Dr. Kermit Gosnell is accused of running a house of horrors. And we can all agree that the crimes for which he is accused are horrific, gruesome and unspeakable. But there is a story behind the story that some are missing in this case, and that is the issue of race.
The West Philadelphia abortion provider is on trial for the murder of a woman during a botched abortion, as well as seven viable, newborn infants—delivering them alive, then immediately killing them by snipping their necks after they survived his late-term medical procedure.
Gosnell, who faces the death penalty if convicted, was not a certified obstetrician or gynecologist, his assistants were untrained and unqualified, and his medical office and equipment were filthy.
Racist medical practices at play
As it turns out, Gosnell allegedly treated his patients of color—his regular clientele— differently from his white patients. White suburban women are said to have been brought into a separate area that was cleaner than the facilities reserved for poor, minority and immigrant patients. Gosnell reportedly provided better, more hygienic conditions for his white clients because they were “more likely to file complaints” about receiving second-rate care.
As reported in The Atlantic, one former employee of Gosnell testified “that white patients often did not have to wait in the same dirty rooms as black and Asian clients. Instead, Gosnell would escort them up the back steps to the only clean office — O’Neill’s — and he would turn on the TV for them.” She said that Karnamaya Mongar, 41, the Nepalese woman who died under Gosnell’s care, would have been treated “no different from the rest of the Africans and Asians.”
“Like if a girl — the black population was — African population was big here. So he didn’t mind you medicating your African-American girls, your Indian girl, but if you had a white girl from the suburbs, oh, you better not medicate her,” the former employee said. “You better wait until he go in and talk to her first. And one day I said something to him and he was like, that’s the way of the world. Huh? And he brushed it off and that was it.”
Case puts abortion back on the hot seat
Some people would point to the Gosnell case as proof that America should ban abortion—made legal under the 1973 U.S. Supreme Court case, Roe v. Wade, and a safe procedure when performed correctly. Since that time, states have enacted regulations to limit and prohibit a woman’s constitutional right to an abortion, including extremely burdensome restrictions and architectural requirements on abortion clinics.
This war on women’s reproductive freedom is also a war on low-income women, including poor, black and brown women. Denial of access has placed their health in danger.
In 1976, Congress passed the Hyde Amendment, which prohibits federal Medicaid funds to be used for abortion, with an exception for rape, incest or when the life of the mother is endangered. The largest health care program in the nation, the joint federal-state Medicare system, covers over 50 million people, and 16 million women, including one in ten women and one in five low-income women.
The impact of the Hyde law is almost exclusively visited upon poor women. Rep. Henry Hyde (R-IL), the sponsor of the legislation said, “I certainly would like to prevent, if I could legally, anybody having an abortion: a rich woman, a middle-class woman or a poor woman. Unfortunately, the only vehicle available is the… Medicaid bill.”
Civil liberties groups say the law is discriminatory, creating second-class citizens. “Federal and state restrictions on public funding for abortion make it extremely difficult and, often, impossible for Medicaid recipients to exercise their constitutional right to safe and legal abortion,” says the ACLU. “In practice, these women do not have the same rights as other American women who can finance an abortion out-of-pocket or through private insurance coverage. Nor do Medicaid-eligible women have the same rights as men who depend on publicly funded health care. For no covered medical service that men need does the federal Medicaid program restrict the standard for reimbursement as it does for abortions.”
Since the Hyde Amendment was enacted, over 1 million women have been unable to afford an abortion, and 25% of poor women are forced to carry an unwanted pregnancy. Obamacare maintains this restriction.
It’s about access
But limiting abortion is what causes the problems in the first place, facilitating the self-induced, ‘coat hanger’ abortions, the back-alley abortions, and creating the space for the Gosnells of the world to operate. After all, Pennsylvania received a grade of F from NARAL Pro-Choice America for access to reproductive health care. There are no women’s clinics in the hundreds of miles between Pittsburgh in the western Pennsylvania, and Harrisburg in the central part of the state.
Making abortions safe, legal and accessible prevent future Gosnells, say pro-choice groups. When poor women—disproportionately women of color—have few choices, they are more likely to fall prey to dangerous, life-threatening options. Typically, the women who sought the services from Dr. Gosnell did so because were unable to receive an abortion under Medicare, in a state that already severely limits access to abortions. Others wanted to go to Planned Parenthood, but were intimidated by anti-abortion protestors.
And in the Pennsylvania House of Representatives, Republicans just pushed out of committee a bill that would block most abortions under the state health exchange provided under Affordable Care Act. This process is playing out throughout the nation.
“We know that women who want to terminate a pregnancy or must terminate a pregnancy for health reasons will do what it takes. We know that legal and accessible abortions save women’s lives, so restricting abortion access doesn’t decrease the number of abortions, it increases the number of unsafe abortions,” said Susan Schewel, executive director of the Women’s Medical Fund, a Philadelphia-based organization providing financial assistance to women who cannot afford an abortion.
Meanwhile, the Guttmacher Institute reports that women in poverty account for 42 percent of all abortions, and black and Latino women have higher rates of abortion than their white counterparts, reflecting higher rates of unintended pregnancies.
Typically, these women say they cannot afford a child, or cite reasons such as work, school or other family responsibilities. But with inadequate access to contraception, abortion bans on the state and federal level and the defunding of Planned Parenthood, they are being punished in the process.
When it comes to lack of access to safe abortions, race is the elephant in the room.
Let’s throw in poverty for good measure, as it is inextricably linked to race in this country. America is no country for poor women. No country for black women.
Follow David A. Love on Twitter at @davidalove