Dr. LeRoy Carhart may be one of the most prominent abortion providers in the country, thanks to the two Supreme Court cases (Stenberg v. Carhart and Gonzales v. Carhart) that bear his name. But the financial wear-and-tear of fighting dozens of courtroom battles over the past decade is visible in the rundown facade of his women's health clinic in Bellevue, Neb., a small town south of Omaha.
The Abortion and Contraception Clinic of Nebraska, which Carhart runs with his wife, Mary, is housed in building that used to be a marina and boat sales business until the Carharts leased the property in 1993. They gutted it to create their clinic, remodeling the inside to include several small exam and patient education rooms. Inside, two old wood-console TVs blare the Lifetime movie of the week, and the walls are cluttered with framed pictures of horses and lefty bumper stickers. It feels almost homey. "They've been so nice and professional," said one woman, who was at the clinic to have an abortion two days before shipping out to Iraq. "But from the outside it looks like a butcher house."
I'm not sure I'd use that exact description, but she was right that, from the street, the Carhart clinic does not look like a doctor's office. At the time of my visit, in the spring of 2006, it badly needed a new paint job. Weeds sprouted through cracks in the parking lot. The two large garage doors on the first floor hark back to the building's previous tenants.
I'll admit it. Despite my knowledge that, inside, they provide safe and professional care, I was incredibly depressed by the outward appearance of the Carhart clinic. Women deserve to get reproductive health care in a doctor's office that looks clean, modern, and professional -- not run-down former boat-sales buildings.
When we talk about the physical space where abortions are provided, we're usually either referencing the pre-Roe era (the back alley) or the gauntlet of clinic protesters women must pass on the sidewalk outside. Rarely does the subject of the actual real estate of abortion providers come up. We don't like talking about how too few clinics look like clean, inviting places, because it props up the anti-choice movement's portrayal of all abortion clinics as dilapidated and riddled with health-code violations. But we should talk about the outward appearance of abortion clinics more often. Those imposing concrete blast walls exist because "pro-lifers" are prone to violence against women's health care providers. Clinic facades can look a little shabby because, well, wouldn't you rather have your health care provider spending the money on medical equipment rather than siding? Not to mention the fact that many states have laws, designed to target abortion providers, which require expensive interior renovations to change air-circulation methods, heighten ceilings, and widen halls and doorways.
Which is why I was so happy to see photos of the $7.5 million Planned Parenthood clinic recently built in the Chicago suburb of Aurora, Illinois. Hoping to avert the kinds of protests that kept other new abortion clinics from opening (like when a contractor backed out of building a new Planned Parenthood facility in Austin in 2003), Planned Parenthood applied for the building permits under the name of a subsidiary, Gemini Office Development LLC. They disclosed to the planning and zoning board that the building would be occupied by a medical office, but did not specify it would be an abortion provider.
After anti-choice activists discovered that the new medical office building in Aurora was to be a reproductive health clinic, they sounded a clarion call to keep the facility from opening. Under pressure from the anti-choice movement, the city denied Planned Parenthood's occupancy permit. And yesterday, a judge declined to grant a temporary occupancy permit, meaning the new clinic (which was supposed to open on Tuesday) will remain shuttered. At the hearing, the Aurora city attorney argued that this is about land use and permit regulations -- not about restricting abortion access. Planned Parenthood lawyers responded, "We wouldn't be here if this was a foot care clinic."
It's interesting that the anti-abortion movement would go after Planned Parenthood for conducting its real estate business using a third party. Because it's a time-honored anti-choice tactic to purchase, often under a third-party name, the building that houses an abortion clinic, then to subsequently raise the rent to exorbitant amounts or to have the abortion provider evicted outright. The next step is to turn the former clinic into a "crisis-pregnancy center."
In 2000, a state senator who was a vocal abortion-rights opponent and two business partners purchased the building that houses Carhart's clinic. Almost immediately thereafter, Carhart received notices that his lease on the lower portion of the building and the parking lot would be terminated in 30 days and that his lease on the rest of the building would end in six months. As the partnership's lead investor, Bill Rotert, said at the time, "If it's possible, I'm going to close it down. I'm already pricing chain."
A judge eventually ruled the eviction notices were not valid. Three years later, Carhart scraped together the money to buy the property himself, after a court ruled that, as the occupant, he had the right to buy the building before it was sold to a third party. No doubt the massive legal fees (and resulting debt) incurred after court battles like this one have contributed to the Carharts' inability to renovate the exterior of their clinic.
The biggest piece of this puzzle is always financial. It's tough to see a run-down abortion clinic, with high concrete walls and peeling paint, next to a sparkling new "crisis-pregnancy center." But the bottom line is that it's really, really expensive to provide actual medical care. And it's cheap to run an office-slash-misinformation center. Roll one ultrasound machine in, buy some beige furniture and, bam, you're done. Lots of money left over to spend on the landscaping.
The Aurora clinic represents the best of both worlds: The shiny façade of professionalism that you get with a crisis-pregnancy center with real medical care for women on the inside. Planned Parenthood's decision to complete the permit paperwork using the name of a subsidiary is a major reason this was possible. But even the most well-funded reproductive-health provider in the country, using this stealth tactic, ended up wrangling with anti-choicers in court.
Planned Parenthood has vowed to keep the legal battle going until the Aurora clinic's doors are open. In similar case in 2001, Planned Parenthood of Northern New England applied for permits to build a new clinic in Manchester, New Hampshire using a subsidiary's name. The court ruled that the local zoning board acted unconstitutionally when it revoked the clinic's building permit, and the clinic is now in operation. So the odds are good that the Aurora clinic will be allowed to open eventually.
An Aurora alderman -- before he was aware the facility was an abortion clinic -- commented as he approved the occupancy permit, "Yeah, it's a nice looking building. I like the way it's laid out." Another alderman echoed, "It's beautiful. I second."
I have to agree with them. It's a beautiful thing that, at least in Aurora, women will soon have the option of going to a clinic that looks as professional on the outside as it is on the inside.
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