Patient first

From Time magazine, “Healthland”, November 2010:

Warren Hern: [Donald Hertz] called my office on the afternoon of June 23, last year, three weeks after Dr. Tiller was assassinated. Dr. Tiller was a very dear friend of mine and a colleague, and his assassination was not just a personal loss for his family and his friends but very, very frightening because the same group of people that urged his assassination have also urged this to happen to me.

[Hertz] called and he told a person in my office that two Vietnam veterans were leaving Utah to come to Boulder to hurt my family. It scared us to death. My 92-year-old mother was evacuated from her home in the middle of the night because law enforcement authorities were afraid for her safety. They increased the level of protection for me and my family.

The FBI and federal marshals tracked the phone call to Donald Hertz and he was arrested and brought to trial. He terrorized me and my family, and all he got was a slap on the wrist.

Healthland: Are you scared?

Hern: I am a physician. I practice medicine. I have been committed to this work since I started in 1973. I will continue doing it. The people who disagree should leave me alone. It is the clear policy of the American anti-abortion movement to kill every doctor who does abortions. It is not a secret.

Healthland: How are you able to continue your work if that’s the case?

Hern: I show up at my office and see my patients.

Many years ago, when I was young and it felt like I had all the time in the world to dialogue with Jehovah’s Witnesses and other fundamentalist Christians, I used to ask them “Do you believe every word of the Bible is true?”

“Yes!” they’d say, starry-eyed, and often (I didn’t interrupt them) go on into a little panegyric about how other people pick and choose but Real True Christians believe the Bible is God’s Word and they believe every word and it shows them how to live their life in accordance with what God wants.

(Yes, I heard this quite a lot.)

“Including the Psalms?”

(Sometimes I’d get “Are those in the Bible?” but usually just an enthusiastic yes, yes.)

“Would that include Psalm 137? The bit about how blessed is he who takes the babies of the Edomites and dashes their heads against the stones?”

Remember, O Lord, against the Edomites
the day of Jerusalem,
how they said, “Lay it bare, lay it bare,
down to its foundations!”
O daughter of Babylon, doomed to be destroyed,
blessed shall he be who repays you
with what you have done to us!
Blessed shall he be who takes your little ones
and dashes them against the rock!

I never realised – such were the values that both I and these evangelical Christians shared – that I ought to be happy their reaction was invariably shock, horror, and denial. (One woman actually told me “I don’t believe that’s in the Bible!” and I had to find her the verse in my copy of the King James Version before she’d stop saying that.)

They ought to have been happy that this verse of the Psalms was the worst bit I could think of: there are passages in the Bible (such as the end of the Book of Esther) which are even worse. But I admit this was rather a juvenile way of Christian-teasing: all I can say is I was rather juvenile (this was before I was 20) and that I only did it to door-to-door evangelists who bugged me in my own home. (These days I just tell them “Sorry, I’m leaving the country in three hours and I have to pack.” Sometimes it’s even true.)

If you are not a Real True Christian, the fact that the Bible contains such ghastly stories isn’t a problem. You should take a look at the horrid details of fairy stories that we now tend to gloss over a bit.

The CEF has been teaching the story of the Amalekites at least since 1973. In its earlier curriculum materials, CEF was euphemistic about the bloodshed, saying simply that “the Amalekites were completely defeated.” In the most recent version of the curriculum, however, the group is quite eager to drive the message home to its elementary school students. The first thing the curriculum makes clear is that if God gives instructions to kill a group of people, you must kill every last one:

“You are to go and completely destroy the Amalekites (AM-uh-leck-ites) – people, animals, every living thing. Nothing shall be left.”

“That was pretty clear, wasn’t it?” the manual tells the teachers to say to the kids.

Even more important, the Good News Club wants the children to know, the Amalakites were targeted for destruction on account of their religion, or lack of it.

The CEF is the Child Evangelism Fellowship; by a peculiar Supreme Court decision, the Good News Club is allowed to teach in American public schools though its intent is

“Knock down all doors, all the barriers, to all 65,000 public elementary schools in America and take the Gospel to this open mission field now! Not later, now!” (Matthew D. Staver, VP of Liberty University, CEF conference 2010)

But these Christian evangelists who believe in teaching the rightness of genocide would certainly describe themselves as pro-life.

Three years ago today, Doctor George Tiller was murdered by a pro-life activist who had learned to take literally the hate stories that the pro-life movement had filled him with. Scott Roeder believed that the man he murdered was a mass murderer – a man who had spent his entire career killing babies in his Kansas clinic, and would continue to do so until he was stopped. We know that was Roeder’s motivation, because he told us so at his trial.

We also know that if you ask a pro-life activist what they think of Doctor Tiller, their response will be very like Scott Roeder’s – almost word-for-word – but then they will say “Oh, but of course that didn’t justify killing him! Pro-lifers don’t kill people!”

Self-identified pro-lifers have celebrated Tiller’s murder, leaving hundreds of comments on rightwing blogs (and a good number at progressive and pro-choice blogs, just for good measure). Conservative writer LaShawn Barber gloated at the “irony” of “Tiller the child killer, cultivator of death” being murdered at church. A quick perusal of the front page of ProLifeBlogs.com includes such headlines as “George Tiller has killed his last baby,” “Baby killer Tiller shot, killed at church,” “Tiller the Killer killed,” “Today Tiller the Killer, now a martyr for Molech, met God” and “Tiller shot to death!”

These are not “bad apples”. They are symptomatic of (and sometimes the spokespeople for) a larger a movement that is disturbed and dangerous.

Nine people have been killed by pro-life activists in the US and women’s health clinics are the target of arson, bombings, and other violent attacks.

I don’t know if anyone’s been able to calculate how many pregnant women may have died because of the pro-life attacks on women’s healthcare, both directly by clinic violence and indirectly via political campaigning and legislation.

Here’s the part of the story where choice comes in. I could, of course, have gone through induced labor and delivered my tiny twins. But my blood pressure was hovering around 165/120 (often going higher), even with treatment. Can you imagine what labor would have done to my body with blood pressure that high? My doctor recommended, and I agreed, that I undergo the much less stressful intact dilation and extraction procedure–what the “pro-life” forces often like to call a “partial birth abortion.” …. My doctor refers to my procedure as the worst moment in his professional career. As I lay on the gurney, waiting for my procedure to start, I felt a gulf of grief and emptiness the like of which I have never known. I felt abandoned by God. I lay there, crying, alone, surrounded by doctors and nurses. You can’t imagine the sadness.

I was lucky. Are you surprised that I would say that? I was lucky because the partial-birth abortion ban was not yet in effect in October of 2004. If it had been, I would have been forced to undergo labor and delivery, no matter the risks to my health, and I might right now be either dead or so brain damaged I would be unable to type this.

This is all justified, the pro-life activists say, in the cause of saving “preborn babies” or “unborn children”: in the cause of saving women from themselves. Abortion, pro-life activists say, causes breast cancer, post-abortion syndrome, and infertility. (There is no evidence that any of this is true.) The overriding message from the pro-life movement is not “We care about babies!” but “We don’t trust women to make the right decisions!”

I also know a woman who had two “partial-birth abortions,” or D&Xs (dilation and extraction) as they are more accurately called. My friend Tiffany is a carrier of a terrible genetic abnormality. In addition to other defects, her babies developed with no faces, with no way to eat or breathe. They were doomed. The only way to extract them without hurting her chances of ever having another baby was through a D&X.

Tiffany named her children. She mourned and mourns their deaths. She is the face of the “partial-birth abortion.” If we listened to women like Tiffany, we could acknowledge the value of the babies they lost, and defend absolutely their right not to carry them full term, not to force themselves and their babies to undergo the trauma of a doomed birth.

Listen to the pregnant woman. Value her. She values the life growing inside her. Listen to the pregnant woman, and you cannot help but defend her right to abortion.

Doctor George Tiller’s motto was “Trust Women”.

That is not the motto of Doctor David Jones of the Anscombe Bioethics Centre. He says;

It is helpful for the right to conscientious objection to abortion to be supported by statute, but this statutory right does not annul the more general right to object to procedures that are not judged in the best interests of the patient, or which are harmful to others. This moral right has some protection in UK and international law (for example, it is freedom of practice and observance, not just freedom of worship, which is protected by Article 9 of the European Convention on Human Rights).

Doctor George Tiller said: “I am a woman-educated physician.”

So I was outraged. Why would these nice people, that my dad had been providing quality health care for over an extended period of time, say that he was a scumbag kind of a physician?

Well, so I started going back through the charts, see who had—what chart looked like somebody might have had an abortion. So I began to ask some of these women. And I found out that there were more than one or two. Here’s what happened. In 1945, ’46 or ’47, a young woman, for whom Dad had already delivered two babies, came to him pregnant again right away and she said something to the effect that, “I can’t take it, can you help me?” And those are the two common denominators. That is apparently the way you asked for an abortion from your regular doctor, before abortion was legal—at least, that’s my impression. That was the common denominator. “I can’t take it, can you help me?” Dad said, “No. Big families are in vogue, by the time the baby gets here, everything will be all right.” She went out, had a non-health care provider abortion and came back 10 days to two weeks later and died.

In 1973, abortion became legal in the US. Doctor George Tiller began to specialise in late-term abortions. Sometime after 1979, the Christian Right in the US began to declare “life begins at conception” as a shibboleth and by 1985, no opposition – no argument that there might be justification for abortion in some cases – could be tolerated. In June 1986 pro-life activists bombed Tiller’s clinic. In 1991 about 2700 pro-life activists were arrested as they picketed Tiller’s clinic. Federal troops were sent in to keep the mob under control. In 1993 a pro-life activist, Rachelle ­Shannon, shot Tiller as he was leaving the clinic and broke both his arms. The next day Tiller was back at work. “I’m a healthcare provider, we had patients to take care of.”

For the next 18 years, pro-life activists would gather outside Tiller’s clinic every day. From 1994 they were forbidden by federal law to block the entrance.

In 1994 my wife and I found out that she was pregnant. The pregnancy was difficult and unusually uncomfortable but her doctor repeatedly told her things were fine. Sometime early in the 8th month my wife, an RN who at the time was working in an infertility clinic asked the Dr. she was working for what he thought of her discomfort. He examined her and said that he couldn’t be certain but thought that she might be having twins. We were thrilled and couldn’t wait to get a new sonogram that hopefully would confirm his thoughts. Two days later our joy was turned to unspeakable sadness when the new sonogram showed conjoined twins. Conjoined twins alone is not what was so difficult but the way they were joined meant that at best only one child would survive the surgery to separate them and the survivor would more than likely live a brief and painful life filled with surgery and organ transplants. We were advised that our options were to deliver into the world a child who’s life would be filled with horrible pain and suffering or fly out to Wichita Kansas and to terminate the pregnancy under the direction of Dr. George Tiller.

We made an informed decision to go to Kansas. One can only imagine the pain borne by a woman who happily carries a child for 8 months only to find out near the end of term that the children were not to be and that she had to make the decision to terminate the pregnancy and go against everything she had been taught to believe was right. This was what my wife had to do. Dr. Tiller is a true American hero. The nightmare of our decision and the aftermath was only made bearable by the warmth and compassion of Dr. Tiller and his remarkable staff. Dr. Tiller understood that this decision was the most difficult thing that a woman could ever decide and he took the time to educate us and guide us along with the other two couples who at the time were being forced to make the same decision after discovering that they too were carrying children impacted by horrible fetal anomalies. I could describe in great detail the procedures and the pain and suffering that everyone is subjected to in these situations. However, that is not the point of the post. We can all imagine that this is not something that we would wish on anyone. The point is that the pain and suffering were only mitigated by the compassion and competence of Dr. George Tiller and his staff. We are all diminished today for a host of reasons but most of all because a man of great compassion and courage has been lost to the world.

Sometimes the pro-life activists “would follow pregnant women and nurses to their hotel rooms or homes and push leaflets under the door. The leaflets showed gruesome ­pictures of aborted foetuses – their severed limbs and heads prominently displayed.”

Coe, who talked to the Guardian using a pseudonym, had an abortion in Wichita [in 2007]. The confluence of the anniversary of her baby’s and Tiller’s death was, she said, very hard to bear.

At 22 weeks of gestation it was ­discovered through ultrasound and other tests that the foetus of her first child had hydrocephalus – an excess of fluid on the brain. Its head was enlarged, and Coe and her husband were told that it would be born without brain function and would have no conscious life.

“We made a difficult decision that that wasn’t the life we wanted for our child,” she said. No doctor on the entire east coast of the US would accept her as the baby was beyond the 20 weeks needed for a foetus generally to become viable outside the womb. They were referred to Wichita and to Tiller.

She says the care they received at the clinic was exceptional. There was ­counselling and support. “We were able to see our little boy after he was ­delivered, no longer alive, and to touch him and say goodbye. They handled the cremation for us and we have his ashes in our home. It was the worst ­experience in our lives and they made it so much easier to bear.”

The process took four days. During that time Coe and her husband ran the gauntlet of anti-abortion protesters. “We were mobbed. They were banging on our car window. My husband wanted to explain and tried to talk to them but quickly backed off. Just by winding down the car window he was putting himself at jeopardy.”

On 23rd October 1998 pro-life activist James Kopp shot and killed Doctor Barnett Slepian, a doctor who performed abortions, at his home in Amherst, New York. James Kopp would not be arrested for the murder until 2001.

A prominent pro-life activist, Reverend Flip Benham, wrote on his website shortly after Doctor Slepian was killed:

“Mr. Barnett Slepian had murdered thousands of baby boys and girls and last night was murdered himself. Everybody wants to point the finger at someone else, but until the finger is pointed in the right direction, we are in store for more bloodshed in the streets — the likes of which will sicken even the sturdiest among us.”

After this murder, Doctor Tiller was warned by the FBI that he was at the top of the violent pro-life movement’s hit lists. Tiller began to wear a flak jacket outside his clinic – he even wore it to church, but Scott Roeder shot him in the head. Most Sundays for 18 years he had been greeted at the Reformation Lutheran church by pro-life activists who heckled him and his fellow worshippers. That Sunday morning three years ago, one of the pro-life activists was Scott Roeder. Inside the church, the others heard a sound “like a balloon popping” when Tiller was shot.

Reverend Lowell Michelson had begun to take the service when he heard the shot. He’d known Tiller for many years and had come to respect his calm endurance. They had talked about the dangers he faced, though Michelson declined to reveal the details of their conversations on pastor confidentiality grounds. “He endured so much. He was committed to women’s health issues. He made that a ­priority in his life even though he knew of the risks,” Michelson said.

A fellow congregant, who asked not to be named in order to protect his wife who worked with Tiller at the abortion clinic, said people were shocked and startled. “He believed in what he did. He really believed it, and that’s what gave him strength,” he said, crying silently outside the church.

He said those who attacked Tiller over the years had misunderstood his work. “He saw many women who had tried so hard for children, but then suffered the agony of having foetuses with ­terrible deformities. The picture the anti-abortionists show is always of a ­perfect beautiful baby, but that’s not what he was dealing with. He did what he did out of love.”

In Kansas law, all terminations after 22 weeks have to be approved by two independent doctors. Pro-life activists and pro-life politicians brought multiple cases against Doctor Tiller, trying to prove that he had acted illegally. Jury after jury examined the evidence and found that Tiller had acted within the law.

In March [2009], he gave a tiny insight into how he coped with such extraordinary pressure. He told the jury at his trial that: “Quit is not something I like to do.” He said his wife, Jeanne, his three daughters – two of whom are doctors – a son and 10 grandchildren were all sources of comfort.

Then he recounted to the jury one particular conversation that he said had given him great succour. “My daughters came into my study. I was reading. And they said: ‘Daddy, if not now, when? If not you, who? Who is going to stand up for women with unexpected and badly damaged babies?’ I had the support of my family, and we were able to proceed ahead.”

The vast majority of abortions are carried out before 12 weeks and happen simply because the woman discovers she’s pregnant, doesn’t want to be, and arranges to terminate the pregnancy. Pro-life campaigners can and have ensured that a woman who needs an abortion must pay more and endure more risk to get one: Irish women must find the money to travel to London, Africa or Latin America they might buy misoprostal over the counter and sometimes die of it, or – if they can afford it – go to a clandestine clinic and have an abortion performed illegally by a qualified doctor. Under pro-life regimes, the richer you are, the safer an abortion you can buy. Only pro-choice health services will provide safe abortions to every woman regardless of her ability to pay for her survival.

Because safe abortions are more expensive, pro-life legislation often ensures that a woman delays her abortion till later simply because she cannot afford to pay for it or arrange travel to get to the overseas clinic. A raped child may not realise that she is pregnant, or know to tell someone who will help, until she begins to show. Still, the majority of even these abortions take place before 20 weeks.

Abortions after 24 weeks aren’t usual. They result from rare complications. Doctor Tiller was legally allowed to perform abortions only when the woman’s health was at risk or the fetus was lethally malformed or an underage girl had been sexually abused. In a country the size of the United States, only dealing with such rare complications but being almost the only doctor in the whole country who would do so, Doctor Tiller saw about 250 patients a year.

my wife and I spent a week in Dr. Tiller’s care after we learned our 21 week fetus had a severe defect incompatible with life. The laws in our state prevented us from ending the pregnancy there, and Dr. Tiller was one of maybe three choices in the whole nation at that gestational age.

My wife just called with the news of his murder, weeping.

I can’t really come up with some profound political statement just now, so let me just list some memories of Dr. Tiller….

-I remember being puzzled about a T-shirt he was wearing, which said “Happy Birthday Jennifer from team Tiller!” or something similar. Turns out it comemmorated the birthday of a fifteen year old girl who was raped, became pregnant, and came to Tiller for an abortion. As luck would have it, she was in the clinic the same week as her birthday. So the clinic threw her a party.

-The walls of the clinic reception and waiting room are literally covered with letters from patients thanking him. Some were heartbreaking – obviously young and/or poorly educated people thanking Dr. Tiller for being there when they had no other options, explaining their family, church etc. had abandoned them.

Each of those patients was greeted on each arrival – the procedures for late term abortion take days – by a howling mob of pro-life activists accusing her of being a murderer.

Losing Laura (Diagnosis: Severe Congenital cystic adenomatoid malformation (CCAM)) By Laura’s Mom:

The baby’s heart was being severely compressed over to the opposite side of where it should have been because of the increasing size and pressure of the cystic masses. I was told that the situation was very grave. Without functioning lungs, there would be no way for the baby to survive post term. There was also a strong indication that the baby could succumb to heart failure prior to term because of the crushing pressure of the cystic masses.

I sought the advice of several well-known perinatologists in my area to get second and even third opinions. But it was the same prognosis each time. I was told that I had two options – either to let nature take its course or to end the pregnancy. The days that follow are kind of a blur to me now. I was devastated to know that my precious baby was not going to make it and quite possibly suffer in the process, and I was helpless to do anything. I could not imagine continuing to carry a child possibly for several more months to term, all the while knowing that there was no hope for survival and just waiting for the inevitable to happen. I was already going through emotional hell, and it seemed pointless to put both myself and my baby through any more needless suffering.

The reason we have all this technology is so that we can make informed decisions. So I decided that if I was going to lose my baby, I wanted to do so on my own terms; and I was referred to Dr. Tiller’s clinic in Wichita. Since I was now past the 24 week cut-off for a termination in my state, I would have to travel there to seek the help that I needed now. Dr. Tiller and his staff were so wonderful to my husband and me. They were more compassionate than any of the doctors at home, who seemed more interested in documenting every aspect of my personal tragic situation for “an interesting case study” and took the attitude of “You can just try again when this is over.”

Dr. Tiller let me talk and cry and he listened to my every word through my tears. He held my hand and hugged me when I needed it; and he really cared about the emotional pain I was going through. I kept telling him that my main concern was for my baby to go peacefully, as I was not concerned for my own comfort. He assured me that the process would be painless for the baby, and would very closely mimic a miscarriage.

There was another couple there the same week going through a similar experience and he encouraged us to talk to each other and support each other through our ordeal. His facility was literally lined with hundreds of framed letters from people from all over who had gone through the very same experiences thanking him and his staff for helping them when they needed it most. It helped to know that I was not alone and that support still means so much to me to this day.

Phillip Wood and his wife were joyfully preparing for the births of twin boys when, midway through the pregnancy, everything went wrong.

An amniocentesis revealed a disease of the placenta. Both twins were dying. With his wife prone on a cot in the back of a van, Wood drove from their home in Columbia, Mo., to a hospital in Florida for a surgical procedure that might save one of the boys.

Doctors at the Catholic-affiliated hospital told them neither twin would survive, and his wife was at risk of a ruptured uterus. That would make her infertile and could threaten her life.

“They had no information as to where we should go. They just said, find an abortion,” said Wood, a professor of psychology at the University of Missouri in Columbia.

Wood and his wife drove to a clinic in Illinois, but doctors there elected not to abort the fetuses, saying the size of one twin’s head was larger than the clinic’s guidelines allowed.

With his wife in physical and emotional distress, Wood drove to Women’s Health Care Services in Wichita, Kan.

They ran the gantlet of protesters, who pleaded with Wood’s wife not to end her pregnancy. Inside, they signed forms required by the state informing them, among other things, that their sons looked human and could feel pain.

After all that, they met George Tiller.

“I wasn’t prepared for this active, energetic, very vocal guy,” Wood said. “He took time to listen to us. He was very appropriate and involved me in all steps of the abortion.”

After the twins had been aborted, Tiller gave the parents time with them. They performed a brief baptismal ceremony.

“While I held the bodies of my sons he stood to the side and wept, very quietly and very briefly,” Wood said.

Annie’s Kansas Story (Diagnosis: Chromosome 18 deletion syndrome):

At this point I was nearing 25 weeks. The whole time, I wasn’t really worried of finding anything wrong with the baby; I figured nothing bad would come of this. Then we got the results. I was blindsided with the information, that my baby was missing the 18th chromosome; the odds were 1 in 400,000. Since it was so rare, the doctors didn’t have any concrete information on what could be wrong with my baby but some things on the list were severe autism, severe retardation, a tendency towards violence, bodily malformations, heart problems. The doctor gave us our options and we spent a few days grappling with the dire situation presented to us.

One can only imagine the fights that go on in your mind when trying to come to a decision such as this. How can you end a pregnancy you were so excited for? Maybe the symptoms would be at the milder end of the spectrum? What kind of life would this child have? Would it be fair to give them that life when we knew ahead of time and had a choice? The questions you ask yourself go on and on. And the hard part was that everyone left the decision entirely up to me; they would support me either way. I almost wanted the decision to be made for me. Ultimately, we decided to terminate. We called the doctor and told him of our decision, at which point I asked for him to tell me the baby’s sex. The giddy feeling of surprise and anticipation was over.

The moment I stepped into the clinic and met the other women I would share the week with, I felt a sense of comfort and peace that I had made the right decision. Dr. Tiller was such a kind and gentle man. I feel like I went through the week a little emotionally disconnected. I couldn’t think too much of what was happening, it was just too sad. Not regretful, just sad that it was ending. The clinic handled matters with such care and professionalism. I am grateful to have left with a receiving blanket, hand and foot prints, pictures, and later, the ashes.

At first I brought out my special box of mementos quite often, but now I find myself pulling it out on the anniversary. I’ll never forget the overwhelming feeling of grief as the plane took off the runway as we headed home. I felt as though I was leaving my daughter behind. It was then that I really let loose and had a good cry. I planted her ashes with a rose bush, and every time it blooms I think of Angeline and how she’s in heaven, waiting to finally meet me.

Since then, I have been remarried and have two beautiful children, a girl and a boy. Each time, at the ultrasounds I held my breath until we got the all clear. I feel very blessed.

Dr. Tiller was a brave soul, and I thank God I was given the opportunity to meet him. He will be greatly missed.

A few months after Roe Vs Wade made abortion legal, in a hospital in Boston, far away from Kansas, a woman waited to find if others would let her have the abortion that could save her life: (Incompatible with Life – Diagnosis: Polyhydramnios)

My case was sent before a panel of medical reviewers at Boston Lying-In, while we went home to wait the interminable days between knowledge of our baby’s condition and medical direction for how to proceed. Lying on my side on the couch (the only position in which the pain was alleviated somewhat), for five days, I was an infant myself, with no direction, no sensibility, as helpless and adrift as was my baby daughter, floating while I waited to hear what was to become of us all. Truthfully, I remember that period of time through a fog of unremitting pain, certainly as much psychological as physical. After two more weeks, I was relieved of my pain, and brought into the world of unending grief, still extant now these 36 years later, by the humanity of the medical team who voted to allow my doctor to deliver her – as it turns out, stillborn. No matter – she had no brain, no autonomic nervous system, no means of drawing her first breath. She could in fact, never have known human life outside my womb.

In all these 36 years, I have rarely had to consider what the consequences might have been had that medical panel voted, “no.” Would my life have been sacrificed? In truth, I recall telling my mother-in-law at that time that I would have gladly given my own life if it meant that the baby would live. I even wished that it were so. But, I had the good sense, and the support of a loving husband, to survive the inevitable. She was delivered and mourned, and ever will be. Those unnamed doctors who brought us through the nightmare have been in my prayers ever since. They provided the only sane response I could have fathomed. Later, I suffered another pregnancy that ended poorly, but never again did I feel so completely vulnerable, so fragile, on the cusp of life and death, so tormented by the loss of that dear baby, who has lived in our hearts ever since. She was our only daughter. A few years ago, I was given a mother’s ring with a stone for each of our two sons, and one for her, as my husband knew I would want.

That is my story. If others have stories of crippling and debilitating, and yes, life-threatening depression, or life-diminishing complications of family dynamics, or if some cannot suffer the shame or confusion caused by pregnancy outside of marriage, or a pregnancy resulting from a rape or an affair, or if some cannot work though the dilemma of being unable to provide for a new child, or whatever condition might drive a woman to this decision – let us be. Bless us in our pain, offer what relief a good friend might provide, but DO NOT JUDGE. We all live in glass houses.

And so, I will not tolerate the demonization of the good Dr. Tiller. I know that he must have been a savior to many. I know that he brought the saving mercies of medical science to his patients. Distortion and lies by right-wing terrorists have somehow fostered perverse untruths about this issue. Today I send my story to those who might allow a first-person testimony to check their blanket condemnations. For obvious reasons, I cannot attach my name to this submission. Yes, I am terrified. In a world where a murder of a doctor can be viewed as beneficial, who knows what zealot out there might decide that I am a she-devil. I know, and I feel, and I hope that I am a carrier of the truth that we are our best human selves when we are able to look into our own hearts to make choices about our own lives.

Pro-life activists in the UK for the most part do not seem so dangerous as in the US. When they write about the need to prevent women from accessing contraception or abortion, they sound bloodless and calm about it.

But I think we should recognise, on this day if on no other, that though their methods may be less evil than the pro-life activists in the US, their goal is the same.

They want to stop women being allowed to make choices about our own lives. And sometimes, as when those choices have to be made very late in pregnancy, the decision is difficult and painful and there will be no good choice. But someone has to make the choice. Even letting a woman die in late pregnancy rather than perform an abortion is a choice, of sorts.

Three years ago today, in a church in Kansas, a very brave and very compassionate man was killed. His answer to “who decides?” was “Trust women.”

We at the Abortion Gang and the Provider Project want to honor Dr. Tiller’s legacy of compassionate care by hosting a collective blog remembrance in response to this question: How can the pro-choice and reproductive justice movements better support the people who have later abortions and providers who perform them?
Why is it so difficult for our movement to talk about and support later abortions?

How easy is it to keep remembering: pregnancy is complicated and difficult and it can be dangerous. No country has a maternal mortality rate that’s zero. Countries where abortion is legal have lower maternal mortality rates. Partly because women who need abortions can have them early and safely and less expensively, so women don’t die of knitting needles or poisoned by a non-prescription drug or infections: but also because women and their physicians have legal resources open to them when something goes wrong.

In the US, many doctors study at hospitals which don’t train them how to perform abortions. Pro-life doctors won’t learn, pro-life hospitals won’t teach. Abortions performed late are medical emergencies. Most of the patients who undergo these medical emergencies are afraid to have their names made public because of what the pro-life movement might do to them. Doctors who are willing to act in these medical emergencies don’t have a choice about having their names and their place of work known to the pro-life movement.

Hard enough for any woman to make these decisions: hard enough for a doctor to help her.

Why does a doctor willing to do that also have to be a hero?

“The last time I talked to him,” says Susan Hill, “I said, ‘Why are you still doing this, George? You certainly don’t need to. Why don’t you just retire, enjoy life?’

“He said, ‘I can’t, I can’t leave these women. There’s no one else for them.’”

I’m a woman-educated physician. I don’t know how many abortions he did, but the women in my father’s practice for whom he did abortions educated me and taught me that abortion is not about babies, it’s not about families. Abortion is about women’s hopes, dreams, potential, the rest of their lives. Abortion is a matter of survival for women. – Doctor George Tiller, interviewed 2001