Thursday, June 25, 2009


Help Women Obtain Abortion Services. Join the Abortion Support Network!

You've heard of "armchair activism." But have you given any thought to "futon activism"? The Abortion Support Network will be a network of volunteers who open their homes to Irish women forced to travel to London for second-trimester abortions.

The “right to choose” is less than an illusion for Irish women. The 1967 Abortion Act does not extend to Northern Ireland, denying female citizens the access to NHS abortion available to every other woman in the United Kingdom. Abortion is also illegal in the Republic of Ireland. Irish women have three choices: travel and pay for a private abortion plus travel and accommodation costs, carry an unwanted pregnancy to term, or seek illegal alternatives. The women who choose to travel to England (5,773 in 2008 according to the Department of Health) face costs ranging from ₤500 to ₤2,000.

While campaigners fight for the rights of women to have access to safe and legal abortion in their own countries, the Abortion Support Network will seek to make their journey a little less of a hardship. Our volunteers will provide women with a place to stay, a meal, and transportation to and from the clinic. The Network will begin in
London but hopes to expand to Manchester, Birmingham, Bristol, and other areas of England where Irish women travel. Ultimately, we will also raise funds to help women pay for the cost of the procedure and travel.

The Abortion Support Network will be an all-volunteer organization. We have relationships with several clinics and women’s organizations in Ireland and England that will refer women to us. Abortion Support Network hosts will provide a safe place to sleep, transportation to and from the clinic, and a meal. When needed, other volunteers will transit patients to hosts' apartments. Volunteers sign up for days to
be "on call" and will generally host once or less per month. To host, you need a place a guest can sleep and the willingness to create the space in your life for this direct-action work.

Have a spare bed, couch, or air mattress? Want to get involved in other ways? For more information, visit or contact

Let us know how you heard about us, and someone will contact you to set up an interview.

Note: We expect to begin housing Irish women no later than 1 September 2009. If you are a clinic or other organisation that serves Irish women, please get in touch so that we can let you know when we are up and running and, should you wish, link to you from our website.

About the Abortion Support Network

The Abortion Support Network will provide housing and ultimately funding for Irish women forced to travel to England for abortions. It was founded by abortion rights activist Mara Clarke. Mara was previously involved with Haven Coalition (, a network of volunteers who open their homes to low income women forced to travel to New York City to obtain second trimester abortions. The Abortion Support Network is a member of the National Network of Abortion Funds (

Tuesday, June 9, 2009

From New York Times: Murdered Doctor’s Abortion Clinic Shuttered

June 10, 2009


The Wichita abortion clinic run by a doctor who was shot and killed will remain closed permanently, his family said on Tuesday.

Dr. George R. Tiller’s clinic was one of the few in the country to provide abortions to women late in their pregnancies, and for decades, women had traveled there from all over the nation and from overseas. It was also the only remaining abortion clinic, even for first trimester abortions, in the Wichita region.

“The family of Dr. George Tiller announces that effective immediately, Women’s Health Care Services, Inc., will be permanently closed,” according to a statement issued on Tuesday morning by the family’s lawyers. “Notice is being given today to all concerned that the Tiller family is ceasing operation of the clinic and any involvement by family members in any other similar clinic.”

After Dr. Tiller was shot and killed on May 31 as he served as an usher at his Wichita church, abortion rights advocates – including at least one abortion provider in Nebraska – had said they hoped others might step in and keep Dr. Tiller’s clinic open to provide late-term abortions. Abortion rights advocates had the loss of such a clinic would be devastating to families of women who learned late in pregnancy of catastrophic health issues.

Even some abortion opponents, who had long devoted their efforts to closing down Dr. Tiller’s clinic, said they did not wish to see it happen under these circumstances. Last week, Troy Newman, the leader of Operation Rescue, had said that closing the clinic now would send a worrisome message. “Good God, do not close this abortion clinic for this reason,” he said in an interview with The New York Times. “Every kook in the world will get some notion.”

Scott P. Roeder, an outspoken opponent of abortion, is in a Wichita jail, charged with murder in Dr. Tiller’s death.

Immediately after the shooting, the Tiller family had announced that the clinic was closed for the moment, but provided no long term plan until Tuesday.

In the statement, the Tiller family said it wished to assure his previous patients that it would work to keep their medical histories and patient records “as fiercely protected now and in the future as they were during Dr. Tiller’s lifetime.”

The family also said Dr. Tiller’s work would be honored through private charitable work. “We are proud of the service and courage shown by our husband and father and know that women’s health care needs have been met because of his dedication and service,” the statement said. “That is a legacy that will never die.”

Abortion rights advocates said they believed the nearest abortion provider to Wichita may now be about three hours away, near Kansas City.

Friday, June 5, 2009

From New York Times: Dr. Tiller's Important Job

by Judith Warner - Domestic Disturbances: A New York Times Blog
June 4, 2009, 9:07 pm

The 9-year-old girl had been raped by her father. She was 18 weeks pregnant. Carrying the baby to term, going through labor and delivery, would have ripped her small body apart.

There was no doctor in her rural Southern town to provide her with an abortion. No area hospital would even consider taking her case.

Susan Hill, the president of the National Women’s Health Foundation, which operates reproductive health clinics in areas where abortion services are scarce or nonexisistent, called Dr. George Tiller, the Wichita, Kan., ob-gyn who last Sunday was shot to death by an abortion foe in the entry foyer of his church.

She begged.

“I only asked him for a favor when it was a really desperate story, not a semi-desperate story,” she told me this week. Tiller was known to abortion providers — and opponents — as the “doctor of last resort” — the one who took the patients no one else would touch.

“He took her for free,” she said. “He kept her three days. He checked her himself every few hours. She and her sister came back to me and said he couldn’t have been more wonderful. That’s just the way he was.”

Other patients of Dr. Tiller’s shared their stories this week on a special “Kansas Stories” page hosted by the Web site “A Heartbreaking Choice.”

One New York mother wrote of having been referred by an obstetrician to Tiller after learning, in her 27th week of pregnancy, that her soon-to-be son was “so very sick” that, once born, he’d have nothing more than “a brief life of respirators, dialysis, surgeries and pain.” In-state doctors refused to perform an abortion.

“The day I drove up to the clinic in Wichita, Kansas, to undergo the procedure that would end the life of my precious son, I also walked into the nightmare of abortion politics. In this world, reality rarely gets through the rhetoric,” wrote another mother, from Texas, of the shouts, graphic posters and protesters’ video camera that greeted her when she came to see Tiller.

Our understanding of what late abortion is like has been almost entirely shaped in public discourse by the opponents of abortion rights. In recent years, discussions of the issue have been filled with the gory details of so-called partial-birth abortion; the grim miseries that drive some women and girls to end their pregnancies after the first trimester have somehow been elided.

“Late abortion is not a failure of contraception. It’s for medical reasons,” Eleanor Smeal, the president of the Feminist Majority Foundation, who has worked to defend abortion providers like Tiller against harassment and violence since the mid-1980s, told me this week. “We’ve made pregnancy a fairy tale where there are no fetal complications, there’s no cancer, no terrible abuse of girls, no cases where to make a girl go all the way through a pregnancy is to destroy her. These are the realities of the story. That’s what Dr. Tiller worked with — the realities.”

There was a great deal of emotion in the air this week as the reality of Tiller’s death set in. Much of it was mournful, some was celebratory, some was cynical and self-serving.

There were the requisite expressions of disapproval and disavowal by politicians from both sides of the abortion divide. And yet it seemed to me that even from pro-choice politicians, the response was muted. In death, as in life, no one wanted to embrace this man who had specialized in helping women who learned late in their pregnancies that their fetuses had gross abnormalities.

It seemed that no one wanted to be too closely associated with the muck and mire of what Tiller had to do in carrying out the risky and emotionally traumatic second- and third-trimester abortions that other doctors and hospitals refused to do. In news reports, there was a tendency to frame the “abortion doctor’s” murder almost as a kind of combat death: a natural occupational hazard.

Yet Tiller — who went to work in a bulletproof vest, lived in a gated community and drove a bulletproof car — was a doctor, not a soldier. And it is precisely this kind of thinking — this viewing of his life and work through the lens of our most gruesome cultural warfare, this slippage and mixing up of medicine and politics — that left him largely unprotected at the time of his death.

Someone resembling Scott Roeder, the man charged in Dr. Tiller’s murder, was seen on Saturday trying to pour glue into the lock on the back door of a Kansas City clinic. Before that, abortion providers around the country had been telling local law enforcement and the United States Justice Department that harassment at their clinics was on the rise, and they were scared. The Feminist Majority Foundation had been hearing all spring that the atmosphere outside clinics was heating up in the wake of the new pro-choice president’s election. “We all lived through Clinton, the shootings in ’93 and ’94. We were concerned some of the extremists said they had to take the fight ‘back to the streets,’” Smeal said.

There are legal protections in place that ought to keep abortion providers like Tiller safe. The Freedom of Access to Clinic Entrances (FACE) Act, passed by Congress after the 1993 murder of Dr. David Gunn outside his Pensacola, Fla., women’s health clinic and the attempted murder of Tiller that same year, prohibits property damage, acts or threats of force, and interference with and intimidation of anyone entering a reproductive health care facility.

When the federal law is backed by complementary state laws, and when local law enforcement officers apply those laws assiduously, serious violence greatly declines. When the law’s not applied strenuously, when vandalism goes uninvestigated, when protesters are allowed to photograph or videotape patients arriving at women’s health clinics, when death threats aren’t followed up, more serious acts of physical violence follow. In fact, when intimidation occurs at a clinic, the reported rate of violence triples, the Feminist Majority Federation’s 2008 National Clinic Violence Survey found.

“We really do need to arrest people who are trespassing. Arrest people who are gluing locks. Committing more minor violations of the law so criminal activity doesn’t escalate, so these criminals don’t feel emboldened,” said Vicki Saporta, the president of the National Abortion Federation. “In places where the laws are enforced, you don’t see violence escalate. Protesters generally go someplace where there’s a more hospitable climate,” she told me. But, she added, in a lot of communities, law enforcement views clinic violence as a political problem. “They don’t view it for what it is: criminal activity outside of a commercial establishment,” she said. “Law enforcement can’t treat this as a political issue. It’s a criminal issue.”

We as a nation cannot continue to provide a hospitable environment for the likes of Roeder because the thought of what happens to fetuses in late abortions turns our stomachs. We have to accept that sometimes terrible things happen to young girls. We have to face the fact that sometimes desired pregnancies go tragically wrong. We have to weigh our repugnance for late abortion against the consequences for women and girls of being denied life-saving medical treatment.

Only a tiny handful of doctors in this country will, like Dr. Tiller, provide abortion services for girls or women who are advanced in their pregnancies. These doctors aren’t well known to patients or even to other doctors, but they’re closely monitored by anti-abortion groups, who know where they work, where they live and where they worship. Roeder may have been a lone gunman, but in the largest possible sense, he did not act alone. The location of Tiller’s gated community was prominently featured on an easily-accessed Web site, along with a map of the streets surrounding his house. It was really only a matter of time before someone was unbalanced enough to take the bait.

Most Americans, I’m sure, do not believe that a 9-year-old should be forced to bear a child, or that a woman should have no choice but to risk her life to carry a pregnancy to term.

By averting our eyes from the ugliness and tragedy that accompany some pregnancies, we have allowed anti-abortion activists to define the dilemma of late abortion. We have allowed them to isolate and vilify doctors like Tiller.

We can no longer be complicit — through our muted disapproval or our complacency — in domestic terror.

Thursday, June 4, 2009

From Washington Post: Slaying Raises Fears on Both Sides of Abortion Debate

By Peter Slevin
Washington Post Staff Writer
Tuesday, June 2, 2009

WICHITA, June 1 -- As the U.S. Marshals Service moved to protect abortion clinics and doctors nationwide, the fatal shooting of the country's most prominent provider of late-term abortions reignited a national debate about reproductive rights.

Supporters of the right to legal abortion worried Monday that the killing of George Tiller in his Wichita church could foretell fresh protests and violence even as many abortion opponents fretted that his death could hurt their image and cause.

Although mainstream antiabortion groups largely condemned Sunday's shooting, Operation Rescue founder Randall A. Terry called Tiller a mass murderer who "reaped what he sowed." Terry said the antiabortion movement is facing irrelevance and must use "confrontational" tactics and "highly charged rhetoric."

Nancy Keenan, president of

NARAL Pro-Choice America, said antiabortion groups should soften their words. She said the killing was "not an isolated incident. It is part of an ongoing pattern of hateful rhetoric that unfortunately can lead to violence."

In Wichita, dozens of mourners left flowers outside Tiller's clinic, where an American flag flew at half-staff. Across town, the man accused of killing the doctor awaited formal charges in the Sedgwick County jail.

Scott Roeder was arrested on an interstate a few hours after an assailant fired a single bullet from a handgun at Tiller at Reformation Lutheran Church as he handed out church bulletins. Roeder, suspected of acting alone, has emerged as a fierce abortion opponent once arrested with bomb components in his car.

Fellow abortion opponents described Roeder as a foot soldier convinced that killing an abortion doctor is not a crime because it saves the lives of unborn children. In a 2007 Internet posting, a person identifying himself as "Scott Roeder" said Tiller is "the concentration camp 'Mengele' of our day and needs to be stopped."

One doctor remembers Roeder confronting him inside a Planned Parenthood clinic in Kansas City in the 1990s after first asking for him by name.

"I came out and he stepped up about six inches from me and said, 'Now I know what you look like,' and turned and walked out of the building," said Robert Crist, 73, adding that he had put the incident out of his mind until Sunday. "It really does send a chill down my spine. You wonder, 'Was I a target?' "

Crist has endured shotgun blasts at his home and picketers at his clinic. He was once knocked down and pummeled by protesters. Since Tiller's killing, he said, he has been pondering whether to stop performing abortions.

"I don't want to be forced out," Crist said. "But it impacts my wife and family, and I've had discussions with them, saying, 'Isn't retirement time about here?' "

Tiller, shot once before by an antiabortion crusader, in 1993, and witness to the chaos of more than 2,000 arrests outside his clinic in the 1991 "Summer of Mercy," reportedly became worried last month about a return of trouble after his clinic was vandalized. Someone scaled the fence, cut wires to knock out lights and surveillance cameras, then sliced holes in the roof and plugged drain pipes to allow rain to pour in, Dan Monnat, Tiller's attorney, said in an interview.

Tiller alerted the FBI, Monnat said. The lawyer said that the clinic is closed for mourning but that doctors intend to reopen next week to serve women who "came to Dr. Tiller because they had nowhere else to turn."

"He often expressed fear about his patients or his family, but I never saw him fear for himself or even flinch," Monnat said. "He was a very dedicated, courageous, compassionate man who devoted his life to serving women patients and honoring their constitutional right to choose."

In accepting the Obama administration's offer of extra protection, clinic operators said women seeking abortions must have secure places to turn to.

"It is critically important that we ensure the safety of our doctors, staff and patients," said Sarah Stoesz, president of a Minnesota-based Planned Parenthood chapter. The group flies physicians anonymously into Sioux Falls, S.D., each week because no doctor in the state is willing to perform elective abortions.

The shooting returned the violent side of the abortion issue to the spotlight just as a diverse array of advocates has begun meeting with White House officials to explore President Obama's appeal for common ground.

The political effect of Tiller's killing is hard to gauge. Shaun Kenney, executive director of the antiabortion American Life League, worries that "extreme" groups "will try to use it for political advantage" and harm the larger movement.

Cynthia Gorney, author of "Articles of Faith," a book about the abortion wars, said the killing will weaken antiabortion forces because Americans will see all opponents in the same light, whatever their moral and tactical differences.

"It's going to bite them in the leg," Gorney said. "And it's going to do it in a very big way."

Roeder has not been charged with a crime in Sedgwick County, where prosecutors have 48 hours to file charges or request more time. District Attorney Nora Foulston told reporters that the case will be tried in state court.

As news of Roeder's arrest traveled, abortion opponent Regina Dinwiddie remembered the day a dozen years ago when Roeder hugged her in glee after his encounter with Crist.

"He grabbed me and said, 'I've read the Defensive Action Statement, and I love what you're doing,' " said Dinwiddie, of Kansas City, Kan. She was a signer of the 1990s statement, which declares that the use of force is justified to save the lives of the unborn.

"I said, 'You need to get out of here. You can get in a lot of trouble,' " Dinwiddie recalled.

Dinwiddie does not consider Tiller's death a murder.

"I don't think he was murdered," she said. "I believe he was absolutely stopped in his tracks and it was long overdue."

Dave Leach, who also signed the statement, said he published some of Roeder's writings in the newsletter Prayer & Action News, which describes itself as "a trumpet call for the Armies of God to assemble."

Leach, who described Roeder as "anti-government," said he stopped to see Roeder in Kansas years ago after visiting Rachelle "Shelley" Shannon in prison. Shannon was convicted of shooting Tiller in his arms outside his clinic 16 years ago.

Roeder's arrest in April 1996 on explosives charges -- dismissed when a court ruled that the car search was improper -- came during a period in which he was captivated by the anti-government Montana Freemen, his father said.

The group, which said it owed allegiance to no government authority, held FBI agents at bay for 81 days before surrendering peacefully. John Roeder, who has since died, told the Atchison Daily Globe that year that his son was "obsessed" and went to Montana for unspecified training.

"Scott would not kill a fly. He would not kill a worm," the elder Roeder said. "So how could he possibly, unless he was being used by somebody, be planning anything that would take human life?"

Roeder's ex-wife told the Associated Press that he had become "very religious, in an Old Testament, eye-for-an-eye way," and moved out of the house at about this time, after 10 years of marriage and one son.

"That's all he cared about is antiabortion, 'the church is this, God is this,' yada yada," Lindsey Roeder said. "The anti-tax stuff came first, and then it grew and grew."

While Roeder remained in custody Monday, flowers stretched for 25 feet along a tall wooden fence outside Tiller's clinic. A police cruiser sat in the driveway, but on the day after the killing, at least, there were more tears than trouble.

Tiller "did what was right. He did nothing illegal," Julie Lawson, 45, said after placing a bouquet. "I knew that if I ever needed him or my daughter ever needed him or a loved one ever needed him, he was there. And now he's not."

Staff writers Garance Franke-Ruta, Philip Rucker, Jacqueline L. Salmon and Rob Stein and staff researcher Julie Tate, all in Washington, contributed to this report.

European Petition For Free Abortion — Seeks One Million Signatures


Give the women of Europe the right to free abortion!

All around the world, women are denied their right to free, legal and safe abortions. Even in Europe, women are deprived of the control over their own bodies and the number and spacing of children. It is the everyday reality facing women in Ireland, Poland and Malta.

When a state denies a woman the right to her own body, integrity and health, it is a violation of her human rights. A woman deprived of the choice of carrying out or terminating a pregnancy is being violated in that precise way.

Despite this, abortion is still considered a health issue in the European Union and sorts under the principle of subsidiarity; to be regulated by the individual member countries. But why should the principle of subsidiarity include a human right that, due to biological reasons, only concerns women, when the respect for human rights in all other matters is a criterion for the EU-membership?

Nowhere in the world should a woman be forced to use a hanger, eat washing powder or see a quack doctor to terminate an unwanted pregnancy, when safe abortion methods are available.

A cornerstone of the European Union is to work for gender equality and health.Therefore, women who lack the access to free, legal and safe abortions in the EU-countries such as Ireland, Malta and Poland, can no longer be ignored. The governments of these countries must be put under pressure.

It is time for the EU to secure the right to free, safe and legal abortions and render it a human right.

Do you want to put pressure on the European power holders? Join others in collecting one million signatures for the right to free abortion. Sign the Make Noise for Free Choice.

From SperoNews: Majority of Spain Opposes Abortion For Minors

Socialist Prime Minister Jose Luis Rodriguez Zapatero faces stiff opposition to proposals to allow girls as young as 16 years of age to have an abortion without parental consent.

Tuesday, June 02, 2009
Martin Barillas

According to polls released on June 1 in Spain, approximately 70 percent of Spaniards oppose plans to allow girls as young as 16 to terminate a pregnancy without parental consent.

Socialist Prime Minister Jose Luis Rodriguez Zapatero faces stiff opposition to a bill to reform current abortion even among people who support his party. This is according to a Metroscopia survey published in the Spanish daily El Pais showed. The surveyd showed that 56 percent of Socialist-oriented voters are against the proposal.

With 64 percent of people opposing the government's plans to let minors get abortions without parental consent, the poll suggested that Zapatero faces opposition in a movement to liberalize abortion law that extends well beyond the conservative opposition and the Catholic Church. In a Noxa poll published in the Barcelona daily La Vanguardia, 71 percent of Spaniards were against, and among Socialist voters, 60 percent.

Proposed legislation to allow abortion to minors abort without parental consent has become the most divisive clause in a bill the government approved last month and will send to Parliament later this year. The broader plan would allow abortion without restrictions up to 14 weeks of pregnancy, and after that under certain conditions.

Under current Spanish law, abortions are available under a clause that allows women to assert mental distress as a reason for ending a pregnancy, but this must be certified by a doctor. The procedure is also permitted in cases of rape or fetal malformation.

Zapatero's government argues that 16-year-olds can undergo other medical procedures with no need of parental consent. Thus abortion should also be freely available to them. Current law requires women to be at least 18 to get an abortion.

Conservatives say teenagers are too young to decide on their own whether to end a pregnancy and there must be parental input.

Spain’s Minister of Health, Trinidad JimĂ©nez said in response to the results “What is important about this law in that it intends, precisely, to avoid coming to abortion.” Moreover, said the lifelong Socialist, “I would be a failure as a mother if my daughter would not come to tell me that she was to have an abortion.”

Wednesday, June 3, 2009

From The New York Times: Abortion Returns as Central Political Issue

June 1, 2009, 2:13 pm

By Katharine Q. Seelye

Abortion was not a major issue in the 2008 presidential campaign, and it has been relatively muted since President Obama’s election.

But three events have conspired in the last two weeks to bring it back to the fore: President Obama confronted it in his commencement address at Notre Dame; Judge Sonia Sotomayor, who has yet to publicly signal her position on the issue, has been nominated to the Supreme Court; and George Tiller, one of the few doctors in the country who performed late-term abortions, was gunned down on Sunday.

While abortion remains one of the most contentious issues in American politics, polling continues to show that people’s views of the procedure are not easily categorized, as our colleague, Dalia Sussman, from The Times’s polling department, wrote last month.

Over time, polling has shown that Americans generally support abortion rights, but they also want more restrictions than are in place today. And a majority (56 percent in a recent Gallup poll) says they personally believe that abortion is morally wrong.

Polls have also suggested that Americans support abortion in some circumstances but not in others. For example, a Fox News poll in October 2007 found voters broadly supportive of abortion if the woman’s life or health is at risk, but more opposed for an unwanted pregnancy.

The polls rarely show wide swings on the subject. But there can be some movement among a few percent of people who appear to be in the middle, fluctuations that may be related to how the question is asked but may also be related to current events.

In April, for example, a Quinnipiac University poll found that 52 percent said abortion should be legal in all or most cases, while 41 percent said it should be illegal in all or most cases.

The same month, however, a Pew poll found less of a split, with 46 percent supporting legal abortion in all or most cases, and 44 percent opposing it.

In mid-May, CNN asked people if they wanted the Supreme Court to overturn Roe v. Wade. Nearly 7 in 10 (68 percent) said no.

But a Gallup poll conducted around the same time said that for the first time since Gallup began asking the question in 1995, a majority of adults (51 percent) identified themselves as pro-life, up seven points from a year ago to a new high.

It is too soon to say whether Dr. Tiller’s killing will have any effect on public opinion about the procedure; there has been widespread shock and horror at his shooting but at the same time, Randall Terry, founder of Operation Rescue, is calling Dr. Tiller a “mass murderer” and summoning images of abortions, which he says are just as horrifying.


Tuesday, June 2, 2009

From New York Times: The Deadly Toll of Abortion by Amateurs

June 2, 2009


BEREGA, Tanzania — A handwritten ledger at the hospital tells a grim story. For the month of January, 17 of the 31 minor surgical procedures here were done to repair the results of “incomplete abortions.” A few may have been miscarriages, but most were botched operations by untrained, clumsy hands.

Abortion is illegal in Tanzania (except to save the mother’s life or health), so women and girls turn to amateurs, who may dose them with herbs or other concoctions, pummel their bellies or insert objects vaginally. Infections, bleeding and punctures of the uterus or bowel can result, and can be fatal. Doctors treating women after these bungled attempts sometimes have no choice but to remove the uterus.

Pregnancy and childbirth are among the greatest dangers that women face in Africa, which has the world’s highest rates of maternal mortality — at least 100 times those in developed countries. Abortion accounts for a significant part of the death toll.

Maternal mortality is high in Tanzania: for every 100,000 births, 950 women die. In the United States, the figure is 11, and it is even lower in other developed countries. But Tanzania’s record is neither the best nor the worst in Africa. Many other countries have similar statistics; quite a few do better and a handful do markedly worse.

Eighty percent of Tanzanians live in rural areas, and the hospital in Berega — miles from paved roads and electric poles — is a typical rural hospital, struggling to deal with the same problems faced by hospitals and clinics in much of the country. Abortion is a constant worry.

Worldwide, there are 19 million unsafe abortions a year, and they kill 70,000 women (accounting for 13 percent of maternal deaths), mostly in poor countries like Tanzania where abortion is illegal, according to the World Health Organization. More than two million women a year suffer serious complications. According to Unicef, unsafe abortions cause 4 percent of deaths among pregnant women in Africa, 6 percent in Asia and 12 percent in Latin America and the Caribbean.

Reliable figures on abortion in Tanzania are hard to come by, but the World Health Organization reports that its region, Eastern Africa, has the world’s second-highest rate of unsafe abortions (only South America is higher). And Africa as a whole has the highest proportion of teenagers — 25 percent — among women having unsafe abortions.

The 120-bed hospital in Berega depends on solar panels and a generator, which is run for only a few hours a day. Short on staff members, supplies and even water, the hospital puts a lot of its scarce resources into cleaning up after failed abortions.

The medical director, Dr. Paschal Mdoe, 30, said many patients who had had the unsafe abortions were 16 to 20 years old, and four months pregnant. He said there was a steady stream of cases, much as he had seen in hospitals in other parts of the country.

“It’s the same everywhere,” he said.

On a Friday in January, 6 of 20 patients in the women’s ward were recovering from attempted abortions. One, a 25-year-old schoolteacher, lay in bed moaning and writhing. She had been treated at the hospital a week earlier for an incomplete abortion and now was back, bleeding and in severe pain. She was taken to the operating room once again and anesthetized, and Emmanuel Makanza, who had treated her the first time, discovered that he had failed to remove all the membranes formed during the pregnancy. Once again, he scraped the inside of her womb with a curet, a metal instrument. It was a vigorous, bloody procedure. This time, he said, it was complete.

Mr. Makanza is an assistant medical officer, not a fully trained physician. Assistant medical officers have education similar to that of physician assistants in the United States, but with additional training in surgery. They are Tanzania’s solution to a severe shortage of doctors, and they perform many basic operations, like Caesareans and appendectomies. The hospital in Berega has two.

Abortions in Berega come in seasonal waves — March and April, August and September — in sync with planting and harvests, when a lot of socializing goes on, Dr. Mdoe said. He said rumor had it that many abortions were done by a man in Gairo, a town west of Berega. In some cases, he said, the abortionist only started the procedure, knowing that doctors would have to finish the job.

Dr. Mdoe said he suspected that some of the other illegal abortionists were hospital workers with delusions of surgical skill.

“They just poke, poke, poke,” he said. “And then the woman has to come here.” Sometimes the doctors find fragments of sticks left inside the uterus, an invitation to sepsis.

In the past some hospitals threatened to withhold care until a woman identified the abortionist (performing abortions can bring a 14-year prison term), but that practice was abandoned in favor of simply providing postabortal treatment. Still, women do not want to discuss what happened or even admit that they had anything other than a miscarriage, because in theory they can be prosecuted for having abortions. The law calls for seven years in prison for the woman. So doctors generally do not ask questions.

“They are supposed to be arrested,” Dr. Mdoe said. “Our work as physicians is just to help and make sure they get healed.”

He went on, “We as medical personnel think abortion should be legal so a qualified person can do it and you can have safe abortion.” There are no plans in Tanzania to change the law.

The steady stream of cases reflects widespread ignorance about contraception. Young people in the region do not seem to know much or care much about birth control or safe sex, Dr. Mdoe said.

In most countries the rates of abortion, whether legal or illegal — and abortion-related deaths — tend to decrease when the use of birth control increases. But only about a quarter of Tanzanians use contraception. In South Africa, the rate of contraception use is 60 percent, and in Kenya 39 percent. Both have lower rates of maternal mortality than does Tanzania. South Africa also allows abortion on request.

But in other African nations like Sierra Leone and Nigeria, abortion is not available on request, and the figures on contraceptive use are even lower than Tanzania’s and maternal mortality is higher. Nonprofit groups are working with the Tanzanian government to provide family planning, but the country is vast, and the widely distributed rural populations makes many people extremely hard to reach.

Geography is not the only obstacle. An assistant medical officer, Telesphory Kaneno, said: “Talking about sexuality and the sex organs is still a taboo in our community. For a woman, if it is known that she is taking contraceptives, there is a fear of being called promiscuous.”

In interviews, some young women from the area who had given birth as teenagers said they had not used birth control because they did not know about it or thought it was unsafe: they had heard that condoms were unsanitary and that birth control pills and other hormonal contraceptives could cause cancer.

Mr. Kaneno said the doctors were trying to dispel those taboos and convince women that it was a good thing to be able to choose whether and when to get pregnant.

“It is still a long way to go,” he said.

From New York Times: Abortion Doctor Slain by Gunman in Kansas Church

June 1, 2009


WICHITA, Kan. George Tiller, one of only a few doctors in the nation who performed abortions late in pregnancy, was shot to death here Sunday in the foyer of his longtime church as he handed out the church bulletin.

The authorities said they took a man into custody later in the day after pulling him over about 170 miles away on Interstate 35 near Kansas City. They said they expected to charge him with murder on Monday.

The Wichita police said there were several witnesses to the killing, but law enforcement officials would not say what had been said, if anything, inside the foyer. Officials offered little insight into the motive, saying that they believed it was the act of an isolated individual but that they were also looking into his history, his family, his associates.

A provider of abortions for more than three decades, Dr. Tiller, 67, had become a focal point for those around the country who opposed it. In addition to protests outside his clinic, his house and his church, Dr. Tiller had once seen his clinic bombed; in 1993, an abortion opponent shot him in both arms. He was also the defendant in a series of legal challenges intended to shut down his operations, including two grand juries that were convened after citizen-led petition drives.

On Sunday morning, moments after services had begun at Reformation Lutheran Church, Dr. Tiller, who was acting as an usher, was shot once with a handgun, the authorities said. The gunman pointed the weapon at two people who tried to stop him, the police said, then drove off in a powder-blue Taurus. Dr. Tiller's wife, Jeanne, a member of the church choir, was inside the sanctuary at the time of the shooting.

The police in Wichita described the man who was detained as a 51-year-old from Merriam, a Kansas City suburb, but declined to give his name until he was charged. The Associated Press reported that a sheriff's official from Johnson County, Kan., where the man was taken into custody, identified him as Scott Roeder.

The killing of Dr. Tiller is likely to return the issue of abortion to center stage in the nation's political debate. Until recently, President Obama, who supports abortion rights, had largely sought to avoid the debate. Last month, he confronted the issue in a commencement speech at the University of Notre Dame, an appearance that drew protests because of his views. During the speech, he appealed to each side to respect one another's basic decency and to work together to reduce the number of unwanted pregnancies.

Mr. Obama issued a statement after Dr. Tiller's killing, saying, However profound our differences as Americans over difficult issues such as abortion, they cannot be resolved by heinous acts of violence.

Advocates of abortion rights denounced the killing, saying it would send a renewed, frightening signal to others who provide abortions or work in clinics and to women who may consider abortions. Some described Dr. Tiller as one of about only three doctors in the country who had, under certain circumstances, provided abortions to women in their third trimester of pregnancy, and said his death would mean that women, particularly in the central United States, would have few if any options in such cases.

This is a tremendous loss on so many levels, said Peter B. Brownlie, president of Planned Parenthood of Kansas and Mid-Missouri, who had known Dr. Tiller for years.

Opponents of abortion, including those here who have been most vociferous in their protests of Dr. Tiller and his work, also expressed outrage at the shooting and said they feared that their groups might be wrongly judged by the act.

Troy Newman, the president of Operation Rescue, an anti-abortion group based in Wichita, said he had always sought out nonviolent measures to challenge Dr. Tiller, including efforts in recent years to have him prosecuted for crimes or investigated by state health authorities.

Operation Rescue has worked tirelessly on peaceful, nonviolent measures to bring him to justice through the legal system, the legislative system, Mr. Newman said, adding, We are pro-life, and this act was antithetical to what we believe.

By late Sunday, Mr. Newman said, some were already suggesting that there were links between the suspect and Operation Rescue. Someone named Scott Roeder had made posts to the group's blog in the past, Mr. Newman said, but he is not a friend, not a contributor, not a volunteer.

Dr. Tiller's death is the first such killing of an abortion provider in this country since 1998, when Dr. Barnett Slepian was shot by a sniper in his home in the Buffalo area. Dr. Tiller was the fourth doctor in the United States who performed abortions to be killed in such circumstances since 1993, statistics from abortion rights groups show.

Although most of the deadly violence occurred in the 1990s, advocates said, abortion clinics and doctors have continued to be the targets of intense, sometimes threatening protests. Some said they feared that Dr. Tiller's death might signal a return to the earlier level of violence. At some clinics on Sunday, administrators were reviewing their security precautions.

Adam Watkins, 20, one of the church members, told The A.P. he was seated in the middle of the congregation when he heard a small pop at the start of the service. An usher came in and told the congregation to remain seated, and then escorted Mrs. Tiller out. When she got to the back doors, we heard her scream, Mr. Watkins said.

Dr. Tiller had long been at the center of the abortion debate here, one that rarely seemed to quiet much in this southern Kansas city of about 358,000.

In 1993, Rachelle Shannon, from rural Oregon, shot Dr. Tiller in both arms. Two years earlier, during Operation Rescue's Summer of Mercy protests, thousands of anti-abortion protesters tried to block off the clinic, the site of a bombing in 1986.

Friends of Dr. Tiller also described regular incidents of vandalism at the clinic, and a barrage of threats to him and his family, threats they say had concerned him deeply for years.

Family members, including 4 children and 10 grandchildren, issued a statement through Dr. Tiller’s lawyer, which read in part: George dedicated his life to providing women with high-quality health care despite frequent threats and violence. We ask that he be remembered as a good husband, father and grandfather and a dedicated servant on behalf of the rights of women everywhere.

In recent years, Dr. Tiller had also been the focus of efforts by anti-abortion groups and others, including a former state attorney general, Phill Kline, who wished to see him prosecuted for what they considered violations of state law in cases of late-term abortions.

Two grand juries, summoned by citizen-led petition drives, looked into Dr. Tiller’s practices, including questions of whether he met a state law requirement that abortions at or after 22 weeks of pregnancy be limited to circumstances where a fetus would not be viable or a woman would otherwise face substantial and irreversible impairment of a major bodily function words whose interpretation were at the root of much debate.

This year, Dr. Tiller was acquitted in a case that raised questions about whether he was too closely tied to a doctor from whom he sought second opinions in abortion cases. As recently as this spring, the State Board of Healing Arts was investigating a similar complaint against him.

Joe Stumpe reported from Wichita, Kan., and Monica Davey from Chicago.