The details seem so outrageous that at first glance you assume they cannot be true. Fifteen-year-olds assisting in abortion procedures. Unsterilized equipment and blood splattered everywhere. Third trimester fetuses delivered and then killed by slicing their spinal cords. But that was the hard reality of Women’s Medical Society, an unassuming clinic in West Philadelphia that for decades operated with little inspection or oversight. The clinic’s now infamous doctor, Kermit Gosnell, is being formally charged with the deaths of one woman and seven infants, but the grand jury report concluded that the death toll of his clinic was likely higher.
Major news outlets have only recently begun to cover Kermit Gosnell’s murder trial, but coverage has focused on the sordid details of Gosnell’s clinic. What’s missing from the headlines is the legacy of the Gosnell case. In Pennsylvania, abortion providers and the women they serve are already feeling the sting of anti-choice legislators all too eager to use the Gosnell case as a flimsy excuse for rolling back reproductive rights and access even further in the state. And it’s only a matter of time until another state invokes Kermit Gosnell’s name in defense of yet another piece of anti-choice legislation.
“All health care providers must be regulated, and these regulations should be based on health care needs—not on politics,” Dayle Steinberg, president and CEO of Planned Parenthood Southeastern Pennsylvania, said in a statement. Abortion providers, like other health-care providers, already are regulated. Abortion clinics and providers already comply with a host of regulations and oversight mechanisms. As Tara Murtha of the Philadelphia Weekly points out, “Those with labs on site—most do [have labs]—must be inspected under the federal Clinical Laboratories Improvement Amendments. Abortion providers performing 100 or more procedures a year must be registered with Patient Safety Authority and comply with MCARE Act, which requires inspections. Abortions in Pennsylvania can only be performed by licensed physicians, regulated by the state’s Board of Medicine.”
None of this mattered to Gosnell. Ask any provider or advocate in Pennsylvania and they’ll tell you: He was a rogue agent operating outside the law and far beyond any sort of ethical code. But even after reports of shockingly unsanitary conditions and multiple deaths, attempts to shut down the clinic were routinely thwarted by massive bureaucracy and simple disinterest in pursuing the case.
The problem wasn’t a lack of regulations, it was a failure to check on Gosnell’s clinic to make sure they were actually following the safeguards on the books.
Despite this, the “discovery” of Women’s Medical Society was the impetus for the passage of Act 122 in 2011. The bill, which the Women’s Law Project of Pennsylvania calls the National Right to Life Committee’s “wish list” of abortion regulations, classified abortion clinics as ambulatory surgical facilities. “Gosnell was the driving force in the debate over [the targeted regulation of abortion providers (TRAP) legislation],” said Andrew Hoover, legislative director of the American Civil Liberties Union of Pennsylvania. The bills were already being debated when his clinic was raided, but the “discovery” of Gosnell’s clinic added to the swiftness with which legislators debated the bills—and the lack of in-depth scrutiny of the proposed restrictions.
Indeed, the specter of Gosnell was raised again and again during debate of SB 732 (what would become Act 122) and HB 574, the state house version of the same regulations. “This is about patient safety and preventing future cases of murder and infanticide within abortion clinics,” state Rep. Matt Baker (R-Bradford/Tioga), chair of the House Health Committee, said in a statement in 2011.
“In the end this is about the protection, yes, the protection of women and innocent unborn and innocent born children in response to the Gosnell situation. The language amended is a reflection of the care and safety to all individuals, given the tragedies that occurred for almost four decades at that particular facility,” echoed state Rep. Mike Turzai (R-Allegheny).
Floor debates suggested that supporters of the regulations either didn’t know that abortion facilities were regulated, or conveniently ignored that fact. Rep. Baker argued that “the template for this legislation … is the grand jury report.” However, it should be noted the grant jury report did not recommend regulating abortion clinics as ambulatory surgical facilities. Nowhere in supporters’ commentary was an acknowledgement of the strong safety records and compliance rates of the other reputable facilities in the state.
Yet Act 122 passed, forcing Pennsylvania’s clinics to adhere to many of the architectural and staffing regulations of ambulatory surgical facilities. Health centers had to make many unnecessary changes that had little impact on women’s health.
The renovations rattled the pro-choice community in Pennsylvania by forcing clinics to shut down, some of them temporarily, and divert staff and financial resources to making sense of somewhat complicated and dense architectural regulations. The burden is ongoing. “Unfortunately the process of compliance, which has involved weekly conversations and frequent, interruptive inspections with the Department of Health, takes an astronomical amount of both staff time and clinic funds that it diverts our efforts away from growing our center in ways that will better serve our community,” said Jen Boulanger, director of communications for the Women’s Centers, which operates clinics in Philadelphia and Cherry Hill, New Jersey. She estimates that the group has spent hundreds of thousands of dollars on the changes for their Philadelphia clinic.
But some clinics never re-opened their doors, and others had to limit their practices to first trimester procedures under local anesthetic, according to Boulanger. The Women’s Law Project of Pennsylvania points out that before Act 122 passed, there were 22 legitimate, safe clinics operating in Pennsylvania. Today, there are just 13. Will that number continue to drop?
Many media outlets seem to care less about that question; they’d rather focus on a play-by-play of Gosnell’s “house of horrors.” But we should be thinking about how anti-choice forces used the Gosnell case to ram through Act 122 in Pennsylvania, and how it devastated Pennsylvania’s already-tenuous network of reproductive health resources, because make no mistake: anti-choicers in other states are taking note and following in lockstep.
The Hill suggests that there will not be any Congressional action on abortion in the wake of the Gosnell case, but that doesn’t stop Congress from attacking its favorite punching bag, the District of Columbia. Rep. Trent Franks (R-AZ) has already re-introduced a bill to outlaw abortions in D.C. after 20 weeks to capture the momentum from the Gosnell case. (“Sanitizing the clinic” by adding regulations and restrictions won’t solve the problem, he says.)
Anti-choice legislators in the states could very well seize the Gosnell case as an opportunity. As RH Reality Check reported last week, legislators in Utah and Virginia are capitalizing on the Gosnell case to build support for more stringent clinic regulations. Elissa Berger, advocacy and policy council for the American Civil Liberties Union (ACLU), notes that ACLU state affiliates are continuing to fight an onslaught of anti-choice legislation, a trend she says will continue regardless of the outcome of the trial.
But she points out that this legislation isn’t about keeping women safe, despite what legislators may claim. “The issues raised in the Gosnell trial are not about safe, legal abortion care,” she said. “But that’s what they’re legislating. It’s hard to imagine being in a climate where worse things could come down the pike [after the Gosnell trial] … it’s clear we’ll have to continue to fight very hard.” And, as more and more safe, reputable providers close their doors, women will go to whatever provider they can find, with potentially devastating consequences.
Yes, the media has largely dropped the ball on the nuances of this case, when they’ve bothered to cover it at all. Yes, issues of racial and socioeconomic disparity are being grossly neglected (though, happily, they are being championed by many feminist and progressive blogs and publications, including this one).
But while we’re debating who is covering what and how, we’re ignoring a growing movement by anti-choice forces to twist a case of plain and simple negligence into a call for rolling back abortion rights altogether. But the more we restrict access to reproductive health, the more opportunities we provide criminals like Gosnell to flourish and fester.
Of course, it’s not as if the legislation wasn’t in the works already; TRAP regulations on the state level are not a new phenomenon. But now, the horrific, grisly details of the Gosnell case provide the perfect exhibit A for why abortion providers should be regulated out of existence. Pennsylvania is a textbook example. But make no mistake: Pennsylvania will not be the only one.