Because I am a Woman

Carhart is 67, heavy-set and deliberate in his movements and speech, a man who looks as if he could use a good rest more than a five-hour drive to Wichita. If his life had taken a different course, he would be thinking about wrapping up an uneventful career as a general surgeon in Omaha. That’s where he founded an emergency walk-in clinic in 1985, after a 21-year career as an Air Force surgeon. Carhart had trained as a fighter pilot in Texas and England—although he never flew in combat—and got his medical degree, from Hahnemann Medical College in Philadelphia, while still in uniform. He was a surgeon at Ouffett Air Force Base near Omaha before retiring as a lieutenant colonel. His life seemed set in a comfortable mold—married to his -elementary-school sweetheart with two teenage children and a 62-acre farm outside town. It all changed in 1987, when a nurse prevailed on him to spend a day at the abortion clinic where she worked. Talking to the women reminded him of the patients he had seen as a medical student, in the days before Roe: women whose botched abortions, anywhere from the first to the third trimester, left them with perforated uteruses, intestines protruding from the vagina, or untreatable pelvic infections. The way Carhart remembers it, it was a good week for the emergency room if only five women died. Soon after the visit he trained at an abortion clinic in Philadelphia, performing more than 500 abortions in four months. When he returned to Omaha, Carhart began splitting his time between his friend’s abortion clinic and his own emergency facility. Some specialists, who objected to his abortion work, refused to see patients Carhart referred to them, even if the patients came from his emergency practice. When his farm burned down in 1991, Carhart got defiant: he added an abortion practice to his walk-in clinic. His two physician assistants quit in protest.

It was at Tiller’s clinic that Carhart first performed late-term abortions. The two met in 1988 at a National Abortion Federation meeting and quickly became friends and confidants: two unassuming Midwestern doctors who were both risking community pressure—if not yet their lives—doing abortions in conservative states. “He would always be there,” says Carhart. “He would call me if he had a hard patient; I would call him when I needed someone to talk to. We became each other’s therapists.” When Kansas passed a law in the mid-1990s requiring second consultations for abortion, Carhart would do Tiller’s over the phone. In 1998 he began assisting with surgeries in Tiller’s clinic, and starting in 2004 he spent every third week there.