What A Horrible Doctor Can Teach Us About Abortion In America

In the aftermath of abortion provider Kermit Gosnell's murder indictment, one thing's becoming increasingly clear — the fact that women felt they had to go to Gosnell's clinic means something is deeply wrong with abortion care in America.

Gosnell is charged with the murders of a woman and eight fully-born infants whom he allegedly delivered and then killed. The strong-stomached can read the full charges here, but some of them have inspired skepticism. Amanda Marcotte writes at Slate,

Until more information is available, I would advise caution on jumping to conclusions about the charges of murder on the seven babies. The accusation that the babies were delivered and then killed with scissors resemble a fairly routine accusation leveled by anti-choicers at doctors who perform late term abortions. The anti-abortion, anti-contraception activist Jill Stanek rose to prominence accusing a hospital in Chicago of doing this; they were cleared of the charges.

However, she notes, "what seems to not be in dispute is that Gosnell ran a crappy clinic" — one that was unsanitary, unsafe, staffed with unlicensed workers. And, significantly, one that provided a different level of care to low-income women of color than to wealthier white women. Writes Lori Adelman at The Grio, "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'."

The question of why low-income women, especially minority women, felt they needed to turn to Dr. Gosnell has a disturbing, though not surprising, answer. Susan Schewel of the Women's Medical Fund offers a pretty succinct breakdown. She looked back at some of the Philadelphia-area women who sought help from the Fund in 2010, and found that their average monthly income was $503. Their abortions would have cost between $350 and $450, and none had insurance that covered the procedure. Though they were able to fund their abortions with help from the WMF, not all women are able to get that assistance from nonprofits, and, says Schewel, many suffer from "the unconscionable public policy that says if you are poor, pregnant and don't want to be, you are out of luck and on your own." On the solution to this, she doesn't mince words: "What will solve the problem is lifting the ban on public funding for abortion."

This is clearly a story about money, but as Adelman points out, it's also intertwined with race. She notes that black Americans have been a point of focus for abortion foes lately, with Rick Santorum even implying that President Obama should be anti-choice because of his race. And she mentions campaigns in the South presenting abortion in the black community as "genocide." These campaigns often claim that abortion clinics are overwhelmingly located in black neighborhoods, which is demonstrably false. As Adelman says, they also ignore the fact that black women's high abortion rates are actually "a reflection of higher rates of unintended pregnancy among black women, which are symptoms of the broader health disparities faced by the black community." What women of color, and low-income women, need is more access to reproductive health care, not less. Writes Adelman, "ultimately, if we fail to pursue policies and procedures that account for the health needs of women of color, we empower the Dr. Gosnells of the world to continue their exploitation."

Abortion Clinics Do Not Target Black Neighborhoods [TBD]
A Letter To WMF Supporters: Why Would Women Seek Care There? [Women's Medical Fund]
Abortion Clinic Horror In Philly Highlights Need For More Access [The Grio]
Philly Doctor Case Shines Light On Access Issues [Slate]

Earlier: Horrifying Abortion Doctor Charged With Murder