Revolution #167, June 7, 2009


The Outrageous Murder of Dr. George Tiller and the Real Truth About “Late-Term” Abortions

by Mary Lou Greenberg

(This article is revised from the article "The Truth About 'Late-Term' Abortions," which originally appeared online at revcom.us on June 7, 2009.)

When Dr. George Tiller was murdered by an anti-abortion assassin on May 31, it was a huge loss to women everywhere and to everyone who values women’s freedom.

The terrible news of Dr. Tiller’s murder brought back a flood of memories of when I visited his Wichita clinic. The walls of the waiting room were filled with moving letters of appreciation framed with care and telling many stories. A woman’s anguish in learning of her fetus’ sure-death condition and the comforting compassion of Dr. Tiller; the desperation of another at an unplanned pregnancy and gratitude for the non-judgmental care at his clinic; the loneliness of feeling abandoned and fearful for the future. I will always remember the words of one: “Thank you for giving me back my life.”

At Dr. Tiller’s funeral in Wichita, and at commemorations in other cities, people held signs with his photograph that said: “HERO.” And indeed he was.

Dr. Tiller began providing abortion care in 1973, as soon as it was legal in Kansas. He was a dedicated physician who helped tens of thousands of women and their families. He had a fearless sense of purpose. And he was not deterred—even in the face of constant picketers of his clinic and home, vandalism, baseless lawsuits and political/legal trials, death threats, and physical attacks.

Dr. Tiller was known for wearing a button with his motto, “Trust Women.” He gave compassionate care to thousands of women, and mentored colleagues and medical students, and was a source of last resort for women with fetal/maternal complications in his Wichita, Kansas clinic. His tremendous courage was grounded on the understanding that women must have the right to safe abortions, that safe abortion is a fundamental component of women’s healthcare—and that without this right, women’s lives are ruined.

What does it say about the nature of this society, of this system, that such a compassionate, caring and courageous person is hounded, constantly under attack, vilified and then finally murdered? What does it say about a system that not only unleashes, but gives leadership to, the most reactionary, anti-women, Christian fascist forces that target doctors like Dr. Tiller; that publicize “hit lists”; that promote widespread ignorance and religious reactionary fervor—that created the atmosphere in which Dr. Tiller was murdered? And what does it say about a system where, when such a hero is gunned down in cold blood—that the officials of government do not step forward to defend him, speak out against this outrage, ensure that his important work continue,and that his killer be brought to justice? This is a system that has at its very foundation the oppression of women.

Obama, the “pro-choice” president, says we should find “common ground” with those who attack the right to abortion, arguing that we need to reduce the number of abortions. But as “A Declaration: For Women’s Liberation and the Emancipation of All Humanity” (Revolution #158) points out, we cannot find “common ground” with the Christian fascists, who are backed and unleashed by powerful forces in the ruling class. Such “compromise” can only mean giving moral legitimacy and political initiative to the movement that wants to force women to bear children against their will. (See excerpts on page 4 and go to revcom.us for the whole Declaration.)

A Fetus is Not a Baby

Very broadly in society, even among people who were outraged and appalled by Dr. Tiller’s murder, there is confusion about abortion in general, and particularly about late term abortions. I want to speak to that. It is not enough to be appalled by this despicable murder that has taken such a precious resource and irreplaceable person from us. To build a movement—so desperately needed today—as unwavering in its support for abortion on demand and without apology as Dr. Tiller was unwavering in his determination to support women who need it—we must be firmly grounded in the science and the morality of abortion at every stage of pregnancy.

Dr. Tiller was a compassionate, skilled doctor who did abortions at every stage of pregnancy, but he was best known for helping women who were in the second (from about 13 to about 24 weeks) or third trimester of pregnancy. Women came to him from all across the country and from many other countries because he was one of the very few physicians who knew how to and did abortions into the third trimester (allowed, with strict qualifications, by Kansas law). Dr. Tiller persisted—insisted, rather—in doing this despite decades of vicious harassment, including being shot in both arms in a failed assassination attempt in 1993, because he knew women needed these services that they could not get elsewhere and that he was the last hope for many in desperate circumstances.

First, the reality of abortion is that close to 90 percent are done in the first trimester of pregnancy. But it is important to understand why abortion at any stage must be available to women, why it is morally right to support that, and why it is not “partial-birth” abortion, much less “baby killing.”

Pregnancy is a process which takes some time. As stated plainly in an earlier article, “What is an Abortion and Why Women Must Have the Right to Choose,” by A.S.K. in Revolutionary Worker (now Revolution) Issue #1265, Jan. 23, 2005, “it is not some mysterious event guided by outside forces. It is part of the normal processes of the woman’s body.... The egg changes and develops into a fetus and keeps on changing for nine months, only because the woman’s physiology (the way her body works) is making these changes happen.” This is why the woman—not the man, not the church or the government or anyone else—must have the choice whether or not to continue her pregnancy and the means to realize that choice.

To briefly summarize, the fetus develops from literally a clump of cells (the embryo) that may develop a few days after fertilization. Three weeks into the pregnancy, the whole embryo is still only about 2 mm (2 millimeters) long, or about the size of the letter “o.” (See Revolution #166, “A Fetus is Not a Baby”.) By the third month of pregnancy, the embryo, now called a fetus, starts to look a little more “human,” but inside, its internal organs, muscles, skeleton and nervous system are still very undeveloped. The whole thing is still only about an inch long.

Again, it is during these first three months, or first trimester, of pregnancy, that almost 90 percent of abortions are done.

Another 10 percent of abortions are done from 13 to 20 weeks of pregnancy. Even at the end of this period, the fetus is still very undeveloped and unable to survive outside the woman’s uterus without special medical measures. Only a little more than 1 percent of all abortions are done at 21 weeks or more, late in the second trimester and third trimester of pregnancy.

But even at this stage of its development, a fetus only has the potential to become a human being. Until it is born, it has no life of its own separate from the life of the woman whose body it is a part of. It does not float in a disembodied bubble (as the antiabortionists would have you believe from the pictures they hold up outside clinics), but is totally dependent on the woman’s bodily processes at every stage until it is born—for example, it gets oxygen from the woman’s blood and takes in nourishment and passes waste through her biologic functions—and cannot survive apart from her. And this is true until a woman gives birth, and a baby takes its first breath, at which point it becomes a human being.

No matter how tiny the fertilized egg or how developed the fetus, so long as it is in the woman’s uterus, it is a part of her body, dependent on and subordinate to the woman’s life. It is not a human being until it is born and takes its first breath, becoming a separate human being.

The Stories Behind Late Term Abortions

There is no question that earlier abortions are less complicated and easier on the woman. So why would women wait?

First, there are no abortion providers in 87 percent of all U.S. counties. Not surprisingly, most of the women needing second or third trimester procedures live in more rural areas, are generally younger and less educated and tend to be poorer than women who get early abortions. (Source: Ann Rose, “Mercy Abortions: What Dr. Tiller Did,” posted on Daily Kos, June 2, 2009)

At an abortion speakout during a recent Hampshire College reproductive freedom conference, I heard many women from different backgrounds get up and painfully detail the difficulties they had in getting an abortion—from restrictive laws to the time it took to borrow enough money ($400 on average for a first trimester procedure), a situation that pushed them farther into pregnancy, requiring a more complicated (and more costly) procedure.

After Mississippi passed a law in 1992 requiring that a woman seeking an abortion receive in person information about the fetus and “alternatives” to abortion and then wait at least 24 hours before getting an abortion, second trimester abortions increased by 53 percent among women who depended on Mississippi providers. (Study published in Family Planning Perspectives, vol 32, #1, Jan/Feb 2000.)

In one study by the Guttmacher Institute, in July 2008, 58 percent of women getting abortions said they would have liked to have gotten them earlier. And nearly 60 percent who were delayed in obtaining an abortion, said it was because of the time it took to make arrangements and get the money together.

Women in urban areas with fewer restrictions on abortion also need late term abortions for a variety of reasons. Merle Hoffman, founder and president of Choices Women’s Medical Center in NYC told me of a very young patient who was just over 24 weeks, the legal cutoff point for abortions in New York State. “She had terrible problems with abuse at home, but we could not do the abortion at Choices,” Hoffman said. “I called George Tiller and asked him if I paid for her to get to Kansas, would he do the abortion free of charge. I sent her and he did the abortion—that was the level of his commitment.”

Susan Hill, another abortion provider and President of the National Women’s Health Foundation, told Kate Harding, in an article posted at Salon.com that she “always sent the really tragic cases to Tiller.” These included “women who had been diagnosed with cancer who needed abortions to qualify for chemotherapy, women who learned late in their pregnancies that their wanted fetuses had fatal illnesses, and rape victims so young they didn’t realize they were pregnant for months.”

Or, consider the situation of an eleven-year-old who doesn’t realize she is pregnant until late in her term. “We sent him 11-year-olds, 12-year-olds who were way too far along for anybody [else] to see,” Hill said. “Eleven-year-olds don’t tell anybody. Sometimes they don’t even know they’ve had a period.”

Many of the women seeking third trimester procedures do so because of serious fetal anomalies—major and terrible deformities in the fetus that compromise critical organ functions and often cause the death of the fetus or of the newborn. These aren’t apparent until later in pregnancy and also often involve potentially dangerous complications for the woman.

Since Dr. Tiller’s murder, some of these stories have been posted on internet blogs, like “Kansas Stories” about women who traveled to Wichita after getting horrible news about the condition of their fetus too late to have a termination in their own state. The first-person stories tell of couples happily planning for the birth of a baby only to be shattered by the news that something is terribly wrong, and rather than endanger the woman’s health or cause suffering to a newborn with no or little chance of surviving, they sought out Dr. Tiller.

Women with similar experiences testified in Washington, D.C. when Congress began considering the so-called Partial-Birth Abortion Ban that would outlaw what some doctors considered the safest and least traumatic later abortion procedure, medically termed D & X, for dilation and extraction. (“Partial-birth abortion” is a coldly calculated made-up name that has no medical basis; there is no such thing as a “partial birth abortion.” Or a “partial birth,” for that matter. A fetus is either aborted or a baby is born.)

They told of their agony and why the government or courts had no right to interfere with decisions between a woman and her doctor as to the best thing to do or best way to end the pregnancy. (The ban was passed and later upheld by the Supreme Court in a case involving Dr. Leroy Carhart, one of two remaining doctors who do later abortions, who flew to Dr. Tiller’s clinic the day after Tiller was murdered to make sure women who had appointments would be taken care of.)

And in any event, a fetus is not a baby until it is born, and becomes a living, viable human being. Women who do not have the right to choose whether or not to take their pregnancy to term at any stage, for any reason, women who have been denied the right and ability to decide themselves if and when to bear children, who do not have even that measure of control over their own bodies, have been reduced to a position that is tantamount to slavery.

• • •

The heart of the matter is women’s freedom, and their ability to contribute to society as half of humanity. What is being fought out here, with abortion providers literally on the front lines, is the profound moral question of whether or not women will be forced to breed against their will or be able to play an active role in all of society as fully emancipated human beings.

Dr. Tiller was a hero. What is needed now more than ever is for everyone who wants to see an end to the days when women seeking to end a pregnancy are denounced and shamed, and the health care providers who make it possible for women to do so must fear for their lives, to stand firmly on science and the deep morality of defending women’s freedom, and struggle without hesitation for abortion on demand and without apology.

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