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.

kermit-gosnell-philadelphia-400In 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 DischargeDeathDeath / Profound Neurodevelopmental ImpairmentDeath/Moderate to Severe Neuro-developmental Impairment
22 Weeks79%80%90%95%
23 Weeks63%63%76%87%
24 Weeks40%41%55%70%
25 Weeks23%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.

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  • Christine T

    Thank you for covering this story.

  • David

    Probably the most even-handed and rational discussion of the issue I have read in years. Thank you.

  • Her

    There’s a heart to stop at about 4 weeks, so that’s not much of an argument.

  • Caleb Herod

    If you remove humans from the womb at gestational ages earlier than 20 weeks, you find out quickly that they aren’t viable outside of the womb.
    Therefore, it is morally permissible to kill humans before they are capable of surviving outside of the womb.

    Similarly, if you launch humans into the sun, you find out quickly that they aren’t viable inside of the sun.
    Therefore, it is morally permissible to launch humans into the sun before they are capable of surviving inside the sun.

    • David

      I read your words three times, and they still make as much sense as a styrofoam submarine…

      • Caleb Herod

        Good. It shouldn’t make sense.
        Using viability outside of the womb as a criterion for whether or not it is okay to kill a human being is a bizarre non sequitur.

        • David

          You misunderstand. The two are not sufficiently similar to illustrate the proposed logical fallacy you are attempting to illustrate. Your original comment fails to make the point you are attempting to make.

          The two statements are not comparable at all. The first represents a movement into a condition that represents normal condition (viability outside the womb) the second condition represents a non-normal condition (viability inside the sun).

          To make your point, you would have to compare two normal conditions.

          • Caleb Herod

            “Outside the womb” isn’t “normal” for any human child at 24 weeks or earlier.
            Indeed, I was comparing two abnormal conditions.

  • Caleb Herod

    It’s telling that he expects pro-lifers to launch argument, and expects abortionists to get angry.

  • Eric Scheidler

    Thank you for this frank, honest article, Steve. I’m sure you’ll get plenty of heat from others on the pro-choice side for daring to suggest reconsidering how late into pregnancy American law allows abortion. I’m just as certain I’ll find myself embarrassed by some of the responses from my fellow pro-lifers.

    I’d like to challenge two of the unsubstantiated claims you make in this article: that 3 out of 10 (sometimes we hear 1 out of 3) women will get abortions in their lifetimes, and that greater access to contraception would drive down abortion rates.

    I haven’t been able to find any solid proof for the 3/10 or 1/3 claim, which I believe originates with Planned Parenthood (or their research arm, the Guttmacher Institute), and which is repeated so often by journalists. I’d encourage you to look into this.

    On the contraception issue, it may seem like a no-brainer that more contraception means less abortion (after all, if an unplanned pregnancy can be avoided, there won’t be an abortion). And yet, greater access to contraceptives, starting with the introduction of the pill in 1960, has not, in fact, achieved this goal.

    The logic behind the “contraception solution” fails to take account of how contraceptives radically alter sexual behavior, and also, in my view, takes too rosy a view of how effectively contraceptives could ever be used.

    Over half the women getting abortions were using a contraceptive method at the time they became pregnant; only 13-17% of them claim to have been using the method correctly. Despite decades of promoting “safe sex,” people still aren’t using condoms of the pill (the most common methods) correctly. What makes us think they ever will?

    I’d like to challenge you to really look into the effectiveness of contraceptives for reducing abortion rates (like a recent study in Spain in which increased access to contraceptives actually increased the incidence of abortion). What seems like such an obvious solution may not really be one.

    Thanks again for your thoughtful piece. I wish you the best as you continue this journey of reflection on the abortion issue.

    Eric Scheidler
    Executive Director
    Pro-Life Action League

  • LeticiaVelasquez

    Thank you for your honesty, that the facts of abortion are shocking because most people, yourself included, are not aware of the reality of fetal development and abortion procedures.
    This begs the question; since abortion is not well understood by most people, and 30% of women are undergoing them, why haven’t women been given an accurate explanation of what exactly an abortion is. Isn’t information supposed to be the basis of choice?

  • MK

    See, I find the question of when viability is achieved, dishonest. The question must be, when does LIFE begin.

    Because by choosing “viability” as your red line, you are making a value judgment. Either ALL human life is sacrosanct, or it isn’t. If it is, then viability is a red herring. If it is not, then who has the power to place a value on this life vs that life? And why is the criteria age, color, mental capacity, location…these are all arbitrary. If they can kill an unborn human life because of where it is located today, or because said life has Down Syndrome, then what is to stop those same people from placing a value on your life, or mine, based on my age, mental ability or location?

    Isn’t this the same logic of Eugenics? That some human lives are more valuable than others and some human beings have the power to decide which lives those are? You say it is the woman’s choice. Why? Why does the woman have the power to decide if a human being lives or dies? Who gave her that power? Where did THEY get that power to give?

    Very scary thinking, indeed.

  • barb

    If you or I had an accident and were attached to life support machines to keep us alive, it would be against the law to remove the support, in most cases. To begin CPR on a person who isn’t breathing, makes the Emergency Medical person, giving the CPR, responsible for keeping that person alive and it’s against the law to stop CPR unless someone else takes over or you can’t physically continue.
    Human life is determined when there is a heartbeat and brainwaves. The womb is the support system for the growing child. Developing children in the womb do have a heartbeat and brainwaves. Why is it ok to take away their life support?

  • Kim Ketola

    Thank you, Mr. Volk, for honestly sharing your process of questioning your views as your awareness has shifted. It took me a decade to alter my views–having myself chosen abortion as problem-solving in my twenties. I hope you continue to listen to your heart.

    I also hope you will reconsider playing into the hands of those who say abortion is the answer to poverty by placing hope in political parties to nurture and succor our young. This is the job of families, and for those families unprepared, the church. Government programs for the poor have been in place for as long as abortion has been legal. And yet poverty remains. Killing the children of the poor cannot be the answer, for that matter eliminating members of the next generation, for any and every reason, can only leave the rest of us the poorer. I help women overcome the choice and I know their pain firsthand. http://www.cradlemyheart.org

  • jonjct

    there is so much opposition to abortion when the facts are put on the table as was done here. read the comments section, ppl are horrified by what they have read. yet americans will continue to support legislators who are extreme pro-choice. legislators who want no restriction on abortion. this doesn’t make any sense. also, where are the father’s rights to reproduce? someone decides for the father whether some stranger will murder his baby in the womb. that is an injustice which is never addressed in the media, and never factored into the discussion of abortion rights. doesn’t the father have the right to protect his baby from murder? guess not fellas.