The Compassion of Dr. Tiller

The Web site A Heartbreaking Choice is a place where women share their stories of late-term abortion. Though clearly pro-choice, the point of the site is not political; it is a support group for grieving parents. These are women who desperately wanted their babies but whose pregnancies turned disastrous. A section of the site is devoted to "Kansas Stories," because when women learn very late in their pregnancies that their fetuses have abnormalities that are likely to be fatal, Dr. George Tiller's Wichita clinic, Women's Health Care Services, was one of the only places in the country that could help them.

One woman described her elation at being pregnant and how the possibility of motherhood offered a glimmer of hope through several family deaths. Then she found out her fetus had severe spinal and cerebral deformities. "I laid on the table crying and knowing in my heart at that point my son was not going to make it," she wrote. At almost 23 weeks pregnant, she was too far along for an abortion in her own state, and so, like many women in her situation, she made the anguished pilgrimage to Wichita.

Writing five weeks after her abortion, she said, "I hate that my son is gone. I hate that I had to make the decision to end his life. I hate that my womb and my arms are empty. But I am strengthened in the fact that I made my decision by focusing on him and what was best for him. I am eternally grateful to the wonderful people that guided me through this horrible experience with compassion, love, and understanding."

Her gratitude toward Tiller and his staff is not unique. Ayliea Holl, the administrator of the site, saw a different doctor for her own abortion, but she's met many of Tiller's patients. "Every single one of them received the kindest, most caring and compassionate, the best health care that they could get," she says. "Dr. Tiller was extremely compassionate. He was so helpful to so many women."

After his murder, it's not clear who will take his place. In the mainstream media, Tiller is frequently described as "controversial." But in the tight-knit world of abortion providers and pro-choice activists, he was often called a saint, because he took on the hardest cases, whether they could pay or not, and was incredibly tender with his patients. "His clinic was known for really treating women with extraordinary decency and respect," says Carol Joffe, a professor of sociology at the University of California, Davis, and one of the country's foremost experts on abortion. They sent him volumes worth of letters of effusive and urgent thanks.

Tiller's death is an incalculable loss to women's health care. There are two other clinics that do late-term abortions, but neither are known for taking patients regardless of their ability to pay or for ministering so comprehensively to their emotional needs. Tiller's murder leaves a void that could imperil women across the country.

Late-term abortion is often spoken of as the most morally dubious aspect of the abortion debate. Many people who are nominally pro-choice, particularly politicians, are quick to condemn it, to treat the work that Tiller did as repugnant even if it's legal.

Ironically, though, many of the procedures Tiller did were as far away from the much-reviled concept of "abortion on demand" as one could get. Unwanted pregnancy can, to some extent, be prevented. A pregnancy that goes horribly wrong cannot. Almost anyone of child-bearing age could end up needing Tiller's services. And now some of them will be forced to carry pregnancies to term against their will even when their fetuses can't survive outside the womb.

Bill Harrison, an abortion provider in Arkansas, referred hundreds of patients to Tiller over the years. "To do what George does is like doing major cancer surgery," he says. "It's a subspecialty all its own. It took a real organization to do it safely and effectively and cheaply like he did it." Over the years, Harrison had 20 orĀ 30 patients who were so poor that he had to give them money for gasoline to get to Wichita. "I would call him and tell him about the patients, and he would say, 'Send them up,'" he says. "Obviously if they couldn't pay for gasoline, they couldn't pay for anything, and he did the abortions anyway."

Of course, not all of Tiller's cases were as morally clear-cut as those recounted on A Heartbreaking Choice. Tiller performed abortions at 26 or 27 weeks for developmentally disabled abuse victims or girls who'd hidden their pregnancies and then become suicidal. Harrison himself is uncomfortable with such late abortions. When patients of his sought them, "unless they were a real threat to the mother's life, and I consider suicide a threat to her life, we would talk about having a baby and putting it up for adoption," he says. But it was precisely because such abortions are so grueling for everyone involved that Harrison admires Tiller's willingness to do them. As everyone who knew Tiller points out, Tiller's motto was "trust women." He had the phrase printed up on buttons.

Tiller never set out to become an abortion provider, or even an ob/gyn. The son of a doctor, Tiller was working as a Navy surgeon when his father, mother, sister, and brother-in-law were killed in a plane crash. He took over his father's family practice, and soon women started asking him if he was going to do what his father did. That's how he found out his father had provided abortions in the years before Roe v. Wade. He committed himself to providing the same service.

"He came to this because it was what his patients needed in the middle of Kansas," says Susan Yanow, the founder of the Abortion Access Project and a longtime friend and colleague of Tiller's who referred many women to him. Whenever Tiller was asked why he endured the endless threats and harassment that came with providing late-term abortions, he would simply say he was doing what his patients needed. "George was able to be with the woman who was his patient in a truly unique way," says Yanow.

Randi Berry saw what that meant six years ago, when her 14-year-old cousin got pregnant. Her cousin hid the pregnancy from her parents until it was too late to get an abortion in New York. At the time, her cousin's mother, Berry's aunt, was herself six months pregnant with twins. Her cousin was "having thoughts of suicide," says Berry. "She was extremely depressed and isolated." She and her family wanted an abortion but her mother couldn't travel, so Berry accompanied her to Witchita.

It was a harrowing time, but at Women's Health Care Services, "everyone was so gentle and understanding," Berry says. "They gave us as much advice as we felt like we needed." There was extensive counseling, individually and in groups. "One of the families that really struck me while I was there, their daughter was developmentally challenged and had a really difficult time communicating," says Berry. "Her parents had no idea what had happened to her, whether she was raped or became sexually active." Without Tiller, she says, "I don't know what they would have done."

The same is true, she says, of her cousin. "I have no idea what would have happened to my cousin if we had to go back to her and say, 'Your only option is to have this baby and put this baby up for adoption.' I don't know if she would have made it." Today, she says, her cousin is doing well. She finished school and has a committed partner and a young child. Berry isn't sure how to break the news to her about Tiller. "I'm sure she looks to him as somebody who saved her life," she says.

Whatever his own qualms about very late-term abortions, Harrison says that if he were younger, he'd take up Tiller's practice. At 73, though, he's already largely given up performing major surgery. "As I say, this is a complex, tough procedure, and I'm much too old to learn this new trick," he says. Women will surely still come to him, sick or desperate or both and too far along for him to end their pregnancies. "I don't know what happens to them now," he says.