The Santorums, according to an account written by the senator for today's Commentary Page in The Inquirer, struggled mightily to avoid the abortion option.
Ultimately, they did not have to make a decision; nature made it for them. Karen went into premature labor from an infection, delivering a boy who had a fatal abnormality. The child died two hours later.
In an interview, the Santorums said they would have authorized an abortion had there been no other choice.
``If that had to be the call, we would have induced labor if we had to,'' the senator said as he sat in his Washington office. ``I consider it a blessing that we didn't have to make that decision.''
An abortion under the circumstances described in this case would not have been a partial-birth abortion - known to physicians as ``intact dilation and extraction'' - nor would it have conflicted with the senator's position.
Santorum opposes abortion ``except in the cases of rape, incest or [to save] the life of the mother.'' He believes Roe v. Wade should be reversed so that states could regulate and restrict abortion, and opposes public funding of abortion.
In the interview, the senator said that his wife's experience reinforced rather than altered his views about abortion.
``I'm not suggesting that abortion is never medically called for to save the life of the mother,'' he said. ``But my son's fetal abnormality was never a threat to Karen. You don't abandon him because there's something wrong with him.''
He said he was struck by the ``incredible irony'' that this experience should have happened to him - a public official with a highly visible position on one of the thorniest issues of the last 30 years.
``You're no different than anyone else,'' Santorum said in discussing his family's ordeal. ``You ask the same questions: Why us? Why this? There is no answer other than, things happen. Most of the time I was just focused on what we could do.''
The couple have three children, ages 6, 4 and 1 1/2.
Santorum has been a prime sponsor of legislation in the Senate to ban partial-birth abortions, a procedure he has termed ``barbaric'' and ``legal infanticide.''
A year ago, President Clinton vetoed a bill outlawing this technique of abortion, which is done only in the second half of pregnancy. In September, Santorum led the unsuccessful effort to override the veto.
In his account, Santorum recalls that during the debate over the proposed veto override an opponent charged that he could not understand the roiling emotions of women who had been through the experience.
Only a week or so later, Santorum said, he understood.
Karen was in her 19th week of pregnancy. Husband and wife were in a suburban Virginia office for a routine sonogram when a radiologist told them that the fetus Karen was carrying had a fatal defect and was going to die.
After consulting with specialists, who offered several options including abortion, the Santorums decided on long-shot intrauterine surgery to correct an obstruction of the urinary tract called posterior urethral valve syndrome.
A few days later, rare ``bladder shunt'' surgery was performed at Pennsylvania Hospital in Philadelphia. The incision in the womb carried a high risk of infection.
Two days later, at home in the Pittsburgh suburb of Verona, Karen Santorum became feverish. Her Philadelphia doctors instructed her to hurry to Pittsburgh's Magee-Women's Hospital, which has a unit specializing in high-risk pregnancies.
After examining Karen, who was nearly incoherent with a 105-degree fever, a doctor at Magee led Santorum into the hallway outside her room and said that she had an intrauterine infection and some type of medical intervention was necessary. Unless the source of the infection, the fetus, was removed from Karen's body, she would likely die.
At minimum, the doctor said, Karen had to be given antibiotics intravenously or she might go into septic shock and die.
The Santorums were at a crossroads.
Once they agreed to use antibiotics, they believed they were committing to delivery of the fetus, which they knew would most likely not survive outside the womb.
``The doctors said they were talking about a matter of hours or a day or two before risking sepsis and both of them might die,'' Santorum said. ``Obviously, if it was a choice of whether both Karen and the child are going to die or just the child is going to die, I mean it's a pretty easy call.''
Shivering under heated blankets in Magee's labor and delivery unit as her body tried to reject the source of the infection, Karen felt cramping from early labor.
Santorum agreed to start his wife on intravenous antibiotics ``to buy her some time,'' he said.
The antibiotics brought Karen's fever down. The doctor suggested a drug to accelerate her labor.
``The cramps were labor, and she was going to get into more active labor,'' Santorum said. ``Karen said, `We're not inducing labor, that's an abortion. No way. That isn't going to happen. I don't care what happens.' ''
As her fever subsided, Karen - a former neonatal intensive-care nurse - asked for something to stop the labor. Her doctors refused, Santorum recalled, citingmalpractice concerns.
Santorum said her labor proceeded without having to induce an abortion.
Karen, a soft-spoken red-haired 37-year-old, said that ``ultimately'' she would have agreed to intervention for the sake of her other children.
``If the physician came to me and said if we don't deliver your baby in one hour you will be dead, yeah, I would have to do it,'' she said. ``But for me, it was at the very end. I would never make a decision like that until all other means had been thoroughly exhausted.''
The fetus was delivered at 20 weeks, at least a month shy of what most doctors consider viability.
The labor ``was just as painful as the others,'' said Karen, ``and emotionally I can't begin to tell you how painful it was.''
Doctors later told her that she very nearly waited too long to accept antibiotics.
Gabriel Michael Santorum was delivered at 12:45 a.m. on Oct. 11, 1996, and lived for two hours. His remains are buried in St. Joseph's Cemetery in suburban Pittsburgh.
Three members of the Garver family are physicians, and Karen's own experience as a nurse helped her understand her options. As an elected official, was Santorum also in a better position to receive quick and reliable medical advice?
``It's how much you want to try, how much time you want to devote to it,'' Santorum responded. ``I would have ended up somewhere with someone doing something - because I wouldn't have given up until I found it.''
In the months after the birth and death of Gabriel Michael Santorum, rumors began circulating in the Pennsylvania medical community that Karen Santorum had undergone an abortion. Those rumors found their way to The Inquirer, prompting the questions that led to this article.
``There are a lot of people who aren't big fans of Rick Santorum,'' the senator said of the rumors. ``You're a public figure, and you're out there. Maybe it accomplishes a political purpose.''
On Saturday, April 5, Santorum gave the Republican response to President Clinton's weekly radio address. The subject he chose was partial-birth abortion.
Santorum said he had been looking for an opportunity to speak about his experience but knew the four-minute radio address was too brief. He also considered discussing it on the Senate floor.
``I'm talking about it with you, but I'm sort of removing myself here,'' he said. ``When I get up in front of people . . . .'' his voice trailed off.
``I consider it a blessing that we found out about the problem, because he became very real to me. He may not be perfect, he may not live long, but he's my son.''
Santorum's face reddened, and the tears he had seemingly fought for an hour rolled down his cheeks. He raised a white-shirted arm and pointed to a credenza adjoining his desk.
``That's his picture.''
There, amid a gaggle of photographs of the Santorum children, was one in a cheery white frame speckled with green highlights.
Photographed on a hospital bed, the fetus stares from unseeing eyes, its features unformed, indistinct.
An adult hand, fingers curled into a gentle fist, rests nearby on the bed, dominating the image.