Only Kermit Gosnell is to blame for the heinous crimes he is alleged to have committed against women seeking abortions, but the tactics and policies of the so-called "Pro Life" movement gave him the opportunity to do so.
While most people thought we said goodbye to "back alley abortionists" when the Supreme Court decided Roe v. Wade, the case that made abortion legal throughout the United States in 1973, anti-abortion activists have worked concertedly over the past 40 years to make abortion as difficult as possible to obtain even if they haven't been able to officially overturn Roe. Their unfortunate success has meant that for a significant portion of women in this country, often the most marginalized, the promise of safe and legal abortion offered in Roe has never been realized.
By stigmatizing and politicizing abortion, by making it harder and costlier for legitimate abortion providers to operate, and by restricting government support for abortion care for low-income women, abortion opponents took away any reasonable options for the vulnerable women in the Philadelphia area who were desperate to end a pregnancy and drove them into Gosnell's hands. Unless we are able to reverse this course, there will be more Gosnells - and more injured and dead women - in our future.
There are three things we can do to protect women from predators like Gosnell going forward:
1) Work to de-stigmatize abortion. One of Gosnell's victims said she first tried to go to a Planned Parenthood but got scared away by the protestors. The harassment of patients and clinics also creates a chilling effect on the provision of abortion care, as few hospitals and medical practices want to deal with the harassment, and sometimes violence, that comes with performing abortions.
2) Fight unnecessary abortion regulations. Measures known as Targeted Regulation of Abortion Providers, or TRAP, laws have become a popular vehicle for abortion opponents to shut down legitimate abortion clinics. By requiring clinics to undergo costly, state-mandated renovations that do nothing to improve safety, these laws make it impossible for many clinics to be able to afford to operate and they drive up the price of care for those that stay open. Just in the last two weeks, Hillcrest Clinic in Hampton Roads, VA, which opened nine months after the Roe decision, had to shut its doors because of a newly implemented TRAP law. Pennsylvania has had its own TRAP law in place since 2006.
3) Ensure that all public and private insurance plans cover abortion. Since 1976, Congress has restricted coverage for abortion in Medicaid, a health insurance program for the indigent, under a law known as the Hyde Amendment. Over time, this policy has been extended at the federal and state level to numerous other public and private health insurance plans and programs. While the cost of abortion care has stayed fairly constant over time relative to other health care services, it can still be completely out of reach for a woman living in poverty. Gosnell offered cut rate prices, which lured many women who had nowhere else to go. Additionally, women who cannot afford to pay for an abortion out of pocket must spend precious time raising the money for their procedure, which can push them later into pregnancy and sometimes past the legal limit for abortion - another factor that drove some women to seek Gosnell's disreputable services.
As we know from the experience of countries throughout the developing world, and from our own pre-Roe history, making abortion illegal does not make it go away, it just makes it unsafe. And as we have learned from the Gosnell story, it turns out that when you make legal abortion inaccessible, you may as well have made it illegal for the women cut off from legitimate care. In other words, it is not enough for abortion to be legal; it must also be available and affordable if it is to be safe.
Jessica Arons is Director of the Women's Health and Rights Program, Center of American Progress.