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Gosnell Verdict Raises Questions About Access To Abortions


I'm Michel Martin and this is TELL ME MORE from NPR News. Later in the program family members of both the suspects in the Cleveland kidnappings and the Boston Marathon bombings have denounced them. And that made us wonder about the family members of other people who have been accused of horrible acts. So we reached out to two of them - the daughter of a serial killer and the brother of the Unibomber will both be with us in just a few minutes.

First though, we want to talk more about another difficult story that's captured the nation's attention for a variety of reasons. It's a difficult subject and aspects of it might not be appropriate for everybody so we'd like to tell you that right now. Because we're going to talk about Dr. Kermit Gosnell.

He is the abortion provider from Philadelphia who was sentenced on Wednesday to life in prison without the possibility of parole for murdering three babies during later-term abortions and for committing other crimes at his clinic that resulted in serious injuries to other patients. He ran the clinic for some 30 years, mostly serving minorities, immigrants and other low income people.

We wanted to talk more about this - what this could mean for the abortion debate and other issues more broadly relating to health care in neighborhoods like the ones where he practiced. So we've called upon two journalists who have been covering this issue. Keli Goff is a political correspondent for She's with us from our bureau in New York.

Julie Rovner is a health policy correspondent for NPR and she's with us in our Washington D.C. studios. Welcome back to you both. Thank you both so much for joining us.

JULIE ROVNER, BYLINE: Thanks for having me.

KELI GOFF: It's good to be here.

MARTIN: Now, Julie, this case has been covered closely in Philadelphia from the beginning but it first kind of, I would say, burst onto the national scene because there were a number of conservative activists who oppose abortion rights who felt that the issue was not getting enough national attention. So I want to talk a little bit later about the impact on public opinion and how activists on both sides are addressing this issue.

But the first thing I wanted to know is now that this case is concluded, are there regulators taking a look at this? Are there some policy implications that seem to be flowing out of this story?

ROVNER: Well, there are some, but you know, I think a lot of it - there was a lot of feeling that this was really a failure not of law, but a failure, as you say, of regulation, that there were laws on the books. Obviously there were laws on the books because he was convicted. So now we have, you know, two committees in Congress, in the House, who are asking state, both public health officials and attorneys general, if there's anything that they need or what are they doing to prevent things like this from happening. But this really seemed to be more of a breakdown in regulation as opposed to a breakdown in law. So it's hard to know what the policy implication, you know, from that would be. Which is not to say that there are not going to be efforts to use this case to push the policy goals of those on both sides of the abortion debate.

MARTIN: We're going to talk about that in a minute, but Keli, you wrote a piece for The Post titled "How Kermit Gosnell Can Save the Abortion Rights Movement." Talk a little bit more about that. Because a lot of people were talking about the fact that this was such a horrific environment. You know, unsanitary conditions.

GOFF: Mm-hmm.

MARTIN: You know, it goes on and on and on, that many people are saying, well, this is kind of a clear - from a public relations standpoint this would clearly redound to the benefit of people who oppose abortion rights.

GOFF: Right.

MARTIN: Because they would say that this is exactly the kind of thing that needs to be stopped.

GOFF: Well, you know, not to sound melodramatic, but I will for a moment and sort of say that - you know the saying that you have to hit rock bottom before you can sort of start climbing back up? And I kind of consider this case that for the pro-choice movement. Because I know there are people who are surprised that I wrote this piece because I've long been identified as someone who is, you know, a staunch supporter of reproductive rights.

And I am. But what I kind of think has happened, Michel, over the years is there has been such a defensive position on the part of the pro-choice movement, and some of it well justified, right, that you have states who are trying to make it difficult for women to have legal and easy access to contraception as well as abortion rights.

So there has been sort of a such defensive focus on fighting and digging your heels in and protecting reproductive rights at all costs that I think that a lot of people on the pro-choice movement have sort of missed the evolution that has happened in this country. And what I mean by that is an overwhelming majority - well, a majority; I won't say overwhelming - but a majority of Americans support Roe v. Wade and don't want to see it overturned.

But an overwhelming majority of Americans oppose late term abortions. And yet even though those numbers have been pretty steady in terms of the number of Americans who oppose late-term abortions, particularly in the third trimester, even some in the second, there has been really an unwillingness of the pro-choice movement to sort of talk about where people who feel that way fit into their movement.

And I think that that's been problematic. I think it's allowed the other side to sort of gain some traction and sort of convince those people that if you're reasonable and you're someone who doesn't support late-term abortions, there's not a place for you in the pro-choice movement. And I think that that's sort of hurt the image of the pro-choice movement in public policy.

And right now a majority of Americans actually identify as pro-life, according to Gallup. Even now what's interesting is a majority of Americans believe that most of the country is pro-choice, which - I found that to be a fascinating contradiction that Gallup just released this week.

MARTIN: Julie, talk more about this, if you would, about where you see public opinion and the activists going on this issue. What are the - how are sort of the two sides framing up? One of the things I found interesting about your reporting is you reported that one of the big questions is whether Gosnell is - Dr. Gosnell is an exception or is he - is he and outlier or not?

ROVNER: Well, and that of course is the big question. You know, that those on the anti-abortion movement would like to say that, you know, there is a Gosnell in every, you know, every state and every city, that they just hadn't been uncovered yet, that there are many, many like him. And of course those in the abortion rights community say that, you know, no, obviously there are, you know, there are very few of these people like this and that the big problem is that the more you restrict abortion rights, the more you will then drive women to people like this. If you make it harder and harder and harder to get safe abortion care, you're going to drive women to unsafe abortion care.

But if I could go back for a second to this question about public opinion, this has been the case all along. If you go back - I've been studying this for 25 years - that the public is basically of two minds. They believe that abortion is bad but it should probably also be legal. And again, they believe that it's more acceptable earlier in pregnancy. So the later in pregnancy you get, the less the public approves of it.

The problem becomes - and this is the case in almost, you know, every state - is that abortion is, in fact, illegal after viability except in what we call the very hard cases, cases in which it is a threat to the life or health of the woman or in cases where the fetus is not viable. And then the question becomes what do you do if you try to ban all abortions late and then the woman, you know, has some terrible problem with the pregnancy?

And you know, most of abortions that are late are not the kinds of things that Dr. Gosnell was doing. Most of them are done in hospitals with women who have terrible problems. Something's gone drastically wrong with the pregnancy. Do you want to then ban those and have, you know, women die? That becomes the question.

GOFF: I agree with...

MARTIN: Hold on a second, Keli. If you're just joining us, we're talking about the murder conviction of abortion doctor Kermit Gosnell in Philadelphia. We're talking about what the national implications might be with that. Our guests are NPR health policy correspondent Julie Rovner. Also with us, political correspondent Keli Goff. Both of them have been reporting on this. Keli?

GOFF: I just wanted to say that I agree with what she said and so do most Americans, right? And that's what I think is so fascinating, is Planned Parenthood released data earlier this year that showed that when push comes to shove, most Americans really don't appreciate being pushed into the black-white labels of pro-choice or pro-life because most people are smart enough to know and empathetic enough to know that real life falls somewhere in the gray area.

MARTIN: Speaking of this issue, kind of speaking of black and white in a different context, Keli, there's something I wanted to ask you about. Recent figures from the Centers for Disease Control - this is 2009 - show that African-American women have the highest abortion rate among ethnic groups. And yet according to opinion research by the Public Religion Research Institute, a slim majority of black women that they surveyed say that having an abortion is wrong, and is morally wrong.

And I'm just, I'm just - I am interested on your take. Are there racial aspects of this story that come to light for you that you think we need to talk about?

GOFF: Absolutely. I mean first of all, we know that minorities and people who are low income are less likely to have health insurance. So they're less likely to have easy access to things like contraception and OB/GYN care and prenatal care.

And also we know that in our community all of the statistics show that we tend to identify as more religious, more church-going, and there is a direct correlation between people who identify that way and access to adequate sexual education. And I mean I've had this conversation with ministers for pieces that I've written and there is just sort of a disconnect in our community where people think that it's better to just go to church and say here's the sex talk, don't have it, don't do it - until you're married.

And then we also know the marriage rates in our community. So there are a lot of layers here, Michel, that have to do with both race and class, but I just have to say really quickly that one of the things I wrote in my piece for The Post is, when Julie was talking about viability, that's really what I was getting at in terms of the fact that I think the pro-choice movement has to do some serious soul-searching and some re-evaluating because one thing they don't really like to talk about is the issue of viability and science - and particularly how science is evolving - and this story, I think, is going to force them to find a way to talk about viability because they've got to or else they're going to continue to lose supporters who are sort of people like me who are common sense supporters of reproductive rights, but also acknowledge I don't have a medical degree, I don't know when a fetus is viable, and I know that a fetus can live - is more viable today earlier than it was 20 years ago. And if that's the case, then we've got to talk about that and how that affects where the reproductive rights movement is heading.

MARTIN: But Julie, on the whole question of - the bottom feeder question, is that something that the prochoice movement is also addressing? I mean, the conservatives, as you said, are making - the people who oppose expansive abortion rights have made the case that this gentlemen is not an outlier, that this is more common than people believe. Have people on the other side made a convincing case around this question either?

I mean their argument has been that, you know, of course there are bottom feeders because the debate has become so hysterical that only people who are either ideologues, strongly committed ideologically or who are bottom feeders would stay in a field where it's so difficult. Have they addressed this question for themselves on that side of the debate?

ROVNER: Well, they're trying to. You know, it's hard to say how well they're doing it. You'd have to sort of ask the public how well they're doing it, but certainly they're making the argument. I mean one of these things is it's like putting a frog in water and boiling it. I mean what's happening to abortion rights and abortion access over the last really 10 years, what's happened is that you've had a lot of very Republican state houses and very conservative state houses in a lot of states in the last really decade who've cut back significantly.

We've had hundreds and hundreds of laws passed cutting back on abortion rights and abortion access, and so what's happened is that you've really had, in many states, made it very difficult for women to access abortion services, and what the abortion rights side is saying is that that has led inevitably to women having no choice but to go and find people like, you know, Kermit Gosnell.

MARTIN: What do you think is the next story you'll write about this, Julie? What's the next thing you're interested in as a person who's covered this issue for such a long time?

ROVNER: I'm actually interested in where the next generation of people who are going to provide abortion is coming from. You've got a lot of medical students who are now - you know, there's such a stigma to providing abortion that, you know, what happens to, as I say, the women? Not so much the women who want the elective abortions. You know, oops, I got pregnant. But the women who have medical problems and actually need abortion care and might not be able to get it because there's nobody who's going to be trained to provide it.

MARTIN: Julie Rovner is health policy correspondent for NPR, with us in Washington, D.C. Keli Goff is political correspondent for, with us from New York.

Thank you both so much for speaking with us.

GOFF: Thanks, Michel.

ROVNER: Thank you. Transcript provided by NPR, Copyright NPR.