As I’ve headed to work in recent days to see abortion patients in my office, I have felt bereft: All the premises of my life, work, education, and future were gone. Something very profound in the meaning of the America I know has been destroyed with the election of Donald J. Trump as president.

One of the reasons I’ve felt this way is that, for the past 45 years, I have dedicated my medical career, skills, and life to the assistance of women who need my services as a physician in performing safe abortions.

It is my definition of practicing medicine: a noble art that involves helping other people at the most personal level. There is nothing more personal, intimate, and private for a woman than deciding whether to have a baby or end a pregnancy.

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This lifetime dedication to helping those women means for me, among other things, that I have a home, a family, an office, a staff, deeply satisfying work, and all the connections and financial obligations that those things bring.

But I have lived for the past 45 years under constant stress. Anti-abortion protests have targeted me personally. I have received innumerable death threats because I do this important work.

I have survived, but some of my colleagues and friends have been murdered by anti-abortion fanatics.

Donald Trump has said that women should be punished for having abortions. Trump’s running mate, Indiana Governor Mike Pence, has used attacks on abortion as the principal focus of his public career.

With Trump as president and the sworn enemies of abortion controlling both houses of Congress, I really wonder if I can leave the country for any purpose and be confident that I will be allowed to return. What if the Republicans won’t let me back into my own country? What happens to my life then?

It seems irrational, but the people now in charge of our national government are not rational people. They have expressed their hatred for the work I do for women. It doesn’t matter that I am a citizen and a physician. I feel that I am subject to hostile, unrestrained arbitrary power.

In fact, one week ago I received a chilling letter from Representative Marsha Blackburn (R-Tenn.), the most ferociously anti-abortion member of Congress, who chairs the Select Investigative Panel on Infant Lives.

The letter demanded that I submit a wide variety of documents, including patient medical records in cases of gestations greater than 22 weeks. I have until Nov. 21 to comply.

The panel is looking for evidence that I am selling “baby body parts.” It has the power of subpoena and can cite me for contempt of Congress if I don’t comply by the deadline.

It is frightening. It is a witch hunt.

I am a physician helping patients, and I am being treated like a criminal.

The star chamber proceedings of the Select Investigative Panel on Infant Lives is a target identification program for the anti-abortion assassins. It is terrifying.

At a deeper level, I have no confidence that Trump and the current Republican leadership will protect my life and liberty because of the work I do to help women. Their public harassment of me increases my risk of assassination.

Trump is a man who seems to care nothing for the protections of the Constitution, including civil rights and free speech. He threatens violence against members of the press and those who disagree with him. His vile, vulgar, and predatory attitudes toward women have been on lurid display from the beginning to the end of his campaign. He threatens the world with nuclear instability. How can he be the president of a country that represents freedom and civility?

Since Roe v. Wade, federal legislation and court decisions have affected us only indirectly. There have been numerous attempts to shut me down at the state level since I began performing abortions in Colorado in 1973.  Many of these bills have been directed specifically at me and at my medical practice. I have testified against them dozens of times, sometimes under armed guard. With the help of pro-choice community and political leaders, I’ve seen most of these bills defeated.

But Trump’s election, combined with continuing control of the Congress by anti-abortion Republicans, ratchets up the threat to what we do to help women. It’s now higher than ever before. Trump can sign the most restrictive anti-abortion legislation with impunity. After he has replaced several sitting Supreme Court justices, Roe vs. Wade will be overturned, and we will all be at the mercy of even more conservative state legislatures.

This is profoundly discouraging to me, especially since I want to bring in a young doctor or two who can continue my important work when I cannot do it.

What can I tell a young physician about the future? Every day is a struggle for survival.

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During the past month, I have had conversations about my specialized abortion practice in Colorado with numerous idealistic young doctors, nurses, medical students, and other health professionals.

The young physicians, including Americans who are studying in Europe, expressed their desire to serve women by performing abortions. They bought copies of my textbook on abortion care and they said they wanted to visit my practice to learn how I safely perform late abortions for women who are terminating desired pregnancies because of catastrophic fetal abnormalities. But they also expressed concern for the intensity, violence, and power of the anti-abortion movement in the United States.

They had read about the assassinations of American physicians such as Dr. George Tiller, who specialized in abortion services. They knew about the attacks on other clinics and physicians, including the time in 1988 when the front windows of my office were shot out.

What security can I offer young physicians that they can have a fulfilling life and medical career in this work helping women and their families?

Under an unrestrained Donald Trump and this Republican Congress, I fear for my life, I fear for my family, and I fear for my future. I fear for my staff and my patients.

Even more, I fear for my country, and I fear for the world.

Warren M. Hern, MD, is a physician and epidemiologist who directs the Boulder Abortion Clinic in Boulder, Colo.

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  • Diana, your comments are callous and invasive. What is wrong with you? Can you not respect Kate’s commentary on her own experience as exactly that without the third degree?

  • I salute you, Dr. Hern, for the work that you are doing at this and just as much, for your fearless testimony in this letter. Any sensible person in your position would fear for his life. I cannot fault the many that have abandoned women who need abortions because of this legitimate fear. But this does not keep my from being in awe of you. The idea that an American in the US would consider that the reason why he is not giving confidential medical information on an intensely stigmatized personal medical procedure is because “he’s afraid of what they will find” in this witch hunt terrifies me. I AM PRO-LIFE, really, really pro-life, but what is being done to this fearless man, this professional, is criminal and shameful. That pregnant women should have to defend their decision to abort a badly wanted pregnancy with a severe disability to POLITICIANS and self-styled “moralists” and internet trolls is terrifying. Dr. Hern, you are always, always in my prayers. I believe, like many pro-lifers, that abortions should be “rare” and safe and pregnancies wanted. But what you do is precisely that: keep those rare abortions safe.

    • Consuelo, some of what you wrote didn’t make sense to me. Here are my comments and an important question:
      • You refer to Dr. Hern’s “fearless testimony,” but the article begins and ends with Dr. Hern’s statements about how fearful he is, and he states the same throughout the article.
      • Some abortion businesses do sell baby parts, and we remember with disgust the atrocities committed at the Gosnell abortuary, so it’s not clear how investigating the abortion industry would be considered a witch hunt, or criminal and shameful.
      • If Dr. Hern’s medical practice complies with appropriate standards of care, and state and federal laws – and PHI would, of course, be protected by HIPAA – I’m not sure why he would object to providing the required documents.
      • You wrote, “That pregnant women should have to defend their decision to abort a badly wanted pregnancy with a severe disability to POLITICIANS and self-styled “moralists” and internet trolls is terrifying.” I’m not sure to what you’re referring.
      • When you say that you’re pro-life, what do you mean?

  • Several years ago, heavily pregnant with my very loved and wanted second daughter, I learned that she was extremely ill. Her illness may or may not have been immediately fatal, but every moment that she lived, she would be in excruciating pain. Her life would be a fate worse than death. I never even imagined a condition like that, but there it was, and my own precious baby had it.

    Her condition would certainly kill her, but not necessarily immediately upon birth. Well over 95% of children like her die within a year, but this is not considered “fatal” by the legal powers that be in my hospital. She would certainly have passed away without intervention, but because the laws around treatment of infants are so dramatically different from the laws that govern end-of-life care for adults, a DNR would hold no weight, and I could not refuse invasive live-saving measures. Hospice was not on offer.

    Cast out from my home state, I turned to Dr. Hern in Boulder Colorado. I am so lucky to have found him. He and his skilled medical team treated me with dignity, compassion, and, most importantly, skill. They counseled me for an entire day. They took every precaution to spare my baby and me suffering. They protected my health and my fertility throughout the procedure. They offered me the chance to view my baby after I birthed her. They sent me home with footprints and her cremated remains.

    I was not offered the chance to donate her tissue. At this clinic, that is not routine. But if I had been offered that chance, I absolutely would have taken it. If anything good could come of my daughter’s horrible illness and my terrifying crisis, I would want to pass on that good to other families to help make kids like my daughter more comfortable and to help bring answers and therapy to future generations. That is why people donate tissue. Because scientists find cures and answers when they can study the remains of babies like mine. Here, it is a moot point. It was not on the table.

    I have seen many doctors over the years, and none of them ever treated me as carefully as Dr. Hern. He is a fanatic about patient safety. He puts his patients first always. He sacrifices so much to do this work every day, because he values the lives of girls and women and the autonomy of families.

    He is a man of deep, abiding goodness. I think of him with love and gratitude every day since my loss for years ago, and I pray for his safety and peace.

    • Thank you for sharing this incredibly moving and personal story. I am so sorry at your loss, and am equally passionate about ensuring that other people are afforded the same rights, protections, and access to critical health care services. Some people would rather pursue ideological witch hunts rather than recognize that everyone’s decisions, health risks, and circumstances are different… which is why protecting women’s rights and access to high quality medical care provided by people like Dr. Hern is so critical.

    • Kate, after reading your story, I found myself wondering if it was just that, a story. Here are my questions and comments:
      • What condition did your daughter have?
      • Who are “the legal powers that be” in your hospital? Why would they be making a medical judgement about your daughter’s condition? What would that have to do with a decision to abort?
      • What do you mean when you say “… the laws around treatment of infants are so dramatically different from the laws that govern end-of-life care for adults”?
      • Of course a baby with a terminal condition can be a DNR.
      • If the invasive measures were life-saving, why would you refuse them, invasive or not?
      • Hospice support is available to children as well as adults.
      • How could you be cast out of your home state? What state, & why?
      • What did the all-day counseling at Dr. Hern’s facility consist of?
      • How did they spare your baby suffering? I don’t think there’s a way to abort a baby late-term that wouldn’t cause immense suffering.
      • What does Dr. Hern sacrifice every day to perform late-term abortions?

    • Kate, thank you for sharing. I’m very sorry you went through that.
      Diana, don’t you have anything better to do than to bully other women about their choices? Quite a busybody, I see.

    • Diana, I have shared here the story of my experience with poor prenatal diagnosis and late term abortion. It is absolutely true, and it is a hard story to share. It’s hard to share not because it’s hard to talk about (it isn’t) but because, every time I share this story of how I lost my baby and why I’m a grieving mother, people are mean to me. Oh so mean.

      Some people call me names. Some people say I belong in prison. Some people question my love for my children and my fitness to be a mother. But perhaps the most hurtful thing of all is when people flat out deny that the most important thing that has ever happened to me ever happened at all.

      So please just know that, how deeply it hurts to be dismissed. I am a human being, a daughter, a wife, a mother, and a sister. I lived this experience. It is such a rare experience that not man people have ever heard about it, and that’s why I share, to educate.

      There are parts of this experience that don’t make any sense to me either. Neonatal hospice SHOULD be available. A DNR for an infant OUGHT to be followed. When you meet the criteria of the laws of your home state for later term abortion, the hospital SHOULD provide it.

      And yet…

      They do not. If you want to birth a baby with a “nonfatal” diagnosis into hospice, you basically have to be cared for either in a Catholic hospital (where, frankly, I do not trust the medical staff to consider my own health as much as my already doomed baby’s), or you have to go to a special hospital like John’s Hopkins, where they actually offer this service. It is IN NO WAY the norm. It should be, but it isn’t.

      Also, if my baby had a disease that was absolutely going to kill her, probably quickly, should it have been called fatal? I think so. But they’re very careful with their language. Hospitals have teams of lawyers whose sole job it is to mitigate the risk not only of legal action, but also of expensive civil suit. This is why the laws are one way, and operations are sometimes another.

      And when you are flat out denied morally acceptable care in your home state, you are cast out. The message is, “We are happy to find you someone to help, but we can not help you here.”

      Dr. Hern serves a great many families from a great many states that would not treat them at home.

      The counseling is comprehensive. I was counseled first at home, where I talked to many doctors and also to someone who works with families with sick and special children so that I knew what life would look like for my daughter. I was put in touch with adoption agencies, and offered contacts to other families raising their children. I was also given Dr. Hern’s information. Once I made my decision and flew to Colorado, the counseling there was very deep. They tell you all about the procedure, its risks, and how this procedure and these risks compare to the risks and experience of carrying the pregnancy to term and birthing a live baby at the hospital. They talk you through every aspect of the procedure, and they have several layers of screening to make sure that you’re not being forced to do anything against your will. They counsel on birth control as well, even though this was not particularly applicable to my situation, they just want to make sure I have my information. They test for drugs to make sure that your judgment isn’t impaired and that your health won’t be at risk. There is absolutely no pressure. They make it very clear that, up until the procedure actually begins, you can just walk away, and they will support you in whatever you decide and provide additional resources to support you if you decide to carry to term.

      This decision was completely mine, and I was so fortunate to be supported in it. I, personally, could also have lived with birthing into hospice, but that would have spared my baby nothing. You have to understand that every day of her life was going to be incredibly painful. Have you ever had a charlie horse in your calf? She was going to have muscle cramps like that in her entire body. She was not going to be able to swallow her own saliva, and would choke on it often. She was not going to ever even be able to sleep because of the discomfort. She was destined for a life without peace.

      Sometimes life is pain. Sometimes life is suffering. I know this, and I do accept it, but when and where there is a way to limit the scope of a terrible situation, I will take the responsibility, and I will make it as much better as I possibly can.

      In this case, that meant euthanizing my baby by injection while she was still in my womb.

      I think of this every time I get a shot myself. I think of all the shots I subject my living children to, so that I might spare them the risk and injury and suffering of terrible disease. I am willing to accept that I bring my daughters — all of my daughters — some pain so that I can spare them something much, much worse.

      That is how it is for the baby that I lost. Yes, I accept responsibility for stopping her heart with a shot. Yes, I accept that that may have involved some suffering. But there is no scenario in which her suffering would have been somehow less had she lived.

      Usually, when we have a baby, we get to give her the gift of peace and the gift of life, all at the same time. I was in this terrible situation where I had to choose one. My baby could not have both.

      Life is a gift.
      Peace is a gift.

      I chose peace. It is okay if you would choose life. I would support you completely in that choice. I would show up and witness your baby’s life and celebrate it, though it contains suffering.

      It is okay that I chose peace. I am deeply grateful that I was able to give my daughter this valuable gift. I gave it from the bottom of my heart. It is the very best that I could do with the tools available to me.

      I am deeply, deeply grateful to Dr. Hern for helping me and my baby find this gift of peace.

      What does he sacrifice? His own peace. His safety. A quiet, private family life. He sacrifices all the other things he cares about so that he can fully concentrate on protecting this one thing. He does not lead a normal life. He can not lead a normal life — for reasons like this investigation listed above.

      Dr. Hern is the only reason that I didn’t end up in the hands of a monster like Gosnell. If you systematically take out (by murder or by politics) the upstanding, thoughtful, professional, safe physicians, and monsters will rise to fill their shoes, and the suffering and death of both women and babies will greatly increase.

      I imagine you scoffing at that, but it is true. I know what desperation feels like, and it is terrifying.

      Thank you, Dr. Hern, for being a thoughtful, capable, exemplary physician and for being the hands I fell into in my darkest hour. You saved my baby from a fate worse than death. You saved me from taking awful risks, and you saved my family from an even worse tragedy.

    • Kate you are a brave and thoughtful woman, and a wonderful mother. I’m so sorry that you are subjected to callous and combative people who feel quite comfortable judging you. Despite this loss you’ve suffered being nobody’s business but your own, you have proven yourself to any rational and compassionate person that your choice was scarcely a choice at all – it was the best parenting option available and I am so sorry that you were driven from your home state to procure this – why is it even called an abortion at this point? – this humane euthanization. People like Diane have no trouble spending a few minutes anonymously casting judgement but where would they be during every excruciating minute/hour/day/month of your child’s life had you birthed her? Are these pro-“life” folks doing anything to help families forced to raise children in sub-optimal conditions, or in the case of fatal disease, inhumane conditions? Every agonizing second that you would have had to watch your baby in pain with no way out and only a clear path to death, I wonder what people like Diana are doing? Are they offering support to exhausted and heartbroken families like respite care, a meal train, a ride to the hospital, a shoulder to cry on? Or are they just trolling strangers online?

  • I wonder if he’s afraid of what they will find in his records? If he’s not breaking any laws, he should not be afraid of allowing his records to be seen… Having his name in the clear for not selling baby body parts. That would prove how good and humble and law abiding he is. Or it could prove just the opposite. I’m sure he doesn’t want to go down like Kermit Gosnell. Also wonder if this article is a distraction from the fact he’s about to be investigated. And perhaps it’s also a financial plea for his defense when the time comes.

    • I don’t think you’re hearing what he is saying. Assume for a moment that his business is above board. He is saying that the warrantless investigation against him will have the effect of resulting in his assassination. Abortion doctors who practice within the law can and have been targeted by people who want to circumvent the legal process and violate people’s rights through violence. You don’t seem to have a problem with that as long as you get your way.

  • Amalthea writes, “Don’t like abortion, don’t have one. This is a simple concept.” What if I wrote, “Don’t like slavery, don’t own one,” or “Don’t like child abuse, don’t abuse your child”? Simple concept? I don’t think so.

  • Amalthea, I do listen to and read the news, thank you. The three people who were shot at the Colorado Planned Parenthood facility last year were killed by a mentally ill man who did not identify with the pro-life cause.

    • “The three people who were shot at the Colorado Planned Parenthood facility last year were killed by a mentally ill man who did not identify with the pro-life cause.”
      Despite the fact that the first words out of the man’s mouth were, “No more baby body parts.”

  • Dr. Hern is a hero (also an extremely honorable man and a poet and photographer) and someone who has put his own life at risk to help women. What can we do to help him so that he doesn’t have to disclose his patient’s names, or worry about re-entry to the country? Can the state of Colorado be of use? Can the reproductive rights organizations help him directly? I really want to know what would be of most use, aside from just supporting reproductive rights organizations, which I already do.

  • Dr. Hern is a hero. What is the best way we can help you? Is there anything the State of Colorado can do to protect you? We can support reproductive rights groups — including Center for Reproductive Rights, but is there anything more that can be done so that you don’t have to release records and can travel safely?

  • Thanks for the work you do Dr. Hern. It’s unfortunate that people can’t look at the issue here, late term abortions are not done unless it is absolutely necessary & ONLY a women & her physician should make that call! People who have no basis of understanding of what that entails should maybe do some research.

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