Lime 5 Chapter 3: The National Abortion Federation

NAF member Abu Hayat

The first inkling I got that all was not kosher at the National Abortion Federation was when I went to Library of Congress and pulled out some National Abortion Federation Annual Reports. There, on a list of members, was Hanam Rotem, the man who had allowed a receptionist to administer general anesthesia and was responsible for the death of Gloria Aponte.

I started looking for other unsavory characters and I found them, including Abu Hayat. For those of you not familiar with him, he was the New York City abortionist who gained national notoriety when he pulled the arm off of a 32-week unborn baby who was subsequently born alive: Ana Rosa Rodriguez. Once the press scented blood they started chasing him down and found egregious activities, including sexual abuse of patients and the death of 17-year-old Sophie McCoy. These revelations won him the sobriquet "The Butcher of Avenue A." (Watch What the National Abortion Federation Provides and The Butcher of Avenue Aon YouTube for more about this guy.)

So what is the National Abortion Federation? As Lime 5 notes:

The National Abortion Federation (NAF) claims that they "ensure continued high standards for safe, quality abortion care. We meet this charge in three ways: offering continuing medical education to reproductive health care providers; chronicling abortion-related complications; and establishing new standards of care." Generally, their argument is that regulation would drive the cost up and deny some women access to abortion services. That has prompted some critics to argue that what NAF wants is not "safe and legal" abortions, but "cheap and legal" ones.

As Lime 5 notes, NAF does publish, and want their members to follow, standards of care. Let's quote Lime 5 again:

Warren Hern

Warren Hern -- who is a NAF board member, former head of its Clinical Guidelines Committed, and author of the book Abortion Practice -- helped write NAF's abortion standards, but now calls them "ornamental," "cosmetic," and "meaningless." He admits that NAF "has never pursued a serious program of standards implementation and program evaluation," adding that, "Following good standards costs money. And people don't want to do that." He also pointed out that NAF has never implemented a system to monitor whether its facilities are following its standards. (Source: "Claiming Abortion Malpractice," Diane Gianelli, The American Medical News, February 6, 1995)

Reactions to Hillview -- and Gosnell

Crutcher then moved into the 60 Minutes episode about Hillview in Maryland, where Debra Gray had died and Susanne Logan was injured (and died after the episode aired). 60 Minutes "asked Barbara Radford, executive director of NAF, if they knew about these problems. She responded that NAF was aware of them, but had decided to remain silent because, 'This is the last thing we need. We had hoped that it wouldn't get national publicity because of the political nature of all this.'"

Dr. Kermit Gosnell

We need look no further than the Kermit Gosnell debacle to see that this "publicize no evil" attitude is firmly entrenched. After the death of Karnamaya Mongar, Gosnell applied for membership in NAF. They sent an evaluator to his clinic on December 14 and 15 of 2009. The conditions she found were appalling enough that NAF denied his request for membership -- but they took no other action. They did not report him to the medical board or the health department. They did not warn other facilities, not even their own, to stop referring to him. They did not even instruct the Delaware facility where he worked on Wednesdays to sever ties. They lay low until the news broke, whereupon they dismissed Gosnell as "an outlier" even though the word "colleague" -- or even "employee" -- would be closer to the truth.

The Safe Abortion Hotline: Steve Lichtenberg

Lime 5 noted that NAF has a toll-free number for abortion-minded women to call, ostensibly to get a referral to a high-quality, safe, compassionately-operated abortion practice. We decided to find out what they'd say if we asked them about a specific case. I called, posing as a woman whose relative was scheduled for an abortion at Albany Medical Surgical Center in Chicago. The phone counselor assured me that their doctor, Steve Lichtenberg, was "a very, very excellent doctor; very well respected."

I started to talk about hearing about malpractice at the facility. The counselor interrupted. "All of the complications are reported here, and if there is an excessive amount of complications, or unnecessary complications, they would not be members of the National Abortion Federation." She discussed stories about complications as "just a rumor."

I was more specific, saying that my brother-in-law had told me about somebody named Deanna who had died from an abortion at that clinic. (I was referring to Deanna Bell, the 13-year-old girl who had died from a massive overdose of Brevitol at Albany.) The counselor put me on hold, then came back and said that the brother-in-law was confused and had Deanna mixed up with a girl who had died from an illegal abortion (most likely referring to Becky Bell, whose death from pneumonia shortly after a miscarriage continues to be presented as a criminal abortion death by abortion advocates). The counselor was adamant that whoever the dead girl "wasn't aware that there was an organization that could refer her to a clinic." She added, "There are still poor abortions performed in the United States, not by NAF doctors."

The previous day I had called and spoken to Susan Shapiro at NAF. When I asked, "Okay, and if they asked if there was malpractice or deaths at that facility or by that practitioner, would you inform them?"

Shapiro responded that "we would not inform them of anything specific, unless there was a problem. Then they wouldn't be NAF members if there was something -- if there was a serious problem, and if the complications were -- were serious, you know. Your NAF members are the best abortion providers in the country."

On a subsequent call I specifically asked about Lichtenberg and the death of Deanna Bell. Shapiro responded that "the people that work on the hotline don't have that information readily available, and they tell the person on the phone, 'We just don't have that information readily available right now.' Their basic goal is to refer them to a NAF member clinic, and that's what they do. They don't get into specifics on the phone."

I clarified, "Even in a case like the situation with Lichtenberg, where there was a death, and the consumer specifically asked, 'Was there a death?', your hotline counselors would not even have access to that information to share it?"

Shapiro responded, "Right. And they ... would not say, 'No, there was not a death.' They would say, 'I don't have that information.' And we can give them the number of the medical board and they could research that themselves."

The Safe Abortion Hotline: Ronald Kuseski and Mayfair

Christi Stile attended to by her father, Fred

Was the misinformation I got a fluke? We had Lisa Beaulieu call on November 10, 1995. Lisa posed as a pregnant 15-year-old from Aurora, Colorado. We'd chosen that location because the Christi Stile case had recently been settled by Mayfair Women's Center. 

Abortionist Ronald Kuseski, not an anesthesiologist, had administered sedatives to Christi through her IV. After the abortion, he looked up to find Christi pale, with bluish lips, and no pulse or respiration. Her heart had stopped. The clinic had no record of Christi's vital signs being recorded during the abortion. Christi's mother says that Kuseski had told her that the clinic had no crash cart. The medical board investigation found that Kuseski didn't have pulse oximetry equipment in place for Christi's abortion. Paramedics were summoned, who managed to restore Christi's pulse and respiration before rushing her to the hospital but she never regained consciousness. She remained in her parents' care for over 22 years until her death in 2015.

Given the appalling lack of attentiveness of staff during the abortion, and the lack of equipment to deal with a very predictable complication, we were curious about how NAF's hotline would describe Mayfair.

As we had anticipated, the counselor referred Lisa to Mayfair. Lisa expressed safety concerns, and the counselor reassured her that "we check out all of our clinics to make sure they're very good places."

Lisa responded, "I've been so nervous because there's been on the news that this girl was -- I guess she's in a coma or something because she had an abortion a couple years ago, and I'm so scared that something like that would ever happen to me because then my parents would know, and..."

The counselor interrupted her, reassuring her that abortion is "the safest surgical procedure in the United States. It's safer than having your tonsils out. There are fewer complications. There's a very, very low likelihood that anything is going to go wrong."

The phone call ended with a lot of reassurance that Lisa would be safe at Mayfair.

Lisa called back the next day, saying that she'd talked to her friend's mother, who had told her that Mayfair was where the girl in the coma had undergone her abortion. The counselor said, "I think that, I'm not sure, but this may be the case, um, where there was a -- she had some sort of condition, and I don't know and I can't say any of this officially, but she had some sort of condition that was not related to any of the procedure itself. It was a problem she had, she had a bad reaction -- it was a strange thing, but it wasn't anything -- there was nothing, nothing medically wrong with the procedure. Um, it's just kind of a -- it was really a fluke kind of thing."

Lisa continued to express reservations, and the counselor continued to reassure her, including telling her that the comatose patient's case was something what was "out of their hands." This, of course, could only be true if there was some sort of outside mandate to run a slipshod abortion clinic that lacked emergency equipment, lacked sufficient qualified staff, and failed to monitor patients during procedures.

NAF's Real Priorities

Lime 5 quotes a seedy abortionist named Ronachai Banchongmanie (referred to jocularly at Life Dynamics as "Raunchy Bunch-a-money" or "Raunchy Botch-a-many") who quit NAF after a brief stint as a member. He described them as "a group of abortion providers that bind together for the purpose of their own benefit."

Raunchy, old fellow, I couldn't have said it better myself.

After noting how many substantiated cases of malpractice and deaths we'd found, Lime 5 shares an exchange I listened to in a tape of the National Abortion Federation's 18th Annual Meeting, April 24-26.

Our old friend Warren Hern was being attacked by some attendees for his willingness to review potential malpractice cases and to provide expert testimony. Hern defended working with attorneys who opposed abortion, saying, "I do not conceal my views from these people, but I have to say this -- There's a lot of crummy medicine being practiced out there in providing abortion services, and I think that some of the stuff I see coming across my desk is very upsetting."

Hern tried to focus the conversation on following standards and avoiding malpractice. His fellows focused more on legal strategies for avoiding lawsuits or getting the women or families to drop them. 

Additional discussion focused on how to attack the women who sue, including ideas about how to discredit, frighten, and/or intimidate them into dropping their suits. Hern spoke up yet again, trying to get the discussion onto providing quality care. He stressed that there was a lot of bad practice that he wanted to see eliminated. Again, his opinion was summarily dismissed, and the discussion returned to attacking the injured woman, her attorney, and any individuals or organizations helping with her case.

Come September of 1994, NAF held their Fall Risk Management Seminar. A consultant they brought in told the group some strategies for managing lawsuits, but "to her credit, the basic thrust of her presentation was that the most effective way not to get sued for malpractice is to not commit malpractice. And once again, Dr. Hern offered his opinion that, 'The way to keep from being sued by these idiots is to practice good medicine. It's really very, very simple.'"

However, as in April, Hern's advice was thrust aside. 

Discussions were held about the need to do the following things: keep clinic records as vague as possible; keep written records to a bare minimum; keep employees from knowing too much so that if they quit they can't testify in a malpractice action; get crisis pregnancy centers out of the phone book so women won't know who to call if they get injured; and harass attorneys who represent women injured by abortion. One presenter even offered to supply a list of attorneys who attended the Life Dynamics Abortion Malpractice Conference to anyone who would target them.

The list of "action plans" went on and on, but the underlying theme was typified by an attendee who lamented that, "We do have bad practitioners. And it's affecting all of us. And we have been reluctant to do anything or say anything or whatever because of the physician shortage. We don't want bad press, but when something happens, under our breaths we all say, 'Well, it was just a matter of time.' You know, that stuff is going to come to the surface more and more.... I want to know how we can control this."

Has NAF Cleaned Up Their Act?

A lot of time has passed since the publication of Lime 5. I'm sure that supporters of the abortion lobby want to believe that NAF has cleaned up their act since then. Sadly, there's not a lot of evidence that they have, and there's plenty of evidence that they haven't.

We can start with that NAF flagship, Family Planning Associates Medical Group. Since the publication of Lime 5, they have added more bodies to their list of shame. Nakia Jorden died of an anesthesia screw-up in 1998, as did Maria Leho in 1999. Kimberly Neil stopped breathing during her abortion in 2000 and died. Maria Rodriguez bled to death after an abortion by Steve Lichtenberg in 2000. Chanelle Bryant died in 2004 from an infection after getting abortion drugs at an FPA clinic. A woman I identify as "Kyla Ellis" bled to death after an FPA abortion in 2014. 

FPA is a huge chain, though, so of course they're going to accumulate more corpses than a small freestanding facility. Nevertheless, NAF members continue to prove deadly.

Tamika Dowdy died in 1998 after an abortion at NAF member Brooklyn Women's Medical Pavilion. 

Malachy DeHenre

Leigh Ann Alford died from hemorrhage in 2003 after an abortion performed by Dr. Malachy DeHenre at NAF member Summit Medical Center of Alabama. DeHenre was later convicted of manslaughter after shooting his wife in the head. He served half his sentence then was deported to his native Nigeria. Not only was he a murderer and a quack -- he was an illegal alien.

National Abortion Federation member Alberto Hodari performed an extremely late abortion on 15-year-old Tamiia Russell at the behest of her 24-year-old abuser's sister. The teen bled to death. Regina Johnson died when she was left inadequately monitored after an abortion performed in 2003 at Hodari's clinic. 

Oriane Shevin died of infection following off-label use of RU-486 at Eve Surgical Center in 2005.

Romeo Ferrer

Romeo Ferrer advertised his private practice, Gynecare Center, as a clinic. He overdosed Denise Crowe on anesthesia in 2006, resulting in her death.

Jennifer McKenna-Morbelli underwent a "fetal indications" abortion at National Abortion Federation member clinic Germantown Reproductive Health Services in 2013. When she suffered complications in the motel where she was staying, her family members called the emergency number provided by Dr. Leroy Carhart. It rang to Carhart's wife's equestrian supply company. This led to a delay in care. Jennifer died. Carhart had also provided the amateurish resuscitation efforts that led to the death of Christin Gilbert at NAF member George Tiller's Wichita clinic in 2004.

Lisa Perriera, who performed Lakisha Wilson's fatal abortion in 2014, serves on the Board of Directors for the National Abortion Federation.

April Lowery bled to death in 2020 after an abortion at NAF member West Alabama Women's Center.

Non-Fatal NAF Quackery Continues as Well

FemCare in North Carolina was closed by the state after inspectors discovered appalling conditions.

Delta Clinic of Baton Rouge has quackery documented from 1981 through 2011 -- when the National Abortion Federation finally suspended their membership and stopped referring patients there from their hotline.

Martin Haskell, whose biggest claim to fame is popularizing the D&X or "partial birth abortion," has an extensive history of malpractice.

Little Rock Family Planning has had some extremely questionable physician on their staff, including Thomas Tvedten, whose license was suspended by the Arkansas Medical Board in 2020, and Willie Parker, who was accused of sexual misconduct.

Northland Family Planning has an extensive history of malpractice, including a 2019 case where they left a patient screaming in agony with a punctured uterus and a collapsed lung.

Closing Thoughts

See for yourself as Mark Crutcher tours a closed National Abortion Federation clinic bought by a prolife group. Note the irony of the women entering the building through the back alley. 

I also went to the NAF website and started looking up their facilities on AbortionDocs.org. The very first one, A Capital Women's Health Clinic, clearly has issues as revealed in the inspection reports. 

Ditto the second one, A Preferred Women's Health Center -- Charlotte. The next one, A Preferred Women's Health Center -- Raleigh, had some deficiencies but passed most inspections without deficiencies. A Preferred Women's Health Center -- Augusta had some issues with fetal disposal but there are no other documents indicating problems. There were no deficiencies noted for the last inspection of A Preferred Women's Health Center -- Forest Park. So this chain seems to have just the one bad apple -- 25% of their locations.

A Tidewater Women's Health Clinic seems to have cleaned up their act after a dismaying inspection report for 2015.

Diamond Williams

A Woman's Choice of Charlotte is where Diamond Williams underwent her fatal abortion in 2016. Until just now I had not known that this clinic -- identified as Carolina Center for Women in other documents -- was a NAF member. They clearly have other issues with running their facility.

A Woman's Choice of Greensboro clearly has some issues that show up in inspections.

A Woman's Choice of Jacksonville mainly seemed to have issues with failing to report adverse events. They seem to have cleaned up their act after their inspection of 2019.

A Woman's Choice of Raleigh has some more serious complaints directly relating to patient care.

A-Z Women's Center in Las Vegas was sued for the death of Kawaida Espenrace, with allegations that they failed to treat her hemorrhage in a timely manner. 

AB Abortion Telemedicine evidently has just one website and phone number but lists itself on the NAF websites in California, Colorado. Connecticut, Delaware, DC, Illinois, Maine, Massachusetts, Montana, New Jersey, New York, Oregon, Rhode Island, Vermont, Virginia, and Washington. AbortionDocs has no information at all about them. Odds are they just have a headquarters in Florida and licenses to prescribe medicine in those other states.

Abortion At Home by carafem is probably fairly new and seem to be listed on the AbortionDocs site purely under CaraFem. All AbortionDocs has is chipper articles noting the joys of abortions by mail. Ditto for Abortion Delivered (aka Just The Pill) and Abortion On Demand. I'm guessing that any women who suffer complications or death won't be connected back to the drug prescriber, but I could be proven wrong. Still, given the high risk of hemorrhage and infection this doesn't seem like a very safe way to approach abortion.

I've hit the first Planned Parenthood affiliate, and since I'm covering Planned Parenthood on the next installment I'll not touch on any of them today. And rather than plow through any more in alphabetical order, I'll take the first non-PP for each letter of the alphabet -- and highlight any I spot that I've heard of that I find out are members.

Beth Israel Deaconess Medical Center just has information about the hospital's "family planning" and their first and second trimester abortions.

Camelback Family Planning went through a period where they weren't exactly up to the stated NAF standards, that's for sure.

Delaware County Women's Center failed to pass licensing requirements in 2012 and seems to have been changing hands a lot since then. 

Early Options doesn't have much information on AbortionDocs.

Falls Church Healthcare Center seems to be pretty seedy, with a lot of deficiencies found in inspections.

I can't find Gynecology & More on the AbortionDocs site -- and they don't seem to have a website themselves.

Hagerstown Reproductive Health Services is the clinic that sent Desiree Hawkins to Kermit Gosnell's clinic. She's one of the patients whose baby's feet were found in jars in the clinic. Hagerstown Reproductive evidently also operates under the name Potomac Family Planning, since they were sued for Jennifer Halner's 1997 abortion death. They have quite a few serious problems noted.

Indianapolis Women's Center is run by Martin Haskell. They racked up quite a lot of deficiencies in 2019.

AbortionDocs doesn't have any inspection reports or other documents of that type about Joan G. Lovering Health Center.

Lakeland Women's Health Center got a smackdown in 2019 for being pretty lackadaisical. 

The only thing AbortionDocs has on Mabel Wadsworth Women’s Health Center is that they joined Planned Parenthood in a lawsuit against the state.

North Durham Women’s Health was closed by the state in 2013, re-opened briefly, was closed again, and evidently was able to re-open and stay open after they got rid of a questionable doctor.

Obstetrics and Gynecology Care Center in Providence, Rhode Island, doesn't appear to actually exist. The website is just a clearinghouse for obstetric care, evidently run by people who want to be affiliated with the National Abortion Federation for some ungodly reason.

Paley Family Planning evidently is a part of Einstein Healthcare Network in Philadelphia, which is the website linked at the NAF page.

AbortionDocs has nothing at all on Red River Women's Clinic.

Safe and Sound only opened in 2014, and their only cited deficiency in 2018 (the only inspection report on AbortionDocs after the original licensing inspection) was leaving medications and syringes where they can be accessed by patients.

Tampa Women’s Health Center doesn't seem exemplary, but not particularly bad either.

There are several university medical centers in the U section, the first of which is UCLA Hospital and Clinics. AbortionDocs has nothing on them at all.

Wasatch Women's Center seemed to have gone through a rough spot with paperwork.

My recommendation is that you pick and choose a few facilities from the NAF site and check what you can find on AbortionDocs. This brief survey should reassure the abortion rights supporter that AbortionDocs isn't just picking on people but actually does include copies of inspection reports where no deficiencies were found.

So is NAF home to seedy abortionists? In some cases I'd certainly say yes, in others no, and in others the jury is still out. But the main lesson is that the NAF sticker is no guarantee of quality care. Do your homework before you trust them. 

Watch Lime 5: The National Abortion Federation on YouTube.