The New Abortion Providers

By EMILY BAZELON
Published: July 14, 2010

On a clear and mild March day in 1993, the Operation Rescue leader Randall Terry spoke at a rally in southern Florida against abortion. “We’ve found the weak link is the doctor,” he told the crowd. “We’re going to expose them. We’re going to humiliate them.” A few days later, Dr. David Gunn, an abortion provider, was shot and killed outside his clinic in Pensacola, Fla., about 500 miles away. It was the first of eight such murders, the extreme edge of what has become an anti-abortion strategy of confrontation.

Terry understood that focusing on abortion providers was possible because they had become increasingly isolated from mainstream medicine. That was not what physicians themselves anticipated after the Supreme Court’s 1973 decision in Roe v. Wade. An open letter signed by 100 professors of obstetrics and gynecology predicted that free-standing clinics would be unnecessary if half of the 20,000 obstetricians in the country would do abortions for their patients, and if hospitals would handle “their proportionate share.” OB-GYNs at the time emphasized that abortion was a surgical procedure and fell under their purview.

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But the clinics also truly came to stand alone. In 1973, hospitals made up 80 percent of the country’s abortion facilities. By 1981, however, clinics outnumbered hospitals, and 15 years later, 90 percent of the abortions in the U.S. were performed at clinics. The American Medical Association did not maintain standards of care for the procedure. Hospitals didn’t shelter them in their wings. Being a pro-choice doctor came to mean referring your patients to a clinic rather than doing abortions in your own office.

This was never the feminist plan. “The clinics’ founders didn’t intend them to become virtually the only settings for abortion services in many communities,” says Carole Joffe, a sociologist and author of a history of the era, “Doctors of Conscience,” and a new book, “Dispatches From the Abortion Wars.” When the clinics became the only place in town to have an abortion, they became an easy mark for extremists. As Joffe told me, “The violence was possible because the relationship of medicine to abortion was already tenuous.” The medical profession reinforced the outsider status of the clinics by not speaking out strongly after the first attacks. As abortion moved to the margins of medical practice, it also disappeared from residency programs that produced new doctors. In 1995, the number of OB-GYN residencies offering abortion training fell to a low of 12 percent.

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http://www.nytimes.com/2010/07/18/magazine/18abortion-t.html?adxnnl=1&pagewanted=all&adxnnlx=1429393007-eyWtGXPvlOd5PFN+AKkp4A