Gruesome Gosnell

On Feb. 18, 2010, the FBI raided the Women’s Medical Society, with the aim of collecting evidence that it was illegally selling prescription drugs. What they found was something much worse. A flea-infested cat walked across a blood-covered floor. Semi-conscious women sat in waiting and recovery rooms on filthy recliners with blood-stained blankets. Public officials inspected the surgery rooms, and found rusty, outdated equipment, corroded suction tubing that was used for abortion procedures and for breathing assistance, as well as a single blood pressure cuff. Throughout the clinic, in paper bags, cat-food containers and orange juice cartons, officials found fetal remains.

These conditions would be outrageous for a medical clinic in a post-apocalyptic television drama, or a country ravaged by a decade of civil war. But this clinic was in Philadelphia. Dr. Kermit Gosnell, the director of the clinic, employed a 15-year-old, high school student and administrative staff to sedate primarily poor, black women. Gosnell admitted that at least 10 to 20 percent of the fetuses he aborted were probably older than 24 weeks, even though Pennsylvania state law prohibits abortions after 24 weeks. According to one former employee’s testimony, Gosnell performed at least four or five illegal abortions each week.

Although the grand jury believes the death toll at Gosnell’s office was “literally incalculable,” the District Attorney’s Office only has sufficient evidence to charge Gosnell with eight counts of murder: seven babies and one pregnant refugee. Evidence presented to the grand jury indicates that the babies were born and may have lived up to 20 minutes before Gosnell or one of his assistants cut their spinal cord. The evidence also indicates that Karnamaya Mongar died when Gosnell’s unlicensed employees doped her up with Demerol. When employees discovered she had stopped breathing, Gosnell briefly attempted CPR. Instead, Mrs. Mongar’s body was rearranged to make it look like she was the victim of a routine complication of a safe abortion procedure. Paramedics were able to get a weak pulse, but it took them 20 minutes to get through the cluttered hallways.

Superficially, this is a case about abortion. But this is more than the latest installment in the epic pro-life versus pro-choice battle. First, Gosnell was not just performing abortions; he was performing them illegally. In the seminal case of Roe v. Wade, Justice Blackmun premised the state’s ability to prohibit abortions on the viability of the fetus, around 24 to 28 weeks. In other words, under both state law and under the language of the case that established a woman’s right to choose, Gosnell was performing illegal procedures (assuming he did not perform these abortions to save the life of the mothers).

Second, Gosnell’s clinic seems like it should be in “The Walking Dead.” It appears that Gosnell’s patients probably ended up at the Women’s Medical Society because of Medicaid’s refusal to cover most abortions, the paucity of abortion providers in Pennsylvania and the fear of facing abortion protesters at Planned Parenthood clinics.

Due to the political rhetoric of the abortion debate, the women who actually get abortions are relegated to the shadows. The definition of abortion as a legal, medical procedure is drowned out by the raging debate over the constitutionality and (im)morality of a woman’s right to choose whether to terminate her pregnancy. As a result, complaints about the inhumane practices at Gosnell’s clinic remained filed away and uninvestigated. I have a sneaking suspicion that reports of back-alley appendectomies would have prompted a full-scale investigation much earlier than the complaints filed by Gosnell’s patients and former employees.

Pro-life advocates may read the grand jury report in this case and cite the atrocities to support overruling Roe v. Wade and its progeny. But Gosnell’s clinic is reminiscent of the back-alley abortions that occurred before 1973. Before Roe v. Wade, approximately 1.2 million illegal abortions were performed every year. Many women died or suffered serious complications after undergoing primitive abortion procedures in unsanitary conditions. By excluding abortion from Medicaid and with the likely prohibition on abortion coverage in health insurance policies sold in the health care exchange under the Affordable Care Act, Pennsylvania has effectively made safe, sanitary abortions impossible to obtain for poor women.

If anything, Gosnell’s clinic should encourage Pennsylvania, other states and the federal government to focus on segregating legal abortion procedures from the political debate to ensure that women of all segments of society can, if they choose, have an abortion in a safe and sanitary clinic before the fetus is viable. At the same time, it is essential to provide support, resources and education for women who cannot legally get an abortion but do not wish to or are not able to care for a child.