Gosnell: No Outlier

by Ian Tuttle
It’s not just Gosnellian houses of horrors that endanger women and kill viable babies.

‘Gosnell is an extreme outlier when it comes to medical practice or abiding by the law,” said National Abortion Federation president Vicki Saporta in late April. The day after Saporta’s comment, the prosecution rested its case against Gosnell after spending weeks detailing the gruesome practices in his “house of horrors.” We learned that he had killed at least one woman and probably hundreds of viable babies — not to mention thousands of legally aborted children — over several decades.

Since then, many have argued that Gosnell is not an “extreme outlier.” Thanks to investigations sparked by the Gosnell case, evidence for that claim — much of it painstakingly collected by pro-life organizations, whose complaints have long been ignored by government authorities — is beginning to mount.

Much has been made of the spectacle of Gosnell’s operation, and rightly so. He operated a slaughterhouse, and he is not alone. But the investigations are beginning to show that even when an abortion clinic is not an abattoir, its personnel tend to engage in illegal or unsafe practices that endanger women, not to mention their babies. This article will attempt a partial chronicle of both degrees of malpractice.

First, the horror houses.

Just days after Gosnell’s conviction, reports emerged that the Texas Department of State Health Services, in conjunction with Harris County authorities, has been investigating Houston-area abortionist Douglas Karpen. Four former employees of Karpen’s claim that he conducted illegal late-term abortions. They have provided pictures to the watchdog group Operation Rescue that, according to the organization’s president, Troy Newman, “show babies that are huge, with gashes in their necks, indicating that these babies were likely born alive, then killed.” The nurses also claimed that he would kill babies by “twisting the head off the neck.” Karpen is still practicing, pending the results of the state’s investigation.

In August 2009, Newsweek published an adoring profile of late-term abortionist LeRoy Carhart. The “abortion evangelist,” as Newsweek called him, was a well-known abortionist who operated in several states. He was an associate of the late George Tiller, who was famous for performing late-term abortions, and who had been shot to death by an anti-abortion activist a few months before the Newsweek article appeared. Carhart, who had frequently worked out of Tiller’s Kansas clinic, became a sort of abortion-industry rock star; he even appeared (as an abortionist) in the 2010 movie Blue Valentine alongside Ryan Gosling and Michelle Williams.

Carhart’s claims that he refuses to perform elective abortions after 24 weeks was debunked in a recent Live Action undercover video, which records him arranging to perform an elective 26-week abortion — strictly illegal in most jurisdictions — on a woman in Sioux Falls, S.D. The same video records Carhart claiming to have performed more than 20,000 abortions on women who were more than 24 weeks pregnant — frequently purely elective, often illegal under state law. He explains to his prospective patient that once the baby has received a lethal injection, there is nothing to worry about; it is just like “meat in a Crock-Pot.”

Those dangerous late-term abortions led to the deaths of two women on Carhart’s table. In 2005, 19-year-old Christin Gilbert died from complications during a 28-week abortion by Carhart in Kansas. And 29-year-old Jennifer Morbelli died in February of this year in Maryland when Carhart botched her 33-week abortion, although Maryland officials announced that there were “no deficiencies” in her care. Morbelli’s death came nearly four years after four former employees reported unsafe and illegal practices at Carhart’s clinic in Bellevue, Neb. That clinic remains open.

Then there is Timothy Liveright, who was recently declared a “clear and immediate danger to the public” by the Delaware Board of Medicine. Two of his former nurses had contacted Delaware authorities repeatedly over several months, seeking to report the “absolute nightmare” occurring at his Planned Parenthood clinic in Wilmington. They testified in late May before the Delaware state senate, claiming that the clinic was unsanitary and unsafe, that he had struck a patient, and that he had left sedated patients unattended; some of them “were found outside walking down Market Street dazed and confused.” Delaware’s Division of Public Health found his clinic in violation of 14 state health regulations.

And there is the notorious Eastern-seaboard abortion tag team, Steven Chase Brigham and Nicola Irene Riley. After Riley perforated a patient’s uterus and pulled out part of her bowels at a secret late-term-abortion clinic in Elkton, Md., investigators raided the clandestine facility. They found the frozen remains of 35 late-term aborted babies. The pair were arrested on murder charges, but the charges were dropped because it could not be proved whether the children were killed in Maryland or in Voorhees, N.J., where Brigham would induce labor, then caravan the women — in mid-labor — to Maryland, where Riley would help finish the procedure under Maryland’s laxer abortion laws. Riley’s license has been revoked by the Maryland Board of Physicians, but Brigham’s cannot be — because he was never licensed to practice there to begin with.

There are other horror clinics too — in Florida, for example, where investigators raided a Hialeah clinic and found “boxes of aborted fetuses buzzing with flies” (cf. Jillian Kay Melchior’s “Horror Clinics Elsewhere” in the June 3, 2013, issue of National Review). The accumulating evidence shows that Gosnell was not an “outlier,” and that it was not particularly lax oversight of abortion clinics in Pennsylvania that permitted his grisly operation to continue. It shows, instead, that horror clinics are distributed throughout the country — and that those who operate them frequently take their life-threatening operations on the road.

But a woman does not need to walk into a “house of horrors” to find herself in danger. Investigators in not only the states mentioned above, but also Alabama, New Mexico, Minnesota, and Colorado, are presenting evidence that abortion clinics are regularly out of compliance with state health regulations.

The Maryland Department of Health and Mental Hygiene reported at the end of May that 12 of the state’s 16 abortion facilities failed to meet state health and safety regulations. While many of the violations were relatively minor — failure “to consistently use chemical indicator strips in sterilized equipment packing” — four clinics owned by Associates in OB/GYN Care were immediately suspended in the interest of “public health, safety or welfare.” Three of those four clinics had been temporarily shut down in March, and at the Baltimore location neither the abortionist nor any of his staff were certified in CPR. A woman had died on their table, although inspectors attributed the death to an unrelated medical condition.

The Gosnell case has applied pressure to states to conduct long-neglected inspections. Before Gosnell, Dennis Byrne recently reported in the Chicago Tribune, a number of Illinois’s abortion clinics had not been inspected in a decade or more, some up to 16 years. The Illinois Department of Public Health temporarily shut down two of the state’s nine “pregnancy termination special centers” (these conduct abortions in pregnancies up to 18 weeks), one of which had failed to administer CPR to a patient who subsequently died. The owner of that facility, the Women’s Aid Clinic in Lincolnwood, told the Associated Press that she felt “victimized” by the surprise inspection.

At the beginning of 2011, spurred by the revelations concerning Gosnell’s Women’s Medical Society, Pennsylvania authorities found 14 of 22 clinics in violation of state health regulations. Most of the clinics had not been inspected in 15 years. In the summer of 2012, the state passed into law a measure raising health and safety requirements for abortion clinics. Out of Pennsylvania’s 22 clinics, only one met full licensing requirements.

Investigators in Charlotte, N.C., and Cuyahoga Falls, Ohio, have found abortion clinics in violation of state regulations. In Birmingham, Ala., the state has brought suit against New Woman All Women, an abortion clinic which was still operating after being ordered to shut down for sending two women to the hospital in one day. In Colorado, where Planned Parenthood clinics are not regulated by the state, a Colorado Springs woman has filed suit against Planned Parenthood of the Rocky Mountains, accusing an abortionist of proceeding with an abortion (sans anesthesia) after she asked him to stop. The plaintiff reportedly went to a local hospital two days later, where doctors informed her that the abortionist had left parts of the unborn child in her body.

This article is hardly exhaustive. However, the instances recounted are representative of the extent to which abortion providers around the country disregard safety regulations.

But why? IBISWorld, an Australia-based market-research organization, issued a report in 2012 showing that the “Family Planning and Abortion Clinics industry” is a lucrative one. Apart from a brief hiccup at the start of the recession, industry revenue has grown at a steady 1 percent annually over the past five years, and it is expected to grow 4 percent annually through 2017 because of health-insurance changes. That will drive up revenue levels that had already reached $2.1 billion last year. That growth is putting a lot of money in the pockets of Planned Parenthood, which controls 71.6 percent of the total U.S. market.

Illegal abortions are especially lucrative. The National Abortion Federation claims that after the 20th week of pregnancy, costs can rise above $1,000 — but Kermit Gosnell charged $3,000 for a late-term abortion, according to the grand-jury report. In March 2011, according to documents obtained by Operation Rescue, Douglas Karpen performed twelve abortions that cost $2,000 to $3,000, and three abortions that cost more than $3,000. The price increased with the age of the child.

Those facts align with the testimony of one of Timothy Liveright’s former nurses: “What I discovered was that the culture at Planned Parenthood of Delaware was focused on maximizing profits and the bottom line,” she testified. “Not quality health care for women.”

Maximizing the profit margin is an enormous incentive to flout what, until the Gosnell revelations, had typically been loosely enforced regulations in most states. Combine that with the moral numbness that performing abortions intensifies, and abortionists’ personal reservations about operating beyond the limits of the law diminish.

In its editorial, “Gosnell Is Not an Aberration,” National Review’s editors wrote: “Gosnell’s human abattoir is the logical endpoint of our morally fraudulent national approach to abortion.” It is, indeed, the reductio ad horrendum of abortion. But while the Gosnell case is helping to expose similarly ghastly operations across the country, it may bring to light something even more important: The incentives that drove Gosnell are intrinsic to the abortion industry as such, and if the result is not slaughterhouses nationwide, it is, at the very least, clinic after clinic endangering women. And it is not hard to imagine even the comparatively tame operations slipping over the edge into nightmare.

— Ian Tuttle is an intern at National Review.