(All photos in this post were taken from Grand Jury report. Click all to enlarge.)

The National Abortion Federation touts itself as “the professional association of abortion providers in North America.”

NAF claims to have a membership of 400 abortion mills. There is a screening process to join. which abortionist Kermit Gosnell attempted in November 2009, “apparently, and astonishingly, the day after Karnamaya Mongar died,” according to a Grand Jury report released on January 20, which charged Gosnell and 9 accomplices with 8 counts of murder, including Mongar’s.

Upon receiving Gosnell’s application, an unnamed NAF evaluator assessed his Philadelphia mill, Women’s Medical Society, on December 14 and 15, 2009. According to the Grand Jury report, “It was the worst abortion clinic she had ever inspected,” and NAF denied Gosnell’s application.

Although initially hiding the fact, Gosnell eventually told the inspector about Mangor’s death.

But, according to the report, the NAF inspector “just never told anyone in authority about all the horrible, dangerous things she had seen.”

I submit that more than that, the NAF inspector admitted observing profuse illegalities she never reported either, such as nonphysicians giving sedation and open defiance of Pennsylvania’s 24-hr waiting period. She also noted several unsafe practices, such as not monitoring mothers after their abortions and leaving them unattended – overnight.

I submit that along with several Pennsylvania state agencies, NAF should also face charges of some sort.  Following are excerpts about NAF from the Grand Jury report:

Despite his various efforts to fool her, the evaluator from NAF readily noted that records were not properly kept, that risks were not explained, that patients were not monitored, that equipment was not available, that anesthesia was misused….

A NAF quality assurance evaluator testified before the Grand Jury. She stated that NAF’s mission is to ensure safe, legal, and acceptable abortion care, and to promote health and justice for women….

In preparation for NAF’s visit, Latosha Lewis said that Gosnell and his wife frantically cleaned the facility. The doctor bought new lounge chairs to replace the bloody ones that were there, although by February 18, 2010, they were filthy again.

Despite these efforts, the NAF review did not go well. The first thing the evaluator noted when she arrived at 3801 Lancaster Avenue was the lack of an effective security system. Although the door was locked, when she rang the bell, no one answered. Even though she could not gain entry by ringing, she was able to walk right in when a man exited the clinic. Once inside, she found that the facility was packed with so much “stuff, kind of crowded and piled all over the place,” that she couldn’t find a space to put her small overnight bag. She found the facility’s layout confusing, and was concerned that patients could not find their way around it or out of it….

Most alarming was the bed where Gosnell told her out-of-state patients were allowed to spend the night. These patients were unattended and it was difficult to locate the bathroom facilities and the exits. Such a practice does not meet NAF protocols.


The NAF evaluator watched a few first-trimester procedures. She noticed that no one was monitoring or taking vital signs of patients who were sedated during procedures. She asked Gosnell about the pulse oximeter that should have been used for monitoring, but he told her it was broken. Apparently, Karnamaya Mongar’s death a month earlier had not caused Gosnell to obtain equipment that worked.

The evaluator did not observe Gosnell’s practice of allowing unlicensed workers to sedate patients when he was not at the facility….

The evaluator did note, however, that while she was talking to Gosnell in his office, a patient appeared to have been sedated by one of the staff. Such an action does not comport with NAF standards either. The evaluator cautioned Gosnell that he should make sure he was complying with state requirements because many states – including Pennsylvania – do not allow unlicensed workers to administer IV medications….

Gosnell’s clinic – without the drugs, staff, or equipment necessary to monitor, resuscitate, or assist his patients in breathing – was not even close to meeting NAF standards or any other standard of care. The evaluator noted that Pennsylvania requires that anesthesia be administered only by licensed personnel, a regulation that Gosnell failed to follow even during the NAF review.


Aside from these life-threatening practices, the evaluator noted numerous deficiencies in the clinic’s recordkeeping, including no notation of RH blood-typing and no record of sedation medications administered or the level of sedation. The clinic’s consent procedures also failed to meet NAF standards. Even with the evaluator watching, patients were not being informed of the risks of the medications, the sedation, or the procedure itself.

The evaluator testified that during the “counseling” she witnessed, a patient was told that Pennsylvania requires a 24-hour waiting period between when a patient is counseled and when the abortion can be performed. After stating the requirement, however, the counselor, according to the evaluator, said: “Okay, well. When do you want to come back for the abortion? Do you want to come back at 8 p.m.?” When the patient’s mother said, “but I thought we had to wait 24 hours,” the staff person responded, “if you want to come back at 8 p.m., you can come back at 8 p.m.”

Patient confidentiality is another important standard for NAF, and another that Gosnell flagrantly violated. The evaluator was troubled to find:

Throughout the office, there were patient charts everywhere. On desks, on this – the area in that upstairs sleeping area by the sleeping room. There were piles and piles and piles of medical records. That was – if that were in an area that was closed off and nobody had access to it, charts being stored there weren’t a big deal, but if there were patients in the sleeping room, who had to leave there to go to the restroom, they had full access to all of these people’s medical information if they wanted to look through it, it was very, very concerning to me.

When asked if she had ever seen anything like the conditions and practices she observed at Gosnell’s clinic in any of the roughly one hundred clinics she has visited in the United States, Canada, and Mexico, the evaluator answered: “No.”

Based on her observations, the evaluator determined that there were far too many deficiencies at the clinic and in how it operated to even consider admitting Gosnell to NAF membership…. The evaluator told the Grand Jury that this was the first time in her experience that NAF had outright rejected a provider for membership. Usually, if a clinic is able to fix deficiencies and come into compliance with the standards, NAF will admit them. Gosnell’s clinic, however, was deemed beyond redemption.

We understand that NAF’s goal is to assist clinics to comply with its standards, not to sanction them for deficiencies. Nevertheless, we have to question why an evaluator from NAF, whose stated mission is to ensure safe, legal, and acceptable abortion care, and to promote health and justice for women, did not report Gosnell to authorities.

The Grand Jury recommended that NAF “reassess” the membership of Atlantic Women’s Medical Services in Delaware, where Gosnell started late-term abortions and then finished them at his Philly office.