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A Tale of Two Abortion Wars

While pro-life activists fight to rescue IVF embryos from the freezer, pregnant women in their third trimester with catastrophic fetal anomalies have nowhere to turn.
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Pro-life rally. (Photo: tsaiproject/Flickr)

Pro-life rally. (Photo: tsaiproject/Flickr)

At a 35-week ultrasound, Julie Smith* of Medford, Massachusetts, saw the big black mark on her daughter Alice’s* brain. “When I saw that dark hole on her cerebellum, I knew right away that it wasn’t good,” she says, “but I was still in shock and denial.” Expecting nothing but good news and wondrous images of her nearly full-term baby, Smith had gone to the routine ultrasound appointment alone.

“After the exam,” Smith recalls, “when I was sitting in the waiting room, the genetic counselor came out to get me. I was knitting a sweater for Alice. With the saddest look on her face, the counselor said, ‘That’s a beautiful sweater.’ Then she said, ‘There are serious problems with your baby.’ That’s when I lost it.” Overcome with grief, Smith wept in the storage closet of the medical office until her husband arrived.

Alice had been diagnosed with the most severe form of Dandy Walker Syndrome, a congenital brain malformation. Along with an abnormal cerebellum and hydrocephaly (fluid in the ventricles of the brain), Smith’s 35-week ultrasound also revealed the complete absence of Alice’s corpus callosum—the neural fibers that connect the left and right cerebral hemispheres. While some children born with the mildest form of Dandy Walker Syndrome may have normal cognition and only moderate physical disabilities, Smith’s neonatal neurologist informed her that those like Alice are doomed to a short life of interminable suffering. “Her brief life was going to be a tortured existence,” says Smith, who explains that her daughter would have needed a feeding tube from the start and that she would have thrown up and seized constantly. “The counselor told us that Alice would not be able to sleep comfortably, even with medication,” Smith says. “When I heard that my baby wouldn’t even get peace from the pain in her sleep, that was it for me.”

"Whatever the reason, the last thing a woman needs after choosing an abortion is more guilt, especially of a religious nature,” says Knox, who believes that when it comes to abortion, “the Bible should be used for solace rather than as a weapon."

What followed was a set of nightmarish choices. “Right away, the counselor talked about the possibilities of adoption and abortion,” says Smith, who adds that she could not imagine adoption. Her first choice, she says, was to give birth at a hospital but not to offer medical interventions such as feeding tubes, ventilators, or resuscitative measures, and to let nature take its course; without such intervention, Alice would likely die shortly after birth, if she was not stillborn, which was also a possibility. But, as Smith explains, the law requires feeding tubes for non-responsive infants, which would have kept Alice alive, but in a way that seemed “wreckless and cruel.” She could not imagine watching her daughter suffer in that way. The only other option that she and her husband considered “was going off the grid,” because, Smith says, even with a home birth state workers would most likely have intervened. But Smith feared that if they “just disappeared” to have the baby somewhere in peace and quiet, and if Alice died as predicted, they could be charged with homicide.

Given these realities, Smith chose what she believed was the most compassionate option: to terminate the pregnancy. “I am a mother, and I would do anything in my power to save my child,” she wrote on her blog. “That’s how the most difficult situation I’ve ever faced, the hardest thing I’ve ever done, was also the clearest choice.” The doctor that Smith’s obstetrician had long been sending patients to, Dr. George Tiller, who ran Women’s Health Care Services in Wichita, Kansas, had been murdered in 2009 by anti-abortion activist Scott Roeder. As a result, Smith was sent to a Boulder, Colorado, clinic run by Dr. Warren Hern, one of only four late-term abortion providers in the U.S.

Smith had only days to arrange for the procedure, which would cost $25,000—money she had to borrow from family members. She says that she and her husband had to wade through protesters and cameras to get into the Colorado clinic, “which seemed like an army bunker,” and where, for security reasons, she could only have one book and one food item. But, Smith says, “contrary to what many might think, it was a peaceful procedure,” which, she explains, began with an injection that stopped her daughter’s heart, although not right away. Hours had passed since the injection, and Smith thought Alice had died. “But then I felt a kick,” Smith recounts through tears.

After she knew that Alice had passed—she says her belly was no longer tight and high, but rather heavy and sagging—Smith was overcome with a feeling of grace. Two days later, after being induced at the Boulder clinic, she gave birth to Alice, who was five pounds 13 ounces. “They cleaned her off and brought her into me,” says Smith, who shows me Alice’s tiny footprints and handprints. Smith, who suffers post-traumatic stress disorder related to the loss, attends two support groups (an infant loss group and an abortion support group) and serves as a mentor to other women who have gone through late-term abortions for similar reasons. She says that she wishes there were more options for women in her circumstances, lamenting the death of Tiller and lauding the courage of Hern, who she describes as “an absolute angel who saved me and my daughter.”

ON THE MORNING OF May 31, 2009, Scott Roeder, a Kansas native who had a history of mental illness, anti-government activism, and anti-abortion militancy, entered the Reformation Lutheran Church in Wichita, where Dr. George Tiller was serving as an usher—Tiller’s wife was in the choir. Roeder opened fire and fatally shot Tiller in the head in front of the whole congregation.


The candlelight vigil for Dr. George Tiller in Boston, Massachusetts. (Photo: Tim Pierce/Flickr)

Tiller, who was the eighth American to die in recent years from anti-abortion violence, was no stranger to threats. His clinic had been pipe bombed, and in 1993 he was shot in both arms by anti-abortion activist Shelley Shannon. He was accustomed to invective like Fox newscaster Bill O’Reilly’s oft-repeated epithet of “Tiller the baby killer.”

When Tiller was in medical school, he had no thoughts of working as an abortion provider; in 1970, after he served as a flight surgeon for the U.S. Navy in California, he planned to go into dermatology. But then his father, a doctor who ran a family practice in Wichita, died in an airplane accident, along with Tiller’s mother, sister, and brother-in-law. Tiller went back to Kansas with the intention of closing his father’s practice, but instead, in a twist of fate, he ended up taking over the business, and in unforeseen ways.

Tiller soon learned that his father had performed abortions on some of his desperate patients. Since it was prior to the 1973 Roe v. Wade decision, there were no safe and legal means for these women to terminate their pregnancies, and Tiller’s father believed that, without him, many would gamble their lives on so-called “back alley abortions.” Some of these patients told Tiller how thankful they were for his father’s services, but still, Tiller did not plan to offer abortions—until he heard of a local woman’s death, which had resulted from a botched illegal procedure. That death changed Tiller’s mind. He began offering abortions—including late-term—at his father’s former facility.

"The counselor told us that Alice would not be able to sleep comfortably, even with medication. When I heard that my baby wouldn’t even get peace from the pain in her sleep, that was it for me."

These late-term abortions made Tiller the target of fierce anti-abortion activism, especially from the pro-life Christian organization called Operation Rescue, which led the famous “Summer of Mercy” campaign in 1991. Protesters from across the nation descended on Wichita, which had become the symbolic ground zero of the abortion wars largely because of Tiller. Thousands were arrested for blocking clinic entrances, clogging up local jails. But the anger against Tiller mounted, becoming more militant and including murderous rants from members of a group known as the Army of God. Those rants took hold in Roeder’s mind (The Army of God’s website, which is filled with gruesome pictures of fetuses, praises Roeder as a hero and invites his admirers to send him a thank you note for killing Tiller.)

Shortly after Tiller’s murder—a crime condemned by pro-life and pro-choice activists alike—Julie Burkhart, who had worked side by side with Tiller from 2002-09, serving as the CEO of his political action committee (PAC), ProKanDo, decided she was going to fight to re-open the clinic. She began by starting a new PAC, naming it Trust Women after one of the many aphorisms that Tiller hung on his clinic walls. The aim of Trust Women, Burkhart says, is to carry on Tiller’s legacy and life work by advancing and advocating for women’s reproductive health care in the Midwest and the South. “We refer to our neck of the woods affectionately as an abortion desert,” Burkhart tells me when we meet at a restaurant in Boston where she has come for a conference aimed at strategizing new approaches to clinic access.

While re-opening Tiller’s clinic proved harder than anticipated, Burkhart accomplished her goal on April 3, 2013, nearly four years after Tiller’s death, although not without a few changes. The name of the clinic is different—it’s now called South Wind Women’s Center—and, more notably, it no longer provides late-term abortions (following Tiller’s death, Kansas banned abortion after 20 weeks).

The four years it took to open South Wind’s doors were filled with an endless parade of seemingly insurmountable obstacles. From the beginning, Burkhart was up against Kansas’ conservative values—the state’s governor, Sam Brownbeck, recently signed a bill declaring that life begins at conception. These values translated into what are known as Targeted Regulation of Abortion Provider (TRAP) laws, or legislative action that restricts access to abortion clinics by mandating, for example, that clinics meet “ambulatory surgical center” requirements (such as a certain room size or corridor width), or that abortion providers have hospital admitting privileges, a standard that is impossible for most providers to meet.

Nearly 16 months have passed since South Wind opened, but still, due to Wichita’s anti-abortion climate, the smallest of tasks can prove difficult for Burkhart and her limited staff. So far, Burkhart has not been able to hire a local provider (she almost had one, but, she says, that doctor caved to intimidation). As a result, the clinic’s current providers come from out of state and fly in for work. The costs of this travel are just another financial blow to the clinic. Every time an anti-abortion group—such as Kansans for Life, or Operation Rescue—files a legal claim, such as a zoning complaint, the clinic must foot the costly bills.

“It’s the little things too,” says Katie Knutter, South Wind’s communications director. Knutter says they can’t get a vending machine, because no one will sell one to them. “There’s only one cab company in the area that will pick patients up. It’s hard to get carpenters or electricians to work for us,” she adds, telling the story of how their current electrician has been “harassed” and “lost business.”

Not surprisingly, Burkhart has also been the target of harassment. She had to secure a temporary stalking order against a local pastor; and Roeder, who is serving life for Tiller’s murder, said in a recorded jailhouse conversation, “For Julie ‘Darkheart’ to walk back in there and re-open a murder mill.... It’s almost like putting a target on your back and saying, ‘Well let’s see if you can shoot me.’”


Opponents and supporters of Planned Parenthood hold separate gatherings at a St. Paul, Minnesota, Planned Parenthood location. (Photo: Fibonacci Blue/Flickr)

Still, Burkhart and her staff are not only determined to keep the clinic running, they’re hoping to open another in the area even though, as Knutter admits, concerning the abortion wars, “We’re just not winning. They [pro-life organizations] have been amazingly successful. Although, last year’s biggest success in a year of few successes was defeating a ballot measure that would have closed the Albuquerque clinic.” By the Albuquerque clinic, she is referring to Southwestern Women’s Option, which is one of the four U.S. clinics left that offer late-term abortions. “It’s clear we need a better strategy,” Knutter says.

THE STATE THAT SMITH traveled to for her 11th-hour abortion is the same state where the Personhood Movement was born: Colorado.

PersonhoodUSA, a Christian-based movement headquartered in Denver, works to legally define life as beginning at the moment of conception, making a fertilized egg entitled to the same 14th Amendment protections and privileges as any other person. The organization was responsible for ballot initiatives in Colorado (in 2008 and 2010) and Mississippi (in 2011) that would have amended the state constitution to define life and personhood as commencing at fertilization.

“The hallmark of Personhood is no exceptions, no compromises,” says Rebecca Kiessling, one of the group’s founders. “We lost in Mississippi because of friendly fire.” By friendly fire, she means pro-life individuals who voted against the personhood initiative for certain reasons, either because they were anti-abortion except in cases of rape or incest; were concerned about the measure’s implications for a pregnant woman with health complications, such as an ectopic or molar pregnancy, or of how it could criminalize doctors who provided abortions for these at-risk women; or troubled by how it might ultimately limit access to, or outright ban, treatments such as in vitro fertilization.

"I see first hand the need to broaden the conversation regarding reproductive health and spirituality, and I am witness to the torment of my patients by the conflict created when they make the decision to have an abortion as one in three women do in this country by the age of 45."

Kiessling, whose mother conceived her after being kidnapped by a serial rapist, has been a staunch advocate for the “no exceptions, no compromises” platform. “If abortion had been legal at the time of my mother’s rape, I wouldn’t be here,” says Kiessling, who released a documentary film last November that features the personal stories of women who chose to have children conceived from rape; women such as Lianna Rebolledo who became pregnant after a brutal abduction at the age of 12 and decided to have the baby. In the film, which shows victims who became pregnant as the result of incest and who chose not to have abortions despite pressure from family and friends, Rebolledo says that she wanted to kill herself after the rape, but that in choosing to give birth, she inadvertently found healing.

While the Personhood Movement has no shortage of critics for its zero tolerance abortion stance, and while its opponents are quick to highlight the organization’s ballot failures in Colorado and Mississippi, the campaign is no passing fad and is supported by a significant sector of the American electorate. The organization’s biggest success came in North Dakota in the spring of 2013 when the state legislature voted overwhelmingly in favor of a personhood amendment to be added to the state constitution, which asserts that “the inalienable right to life of every human being at any stage of development must be recognized and protected.”

This November, in what will be an emotionally charged referendum with lobbyists on both sides pulling out all the stops, North Dakotan voters will decide the fate of the measure. Meanwhile, in Colorado, voters will cast their ballots on another personhood initiative known as the Brady Amendment, which came about after Heather Surovik was struck by a drunk driver in Longmont, Colorado, at eight months pregnant on her way home from a prenatal doctor’s visit. The crash resulted in the death of her unborn son—Brady, who weighed eight pounds two ounces at the time and who, doctors say, saved Surovik’s life. Because Colorado law did not consider Brady a human being, the driver, who had prior drunk driving convictions, did not serve time in jail (he committed suicide during a plea bargain process). While the Brady Amendment is a fetal homicide law, the official ballot text adopts the language of personhood, asking voters if the Colorado constitution should “protect pregnant women and unborn children by defining ‘person’ and ‘child’ in the Colorado criminal code and the Colorado wrongful death act to include unborn human beings.”

Still, some of the country’s most respected pro-life advocates are hesitant to fully endorse PersonhoodUSA’s “no exceptions, no compromises” approach. Maria Lancaster, co-founder and executive director of Embryo Adoption Services of Cedar Park, which matches unused IVF embryos with infertile couples, says that while she admires Kiessling and understands where she is coming from, she prefers “the strategy of incrementalism” rather than what Kiessling disapprovingly calls the “save the 99 in exchange for the one strategy.” Says Lancaster, “There have been exactly zero babies saved [from PersonhoodUSA],” adding that “the strategy of incrementalism,” meaning the step by step law changes restricting abortion, has been very successful and has “saved countless thousands of lives.”

WHEN MARIA LANCASTER OF Issaquah, Washington, found herself unable to conceive a child, after years of trying, she was overcome with despair. After surrendering to the reality, and putting her faith in God—she is a devout evangelical Christian who turns to the Bible for moral and spiritual guidance—her husband arrived home one night after hearing a talk on the radio by Dr. James Dobson of Focus on the Family, the Colorado-based Christian organization that promotes socially conservative views on public policy, including opposition to abortion at all stages. On the show, Dobson spoke of the first woman, Marlene Strege, to give birth to a baby from embryo adoption, which is when unused embryos from a couple’s fertility treatments are donated to another couple.

As a result of hearing that story, Lancaster went through the same embryo adoption agency as Strege—Nightlight Christian Adoptions—and, several months later, two embryos from a North Carolina couple were shipped across the country. After four years of being frozen at -200 degrees, the two embryos, which Lancaster marveled at through a microscope, were implanted into her uterus. While one of the embryos did not make it, the other grew into what Lancaster calls her “child of destiny.” She named her Elisha Ramiah.

Almost immediately, Elisha became a symbol of the national debate on abortion. After sending a note to President George W. Bush with Elisha’s picture, thanking the president for his pro-life stance, the Lancasters were invited to be on stage when Bush discussed his veto of the funding of embryonic stem cell research. As Lancaster explains, there are four options for couples with remaining embryos from fertility treatments: freeze them indefinitely (there are over a half million embryos currently frozen); donate them to embryonic stem cell research; legally throw them away; or donate them to another family. “How could anybody throw out a life?” writes Lancaster in her book, Souls on Ice: True Miracle Stories of Embryo Adoption.


Cops at the clash of pro-life and pro-choice rallies in San Francisco, California. (Photo: Steenaire/Flickr)

In the forward to the book, former presidential candidate Mike Huckabee writes, “Life begins at conception—not some arbitrary point thereafter. Every embryo is a human life, unique and individual, with worth and value, and absolutely deserving of protection by society.” Huckabee carries a photo of Elisha in his wallet so that when asked why he is pro-life, he can show people the photo and recount Lancaster’s story.

Lancaster also co-founded her own embryo adoption agency along with Dr. Joseph Fuiten, senior pastor of Cedar Park Church in Issaquah. For several years now she has been connecting families who have remaining embryos after fertility treatments with those unable to conceive. Lancaster says that she “prays over the files” that come to her, trying to create the best match. She pairs couples in terms of race, religion, and ethnicity, “like God does it,” so that the child “will feel a real part of the pack,” adding that her efforts have only confirmed her belief that “rescuing these unseen lives from the freezer” is her moral duty.

WHILE SMITH’S STORY OF late-term abortion and Burhkart’s struggle to re-open her slain mentor’s clinic may seem a world apart from Kiessling’s no exceptions platform or Lancaster’s embryo adoption mission, the stories of these four women are in fact deeply connected, flip sides of the same coin.

Perhaps there is no other issue that touches on so many core dimensions of American society—legal, medical, scientific, theological, political, philosophical, biological, ethical, and ecological. What some on one side of the debate call reproductive justice, others call taking a life. What some call a person, others call a cluster of cells. This seemingly intractable split is part of the larger culture wars that have fractured the nation for decades, pitting traditionalist and progressive values against each other. Most often these values are rooted in clashing religious and secular worldviews concerning the role of sexuality and reproduction in modern life.

"God loves women who have abortions just as God loves women who choose not to have abortions."

Still, the glaring reality remains that approximately one in three women continues to seek abortions despite the shrinking number of clinics, and that, according to the Guttmacher Institute, a non-profit organization that works to advance reproductive health, half of pregnancies among American women are unintended. Because of this reality, says Harry Knox, president of the Religious Coalition for Reproductive Choice (RCRC), a faith based pro-choice advocacy group founded in 1973 by clergy and lay leaders from mainstream religions, “it is best to try to take shame out of the equation if possible” and to have a “rational, healing perspective” about abortion that includes “more nuanced and pragmatic discussions concerning the painfully complex and personal reasons women seek abortions.” Sometimes, Knox points out, it is a serious medical issue. More commonly, though, it is poverty and other socioeconomic dead-ends that are suffered disproportionately, Knox stresses, by minority women, low-income communities, single mothers, or women with disabilities, echoing another Guttmacher Institute statistic: Forty-two percent of women obtaining abortions have incomes below 100 percent of the federal poverty level.

“Whatever the reason, the last thing a woman needs after choosing an abortion is more guilt, especially of a religious nature,” says Knox, who believes that when it comes to abortion, “the Bible should be used for solace rather than as a weapon,” reminding me that there is no mention of abortion anywhere in the Bible. “What the Bible does talk about is the sacred nature of life and of children in particular,” but, he adds, “we are not even properly caring for the children that are here. If we can’t provide women and their children with health care for themselves, a living wage, educational opportunities, day care, and basic hope, what sort of life is that?” That is why, Knox says, abortion should be considered “an issue of economic justice.”

One of RCRC’s most recent campaigns, “It’s Time to Talk,” advocates for new and honest conversations about the intersection of religion, sexuality, and abortion, including the complicated reasons so many women have abortions. Partnering up with the “1 in 3 Campaign,” which encourages women who have had abortions “to end their silence, share their stories, and start a new and more personal conversation about abortion in our society,” the goal of “It’s Time” is, as Rabbi Jessica Kirschner says, “for real women to have real conversations about the difficult choices we face as human beings with the holy and complicated capacity to give birth and raise the next generation.”

As Dr. Willie J. Parker, a Chicago-based abortion provider, said at the “It’s Time” campaign launch, “I see first hand the need to broaden the conversation regarding reproductive health and spirituality, and I am witness to the torment of my patients by the conflict created when they make the decision to have an abortion as one in three women do in this country by the age of 45.”

“God loves women who have abortions just as God loves women who choose not to have abortions,” says Knox, adding that it is important to use the words God and abortion in the same sentence in a loving and compassionate manner. “Usually God and abortion are used synonymously to intimidate, shame, and condemn,” he says, pointing out that the vast majority of women who seek abortions report a religious affiliation. “Our goal is to undo this to help women rest at night after having an abortion by creating a safe space to talk about their experiences without shame.”

*These names have been changed.