01.20.11

The Twisted Abortion Doctor

Antiabortion activists have new fodder after the arrest of a Philadelphia abortion doctor charged with murder and infanticide. The Daily Beast’s Michelle Goldberg on why they’re wrong and the need for safe abortions remains urgent.

Here is something the most doctrinaire pro-choice and antiabortion advocates can probably agree on: If Philadelphia doctor Kermit Gosnell is guilty of even a fraction of the carnage he’s been charged with, he should spend the rest of his life in prison. The grand jury report charging him with eight counts of murder and a host of other crimes describes his clinic as a house of horrors, where live babies were murdered with scissors and women treated with hideous cruelty. His practice, the report says, was “a filthy fraud in which he overdosed his patients with dangerous drugs, spread venereal disease among them with infected instruments, perforated their wombs and bowels—and, on at least two occasions, caused their deaths.”

It’s hard to blame the antiabortion movement from running with this story. Its activists have long described abortion clinics as abattoirs; Gosnell would seem to prove them horrifically right. “[T]he difference between this gruesome killing machine and a ‘safe’ clinic is aesthetics, really,” wrote Lori Ziganto in RedState.com. “There is no denying the horror of what was found in this ‘doctor’s’ office. But it happens in every abortion clinic across the land.”

She’s completely wrong. Gosnell’s clinic was in no way representative of most abortion facilities, which is why the country’s largest organization of abortion providers, the National Abortion Federation, refused him membership and testified against him to the grand jury. In fact, Gosnell’s crimes only underline the need for all women to have access to affordable and genuinely safe providers. His patients subjected themselves to terrible abuses because that’s what women will do when they’re desperate and they don’t see other options.

While Gosnell’s clinic was an anomaly, it wasn’t entirely unique; the stigma and secrecy around abortion has long attracted the occasional criminal to the field. In her book Dispatches From the Abortion Wars, the sociologist Carole Joffe wrote about what she called “rogue clinics.” “These clinics—or in some cases individual doctors—typically prey on women in low-income immigrant communities.” She described a case in 2008 in which two sisters, Berta and Raquel Bugarin, were arrested for practicing medicine without a license at a string of clinics in Southern California and sued for causing injury and wrongful death. “That such clinics can flourish until the inevitable disaster occurs strikes me as a ‘perfect storm’ caused by the marginalization of abortion care from mainstream medicine, the lack of universal health care in the United States, and the particular difficulties facing undocumented immigrants in obtaining health care in the United States,” she wrote.

Gosnell’s perversely named Women’s Medical Society was just the sort of rogue clinic Joffe was describing. “There was blood on the floor,” the grand jury report said. “A stench of urine filled the air. A flea-infested cat was wandering through the facility, and there were cat feces on the stairs. Semi-conscious women scheduled for abortions were moaning in the waiting room or the recovery room, where they sat on dirty recliners covered with blood-stained blankets.

No woman would subject herself to such a place if she thought she had somewhere else to go. Forty-one-year-old Karnamaya Mongar, who died after being given an overdose of sedatives at the clinic, was a refugee who had recently arrived in the U.S. from a resettlement camp in Nepal. She couldn’t read English and may not have had any idea how to find a decent clinic. Minors went to Gosnell’s clinic—it was the one place they could skirt state law and get abortions without parental consent. Gosnell performed illegal late-term abortions on women who should have been cared for months earlier.

It should go without saying that Gosnell failed to meet the standards that the overwhelming majority of clinics adhere to. He actually applied to the National Abortion Federation in 2009, and apparently tried to make his clinic look somewhat respectable when an investigator from the organization visited him. “Despite his various efforts to fool her, the evaluator from NAF readily noted that records were not properly kept, that risks were not explained, that patients were not monitored, that equipment was not available, that anesthesia was misused,” the grand jury report says. “It was the worst abortion clinic she had ever inspected. Of course, she rejected Gosnell’s application.”

The grand jury report says that the National Abortion Federation’s standards are “in many ways, more stringent and more protective of women’s safety than are Pennsylvania’s abortion regulations.” It’s possible that NAF didn’t realize the extent of the clinic’s illegality. Gosnell’s staff “went to great lengths to try to cover up some of their practices and put on their best face,” says Vicki Saporta, NAF’s chief executive.

One can fault them for not being more proactive in trying to shut Gosnell down, though they are pretty far down the chain of culpability. The grand jury report is scathing about the failures of the Pennsylvania Department of Health, which hadn’t visited the clinic for 15 years prior to the police raid last February. The raid, when it finally came, was for trading in prescription drugs, not abusing women or committing infanticide. Gosnell was able to do what he did because the women who came to him had fallen through the cracks of our damaged medical system. No one seemed to care what happened to them.

His patients subjected themselves to terrible abuses because that’s what women will do when they’re desperate and they don’t see other options.

When abortion is shrouded in shame, excluded from public health-insurance programs, and made harder to get because of a web of legal restrictions, horror ensues. It happened before Roe v. Wade—searing memories of those days still motivate the women who lead the pro-choice movement and the aging doctors who continue to practice despite constant threats and harassment. It’s happening now around the world, in poor countries like Kenya, where abortion is illegal and a staggering one-third of maternal deaths are caused by botched procedures. And it happened with this modern-day back alley butcher in Philadelphia. It would be grotesque if Gosnell’s crimes were used as a pretext to make it even harder for vulnerable women to get the care they need.

Michelle Goldberg is a journalist based in New York. She is the author of The New York Times bestseller Kingdom Coming: The Rise of Christian Nationalism and The Means of Reproduction: Sex, Power and the Future of the World, winner of the 2008 J. Anthony Lukas Work-in-Progress Award and the Ernesta Drinker Ballard Book Prize. Goldberg's work has appeared in Glamour, Rolling Stone, The Nation, New York magazine, The Guardian (UK) and The New Republic. Her third book, about the world-traveling adventuress, actress and yoga evangelist Indra Devi, will be published by Knopf in 2012.