's ultrasound equipment clearly shows the form of a baby at just eight weeks. This 'window on the womb' is a powerful tool for pro-life campaigners.
Darla St Martin, associate executive director of America's pro-life National Right To Life Committee, says: 'In the modern world you can't claim that it's not a human life. Can a foetus feel pain? Of course it can.' So why is abortion so common? 'It is made to seem simple and easy,' she says. 'It is presented not as killing a child, but as becoming unpregnant.
'Women are told it is a simple and quick procedure - 15 minutes as opposed to 18 years of having to care for a child. It's tragic. We need to build a support network for women so they feel they have a real choice.' And so the decision remains as divisive as ever. Pro-choicers are deeply nervous about the intentions of their pro-life government.
As well as promising to ban partialbirth abortions (which are not normally carried out in Britain) the prolife Bush administration is introducing measures to recognise 'foetal personhood', such as supporting a bill to make it a double offence to kill a pregnant woman and extending health insurance to 'unborn children'.
Suzanne Olds, North America representative for Marie Stopes International, is worried. She remembers the historic day 30 years ago when the Supreme Courts ruled abortion was legal in all 50 states.
'It was an incredible moment. I was jumping up and down with joy. It was a sign of emancipation, a step forward in the sexual revolution. I can't believe where we're heading now.' At the time, Mrs Olds had started up a Planned Parenthood clinic in Michigan offering family planning services. The clinic did not provide abortion, but would refer women to clinics abroad.
'I would get women coming in and begging me to find somewhere for them to go to have an abortion,' she says. 'They were desperate. Some had so many children they could no longer cope, others were unmarried and terrified of their parents' reaction.
Do we really want to go back to those dark days?
'I respect the beliefs of the pro-life lobby. What I don't like is the way they try to impose them on others.
It's my body and I don't think anyone has the right to tell me what to do with it.' The pro-choice movement NARAL, the National Abortion and Reproductive Rights Action League, which recently changed its name to NARAL Pro-Choice America (an admission, perhaps, that the word abortion does not resonate well among the public) is equally concerned.
'If the law is overturned, women will return to - and die in - the back alleys of this nation,' warns Kate Michelman, the group's president.
Indeed, it is the spectre of the backstreet abortion that provides the pro-choice movement with one of its most powerful arguments to keep abortion legal and accessible.
In Britain today one in four pregnancies will end in termination and every day hundreds of abortions take place in clinics across the country.
Yet behind the issues, the statistics and the politics, there are powerful personal stories.
To find some, I went to Marie Stopes House in the West End, a handsome Victorian townhouse said to be haunted by the woman herself.
There is a concerted effort to create a cheerful atmosphere. The walls are painted sunshine yellow and after the procedure the women are taken to a room where they relax with tea and biscuits on reclining chairs.
Today around 25 terminations will be undertaken, the women are given 'conscious sedation' to make them groggy but not unconscious. This enables them to be in and out of the clinic within an hour and a half.
Amanda, a 27-year-old nanny from London, is among the first to have the procedure. 'Deep down I know I would have liked to have had the baby but I know it's not the right time for me,' she says.
'It's too much stress. I'm not ready to take on the responsibility of bringing a child into the world - I know how much hard work it is.
'My boyfriend and I are getting married soon, and perhaps after we're married we'll try for a baby. We normally use contraception but we got drunk one night and had unprotected sex. To be honest I'm feeling pretty guilty about it all and am very emotional. And the abortion itself was very painful.' LOUISE, a 25-year-old party planner, is next on the list. 'I'm on the Pill but took some antibiotics which I'm told may have affected its effectiveness,' she says. 'I was shocked and upset when I found out I was pregnant. My boyfriend and I discussed it for five days before we reached the decision to have an abortion.
'To be honest he wanted me to have the baby but I've just got a new job and I know if I had a baby now it would put paid to it. Right now I feel relieved but also upset. It's a bit of a rollercoaster. The woman next to me in the recovery room was crying.' Tony Kerridge, senior communications manager of Marie Stopes, rigorously defends the right of women to choose abortion. 'Have we in the 21st century the right to question the choices that women make?
We have to respect their decisions.' Of course, Paul Tully, general secretary of Britain's Society for the Protection of the Unborn Child, does not agree. 'The cracks are starting to appear in America and I'm optimistic that one day we will see the same happen here,' he says.
'People are beginning to see that the prevailing orthodoxy, logically ethically and morally, is not sustainable in the face of increasing evidence of the inhumanity of the procedure.' Right now the majority of Britons remain convinced that abortion, unpleasant as it is, is a better option than forcing an unwanted pregnancy on a woman.
But, regardless of the moral and ethical questions involved, it would be foolhardy to ignore the warnings coming out of America. After all, they are from women themselves, and the most vocal of all are from those who exercised their right to choose, chose abortion - and bitterly regret it.