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WASHINGTON — The Supreme Court on Monday struck down parts of a restrictive Texas law that could have reduced the number of abortion clinics in the state to about 10 from what was once a high of roughly 40.

The 5-to-3 decision was the court’s most sweeping statement on abortion rights since Planned Parenthood v. Casey in 1992. It applied a skeptical and exacting version of that decision’s “undue burden” standard to find that the restrictions in Texas went too far.

The decision on Monday means that similar restrictions in other states are most likely also unconstitutional, and it imperils many other kinds of restrictions on abortion.

Justice Stephen G. Breyer wrote the majority opinion, joined by Justices Anthony M. Kennedy, Ruth Bader Ginsburg, Sonia Sotomayor and Elena Kagan. Chief Justice John G. Roberts Jr. and Justices Clarence Thomas and Samuel A. Alito Jr. dissented.

The decision concerned two parts of a Texas law that imposed strict requirements on abortion providers. It was passed by the Republican-dominated Texas Legislature and signed into law in July 2013 by Rick Perry, the governor at the time.

One part of the law requires all clinics in the state to meet the standards for ambulatory surgical centers, including regulations concerning buildings, equipment and staffing. The other requires doctors performing abortions to have admitting privileges at a nearby hospital.

“We conclude,” Justice Breyer wrote, “that neither of these provisions offers medical benefits sufficient to justify the burdens upon access that each imposes. Each places a substantial obstacle in the path of women seeking a previability abortion, each constitutes an undue burden on abortion access, and each violates the federal Constitution.”

Last June, the United States Court of Appeals for the Fifth Circuit, in New Orleans, largely upheld the contested provisions of the Texas law, saying it had to accept lawmakers’ assertions about the health benefits of abortion restrictions. The appeals court ruled that the law, with minor exceptions, did not place an undue burden on the right to abortion.

Justice Breyer said the appeals court’s approach was at odds with the proper application of the undue-burden standard. The Casey decision, he said, “requires that courts consider the burdens a law imposes on abortion access together with the benefits those laws confer.”

In dissent, Justice Thomas said the majority opinion “reimagines the undue-burden standard,” creating a “benefits-and-burdens balancing test.” He said courts should resolve conflicting positions by deferring to legislatures.

“Today’s opinion,” Justice Thomas wrote, “does resemble Casey in one respect: After disregarding significant aspects of the court’s prior jurisprudence, the majority applies the undue-burden standard in a way that will surely mystify lower courts for years to come.”

The majority opinion considered whether the claimed benefits of the restrictions outweighed the burdens they placed on a constitutional right. Justice Breyer wrote that there was no evidence that the admitting-privileges requirement “would have helped even one woman obtain better treatment.”

At the same time, he wrote, there was good evidence that the admitting-privileges requirement caused the number of abortion clinics in Texas to drop from 40 to 20.

In a second dissent, Justice Alito, joined by Chief Justice Roberts and Justice Thomas, said the causal link between the law and the closures was unproven. Withdrawal of state funds, a decline in the demand for abortions and doctors’ retirements may have played a role, Justice Alito wrote.

Justice Breyer wrote that the requirement that abortion clinics meet the demanding and elaborate standards for ambulatory surgical centers also did more harm than good.

“Abortions taking place in an abortion facility are safe — indeed, safer than numerous procedures that take place outside hospitals and to which Texas does not apply its surgical-center requirements,” he wrote, reviewing the evidence. “Nationwide, childbirth is 14 times more likely than abortion to result in death, but Texas law allows a midwife to oversee childbirth in the patient’s own home.”

In dissent, Justice Alito said there was good reason to think that the restrictions were meant to and did protect women. “The law was one of many enacted by states in the wake of the Kermit Gosnell scandal, in which a physician who ran an abortion clinic in Philadelphia was convicted for the first degree murder of three infants who were born alive and for the manslaughter of a patient,” Justice Alito wrote.

Justice Breyer acknowledged that “Gosnell’s behavior was terribly wrong.”

“But,” he added, “there is no reason to believe that an extra layer of regulation would have affected that behavior.”

The clinics challenging the law said it has already caused about half of the state’s 41 abortion clinics to close. If the contested provisions had taken full effect, they said, the number of clinics would again be cut in half.

The remaining Texas clinics would have been clustered in four metropolitan areas: Austin, Dallas-Fort Worth, Houston and San Antonio. “None is located west or south of San Antonio, a vast geographic area that is larger than California,” a brief for the clinics said. An appeals court did allow a partial exemption for a clinic in McAllen, the brief added, but “imposed limitations on the clinic’s operational capacity that would severely restrict its ability to provide abortions.”

Justice Breyer, announcing the majority opinion in the hushed Supreme Court chamber, said that the requirements in the Texas statute “are not consistent with the constitutional standard set forth in Casey,” and were, therefore, both unconstitutional.

Justice Alito responded with an extended dissent from the bench, a sign of deep disagreement. “We are supposed to be a neutral court of law,” he said, outlining what he conceded were “dry and technical” points of legal doctrine he argued should have precluded the petitioners from presenting the challenge in the first place. “There is no justification for treating abortion cases differently from other cases.”

Julie Hirschfeld Davis contributed reporting.

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Supreme Court Strikes Down Texas Abortion Restrictions,
NYT,
June 27, 2016,
https://www.nytimes.com/2016/06/28/
us/supreme-court-texas-abortion.html

Philadelphia Abortion Doctor

Guilty of Murder

in Late-Term Procedures

May 13, 2013

The New York Times

By JON HURDLE

and TRIP GABRIEL

PHILADELPHIA — A doctor who was responsible for cutting the spines of babies after botched abortions was convicted Monday of three counts of first-degree murder in a case that became a sharp rallying cry for anti-abortion activists.

The doctor, Kermit Gosnell, 72, operated a clinic in West Philadelphia catering to poor women that prosecutors called a “house of horrors.”

The case turned on whether the late-term pregnancies Dr. Gosnell terminated resulted in live births. His lawyer, Jack McMahon, argued that because Dr. Gosnell injected a drug in utero to stop the heart, the deliveries were stillbirths, and movements that witnesses testified to observing — a jerked arm, a cry, swimming motions — were mere spasms.

But after deliberating 10 days, the jury found Dr. Gosnell guilty in the deaths of victims known as Baby A, Baby C and Baby D. He was found not guilty of murdering Baby E.

Prosecutors have said they will seek the death penalty when the trial moves into the sentencing phase next Tuesday.

While abortion rights groups argued that Dr. Gosnell operated far outside the legalities and norms of women’s health care, abortion opponents seized on the case to raise questions about the ethics of late-term abortions. Put simply, they asked why a procedure done to a living baby outside the womb is murder, but destroying a fetus of similar gestation before delivery can be legal.

“What we need to learn from the Gosnell case is that late-term abortion is infanticide,” the Daily Beast columnist Kirsten Powers wrote last week, after starting an online furor earlier with a column suggesting that the news media had ignored the case for ideological reasons.

Abortion rights supporters said it was opponents who politicized the trial. What abortion opponents really sought from the trial, they said, was an acceleration of restrictions at the state level to effectively end legal abortion.

“Justice was served to Kermit Gosnell today and he will pay the price for the atrocities he committed,” Ilyse Hogue, president of Naral Pro-Choice America, said in a statement. “Anti-choice politicians, and their unrelenting efforts to deny women access to safe and legal abortion care, will only drive more women to back-alley butchers like Kermit Gosnell.”

In recent weeks, the case was cited in Congress to support restricting abortions past 20 weeks of pregnancy, and it was invoked by an anti-abortion political action committee in radio ads to attack the Democratic candidate for governor of Virginia, Terry McAuliffe.

Although the trial has not brought new issues or tactics to America’s long-running abortion wars, it provided an emotional jolt through five weeks of graphic testimony and an earlier grand jury report.

“This is a visual argument that no one would ever want to have,” said Marjorie Dannenfelser, president of the Susan B. Anthony List, which works to elect women opposed to abortion. “But if we’re going to have it, let’s go ahead and have it. What are the limits? What are we as a society willing to forbear?”

She and others predicted greater support for laws banning abortions past 20 weeks, which have been adopted in several states in recent years, on the disputed theory that fetuses of that age feel pain. Dr. Gosnell was found guilty of 24 counts of performing an abortion beyond 24 weeks, the limit in Pennsylvania.

Opponents of the restrictions argue that later abortions are very rare: fewer than 1.3 percent are past 20 weeks of gestation, according to the Centers for Disease Control and Prevention. Abortion rights activists say restrictions before fetal viability, generally 24 weeks, violate the constitutional protections of Roe v. Wade.

Nonetheless, “the imagery” of later abortion “is very powerful,” said Elizabeth Nash, state issues manager for the Guttmacher Institute, a research group that supports abortion access. “In 2010 Nebraska banned abortion at 20 weeks post-fertilization,” she said. “That bill was seen as the type of bill that was going to catch fire across the country. It did.”

Dr. Gosnell was also convicted of involuntary manslaughter in the death of a 41-year-old patient, Karnamaya Mongar, who died of an overdose of sedatives. Among lesser charges, he was found guilty of 211 counts of not waiting 24 hours after consulting with a patient before performing an abortion.

Activists on both sides debated whether the deplorable conditions at Dr. Gosnell’s clinic — including broken equipment, bloodstained recovery chairs and an untrained staff giving anesthesia and other drugs — could be found at other clinics.

Anti-abortion groups cited the case to press for more regulations of clinics. “By pulling back the secrecy that cloaks this industry that preys on women’s misery, we have a real agenda moving forward,” said Charmaine Yoest, the president of Americans United for Life, which pushes for stricter clinic rules.

But abortion rights groups attacked the regulations as a backdoor route to shut clinics by requiring costly but medically unneeded upgrades, like wider hallways and bigger closets.

“What’s going on with these laws is really about the agenda of having abortion eventually made illegal again,” said Nancy Northup, president of the Center for Reproductive Rights in Washington, which has challenged the laws in court. “And if that were to happen, unfortunately you’d have a lot more Gosnells out there.”

The scathing grand jury report in 2011 on Dr. Gosnell’s clinic, the Women’s Medical Society, on Lancaster Avenue, detailed how despite complaints and malpractice suits, no inspector had visited in 16 years. The clinic was raided only after a tip that it operated as an illegal prescription mill. A month after the report, Gov. Tom Corbett fired six employees of the Health and State departments.

In the witness box, clinic employees said live births occurred regularly, and they believed Dr. Gosnell’s explanation for snipping necks with surgical scissors — to “ensure fetal demise” — was accepted practice in late-term abortions. An abortion doctor who testified for the prosecution said such practice was unheard of.

One witness, Steven Massof, testifying under a plea agreement to avoid first-degree murder charges, instructed jurors to feel the backs of their own necks and said, “It’s like a beheading.”

Another former employee, Adrienne Moton, sobbed as she described the death of Baby A, aborted when his teenage mother was about 29 weeks pregnant. Ms. Moton was so upset she took a cellphone photograph of him, which was shown in court. She said Dr. Gosnell had joked that the baby was big enough to walk to a bus stop.

Ms. Moton, who also testified under a plea agreement, said she cut the neck of Baby D, who was delivered into a toilet while its mother, given a large dose of a drug to dilate the cervix, waited for Dr. Gosnell to arrive.

Another clinic worker said she followed Dr. Gosnell’s instructions and cut the neck of Baby C after it moved an arm. The doctor told her was an “involuntary movement.”

Dr. Gosnell was originally charged with seven counts of first-degree murder, but Judge Jeffrey P. Minehart of Common Pleas Court earlier threw out three other cases of infants said to have been born alive, known as Baby B, Baby F and Baby G.

Several weeks into the trial, which began March 18, anti-abortion activists and some conservative commentators accused the national news media of skipping it, a charge amplified across social media.

On April 15, President Obama’s spokesman was asked if he was following the trial. “The president is aware” of the case, said Jay Carney, the White House spokesman.

Even as reporters from national newspapers arrived in Courtroom 304 of the Criminal Justice Center, a blog war continued between abortion-rights supporters, who had written of Dr. Gosnell’s abuses from the time of his indictment, and conservatives, who continued to fault broadcast television for a “blackout.”

On Monday, there were 29 reporters in the courtroom and a row of television crews on the sidewalk.

Jon Hurdle reported from Philadelphia,

and Trip Gabriel from New York.

Philadelphia Abortion Doctor Guilty of Murder in Late-Term Procedures,
NYT,
13.5.2013,
http://www.nytimes.com/2013/05/14/us/
kermit-gosnell-abortion-doctor-found-guilty-of-murder.html

Both Sides Rest in Trial

of a Philadelphia Abortion Doctor

Charged With Murder

April 29, 2013

The New York Times

By TRIP GABRIEL

PHILADELPHIA — They are known as Baby Boy A, Baby C, Baby D and Baby E, all of whom prosecutors call murdered children and the defense calls aborted fetuses — the very difference in language encapsulating why anti-abortion advocates are so passionate about drawing attention to the trial of Dr. Kermit Gosnell, which wrapped up here on Monday with summations by both sides.

In five weeks of testimony, jurors were told that Dr. Gosnell, 72, had performed late-term abortions by injecting a drug to stop the heart of the fetus, but that when one jerked an arm, cried or drew breath outside the womb, its spinal cord was cut with surgical scissors.

To anti-abortion leaders, the accounts have the power to break through decades of hardened positions in the abortion wars, not just because of the graphic details but because they raise the philosophical issue of why an abortion procedure performed in utero is legal, but a similar act a few minutes later, outside the womb, is considered homicide.

The distinction “is maybe a 15-minute or half-hour time frame and 10 inches of physical space,” said Michael Geer, the president of the Pennsylvania Family Institute, an anti-abortion group. “I think it’s going to resurrect a debate about the humanity of the unborn child.”

Abortion rights groups have a very different view. They say that Dr. Gosnell was a rogue practitioner, and that if abortion is further restricted, more women will be driven to clinics like his, which prosecutors called a “house of horrors.”

Jay Sekulow, the chief counsel of the American Center for Law and Justice, a conservative legal organization in Washington, said, “This case in the end is going to be viewed as monumental, no matter what the verdict is.”

Last week, Judge Jeffrey P. Minehart of the Court of Common Pleas threw out three of seven first-degree murder charges against Dr. Gosnell. The doctor’s defense lawyer, Jack J. McMahon, argued Monday that none of the remaining four cases had resulted in live births.

Because the women were given injections of the drug digoxin, which causes “fetal demise,” Mr. McMahon argued, any postdelivery movements were involuntary spasms.

“Every single piece of scientific evidence in this case has shown stillbirth,” he said.

But Edward Cameron, an assistant district attorney, countered that testimony showed Dr. Gosnell did not always use digoxin and that it did not always work as intended. He quoted a former clinic worker with medical school training but no doctor’s license who testified that the drug “wasn’t giving the desired effect, the heart was always beating.”

The prosecutor cited Pennsylvania law stating that if a baby delivered during an abortion “shows any sign of life, it’s considered alive — a heartbeat, breathing, a cry, movement.”

The jury will now make that determination in the cases, including that of Baby Boy A, whom clinic workers testified Dr. Gosnell joked was big enough “to walk me home.”

Baby D, a clinic worker testified, was delivered into a toilet by a woman waiting for Dr. Gosnell and it appeared to make swimming motions before one of the doctor’s assistants pulled it out and cut its neck.

Two workers said they heard Baby E crying before Dr. Gosnell cut its spine with scissors. The prosecutor quoted a worker: “It made noises, a whine like my baby.”

Mr. McMahon also cited the trial testimony, in which the clinic worker acknowledged she did not know for sure if Baby E was born alive. Eight workers from the clinic, the Women’s Medical Society in West Philadelphia, have pleaded guilty to lesser charges in the case, including Dr. Gosnell’s wife, Pearl, a cosmetologist who helped perform abortions.

If convicted, Dr. Gosnell could face the death penalty.

The case became a cause célèbre when anti-abortion activists complained that the mainstream news media were ignoring it for ideological reasons. It has since been widely covered, and every seat in the courtroom was taken on Monday.

Anti-abortion campaigners have seized on the trial because it highlights late-term abortions performed after fetal viability. The same public opinion polls that for decades have shown that a majority of Americans support abortion also show that most of them want it banned in certain cases.

Abortion opponents have leveraged these mixed feelings in recent years to lobby at the state level to restrict the procedure. Nine states have banned most abortions beyond 20 weeks of pregnancy. Last month, two states went further: Arkansas banned abortion after 12 weeks and North Dakota beyond about 6 weeks, when a fetal heartbeat is “detectable.” Abortion rights groups said both limits would be found unconstitutional in federal court.

Though late-term abortions are central to the Gosnell case, they are extremely rare. According to the Centers for Disease Control and Prevention, 92 percent of abortions are performed before 14 weeks, with 1.3 percent beyond 20 weeks.

“No woman carries their child to six, seven, eight months and then one day decides they don’t want to become a parent,” said Ilyse Hogue, the president of Naral Pro-Choice America. “These are terrible, tragic situations where families have to make difficult choices with their doctors. I think most Americans believe that’s where they belong.”

To abortion rights groups, if abortion is further restricted, desperate women will be forced to seek providers like Dr. Gosnell, who is also accused of performing 24 abortions beyond 24 weeks of pregnancy, the limit in Pennsylvania.

“Restrictions really work to hinder access to safe abortion,” said Dayle Steinberg, the president of Planned Parenthood Southeastern Pennsylvania. “It only increases the number of economically disadvantaged women who find themselves in extreme circumstances and they turn to unsafe options for care.”

Dr. Gosnell is also accused of third-degree murder in the death of a 41-year-old patient from Virginia, who visited his clinic after being turned away by three clinics closer to her home, according to testimony by a daughter of the woman.

Mr. McMahon said Dr. Gosnell’s staff members who pleaded guilty did so out of fear of the district attorney’s office, which he accused of creating “a tsunami of hype” in a grand jury report and in the news media about Dr. Gosnell’s practices. To counter that, he showed slides of a waiting room, hallway and procedure rooms at the defunct clinic that looked scrubbed and clean.

The prosecution, for its turn, rolled in a filthy procedure table and broken equipment removed from the clinic. Mr. Cameron, the assistant district attorney, brandished a stained ultrasound probe with unconcealed disgust.

The jury was expected to begin deliberations on Tuesday.

Both Sides Rest
in Trial of a Philadelphia Abortion Doctor Charged With Murder,
NYT, 29.4.2013,
https://www.nytimes.com/2013/04/30/
us/trial-abortion-doctor-kermit-gosnell.html

If Roe v. Wade Goes

October 15, 2012

The New York Times

It is no secret that Mitt Romney and his running-mate, Representative Paul Ryan, are opponents of abortion rights. When Mr. Ryan was asked at last week’s debate whether voters who support abortion rights should be worried if the Romney-Ryan ticket were elected, he essentially said yes.

They would depart slightly from the extremist Republican Party platform by allowing narrow exceptions for rape, incest or the life of the woman. Beyond that, they would move to take away a fundamental right that American women have had for nearly 40 years.

Mr. Romney has called for overturning Roe v. Wade, the 1973 Supreme Court ruling that recognized a woman’s constitutional right to make her own childbearing decisions and to legalized abortion nationwide. He has said that the issue should be thrown back to state legislatures. The actual impact of that radical rights rollback is worth considering.

It would not take much to overturn the Roe decision. With four of the nine members of the Supreme Court over 70 years old, the next occupant of the White House could have the opportunity to appoint one or more new justices. If say, Justice Ruth Bader Ginsburg, the oldest member, retired and Mr. Romney named a replacement hostile to abortion rights, the basic right to abortion might well not survive.

The result would turn back the clock to the days before Roe v. Wade when abortion was legal only in some states, but not in others. There is every indication that about half the states would make abortion illegal within a year of Roe being struck down, according to the Guttmacher Institute. The Center for Reproductive Rights, which challenges abortion restrictions around the country, puts the number at 30 states. For one thing, abortion bans already on the books in some states would suddenly kick in. And some Republican-controlled state legislatures would outlaw abortion immediately.

Even with Roe and subsequent decisions upholding abortion rights, more than half the states have enacted barriers like mandatory waiting periods, “counseling” sessions lacking a real medical justification; parental consent or notification laws; and onerous clinic “safety” rules intended to drive clinics out of business.

Mr. Romney is a vocal supporter of this continuing drive in the states and in Congress to limit the constitutional right, even without overturning Roe. To a large degree, the anti-abortion forces have succeeded. In 1982, there were about 2,900 providers nationwide; as of 2008, there were less than 1,800. In 97 percent of the counties that are outside of metropolitan areas, there are no abortion providers at all.

We do not need to guess about the brutal consequences of overturning Roe. We know from our own country’s pre-Roe history and from the experience around the world. Women desperate to end a pregnancy would find a way to do so. Well-to-do women living in places where abortion is illegal would travel to other states where it is legal to obtain the procedure. Women lacking the resources would either be forced by the government and politicians to go through with an unwanted or risky pregnancy, attempt to self-abort or turn to an illegal — and potentially unsafe — provider for help. Women’s health, privacy and equality would suffer. Some women would die.

Mr. Romney knows this, or at least he used to. Running for the United States Senate in Massachusetts in 1994 against Edward Kennedy, Mr. Romney spoke of a young woman, a close relative, who died years before as result of complications from an illegal abortion to underscore his now-extinct support for Roe v. Wade. In a report in Salon last year, Justin Elliott, a reporter for ProPublica, found that when the young woman passed away, her parents requested that donations be made in her honor to Planned Parenthood. That’s the same invaluable family-planning group that Mr. Romney has pledged to defund once in the White House.

If Roe v. Wade Goes, NYT, 15.10.2012,
http://www.nytimes.com/2012/10/16/opinion/if-roe-v-wade-goes.html

Women’s Health Care at Risk

February 28, 2012
The New York Times

A wave of mergers between Roman Catholic and secular hospitals is threatening to deprive women in many areas of the country of ready access to important reproductive services. Catholic hospitals that merge or form partnerships with secular hospitals often try to impose religious restrictions against abortions, contraception and sterilization on the whole system.

This can put an unacceptable burden on women, especially low-income women and those who live in smaller communities where there are fewer health care options. State regulators should closely examine such mergers and use whatever powers they have to block those that diminish women’s access to medical care.

Gov. Steve Beshear of Kentucky, for example, recently turned down a bid by a Catholic health system to merge with a public hospital that is the chief provider of indigent care in Louisville. He cited concerns about loss of control of a public asset and restrictions on reproductive services.

The nation’s 600 Catholic hospitals are an important part of the health care system. They treat one-sixth of all hospital patients, and are sometimes the only hospital in a small community. They receive most of their operating income from public insurance programs like Medicare and Medicaid and from private insurers, not from the Catholic Church. They are free to deliver care in accord with their religious principles, but states and communities have an obligation to make sure that reproductive care remains available. This should be a central goal for government officials who have a role in approving such consolidations.

As Reed Abelson wrote in a recent report in The Times, these mergers are driven by shifts in health care economics. Some secular hospitals are struggling to survive and eager to be rescued by financially stronger institutions, which in many cases may be Catholic-affiliated. By one estimate, 20 mergers between Catholic and non-Catholic hospitals have been announced over the past three years and more can be expected.

The 2009 “Ethical and Religious Directives” issued by the United States Conference of Catholic Bishops warns that Catholic institutions should avoid entering into partnerships “that would involve them in cooperation with the wrongdoing of other providers.” Catholic hospitals have refused to terminate pregnancies, provide contraceptive services, offer a standard treatment for ectopic pregnancies, or allow sterilization after caesarean sections (women seeking tubal ligations are then forced to have a second operation elsewhere, exposing them to additional risks).

In one case, the sole hospital in a rural area in southeastern Arizona announced in 2010 that it would partner with an out-of-state Catholic health system, and would immediately adhere to Catholic directives that forbid certain reproductive health services. As a result, a woman whose doctors wanted to terminate a pregnancy to save her life had to be sent 80 miles away for treatment. A coalition of residents, physicians and activists campaigned against the merger and it was called off before it was finalized.

Over the past 15 years, MergerWatch, an advocacy group based in New York City, has helped block or reverse 37 mergers and reached compromises in 22 others that saved at least some reproductive services. As mergers become more common, state and local leaders would be wise to block proposals that restrict health services.

Women’s Health Care at Risk, NYT, 28.2.2012,
http://www.nytimes.com/2012/02/29/opinion/womens-health-care-at-risk.html

Virginia Lawmakers

Backtrack on Conception Bill

February 23, 2012
The New York Times
By SABRINA TAVERNISE

Republican lawmakers in Virginia changed course on another piece of conservative legislation on Thursday, with the State Senate voting to suspend consideration of a bill that would define life as beginning at conception.

It was an abrupt reversal for Republicans, and came hours after a Senate committee voted to approve the legislation for consideration by the full body. There was broad speculation that Gov. Bob McDonnell was behind the move.

“This is a major disgrace for the Republican leadership,” said Don Blake, who runs the Virginia Christian Alliance, a conservative group that backed the bill. Republicans should have had the votes to pass the bill, he said, and the fact that they opted to suspend it raised suspicions of the governor’s involvement.

“Pro-life groups are concerned that the governor had a hand in this,” Mr. Blake said. A spokesman for Mr. McDonnell, a Republican who is mentioned as a possible candidate for vice president, did not respond to messages seeking comment.

The rapid-fire procedural maneuvering came one day after Mr. McDonnell ordered Republicans in the House of Delegates to soften a bill requiring a vaginal ultrasound before an abortion. The new version, which requires a noninvasive abdominal ultrasound, appeared aimed at defusing a mounting controversy over the bill that included spoofs on television shows.

The stalling of the legislation on Thursday also illustrated the divisions among Republicans over the bill. Opponents say it would confer legal status from the moment of conception and, in the process, cause huge legal uncertainties and lead to the banning of abortion. It would quickly be challenged in court, they say.

The eight members of the party on the Education and Health Committee approved the bill on a party-line vote in the morning, only to have it sent back several hours later with orders that it not be considered again this legislative season, scheduled to end in two weeks.

The measure, known as the personhood bill, could be revived in the next session, which opens early next year — timing that critics of the bill point out falls safely outside the electoral cycle.

“This takes it off the late-night shows,” said one Democratic aide who asked not to be identified by name because she was not authorized to speak publicly on the matter.

Delegate Bob Marshall, the bill’s sponsor, said he had approached the governor about the bill once at a reception, but did not get a positive response. Still, he had fresh hopes for it, after it passed the committee Thursday. “This could not have happened without the consent of the leadership,” he said.

State Senator Richard L. Saslaw, a Democrat who made the motion to shelve the legislation, said that he did not know whether Mr. McDonnell had intervened, but that the bill was far enough to the right that the governor would probably not have relished the prospect of signing it.

“I’m shocked that it got out of the House,” he said. “The people of Mississippi had the good sense to vote that thing down. What does that say?”

    Virginia Lawmakers Backtrack on Conception Bill, NYT, 23.2.2012,
    http://www.nytimes.com/2012/02/24/us/
    virginia-lawmakers-backtrack-on-conception-bill.html

The ‘Safe, Legal, Rare’ Illusion

February 18, 2012
The New York Times
By ROSS DOUTHAT

AMID the sound and fury of the latest culture-war battles — first over breast cancer dollars and Planned Parenthood, and then over the White House’s attempt to require that religious employers cover contraception and potential abortifacients — it’s easy to forget that there is at least some common ground in American politics on sex, pregnancy, marriage and abortion.

Even the most pro-choice politicians, for instance, usually emphasize that they want to reduce the need for abortion, and make the practice rare as well as safe and legal. Even the fiercest conservative critics of the White House’s contraception mandate — yes, Rick Santorum included — agree that artificial birth control should be legal and available. And both Democrats and Republicans generally agree that the country would be better off with fewer pregnant teenagers, fewer unwanted children, fewer absent fathers, fewer out-of-wedlock births.

Where cultural liberals and social conservatives differ is on the means that will achieve these ends. The liberal vision tends to emphasize access to contraception as the surest path to stable families, wanted children and low abortion rates. The more direct control that women have over when and whether sex makes babies, liberals argue, the less likely they’ll be to get pregnant at the wrong time and with the wrong partner — and the less likely they’ll be to even consider having an abortion. (Slate’s Will Saletan has memorably termed this “the pro-life case for Planned Parenthood.”)

The conservative narrative, by contrast, argues that it’s more important to promote chastity, monogamy and fidelity than to worry about whether there’s a prophylactic in every bedroom drawer or bathroom cabinet. To the extent that contraceptive use has a significant role in the conservative vision (and obviously there’s some Catholic-Protestant disagreement), it’s in the context of already stable, already committed relationships. Monogamy, not chemicals or latex, is the main line of defense against unwanted pregnancies.

The problem with the conservative story is that it doesn’t map particularly well onto contemporary mores and life patterns. A successful chastity-centric culture seems to depend on a level of social cohesion, religious intensity and shared values that exists only in small pockets of the country. Mormon Utah, for instance, largely lives up to the conservative ideal, with some of America’s lowest rates of teenage pregnancies, out-of-wedlock births and abortions. But many other socially conservative regions (particularly in the South) feature higher rates of unwed and teenage parenthood than in the country as a whole.

Liberals love to cite these numbers as proof that social conservatism is a flop. But the liberal narrative has glaring problems as well. To begin with, a lack of contraceptive access simply doesn’t seem to be a significant factor in unplanned pregnancy in the United States. When the Alan Guttmacher Institute surveyed more than 10,000 women who had procured abortions in 2000 and 2001, it found that only 12 percent cited problems obtaining birth control as a reason for their pregnancies. A recent Centers for Disease Control and Prevention study of teenage mothers found similar results: Only 13 percent of the teens reported having had trouble getting contraception.

At the same time, if liberal social policies really led inexorably to fewer unplanned pregnancies and thus fewer abortions, you would expect “blue” regions of the country to have lower teen pregnancy rates and fewer abortions per capita than demographically similar “red” regions.

But that isn’t what the data show. Instead, abortion rates are frequently higher in more liberal states, where access is often largely unrestricted, than in more conservative states, which are more likely to have parental consent laws, waiting periods, and so on. “Safe, legal and rare” is a nice slogan, but liberal policies don’t always seem to deliver the “rare” part.

What’s more, another Guttmacher Institute study suggests that liberal states don’t necessarily do better than conservative ones at preventing teenagers from getting pregnant in the first place. Instead, the lower teenage birth rates in many blue states are mostly just a consequence of (again) their higher abortion rates. Liberal California, for instance, has a higher teen pregnancy rate than socially conservative Alabama; the Californian teenage birth rate is only lower because the Californian abortion rate is more than twice as high.

These are realities liberals should keep in mind when tempted to rail against conservatives for rejecting the intuitive-seeming promise of “more condoms, fewer abortions.” What’s intuitive isn’t always true, and if social conservatives haven’t figured out how to make all good things go together in post-sexual-revolution America, neither have social liberals.

At the very least, American conservatives are hardly crazy to reject a model for sex, marriage and family that seems to depend heavily on higher-than-average abortion rates. They’ve seen that future in places like liberal, cosmopolitan New York, where two in five pregnancies end in abortion. And it isn’t a pretty sight.

    The ‘Safe, Legal, Rare’ Illusion, NYT, 18.2.2012,
    http://www.nytimes.com/2012/02/19/opinion/sunday/
    douthat-the-safe-legal-rare-illusion.html

Mississippi Voters

Reject Anti-Abortion Measure

November 8, 2011
The New York Times
By KATHARINE Q. SEELYE

Voters turned a skeptical eye toward conservative-backed measures across the country Tuesday, rejecting an anti-labor law in Ohio, an anti-abortion measure in Mississippi and a crackdown on voting rights in Maine.

Even in Arizona, voters were close to turning out of office the chief architect of that state’s controversial anti-immigration law. State Senator Russell Pearce, a Republican power broker and a former sheriff’s deputy known for his uncompromising style, came close to conceding the race Tuesday with a look of shock on his face.

“If being recalled is the price for keeping one’s promises, then so be it,” he said. His opponent had declared victory. Mr. Pearce, the president of the Senate, was a hero to the Tea Party movement, and apart from his anti-immigration efforts, he had introduced numerous bills to nullify federal laws.

Taken together, Tuesday’s results could breathe new life into President Obama’s hopes for his re-election a year from now. But the day was not a wholesale victory for Democrats. Even as voters in Ohio delivered a blow to Gov. John R. Kasich, a Republican, and rejected his attempt to weaken collective bargaining for public employees, they approved a symbolic measure to exempt Ohio residents from the individual mandate required in Mr. Obama’s health care law.

And while voters in Mississippi, one of the most conservative states, turned away a measure that would have outlawed all abortions and many forms of contraception and had drawn conservative support from members of both parties, they tightened their voting laws to require some from of government-approved identification. Democrats had opposed the requirement, saying it was a thinly disguised attempt to intimidate voters of color.

In Maine, where Republicans recently had ended same-day registration at polling places, voters decided to restore the practice, which Democrats support.

Despite the anger at Washington, voters did not appear to be in a throw-the-bums-out frame of mind at the city and state levels. In Philadelphia, Mayor Michael Nutter, a Democrat, won re-election, as did Mayor Greg Ballard, a Republican, in Indianapolis and Mayor Stephanie Rawlings-Blake, a Democrat, in Baltimore. In Phoenix, Greg Stanton, a Democrat, was the winner while in San Francisco, Edwin M. Lee, the interim mayor, seemed poised to become that city’s first mayor of Chinese descent.

Steve Beshear, the Democratic governor of Kentucky, was re-elected. In Mississippi, Phil Bryant will succeed Gov. Haley Barbour, a fellow Republican, who was prevented by term limits from running for reelection.

And in something of a surprise, an attempt by Republicans in Virginia to take over the state Senate — and thereby take complete control of the state government — appeared stalled. In one district, the final vote showed the Republican candidate with an edge of fewer than 100 votes, putting the party within striking distance of a 20-20 tie with Democrats in the Senate. When the Senate is deadlocked, the lieutenant governor — a Republican — casts the tie-breaking vote.

But in Iowa, Republicans failed in their attempt to win control of the State Senate. Had they won a special election there, they would have likely been able to pass numerous measures, including a ban on same-sex marriage, that had been blocked by Democrats.

In one of the biggest surprises of the night was Mississippi’s rejection of a far-reaching and stringent anti-abortion initiative known as the “personhood” amendment, which had inspired a ferocious national debate.

Initiative 26 would have amended the state Constitution to define life “to include every human being from the moment of fertilization, cloning or the functional equivalent thereof.”

Supporters, including evangelical Christians, said it would have stopped the murder of innocent life and sent a clarion moral call to the world. They said they expected that passage in Mississippi would have built support for similar laws in other states.

Opponents, led by Planned Parenthood and the American Civil Liberties Union, said the proposal would have outlawed all abortions, including in cases of rape and incest and when the mother’s life was in danger; would have barred morning-after pills and certain contraception such as IUD’s; and could have limited in vitro fertility procedures.

“The message from Mississippi is clear,” Nancy Keenan, president of NARAL Pro-Choice America, said in a statement. “An amendment that allows politicians to further interfere in our personal, private medical decisions, including a woman’s right to choose safe, legal abortion, is unacceptable.”

The push for a personhood amendment split the country’s anti-abortion movement. Traditional leaders including the Roman Catholic bishops and National Right to Life opposed it on strategic grounds, fearing it would lead to a United States Supreme Court defeat and set back to their efforts to chip away at abortion rights.

Governor Barbour is a strong opponent of abortion rights but expressed skepticism about the amendment’s wording

“It’s unnecessarily ambiguous,” he told MSNBC on Tuesday. He also criticized the strategy of sending it to voters rather than to the Legislature — a blunder he attributed to people in Colorado, who wrote the measure — and said it would not be a good test case with which to try to overturn Roe v. Wade, the 1973 Supreme Court decision that legalized abortion. Nonetheless, Mr. Barbour said, he had supported the measure because he believes that life begins at conception.

Theo Emery, Erik Eckholm and Kirk Johnson

contributed reporting.

This article has been revised

to reflect the following correction:

Correction: November 9, 2011

An earlier version of this article mistakenly said

there were governor’s races in Louisiana

and West Virginia;

there were not.

    Mississippi Voters Reject Anti-Abortion Measure, NYT, 8.11.2011,
    http://www.nytimes.com/2011/11/09/us/politics/
    votes-across-the-nation-could-serve-as-a-political-barometer.html

The Courts Step In

July 13, 2011
The New York Times

In three new rulings, federal judges in different states have acted to block immediate enforcement of measures that restrict abortion rights and women’s access to affordable contraception, lifesaving cancer screenings and treatment for sexually transmitted diseases. These rulings are important victories for women’s health and reproductive rights.

On June 24, Judge Tanya Pratt of the Federal District Court in Indianapolis issued a preliminary injunction blocking enforcement of a new Indiana law banning the use of Medicaid funds at Planned Parenthood clinics, which provide essential health services to low-income women. The mean-spirited law is part of a Republican-led national campaign to end public financing for Planned Parenthood. The Obama administration promptly told Indiana, and other states weighing similar legislation, that the measure violated federal law by imposing impermissible restrictions on the freedom of Medicaid beneficiaries to choose health care providers. Judge Pratt agreed with that assessment in her decision.

In another ruling six days later, a federal trial judge in South Dakota issued a preliminary injunction blocking, on constitutional grounds, a deeply intrusive state law requiring women to wait at least 72 hours after an initial doctor’s visit before terminating a pregnancy — the longest waiting period in the nation. This law also requires that women seeking abortions endure counseling at so-called pregnancy help centers run by antiabortion activists with the aim of discouraging abortions.

“Forcing a woman to divulge to a stranger at a pregnancy help center the fact that she has chosen to undergo an abortion humiliates and degrades her as a human being,” Judge Karen Schreier wrote in her decision.

On July 1, Judge Carlos Murguia, a federal district judge in Kansas, blocked immediate enforcement of a new Kansas licensing law and health department regulations imposing extensive, medically unnecessary requirements on the state’s three remaining abortion providers — like mandating 50 square feet of storage space for janitorial supplies — with the obvious goal of shutting them down.

While these rulings are preliminary, each is a determination that enforcing the law would cause irreparable harm and that the plaintiffs are likely to prevail at trial. They do not, however, address other threats to women’s health. Those include the slashing of state support for family-planning services by governors like Chris Christie of New Jersey, and attacks from Congress like the bill Republicans pushed through the House in May that would use the nation’s tax system as a weapon to end abortion insurance coverage in the private market.

Still, these rulings serve as a reminder that courts have a vital role to play in blocking the extreme anti-abortion, anti-family-planning movement accelerating in the states and in Washington.

The Courts Step In, R, 13.7.2011,
http://www.nytimes.com/2011/07/14/opinion/14thurs1.html

Late Clash on Abortion

Shows Conservatives’ Sway

April 8, 2011
The New York Times
By JENNIFER STEINHAUER

WASHINGTON — The emergence of abortion as the last and most contentious of the issues that held up the budget deal reached Friday night highlighted the enduring influence of social conservatives within the Republican Party even at a time when the Tea Party movement’s focus on fiscal austerity is getting most of the attention.

The main abortion-related provisions sought by Republicans were stripped out, apparently in return for deeper cuts in federal spending. But the intense push by abortion opponents, including Representatives Christopher H. Smith of New Jersey, Joe Pitts of Pennsylvania and Mike Pence of Indiana, sent a signal that Republicans intend to keep social issues on the front burner as Congress moves on to a further series of battles.

The abortion opponents lost on their effort to restrict money going to Planned Parenthood and other abortion providers as part of the budget deal. But they succeeded in winning agreement for a separate vote on that issue next week — Senate Democrats are sure to defeat it — and in keeping in the budget deal a provision that would restrict abortion financing in Washington.

The social conservatives established that they have a welcome ear in Speaker John A. Boehner of Ohio, who has won awards from opponents of abortion rights and during the debate over health care of provisions was a visible supporter of preventing federal money from going to abortion providers like Planned Parenthood. (Federal law already prohibits the use of federal dollars for abortions..)

The main restrictions Republicans had sought were included in the first spending bill passed by the House, in February. They had the backing, with varying degrees of intensity, not just of Republicans identified primarily as social conservatives but also of many fiscal conservatives. While the party ultimately chose not to close down the government over its position on abortion, social conservatives were heard more clearly on the issue than they have been since the November election focused Washington on cutting spending.

“The life issue is important to a lot of us,” said Representative Steve Chabot of Ohio, who has been very involved in anti-abortion measures in the past. “For some, people, for example, abortion is more important. For some people, spending is more important. For me, it would be hard to say one over the other.”

Republicans had sought to take away federal money for family planning for poor women and give that money instead to states, to forbid the District of Columbia from using its tax dollars to help the poor obtain abortions, and to end family planning subsidies to some international groups.

In one sense, the flashpoint nature of the battle presented both parties with an opportunity to energize their bases.

Senator Harry Reid of Nevada, the Democratic majority leader, stressed repeatedly on Friday that his party was committed to defending abortion rights, and he characterized the fight as one over women’s health. Equally, House Republicans portrayed themselves as determined to stand by their principles.

But the high-profile fight held political peril for Republicans in particular when it comes to appealing to women and the broad center of American politics.

In polls taken this year and last by The New York Times/CBS News, when Americans were asked to name the most important problem facing the country, fewer than 1 percent cited abortion. In December, when respondents were asked how available abortions should be to those who seek them, 36 percent said generally available, 40 percent said available with limits, and 20 percent said abortions should not be permitted.

The risks were not lost on Republicans like Senator Susan Collins of Maine, who favors abortion rights. “Senator Collins does not believe this rider belongs on this bill,” said a spokesman, Kevin Kelley, in an e-mail before the deal was announced. “She believes it is the height of irresponsibility for Congress to jeopardize pay for our dedicated troops, who are serving in harm’s way in three wars, because of a policy debate that can occur later this year.”

Other Republicans, including Senator Tom Coburn of Oklahoma, also urged the party not to sacrifice the budget deal to make a point on the abortion issue.

Few Republicans wanted to be seen as shutting down the government over the issue, which may be why House freshmen insisted that the issue was irrelevant to the budget battle, even as aides to lawmakers negotiated them down to the wire.

“This is not about policy riders,” said Representative Raúl R. Labrador of Idaho, echoing almost word for word seven other House Republicans and Mr. Boehner as well. “It’s about spending.”

America has seen this play before. Over the nearly four decades since the Supreme Court affirmed women’s abortion rights, Congress has worked to chip away at them, often through measures like those on the table in the final stages of the budget battle. Those efforts have largely been led by Republicans, but not exclusively; it was Democrats who favored restrictions on abortion who came close to unraveling the 2009 health care overhaul.

While the 87 freshmen Republicans in the House ran on a platform of containing federal spending, and while some Republicans, like Gov. Mitch Daniels of Indiana, have suggested de-emphasizing social issues until the nation’s fiscal problems can be addressed, the desire among social conservatives to curb abortion rights has never gone away.

While few of the measures Republicans sought would cut spending — in the case of funds used by Planned Parenthood, it would simply move them — Republicans repeatedly said supporting family planning groups was a waste of taxpayer funds.

“This has been an ongoing struggle for decades,” said Norman J. Ornstein, a resident scholar at the American Enterprise Institute, a conservative research group. “But in this particular context, there is a different twist. It is one thing to be deeply opposed to a policy and look at every vehicle you can for changing it. It’s another when you frame the entire narrative around the debt crisis we face.”

Using the amendment process to pull away at abortion rights has a history that dates back almost as far as Roe v. Wade, which was decided in 1973. In 1976, the House passed the Hyde Amendment, which excludes abortion from health care services provided through Medicaid.

The amendment has been tacked on to annual appropriations bills ever since. Under the Balanced Budget Act of 1997, health maintenance organizations gained the right to refuse to cover counseling or referrals for abortion on moral or religious grounds. The law restricting the use of District of Columbia funds for abortions, known as the Dornan Amendment, was first introduced in 1988.

In the final hour, another social policy amendment of sorts, one that would finance a school voucher program in the District of Columbia near and dear to Mr. Boehner, went into the bill.

Late Clash on Abortion Shows Conservatives’ Sway, R, 8.4.2011,
http://www.nytimes.com/2011/04/09/us/politics/09rider.html

A Bush Rule

on Providers of Abortions

Is Revised

February 18, 2011
The New York Times
By ROBERT PEAR

WASHINGTON — The Obama administration on Friday rescinded most of a 2008 rule that granted sweeping protections to health care providers who opposed abortion, sterilization and other medical procedures on religious or moral grounds.

Kathleen Sebelius, the secretary of health and human services, said the rule, issued in the last days of the Bush administration, could “negatively impact patient access to contraception and certain other medical services.”

Federal laws make clear that health care providers cannot be compelled to perform or assist in an abortion, Ms. Sebelius said. The Bush rule went far beyond these laws and upset the balance between patients’ rights to obtain health care and “the conscience rights of health care providers,” she added.

The Obama administration retained and updated part of the 2008 rule that established procedures to investigate complaints from health care workers who believe they have been subjected to discrimination or coercion because of their “religious beliefs or moral convictions.”

Although the Bush rule is still on the books, the Obama administration has not enforced it. Eight states and several organizations filed a lawsuit in Federal District Court in Connecticut challenging the 2008 rule as vague and overly broad. The court suspended proceedings in the case, pending issuance of the rule published Friday.

The Roman Catholic Church and some Republicans, like Representative Joe Pitts of Pennsylvania, criticized the Obama administration’s decision to revoke the Bush rule. But advocates for abortion rights welcomed it.

“The administration’s action today is cause for disappointment,” said Deirdre A. McQuade, a spokeswoman for the Pro-Life Secretariat at the United States Conference of Catholic Bishops.

Senator Richard Blumenthal, Democrat of Connecticut, said: “I applaud the Obama administration for ensuring that women will have access to the information and services they need while still protecting the conscience rights of health care providers. The Bush rule clearly went too far and threatened the health and well-being of millions of patients.”

The 2008 rule provoked a torrent of criticism from doctors, pharmacists, hospitals and state officials. Pharmacies said the rule would allow their employees to refuse to fill prescriptions for contraceptives. State officials said the rule could void state laws that require insurance plans to cover contraceptives and require hospitals to offer emergency contraception to rape victims.

Clare M. Coleman, president of the National Family Planning and Reproductive Health Association, which represents hundreds of family planning clinics, said President Obama was rescinding “the most harmful elements” of the Bush rule.

The Obama administration said the 2008 rule might have mistakenly suggested that health care providers could refuse to treat entire groups of people on account of the providers’ religious or moral beliefs.

Federal laws provide no protection for such refusals, the administration said.

The bishops conference and the Catholic Health Association, representing Catholic hospitals, had supported the Bush rule as a way to protect health care providers against pressure to perform abortions.

Sister Carol Keehan, president of the Catholic Health Association, said that in recent years “we have seen a variety of efforts to force Catholic and other health care providers to perform or refer for abortions and sterilizations.”

In response to such concerns, the Obama administration said, “Roman Catholic hospitals will have the same statutory protections afforded to them for decades” because the laws were not affected by the cancellation of the Bush rule.

A Bush Rule on Providers of Abortions Is Revised, NYT, 18.2.2011,
http://www.nytimes.com/2011/02/19/health/policy/19health.html

City’s High Abortion Rate

Defies Easy Explanation

February 3, 2011
The New York Times
By ANEMONA HARTOCOLLIS

At a time when evidence suggests that people in New York City are smoking less, eating better and biking more, one health statistic that has not budged is the abortion rate.

Two of every five pregnancies in the city end in abortion, a statistic that has barely changed in more than a decade. At a news conference last month, Timothy M. Dolan, the Roman Catholic archbishop of New York, called the city’s 41 percent abortion rate “downright chilling,” and on Thursday, State Senator Rubén Díaz Sr. of the Bronx, an abortion opponent, is holding a community meeting to discuss the issue. Nationally, the issue is receiving a new round of attention, with numerous state legislatures and the House of Representatives considering bills that would add restrictions on abortion, and Planned Parenthood was recently a target of undercover videos by an anti-abortion group.

But city health officials and groups that support access to abortion say that behind the 41 percent statistic — nearly twice the national rate — are complex social and legal factors: fewer obstacles to abortion in state law; the absence of mandatory sex education in New York City public schools; the ignorance of people, especially young ones, about where to get affordable birth control; and the ambivalence of young women living in poverty and in unstable relationships about when and whether to have children.

And although the percentage of pregnancies that end in abortion is basically unchanged, a particularly vulnerable group, teenagers, is having fewer babies and fewer abortions.

The hand-wringing has led to a rare moment of synchronicity between the Catholic Church and pro-choice women’s groups, as both say they are disturbed that the rate is so high, but disagree over what to do about it.

“Listening to Archbishop Dolan, I took a little bit of comfort in that he recognizes it is important to bring this rate down,” said Joan Malin, president of Planned Parenthood of New York City. But, she added, “The way we think about these issues is to really step back a bit and say that the major concern or the underlying issue that we think is so important is the high rate of unintended pregnancies.”

The issue came to light with the city health department’s recent release of its annual Vital Statistics report, which showed that 41 percent of pregnancies, excluding miscarriages, in 2009 ended in abortion.

Health experts say the abortion rate is tied to factors like race and income.

“If you look at the pregnancy rates by race and ethnicity in New York City versus nationally, they are essentially the same for black and Hispanic teenagers, and lower for whites,” said Susan Craig, a spokeswoman for the city’s health department.

There were 126,774 births, 11,620 miscarriages and 87,273 abortions in New York City in 2009. Despite the contention of some critics that New York, with its liberal abortion laws, is a destination state for abortion, nonresidents accounted for only about 7,000 of these abortions. (Factoring out nonresidents does not alter the 41 percent abortion rate, because 10,000 nonresidents also gave birth in the city.)

The little-changed abortion rate figure is a commonly cited statistic. But it masks large changes in fertility among teenagers.

Since 1996, the number of babies born to teenagers has fallen by 39 percent. The number of abortions has fallen by more than 16 percent, even though the population of teenagers has risen modestly. Ninety percent of the teenage mothers were not married, according to health department estimates.

In that age group in 2009, the rate of abortions was strikingly high for blacks (74 percent), followed by whites (66 percent) and Hispanics (53 percent). The rate was also very high for Asians (74 percent), though they were much less likely to become pregnant.

The drop in teenage pregnancies and abortions, however, was not enough to significantly alter the overall abortion rate. Most abortions, like most pregnancies, occurred among women in their 20s. Women in their 30s had abortions 29 percent of the time, and women 40 and older about a third of the time. Unmarried women accounted for 84 percent of abortions in 2009.

New York State law does not place as many restrictions on abortion as laws in some other states, like requiring parental consent for minors, or requiring women to undergo counseling that discourages abortion or to go through a waiting period.

According to Rachel Jones, a senior research associate at the Guttmacher Institute, which studies reproductive health issues, the high rate of unwed pregnancy and abortion among poor women is a sign of ambivalence. They are torn, she said, between the desire to have a baby and the realization that it would be hard to bring up a child as a single mother.

“In the U.S., most women want to have kids,” Ms. Jones said. “If you don’t have a lot of money, when is the responsible time to say, Now I want to have a child? How long are you supposed to put this off?”

That inner conflict could be seen recently in several women coming out of Planned Parenthood’s Margaret Sanger Center, a family planning and abortion clinic in Greenwich Village.

A 17-year-old girl there to pick up a friend said she had had an abortion in May. It was her second; the first was when she was 15. The girl said she sometimes used condoms. “But I wasn’t using them when I got pregnant,” she said. “I might use them more now, but I don’t know.” Like the other women outside the clinic, she asked not to be named to preserve her privacy.

A 20-year-old woman being helped by two male friends said she had her first abortion at 16, and also had a 7-month-old child. “It was an accident,” the woman said. “I used a condom every time, but I already have a kid, and I’m not ready for another one.”

Another woman, who was 22, said she had become pregnant after not using birth control because a doctor had told her she was infertile. “I’ve always been against abortion,” the woman, who is white and lives on Staten Island, said. “But if I had a kid now, it would have a terrible life. I’d rather wait.”

The health department distributes a pocket-size guide to clinics where teenagers can get medical care and low-cost or free contraception (information that is also available through the city’s 311 hotline). It has provided training in issues like protecting confidentiality and dispensing contraception to 50 clinics serving 32,000 teenagers a year in the neighborhoods with the highest pregnancy rates among teenagers. School-based classes use role-playing to help teenagers “learn how to negotiate maybe saying, I don’t want to have sex,” said Deborah Kaplan, assistant commissioner of the health department’s bureau of maternal, infant and reproductive health.

Condoms are distributed through health offices at every public high school, Ms. Kaplan said.

Archbishop Dolan agreed to speak out with other religious leaders at a news conference last month at the invitation of the Chiaroscuro Foundation, an anti-abortion group coordinated by an investment banker active in conservative causes, according to the archbishop’s spokesman, Joseph Zwilling.

The archbishop “reaffirmed and was looking to spread the word as well of the archdiocese’s longstanding commitment that any woman who is pregnant and in need can come to the Archdiocese of New York for assistance,” Mr. Zwilling said.

On Thursday, Senator Díaz, a minister who, like the archbishop, advocates abstinence and not condom use, convened a meeting of other Hispanic ministers to discuss the abortion statistics and urge them to talk to their congregations about it.

Juliet Linderman contributed reporting.

City’s High Abortion Rate Defies Easy Explanation,
NYT, 3.2.2011,
http://www.nytimes.com/2011/02/04/nyregion/04abortion.html

Lawmakers in Many States

Pushing for Abortion Curbs

January 21, 2011

The New York Times

By ERIK ECKHOLM

Newly energized by their success in November’s midterm elections, conservative legislators in dozens of states are mounting aggressive campaigns to limit abortions.

The lawmakers are drafting, and some have already introduced, bills that would ban most abortions at 20 weeks after conception, push women considering abortions to view a live ultrasound of the fetus, or curb insurance coverage, among other proposals.

In Florida and Kansas, legislators plan to reintroduce measures that were vetoed by previous governors but have the support of the new chief executives, like ultrasound requirements and more stringent regulation of late-term abortions.

“I call on the Legislature to bring to my desk legislation that protects the unborn, establishing a culture of life in Kansas,” Gov. Sam Brownback said last week in his first State of the State message.

“This is the best climate for passing pro-life laws in years,” said Michael Gonidakis, executive director of Ohio Right to Life, expressing the mood in many states. “We’ve got a pro-life governor and a brand new pro-life speaker. Our government now is pro-life from top to bottom.”

Abortion opponents plan marches in Washington and elsewhere this weekend and on Monday to mark the anniversary of the 1973 Supreme Court decision, Roe v. Wade, that established a woman’s right to an abortion.

Republicans in Congress hope to strengthen measures to prevent even indirect public financing of abortions, but laws in the states have the greatest impact on access to them. Abortion opponents have been emboldened by major changes in the political landscape, with conservative Republicans making large gains.

Although social issues were often played down in the campaigns, many of the newly elected governors and legislators are also solidly anti-abortion, causing advocates of abortion rights to brace for a year of even tougher battles than usual.

The biggest shift is in the state capitols, with 29 governors now considered to be solidly anti-abortion, compared with 21 last year. “This is worrisome because the governors have been the firewall, they’ve vetoed a lot of bad anti-choice legislation,” said Ted Miller, a spokesman for Naral Pro-Choice America.

In 15 states, compared with 10 last year, both the legislature and the governor are anti-abortion, according to a new report by Naral, and those joining this category include larger states like Michigan, Ohio and Wisconsin, as well as Georgia and Oklahoma. Maine and Pennsylvania are now strongly anti-abortion as well, if not quite as solidly.

Just which measures will pass is impossible to predict, particularly because many states are bogged down by budget crises.

Elizabeth Nash, who tracks state policies on abortion for the Guttmacher Institute, a research organization, said that while states would be preoccupied with budget issues, it appeared rather likely that more measures would pass this year than in 2010, which anti-abortion advocates considered a banner year, with more than 30 restrictive laws adopted in at least nine states.

The elections brought even more gains for their side than expected, said Mary Spaulding Balch, state policy director of the National Right to Life Committee, leading her group to call in its affiliates for a special strategy session on Dec. 7.

While many anti-abortion measures have been adopted or debated over the years, including requiring parental consent for minors and waiting periods, advocates have set a few top priorities for the months ahead:

¶Banning abortions earlier in pregnancy. Most states place restrictions on later abortions, often defined as after fetal viability, or around 22 to 26 weeks after conception. But last year, Nebraska set what many advocates consider a new gold standard, banning abortions, unless there is imminent danger to the woman’s life or physical health, at 20 weeks after conception, on a disputed theory that the fetus can feel pain at that point. The measure has not been tested in court, but similar measures pushing back the permissible timing are being developed in Indiana, Iowa, New Hampshire, Oklahoma and other states.

The 20-week law in Nebraska, which took effect in October, forced a prominent doctor who performed late-term abortions to leave the state. Jill June, president of Planned Parenthood of the Heartland, said women suffering from complicated pregnancies but are not yet sick enough to qualify for an emergency abortion would be forced to travel to other states. Or, she said, doctors fearing prosecution will wait until such women become dangerously ill before considering an abortion.

¶Pressing women to view ultrasounds. While several states encourage women seeking abortions to view an ultrasound, Oklahoma last year adopted a requirement that doctors or technicians perform the procedure with the screen visible to the woman, and explain in detail what she is seeing. The measure is under court challenge, but the Kentucky Senate has passed a similar bill, and variants are expected to come up in states including Indiana, Maryland, Montana, Ohio, Texas, Virginia and Wyoming.

In Florida, former Gov. Charlie Crist vetoed an ultrasound bill. The new governor, Rick Scott, attacked him for that veto and is expected to support a new proposal.

¶Banning any abortion coverage by insurance companies in the new health insurance exchanges. Numerous states are poised to impose the ban on plans that will be offered to small businesses and individual insurance buyers under the Obama administration health plan.

The shifts to conservative governors, in particular, have opened new opportunities for abortion opponents. In Kansas, legislators said they would act quickly to adopt measures that were previously vetoed, including regulations that will make it harder to open abortion clinics or to perform abortions in the second trimester.

“There’s pent-up demand in the Legislature for these changes,” said State Representative Lance Kinzer, the chairman of the Judiciary Committee in the Kansas House. Once these long-debated steps are taken, he said, the Legislature will consider more sweeping restrictions, including banning most abortions after the 20th week.

The politics of abortion have changed profoundly in some larger states including Michigan, Pennsylvania and Wisconsin.

“We’re facing the biggest threat to reproductive rights we’ve ever faced in this state,” said Lisa Subeck, executive director for Naral Pro-Choice Wisconsin.

In Michigan, because of the switch to an anti-abortion governor, “the dominos are lined up well for us this time,” said Ed Rivet, legislative director for Right to Life of Michigan. For starters, advocates hope to pass a state ban on the procedure opponents call partial-birth abortion that had been vetoed twice. After that, he said, “We have quite a list.”

Many defenders of abortion rights argue that because the election hinged largely on the economy and the role of government, officials did not receive a mandate for sweeping new social measures. “This last election was not about these issues at all,” said Cecile Richards, president of the Planned Parenthood Federation of America. “We now are concerned about a real overreaching by some state legislators and governors that will make it very difficult for women to access reproductive health care.”

Daniel S. McConchie, vice president for government affairs with Americans United for Life, responded that laws restricting abortion have been adopted right along by the states and that while he expected large gains in the year ahead, they will be part of steady trend.

The abortion rate in the United States, which had declined steadily since a 1981 peak of more than 29 abortions per 1,000 women, stalled between 2005 and 2008, at slightly under 20 abortions per 1,000 women, according to a new report from the Guttmacher Institute.

Robbie Brown contributed reporting from Atlanta,

Dan Frosch from Denver

and Emma Graves Fitzsimmons from Chicago.

Lawmakers in Many States Pushing for Abortion Curbs,
NYT, 21.1.2011,
http://www.nytimes.com/2011/01/22/us/politics/22abortion.html

Reproductive Choices Women Face

January 8, 2011

The New York Times

To the Editor:

Re “The Unborn Paradox” (column, Jan. 2): Ross Douthat seems to be suggesting that women with unintended pregnancies should bear children rather than have abortions because infertile women want babies. In doing so, Mr. Douthat ignores the serious health risks that pregnancies sometimes incur. Should women with unwanted pregnancies be compelled to take those risks?

Consider New Year’s Eve, a typical night on my obstetrics floor. Several pregnant women were suffering from complications. Two needed emergency surgery. One was 19 years old and 20 weeks pregnant with an abnormal fetus. She had decided to see the pregnancy through. But the amniotic sac ruptured five months early. We had to stop the heavy bleeding and infection that followed. Her baby didn’t survive.

Abortion opponents would impose all the risks of pregnancy on women who wish to end their pregnancies. Instead, let’s make sure that everyone on the socioeconomic ladder can prevent and plan conception.

Anne Davis
New York, Jan. 3, 2011

The writer, an obstetrician, is medical director of Physicians for Reproductive Choice and Health.

•

To the Editor:

I have supported abortion rights for as long as I can remember, but nothing cemented my commitment to women’s reproductive freedom like my own very much wanted pregnancy nine years ago.

As I grew increasingly delighted about both my experience of pregnancy and planning for a life with twin babies, I imagined how differently I would feel in other circumstances. What if I were 14 rather than 34? What if my partner and I had as many children as we could handle, or more? What if one or both of us were unemployed?

How might our thrill at the short-term changes in my body and the long-term changes in our lives transform into dread, depression and anxiety?

Moreover, just because expectant parents are able to think of the fetus as a baby does not mean it actually is one, and that abortion is the same as the taking of an actual life, rather than a fantasized one.

Sarah E. Chinn
Brooklyn, Jan. 3, 2011

•

To the Editor:

Ross Douthat provides an eloquent analysis of the abortion conundrum. We embrace the humanity of our “wanted” babies while we strip the human rights from those whose conception was unplanned and unwanted. And yet, the circumstances of conception don’t change the fact that a child in the womb is a separate and unique human being, morally and ethically entitled to the same rights as you and I.

Mr. Douthat also points out that adoption has become an unlikely choice for young mothers like Markai Durham, the subject of an MTV show, who says she couldn’t bear to give up a child she carried in her womb for nine months, and opts, instead, to kill that child.

Did anyone along the way point out the deadly flaw in her thinking? Markai and the million-plus babies who fall into the “unwanted” category every year deserve to be given a choice that doesn’t involve murder. (Rev.)

Frank Pavone
National Director, Priests for Life
Staten Island, Jan. 3, 2011

•

To the Editor:

What MTV depicted in its documentary “No Easy Decision,” and what Ross Douthat does not acknowledge in his column, is that Markai Durham and thousands of women like her are capable of sensitively and wisely weighing the decisions that have consequences of life or death.

Mr. Douthat offers no evidence that fewer abortions would mitigate complex fertility treatments or the enormous amount of bureaucratic red tape surrounding the adoption process. Many studies in fact suggest that, in a culture that treasures biological children, prospective parents opt first for fertility treatments and then, if at all, pursue adoption.

A thoughtful look at reproductive decision-making is always welcome, but a broadside that once again seeks to demonize and make guilty those women who elect to terminate their pregnancies is not adding to the civil discourse.

Conflating fertility, adoption and abortion in no way alleviates the myriad challenges involved in deciding whether or not to become a parent.

Joan Malin
President and C.E.O.
Planned Parenthood of New York City
New York, Jan. 3, 2011

•

To the Editor:

I disagree with Ross Douthat’s appraisal of adoption as an answer to unplanned pregnancies and infertility. I have worked with many pregnant teenagers and young adult women in my 25 years as a director of an adoption agency, and adoption is only a small part of the solution.

While I am obviously sympathetic to the desire of infertile couples to become parents, their needs can never supersede those of pregnant women who are not prepared to be parents.

Research has shown that abortion very rarely leads to long-term negative psychological consequences for those women who choose it (myself included).

Yes, of course there is regret and sadness for some women, but carrying a baby to term and placing him or her for adoption more often than not leads to a lifetime of pain and sadness, regardless of how right the situation may seem. It is the right choice for the very few.

Abortion and adoption are two ends of the same spectrum — women having choices about their reproductive lives. But the agony of a woman placing a child for adoption cannot be understated.

Randie Bencanann
San Francisco, Jan. 3, 2011

Reproductive Choices Women Face, NYT, 8.1.2011,
http://www.nytimes.com/2011/01/09/opinion/l09douthat.html

The Unborn Paradox

January 2, 2011

The New York Times

By ROSS DOUTHAT

The American entertainment industry has never been comfortable with the act of abortion. Film or television characters might consider the procedure, but even on the most libertine programs (a “Mad Men,” a “Sex and the City”), they’re more likely to have a change of heart than actually go through with it. Reality TV thrives on shocking scenes and subjects — extreme pregnancies and surgeries, suburban polygamists and the gay housewives of New York — but abortion remains a little too controversial, and a little bit too real.

This omission is often cited as a victory for the pro-life movement, and in some cases that’s plainly true. (Recent unplanned-pregnancy movies like “Juno” and “Knocked Up” made abortion seem not only unnecessary but repellent.) But it can also be a form of cultural denial: a way of reassuring the public that abortion in America is — in Bill Clinton’s famous phrase — safe and legal, but also rare.

Rare it isn’t: not when one in five pregnancies ends at the abortion clinic. So it was a victory for realism, at least, when MTV decided to supplement its hit reality shows “16 and Pregnant” and “Teen Mom” with last week’s special, “No Easy Decision,” which followed Markai Durham, a teen mother who got pregnant a second time and chose abortion.

MTV being MTV, the special’s attitude was resolutely pro-choice. But it was a heartbreaking spectacle, whatever your perspective. Durham and her boyfriend are the kind of young people our culture sets adrift — working-class and undereducated, with weak support networks, few authority figures, and no script for sexual maturity beyond the easily neglected admonition to always use a condom. Their televised agony was a case study in how abortion can simultaneously seem like a moral wrong and the only possible solution — because it promised to keep them out of poverty, and to let them give their first daughter opportunities they never had.

The show was particularly wrenching, though, when juxtaposed with two recent dispatches from the world of midlife, upper-middle-class infertility. Last month there was Vanessa Grigoriadis’s provocative New York Magazine story “Waking Up From the Pill,” which suggested that a lifetime on chemical birth control has encouraged women “to forget about the biological realities of being female ... inadvertently, indirectly, infertility has become the Pill’s primary side effect.” Then on Sunday, The Times Magazine provided a more intimate look at the same issue, in which a midlife parent, the journalist Melanie Thernstrom, chronicled what it took to bring her children into the world: six failed in vitro cycles, an egg donor and two surrogate mothers, and an untold fortune in expenses.

In every era, there’s been a tragic contrast between the burden of unwanted pregnancies and the burden of infertility. But this gap used to be bridged by adoption far more frequently than it is today. Prior to 1973, 20 percent of births to white, unmarried women (and 9 percent of unwed births over all) led to an adoption. Today, just 1 percent of babies born to unwed mothers are adopted, and would-be adoptive parents face a waiting list that has lengthened beyond reason.

Some of this shift reflects the growing acceptance of single parenting. But some of it reflects the impact of Roe v. Wade. Since 1973, countless lives that might have been welcomed into families like Thernstrom’s — which looked into adoption, and gave it up as hopeless — have been cut short in utero instead.

And lives are what they are. On the MTV special, the people around Durham swaddle abortion in euphemism. The being inside her is just “pregnancy tissue.” After the abortion, she recalls being warned not to humanize it: “If you think of it like [a person], you’re going to make yourself depressed.” Instead, “think of it as what it is: nothing but a little ball of cells.”

It’s left to Durham herself to cut through the evasion. Sitting with her boyfriend afterward, she begins to cry when he calls the embryo a “thing.” Gesturing to their infant daughter, she says, “A ‘thing’ can turn out like that. That’s what I remember ... ‘Nothing but a bunch of cells’ can be her.”

When we want to know this, we know this. Last week’s New Yorker carried a poem by Kevin Young about expectant parents, early in pregnancy, probing the mother’s womb for a heartbeat:

The doctor trying again to find you, fragile,

fern, snowflake. Nothing.

After, my wife will say, in fear,

impatient, she went beyond her body,

this tiny room, into the ether—

... And there

it is: faint, an echo, faster and further

away than mother’s, all beat box

and fuzzy feedback. ...

This is the paradox of America’s unborn. No life is so desperately sought after, so hungrily desired, so carefully nurtured. And yet no life is so legally unprotected, and so frequently destroyed.

The Unborn Paradox,
NYT,
2.1.2011,
https://www.nytimes.com/2011/01/03/
opinion/03douthat.html

Dr. William Harrison,

Defender of Abortion Rights,

Dies at 75

September 25, 2010

The New York Times

By DOUGLAS MARTIN

“Oh, God, doctor, I was hoping it was cancer.”

Those words so affected Dr. William Harrison that for years, he said, he could not repeat them. They made him break down in tears.

The woman who spoke them — black, poor and middle-aged — had come in 1967 to the Arkansas hospital where Dr. Harrison was a medical student in obstetrics. A doctor, after examining her swollen belly, had told her she was pregnant.

Dr. Harrison went on to perform 20,000 or so abortions over three decades, became a frequent target of abortion protesters and spoke out forcefully in national forums. In the 1980s, when the abortion wars raged fiercest in Arkansas, his clinic, the Fayetteville Women’s Clinic, was firebombed, picketed, blockaded and vandalized. Death threats became routine.

In essays, articles and interviews he castigated abortion-rights opponents as “right-wing crazies.” They responded just as fervently, calling him a murderer, particularly after he gained wide attention for offering free abortions to survivors of Hurricane Katrina in 2005.

Dr. Harrison felt compelled to perform abortions after many doctors in northwest Arkansas abandoned the practice. For decades, he was the only doctor in the region willing to provide the procedure. In typically flamboyant language, he said, “I have chosen to ride this tiger unquietly, raking its side with verbal spurs, swinging my hat and whooping like a cowboy.”

Dr. Harrison died on Friday at the age of 75, the Nelson-Berna Funeral Home in Fayetteville said. He had received a diagnosis of leukemia in May.

Dr. Harrison readily admitted that he destroyed life, but denied that he killed babies. His view was that an embryo was far from being a human being with a brain. The higher moral value to Dr. Harrison was salvaging the future of an often disadvantaged girl or woman.

But he drew a line at performing abortions in the third trimester of pregnancy, partly, he said, because they made him uncomfortable and partly because he felt he lacked the expertise. He sent those who wanted one to his friend Dr. George Tiller in Wichita, Kan., an expert surgeon who was assassinated in his church by an anti-abortion zealot in 2009. Dr. Harrison often gave those patients money for gasoline for the trip to Wichita.

William Floyd Nathaniel Harrison, the son of small-town teachers, was born in rural Faulkner County, Ark., on Sept. 8, 1935. His mother would say that she knew he was destined to become an obstetrician because he essentially delivered himself as his father rode on horseback to fetch the doctor. He grew up going to Methodist and Baptist churches (his mother played piano at both), and twice read the entire Bible at 12, ending up, he said, thoroughly unimpressed with the God it described.

By his account, he piled up D’s and F’s at what is now the University of Central Arkansas in Conway before enlisting in the Navy at 17. He later enrolled at the University of Arkansas, where he studied business until he fell for Betty Waggoner. She was dating a pre-med student, he said, so he switched to that to impress her. They were married for 50 years.

In addition to his wife, Dr. Harrison is survived by his daughters, Amanda Robinson and Rebecca Harrison; his son, Benjamin III; a brother, Ben; two sisters, Mary Harrell and Martha Harrison; and seven grandchildren.

Dr. Harrison received his undergraduate and medical degrees from the University of Arkansas and did his internship and residency there. He and a colleague set up the Fayetteville Women’s Clinic in 1972.

Dr. Harrison performed his first abortion in 1974, a year after they became legal, and found himself doing them sporadically while his clinic was booming delivering babies. But by 1984, as older doctors retired and younger ones shied from offering abortions, often fearing being ostracized or attacked, he became the only doctor in his area performing them.

As more and more abortion patients knocked on his door, he said, he began recalling the woman who would have preferred cancer to pregnancy. He also recalled the many women who had come to the hospital seriously injured by illegal abortions.

So after delivering more than 6,000 babies, he gave up that practice and devoted himself to abortions, writing that if he wanted them to be legal, safe and available, the only moral and ethical course was for him to do them.

As for the protesters frequently outside his clinic, he often said they were splendid advertising, drawing women in need to the clinic who might otherwise have not known where to go.

Dr. William Harrison, Defender of Abortion Rights, Dies at 75,
NYT,
25.9.2010,
https://www.nytimes.com/2010/09/26/
us/26harrison.html

Doctor’s Killer

Puts Abortion on the Stand

January 29, 2010

The New York Times

By MONICA DAVEY

WICHITA, Kan. — Scott Roeder, the man charged with murder in the shooting of George R. Tiller, one of the few doctors in the country to perform late-term abortions, took the witness stand in his own defense on Thursday, and said that, yes, he did it.

Yes, he bought a gun. Yes, he took target practice. Yes, he had learned about Dr. Tiller’s habits, his home address, his security precautions. And, yes, he shot Dr. Tiller last May 31 as Dr. Tiller stood inside his church.

“That is correct, yes,” Mr. Roeder told the jurors, in a calm, matter-of-fact voice.

But there was a twist.

Lawyers for Mr. Roeder, who provided the only testimony for the defense in a trial that has spanned several weeks, are hoping that jurors will consider Mr. Roeder’s motive: his growing opposition to abortion, which he deemed criminal and immoral, and his mounting sense that laws and prosecutors and other abortion opponents were never going to stop Dr. Tiller from performing them.

“I did what I thought was needed to be done to protect the children. I shot him,” he testified, adding at another point, “If I didn’t do it, the babies were going to die the next day.”

Was he remorseful? No, Mr. Roeder said without emotion. After the killing, he said, he felt “a sense of relief.”

And so, in a way, the hearing here, watched intensely by all sides of the abortion debate, turned into precisely what the presiding judge had said all along that it ought not to be — a trial over abortion. Judge Warren Wilbert has wrestled with requests from the prosecution and the defense over how to permit Mr. Roeder to mount a murder defense without allowing him to turn the case into a public forum on abortion.

But even with his pointed testimony, based on a ruling late Thursday by Judge Wilbert, Mr. Roeder continues to face a difficult legal hurdle in beating back a charge of first-degree murder.

Judge Wilbert ruled that he would not instruct the jury to consider a lesser charge when they begin deliberations on Friday. Mr. Roeder has pleaded not guilty to murder, but defense lawyers had argued that his beliefs about abortion might warrant a voluntary manslaughter conviction if jurors concluded that Mr. Roeder possessed, as Kansas law defines it, “an unreasonable but honest belief that circumstances existed that justified deadly force.”

Seated on the witness stand, facing a tiny courtroom gallery that included Dr. Tiller’s widow, Jeanne, abortion opponents from other parts of the country, and national abortion rights supporters, Mr. Roeder seemed quiet, almost lawyerly, in his responses to inquiries about the killing, in which Dr. Tiller was shot in the forehead, the gun pressed to his skin.

Mr. Roeder, 51, of Kansas City, Mo., told jurors that he had a growing sense of his own faith and opposition to abortion in the 1990s after watching “The 700 Club,” the evangelist Pat Robertson’s television talk show. Mr. Roeder’s views on religion and abortion, he said, went “hand in hand.”

Mr. Roeder acknowledged under cross-examination that he had, as early as 1993, thought about killing Dr. Tiller. A year before the shooting, he said, he had gone to Dr. Tiller’s church with a gun intending to shoot him. (Dr. Tiller was not there that day, he said.) And he said he considered other alternatives: cutting off Dr. Tiller’s hands with a sword, shooting him from a distance with a rifle, or finding him at his house.

Of his decision to go to the church, he said, “It was the only window of opportunity I saw that he could be stopped.”

Abortion opponents here, including some who have served time in jail for abortion clinic violence, praised Mr. Roeder for his testimony. But some complained bitterly that Judge Wilbert had severely limited the defense by barring the testimony of Phill Kline, a former Kansas attorney general who had unsuccessfully pursued criminal investigations against Dr. Tiller and by preventing jurors from considering some conviction short of murder.

Abortion rights supporters, meanwhile, called Mr. Roeder’s statements deeply chilling, and said they mandated nothing short than a first-degree murder conviction, which could carry a life sentence. “It should send a message that there is no justification for this,” said Vicki Saporta, the president of the National Abortion Federation, who sat in the court.

Over four days, prosecutors laid out a case that rarely dealt with abortion, but stuck instead to dates and times and forensic and witness evidence implicating Mr. Roeder in the Tiller shooting. Abortion rights supporters said that was as it should be: this was murder, plain and simple.

By the middle of the week, the courthouse had drawn some of the most outspoken members of the abortion debate from around the country.

“George Tiller shed the blood of 60,000 innocent children,” Randall Terry, the founder of Operation Rescue, told reporters. Mr. Terry (who is in a legal dispute over the use of the group’s name with Operation Rescue’s current president, Troy Newman) said that he was neither condoning nor condemning Mr. Roeder’s actions, but that people should remember the children.

Days after Mr. Roeder’s arrest, the United States Department of Justice announced it was investigating Dr. Tiller’s death to determine whether there was anyone else involved in the plot. On Thursday, Mr. Roeder acknowledged that he has friends who, like him, believe that the killing of abortion doctors is justifiable. One such friend, Shelley Shannon, was imprisoned for shooting Dr. Tiller in both arms in 1993. Still, Mr. Roeder said on Thursday, he acted alone.

Justice Department representatives are “actively monitoring” Mr. Roeder’s case, a department spokesman said, adding, “Our investigation into the murder of Dr. Tiller is open and ongoing.”

Guided by lawyers, Mr. Roeder methodically described the morning of the shooting — how he had fired the gun inside the church, driven away from Wichita, hidden the gun in a small town, and picked up a snack, a pizza. In the days after the killing, Dr. Tiller’s family announced that it would close the abortion clinic, the only one in Wichita.

So, Nola Foulston, the prosecutor asked him, do you feel you have successfully completed your mission?

“He’s been stopped,” Mr. Roeder said.

But do you feel you have successfully completed your mission, she asked again.

“Yes,” he said.