Byron Calhoun says abortion is never necessary to save a mother’s life.He’s the onlyhigh-risk OB/GYN in central West Virginia.

At a 2019 antiabortion conference in Ontario, Canada, Byron Calhoun was introduced as a “messenger of God.”

The doctor assumed the podium in a pinstripe suit and bow tie, his high forehead glinting underneath the hotel ballroom’s bright fluorescents. Dozens of conference-goers clapped, then grew quiet, eyes fixed on Calhoun and the statistic that brought them all there, blown up on a banner behind him: “1 out of every 5 babies is killed by abortion.”

“I can either throw my hands up, and be like a lot of my colleagues,” Calhoun said. Or “I can be like Queen Esther,” a biblical figure known for saving her people from genocide.

It can be “unpleasant business” to fight for the lives of the unborn, he said. “But that’s what I’m called to do.”

Calhoun is the only high-risk obstetrician and gynecologist in Charleston, W.Va., with a strong hold over much of the central part of the state. He is also an internationally known antiabortion activist. In treating women with fetal abnormalities or preexisting conditions that could complicate their pregnancies, Calhoun rarely discusses abortion, according to interviews with three former patients and six doctors. His practice highlights a fraught ethical area: When doctors personally oppose abortion, their beliefs can affect the care they provide, leading a patient down a path that could put their health at risk.

Six OB/GYNs who work in the Charleston area, or who have worked there in the past, say they see Calhoun’s open antiabortion advocacy and his medical practice as a conflict with the potential to harm patients, especially in a state short on doctors with his expertise. Four of those doctors — three of whom spoke on the condition of anonymity because they work closely with Calhoun — say they avoid sending certain cases to his office because patients have told them he does not discuss abortion as an option. If they believe a patient with a high-risk pregnancy or fetal anomaly should consider termination, they said, they will try to send her somewhere else.

Three said they also avoid sending Calhoun any patients who need more advanced testing to determine the severity of their anomalies, because they have also heard from patients that he often refuses to perform these tests. In a 2016 lawsuit filed against the Charleston Area Medical Center and West Virginia University, a doctor who trained under Calhoun claimed that Calhoun denied an amniocentesis — the most definitive form of fetal genetic testing — to a patient who requested the procedure. According to the lawsuit, the other tests he performed were not conclusive and “came back past the date for this patient to have an elective abortion," though Calhoun had allegedly assured the patient those results would come quickly.

Charleston is the closest option for many West Virginians seeking high-risk pregnancy care, and even then, it can be a long trip. Pictured is Rainelle, a drive of 1 hour and 45 minutes. (Bonnie Jo Mount/The Washington Post)
Charleston is the closest option for many West Virginians seeking high-risk pregnancy care, and even then, it can be a long trip. Pictured is Rainelle, a drive of 1 hour and 45 minutes. (Bonnie Jo Mount/The Washington Post)
Downtown Charleston.  (Bonnie Jo Mount/The Washington Post)
Downtown Charleston. (Bonnie Jo Mount/The Washington Post)

LEFT: Charleston is the closest option for many West Virginians seeking high-risk pregnancy care, and even then, it can be a long trip. Pictured is Rainelle, a drive of 1 hour and 45 minutes. (Bonnie Jo Mount/The Washington Post) RIGHT: Downtown Charleston. (Bonnie Jo Mount/The Washington Post)

“I would not send patients to him because I was finding that they were not getting appropriately counseled,” said Lori Tucker, an OB/GYN based in Martinsburg, W.Va., who has advocated for abortion access. “I don’t think he wants to be put in a position where he would have to take on the responsibility of having a conversation about termination.”

The Lily provided Calhoun with a detailed list of questions, facts and assertions that would be included in this story. He did not respond to many attempts to contact him, through multiple channels, over a period of 18 months.

As Texas bans abortion after six weeks gestation — and other states indicate that they will soon follow suit — abortion rights advocates have been laser-focused on the threat posed by state legislation. But there are other, less visible, barriers that patients seeking abortions face. Approximately 4,500 doctors are members of the American Association of Pro-Life Obstetricians and Gynecologists, an organization Calhoun led as president from 2000 to 2006. When doctors consult on fetal abnormalities and high-risk pregnancies, their conversations can alter the course of their patients’ lives. And while doctors who choose not to discuss abortion aren’t breaking any laws, they are violating guidance widely accepted by the OB/GYN community.

According to the American College of Obstetricians and Gynecologists (ACOG), the 60,000-member professional organization for OB/GYNs to which Calhoun belongs, the “standard of care” is for doctors to raise abortion as an option if they have reason to think their patient might be unsure about a pregnancy. This includes any case with a severe fetal abnormality or any high-risk case, when pregnancy complications “may be so severe that abortion is the only measure to preserve a woman’s health or save her life.” The doctor should inform her of all the options “in a balanced manner,” avoiding any “personal bias,” ACOG says. If a patient decides to terminate, ACOG says, the doctor should either perform the abortion or make a referral.

From 2006 to 2014, Calhoun worked alongside another maternal-fetal medicine specialist at the Charleston Area Medical Center, Luis Bracero, who would perform abortions at the hospital. Because the doctors worked on some of the same cases, Bracero heard from patients that he and Calhoun approached their consultations differently, Bracero said. Bracero would lay out all the patient’s options, he said, and Calhoun “would just tell them to continue with the pregnancy.”

“If no one speaks up, no one will know.”

Jen Villavicencio, ACOG spokesperson

In conservative states, this kind of guidance is not uncommon, said Jen Villavicencio, an ACOG spokesperson and expert in complex family planning who performs abortions as part of her medical practice. Many doctors “don’t think twice” about leaving abortion out of the conversation, she said — and few ever face censure from their state medical boards. Patients in antiabortion areas are especially unlikely to recognize and report the omission, Villavicencio said. West Virginia is among the most antiabortion states in the country, where 58 percent of people believe abortion should be illegal in all or most cases, according to a 2014 Pew Research Center survey. Though medical professionals overwhelmingly say it’s unethical and medically risky to omit abortion from medical consultations, two of Calhoun’s patients interviewed for this story say they are glad abortion was never discussed.

“The burden is placed on the person who has been wronged — the patient,” said Villavicencio. “If no one speaks up, no one will know.”

While confidentiality laws protect the identities of Calhoun’s patients, The Lily was able, through infant obituaries and online reviews of medical care, to speak with eight women who say they received care from Calhoun. Three of those patients — two of whom spoke on the record — said Calhoun told them their babies would likely die but did not mention abortion as an option. One patient said Calhoun counseled her to have an abortion when she saw him 11 years ago. The other four said they saw Calhoun for care that did not include conversations about the future of their pregnancies.

Several leading maternal-fetal medicine specialists, when told the histories of some of Calhoun’s patients, said the doctor had offered false hope. In one case, this led to months of emotional distress and significant health risks during delivery.

In the United States, “you have to tell people they have the legal opportunity” to have an abortion, Calhoun said at the Ontario conference — and he said he makes sure he’s “clear on that.” But he is open about the fact that he doesn’t perform abortions or refer patients to them, a violation of ACOG guidance. Asked about this in a 2014 deposition that he gave as an expert witness in a lawsuit against an abortion clinic, Calhoun said that if a patient doesn’t know where to go, “the yellow pages are available.”

Calhoun has been the vice-chair of obstetrics and gynecology at West Virginia University since 2006, despite many calling for his removal after that same 2014 lawsuit. On Calhoun’s recommendation, a former patient sued the clinic for allegedly leaving a 13-week fetal skull in her uterus. A circuit court judge dismissed the case, ruling in favor of the clinic and raising questions about Calhoun’s role. The medical director for the National Institute of Family and Life Advocates, Calhoun remains closely connected to one of the country’s most prominent antiabortion legal groups.

Despite the opposition, Calhoun is “well respected” in the West Virginia medical community, said David Patton, an OB/GYN in Charleston. In the 15 years he has referred patients to Calhoun, Patton said he has “never had a problem.” None of his patients have ever complained about a lack of counseling on abortion. “I think he’s really honest,” Patton said. “He doesn’t sugarcoat a lot of things.”

Christina Menkin, a nurse-midwife in Charleston, said she has worked with dozens of patients who also saw Calhoun. No one ever shared a negative experience, she said. She knows Calhoun as a “competent, respectful, conscientious physician.”

At the Ontario conference, hosted by the antiabortion nonprofit Alliance for Life, Calhoun shared some of his personal history that has helped shape his convictions. He and his wife struggled with infertility before they had their biological daughter. They adopted four kids, including two with special needs. One of their adopted children, Faith, was born with a metabolic disorder and required round-the-clock care before she died in August 2017 at age 27.

During his presentation, Calhoun clicked through to a photo of Faith, strapped into her wheelchair with a big smile. “She was going to die in three weeks, she was going to die in a week, she was going to die in a year, she was going to die, blah blah blah blah blah blah blah. You know, the usual, omniscient doctor telling you what’s going to happen.”

Doctors “think they’re Godlike, but they’re not,” he said.

They insist they know too much from ultrasounds, he added, which are really just “shades of black and white and gray.”

Spring daffodils outside the Charleston Area Medical Center Women and Children's Hospital. (Bonnie Jo Mount/The Washington Post)
Spring daffodils outside the Charleston Area Medical Center Women and Children's Hospital. (Bonnie Jo Mount/The Washington Post)

When they walk out of Calhoun’s consultation room, some patients question the care they receive. Two or three times a year, patients who have been to Calhoun’s practice travel an additional two and a half hours to Morgantown, W.Va., said Leo Brancazio, who practices there as a maternal-fetal medicine specialist. They come to Brancazio for a second opinion, he said, recognizing that abortion should have been discussed.

This doesn’t happen a lot, because most patients in West Virginia are personally opposed to abortion, Brancazio said. Patients who seek a second opinion, he added, must be confident enough to question their doctor and “health-savvy” enough to find the next-closest high-risk specialist without a referral. They also need the time and money necessary to travel.

“They are, for the most part, accepting what their doctor tells them.”

When Hayley and Donnie Smelcer arrived for their appointment at the Charleston Area Medical Center in June 2018, Calhoun, they said, already had their file open on the table. There was a large black splotch on the ultrasound where their baby’s brain should have been.

Calhoun confirmed what Hayley’s OB/GYN had told them to expect: Their unborn daughter had holoprosencephaly, a disorder in which the right and left sides of a baby’s brain are fused together. They recall Calhoun saying that the baby statistically would probably not survive to term — and even if she did, she would require permanent life support and 24-hour care. But then Calhoun said something they hadn’t heard from the other doctor: They had reason to hope.

Hayley and Donnie Smelcer at home in April with their infant twins, Lucy and Oliver, in April. Their first child lived for only 20 hours. (Bonnie Jo Mount/The Washington Post)
Hayley and Donnie Smelcer at home in April with their infant twins, Lucy and Oliver, in April. Their first child lived for only 20 hours. (Bonnie Jo Mount/The Washington Post)

“I don’t play God. I’m going to fight for this baby,” they remember him saying. He would line up a team of specialists at a major research hospital in Cincinnati, a five-hour drive from where they live in Rainelle, W.Va. If Hayley, who was relying on Medicaid for insurance, went into early labor, Calhoun said he would charter a helicopter to get her there.

The Smelcers, who are staunchly opposed to abortion, said Calhoun never mentioned it. Even after learning the severity of the condition, they say they never asked about it. They were happy to find a doctor who believed in their baby.

“From the beginning, through every appointment, he never at all said anything about termination or anything like that,” said Hayley, who was 19 and working on her GED when she got pregnant. “He never even asked if that was an option we wanted to do.”

Hayley focused on a future where her daughter would be born healthy. Every week, an app on her phone compared her baby to a different kind of produce. Isabella was the size of a pomegranate, a sweet potato, a cantaloupe. Hayley browsed newborn Halloween costumes and picked out hair bows. Sometimes she allowed herself to imagine the nursery. It would be elephant-themed, with gray walls and pink glitter.

Sixteen weeks before her due date, Hayley went into labor. At the closest hospital, in Fairlea, W.Va., 45 minutes from their house, Donnie begged the doctors to call the helicopter he said Calhoun had promised. There was no point, they said: It was storming and the baby was too sick. Izzy lived for 20 hours, Hayley and Donnie said, passing away in Hayley’s arms from cardiac arrest.

Calhoun was an “amazing” doctor, Hayley said, who cared enough to send a bouquet of flowers to Izzy’s funeral. A few days after she got home from the hospital, Hayley said he called to check in, letting her know that he had lost a child, too.

These kinds of connections are important, said Steve Calvin, a high-risk pregnancy doctor and adjunct professor at the University of Minnesota, who is a member of the American Association of Pro-Life OB/GYNs. When antiabortion doctors allow their beliefs to shape their counseling, he said, they are uniquely equipped to connect with patients who share their convictions.

Isabella is buried at Wallace Memorial Cemetery in Clintonville, W.Va. (Bonnie Jo Mount/The Washington Post)
Isabella is buried at Wallace Memorial Cemetery in Clintonville, W.Va. (Bonnie Jo Mount/The Washington Post)
The Smelcers say Calhoun never mentioned abortion was an option when Hayley was pregnant with their first child. The couple is staunchly opposed to abortion. (Bonnie Jo Mount/The Washington Post)
The Smelcers say Calhoun never mentioned abortion was an option when Hayley was pregnant with their first child. The couple is staunchly opposed to abortion. (Bonnie Jo Mount/The Washington Post)

LEFT: Isabella is buried at Wallace Memorial Cemetery in Clintonville, W.Va. (Bonnie Jo Mount/The Washington Post) RIGHT: The Smelcers say Calhoun never mentioned abortion was an option when Hayley was pregnant with their first child. The couple is staunchly opposed to abortion. (Bonnie Jo Mount/The Washington Post)

Still, it’s important to make sure patients know that abortion is an option, said Alan Peaceman, a maternal-fetal medicine specialist at Northwestern’s Feinberg School of Medicine. He says he always talks about termination, even if a patient has explicitly said that she opposes the procedure. Some patients might not know that abortion is something they should consider, or may feel differently about the issue when confronted with it in their own lives, Peaceman said. He always makes sure the option is “overtly known.”

The Lily asked Mary Norton, the division chief of maternal-fetal medicine at the University of California San Francisco School of Medicine, the top OB/GYN department in the country, to comment on the care the Smelcers say they received from Calhoun. It’s “ridiculous,” she said, to suggest sending a helicopter when there are no treatments that could improve the baby’s condition.

“It sounds like he was trying to paint a different picture than what was really happening,” she said.

“It sets up unrealistic expectations for the family, and that’s not fair to them,” Peaceman said. “There is an emotional cost to prolonging something that is inevitable.”

Brooklynn Stalnaker was a high school senior, and 20 weeks pregnant, when she learned her daughter had polycystic kidney disease, a condition where babies are born without working kidneys and underdeveloped lungs. Because she lived in Clarksburg, closer to Morgantown than Charleston, Brancazio was the first high-risk doctor she saw.

Brancazio suggested termination when she saw him in 2016, warning her that she may be risking her health if she continued the pregnancy, said Stalnaker and her grandmother, Betty Lopez, who was also in the consultation room. Brancazio said the baby “would die as soon as she was born,” Stalnaker and Lopez recalled. Although she opposes abortion, Stalnaker said, she briefly considered it, worried about her health. (Brancazio says he doesn’t recall Stalnaker’s case.)

Together with her family, who Lopez says are all deeply opposed to abortion, Stalnaker decided to consult with another doctor. They drove to Charleston, where she said they heard something very different. While Calhoun told her that her baby — whom Stalnaker planned to name “Braelynn” — would likely die soon after she was born, he also told Stalnaker that “he’s seen babies do crazy things and survive crazy things,” she said. “He never mentioned abortion.” He told her there would be no risk to her health if she carried the baby to term, she said.

Brooklynn Stalnaker honored her late daughter, Braelynn, with a tattoo. Braelynn lived for two hours. (Bonnie Jo Mount/The Washington Post)
Brooklynn Stalnaker honored her late daughter, Braelynn, with a tattoo. Braelynn lived for two hours. (Bonnie Jo Mount/The Washington Post)

He also said she had to deliver the baby through a Caesarean section, according to Stalnaker. Because she had no amniotic fluid, she said she was told, vaginal birth was not an option. When informed of this assessment in an interview, without medical records, all four maternal-fetal medicine specialists interviewed by The Lily, including Norton and Peaceman, disputed it. While a C-section may increase the chance that a mother could deliver a live baby with polycystic kidney disease, it would have no impact on the baby’s health outcomes, and increases the risk to the mother, Norton said.

There are health risks associated with the decision to carry any fetus to term, which can be hard to justify with a fatal diagnosis, said Norton. The longer you carry a baby, the more susceptible you become to various health complications, all four specialists agreed, including blood clots, hemorrhaging and hypertension. Among high-income countries, the U.S. has one of the highest maternal mortality rates.

Mothers who give birth with a C-section are three to four times as likely to die during childbirth as mothers who give birth vaginally. The scar on the uterus left behind from the procedure can make it more difficult to have additional children. A C-section is typically performed to help the baby, said Norton, except in cases when the mother’s health is at risk.

“We would basically never do a C-section if the baby was not going to survive,” she said.

After her initial appointment, Stalnaker and her family started driving to Charleston regularly. Calhoun would bring up plans for Braelynn’s future, Stalnaker said, describing how the NICU doctors would push air inside her baby’s body until her lungs developed.

The whole time, Stalnaker said, she knew her daughter wasn’t going to make it. Maybe it was just a “mother’s instinct,” she said, but it was frustrating to talk about the pregnancy with her family members, buoyed by Calhoun. Her 8-year-old sister told her friends that she couldn’t wait to be an aunt. Her grandmother set up a bassinet in Stalnaker’s room and stocked the house with diapers and lotions. Every time Stalnaker found something baby-related lying around the house, she said, she wanted to stuff it in a closet.

“I mean, personally, I felt like I was counting down the days for my baby to die. So pretty much every day it felt worse.”

To appease her grandmother, Stalnaker spent hours at a maternity photo shoot, posing with baby dresses and baby shoes. On the day of the C-section, Stalnaker’s grandfather drove to the hospital with a car seat, Lopez said.

Braelynn died of kidney disease two hours after Stalnaker gave birth.

“I felt like I was counting down the days for my baby to die.”

Brooklynn Stalnaker

Stalnaker did not have any complications during her pregnancy, and says she is happy with the care she received from Calhoun, who sent a bouquet of flowers after she left the hospital. No doctor had ever given her that kind of personal attention, she said.

But even though the C-section went as planned and Stalnaker went on to have two healthy children, Norton said a patient in this situation deserved to fully understand the risk she was taking. If Stalnaker had been Norton’s patient, she added, she would have cautioned her against a C-section.

Calhoun has said publicly that an abortion is never necessary to save the life of the mother. He will deliver babies early, and they will die from prematurity, he said, but he will never engage in what he calls “direct killing.” He has repeated versions of this statement at conferences, in an online video series, and while testifying on abortion legislation before the U.S. House Judiciary Committee.

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Norton says she regularly sees patients with medical conditions that require abortion. While doctors should generally remain neutral in consultations about the future of a pregnancy, Norton said, they must make an exception for patients with certain health conditions, like severe cases of pulmonary hypertension or heart disease. If patients do not opt for an abortion in these situations, studies show, they can die. In one case, Norton said, she recommended termination to a patient who decided to continue with her pregnancy, despite risks to her health. The patient died just after the delivery.

Calhoun sees patients with heart conditions regularly, he said at a Christian conference for doctors and nurses in London in October 2018. These patients, he said, often tell him that they need an abortion.

“I say, so? … Why don’t we just take care of you?” he told members of the Christian Medical Fellowship. “You’re more likely to die in the surgery for the abortion than you are with pregnancy, trust me. I’ve been doing this a long time.” (Studies show that abortions in the United States are safe and have few complications.)

Calhoun’s position on this issue is rare even among antiabortion OB/GYNs, said Calvin, who opposes abortion himself. It’s an “irrational” belief that “does not reflect reality,” he said, adding that sometimes abortion is the only thing that will save a mother’s life.

Calhoun has traveled all over the world to lecture on the dangers of abortion, sought out by antiabortion organizations for his expertise. He has published over 80 peer-reviewed articles in medical journals and has presented his work at more than 90 conferences and lectures, according to his resume.

His routine at these conferences is often the same: He pulls up a PowerPoint presentation, running through the potential risks. Abortion has been linked to breast cancer, sleep disorders, alcoholism, drug abuse, “death by violent causes,” he says, and a variety of mental health disorders. (These claims are “lies,” said American College of Obstetricians and Gynecologists representative Kate Connors, adding that these kinds of statements spread “fear and stigma” around abortion.)

Calhoun has blamed ACOG. The organization is perpetuating a “conspiracy of silence” around abortion, Calhoun said, refusing to acknowledge its harmful side effects.

It’s a view shared by many in the American Association of Pro-Life Obstetricians and Gynecologists. Created in April 1973, three months after Roe v. Wade legalized abortion, the group is a home for doctors who oppose ACOG’s stance on abortion. By joining, members make a commitment: Elective abortion “will have no role or place in our practice of the healing arts,” according to a letter the group sends to members.

In interviews, the members referred to medicine as “art” and doctors as “artists,” free to sculpt their practice in their own image. By recommending that all physicians discuss abortion and either “perform or refer,” no matter their views on the issue, ACOG is treating its doctors like “robots,” says Christina Francis, an OB/GYN in Fort Wayne, Ind. and chairman of the board of the American Association of Pro-Life Obstetricians and Gynecologists.

“Our educated opinions and even sometimes our moral opinions come into play” — as they should, Francis said. “People do not want amoral physicians.”

Connors defended ACOG’s position on abortion. The organization’s “affirmation of abortion as medical care,” she said, “is an evidence-based position that is without bias or judgment.”

In the early 1990s, Calhoun developed the concept of “perinatal hospice,” an approach to fetal care that reflected his own values. The idea sprung from a patient, he has said in several lectures. Her baby had a fatal diagnosis, but she was opposed to abortion. When the baby was born, Calhoun said, he invited the baby’s siblings to join the parents in the delivery room. For the duration of the baby’s life, they passed him back and forth, holding him until he passed away.

A life might only be 20 minutes long, he told a group of medical students at the University of Texas Medical Branch at Galveston in April 2018, at a lecture hosted by an antiabortion student group. But if “the whole time you’re alive, someone is loving you, and holding you, and supporting you, and with you,” he said, “that is a life well lived.”

The idea of “hospice” was wildly popular among people who are dying, Calhoun said. “So what if we take those concepts,” he asked himself, “and apply them before babies are born?”

“Our educated opinions and even sometimes our moral opinions come into play.”

Christina Francis, an OB/GYN and chairman of the board of the American Association of Pro-Life Obstetricians and Gynecologist

Working with a few other doctors, Calhoun decided that “perinatal hospice” would be “very high touch, not so high tech.” He would bring together a team of medical and nonmedical specialists that would care for the baby and the family, helping the mother to mourn her child while it was still inside her.

Since Calhoun first wrote about the idea of perinatal hospice in 1996, the concept has ballooned, spurred by Calhoun’s continued advocacy and research.

Perinatal hospice services are now offered by approximately 250 U.S. hospitals, medical centers and hospice facilities, and more than 70 around the world.

Abortion access in conservative states is more tenuous today than it’s been in decades. A 6-3 conservative majority on the Supreme Court has emboldened state legislatures to pass sweeping antiabortion legislation, with clinics forced to adapt to new regulations or close their doors. In Charleston, abortion rights advocates say Calhoun is on a mission to shut down the Women’s Health Center, the last clinic in the state.

A waiting room at the Women's Health Center of Charleston, West Virginia's lone abortion clinic. (Bonnie Jo Mount/The Washington Post)
A waiting room at the Women's Health Center of Charleston, West Virginia's lone abortion clinic. (Bonnie Jo Mount/The Washington Post)
A procedure room at the clinic. (Bonnie Jo Mount/The Washington Post)
A procedure room at the clinic. (Bonnie Jo Mount/The Washington Post)

In June 2013, a former clinic patient, Itai Gravely, filed a lawsuit against the Women’s Health Center, claiming a physician had left a 13-week fetal skull in her uterus during her abortion. Calhoun was the catalyst for the complaint, according to the court decision and an interview with Gravely. He also served as the plaintiff’s expert witness.

Gravely went to the hospital the day after her abortion with residual bleeding. Calhoun, working in the emergency room, performed a dilation and curettage (D&C), records show, a common procedure used to clear out the uterus after an abortion or miscarriage.

Gravely got a call from Calhoun one year later, according to the decision. He told her he’d seen the skull on the ultrasound, though he’d never mentioned it at the hospital. Then, the decision shows, he gave Gravely the name of a lawyer, Jeremy Dys, who was the president and general counsel for the Family Policy Council of West Virginia, a conservative, faith-based advocacy group.

At the hearing, the judge called Gravely’s claims “immaterial and, frankly, sensational.” Evidence showed that there was no 13-week fetal skull. She questioned why Calhoun had waited a full year to tell Gravely about it. It was remarkable, the judge wrote, that Calhoun had referred Gravely to Dys. (When asked in his deposition what prompted him to call Gravely a year after her hospital visit, Calhoun said that recent complications at other abortion clinics had jogged his memory.)

That same month, Calhoun wrote a letter urging West Virginia Attorney General Patrick Morrisey (R) to investigate the state’s abortion clinics. West Virginia’s clinics are a “totally unregulated environment” that provide “substandard care,” he wrote. He said in the letter that he saw post-abortive patients with complications “probably at least weekly,” a statement that was disproved by data issued by Calhoun’s hospital.

The letter and lawsuit prompted an outcry from women who sought OB/GYN care in the area, with many calling on WVU to take action against Calhoun for his antiabortion activism. State Del. Nancy Guthrie (D) filed a complaint with the West Virginia Board of Medicine in December 2013, suggesting that Calhoun’s claims about abortion complications at the hospital may have been “knowingly false” and urging the board to investigate.

“How in the world could a state-run university allow this guy to practice as the vice head of obstetrics?” Guthrie said in an interview. “It just didn’t make any sense.”

Guthrie never heard anything from the Board of Medicine about Calhoun, she said. (The board expunges this type of correspondence after two years, and said they have no recollection of Guthrie’s letter.)

Since 2006, Calhoun has taught classes and overseen dozens of residents at the West Virginia University School of Medicine. For his teaching work, separate from his work at the hospital, he makes $80,000 a year, according to his contract. At antiabortion conferences, he is introduced with his university title, though he clarifies that he is not speaking on behalf of the University.

Executive director of communications April Kaull said the university is “strongly committed to the ideals of free thought and speech.” When that commitment is “tested,” she wrote in an email, “our governing principle is to resolve such differences through discussion, debate and rigorous scientific inquiry.”

“Dr. Calhoun’s affiliation with West Virginia University does not preclude him from formulating personal ideas and beliefs regarding reproductive health and does not prohibit him from sharing his personal beliefs with others. However, when he is speaking as a private citizen, he must have a clear understanding that he is not speaking as a WVU representative,” added executive director of communications and institutional relations Tara Scatterday.

Calhoun works closely with OB/GYN residents who pass through West Virginia University, according to several doctors affiliated with WVU, supervising their work before they disperse to hospitals and medical practices all over the country.

“The footprint he’s leaving is so much bigger because he’s making an impression on kids who are in medical school and residency when they’re learning about these things,” said Tucker, the OB/GYN in Martinsburg.

In Ontario, an audience member asked Calhoun if his antiabortion lecture material was part of the standard medical school curriculum.

He couldn’t speak for all medical schools, he said, but his students know this information.

“I teach them this stuff all the time,” he said.

Do you have an experience with an antiabortion OB/GYN? Email us.

Correction: An earlier version of this article misstated where Lori Tucker works. It is Martinsburg, not Martinsville. An earlier version of this article also misstated when the Pew Research Center collected data on antiabortion beliefs in West Virginia. It was collected in 2014, not 2020.

About this story

Editing by Neema Roshania Patel and David Fallis. Design and development by Christine Ashack. Art direction by Amy Cavenaile and Rachel Orr. Photo editing by Haley Hamblin. Research by Alice Crites. Copy editing by Laura Michalski. Graphic by Dylan Moriarty. Illustrations by Lisk Feng. Photos by Bonnie Jo Mount.