In wake of Tiller murder, abortion patients head to Colorado

BOULDER, Colo. — Behind the bulletproof glass and drawn blinds, Warren Hern tends to his patients in the lower level of his clinic, padding up and down the stairs in green surgical scrubs.

There are no protesters outside, no white crosses lining the clinic's grounds.

There is also no doubt about what happens in this sandy brick building across from Boulder Community Hospital: The Boulder Abortion Clinic is clearly marked.

Downstairs is a woman who chose to terminate her pregnancy because of a fetal abnormality, Hern tells a visitor in an upstairs room. The woman was scheduled to have a late abortion at George Tiller's Women's Health Care Services clinic but came to Hern after Tiller's clinic closed following his May 31 shooting death.

Hern, 70, has thick gray hair, glasses and a rapid-fire cadence to his speech. He has seen more patients since Tiller's death and expects that to continue.

Hern specializes in late abortions, which he defined as 20 weeks and more in a March letter to area medical colleagues. He says about 95 percent of his practice is late abortions.

Since Tiller's death, Hern — who was a pallbearer at the funeral — is guarded 24 hours a day by federal marshals. A sign inside his clinic's lobby door cautions patients, "For your safety, do not open this door for anyone who has not accompanied you."

Hern would not disclose how many abortions he performs in an average week. In the March letter to fellow medical professionals, Hern said his clinic, which opened in 1975, had performed about 15,000 abortions from 15 through 26 weeks of pregnancy and about 2,000 beyond 26 weeks.

He said that patients whose pregnancies are beyond 26 weeks are evaluated individually "to determine specific indications for pregnancy termination. Such indications have included fetal abnormality, fetal demise, several medical complications, rape, incest and documented psychiatric disturbance."

If patients request, Hern's clinic also arranges for religious or spiritual ceremonies as well as cremation and burial.

What has been lost in all the rhetoric of the abortion debate, all the protests, all the violence, Hern says, is the rights of women.

"This is not about abortion," Hern says vehemently. "This is about power."

And the abortion debate, he says, is not a debate at all.

"This is a civil war," he says. "These people are using bullets and bombs. That is not a debate."

After he was shot in both arms in 1993, Tiller largely kept a low profile, declining requests for interviews. In contrast, Hern, speaks out openly.

On June 10, he wrote a letter to President Obama saying it was "past time for this continuing anti-abortion terrorism and violence to end."

In it, Hern wrote about the "thousands of death threats" he has endured and what he describes as attempts to end his life.

He signed the letter: "We need your help -- now."

Hern said that he did not perform as many abortions as Tiller. He also said that Boulder is a much different place than Wichita and is more tolerant of a woman's right to choose.

Protesters, he said, come and go at his clinic, just blocks from Boulder's busy Pearl Street Mall shopping and entertainment area.

In his office, he motions to the parking lot and says a protester once tried to run him over there. In 1988, his clinic was riddled with five bullets from what he says was a high-powered rifle.

Asked how long he will continue his practice, Hern shrugged.

His mother, Edna Hern, said she thinks her son would like to retire.

"I would like for him to, and I think he would like to," she said.

But he feels an obligation to women, especially now that there is one fewer doctor willing to perform late abortions, she said.

Her son, she said, has been threatened his entire career.

The National Abortion Federation in 2007 said that Tiller, Hern and the Atlanta SurgiCenter were its only members to perform late abortions. After Tiller was killed, the federation would not say how many doctors perform late abortions other than it's a "small handful" of its 400 members.

National Abortion Federation president Vicki Saporta said she didn't want to publicly name any other doctors or clinics that offer late abortions "because of legitimate security concerns."

"Doctors are now stepping up to fill the void," she said. "We're determined to ensure women have access."

About 20 percent of the nation's 1,787 abortion providers in 2005 offered abortion after 20 weeks, and 8 percent offered abortions at 24 weeks, according to the Guttmacher Institute, a research group that supports abortion rights.

Hern spoke June 11 at an evening vigil service for Tiller in Denver sponsored by NARAL (National Abortion Rights Action League) Pro-Choice Colorado and the Colorado Religious Coalition for Reproductive Choice.

The vigil was held at Temple Emanuel and featured Hern and the comments of the congregation's rabbi, Steven Foster, the Rev. Barbara Molfese of the Unitarian Universalist Church of Boulder and Sister Mary Ann Cunningham.

Foster opened the vigil by denouncing Tiller's shooting and violence June 10 at the U.S. Holocaust Memorial Museum in Washington, D.C.

A young girl seated in the chapel wrote a question to her mother in a wide-lined notebook: "Did both of those people die?"

"Yes," the mother wrote back.

"You didn't tell me that," the girl responded.

Foster said Tiller's shooting and that at the Holocaust museum were borne of the same hatred.

Hern spoke of how Tiller took over his father's family practice after his parents, sister and brother-in-law were killed in a 1970 plane crash. Tiller, Hern said, had planned a career in dermatology.

"He soon found that women had come to his father for help to have safe abortions, illegal at that time. Women appealed to George to continue his father's compassion and service. At first, he refused, and one woman died from a badly done abortion. George changed his mind. He became not only a skilled family practioner, he became highly skilled in difficult late abortion procedures. His patients came from around he world with tragically complicated pregnancies for his help."

Both in his office and at the vigil, Hern said that he and Tiller "were each others' only peers."

Women who seek late abortions usually want their pregnancies, but their fetuses have anomalies "incompatible with life," said National Abortion Federation president Saporta.

"For them, there is no choice," she said.

Anti-abortion groups, who have particularly spoken out against doctors such as Tiller and Hern, disagree.

Late abortions are "never necessary," said Troy Newman, president of Operation Rescue. Advances in medicine have made it possible for fetuses to be viable outside the womb earlier and could be delivered if the mother's health is at risk, he said.

Abortions due to fetus abnormalities or predicted short life are also unnecessary and based on doctors' opinions, which aren't always right, Newman said.

"We do not kill someone because of life expectancy," he said.

Anti-abortion groups condemned Tiller's shooting, saying they do not support violence.

Mary Kay Culp, executive director of Kansans for Life, said the shooting death of Tiller is "tragic" and won't help the cause.

"It offers our opponents a chance to distort it -- as if we think it's OK," Culp said. "It's not OK. We labor through the system to accomplish our goals."

The U.S. Supreme Court's 1973 decision in Roe v. Wade prohibited states from banning abortion in early stages of pregnancy. The case, along with a companion one, allowed states to restrict abortion rights later in pregnancy -- as long as it included exceptions for the mother's physical, emotional and psychological health.

About 1.1 percent of abortions nationwide were done after 21 weeks in 2005, according to the Guttmacher Institute, a research group that supports abortion rights.

About 3 percent of abortions in Kansas in 2008 were done after 21 weeks of pregnancy, according to the Kansas Department of Health and Environment.

State law bans abortions of a viable fetus unless it is necessary to preserve the life of the woman or if the birth will cause a substantial and irreversible impairment of a major bodily function of the pregnant woman. Kansas law doesn't mention fetal anomalies.

Kansans for Life and other groups have focused on state laws regarding abortions after 21 weeks because they think Tiller and other doctors violated them, Culp said.

If the fetus is considered viable, the doctor must say the abortion was done in the interest of the mother's physical or mental health and have a second, unaffiliated doctor agree.

Tiller was acquitted in April of charges that he did not consult an independent doctor before performing late abortions on viable fetuses.

"They're not applying the law correctly," Culp said. "We're just trying to go through every legal, legislative and political means possible.

"That's why we've been focusing on late-term abortion law in Kansas for the past six years."

The administrator of, Ayliea Holl, said she had an abortion at almost 19 weeks.

She said she had never expected to be able to have children because of endometriosis when she found out she was pregnant at 40. She underwent an amniocentesis at 15.5 weeks, and later learned her baby, a girl, had Trisomy 21 -- Down syndrome -- with heart and digestive disorders.

She decided on an abortion after three doctors told her that her daughter would be mentally disabled and there was a good chance she would not survive the needed surgeries, she said.

"It was the hardest, most anguishing decision I have ever had to make."

She worries for women who find themselves in her situation in the future.

"I think that the death of Dr. Tiller is going to play a huge role in women's health care," she said. "Dr. Tiller didn't 'just' perform abortions, he provided much needed health care for all women, and especially for those whose own states would not provide care for them when they found out that their children were diagnosed with severe or fatal anomalies."

Holl said it isn't her place to judge another person's choice about whether to have an abortion.

"It is my place to speak out and say that yes, I had one, and yes, I would do it again," she wrote. "I would make the same choice to spare my child from any kind of suffering, and so would many other women."

Another Web site,, encourages women to carry to term after diagnoses of fetal anomalies.

"Even a dying baby can have the dignity of living out their natural life -- however short it might be," said Colorado Springs resident Michele Wood, who supports the site. "The pain of these women's decisions is excruciating. They feel that their babies are better off never being born. But after their baby is gone, they are left with the pain of having decided the time and place of their baby's death.

"Can anyone bear that pain? I see these women on the (discussion) boards for years justifying to everyone -- themselves mostly -- that they made the right choice. After seeing their anguish I wonder if perhaps that decision isn't anyone's to make."

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