On second thought about Kermit Gosnell

He does tell us a few things about abortion. They just aren’t what William Saletan thinks.

The Gosnell case shows us the worst of what happens when abortion isn’t accessible. Gosnell’s “clinic” was nothing short of a house of horrors, and he preyed upon women who couldn’t get abortions anywhere else or who were unfamiliar with the American medical system — poor women, immigrants, minors. Michelle Goldberg writes:

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.

As Florence pointed out in a comment on the previous Gosnell post, “It also says quite a bit about how important it is to give laws teeth. The laws were in place to prevent this from happening, but despite numerous complaints the state couldn’t or didn’t intervene.”

Gosnell’s clinic hadn’t been reviewed by the Department of Health in 15 years. Members of his staff were unlicensed and not properly trained. And Gosnell knew that he could get away with offering sub-par care to women who he thought were less likely to complain — young women, immigrants, poor women and women of color. As Lori Adelman details:

As you may have witnessed, media coverage of these charges against Dr. Gosnell and nine staff members of his clinic has been rife with gruesome details like this one, which have understandably generated public reactions of horror and disgust. But buried deep in articles describing “bloodstained furniture” and ” jars packed with severed baby feet,” is a less gory but equally as horrifying insight that, at Dr. Gosnell’s clinic, “white women from the suburbs were ushered into a separate, slightly cleaner area” than Gosnell’s regular clientele, which was comprised primarily of poor minority women, including many immigrants. Gosnell reportedly treated these white suburban clients to a more pleasant and sanitary experience because he believed they were “more likely to file complaints” about substandard care.

He was right about that for a long, long time. Lori continues:

The crimes of which Gosnell is accused are exceedingly serious; he must be prosecuted for them to the fullest extent of the law. But the undeniably racialized elements of his practice reflect a need to explore the bigger picture of this story, beyond Gosnell’s presumed guilt or innocence: why Gosnell’s clinic was allowed to continue for so long, and why Dr. Gosnell’s patients, who were overwhelmingly poor minority women, had come to expect their health care needs to be met with such inadequacy that they were forced to accept Gosnell’s “care”.

Gosnell tells us quite a bit about the state of health care in the United States — and especially about abortion care. His clinic was by all accounts a disgusting, flea-infested mess. It doesn’t sound like the kind of place that women would go if they felt like they had any other options. Obviously anti-choice advocates are latching onto this story as an illustration of the horrors of abortion, even though most abortion clinics don’t look like Gosnell’s and are in fact subject to must stricter rules than other medical facilities — but there are more than a few health clinics, abortion-related or not, that are decrepit and run by incompetent practitioners. Those sub-par centers almost exclusively serve communities that are poor, of-color, immigrant, or non-English-speaking. It is absolutely a crisis.

But that’s not the story that you’re going to hear from anti-choicers and conservatives. You’ll hear “abortion is bad” without any recognition that outlawing abortion would have done absolutely nothing to help the women and babies who died or suffered in Gosnell’s care. You won’t hear about how affordable and accessible health care for everyone could have alleviated this situation, or how greater government oversight and enforcement of health care laws could have shut down Gosnell’s operation years ago. To prevent this from happening again — to stop other predatory clinics that offer a variety of health care services, not just abortion — we’d have to get into the hard stuff of recognizing the socioeconomic and racial inequalities in our current health care system. We’d have to admit that for many Americans, decent health care is inaccessible, and reproductive health care is especially poor. There’s a reason we have one of the highest infant death rates in the developed world. There’s a reason that in Washington D.C. the infant death rate is 14.1 per 1,000 live births, while in Connecticut it’s 5.5.

If we want to actually help women and babies (and men and children too), we can increase access to health care and increase government oversight of health care facilities and practices. We can give government entities greater ability to enforce existing laws, and we can push for new laws across the spectrum of consumer safety — in health care, in food regulation and in consumer goods. But those are tough, across-the-board changes. They take (yikes) taxes and government involvement. They require recognizing that we have a problem, and that the USA is not #1 where health care is concerned.

Which is to say that enacting those changes is almost certainly a pipe dream. But that would be a whole lot more life-affirming (and life-saving) than simply using the Gosnell atrocity to fall back on the same old “make abortion illegal” position in the abortion debates. Illegality doesn’t end abortion. Demonizing abortion doesn’t end abortion. Using the Gosnell case as an example of why abortion is bad doesn’t end abortion. But affordable and accessible health care, including abortion care, for everyone regardless of socioeconomic status or location or immigration status or race or English language skills? That saves lives. That decreases the abortion rate. And that’s how we make sure that women aren’t forced to accept inadequate and dangerous “care” because they have no other options.


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About Jill

Jill began blogging for Feministe in 2005. She has since written as a weekly columnist for the Guardian newspaper and in April 2014 she was appointed as senior political writer for Cosmopolitan magazine.
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37 Responses to On second thought about Kermit Gosnell

  1. Lynnsey says:

    There’s a very common sense solution here. The way to reduce the number of abortions is to reduce the number of unwanted pregnancies. The way to reduce the number of unwanted pregnancies is to provide age-appropriate, medically sound sexual health education (it can even stress abstinence if it teaches about the rest) and real, affordable access to reproductive health care, especially contraceptives (which should be free to any woman of reproductive age who wants them). These two very simple things would go a long way towards reducing the number of abortions, which I think is a goal that even most pro-choice people can get behind.

    It’s interesting to note that the parties most opposed to abortion are also most opposed to these two very sensible solutions to its prevention. Makes their supposed concern for women and children ring hollow.

  2. The obvious lesson from this horrible situation is that this is exactly what happens when you restrict access to abortion, either through absurd “hoop-jumping” laws or by withholding financial support for abortion from people who can’t otherwise afford it. The equally obvious corollary is that the more restricted access to abortion becomes, the more prevalent this kind of horror becomes. I can’t bring myself to read Saletan’s smug nauseating drivel, so I can’t speak to specifics of his arguments, but it is 100% morally and intellectually bankrupt to conclude from this horrible situation that abortion itself is wrong, bad, or whatthefuckever.

  3. Thom says:

    I tried to explain this to a person on Facebook. They didn’t quite understand it and said I shouldn’t blame the law here.

  4. Justifying the natural end of abortion is what you are doing here. Infanticide is the logical and necessary conclusion of your pro-abortion world view. Anyone who resists any attempt at common sense restrictions on abortion is pro-abortion. If you are against a woman seeing an ultrasound, mere information, if you are against underage girls having to go to their parents before getting an abortion, then you are pro-abortion. Late term abortion is infanticide in the womb. You arbitrarily decide when life has value and it is not because the location of the baby changes. Identity and value are not dictated by one’s location or dependence on another. If we followed your logic, then the murder of many newborn babies could be justified just as you argue for abortion.

  5. FYI says:

    I am entirely pro-life, or anti-choice as you put it, but I am also in total support of widening the availability of health care, contraceptives, and honest sexual education. While I believe that life is sacred at all levels and should never be discarded, I am not naive enough to believe that I am in the majority. I know that in the US, abortion (at least some forms of it) will more than likely always be legal. If it’s going to be legal, then it should also be accessible and safe.

    All “anti-choicers” are not self-righteous idiots. Just sayin’.

  6. Lynnsey says:

    Blue Collar Todd: You arbitrarily decide when life has value

    As do anti-choicers…Apparently, the woman’s life has little value beyond its role in carrying said fetus.

    Plus, you’re ignoring the facts of late-term abortion…less than 1% of abortions, the majority of which are due to imminent threat to the health of the mother or catastrophic fetal abnormality.

  7. As do anti-choicers…Apparently, the woman’s life has little value beyond its role in carrying said fetus.

    The woman’s life is very important to me. Having three children of my own I have been through a pregnancy before with my wife. I would agree that the life threatening condition of the mother is legitimate for an exception. So then lets restrict abortion except in those cases. Surely you could agree to that?

  8. groggette says:

    Blue Collar Todd: So then lets restrict abortion except in those cases. Surely you could agree to that? Blue Collar Todd

    Sure wouldn’t.

  9. Lynnsey says:

    Blue Collar Todd: Surely you could agree to that?

    No, I can’t. Because you haven’t “been through a pregnancy” and cannot fathom the demands, both emotional and physical, of pregnancy and childbirth. In the best of circumstances it is life-changing, in the worst it is life-threatening. If my own pregnancies have done nothing else, they’ve strengthened my resolve that no woman should ever be forced to carry a pregnancy for any reason.

    Again, I would like to see some common sense approaches to preventing abortion, but there will always be a need…whether or not you or anyone else agrees with an individual woman’s choice to make that decision. It is a decision that should be between a woman and any or all of the following as applicable: her medical advisers, her family, and her spiritual community. You’ll perhaps notice that neither you nor our government is in that list.

  10. EAMD says:

    Blue Collar Todd: I would agree that the life threatening condition of the mother is legitimate for an exception. So then lets restrict abortion except in those cases. Surely you could agree to that?  

    Well, I’m not sure what groggette’s problem is, but I sure would, Blue Collar Todd. Since pregnancy is a life-threatening condition, let’s restrict abortion except in cases of pregnancy. I am glad we could come to this compromise.

  11. groggette says:

    EAMD, I think I love you.

  12. Lynnsey says:

    groggette: EAMD, I think I love you.  

    Indeed.

  13. PrettyAmiable says:

    Hey, hasn’t Blue Collar Todd won a previous round of Top Troll? Look at the persistent little bugger. And he brought a friend!

    Whaddya say gals; let’s go have indiscriminate unprotected sex and have an abortion for the fuck of it, yeah? That’s obviously what all of us silly “pro-abortion” folks do, amirite? Emotional bitches that we are, with our willy-nilly thoughts on when life begins and thoughtless ideals about reproductive autonomy.

  14. JPlum says:

    I had to break up with my last lover because he’d had a vasectomy so I wasn’t able to get pregnant and have abortions. Having sex just didn’t seem worth it without the abortions, you know?

  15. Dan says:

    Actually, there are several good reasons for why the US lags behind in infant mortality. 1) Not a homogenous population like Sweden, Italy, Japan, and all the rest. 2) Massive immigration (legal and illegal) from 3rd world countries 3) And most importantly, we try to save lots of babies that would go down in the books as “miscarriages” in other countries, and thus not count as ‘infants’. Remember that a 21 weeker in the US takes a few breaths and then dies and is counted as an infant mortality…the 21 weeker in most other places isn’t even worthy of an attempted rescue, and expires. It is a miscarriage. So, weirdly, our excellent medical care is responsible for higher infant mortality. Doubt my premise? Read the research, as I have, and also do a thought experiment: where would you rather have a baby: the US or overseas…pick your country. My wife had our first in Korea, and our second and third in the US. No contest.

  16. The issue here is that people are often short-sighted. They’re only focused on the immediate cost to themselves that they can see at the end of an itemized statement.

    They fail to see the big picture, whereby they will certainly pay for the discrepancy in adequate coverage somewhere, often monetarily, but also in their own quality of life.

  17. PrettyAmiable says:

    Postscript: I went back and checked, and have to admit that I may have been wrong about BCT being nominated as a top troll. I feel this is an honest mistake to make, given the content of his comments.

    However, relevant to this thread and the CURRENT top troll contest – I believe someone said that this was the best top troll to date. I beg to differ after discovering this line from the March Madness edition: “I hope all you horrible liberals choke on your fetus fritters, and terrorist twists.”

    Sorry for the derail, but… fetus fritters. JPlum, let’s get together and discuss some recipes.

  18. Dan S. says:

    if you are against underage girls having to go to their parents before getting an abortion, then you are

    pro- underage girls getting a safe, legal abortion, instead of having their boyfriend beat them in the abdomen with a baseball bat in the hope of causing a miscarriage, or getting a – possibly fatal – abortion in some place like Gosnell’s, or worse.

    If 15 years down the road my baby daughter ends up in this that kind of situation, I really hope she’d come to us, knowing that we would support her. But you know what? I really, really don’t want to find out that she died in some shitstained hellhole because she was afraid to talk to us.

  19. JPlum says:

    I just realized that next month I will be celebrating the 20th anniversary of ‘losing my virginity’. Yes, I’ve been whoring it up (intermittently) for almost 20 years now. And not once have I been pregnant. Know why? Easy and cheap access to contraception, and the education to know how to use it.

  20. groggette says:

    Damn, you got me beat by 10ish years. I need to get cracking on my whoredom.

  21. groggette says:

    On a more serious note though, I’ve never been pregnant either but in may case my choice of contraception (sterilization) was neither easy nor cheap. People like Todd up there don’t want me to have an abortion, but they’re also the ones putting up the roadblocks for me and other women looking for alternatives.

  22. Julian Morrison says:

    I think the “pro lifers” want places like this to exist. Not too many nor too accessible, but enough for one to be closed down amid horror and scandal every so often, as a propaganda piece – and enough to kill, maim, sicken and agonize women as punishment for sex. Because that’s what their dogma is ultimate about – control of female sexuality via terror.

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  24. Serenity says:

    oh my god THIS!!!!!!!!! !

    and the reason I want to be a sex educator.

    Lynnsey: There’s a very common sense solution here.The way to reduce the number of abortions is to reduce the number of unwanted pregnancies.The way to reduce the number of unwanted pregnancies is to provide age-appropriate, medically sound sexual health education (it can even stress abstinence if it teaches about the rest) and real, affordable access to reproductive health care, especially contraceptives (which should be free to any woman of reproductive age who wants them).These two very simple things would go a long way towards reducing the number of abortions, which I think is a goal that even most pro-choice people can get behind.It’s interesting to note that the parties most opposed to abortion are also most opposed to these two very sensible solutions to its prevention.Makes their supposed concern for women and children ring hollow.  

  25. Wednesday says:

    Actually, there are several good reasons for why the US lags behind in infant mortality. 1) Not a homogenous population like Sweden, Italy, Japan, and all the rest. 2) Massive immigration (legal and illegal) from 3rd world countries 3) And most importantly, we try to save lots of babies that would go down in the books as “miscarriages” in other countries, and thus not count as ‘infants’.

    Dan, please take those USAmerican Exceptionalism blinkers off.

    (Third World? Seriously? Korea? Because it’s Asian?)

    No love,
    someone from Singapore (infant mortality rate: 2.6 per 1,000 live births in 2008 and 2.2 in 2009).

  26. Christina says:

    I’ve Wikified the Grand Jury Report, breaking it down into manageable pieces, cross-linking, and providing supplemental material: http://kermitgosnellcrimes.wikispaces.com/

    It was a real Common Ground effort by citizens across the political spectrum, pulled together for a gruesome task by sheer luck of the draw. We would do well to give it due consideration.

  27. Lynnsey says:

    @Serenity…Before I took advantage of the opportunity to stay home with my son, I taught what anyone over the age of 25 would call Home Ec. A big part of our curriculum is child development and I always used it as an opportunity to stress the fact that the only way to be sure they didn’t get pregnant was to not have sex. I used myself as an example…I got pregnant with my son while on the pill. For whatever reason, a lot of teenagers felt very comfortable having very frank discussions about sex with me (which at times it a little odd, but, hey…). The amount that they don’t know or have totally wrong is staggering. We always talked about the different types of contraceptives, the whole biological process, the complications that can arise if you’re very young and pregnant, etc. I think it was a real eye-opener for a lot of them.

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  30. chava says:

    This clinic is in my neighborhood, used to walk by it frequently. I’m not exactly surprised that the city couldn’t bring itself to care what a medical practice was doing there—they can’t even fix the sidewalks or deal with abandoned buildings.

    The fact that this clinic is about two blocks away from Penn Presbyterian disturbs me the most. I always assumed that hospital offered safe, reliable abortion services to the community. I have to wonder how they are falling down, or what the disconnect is.

    PA doesn’t allow abortions after 6 months–Gosnell would provide them at any time. So I can see women who couldn’t afford a plane ticket to one of the (what is it now, two?) reputable late-term clinics feeling that she had no other option.

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  32. Jjuliaava says:

    Blue Collar Todd: Anyone who resists any attempt at common sense restrictions on abortion is pro-abortion. If you are against a woman seeing an ultrasound, mere information, if you are against underage girls having to go to their parents before getting an abortion, then you are pro-abortion. .  

    COMMON SENSE! HAHA!!
    Forcing women to read (fake Christian) PROPAGANDA and LIES from the anti-choice agenda is not sensible in the least. In my state (MO) those in pursuit of medical treatment are subject to be “informed” in writing (propaganda pamphlets complete with photoshoped fake gruesome pictures) AND by someone “qualified” to tell them all kinds of BS, for example: women seeking this medical treatment are told that fetuses FEEL PAIN and they are told the amounts of anesthetics are administered to fetuses throughout the various terms with no regard for how far along in pregnancy the specific patient is. It should be noted, it is disputed the actuality of “feeling pain” with no developed central nervous system. They are asked questions like: “If you found that you’re pregnant with twins, would you still make this choice?” Further, the “information” must clearly state that “ALL PEOPLE ARE CREATED” .. Wait. What?? silly me to think there is separation of church and state in Missouri… Then the patient is subject to an ultrasound–not the biological father or rapist. Then a 24 hour wait to mull over the propaganda so she can be sure to feel like a murderer who will go to hell.
    Think about it in terms of a 12 year old child who was brutalized seeking the freedom to not carry her rapist’s embryo, she is told this viscous propaganda, told she is a murderer in the eye of God and is forced to see the ultrasound! How is the world is that SENSIBLE! It is completely ludicrous! In fact, no woman or child should be subject to this trauma! It is abusive and absurd.
    The trauma of an unplanned pregnancy is difficult and life altering enough without this flat-out PTSD inducing machine my state is engaged in. There is a war on women going on.

  33. Politicalguineapig says:

    I thought it had to be a hoax when I first saw the headlines. I’m really upset that it’s not and that the anti-choicers have yet another bludgeon.

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  35. rainne says:

    Then I’m pro-abortion. I’m fine with that.

    And, Dan, I get to pick my country? Then I’ll stay right here in Australia, infant mortality rate 4.4/1000 babies, public health care, and all. Cheers.

  36. RD says:

    Blue collar todd – so, you want a girl who is being raped by her father to have to go ask him for permission to get an abortion?

  37. Niall says:

    rainne: And, Dan, I get to pick my country?Then I’ll stay right here in Australia, infant mortality rate 4.4/1000 babies, public health care, and all.Cheers.  

    I don’t know what the exact stats are offhand, but the same could be said about Canada where the rate is comparable. And we have public health care too.

    Glad to see I wasn’t the only one annoyed by Dan’s chauvinistic U.S-centric bullshit.

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