I want to revise some of my earlier statements. There is, in fact, a conspiracy around the case of Philadelphia doctor Kermit Gosnell. But it's being engineered not by a mainstream media cowed by the left out of covering his trial, but by the antiabortion movement. And while Gosnell's trial deserves fair, accurate and contextualized coverage, some journalists seem happy to stop at playing into the right's hands by buying their phony media narrative.
No one who supports the provision of safe abortion care to women excuses any of what Gosnell is accused of, from willfully gruesome conditions to sadistic treatment to infanticide. He is not typical, and there was, and has been, swift renunciation of his facility. But the case provides the ideal opportunity for the right-to-life movement to conflate his abusive clinic with all abortion as it's widely practiced in the U.S., and to focus on graphic later abortions, conveniently redirecting attention from their desire to ban all abortions for everyone. That desire, by the way, is being enacted into law explicitly in states like Arkansas and North Dakota, and implicitly with laws designed to close abortion clinics in states like Mississippi and Virginia.
Don't take my word for it. Ask James Bopp, the general counsel of the National Right to Life Committee and a major architect of the mainstream anti-choice movement's strategy. Here's what he wrote in an internal memo in 2007, chiding people on his side who wanted to try to goad the Supreme Court into overturning Roe all at once, instead of pursuing Trojan horses like the so-called Partial Birth Abortion Ban:
A vital battle stratagem is to choose proper terrain—favorable to you, unfavorable to your foe. To change the hearts and minds of the public on abortion, it is necessary for pro-lifers to frame the debate to their advantage. Pro-life leaders have wisely focused on this strategy. The debate over partial-birth abortion has furthered this strategy because it has forced the proabortion camp to publicly defend a particularly visible and gruesome practice….[D]espite pro-life efforts, many people still believe that abortion only happens early in pregnancy, only happens for important reasons, and involves “products of conception.” The [partial-birth abortion] drawings set before the public showed a developed baby, capable of life outside the womb, within inches of birth, being slaughtered by a stab in the skull and the suctioning of its brains. People were shocked out of their lethargy and flawed beliefs.
In other words, make people uncomfortable by focusing on rare and extreme cases and pretending they're the norm, whether that's true or not. After all, "partial birth abortion" is a phrase the right-to-life movement made up as a strategy to stigmatize and eventually ban all abortion. Per Bopp and judging by the political climate that ensued, it worked, and even Democrats scrambled to declare themselves morally superior to a rare abortion procedure that occurred only in very limited circumstances.
But last year, despite considerable legislative success restricting abortion in the states, the battle was decidedly not occurring on terrain that was favorable to the movement to restrict reproductive rights. People were talking about defunding Planned Parenthood, Todd Akin's comments on rape victims becoming pregnant, and birth control access. The antiabortion Susan B. Anthony List insisted that Romney lost more or less because he hadn't shown enough bloody fetuses. No wonder that when Peggy Noonan was asked about a North Dakota abortion ban, she brought up Gosnell. But in the past few days, the right has succeeded in getting the media to talk about an "abortionist" who conducted unsafe abortions and allegedly committed infanticide, with the desired implication that he is representative of abortion care in this country. He isn't, not that the right isn't trying to pretend that he is: "As this nearly month-long trial continues, it paints the stark and unmistakably abhorrent reality of abortion," claimed conservative litigators Jordan Sekulow and Matthew Clarke in the Washington Post this week.
How did they succeed in creating a national firestorm around a case whose main revelations were broken up two years ago? By making it about the media.
I am reliably informed that Kirsten Powers, who amplified the call for more coverage of the trial in USA Today and celebrates herself for it again today, calls herself a Democrat. It wouldn't be the first time a self-identified Democrat has used the health and lives of women with the fewest resources as a cudgel to score political points. Powers herself only seems to have become opportunistically interested in the women driven to desperate measures when they could be used as a stick to beat "the left" or the "liberal media." Indeed, her ignorance of the topic is manifest when she says, "There is a reason the late Democratic senator Daniel Patrick Moynihan called this procedure infanticide," to refer to Gosnell's actions or later abortion (it isn't really clear), when Moynihan was actually referring to the now-banned dilation and extraction procedure.
In her follow-up, Powers says that when she claimed a media blackout, she wasn't talking about "activist media" but then reverses herself halfway through to claim there is a "near silence from the feminist organizations that lecture us endlessly about how they stand for women’s health." Powers might not have been able to turn up coverage from the League of Women Voters (?) but the activists, providers and journalists writing on the case at RH Reality Check, now and since 2011, might be a good place for her to start, among many. Broadly speaking, the people who did write about this case based on the Grand Jury Report in 2011 are not the people who have the resources or general habit of sitting in a courtroom for a month or more. Journalists who cover reproductive rights, as I often do, could spend every day and all day just writing about the thicket of abortion restrictions being debated, passed and challenged in the states every day -- 694 provisions in the first three months of this year alone -- not to mention hundreds of other topics that fall under our rubric. Still others who weighed in on the case when the Grand Jury Report was released are engaged in direct service or activism around providing actual medical care.
As for why there hasn't been more day-to-day coverage of the trial by big news organizations -- groups I already said I couldn't begin to speak for -- Conor Friedersdorf collected a few theories, some more persuasive than others; the least convincing one being the one offered by Erick Erickson, which is a cocktail of claiming coastal liberal media bias and evidence-free allegations that "in churches, local restaurants, and small town hair salons a lot of people across the country are talking about the terrible trial of Kermit Gosnell." If the conspiracy theory rests on the assumption that this story looks bad for people who care about access to safe and legal abortion, then why did people who care about access to safe and legal abortion discuss it assiduously when the news first broke? If the mainstream media was scared to touch it, why did they cover it back in 2011? If lack of day-by-day trial coverage was a function of the mainstream media being in the tank for liberals, why weren't Fox News or the Weekly Standard or the Washington Times in those empty press seats? So far, the most plausible theory is that the media, including the right, doesn't have a very reliable attention span.
In any case, the media coverage obsession is a red herring. By all means, let's talk about Kermit Gosnell -- who is accused of acts that are already illegal -- but in a fact-based fashion. As Philadelphia Weekly reporter Tara Murtha put it, this was about a "multi-level, panoramic, institutional negligence, a culture of passing the buck and flagrant disregard for patient’s welfare, [which] prevented any meaningful investigation." This is not about how Gosnell performed "late term abortions" (a highly imprecise term) as much as it is about the fact that the women who went to him felt they had nowhere else to go, an issue I have yet to see all the right-wing grandstanders fully address. As Erin Grant of the Philadelphia Women's Center wrote, "Now, instead of people who morally oppose what I do just being outside my door on Thursdays, Fridays, and Saturdays, they are emboldened on the state Senate floor to 'save women’s lives.' Yet, nothing has been done to provide low-income women with dignified health care, including safe abortion care." Instead, they are making abortion early in pregnancy more difficult to get -- in trying to shut down legitimate providers, in seeking to restrict how women can access medication abortion, and in making women go through expensive and shaming obstacle courses before exercising their constitutional right to end a pregnancy.
Such restrictions have been shown to increase the number of later abortions, which remain exceedingly rare, no matter how much the right wants to change the subject to them. According to CDC data (in which 39 of 45 reporting areas provided gestational age), 98.7 percent of abortions were conducted well before 21 weeks, which itself is several weeks before viability. We don't know how many of that tiny remaining number -- 1.3 percent of all abortions -- were conducted after 24 weeks, which is roughly viability, but only 11 percent of providers surveyed by the Guttmacher Institute in 2008 even provide abortions at or after viability, and those providers are much more likely to be hospitals. In 41 states, post-viability abortions are prohibited except when medically indicated (as assessed by a physician, with a second opinion required in nine states) -- when continuing the pregnancy is a threat to the woman's life, or when the fetus isn't viable. Many of the nine states that don't formally restrict third-trimester abortions -- including Alaska, Mississippi and West Virginia -- likely don't even have a provider willing to conduct them, and many providers only will with a medical reason.
Why do some women have abortions later in pregnancy? Per the American Journal of Public Health on second trimester abortions (before viability), "Several studies indicate that the factors causing women to delay abortions until the second trimester include cost and access barriers, late detection of pregnancy, and difficulty deciding whether to continue the pregnancy." The later in the pregnancy, the higher the price, meaning that women -- especially women on Medicaid, who overwhelmingly cannot get coverage for abortions under the Hyde Amendment -- get trapped in a vicious cycle. At the same time, legal restrictions like the ones in Mississippi and Virginia, and their antecedents, have limited the number of providers who will perform abortions later in pregnancy: "These regulations cause physicians to change their clinical practices or reduce the maximum gestational age at which they perform abortions to avoid legal risks. Ambulatory surgical center requirements significantly increase abortion costs and reduce the availability of abortion services despite the lack of any evidence that using those facilities positively affects health outcomes. Both types of laws threaten to further reduce access to and quality of second-trimester abortion care."
Abortion, when conducted under safe and legal conditions, is an extremely safe procedure -- according to one recent study, the risk of death associated with childbirth is 14 times higher than associated with abortion. Meanwhile, the U.S. ranks 50th in the world for maternal mortality, and African-American women are 3.2 times more likely to die from pregnancy and childbirth-related complications, though I haven't seen much outrage on the right about that, either. Of course, the people who are claiming a media conspiracy over Gosnell aren't interested in talking about access to safe abortion or better healthcare outcomes for women. They just want all reproductive freedom curtailed.
But even banning abortion outright won't eliminate the Gosnells of the world. The abortion rate is higher in countries where it's illegal, and around 47,000 women die every year from unsafe abortions in clinics that likely look a lot like Gosnell's. Apart from pro-choice advocates and feminist journalists, where's the outrage about those women's deaths?