Why Did They Seek Abortions There? How Abortion Bans Threaten Women’s Lives

Editor’s note: This article, being republished in April 2013, was originally published by RH Reality Check in 2011 when the details about illegal abortions performed by Dr. Kermit Gosnell first became clear.

See all our coverage of the Kermit Gosnell case here.

It became tragically clear this week that hurdles to safe, legal abortion can prove life threatening. In West Philadelphia, Karnamaya Mongar lost her life in the horrific facility where Dr. Kermit Gosnell killed and maimed immigrant women and women of color seeking to end unwanted pregnancies. She is one of tens of thousands of poor women who die every year at the hands of butchers and quacks. We sometimes comfort ourselves with the thought that those deaths don’t happen here. But clearly they can.

Around the world — even here in Pennsylvania — women face obstacles to legitimate medical care, including preventive services like contraception, prenatal care and safe abortion care. However, such obstacles — legal and financial barriers, social stigma or language barriers — do not affect all women equally.

It is poor women, young women, women of color and immigrant women who bear the burden of these restrictions, particularly federal bans on funding for abortion care. These bans – such as the Hyde Amendment that affects Medicaid and the international Helms Amendment that affects our foreign aid – exacerbate the circumstances that lead women to facilities like the West Philadelphia clinic in the first place.

In Nepal, where Mongar had emigrated to the U.S., the U.S. Government has placed hurdles to safe abortion too great for some of the country’s poorest women. While the Nepali government works to ensure women’s access to safe, legal abortion care in their government health centers, clinics supported by the U.S. Government – a major reproductive health donor in Nepal – can undermine their efforts.

In 2009, a provider at a U.S.-supported clinic in Nepal told an Ipas researcher the story of a woman who came seeking a legal abortion. She was turned away because that clinic, supported by U.S. assistance, could not provide her care. She returned two weeks later with complications from an unsafe abortion.

She was bleeding and had an infect[ion]. …. She has inserted sticks, inserted in the vagina, inside her.  She was 23 years old, married, and had 2 children. She had no money and she couldn’t travel. Her husband was in India, she was illiterate, a housewife.

She ultimately survived after emergency treatment, treatment that would not have been necessary had she received the safe, legal procedure that was her right.

In Philadelphia, hemorrhage and infections are also documented in the Grand Jury report in Gosnell’s case. Likewise punctured uteruses, infertility and sepsis found in the report are documented throughout the global south where abortion is inaccessible. And the circumstances of women who seek unsafe abortion – marginalized by poverty, immigration, language – are shared across borders.

Yet the stories of the women who sought care from Gosnell’s facility are similar to the stories of women who are able to secure safe, quality abortion care with the help of the Philadelphia-based Women’s Medical Fund.

In 2007, the Women’s Medical Fund helped a 16 year-old immigrant girl afford a safe abortion.  The girl came from Central America to follow her older brother. She was raped by her “coyote” (an individual who facilitates illegal border crossing) along the journey.  When she got to Pennsylvania she was living with her brother and some other young men who were working at the mushroom farms outside of Philadelphia. She knew no English, but found her way to a Planned Parenthood whose bilingual staff called Women’s Medical Fund on her behalf.

During the spring of 2010 when Gosnell’s clinic was raided, Women’s Medical Fund received calls from six different women who lived right in that same neighborhood. The support provided by the fund allowed these six to secure abortions from local high-quality abortion providers.  Five were mothers.  Four were enrolled in Medicaid (which does not cover abortion under Hyde); two had no health insurance at all. Two were receiving unemployment checks and one had just been laid off. One was working at McDonald’s and earning $450/month. $200 of that went toward rent. One was obtaining a protection from abuse order against her violent husband. Another was pregnant due to a rape. One was living in a homeless shelter with her young child. The average monthly income of the six women was $503.

“Pennsylvania is not a Third World country,” writes District Attorney Seth Williams in the Grand Jury Report. But for women marginalized by their circumstances in the Philadelphia area, it may as well be. Certainly, Dr. Gosnell’s victims experienced the horrors of unsafe abortion just like women in the global south.

Financial obstacles may not be the only reason Karnamaya Mongar and untold numbers of other women risked their lives at Gosslin’s West Philadelphia clinic. Certainly stigma plays a role in whether a woman feels she can seek abortion care openly. Distance is another barrier: 35 percent of women in the United States live in counties with no abortion provider.  An end to bans on federal funding on abortion does not guarantee that the 20 million women who experience unsafe abortion worldwide every year would instead go to a trained medical provider.

But the Helms and Hyde Amendments are barriers cruelly targeted at poor women, immigrants, women of color and women living in the global south dependant on public health services. Stories highlighted through Gosnell’s grand jury report and the coverage of his West Philadelphia office of horrors should be a clarion call to all of us that poor women deserve better.

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  • billfalls

    To my surprise, protesters at the clinic where I escort haven’t thrown the Gosnell case in our faces. Maybe even they recognize the difference between a competent, caring medical facility and the situation that has been reported in the Philadelphia case.

    The post is horrifyingly accurate about the link between denial of access to abortion care and women’s desperate recourse to unsafe back-alley and self-abortions. Still, it would be appropriate to say “allegedly killed and maimed” until the case has been decided.

  • unyimeabasi

    Its quite unfortunate that in Philadelphia such case is at high rate; and even married women lacks knowledge about contraceptives. This implies that the health sector are not working. Ok. What is the Obama Health Reform upto?

    I believe there should be routine checks on clinics and their performances. Also, information on Reproductive Health should be made accessible to all, especially young girls through local media. Its worse than a third world country.

    We are far from achieving MDGs 4 & 5 that is; Reducing child mortality & Improving maternal health)

  • collinsd73

    Having been a family planning activist since 1965, I have witnessed and shared many battles against those who seek to limit women’s choices as to how many children they bear, when and under what conditions.

    Recently, a group called Venture Strategies has helped distribute misoprostol to more than a dozen countries in Asia and Africa. Approved by the Food and Drug Administration (FDA), originally used for ulcers and now off-patent and costing about 10 cents per pill, misoprostol helps stop hemorrhaging during childbirth. Women also can use it to terminate early pregnancies.

    The Rockefeller Commission’s famous 1972 recommendation favoring abortion choice so galvanized the politically influential Roman Catholic Church in America that it mounted an all-out attack on all family planning. Subsequently, many U.S. civic and political leaders who’d had good support for family planning could not maintain that effective leadership.

    A powerful U.S. force fostering domestic and international family planning services languished as world population needlessly rose from 3.9 billion in 1972 to 6.9 billion in 2010. U.S. population went from 210 million in 1972 to 310 million now, principally as the result of unchecked legal and illegal immigration, aided and abetted by the Catholic Church and those seeking cheap foreign labor.

    Dr. Stephen D. Mumford fully discusses this tragic history at population-security.org. Why am I reiterating it? The advocates of abortion choice are going to win their battle in the next decade or so!

    Why? Because the women of the world have already discovered and are widely apprised of ways to abort using medical means that need no attending physician or clinic. Wow! Imagine: Women, as they should have been all along, will soon be in charge.

    Some governments will try to stop importation of such medicines, but as one family planning expert opined, “Stopping medical abortion usage by women will be like stopping porn on the Internet!”

    Sadly, some who were for choice now seem to show a weakness of spine in calling for compromise with the anti-abortion crowd just as we are close to winning. What compromise could there be? This is a civil rights issue.

    In November, as a member of a team surveying successful family planning programs in Cambodia and Vietnam — where abortion is legal and widely and safely practiced — I learned how these safe, economical and available pills routinely help women and their families.

    In Cambodia, a product called Medabon is being provided through private clinics and pharmacies carefully vetted in its use. Its promoters and managers, based in Asia, apparently are not going to bother with the U.S. FDA now, although U.S. women would certainly find this product appealing. Used as prescribed, it can induce early abortions up to 63 days of pregnancy.

    Medical abortions now constitute a third of abortions obtained by U.S. women and the number is expected to rise. Women opting for a clinic need a trained provider. While pills take two or three days to work, they are private and much cheaper. And the “morning after” pill can be used immediately if contraception failed or was not used.

    How can women be stopped from using medicines that are already out there or will be in abundance? They can’t and won’t be. Experts have estimated that half of the last century’s births were unintended, but with rapid distribution of all methods, that need not be true in this century.

    Those of us who favor all choices for fecundity control will not let up despite this major medical abortion breakthrough. Abortion as family planning is not ideal, of course. An inexpensive nonsurgical sterilization method would back up this coming progress. FDA approval for marketing one such method, “QS,” is being sought (see isafonline.org).

    Is the day nearly here when women can call the shots on childbearing? Yes!

  • genevieve-dusquesne

    You have no idea how many worries you have substantially lifted off my shoulders just now.  I am escorting soon and I was wondering what the protesters might say.  I can usually handle their bullshit, but this whole case makes me angrier than pretty much anything else.  Even though we’re at different clinics, this gives me a ray of hope.  Thank you for existing.

  • susmart3

    All this is very nice and informative. But, I want to know about Kermit Gosnell’s clinic. Which apparently, has managed to run under the radar for almost… TWO DECADES?

    Not concerned with Gosnell. He is clearly an amoral indivdual who had no business handling food anywhere, much less dealing with animals or humans. He was not “pro-choice.” He was “pro-Gosnell.”

    But I find it… unbeliveable/amazing/whatever… that NO ONE ON EITHER SIDE of the abortion spectrum (apparently) did anything.

    I can’t believe ‘pro-life’ didn’t know about him and wouldn’t have turned him in. I can’t believe ‘pro-choice’ didn’t know about him and wouldn’t have turned him in.  I can’t believe that West Philadelphia didn’t know about him and wouldn’t have turned him in. 

    WHY did this go on so long? (In my neighborhood, a kid can’t sell lemonaid without a permit.) Not the whole issue of abortion, not ‘which side are you on.’ THIS SPECIFIC EXAMPLE. JUST THIS CLINIC.


  • julie-watkins

    Possibly bribes. People figuring it was someone else’s responsibility. People shuffling a report to whatever pile/folder meant they could avoid it. Maybe someone here who lives near Philidelphia can let us know if it comes out, if all the CYA fingerpointing doesn’t hopelessly muddy it.

    I agree with your comment about the “other side”. I did some googling, and haven’t found pre-scandel reports of protests, except for protests against, of course, Planned Parenthood:


    If I google <<protest philadelphia “Women’s Medical Society”>> … nothing pre-scandal. It’s not as if Gosnell’s business couldn’t be found looking for “abortion” in the phone book. … but the local anti-abortion protestors apparently didn’t want to protest there, aparently.

    Unless it’s that the local newspapers only reported on the protests at PP — but I haven’t seen any trumpeting “We told you so about WMS!” from the anti-choice websites.


  • carolrhill814

    If we don’t allow legal abortions there will be deaths of innocent babies and their mothers all over this land in record numbers that we have never seen before and that is something people don’t even want to discuss.

    I don’t know if people on this site would remember a movie back in the 70’s called THE OTHERSIDE OF MIDNIGHT if not look it up and that is what is going to happen more and more and it sad to think that would happen again.

    Yet men can do anything to themselves to make sure they stop themselves from doing things they don’t want to happen but it comes to women they don’t have the same right.

    Women are still considered second class citizens because they want to stop births they just don’t want even if they were with child because of rape.

    This is why I want to change the law from rape to manslaughter because that is what it is because once a woman or man is raped the person you were is gone for life and the new person is someone that is so different and so angry they are completely different.

    I have a little petition I need signatures on that I desperate for signatures and if you feel like I do please sign it and express yourself on it as well.

    This is my petition: http://www.thepetitionsite.com/1/rape-is-manslaughter-and-the-law-should-change

    Please help people that are going through that hell everyday of their lives.

    Thank you.

  • http://www.facebook.com/profile.php?id=100000466219087 Pat Armstrong Holman

    What comment can you make…when I was young abortions were for the wealthy.All the rest of us could take our chances with rusty coathangers and back alley hacks,..then abortions became legal and fairly safe. Now here we are with the same old fears again..this is not a religous matter..this is a simple matter of controlling and punishing the poor. It is sexist, raceist, and elitest in what ever way they choose to veil it..it is WRONG and it is NO ONES business to choose for another what decision a woman makes for her body.

  • Amorette

    Abortion has always been an issue of money. Rich people get abortions. Poor people either have more children to work for the rich or they die of a botched illegal job. Morality has never really entered into it.

  • luckymama6

    Novel idea… what if these women were instead given moral support and they placed for adoption? Abortion is not a must-have. When I fled my abusive husband, pregnant, with no degree and four other young children, adoption was a consideration. I tell you what, I NEVER would have turned to back-alley. Frankly, most women didn’t and don’t… emotional support is so much more important than handing someone money to go to a clinic.

    • HeilMary1

      And what if a pregnancy is threatening your life and health with gross, bankrupting injuries?

    • http://twitter.com/JenGStarr Jennifer Starr

      Novel idea. What if women were given emotional support to be able make the decision that is best for them? We’re not talking about which decision was best for you.

    • http://www.facebook.com/Feral.9.Hex Carla Clark

      Abortion is a must-have for those women who don’t want to be pregnant. Also, in many cases adoption is FAR more traumatic than abortion. Kthx.

    • http://twitter.com/Tonks07 Mandy

      Why do you automatically think adoption wasn’t considered by these women? Maybe they did consider it and rejected it. Pregnancy is expensive and can come with many health problems. Not to mention the whole actual giving birth, which isn’t a picnic as you probably know. Some women can’t or won’t go through with all that. Part of beng prochoice means I support ALL options: abortion, giving birth and deciding to give the baby up for adoption, or giving birth and decidiing to raise the baby. Just remember there are already THOUSANDS of kids waiting in the system to be adopted already. What makes you think one more has a better chance of being adopted? It should be a option that women are educated on but also so should abortion.

      (It’s also pretty gross that you think women going to clnics are just “handed money” and don’t need emotional support. Trust women to be smart enough to educate themselves on ALL their options and make the choice right for them. Your job isn’t to judge their choice, but to support them. Even if it isn’t the choice you or I would make.)