Working with Dr. Tiller: Staff Recollections Of Women’s Health Care Services of Wichita

WHCS’s closure raised important public health concerns; chief among these was what would become of women carrying wanted pregnancies that go horribly wrong late in pregnancy. For abortion providers wishing to offer similar specialized abortion care, and for scholars of the nation’s longstanding abortion confl ict, the closure raises other important questions: What services were developed for this unique segment of abortion patients? How did staff cope with working in a facility that was continually under attack by antiabortion activists? This report draws on interviews the author conducted with seven former WHCS staff members to address these questions. Open-ended group interviews took place in Wichita in December 2009. The author made follow-up queries by e-mail and phone. The institutional review board of the University of California, San Francisco, approved the project. The focus here is on the carefully choreographed experience of women who qualifi ed for abortions after 24 weeks’ gestation because of fetal indication—that is, their fetuses had anomalies such as anencephaly (the absence of a large part of the brain and skull) or trisomy 13 (a genetic disorder characterized by multiple abnormalities, which typically leads to death within the fi rst month of life). According to staff, Dr. Tiller devoted much thought to the particular care needed by fetal indication patients, and he refi ned his approach over many years. These patients made up about 15–20% of the WHCS caseload. (Of the remaining patients, about half sought fi rst-trimester abortions, and half either sought second-trimester abortions or came for later abortions because of “maternal indications”—serious physical or mental health conditions, such as cancer or pregnancy resulting from incest.)