By Carole Joffe
What is there to say, five years after the tragic murder of Dr. George Tiller, about the legacy of this remarkable man? The polarization—around Tiller specifically, and abortion in general—that occurred in Kansas during his lifetime has in no way abated. The abortion situation in Kansas in the post-Tiller era can be best understood as a series of both skirmishes and high-profile battles between the two sides of the endless abortion war.
Around the time of Tiller’s death, Kathleen Sebelius, then the Democratic governor of the state, who had served as a firewall between Tiller and other Kansas providers and the anti-choice state legislature, left to join the Obama administration; she was soon replaced by Republican Sam Brownback, a former senator and anti-abortion fanatic. The Kansas legislature which—in a move engineered by Brownback—has seen many moderate Republicans replaced by extreme right-wing ideologues, has passed one abortion restriction after another, all eagerly embraced by the governor. These measures include requiring women in emergency situations to wait 24 hours before obtaining an abortion, discriminatory tax penalties on abortion providers, mandates to impart medically inaccurate information to their patients, and, perhaps most surreal of all, a law that prohibits abortion providers from involvement with local schools, including serving as chaperones on school trips. The Center for Reproductive Rights has fought valiantly to challenge most of the above-mentioned laws passed by the legislature, achieving some victories.
After Tiller’s death, the Kansas Board of Healing Arts launched a witch hunt against Dr. Ann Kristin Neuhaus, who had served as Tiller’s second opinion on the third-trimester procedures performed at his clinic, as Kansas law required. Arguing that Neuhaus had inadequately documented the need for third-trimester procedures, the board revoked her medical license. But after a court case (which nearly bankrupted her), Neuhaus’ license was restored—only to have the board announce it would appeal the judge’s ruling. (As of this writing, the matter remains unresolved.)
As the closing of Tiller’s clinic after his murder left the city of Wichita (population 385,000) without any abortion facility, Dr. Mila Means, a local Wichita doctor, attempted to incorporate abortion into her family medicine practice, but her landlord forbade this, claiming this would cause a “nuisance,” a claim upheld by a judge. Julie Burkhart, a former associate of Tiller’s, has successfully opened an abortion facility, South Wind Women’s Center, at the site of his former clinic. But Means, Burkhart, and some of the staff of South Wind have been subject to terroristic threats.
Two of the physicians who had worked with Dr. Tiller in Wichita began to work at the Southwest Women’s Center in Albuquerque, where they continue to provide third-trimester abortions on a case-by-case basis while also incorporating many of the emotional support services Tiller had pioneered for this special patient population. (A third former Wichita colleague opened a facility in Maryland.) In response to the expanded services at Southwest, Operation Rescue operatives and other anti-choice forces succeeded in getting a referendum on the Albuquerque ballot in fall 2013 that would have imposed a ban on abortion after 20 weeks (an increasingly common restriction passed by some states, though quite rare to be city-specific). To the immense relief of the pro-choice community, both in New Mexico and nationally, the measure failed.
The most unequivocal victory that abortion rights supporters in Kansas have experienced since Tiller’s death is the disbarring of the former attorney general of Kansas, Phill Kline. In a move recently upheld by the U.S. Supreme Court, the Kansas Supreme Court revoked his legal license, citing his abuse of power in his investigation of Tiller, Neuhaus, and other abortion providers in Kansas. Among other acts of misconduct, Kline had leaked the records of abortion patients.
Nationally, arguably the most significant cultural event that has occurred concerning George Tiller in the past five years has been the debut of the film After Tiller, which focuses on the third-trimester procedures provided by his above-mentioned former colleagues working in New Mexico and Maryland, as well as a longtime friend and associate in Colorado. Quite remarkably for an independent film, After Tiller, its distributor told me, has been released in 45 U.S. cities, as well as a number of places abroad; shown at 33 American film festivals and 11 international ones; and has had more than 100 non-theatrical screenings. Katrina Kimport and Gretchen Sisson, two University of California, San Francisco sociologists, have been conducting research on the impact of this film on viewers across the country. As Sisson told me, “Viewers of After Tiller do seem to be thinking more deeply and carefully about third-trimester abortion. For many, later abortion isn’t something they’ve thought much about, either in terms of why women would seek them or why doctors would provide them. But most viewers that we’ve interviewed recognize the humanity and moral agency of the patients, and the commitment, compassion, and ethical practice of the provider. … The intimate reality of later abortion care seems to move people very differently than does the charged political rhetoric surrounding it.”
The bottom line, of course—the crucial question to ask about George Tiller’s legacy—is whether the women about whom he cared so deeply and whom he understood so well are currently able to receive high-quality, respectful care at later stages of pregnancy. Various organizations, such as the National Abortion Federation and numerous local abortion funds, are making every effort possible to help women who need this care to get to one of the clinics profiled in After Tiller. A handful of facilities, mainly on the coasts, extended their abortion gestational limits to the extent legally permitted, as a response to the closing of Tiller’s clinic. But we are currently in an era of a ferocious legislative backlash against all abortions, including first-trimester ones—a development that started with the Republican sweep of state elections in 2010. So the road ahead for providers and their allies to not only preserve George Tiller’s specialized service, but simply to stay open, is hardly an easy one. Nevertheless, many of those who knew Dr. Tiller as a colleague and friend are no doubt fortified by remembering one of his favorite sayings: “Attitude is everything.”
Note: This article originally appeared in RH Reality Check.
Dr. Carole Joffe is a professor at the Bixby Center for Global Reproductive Health at the University of California, San Francisco. She is the author of four books: Friendly Intruders: Childcare Professionals and Family Life (1977); The Regulation of Sexuality: Experiences of Family Planning Workers (1986); Doctors of Conscience: The Struggle to Provide Abortion before and after Roe v Wade (1996); and Dispatches from the Abortion Wars: The Costs of Fanaticism to Doctors, Patients and the Rest of Us (2009). She is also the author of numerous articles on various aspects of reproductive health services and politics.