Abortion’s <i> Cause Celebre</i>

To supporters of abortion rights, Dr. Bruce Steir is a brave--if beleaguered--warrior, one of the few doctors willing to fly to far-flung clinics, don a bulletproof vest and march through throngs of taunting protesters.

To abortion foes, Steir is a “butcher” whose career epitomizes the horrors wrought by Roe v. Wade, the 1973 U.S. Supreme Court ruling legalizing abortion.

But to Riverside County prosecutors, Steir is simply a doctor who, late one December afternoon in 1996, committed the crime of second-degree murder.

On that day, prosecutors say, Steir knowingly punctured the uterus of a 27-year-old Barstow woman in a Moreno Valley clinic, then flew home to San Francisco without sending her to a hospital. Sharon Hamptlon, a fast-food worker on Medi-Cal, bled to death in her mother’s car on the way back to Barstow, her 3-year-old son by her side.

“This [case] is not even about abortion,” said Riverside County Deputy Dist. Atty. Kennis Clark. “This is about a person who knows he did a life-threatening act, knew it . . . could kill somebody, and consciously disregarded the danger.”

Yet the case--believed to be the first murder prosecution of an abortion doctor in California in nearly two decades--has set off a fierce battle in the political war over abortion.

Abortion rights advocates across the state and nation stand behind him, claiming he is being prosecuted for his politics. Escalating violence against abortion doctors has only intensified their support for Steir, a veteran of 40,000 procedures who has traveled to clinics throughout the state. Some cast Steir in the same heroic mold as Barnett Slepian, the New York abortion provider slain last month by a sniper.

These advocates have drawn support from physician groups--including the California Medical Assn.--that decry criminal prosecution of doctors for alleged medical malpractice, a national mini-trend that physicians find chilling.

Abortion opponents portray Steir as a villain. They cite his long history of run-ins with state licensing regulators and portray Hamptlon’s death as the latest grisly proof of abortion’s harms.

“A tragically unnecessary death finally halts the abortionist butchery of Dr. Bruce Steir,” proclaims the headline to a National Right to Life Committee statement.

In reality, this case cast so boldly in black and white terms is a blur of grays. The legal and medical issues are complex. Was this a murder--part of a pattern of “callous” actions by Steir, as the prosecutor alleges? Could it have been a terrible misjudgment? Or perhaps a tragic--but unavoidable--medical complication?

Moreover, Steir, who at one time saw providing abortions largely as “a way to make ends meet,” appears an unlikely symbol for either side in the abortion debate. A short, slight 67-year-old who limps from recent knee surgery, the doctor says he didn’t see his abortion practice as particularly political until “the opposition made it political.”

Steir insists he didn’t know he punctured Hamptlon’s uterus that day and would never have left the clinic if he had known. But he has given up the fight for his practice. He relinquished his medical license in March 1997, saying he didn’t have the resources to battle charges in this and other cases brought by the Medical Board of California, which regulates doctors.

Now he’s fighting full time to stay out of prison. “I’m fighting,” he said, “for my life.”

Disputed Recollection

For all the debate the charges have unleashed, the crux of the prosecution’s case is a brief conversation nearly two years ago between Steir and a sonogram technician.

Technician Nancy Myles, Steir’s only assistant during Hamptlon’s abortion, testified in a February preliminary hearing that Steir gave her an unusual, almost indescribable look--then said, “I think I pulled bowel.”

“Pulling bowel” would mean Steir pierced Hamptlon’s uterus and grabbed the bowel through the breach. Hamptlon was 20 weeks pregnant, well into her second trimester, and while poking through the uterus is a standard complication, it requires immediate hospitalization.

By Myles’ account, Steir assured her he had not mistaken bowel for fetal cord, saying, “I know cord when I see it.” If he had pulled bowel, he told her, he would call 911. Instead, she said, he worked for a few minutes, then said, “I think I got it.”

The prosecution’s argument is that Steir, knowing he pulled bowel, pushed the bowel back through the hole in the uterus in an effort to patch over his mistake--that’s why he said, “I got it.”

Prosecutor Clark speculates that his motive may have been to avoid the hassle of a complication or perhaps to stay out of trouble with the medical board. In court papers, she says Steir, who was on probation with the board at the time, may not have wanted to call attention to a complication because he didn’t have a supervising physician, or monitor, overseeing his practice as required.

Doron Weinberg, Steir’s attorney, contends that Myles’ recollections were colored by the shock of Hamptlon’s death. According to Weinberg, Steir actually told Myles that he wanted to ensure that he did not pull bowel.

He says Myles has been inconsistent, telling authorities early on that the doctor wasn’t sure whether he had hit cord or bowel. If Steir said, “I got it,” Weinberg said, he was referring to his successful search for the fetal skull.

As for the alleged motive, Weinberg says Steir had previously in the same clinic referred two women with complications to another doctor for hospitalization. Why, he asks, would he do differently with Hamptlon? In an interview, Steir said he didn’t have a physician-monitor because the board rejected every candidate he proposed.

Confusing matters are the conflicting reports of Hamptlon’s recovery in the clinic.

Prosecutors, relying on witness accounts, say she was unstable: unable to walk on her own; complaining of pain; pale, shaky and throwing up.

Weinberg and Steir insist that Hamptlon’s condition was no different from any second-trimester patient and that her vital signs--blood pressure, heart rate etc.--were normal. Only after monitoring the patient for an hour and requesting a final report on her vital signs did Steir depart, Weinberg said.

Hamptlon was wheeled to her mother’s car about 10 minutes later. On the way home, said Doris Hamptlon, Sharon’s mother, 3-year-old Curtis asked his mother if she was OK. “She says, ‘Yes, come . . . back here and let me hold you and tell you how much I love you.’ ” Then she fell silent. Doris thought she was asleep.

“She didn’t wake up to help me find my way, just groaned a couple of times. . . . By the time I got [to Barstow] . . . she was not responsive at all. Her color was all gone,” Hamptlon said.

The San Bernardino County coroner initially called the death accidental--then, after receiving additional information, changed the finding to homicide.

Ten months after Hamptlon’s death, detectives turned up at Steir’s door to arrest him on suspicion of second-degree murder.

“It was devastating,” Steir said, recalling how he was handcuffed, shackled and thrown in jail for three days.

Two Views of Steir

Steir’s supporters say the murder charge doesn’t make sense, either medically or from what they know of Steir as a man.

How could it be, asked Dr. William Harrison, an experienced abortion provider in Arkansas, that the coroner found no damage to Hamptlon’s bowel? The coroner’s report notes that although Hamptlon’s uterus was torn and there was a hemorrhage on the bowel membrane, the bowel was intact.

“You can’t draw somebody’s gut through a tear in the uterus and not have a rent in the gut,” Harrison said.

A committee of the California Medical Assn., after reviewing records in the case, found no basis for a charge of criminal negligence.

Shauna Heckert, executive director of the Feminist Women’s Health Centers in Northern California, where Steir worked 12 years, said the charge is out of keeping with his character and past performance. His complication rate was low, and “he really did have a bigger goal in mind . . . to help women,” Heckert said.

Yet Clark and the Medical Board of California, which worked with the prosecutor in preparing the case, have a different view of Steir.

Records show that the doctor had been on probation with the board since 1988, when authorities learned that he had been stripped of clinical privileges in the Navy. (Clark says Steir lost his Navy privileges for medical negligence unrelated to abortions, though Steir and his attorney insist that the charges were a result of a commanding officer’s displeasure that Steir “moonlighted” as an abortion provider in Chico on weekends.)

In subsequent years, Steir was accused by the board of, among other things, mishandling six abortion cases. Weinberg points out that some of the board’s own experts failed to find “gross negligence” in several of these cases. Medical board records indicate that most of these allegations were pending at the time of Hamptlon’s death.

In court papers, Clark contends that at least two earlier cases demonstrate a pattern of “callousness in post-recovery care.”

Clark cites a 1988 case involving a 31-year-old woman, 23 weeks pregnant, who, she says, was discharged by Steir within an hour of her abortion, though she “continually complained of pain.” Later, she landed in an emergency room with a perforated uterus, internal bleeding and a three-inch loop of gangrenous bowel, Clark said.

In a 1992 case, according to Clark, Steir could not find the fetal skull in the body of a 34-year-old patient. By Clark’s account, Steir suspected that he might have perforated the woman’s uterus but discharged her anyway, telling her to return if she had fever, pain or bleeding. It turned out that the fetal skull and other body parts had poked through her uterus, causing damage that led to the removal of her pelvic organs.

Weinberg said these earlier cases are inflammatory and irrelevant. In the 1988 case, he said, one board expert contended that the decision to discharge the patient was at most an error in judgment, “not gross malpractice.” In the 1992 case, Weinberg said Steir did not know that the patient was in danger when he discharged her.

Steir describes the prosecutor’s case as the culmination of harassment he has endured since Roe vs. Wade. In time, Steir said he developed a commitment to providing abortions in underserved clinics--a commitment that he believes he is being punished for.

Yet, the doctor portrays himself as a somewhat reluctant warrior, wearing a bulletproof vest because he was threatened, fighting his enemies because he was attacked.

“It never really was political until the opposition made it political,” he said.

A Different Perspective

From the standpoint of Steir’s critics, it is the doctor and his defenders who are playing politics.

“They are raising . . . red-herring issues,” said Jack Schuler, the Hamptlon family’s attorney, who settled a malpractice lawsuit against Steir, the clinic and others in early November. He says the family, including Curtis, now 5, will collect up to $2 million over their lifetimes.

“I don’t understand why the pro-choice people want to rally around the cause of a shoddy physician,” Schuler said. “If I were in their shoes, I would do as much as possible to distance myself from the likes of Steir . . . rather than having him be the poster boy for my cause.”

Weinberg is trying to prove that Steir is a victim of “selective prosecution,” singled out because he provides abortions. By his reckoning, the prosecutor and the medical board were unduly influenced by anti-abortion forces in conservative Riverside County--in particular, by an ardent Palm Springs activist named Jeannette Dreisbach.

Dreisbach, a doctor’s wife, has made a crusade of blowing the whistle on what she considers shoddy abortion providers. Though personally opposed to abortion, she has in recent years portrayed her cause as women’s safety.

Weinberg argues that Dreisbach is “all over this case,” noting that she referred the Hamptlon family to Schuler, who has sued several abortion providers, and sent a flurry of memos, complete with tactical advice, to the medical board and prosecutors. Dreisbach has received extraordinary attention and access in this case, Weinberg said, and may have been given inside information.

Dreisbach could not be reached, but she told the Riverside Press-Enterprise in Riverside in October that while she had contacted officials about the case, she had received no inside information. Earlier this year, Dreisbach said prosecutors had asked her to keep a low profile and “let them do their job.”

Clark said she has taken great pains to keep politics--and Dreisbach--out of this case. She cites a letter she sent Dreisbach in early 1997, thanking her for her “input” but warning her that “a criminal investigation precludes my sharing information with you.”

With or without Dreisbach’s help, the case has become a cause celebre to both sides in the abortion struggle.

“So much for the ‘safe’ part of safe and legal abortions!” said a National Right to Life statement posted on the World Wide Web. “Despite numerous deaths and maimings, there is not one abortionist sitting in a California jail . . . save Steir [who was released on bond]. The rest have fled the country or are continuing to prey on . . . young women.”

Steir’s defenders are just as dramatic. The criminal charge is “part of an orchestrated campaign by anti-abortion extremists that targets health care workers and continues to harass them until they quit,” Kathy Spillar of the Feminist Majority Foundation wrote to the Medical Board.

Many abortion rights advocates fear that criminal prosecution will become a new weapon against doctors who risk so much already--from violence to frivolous malpractice suits--to keep the procedure accessible. They warn of a de facto return to back-alley surgeries.

Meanwhile, the California Medical Assn. warns of the overall “chilling effect” of criminal prosecution on medical practice. “The thing you worry about the most is that physicians will not serve . . . in risky situations,” said CMA President Robert Reid.

In the war of words, even Sharon Hamptlon has become a symbol. She is seen by abortion foes as another needless victim of a wretched practice. Defenders say she’s a victim too--of abortion’s inaccessibility. Without that long drive, they say, she might have gotten help sooner.

Doris Hamptlon doesn’t have much use for talk, beyond saying that Steir failed in his responsibility as a doctor. These days, she is busy raising Curtis and sorting through memories of her daughter.

She still doesn’t know why Sharon wanted an abortion--they never discussed it. Maybe Sharon knew her mother wouldn’t approve. Maybe that’s why she didn’t tell Doris where they were going that day until they had arrived in Moreno Valley.

Doris says her daughter was a “very caring” woman who found time to call her mother every day, despite working at Burger King and raising Curtis. They used to cook, shop and sew together.

“I miss her a lot,” Doris Hamptlon said. “I don’t have her to talk to like I used to.”