Editor’s note. The following are excerpts from a devastating grand jury report from the First Judicial District of Pennsylvania. The 261-page report excoriated abortionist Kermit Gosnell, charged with eight counts of murder. It was equally hard on the lackadaisical, indifferent response by state and local regulatory agencies charged with oversight, which proved fatal to two women and left hundreds of late-term babies to the tender mercies of a man who joked about the size of the children he aborted alive.
This case is about a doctor who killed babies and endangered women. What we mean is that he regularly and illegally delivered live, viable, babies in the third trimester of pregnancy—and then murdered these newborns by severing their spinal cords with scissors. The medical practice by which he carried out this business was a filthy fraud in which he overdosed his patients with dangerous drugs, spread venereal disease among them with infected instruments, perforated their wombs and bowels—and, on at least two occasions, caused their deaths. Over the years, many people came to know that something was going on here. But no one put a stop to it. …
Murder in plain sight
With abortion, as with prescriptions, Gosnell’s approach was simple: keep volume high, expenses low—and break the law. That was his competitive edge.
… At the Women’s Medical Society, the only question that really mattered was whether you had the cash. Too young? No problem. Didn’t want to wait? Gosnell provided same-day service.
The real key to the business model, though, was this: Gosnell catered to the women who couldn’t get abortions elsewhere—because they were too pregnant.
… When you perform late-term “abortions” by inducing labor, you get babies. Live, breathing, squirming babies. By 24 weeks, most babies born prematurely will survive if they receive appropriate medical care. But that was not what the Women’s Medical Society was about. Gosnell had a simple solution for the unwanted babies he delivered: he killed them. He didn’t call it that. He called it “ensuring fetal demise.” The way he ensured fetal demise was by sticking scissors into the back of the baby’s neck and cutting the spinal cord. He called that “snipping.”
Over the years, there were hundreds of “snippings.” Sometimes, if Gosnell was unavailable, the “snipping” was done by one of his fake doctors, or even by one of the administrative staff. But all the employees of the Women’s Medical Society knew. Everyone there acted as if it wasn’t murder at all.
Section III: Gosnell’s Illegal Practice
… Gosnell routinely performed abortions past Pennsylvania’s 24-week limit.
… [Employee] Kareema Cross told us, “If it’s big baby, he [Gosnell] never tell us the truth.” Instead, “He’ll always say the baby was 24.5.” According to his workers, Gosnell recorded any fetus over 24 weeks as “24.5” weeks on their charts. The fetus could be 26 or 28 weeks, but on the chart, the doctor would always write 24.5. They testified that he told them 24.5 weeks was the legal limit. Yet because Gosnell regularly recorded late-term abortions as 24.5 weeks, his own notations prove that he performed numerous illegal abortions in violation of Pennsylvania’s 24-week limit.
Sometimes, where the gestational age exceeded the 24-week limit, Gosnell forgot—or did not bother—to include a manipulated ultrasound in the file. Instead, even where the only ultrasound established a gestational age greater than 24 weeks, Gosnell performed an abortion anyway, indicating, in the patient’s file, that the patient was exactly 24.5 weeks pregnant.
Law enforcement officers seized some abortion patient files from Gosnell’s clinic. Between the time that law enforcement raided Gosnell’s office in February and the time that investigators returned with a warrant to seize patient files, many files had disappeared. The Grand Jurors viewed a videotape of the February 2010 raid and saw files on shelves outside the procedure rooms and along a hallway. Those shelves and that hallway were empty when investigators returned. Lewis and others told us that these were second-trimester files. Most of the second-trimester files from 2008, 2009, and 2010 remain missing.
The Grand Jury, reviewing just the fraction of Gosnell’s abortion files seized by authorities, was still able to document numerous instances in which ultrasound readings were manipulated to disguise illegal late-term abortions. Our review, although limited by the disappearance of many patient files, revealed that Gosnell reported performing abortions on 24.5-week fetuses more than 80 times between 2007 and February 2010.
Clinic staff testified that Gosnell took patients files home and did not keep records of most of his late-term abortions at the clinic. Tina Baldwin explained that Gosnell took second-trimester files home “if there were difficult cases or some cases where he thought they shouldn’t be in there.” [employee Steve] Massof told us that Gosnell always took files home, so “I think he has them. If he hasn’t destroyed them, he has them.” A subsequent search of Gosnell’s home and car turned up only some of these files. One of the files seized from Gosnell’s car was partially shredded. …
Gosnell began an abortion on a 29-week pregnant woman and then refused to take dilators out when the woman changed her mind.
We learned of another illegal, third-trimester abortion only because the mother changed her mind. In 2004, a 27-year-old woman went to Gosnell, pregnant with her first child. She testified that she was surprised when Gosnell told her she was 21 weeks pregnant. On the first day of what was to be a two-day procedure, Gosnell inserted dilators in the woman’s cervix. After Gosnell had finished inserting the laminaria, the woman asked him what happened to the babies after they were aborted. She testified that Gosnell told her they were burned.
At home, thinking over how Gosnell disposed of the fetuses, the woman had a change of heart. She called her cousin and the cousin called Gosnell to tell him that they wanted him to take the laminaria out. And he did not want to return the $1,300 that the patient had already paid. The pregnant woman ended up going to the Hospital at the University of Pennsylvania to have the laminaria removed. It was determined at the hospital that she was 29 weeks pregnant. A few days later, the 27-year-old delivered a premature baby girl. She was treated at Children’s Hospital of Philadelphia and is today a healthy kindergartener.
Either a doctor or a nurse at the hospital told the woman that what Gosnell had done was illegal. Gosnell recorded in the woman’s chart that she was 24.5 weeks pregnant.
Gosnell’s illegal practice was a huge moneymaker.
A national association of abortion providers declined to admit the Women’s Medical Society as a member, finding it to be the worst facility its inspector had ever seen.
… Based on her observations, the evaluator [from the National Abortion Federation] determined that there were far too many deficiencies at the clinic and in how it operated to even consider admitting Gosnell to NAF membership. On January, 2010, she wrote to Gosnell informing him of NAF’s decision and outlining the areas in which his clinic was not in compliance. The evaluator told the Grand Jury that this was the first time in her experience that NAF had outright rejected a provider for membership. Usually, if a clinic is able to fix deficiencies and come into compliance with the standards, NAF will admit them. Gosnell’s clinic, however, was deemed beyond redemption.
We understand that NAF’s goal is to assist clinics to comply with its standards, not to sanction them for deficiencies. Nevertheless, we have to question why an evaluator from NAF, whose stated mission is to ensure safe, legal, and acceptable abortion care, and to promote health and justice for women, did not report Gosnell to authorities. …
Section IV: The Intentional Killing of Viable Babies
Gosnell left dozens of damaged women in his wake. His reckless treatment left them infected, sterilized, permanently maimed, close to death, and, in at least two cases, dead. Their injuries and deaths resulted directly from Gosnell’s utter disregard for their health and safety. However, if their fate was entirely foreseeable, it was not necessarily the product of specific intent to kill. The same cannot be said of untold numbers of babies—not fetuses in the womb, but live babies, born outside their mothers—whose brief lives ended in Gosnell’s filthy facility. The doctor, or his employees acting at his direction, deliberately killed them as part of the normal course of business.
Gosnell and his staff severed the spinal cords of viable, moving, breathing babies who were born alive.
Surgical abortions in Pennsylvania, performed up to 24 weeks of gestational age, are legal. Killing living babies outside the womb in not. The neonatologist who testified before the Grand Jury defined “born alive.” According to his expert witness, the federal Born-Alive Infants Protection Act defines a human as “somebody who’s been completely expelled from the mother and has either a heartbeat, pulsating cord, or is moving.” Pennsylvania’s Abortion Control Act defines “born alive” similarly, but adds breathing and brain wave activity as indicators of life. 18 Pa.C.S. § 3203.
Gosnell’s staff testified about scores of gruesome killings of such born-alive infants carried out mainly by Gosnell, but also by employees Steve Massof, Lynda Williams, and Adrienne Moton. Theses killings became so routine that no one could put an exact number on them. They were considered “standard procedure.” Yet some of the slaughtered were so fully formed, so much like babies that should be dressed and taken home, that even clinic employees who were accustomed to the practice were shocked. …
Baby Boy A
… After [Baby Boy A.] was expelled, [Kareema] Cross noticed that he was breathing, though not for long. After about 10 to 20 seconds, while the mother was asleep, “the doctor just slit the neck,” said Cross. Gosnell put the boy’s body in a shoebox. Cross described the baby as so big that his feet and arms hung over the sides of the container. Cross said that she saw the baby move after his neck was cut, and after the doctor placed it in the shoebox. Gosnell told her, “it’s the baby’s reflexes. It’s not really moving.”
The neonatologist testified that what Gosnell told his people was absolutely false. If a baby moves, it is alive. Equally troubling, it feels a “tremendous amount of pain” when its spinal cord is severed. So, the fact that Baby Boy A. continued to move after his spinal cord was cut with scissors means that he did not die instantly. Maybe the cord was not completely severed. In any case, his few moments of life were spent in excruciating pain.
Cross was not the only one startled by the size and maturity of Baby Boy A. Adrienne Moton and Ashley Baldwin, along with Cross, took photographs because they knew this was a baby that could and should have lived. Cross explained:
Q. Why did you all take a photograph of this baby?
A. Because it was big and it was wrong and we knew it. We knew something was wrong.
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