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Why a Gruesome Pennsylvania Abortion Clinic Had Not Been Inspected for 17 Years

State health officials deliberately chose not to enforce laws giving abortion clinics the same level of care as other medical service providers.
 
 
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While this week's indictment involving a grisly abortion mill in Philadelphia has shocked many, the grand jury's nearly 300-page report also contains a surprising and little-noted revelation: In the mid-1990s, the administration of Pennsylvania governor Tom Ridge, a pro-choice Republican, ended regular inspections of abortion clinics—a policy that continued until just last year. 

According to the grand jury report[PDF] released this week by Philadelphia prosecutors, Pennsylvania health officials deliberately chose not to enforce laws to ensure that abortion clinics provide the same level of care as other medical service providers.

The District Attorney’s office this week charged an abortion doctor, Kermit Gosnell, with murder and infanticide. Nine other workers at the abortion clinic, the Women’s Medical Society, also face charges. According to the prosecutors, Gosnell and his associates not only broke state law by performing abortions after 24 weeks—they also killed live babies by stabbing them with scissors and cutting their spinal cords. Law enforcement officials found blood-stained furniture, unsterilized instruments and fetal remains scattered about the clinic. At least one woman, a refugee from Nepal, had died under Gosnell’s care after being given repeated injections of a dangerous sedative. Prosecutors said Gosnell made millions from treating and sometimes maiming his patients, who were mostly low-income, minority women.

But perhaps most frightening of all? The atrocities were discovered by accident, as the Philadelphia Inquirer points out. Warnings—from patients and their attorneys, a doctor at a Philadelphia hospital, women’s health groups, pro-choice groups, and even an employee of the Philadelphia Department of Public Health—failed to prompt state and local authorities to investigate or take action against the clinic.

The grand jury report said that one look at the place would have detected the problems, but the Pennsylvania Department of Health hadn’t inspected the place since 1993. Here’s the grand jury report, in surprisingly strong language:

The Pennsylvania Department of Health abruptly decided, for political reasons, to stop inspecting abortion clinics at all. The politics in question were not anti-abortion, but pro. With the change of administration from Governor Casey to Governor Ridge, officials concluded that inspections would be “putting a barrier up to women” seeking abortions.

“Even nail salons in Pennsylvania are monitored more closely for client safety,” the report states. "Without regular inspections, providers like Gosnell continue to operate; unlawful and dangerous third-trimester abortions go undetected; and many women, especially poor women, suffer."

According to the report, the policy change occurred after 1993 when attorneys under the administration of then-governor Tom Ridge "interpreted the same regulations that had permitted annual inspections for years to no longer authorize those inspections." Thereafter, only inspections triggered by complaints were authorized. The report noted that Department of Public Health officials reinstituted regular inspections of abortion clinics in February 2010. Ed Rendell, the Pennsylvania Democrat whose second term as governor ended last week, released a statement saying he was "flabbergasted" when he learned of the department's lax scrutiny of abortion clinics and immediately ordered increased inspections, the Associated Press reported.

Still, the earlier policy had its defenders. According to the grand jury report, when the Department of Health's chief lawyer was asked about it, she responded, "People die."

Given that between 30,000 to 40,000 abortionsare performed each year Pennsylvania, it’s unclear how many women have been put at risk in the almost two decades that regulators suspended regular inspections of abortion clinics in Pennsylvania. The grand jury report does note that many organizations perform safe abortion procedures and have high standards of care, but that’s “no thanks to the Pennsylvania Department of Health.”

The state’s Department of Health did not comment on the matter but said it would forward our request on to the governor’s press office. We've also left a message with Tom Ridge's spokeswoman. We’ll update if they respond.

Marian Wang is ProPublica's lead reporter-blogger. She previously worked for Mother Jones, where she spearheaded the magazine's social media strategy.