Over a lunch of salmon and wine, Planned Parenthood's Senior Director of Medical Services, Dr. Deborah Nucatola, chatted about the various ways to keep fetal organs intact for sale after abortions.

I’d say a lot of people want liver.

Nucatola said to a man and woman from The Center for Medical Progress, who were posing as buyers from a fetal tissue procurement company.

And for that reason, most providers will do this case under ultrasound guidance, so they’ll know where they’re putting their forceps. The kind of rate-limiting step of the procedure is the calvarium, the head is basically the biggest part. Most of the other stuff can come out intact. It’s very rare to have a patient that doesn’t have enough dilation to evacuate all the other parts intact.

The actors posing as buyers met with Nucatola over a series of meetings, and recorded their conversation. Here is and 8+-minute compilation of footage from those meetings:

Full footage of the meetings can be seen here.

 In one conversation, Nucatola explains that, in the morning, she looks at her list of patients and decides which organs and other body parts she can harvest from which patients:

I had 8 cases yesterday. And I knew exactly what we needed, and I kinda looked at the list and said okay, this 17-weeker has 8 lams, and this one—so I knew which were the cases that were probably more likely to yield what we needed, and I made my decisions according to that too, so it’s worth having a huddle at the beginning of the day, and that’s what I do.

"Lams" are laminaria, the seaweed sticks inserted into a patient's body to induce or prepare for an abortion. They absorb moisture and widen, dilating the cervix to aid extraction of a fetus and scraping of the uterus. There is, according to Nucatola, no consensus on what is the proper number of laminaria to use. She says,

As far as medicine goes, this, for a very long time has been a data-free zone. 

Once the patient's cervix is dilated enough to extract the child's body, it's simply a matter of making careful choices of where to apply the grasping, tearing, and crushing tools that bring the child out in as few pieces as possible. It helps to know which organs you are hoping to retrieve, Nucatola explains:

So then you’re just kind of cognizant of where you put your graspers, you try to intentionally go above and below the thorax, so that, you know, we’ve been very good at getting heart, lung, liver, because we know that, so I’m not gonna crush that part, I’m going to basically crush below, I’m gonna crush above, and I’m gonna see if I can get it all intact. And with the calvarium [head], in general, some people will actually try to change the presentation so that it’s not vertex, because when it’s vertex presentation, you never have enough dilation at the beginning of the case, unless you have real, huge amount of dilation to deliver an intact calvarium.

If a buyer is in the market for fetal heads (calvaria), Nucatola explains that a breech delivery makes it easier to retrieve the child's head whole, so you should try to manipulate the fetus so as to extract his feet first:

So if you do it starting from the breech presentation, there’s dilation that happens as the case goes on, and often, the last, you can evacuate an intact calvarium at the end. So I mean there are certainly steps that can be taken to try to ensure—

Buyer: So they can convert to breach, for example, at the start of the—

Exactly, exactly. Under ultrasound guidance, they can just change the presentation.

The market for fetal parts is still in flux, Nucatola notes, and it makes sense to do your research ahead of time and figure out which specimens are in demand:

PP: You know I asked her at the beginning of the day what she wanted, yesterday she wanted, she’s been asking, a lot of people want intact hearts these days, they’re looking for specific nodes. AV nodes, yesterday I was like wow, I didn’t even know, good for them. Yesterday was the first time she said people wanted lungs. And then, like I said, always as many intact livers as possible. People just want—

Buyer: Yeah, liver is huge right now.

PP: Some people want lower extremities too, which, that’s simple. That’s easy. I don’t know what they’re doing with it, I guess if they want muscle.

When questioned about how much clinics could expect to receive for harvesting organs and other body parts, Nucatola says:

I would say it’s probably anywhere from $30 to $100 [per specimen], depending on the facility and what’s involved. It just has to do with space issues, are you sending someone there who’s going to be doing everything, is there shipping involved, is somebody gonna have to take it out.

Partial birth abortion, in which a child is partially delivered and then killed, was banned in the United States in 2003, in part because Congress determined that the procedure is never medically necessary. Nucatola says,

PPFA National policy is you must comply with the Federal Abortion Act. There are a variety of ways to do that.

She says,

[T]he Federal Abortion Ban is a law, and laws are up to interpretation. So there are some people who interpret it as intent. So if I say on Day 1 I do not intend to do this, what ultimately happens doesn’t matter. Because I didn’t intend to do this on Day 1 so I’m complying with the law. There are other people that say well if you induce demise it doesn’t matter, you’re never gonna do it so you don’t have to worry about intent.

As one lunch meeting winds down, Nucatola comments that she had originally considered being a pediatrician.

I don’t know if you know much about pediatrics, it’s really treating moms. It’s not really treating kids,  and the kids you do treat, they’re sick, and it’s very depressing and I said there’s no way I can do this.

The waitress comes by and asks what to do with the remaining wine at the table.

Waitress: A little more wine, do we split it between the two of you? 

PP: We should just pour out what’s in the bottle. And if we drink it we drink it, and if we don’t we don’t. 

Waitress: Yeah. 

PP: Not gonna throw it away. It’ll evaporate. I’m very practical.


The entire transcript of several conversations between Dr. Nucatola and the two undercover investigators from the Center for Medical Progress is available here in pdf form 

Full footage of the meetings is available here.  Highlight footage is here.