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Doctor opening new late-term abortion clinics in D.C. area, Iowa

By Rob Stein and Lena H. Sun
Wednesday, November 10, 2010; 1:38 PM

A Nebraska doctor who is one of the few in the nation to perform abortions late in a pregnancy said Wednesday that he will open clinics in the Washington area and in Iowa.

LeRoy Carhart said he decided to open the facilities, and expand a clinic in Indiana, because Nebraska had implemented a new law that makes it illegal to perform abortions beyond the 20th week of a pregnancy and he needed other sites to care for patients he had served in Wichita.

The Kansas clinic was closed after George Tiller was fatally shot by an antiabortion demonstrator while attending church in 2009. Carhart had worked with Tiller for 11 years and had hoped to reopen his clinic in Kansas but decided to look for another location when Tiller's family decided against that.

"I need a place where we could take care of patients we used to take care of in Kansas," Carhart said in a telephone interview with The Washington Post. Carhart's plans were first reported by Omaha television station KETV and the Omaha World-Herald newspaper, according to the Associated Press.

"The laws are more favorable in these other jurisdictions, and we're going to do the maximum the law allows," Carhart said.

Before Tiller's death, "we used to have patients come to us all the time from Washington, Virginia and Baltimore. So it's clear patients who need the services are there," Carhart said.

The Iowa clinic will be in or near Council Bluffs, Iowa. Citing concerns about abortion protests, Carhart would not disclose the location of the Washington area facility, which will open Dec. 6.

"The patients, when they call, will be told where to go. The 'antis' will find out soon enough, but I don't want to help them," Carhart said. "We will be subject to protests, but I'm not going to give them a head start."

The location was selected based on a combination of factors, including which jurisdiction has the most favorable laws.

In the Washington area, the District has the fewest restrictions, with no specific rules governing late abortions. In Virginia and Maryland, abortions are not allowed beyond when the fetus becomes viable, except in situations where the woman's "life and health" are threatened. The doctor performing the abortion makes those determinations. In Virginia, a second doctor must approve the procedure.

"That's not the only consideration," Carhart said. "We also considered things like being near the Metro and good transportation and access to airports."

Carhart said he would initially work at the Washington area clinic with a nurse and that he hopes to add two more doctors. The clinic would also provide other services, including contraceptives for women and vasectomies, he said.

Opponents gear up

Abortion opponents said they were skeptical about Carhart's claims, doubting that he had raised enough money to open new clinics.

"He makes a lot of grandiose boastings about the future, but rarely if ever does he follow through with them," said Cheryl Sullenger of Operation Rescue, an antiabortion group based in Wichita that targeted Tiller and Carhart for years.

"We're going to do what we can to limit his ability to kill babies there, either through the laws or peaceful prayer and protests and sidewalk counseling," she said. "We're going to do what we need to do."

In Maryland, antiabortion activist Michael Martelli said some groups are concerned that doctors are seeing the state as "accommodating." He cites the case of Steven Brigham, a doctor who has been accused by New Jersey state officials of putting patients' health at risk by starting late-term abortions in New Jersey and completing them in Maryland.

Brigham, who owns and operates American Women's Services, which provided abortion services at facilities in New Jersey, Pennsylvania, Virginia and Maryland, was not licensed in Maryland but had been regularly performing abortions in Elkton, according to records of the Maryland Board of Physicians.

In August, the board ordered him to stop practicing medicine after a bungled abortion that month.

The procedure began in New Jersey at one of the clinics, but the patient then traveled to an Elkton clinic for the actual abortion, according to board records. The woman suffered a punctured uterus and had to be taken to Johns Hopkins Hospital for emergency surgery, according to records.

Doctors "are starting to look at Maryland as the place to come," said Martelli, executive director of Hanover, Md.-based Living Hope for Life.

Reproductive rights activists praised Carhart's plans, saying Tiller's death had made it more difficult for women needing late abortions to obtain them. Abortion protester Scott Roeder was sentenced to life in prison in April for Tiller's murder.

"Dr. Carhart has dedicated his career to making sure women have access to the abortion care they need. Opening new clinics in Iowa and the D.C. area will expand women's access to abortion care, and hopefully women will not have to travel as far to obtain the care that they need," said Vicki Saporta, president of the National Abortion Federation.

Late-term procedure rare

Tiller's shooting focused attention on the practice of performing abortions late in pregnancies. While such abortions account for a tiny fraction of the 1.2 million abortions done each year in the United States, it is not clear how many are done, by whom and under what circumstances. The government does not collect detailed data, and doctors who perform them publish little information.

More than 88 percent of abortions are done in the first trimester, and most doctors will not perform them beyond 22 or 24 weeks because of moral qualms, social stigma, legal concerns, inadequate training or lack of experience.

Abortion rights activists argue that late abortions are performed only when absolutely necessary ¿ often when devastating abnormalities in the fetus or life-threatening problems in the women are discovered.

"For many women who find out that they are carrying fetuses with anamolies incompatible with life, there are no real choices," Saporta said.

"Sometimes they can get that care at a hospital near where they live, but more often they have to travel to an abortion provider who specializes in providing that care. In the wake of Dr. Tiller's murder, there has been a real void. In opening these clinics, Dr. Carhart is trying to help meet that need."

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