LeRoy Carhart is determined to train as many late-term-abortion providers as possible—or the practice just might die with him.
By Sarah Kliff | NEWSWEEK
Published Aug 15, 2009
From the magazine issue dated Aug 31, 2009
Leroy Carhart was at his abortion clinic near Omaha when he got the phone call. It was Sunday morning, a little after 10, and the doctor was in surgery. He felt his cell phone vibrate. Carhart ignored it, finishing the abortion before checking his phone. The number for George Tiller's head nurse in Wichita, Kans., flashed on the screen. The timing was unusual; Carhart didn't often hear from Tiller on Sunday mornings. He thought it might have to do with a patient, maybe an emergency. But when Carhart called back, Tiller's nurse was crying. "George is dead," she told him through sobs, relaying the news that Tiller, the late-term-abortion provider, had been fatally shot at his Lutheran church.
Carhart was scheduled to work in Tiller's clinic the next day; he was one of three abortion doctors who took turns assisting there. His car was already packed for the five-hour drive from Omaha to Wichita he'd made every third Sunday for the past five years. Carhart decided he would still go, to see Tiller's family and help figure out what would happen to the clinic. But first he would see the patients at hand. His waiting room, after all, was full of women who'd crossed state lines and waited hours to see him. "I didn't have any time to sit here and feel sorry for myself," says Carhart. He hung up the phone, went back into the operating room, performed another abortion. By day's end, he had seen a dozen women.
Carhart knows there are people who want him dead, too. A few days after Tiller's murder, Carhart's daughter received a late-night phone call saying her parents too had been killed. His clinic got suspicious letters, one with white powder. It's been like this since Carhart started performing abortions in the late 1980s. On the same day Nebraska passed a parental-notification law in 1991, his farm burned down, killing 17 horses, a cat, and a dog (the local fire department was unable to determine the fire's cause). The next day his clinic received a letter justifying the murder of abortion providers. His -clinic's sidewalks have been smeared with manure. Protesters sometimes stalk him in airports. The threats, the violence, now the assassination of his close friend—all of it has left Carhart undaunted, and the billboard-size sign over his parking garage still reads, in foot-high block letters, ABORTION & CONTRACEPTION CLINIC OF NEBRASKA. "They're at war with us," says Carhart of the anti--abortion activist who killed Tiller. "We have to realize this isn't a difference of opinions. We need to fight back."
What makes Carhart such a target isn't just that he performs abortions—about 1,800 doctors do so today—but that he is among the very few still willing to do so late into pregnancy. Only 1.3 percent of abortions happen after the 21st week of pregnancy, according to the Centers for Disease Control. But those procedures have become the focus of intense debate. To pro-choicers they are tragic stories of late-discovered anomalies, with heroic doctors terminating a fetus that wouldn't survive long after birth. To pro-lifers they are morality tales that best prove the point about all abortion. "I don't support any abortions, but I think third-trimester abortions are particularly abhorrent," says Nebraska's attorney general, Jon Bruning, who has publicly called Carhart "one sick individual" and vowed to act on any evidence that would warrant an investigation. In the third trimester, Bruning says, abortion is "not only morally abhorrent but visually and physically abhorrent. You have a child with arms and legs."
A public-opinion poll in May found 68 percent of Americans support Roe v. Wade's comprehensive protection of elective, first-trimester abortion. But the farther along a pregnancy gets and with each biological milestone a fetus passes, the numbers drop and Americans become more cautious and conflicted. Around 24 weeks, when the fetus is likely viable outside the womb, the right to terminate becomes most controversial and abortion least accessible. Roe recognized the unique status of late-term abortions and gave states the power to restrict or disallow abortion when the fetus is viable (with an exception for "the preservation of the life or health of the mother").
Past viability, no doctor will terminate a pregnancy without a compelling reason. But what is a compelling reason, and who decides? Some would count a serious fetal abnormality, mental or physical; others would not. What if the baby has a 50 percent chance of surviving outside the womb? A 30 percent chance? While most of us navigate these questions in theory, Carhart deals with them in practice. At Tiller's clinic, he saw a rape victim in the third trimester of pregnancy. Every time she felt the baby move, she said, it brought back the rape all over again. She'd made three suicide attempts. Carhart performed her abortion. "If a woman is going to kill herself, then I think you have to look at it for her health," he says. The day before Tiller's death, a woman came into Carhart's Nebraska clinic 28 weeks along. Carhart asked her what she would do if she had to carry the baby to term. "She didn't say she was going to kill herself," he says. "She said she would put it up [for adoption]." He turned her away.
Carhart has a few firm lines; he won't, for example, do elective abortions past 24 weeks, because the fetus is likely viable. "It just makes sense to me," says Carhart. "After a certain point in time, the fetus is viable and we have to look at it differently than if it were not viable." And at 24 weeks, many studies show a fetus's chance of survival to be above 50 percent. Any earlier and the survival rate is lower; at 22 weeks it's less than 10 percent. But Carhart admits that such clear guidelines rarely present themselves. "There are times when abortion is the right answer," he says. "There are times when abortion is not the right answer. I hope I get it right."