Talking to poor women like those who sadly found themselves on Kermit Gosnell's doorstep about choosing to terminate a pregnancy or bring another baby into
the world is something I've done a number of times a social worker. The decision is often complicated by issues of substance use, mental illness, and
general ability to provide for another mouth; there's a real question as to whether or not bringing another child into such an unpredictable world is the
right thing to do. Money for the procedure is always an issue. I provide information about where to find safe, affordable service should she choose to get
an abortion but never try to influence the ultimate decision.
Ashely's decision was complicated by her mother's pleas for her not to terminate the pregnancy. Abortion among the often Biblically-literalist
and very conservative black churches of Philadelphia is heresy; black genocide narratives like the one suffusing 3801 Lancaster, a recently-released documentary about
Gosnell, take hold in this fervent religious culture. "Don't kill your miracle!" Ashley's mother begged her. Watching Ashley struggle with a decision that
on one hand could ruin her own future but on the other ruin her relationship with her mother and her church was heart rending.
What's worse is that the cost of the abortion, $300, would break Ashley's budget. There was no such thing as an extra $300 in Ashley's world. If she was
going to go through with it, could she raise the money, and could she do it in time? I was concerned that if she paid for the abortion she would get behind
on rent, and wind up back on the streets. If welfare medical assistance provided funds for women to have abortions, she could have very quickly and safely
had the procedure done. Instead, the clock was quickly ticking as she explored every avenue for getting the money together. The longer it ticked, the more expensive the procedure would become, until ultimately it would become illegal and she would have to bring the baby to term. Or, if she
was that desperate, she might have turned to Kermit Gosnell, who allegedly exploited exactly this scenario of poor women past the term limit for a legal abortion,
maybe because while they were struggling to get the money together for it the clock ticked to long, maybe because they were ignorant of other, better
resources for the service.
In retrospect, it seems to me almost inevitable that if a Kermit Gosnell were to exist, he would exist in Philadelphia. The poorest of America's largest cities, saddled
with a dysfunctional system of institutions that serve the poorest communities, a state level bureaucracy hostile towards us because we're so poor and need
so much, with a frequently broken system of oversight that has produced scandal after scandal, tragedy after tragedy in our child welfare system, our
schools and our health services. Of course Gosnell, operating in plain sight for years, should have been stopped long before he was. However, I
would further argue that if access to safe and legal abortions were expanded, and public funds used to provide them, there wouldn't have been a Kermit
Gosnell. The poor women upon whom Gosnell preyed would not be shunted into the black market if earlier on there had been safe, free services available to everyone in need.