I’ve been dreading talking about this, because it’s horrible, and we’ve had enough horrible lately. But it’s also really important.
There’s a case going on right now against an illegal abortion provider in the Philadelphia area, Kermit Gosnell. The clinic he operated has come to be commonly referred to as a ‘house of horrors’ – decrepit, unsanitary, and inhumane – where he performed, among other things, third-trimester abortions that amounted to infanticide. (I’ve chosen to leave out the more graphic details. If you want to know them, Google his name, and click with care.)
Anti-choicers have seized on the case as evidence of the inherent evil of abortion. Pro-choicers argue that Gosnell represents the modern face of pre-Roe back-alley abortion. The one thing everyone agrees on is a desire to eliminate practices like Gosnell’s – but how? Much of what he did, including third-trimester abortion, is already illegal in Pennsylvania, but that didn’t stop him or his patients. So in modern America, what drives women to seek out dangerous, illegal abortion services?
First, lack of access. As of 2008, 87% of counties in Pennsylvania had no legal abortion provider. 48% of women lived in those counties. Per the Guttmacher Institute, Pennsylvania ranks in the lower-middle range for things like ‘state efforts to help women avoid unintended pregnancy’ and ‘availability of publicly supported family planning services.’ So while these services may be legal, they are not available in any real way to the women who need them.
Second, lack of money. Abortion rates have been dropping for years – except among the poor. In 2000, women below the poverty line accounted for 27% of all abortions performed in the US. In 2008, it was 42%. These women rely on public health care, like Medicaid – which is barred from covering abortion because of the Hyde Amendment. They don’t have disposable income, and cannot afford to pay $470 (the average cost of an abortion, before travel and lost wages.) Gosnell charged significantly less for first-and second-trimester abortions than legal clinics, making him the only option for many women – even those with geographic access to other services.
Simply put, clinics like Gosnell’s exist because women lack the resources to avoid unwanted pregnancy (comprehensive sex education and open access to contraception) and lack real access to safe, legal, early abortion. No matter how horrible the question, that combination was, is, and will continue to be the only answer.