Like most providers I've talked with, I’ve found it difficult to ignore the stream of news stories over the last 48 hours or so about the arrest and charges brought against Dr. Kermit Gosnell and his staff. Arrested just short of the 38th anniversary of Roe v. Wade, I’m haunted by how many of the charges brought against him echo women’s stories of abortions prior to legalization.
As a provider, I’m disgusted by the activities and attitude described and struck by how thoroughly the state of Pennsylvania ignored their obligation to protect women from unsafe and unscrupulous physicians—despite the fact that they have some of the most restrictive abortion regulations in the country! As one colleague put it, ‘you can have all the laws in the world regulating medicine, but if no one cares enough to enforce them, what’s the use?’ It’s worth noting that, despite numerous complaints, it was not his abortion practice, but his pain medication prescriptions that finally got the state’s attention.
I'm also struck, reading the link above, how the grand jury uses the phrase 'abortion mill.' If I had a nickel for every time that allegation has been thrown at good, reputable clinics by the anti's. (Does that make the large OB & perinatal loss unit at our local hospital a 'baby mill?' or a 'miscarriage mill?') How do you even begin to talk about good abortion care when rhetoric makes it impossible to parse out the good clinics from the bad.
The women who utilized Dr. Gosnell’s clinic were largely, by most accounts, poor women, immigrants, underserved women of color. Desperate pregnant women with little money and little knowledge of the medical world are easy prey for exploitative physicians—particularly if women have immigrated from areas where abortion is illegal or unsafe. I remember holding the hand of a woman who had emigrated from an African nation where abortion was illegal. I was struck by the fact that she had walked in the door with no expectation that she would be safe in our clinic—she just knew that she desperately wanted an abortion. She asked few questions, had little money and tried to be as compliant as could be. I could have easily imagined her as one of his patients—following instructions, not making a peep. Our session went slowly, as I reviewed everything that would happen and we talked about birth control, her family back home, her fears that they would disown her if they ever knew she had been pregnant.
The social stigma against abortion services coupled with the Hyde Amendment’s refusal to cover abortion procedures for low-income women create an atmosphere wherein activities like those described in Gosnell’s case can exist. As Charlotte Taft describes in her excellent essay, secrecy, shame and desperation breed subpar care. Also, as SisterSong's excellent primer on Reproductive Justice illlustrates, Hyde represents just one arena in which the reproductive rights and dignity of low-income women and women of colors are dismissed.
This year, for the 38th anniversary of Roe v. Wade, I’d like to challenge our readers to imagine a higher standard for abortion care—not just safe and legal. I’d actually argue that ‘safe and legal’ is a pretty low bar. Would you go to an OB or a pediatrician whose services were described as merely ‘safe and legal?’ What does compassionate, whole-woman abortion care look like? No one wants a loved one to have an unsafe or an illegal abortion. But what kind of care DOES your loved one deserve? Take the question of whether they should have an abortion or whether “you approve” off the table entirely. This ain’t about you. If your sister, your niece, your cousin, your best friend or your wife decided that they were going to have an abortion—what kind of care would you wish for them? This is where we should start.