Crime Library: Criminal Minds and Methods

Dr. Kermit Gosnell and the Philadelphia Abortion Mill

The Procedures

Despite being in charge of the clinic, Gosnell was almost never on the premises, leaving his untrained, incompetent staff alone. They would only resort to calling him once in a while because, as they told the Grand Jury, he had a temper and didn't like to be bothered. What was Dr. Gosnell doing while his patients moaned in pain, unmonitored by his minimum-wage staff? Swimming, jogging and relaxing.

Meanwhile, his staff were performing dangerous procedures -- using outdated, unsterilized and often broken equipment.

The motive for the madness at the Women's Medical Society was simple: money. In a normal medical clinic, only a doctor administers drugs; this is especially important during surgical procedures when the patient needs to be under anesthesia. But at Gosnell's clinic, drug packages were sold to women, often for abortions that in a normal clinic would be done in an hour and not require any major pain medication.

The choices were outlined in a handwritten chart made by Ashley Baldwin, the 15-year-old high school student.

The words "Heavy," "Twilight," "Custom" and "Local" were color-coded with yellow, green, and blue dots. The amount of drugs for each was incredibly high by any standard, and included a mixture that often could have dangerous double effects on the central nervous system.

The "recipe" for "Twilight": 75 milligrams of Demerol (meperidine); 12.5 milligrams of promethazine (Phenergan); and 7.5 milligrams of diazepam (Valium).

They were administered without regard to the height or weight of the woman receiving the treatment, not to mention her prior medical history.

Sedation chart drawn by Ashley Baldwin.
Sedation chart drawn by Ashley Baldwin. More Photos

Latosha Lewis told the Grand Jury how the patients were presented with their choice of medicine: "You can pick which anesthesia you want to receive, whether you want to be up, half asleep, if you want to be knocked out, and it's additional to your procedure, but local anesthesia is included in the smaller cases and custom anesthesia, which is the highest, to be put to sleep in the bigger cases."

Again, no qualified anesthesiologist was on staff.

The cost of the medicines were printed on a chart that advised:

It will probably be best to pay the extra money and be more comfortable if some of the following conditions are true for you.

1. The decision to have the procedure is a difficult decision.

2. Medication is usually necessary for your menstrual cramps.

3. Your decision has been forced by your parents or partner.

4. Your family members or friends 'don't like pain.'

The drugs cost $50 more for heavy sedation; $140 for twilight sedation and $200 for the custom option. The cost of an abortion was rated based on how far along the mother was -- if the woman was willing to pay cash and was only four to eight weeks pregnant, the procedure cost $450. But women who were between 21 to 24 weeks pregnant paid between $1575 to $1850 in cash.

For those women who were there for the late term abortions, the procedures were a two-day affair. They would arrive the afternoon or evening prior to the operation, and one of Gosnell's untrained staff would start inducing labor. Cytotec was given to most of the women to begin contractions. Normally put inside a patient's lip, Williams habitually put in it inside their vaginas. Sometimes, the staff would sometimes insert synthetic or seaweed rods called laminaria the night before their procedure, to help the dilation of the cervix. This procedure is delicate and should be performed by a doctor. .

Because the cramping from the laminaria and the Cytotec was so severe, the women were often in excruciating pain for hours at a time. Gosnell was usually not on the premises. This meant they were immediately drugged -- often to the point of overdosing. Restoril, a sleep disorder treatment with muscle relaxant properties, was the drug of choice -- often given in addition to the sedation packages.

Most of the time, eight or ten women were kept in a single room, moaning and groaning in pain. Gosnell's instructions were to drug them up as much as possible to "quiet them."

Tina Baldwin testified at the Grand Jury that they would take the loudest woman, "Put her in a room, let's give her her medication, quiet her up. She's upsetting everybody else. So usually she would get done first."

Sometimes, Baldwin testified, Gosnell would slap women to get them to shut up; if that didn't work, he would completely sedate them. He did this because he was afraid that any screaming would be cause for attention from the police.

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