In the wake of the Kermit Gosnell trial, you’d think it would be easier these days to shut down rogue abortion providers offering cut-rate, unsafe services. However, responsible health providers and government officials are finding that things are not so simple when it comes to trying to run Steven Brigham out of business. In a lengthy piece for The New Yorker, Eyal Press reports on the multiyear attempts, spearheaded by more reputable abortion providers, to get Brigham out of the abortion business, and how the man's massive ego and apparent greed keep him in the business, despite a growing list of women allegedly injured either directly at his hands or in one of the many clinics he owns on the East Coast.
The list of accusations against Brigham is dizzying: advertising cut-rate fees to attract poor clients and hitting them with a bunch of hidden charges when they show up for care, replacing effective abortion medications with cheaper ones that leave patients sick and often still-pregnant, using unqualified and underpaid staff, performing later term abortions without proper training, and maintaining unsanitary conditions. Brigham has personally injured a lot of women by performing substandard abortions, which is why, as RH Reality Check reported over the summer, his license has been suspended in up to six states, but this hasn't stopped him from owning clinics and hiring other people to keep providing the dangerous abortions. He is currently trying to defend his right to practice medicine in New Jersey.
Brigham tends to ascribe his continuing legal problems to anti-abortion forces that are out to destroy him, but his many and varied pro-choice opponents strongly disagree. As the New Yorker piece shows, pro-choicers have been trying to get rid of Brigham for years, and many argue that Brigham's career is only possible because of abortion politics. Abortion stigma, protesters, and unnecessary laws designed to run good providers out of business all help create a vacuum that people like Brigham and Gosnell fill. "As reputable doctors, hospitals, and medical schools increasingly distanced themselves from abortions, it became more likely that substandard providers would fill the void," Press writes.
Greedy, unscrupulous doctors don't just exploit the fact that demand for abortion remains high while the number of quality providers is declining. They also realize that the constant drumbeat of shame aimed at women who seek abortion means they can treat patients terribly without worrying too much about complaints. Some patients don't think they deserve to be treated any better and others are just simply afraid to out themselves as abortion patients by registering their complaints about the service they received. Press interviewed Sarah Tombler-Gimpel, a patient who was seriously injured at a Pennsylvania clinic that Brigham owns.* Tombler-Gimpel had, in the past, had a safe and satisfactory experience at another nearby clinic but decided to go to Brigham's instead because she felt extreme shame that the workers at the safer clinic would know this was her second abortion. "Determined to avoid getting trapped in the same cycle—and to keep her abortion a secret—she sought out a clinic that was quick, cheap, and anonymous," writes Press. Tombler-Gimpel herself called it the "fast-food experience." She very nearly died from the infection she got at Brigham's clinic.
So what can be done to stop dangerous abortion providers? One major thing is to stop marginalizing abortion from the rest of medical care through anti-choice legislation and social stigma. If good doctors felt they could offer abortion as a normal part of their medical practice without drawing the ire of anti-choice protesters and legislators who want to run them out of business, then it would make it much harder for rogue providers to exploit women who need abortions but feel their options are limited.
*Correction, Jan. 27, 2014: A previous version of this post misspelled the last name of Sarah Tombler-Gimpel.