Kermit Gosnell Is Smart, Funny, Warm … and Bent

Steve Volk opens up about the demons he confronted in reporting on and speaking with the infamous abortion doctor.

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In the 16 years I’ve been a journalist, no story disturbed me quite as much as my most recent, on Kermit Gosnell. I could recite a long list of reasons, Gosnell himself chief among them. In conversation, Gosnell is smart, funny, warm—and bent.

His case is more complicated than most media portrayals allow. Yet, up close, his story is worse than we knew—a lesson in how self-righteousness and cold rationalizations blur distinctions between man and monster. But the other source of my discomfort is that true crime stories don’t often intersect, so inextricably, with politics—let alone the most contentious subject in politics: abortion.

To be straight about it, I have always been comfortably pro choice—a moderate lefty content with Roe. But covering the Gosnell trial provoked a new unease.

I am not the only person who felt disturbed by the testimony on both illegal and legal abortion. Two jurors, Sarah Glinski and David Misko, told me that the testimony convinced them the legal limit for elective abortion should be rolled back from 24 weeks (the generally recognized point of viability outside the womb) to something earlier, perhaps even the beginning of the second trimester. Gosnell’s own defense attorney, Jack McMahon, told Fox’s Megyn Kelly (and repeated to me) that he now believes abortion should cease to be legal at 18 weeks. “The woman still gets a right to choose,” he told me, “but she needs to choose faster.”

The reasons they expressed these views differed. Glinski told me that, prior to the trial, she thought of the fetus as just an unformed collection of cells. “I never thought of anything as being killed,” she said.

When she heard testimony describing a legal abortion procedure, in which a lethal injection stops the fetus’s heart, she felt stunned.

McMahon’s reasoning is more legalistic. Estimates of gestational age, whether conducted manually or by ultrasound, can be inaccurate by up to two weeks or more. “If you push it back, you don’t have this question of ‘was it viable or not?’” he says.

For me, the net effect of sitting there in the gallery day after day was a bit surreal—not only in terms of the graphic testimony, but the politics that lurked at the edges. The right complained, bitterly, that the mainstream media ignored the trial in order to protect abortion. In this assessment, I still believe they were wrong. (And I ask, again: Why didn’t Fox News send a reporter from its national network? Also, why not give CNN some credit for sending an online reporter to provide daily coverage?)

But I also fully understood why pro-life factions wanted the media there: To paraphrase a line from Gosnell’s Babies, abortions in the second trimester are brutal. And the Gosnell trial was rife with images of second-trimester abortion—from verbal descriptions of needles, forceps and hearts, to photos of fetuses and babies, ranging from the mid- second trimester to as old as 32 weeks gestation. (I should pause here, momentarily, to acknowledge that the vast majority of abortions, roughly 90-percent, occur in the first trimester. Further, just 1.5 percent of abortions occur between weeks 21 and 24.)

Still, even that “low” figure represents about 18,000 such abortions per year—a number I’d argue is significant enough to consider as part of the debate.

My own reasons for questioning the 24-week limit are perhaps different from McMahon’s, Glinski’s or Misko’s: I, too, feel increasingly uncomfortable the closer we get to viability. But I also wonder what sort of cultural and political progress we might make through a change.

To again paraphrase Gosnell’s Babies again, we appear to be a pro-choice country with increasing misgivings the closer we get to 24 weeks gestation. This past summer a Washington Post-ABC poll found a majority of Americans reject increased legislation of abortion providers (a point for the pro-choice), but they do want abortion rights rolled back from the Roe standard of viability outside the womb to 20 weeks gestation (score one for the pro-life).

The truth, medically and scientifically, remains 24 weeks.

Outcomes Only for Mechanically Ventilated Infants in the Sample Outcomes at 18 to 22 Months Corrected Age* Gestational Age (In Completed Weeks) Death Before NICU Discharge Death Death / Profound Neurodevelopmental Impairment Death/Moderate to Severe Neuro-developmental Impairment 22 Weeks 79% 80% 90% 95% 23 Weeks 63% 63% 76% 87% 24 Weeks 40% 41% 55% 70% 25 Weeks 23% 24% 37% 54%

(Source: Eunice Kennedy Shriver National Institute of Child Health and Human Development, outcomes for mechanically ventilated infants.)

That said, the argument that a fetus is only the “possibility” of a baby loses credibility in the second trimester, when the incidence of miscarriage drops to 0.5 percent.

In addition, even most abortion providers resist or refuse late second-trimester abortions.

The reasons for this are varied. Complication rates rise with each passing week, rendering the procedure more dangerous.

Second, after the assassination of George Tiller, who provided third trimester abortions, providers remain understandably nervous for their personal safety.

But some of this reluctance comes down to the grisly realities of providing such a service. When a fetus gets into the second trimester, we are talking about stifling off the growth and development of something that is visibly, anatomically, human, with a heart to stop.

I asked Dayle Steinberg, president and CEO of Planned Parenthood Southeastern Pennsylvania, about the availability of doctors to carry out the procedure later than 19 weeks gestation. “Doctors who will perform abortions later in the second trimester are few and far between,” she replied in an email.

In 2010, The New York Times published an article by Emily Bazelon called “The New Abortion Providers,” in which she captures this sense of conflict. One of her central subjects, Emily Godfrey, an abortion provider and a pro-choice activist, performs abortions up to 14 weeks. But she also describes herself as “almost grateful” that she lacks the medical qualifications to go to 19 weeks or more.

Bazelon writes of the residents who “opt out” of abortion training, for personal reasons, and recounts the following story: “Two years ago, a young professor at the University of Michigan named Lisa Harris wrote an academic article about performing a 18-week abortion while she was 18 weeks pregnant. Harris described grasping the fetus’s leg with her forceps, feeling a kick in her own uterus and starting to cry.”

During a phone interview, Bazelon concedes that, in a sense, the right will always hold a rhetorical advantage when it comes to second trimester abortion. “I think these sorts of descriptions will always be shocking,” she says. “And maybe that should tell us something.”

We recoil from the images we see on the placards carried by pro-life activists, which depict fetuses aborted in the second trimester—bloody body parts and pulpy tissue, held aloft on signs. And this raises a question: If we recoil, if even health care practitioners resist performing these procedures, is 24 weeks too great a limit?

I expect that many pro-life advocates will launch arguments in response to this question toward making the entire practice of abortion illegal. And many in the pro-choice camp will be angry that I am asking this question at all. But I wonder if we might be able to brush past some of the usual responses and actually talk to each other.

We live in a country where three in 10 women will receive an abortion at some point in their lifetimes, yet the practice is so private, so taboo, that we don’t discuss it. We live in a society where the political party most associated with protecting the unborn is also famous for attempting to set fire to the social safety net that would ensure that baby be fed, clothed and well-educated after birth. Conservatives also tend to oppose attempts at sex education and the distribution of birth control, both of which would reduce the number of unwanted pregnancies and therefore the number of abortions.

Bazelon, for her part, said she might be willing to trade a ban on elective abortion at 20 weeks in exchange for concessions on birth control and sex ed. I wonder what we might gain if conservatives and liberals actually worked together on such a compromise.

Though abortion is the single-most contentious issue in all of America’s politics, the possibility of compromise does surface from time to time. Slate’s Will Saletan (pro choice) and The New York Times‘ Ross Douthat (pro life) engaged in an unofficial back-and-forth in columns on a “deal” to end elective abortions as early as 12 weeks gestation. Problem is, fundamentally, any such deal would require undoing Roe. But it also seems unlikely that the pro-choice and pro-life movements as a whole would ever agree to accept such a compromise.

For myself, I wrote about Gosnell, first, as the criminal in a true crime story but I also tried to convey my own “unsettled” feeling I described earlier. The left suggests Gosnell’s case is purely about access—the poor women forced to go to an unlawful provider because they lacked the resources to go anywhere else.

Such concerns are real. But we’re either kidding ourselves or merely trying to lie to others if we insist that’s the only point that can be credibly made from a reading of Gosnell’s story. And I wanted to take this occasion to state, flatly, that when the right said the Gosnell case deserved wider coverage, they were right.

I don’t believe the media shied away from Gosnell out of liberal bias. But I do believe a big story didn’t receive the coverage it warranted. And I hope it’s not too late for the story of Kermit Gosnell to serve as an entry point for a larger conversation.

Steve Volk’s story “Gosnell’s Babies” runs in the October issue of Philadelphia magazine. You can read an excerpt here. The magazine is simultaneously publishing an expanded version, Gosnell’s Babies: Inside the Mind of America’s Most Notorious Abortion Doctor, as an e-book. Buy it for Kindle, iPad/iPhone, Android, Windows and Mac exclusively at amazon.com.

Watch Steve Volk and Philadelphia magazine Editor-in-chief Tom McGrath discuss “Gosnell’s Babies” below.