Since Dr. Tiller was shot to death in May, his colleague, Dr. LeRoy H. Carhart, has hired two people who worked at Dr. Tiller’s clinic and has trained his own staff members in the technical intricacies of performing late-term abortions.
Dr. Carhart has also begun performing some abortions “past 24 weeks,” he said in an interview, and is prepared to perform them still later if they meet legal requirements and if he considers them medically necessary.
“There is a need, and I feel deeply about it,” said Dr. Carhart, visibly weary after a day when eight patients had appointments at his clinic here.
The late-term abortions, coming after the earliest point when a fetus might survive outside the womb, are the most controversial, even among some who favor abortion rights. A few of Dr. Carhart’s employees quit when he told them of his plans to expand the clinic’s work.
Opponents of abortion, who had devoted decades to trying to stop Dr. Tiller’s business with protests and calls for investigations, are now turning their efforts to stopping Dr. Carhart. Troy Newman, the president of Operation Rescue, an anti-abortion group, said he had traveled from the group’s headquarters in Wichita, Kan., to Nebraska six times in recent months, portraying this suburb of fewer than 50,000 as a new battlefield in the abortion fight.
“We’re trying to get criminal charges against him, to get his license revoked, and to get legislators there to look at the law,” Mr. Newman said of Dr. Carhart.
State law in Nebraska bans abortions in cases when a fetus clearly appears to have reached viability, except to “preserve the life or health of the mother.”
Abortion-rights advocates say the need exists for late-term abortions, in cases of extraordinary genetic defects and other dire health circumstances, and some had worried that only a few physicians would be willing to provide such care after Dr. Tiller’s killing, an act prosecutors say was carried out by an abortion foe.
“He’s standing up, and so are some others,” Vicki Saporta, president of the National Abortion Federation, said of Dr. Carhart.
A few other doctors have long performed late-term abortions, and some said both the threats against them and their efforts at security had increased since Dr. Tiller’s death.
Dr. Carhart, 68, knew Dr. Tiller for years, and would make regular trips to his clinic in Wichita to perform abortions there, as other physicians did. Though Dr. Tiller’s clinic was not the only one in the country performing late-term abortions, it was a focal point for controversy. Operation Rescue even moved its headquarters to Wichita because of Dr. Tiller’s practice.
Dr. Carhart, who has been performing abortions since the 1970s, is no stranger to the debate; he has been a litigant in two abortion-related cases decided by the United States Supreme Courtover a particular method of abortion referred to by critics as “partial-birth abortion.” And immediately after Dr. Tiller’s killing, Dr. Carhart offered to continue operating his clinic, but the Tiller family decided to close it.
Still, in the months since the killing, Dr. Carhart has made changes at his clinic and to his lifestyle as he has openly moved to take up Dr. Tiller’s cause.
Visitors to the clinic here must pass through a metal detector, new security cameras scan outside the building and a security consultant is employed full time. Dr. Carhart says he goes out publicly only on short, unscheduled trips and rarely eats out (and when he does, he says he stays less than 30 minutes). Dr. Carhart, an Air Force veteran, said his daughter was wed this fall on a nearby military base, mainly for security and privacy.
“We do everything differently now,” he said.
Dr. Carhart declined to provide specifics on how late in a pregnancy he would be willing to perform an abortion. Dr. Tiller performed them, in some cases, as late as in the third trimester of pregnancy. Dr. Carhart’s fee schedule lists prices for abortions up to 22 weeks and 6 days (at that point, $2,100 in cash or $2,163 on a credit card), but notes that abortions after 23 weeks are available “after consultation with our doctor,” and that abortions after the 27th week may take four days.
At his clinic in the past, Dr. Carhart said, he had performed abortions up to about 22 weeks into gestation — considered by some to be near the earliest point at which a fetus can survive outside the womb, a notion known as viability and one that is cited in many laws related to abortion.
Dr. Carhart’s opponents insist that late-term procedures violate state and federal statutes as well as professional rules. They have approached officials in Nebraska seeking an investigation. Mr. Newman, who had regularly called for investigations into Dr. Tiller’s work but strongly denounced his killing, has submitted a complaintabout Dr. Carhart to Jon Bruning, Nebraska’s attorney general. In it, Mr. Newman accuses Dr. Carhart of using improper operating procedures under shoddy conditions.
Representatives of Mr. Bruning would not comment on whether an investigation was taking place. Marla Augustine, a spokeswoman for the State Department of Health and Human Services, which regulates physicians, said Dr. Carhart had no formal disciplinary actions on his record.
(In 1993, she said, he signed an assurance of compliance with the state, promising not to do certain things, like talk on the phone during surgical procedures, but the agreement says it did not mean he had admitted committing any violations and was not considered a disciplinary action.)
Dr. Carhart, meanwhile, said he had heard nothing lately from state officials. “Anybody can file a claim,” he said.
A brochure for his clinic shows a photograph of Dr. Carhart beside Dr. Tiller, and says that the clinic dedicates “our services to women in honor of” Dr. Tiller. Asked whether he feared a similar fate as Dr. Tiller’s, Dr. Carhart said he had signed up for this life.
“They have never targeted me more,” he said of abortion opponents. “But to me, the most dangerous response would be for me to stop what I am doing. The thought that killing Tiller might also succeed in closing another clinic — that’s my main reason for keeping open.”