Dr. Tiller’s clinic Web site boasted that he had more experience with late-term abortions “than anyone else currently practicing in the Western Hemisphere.” Since 1998, interviews and state statistics show, his clinic performed about 4,800 late-term abortions, at least 22 weeks into gestation, around the earliest point at which a fetus can survive outside the womb. At 22 weeks, the average fetus is 11 inches long, weighs a pound and is starting to respond to noise.
PASTOR The Rev. Lowell Michelson said that Dr. Tiller gave options to women “when they had none.” Credit Steve Hebert for The New York Times
About 2,000 of these abortions involved fetuses that could not have survived outside the womb, either because they had catastrophic genetic defects or they were simply too small.
But the other 2,800 abortions involved viable fetuses. Some had serious but survivable abnormalities, like Down syndrome. Many were perfectly healthy.
Like many states, Kansas has long placed limits on late-term abortions of viable fetuses. They can be done only to save the woman’s life or because continuing the pregnancy would cause her a “substantial and irreversible impairment of a major bodily function,” a phrase that Kansas legal authorities, citing United States Supreme Court cases, have said encompasses the woman’s physical and mental health. The state also requires the approval of a second Kansas physician “not legally or financially affiliated” with the doctor performing the abortion.
Even so, Kansas law gives considerable deference to physicians’ judgments. Dr. Tiller and his staff said they had a rigorous screening process to comply with the law.
The vast majority of women seeking late-term abortions from Dr. Tiller’s clinic were from other states, records and testimony show. Dozens more came each year from Canada and other countries. Many were referred by their obstetrician. Law enforcement officials sometimes gave Dr. Tiller’s name to victims of rape or incest.
Prospective patients were required to submit a battery of medical records. They were asked whether they had considered adoption. Before meeting Dr. Tiller, women were interviewed by at least two clinic counselors. Many of the questions — about appetite, sleep habits, thoughts of suicide — were intended to detect symptoms of severe mental illness. Patients were also examined by a second physician, as required by law.
According to sworn testimony by his staff, hundreds of women were turned away each year because they did not meet the legal requirements for a late-term abortion.