From Gosnell to Coathangers to the Religious Right

PHILADELPHIA, PA—By pretty much all accounts—most notably, the 281-page report prepared by Philadelphia County Investigating Grand Jury XXIII—Dr. Kermit Gosnell is not a good person. For those who don't know, he ran the Women's Medical Society at the corner of 38th Street and Lancaster Avenue in one of the lower-income areas of West Philly, where he performed abortions—many of them late-term—and according to the charges leveled against him by the District Attorney's office, killed at least seven new-borns and one patient in the process.

"The clinic reeked of animal urine, courtesy of the cats that were allowed to roam (and defecate) freely," stated District Attorney R. Seth Williams for the grand jury. "Furniture and blankets were stained with blood. Instruments were not properly sterilized. Disposable medical supplies were not disposed of; they were reused, over and over again. Medical equipment—such as the defibrillator, the EKG, the pulse oximeter, the blood pressure cuff—was generally broken; even when it worked, it wasn’t used. The emergency exit was padlocked shut. And scattered throughout, in cabinets, in the basement, in a freezer, in jars and bags and plastic jugs, were fetal remains. It was a baby charnel house.

"The people who ran this sham medical practice included no doctors other than Gosnell himself, and not even a single nurse," the report continued. "Two of his employees had been to medical school, but neither of them were licensed physicians. They just pretended to be. Everyone called them 'Doctor,' even though they, and Gosnell, knew they weren’t. Among the rest of the staff, there was no one with any medical licensing or relevant certification at all. But that didn’t stop them from making diagnoses, performing procedures, administering drugs."

And speaking of "administering drugs": "There were two primary parts to the operation," the grand jury noted. "By day it was a prescription mill; by night an abortion mill. A constant stream of 'patients' came through during business hours and, for the proper payment, left with scripts for Oxycontin and other controlled substances, for themselves and their friends. Gosnell didn’t see these 'patients'; he didn’t even show up at the office during the day. He just left behind blank, pre-signed prescription pads, and had his unskilled, unauthorized workers take care of the rest. The fake prescriptions brought in hundreds of thousands of dollars a year."

Like we said, not a good person—and as this is written, the jury, which spent nearly two months hearing the case from a variety of witnesses, including some who worked at the clinic and some who were patients there, has been deliberating since April 30, though no verdict has been reached yet.

Now, disgusting as it may be, there are some people out there who love a "good" abortion story, and plenty of those folks blog for right-wing religious websites—and anyone who'd read any of those sites during the second week of April would have been "treated" not only to lurid accounts of what Gosnell did, but claims that Gosnell's practices were little different than those of all the other women's clinics performing abortions throughout the country, most notably Planned Parenthood—and with that "fact" engraved on their frontal lobes, the bloggers found it only a short mental distance from these alleged "widespread abortion horrors" to the idea that the "liberal-dominated" mainstream media had affirmatively decided not to report on the trial lest such reportage lead to more arrests of abortion providers and more closings of women's clinics that performed abortions.

"This week, the right wing has been working the refs, demanding to know why the press has been allegedly silent on the trial of Kermit Gosnell, the Philadelphia doctor who allegedly committed horrific acts against his patients with impunity for years," wrote Salon.com's Irin Carmon. "Fox News' Kristen Powers kicked it off with an Op-Ed in USA Today, claiming, 'The deafening silence of too much of the media, once a force for justice in America, is a disgrace.' Michelle Malkin has helped spearhead a Twitter campaign. Breitbart.com calls it 'a full-blown, coordinated blackout throughout the entire national media.'"

But in fact, anyone who read Feministing.com or RHRealityCheck.com or any of the other woman-centric blogs on the internet (and there are many) was fairly well-informed about Gosnell's crimes, about the grand jury report—and about the fact that it had been more than 25 years since a state agency had even set foot inside this state-licensed "medical clinic."

However, despite how abominable Gosnell's acts were, his case really was simply a local story—except to all the fundamentalists who not only oppose abortion but who have convinced themselves that what happened in Gosnell's clinic was just about the same as happens at nearly every other women's clinic in the country. To them, Gosnell was simply the latest example of what they'd been claiming for more than 40 years was going on in the so-called "abortion mills"—like Planned Parenthood, and of course the clinic of late-term abortion provider Dr. George Tiller until they assassinated him, and then by Dr. Leroy Carhart.

"This is the war on women," declared an editorial in the Family Research Council online newsletter. "A profit-driven abortion industry, so focused on making a buck that they can't be bothered to clean rusty equipment, wipe down bloody operating tables, appropriately sedate patients, or monitor mutilated women."

So it was hardly surprising that while national newspapers and broadcast networks pretty much took a "Move along; nothing to see here" approach to covering the Gosnell trial, which began on March 18, it took conservative media nearly a month before even mentioning that the trial was in progress—and to begin bashing the national media for failing to cover it and/or Gosnell himself, since the Grand Jury report was issued way back in 2011.

As Alex Seitz-Wald has pointed out, not only did the right-wing media ignore the trial during most of its first month, with Fox News "liberal" Kirsten Powers having published her USA Today piece on April 11 (after which just about all the other major right-wing propaganda outlets like the National Review, the Weekly Standard and WorldNetDaily jumped on board), no member of Congress commented on either the Grand Jury report or the trial itself until the day after Powers' article saw print—and besides, Common Pleas Judge Jeffrey Minehart had issued a gag order prohibiting attorneys for both sides from discussing the case in the press!

But all the press about who beat who to the story is itself a glossing-over of several major issues, including how Gosnell was able to operate free from government oversight for so many years, despite myriad complaints from patients and others familiar with the "practice," and why, with so many safe, ethical abortion providers in the area, women still went to Gosnell.

"The first line of defense was the Pennsylvania Department of Health," the grand jury report noted. "The department... had contact with the Women’s Medical Society dating back to 1979, when it first issued approval to open an abortion clinic. It did not conduct another site review until 1989, ten years later. Numerous violations were already apparent, but Gosnell got a pass when he promised to fix them. Site reviews in 1992 and 1993 also noted various violations, but again failed to ensure they were corrected... After 1993, even that pro forma effort came to an end. Not because of administrative ennui, although there had been plenty. Instead, the Pennsylvania Department of Health abruptly decided, for political reasons, to stop inspecting abortion clinics at all. The politics in question were not anti-abortion, but pro. With the change of administration from Governor Casey to Governor Ridge, officials concluded that inspections would be 'putting a barrier up to women' seeking abortions. Better to leave clinics to do as they pleased, even though, as Gosnell proved, that meant both women and babies would pay.

"But even this total abdication by the Department of Health might not have been fatal," the report continued. "Another agency with authority in the health field, the Pennsylvania Department of State, could have stopped Gosnell single-handedly. While the Department of Health regulates facilities, the Department of State, through its Board of Medicine, licenses and oversees individual physicians. Like their colleagues at Health, however, Department of State officials were repeatedly confronted with evidence about Gosnell, and repeatedly chose to do nothing."

But several commentators didn't buy the simplistic "political" explanation.

"After all, the question is not just why the state failed to respond to the complaints of women and advocates who visited the clinic, although that matters hugely. It’s why women kept going there anyway: because they felt they had no alternative," noted Carmon. "For these women the cost of paying for an abortion out of pocket breaks the budget, leaving mom scrambling to make next month’s rent or possibly wind up on the street. Cost is also how women often get past the legal gestational limit, as they struggle to save up enough money — and Gosnell’s willingness to break the law was what made him their last chance. To everyone who thinks his case was a reason for more abortion restrictions: What he did was already illegal."

"In 2011, the Grand Jury report stated, 'We think the reason no one acted is because the women in question were poor and of color'," added Abortion Care Network's Erin Grant. "Almost all of Gosnell’s patients are identified as poor women of color. Still, the mainstream media is largely not paying attention to the issues of race and class inherent in this story, which contribute to the reasons why Gosnell could thrive. Poor, under-insured women are not getting acceptable health care of any kind, but because this story is about abortion, these usually invisible women are suddenly the subject of public pity by anti-choice activists. They were made to suffer until many lives were taken.

"In an age of rising stigma, discrimination, widespread misinformation, and violence against providers, facts get trampled," she continued. "What Gosnell underscores is a point that women’s health and rights advocates have long asserted: Women who need to terminate a pregnancy will go to desperate lengths to do so, and by isolating abortion care, we drive women to back-alley providers."

And who/what are those driving forces behind the long list of women waiting to get into Gosnell's facility? Well, to start with, there are the state legislatures, which in 39 states require an abortion to be performed by a licensed physician. Twenty states require an abortion to be performed in a hospital after a specified point in the pregnancy, and 18 states require the involvement of a second physician after a specified point in the pregnancy. Moreover, 41 states prohibit abortions, generally except when necessary to protect the woman’s life or health, after a specified point in pregnancy, most often fetal viability.

Adding to the misery, 26 states require a woman seeking an abortion to wait a specified period of time, usually 24 hours, between when she receives counseling and the procedure is performed, and 17 states mandate that women be given counseling before an abortion that includes thoroughly discredited "information" on at least one of the following: the purported link between abortion and breast cancer, the ability of a fetus to feel pain, or long-term mental health consequences for the woman. (H/t to the Guttmacher Institute for these statistics.)

But that's hardly all. At the urging of myriad anti-abortion groups, legislators are creating new and even more outrageous ways to close existing clinics. One of the worst of these methods is the Targeted Regulation of Abortion Providers (TRAP) law.

"In 2012, Arizona, Michigan and Virginia took steps to establish stringent regulations that affect only surgical and medication abortion providers, but not other providers of outpatient surgical and medical care," the Guttmacher Institute website reports. "A law enacted in Arizona requires the state health department to develop regulations that include rules on follow-up procedures after a medication abortion, requirements for reporting abortion complications and penalties for noncompliance. In Michigan, legislation enacted at the very end of the year directs the state health department to develop regulations that will require providers that perform at least 120 abortions per year to meet the same architectural and licensing requirements as ambulatory surgical facilities. In Virginia, Gov. Bob McDonnell approved regulations requiring all abortion clinics performing at least five procedures a month to meet the same architectural standards as hospitals."

Other impediments to women seeking abortion on demand include requiring medically unnecessary procedures like invasive vaginal ultrasounds or requiring abortion seekers to listen to fetal heartbeat monitors prior to the procedure, and requiring doctors who perform abortions to have admitting privileges at local hospitals, supposedly in case of emergency but in reality, since the vast majority of abortions have no complications whatsoever, such laws are simply meant to decrease the number of licensed abortion providers and force clinics to close because of inability to staff them.

But perhaps equally as egregious are the multitude of plans designed to keep women barefoot and pregnant as often as possible. Take all the brouhaha about the recent decision handed down by U.S. District Judge Edward Korman in the Eastern District of New York, which mandated that the Food and Drug Administration "make levonorgestrel-based emergency contraceptives [like Plan B] available without a prescription and without point-of-sale or age restrictions within thirty days." Almost immediately, FDA Commissioner Margaret A. Hamburg tried to limit the judge's order only to women 15 years of age or older, but even that restriction was superceded by the U.S. Department of Justice's announcement that it was going to appeal Judge Korman's decision in its entirety—even though the FDA's own Plan B review panel had recommended exactly what Judge Korman had ordered—except that that recommendation was overruled by Health and Human Services head honcho Kathleen Sibelius!

Even worse, however, has been the widespread gutting of sex education in public schools and its attempted replacement by error-filled "abstinence education" courses and speakers. For example, in early April, abstinence "expert" Pam Stenzel told students at George Washington High School in Charleston, WV that "If you take birth control, your mother probably hates you," and "I could look at any one of you in the eyes right now and tell if you’re going to be promiscuous." Stenzel's statements were so outrageous that student body president Katelyn Campbell spoke out publicly against the school's decision to fund Stenzel's lecture—which moved the school's principal to denounce Campbell to Wellesley College in hopes that they would rescind their acceptance of Campbell as a student there. (Actually, Wellesley tweeted that "Wellesley is excited to welcome you this fall.")

But despite the findings of the December, 2004 report prepared for U.S. Rep. Henry A. Waxman regarding abstinence education, which found, according to the American Public Health Association, that "11 out of 13 of the most commonly used abstinence-only-until-marriage curricula used fear and shame, blurred religion and science, perpetuated gender role stereotypes and contained medical misinformation, many state legislatures still champion their use.

"For example," the APHA summary continued, "one program reportedly teaches students that HIV/AIDS can be transmitted though tears and sweat; body fluids that have never been shown to transmit HIV. Many other curricula reportedly attempt to discourage young people from using condoms and other forms of contraception by distorting information about their efficacy."

The terrible damage done by these bogus programs was brought home earlier this month, when Elizabeth Smart, a 14-year-old girl who had been kdinapped from her parents' home in Salt Lake City, tortured and raped by itinerant worker Brian David Mitchell and his wife, spoke at an anti-human trafficking program at Johns Hopkins University.

After recalling that one of her school teachers in the Salt Lake City public schools had spoken once about abstinence and compared sex to chewing gum,  "I thought, 'Oh, my gosh, I'm that chewed up piece of gum! Nobody re-chews a piece of gum; you throw it away.' And that’s how easy it is to feel like you no longer have worth, you no longer have value," the now-25-year-old said. "Why would it even be worth screaming out? Why would it even make a difference if you are rescued? Your life still has no value."

It's "logic" like that, based on deliberate distortions and misinformation, that often causes pregnant women to ignore the fetus growing inside them until they realize that birth may be near, and lacking any local late-term abortion facilities, they seek out butchers like Kermit Gosnell who, among other atrocious acts, would only give his patients as much anesthetic as they were willing to pay hundreds of dollars for.

But the point is, with conservative religionists attempting to paint Gosnell as a "typical" abortion provider rather than the abberation he actually is, the federal and state legislators who accept that horseshit will continue to make laws that deprive women of their right to a safe abortion—and when enough of those laws are passed (and in some states, that threshhold has already been reached), what America will see is a return to the "abortion methods" of yore: More "clinics" like Gosnell's... and more instances where women will try to self-abort using coathangers or whatever materials they have lying around that they think will do the job.

And many of them will die. And too many people's reaction will be, "Well, that's the wages of sin."

Just something to think about.