The Kermit Gosnell trial: we’re asking the wrong questions

warning: this post contains graphic details about abortion and infant demise

Over the past week, I have learned about the trial of Kermit Gosnell, the Philadelphia abortion provider who has been accused of delivering full-term babies and killing them by snipping their necks. Like everyone, I have been horrified by the grisly details of his practice. A part of the grand jury report provides harrowing details of the clinic:

This case is about a doctor who killed babies and endangered women. What we mean is that he regularly and illegally delivered live, viable, babies in the third trimester of pregnancy – and then murdered these newborns by severing their spinal cords with scissors. The medical practice by which he carried out this business was a filthy fraud in which he overdosed his patients with dangerous drugs, spread venereal disease among them with infected instruments, perforated their wombs and bowels – and, on at least two occasions, caused their deaths.

The story is shocking, and I learned about it last week, as many people did, when twitter and facebook were flooded with questions about why the case was not being covered in the mainstream news cycle. I had many, many people emailing me and messaging me to please write about this story. But what most people wanted me to cover was not even the story itself, but the angle of the mainstream media cover-up. Most of the posts I saw were in reference to the media silence as well.

I’m clearly going to disappoint a few people who assumed that I would corroborate the media conspiracy, but I don’t believe this was the case. If you disagree with me on this, I really hope you will keep reading, because I think we can agree to disagree and then move on to more pressing matters about this story. (Also? Full disclosure: I’m not a fan of abortion. If you disagree with me on that, I also request that you keep reading. I think there are questions about this case that we can all ponder, regardless of our political persuasion in regards to abortion.)  I’ll address the media coverage, but then I want to address a  more important question, one I think should be more important than media coverage:

Why did this happen?

I am as outraged by this story as anyone. In fact, the first day I read about it I had to close my laptop because it was making me physically sick. When we feel outrage, when we see an injustice, it’s a normal response to look for someone to blame. For many of you, the media became that target. But the media did not make this story happen. The media could not have prevented this. I think we need to figure out where the culpability really lies.

In addition to writing for this blog, I have done freelance work for a couple major news outlets. I am openly Christian. I am opposed to abortion morally. I also know other Christians, and pro-life people, who write at nearly every major news outlet I can think of. I know it is easy to point the finger at the “Main Stream Media” as some kind of monolithic liberal propaganda machine, but when you do that you are forgetting that it is made up of individuals of varying viewpoints. There is no giant staff meeting of the MSM in which stories are approved or slashed based on political agenda. There are writers, and there are editors, and everyone . . . EVERYONE . . . is chasing the story.  And what drives the story? Popular demand. Not politics. After the topic started trending on twitter, I saw most major news outlets pick it up. In fact, most of the news sites I read have done several stories on it since then. So if it wasn’t highlighted before, it’s because when the news broke in 2011 (and it WAS covered then), few people paid attention. The story fizzled. We cannot blame the media for this. And let me also point out . . . there are stories of murder and injustice EVERY DAY that do not get attention. If we want to play the game of shocking stories that the media and public ignore, we could be here all day. Remember – the Trayvon Martin case was ignored for weeks until social media made it a national story. But there are plenty of stories of injustice that never make national news.

Why some news outlets ran with this story and others didn’t is based on a variety of factors, but the fact remains that it gained little coverage on both MSM and conservative media outlets, with a few exceptions.  I have plenty of friends (and family) who watch FOX news on a regular basis and this story was a shock to them as well.  I did an informal poll on facebook, and most of my readers had never heard of it. The few that had either learned about it from a pro-life site or a feminist site (the most popular answer being Jezebel.com or Feministing). This story  isn’t new . . . Gosnell was arrested in 2011, and the story broke then. It was covered on several major news outlets then:

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Between then and now, it didn’t get a lot of attention until this week, and I tend to agree with Salon’s analysis:

If you’ve never heard of the Gosnell story, it’s not because of a coverup by the liberal mainstream media. It’s probably because you failed to pay attention to the copious coverage among pro-choice and feminist journalists, as well as the big news organizations, when the news first broke in 2011. There would be something rich, if it weren’t so infuriating, about these (almost uniformly male, as it happens) reporters and commentators scrambling to break open this shocking untold story. You know, the one that was written about here, here and here, to name some disparate sources.

I can’t speak for big news organizations like CNN and the networks, but let’s think about this question another way: How often do such places devote their energies to covering the massive health disparities and poor outcomes that are wrought by our current system? How often are the travails of the women whose vulnerabilities Gosnell exploited — the poor, immigrants and otherwise marginalized people — given wall-to-wall, trial-level coverage?

And according to the Washington Post, some outlets didn’t cover it because they simply didn’t know about it:

Martin Baron, The Post’s executive editor, offers a more mundane rationale for the newspaper’s lack of coverage: He wasn’t aware of the story until Thursday night, when readers began e-mailing him about it. “I wish I could be conscious of all stories everywhere, but I can’t be,” he said. “Nor can any of us.”

The media appears to be responding to the criticism. CNN devoted multiple segments to the story Friday. CBS said it plans two segments and MSNBC will discuss the trial on its “Morning Joe” program Monday. The Post ran a full AP report on it in Saturday’s editions; the paper has also assigned its own reporter to cover the trial in Philadelphia this week.

I know that some people will disagree with me, but I don’t believe there was a media cover-up. But regardless of what we think about that . . . it’s time to move on. Quibbling over bias in the media is not the point of this story, is it? This is a story about a man who was putting women at risk, who is responsible for several deaths, and who murdered viable babies. The media isn’t culpable for that.  Who is? Let’s look further: From the grand jury report, which is available here:

Pennsylvania is not a third-world country. There were several oversight agencies that stumbled upon and should have shut down Kermit Gosnell long ago. But none of them did...The first line of defense was the Pennsylvania Department of Health. The department's job is to audit hospitals and outpatient medical facilities, like Gosnell's, to make sure that they follow the rules and provide safe care. The department had contact with the Women's Medical Society dating back to 1979, when it first issued approval to open an abortion clinic. It did not conduct another site review until 1989, ten years later. Numerous violations were already apparent, but Gosnell got a pass when he promised to fix them. Site reviews in 1992 and 1993 also noted various violations, but again failed to ensure they were corrected.

But at least the department had been doing something up to that point, however ineffectual. After 1993, even that pro form a effort came to an end. Not because of administrative ennui, although there had been plenty. Instead, the Pennsylvania Department of Health abruptly decided, for political reasons, to stop inspecting abortion clinics at all... The only exception to this live-and-let-die policy was supposed to be for complaints dumped directly on the department's doorstep. Those, at least, would be investigated. Except that there were complaints about Gosnell, repeatedly. Several different attorneys, representing women injured by Gosnell, contacted the department. A doctor from Children's Hospital of Philadelphia hand-delivered a complaint, advising the department that numerous patients he had referred for abortions came back from Gosnell with the same venereal disease. The medical examiner of Delaware County informed the department that Gosnell had performed an illegal abortion on a 14-year-old girl carrying a 30-week-old baby. And the department received official notice that a woman named Karnamaya Mongar had died at Gosnell's hands.

Yet not one of these alarm bells -- not even Mrs. Mongar's death -- prompted the department to look at Gosnell or the Women's Medical Society... But even this total abdication by the Department of Health might not have been fatal. Another agency with authority in the health field, the Pennsylvania Department of State, could have stopped Gosnell single-handedly.

The Department of State, through its Board of Medicine, licenses and oversees individual physicians... Almost a decade ago, a former employee of Gosnell presented the Board of Medicine with a complaint that laid out the whole scope of his operation: the unclean, unsterile conditions; the unlicensed workers; the unsupervised sedation; the underage abortion patients; even the over-prescribing of pain pills with high resale value on the street. The department assigned an investigator, whose investigation consisted primarily of an offsite interview with Gosnell. The investigator never inspected the facility, questioned other employees, or reviewed any records. Department attorneys chose to accept this incomplete investigation, and dismissed the complaint as unconfirmed.

Shortly thereafter the department received an even more disturbing report -- about a woman, years before Karnamaya Mongar, who died of sepsis after Gosnell perforated her uterus. The woman was 22 years old. A civil suit against Gosnell was settled for almost a million dollars, and the insurance company forwarded the information to the department. That report should have been all the confirmation needed for the complaint from the former employee that was already in the department's possession. Instead, the department attorneys dismissed this complaint too... The same thing happened at least twice more: the department received complaints about lawsuits against Gosnell, but dismissed them as meaningless...
Philadelphia health department employees regularly visited the Women's Medical Society to retrieve blood samples for testing purposes, but never noticed, or more likely never bothered to report, that anything was amiss. Another employee inspected the clinic in response to a complaint that dead fetuses were being stored in paper bags in the employees' lunch refrigerator. The inspection confirmed numerous violations... But no follow-up was ever done... A health department representative also came to the clinic as part of a citywide vaccination program. She promptly discovered that Gosnell was scamming the program; she was the only employee, city or state, who actually tried to do something about the appalling things she saw there. By asking questions and poking around, she was able to file detailed reports identifying many of the most egregious elements of Gosnell's practice. It should have been enough to stop him. But instead her reports went into a black hole, weeks before Karnamaya Mongar walked into the Woman's Medical Society.

...And it wasn't just government agencies that did nothing. The Hospital of the University of Pennsylvania and its subsidiary, Penn Presbyterian Medical Center, are in the same neighborhood as Gosnell's office. State law requires hospitals to report complications from abortions. A decade ago, a Gosnell patient died at HUP after a botched abortion, and the hospital apparently filed the necessary report. But the victims kept coming in. At least three other Gosnell patients were brought to Penn facilities for emergency surgery; emergency room personnel said they have treated many others as well. And at least one additional woman was hospitalized there after Gosnell had begun a flagrantly illegal abortion of a 29-week-old fetus. Yet, other than the one initial report, Penn could find not a single case in which it complied with its legal duty to alert authorities to the danger. Not even when a second woman turned up virtually dead...

So too with the National Abortion Federation.

NAF is an association of abortion providers that upholds the strictest health and legal standards for its members. Gosnell, bizarrely, applied for admission shortly after Karnamaya Mongar's death. Despite his various efforts to fool her, the evaluator from NAF readily noted that records were not properly kept, that risks were not explained, that patients were not monitored, that equipment was not available, that anesthesia was misused. It was the worst abortion clinic she had ever inspected. Of course, she rejected Gosnell's application. She just never told anyone in authority about all the horrible, dangerous things she had seen.

I think it’s time to stop questioning the media, and start questioning the Pennsylvania Department of Health, the
Pennsylvania Department of State, and the Philadelphia Department of Public Health for their failure to shut this place down. Why are we focusing on what the media supposedly ignored when the very entities in place to assure this kind of thing never happens totally failed? There were numerous alarm bells on the way that should have warranted investigation, and yet he continued to practice. Is it because these departments were underfunded? Is it because the women involve were poor and uneducated and therefore effectively mute? What happened in the chain of accountability that allowed this to continue?

And what about the women?

I think that because this story is about abortion, it’s tempting for each side to use it as an illustration to prove their viewpoint. I’ve seen many pro-choice people try to use this as an example of what will happen if we regulate abortion too much. “Women go to clinics like these because they don’t have access”, they say. But this didn’t happen because there was no access to legal abortion. In Philadelphia there are a number of abortion clinics these women could have visited. This is not an issue of access.

On the other hand, pro-life advocates want to wave it as an example of the atrocities of late-term abortion, but it’s important to note that Dr. Gosnell was performing illegal abortions (and infant murder).  In the state of Pennsylvania, abortion is only legal until 24 weeks of gestation. So while the debate over late-term abortion is valid, this story does not represent legal late-term abortion. It  represents the actions of a mad man.

Let me be clear on this: I think late-term abortion is generally detestable. I think that there are a few cases where it is warranted . . . my friend Cecily had one such tragic experience. She experienced pre-eclampsia during her pregnancy (if you watched Downton Abbey, you will recall what this looks like) and had to terminate her pregnancy – her very wanted pregnancy – to save her own life. It was devastating. Late-term abortions are very rare, (less than half a percent of all abortions) and usually involve risk of maternal demise. They are generally not done for elective reasons or because a woman changes her mind.

Which brings me to what I think may be the most important question here – what was going on for these women who came to see Dr. Gosnell? Why were they seeking abortions in their last trimester? I know people have varying views on abortion but I think (hope?) most of us agree that by the 7th or 8th month of pregnancy, we’ve past the point of reasonable decision making. So why is it that these women were seeking abortions so far into their pregnancy? It is unlikely that they were done as a result of some discovery about the baby, because fetal testing is quite expensive. And it seems that most of these women were in good health (at least prior to their abortion), so it doesn’t appear they were seeking an abortion because of a health risk. It’s reported that many of the women were recent immigrants. Most of them were poor. I have to wonder if their abortion was the first prenatal appointment they had during their pregnancy. They must have been desperate to seek an abortion at this point. Were they under pressure from boyfriends or family members? Were they unclear about how far along they were? Were they addicts in need of treatment? Were they in denial about being pregnant? The bottom line here:: I don’t think there is much we can do to prevent someone like Dr. Gosnell from preying on people again. We cannot always squelch evil, but men like Dr. Gosnell, one can hope, are rare. However, for that one evil doctor, there are hundreds and hundreds victims, and I think the victims are what we should focus on. How can we prevent women from being victimized in this way?

I don’t like abortion. I am morally opposed to it. But I can concede that regardless of my personal feelings about it, women will continue to seek them. And I can acknowledge that I would prefer for women in desperate situations to have access to healthcare so that they can detect a pregnancy early on, and that there be an option, if they choose an abortion, for that to take place early in the first trimester in a safe medical atmosphere. Being pro-life, for me, means I cannot put my head in the sand about the fact the people will still have abortions if abortion is made illegal. It means I have to concede that it will be a reality. Perhaps this is a conversation those in the pro-life camp need to have.

On the other hand, I think this case does illustrate that abortion performed on babies at the point of viability is morally reprehensible, and there are abortion techniques that are a technicality away from what Dr. Gosnell was doing. The details of Gosnell’s behavior towards infants he delivered are horrible, but I have to say that I was equally disgusted reading about the techniques of late-term abortion as I researched for this post. I am frequently disturbed by the causal attitude some pro-choice people have about late-term abortions. I’ve heard so many people say that such decisions should always be left to a woman and her doctor . . . but I think this story points to the need for safeguards. Do we really want to champion abortion on-demand at any stage of pregnancy, even when an infant is healthy and developed enough to live outside the womb?  Perhaps this is a conversation those in the pro-choice camp need to have.

I don’t have all the answers here. I’m  just trying to shift the conversation away from the media.  I’ve been reading posts all week that have wrapped this whole story up as a perfect illustration for their case. I don’t think it’s that simple.

There should be no glee in sharing this story as a talking point for our own convictions. At the same time, I think there are aspects of this story that require both sides to examine how we look at abortion and health care accessibility. Let’s stop focusing on the media, and start focusing on the victims: both the women and the infants who were hurt by Kermit Gosnell. How do we, as a society, respond?


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