How one physician successfully confronted her hospital’s clandestine partnership with Planned Parenthood
Years before she plunged into her life’s work as an anesthesiologist — and decades before she waded reluctantly into the stormiest professional, moral, and emotional whirlpool of her life — Nancy Fredericks was busy learning how not to swim.
Her parents kept taking their little girl for lessons at the community pool in her native Ellsworth, Wisconsin, and Nancy kept looking at the water up to everybody’s neck and finding reasons to slip away to the root beer stand. Finally, after countless floats and three failing efforts to pass the beginner’s course, some deep-down tide turned, and Nancy fell in love with the water.
She spent her summers at the pool, mastering the backstroke and breaststroke, water safety classes, and, in time, the lifesaving training program. She worked three happy summers as a local lifeguard.
"No one ever suggested I couldn’t do this job because of my size," she says (Nancy is 5' 3"), "and I never doubted that I could."
That confidence would come in handy, in years to come. By then, Nancy had traded her whistle and swimsuit for a stethoscope and scrubs. But to her mind, she was still guarding lives.
And still drawing on some of the lessons she learned in the deep end of the pool.
Lesson 1: Be vigilant.
"Being a lifeguard’s like what they say about being a soldier: ‘Stretches of boredom, punctuated by moments of sheer terror.’ You have to be on your toes all the time. It’s like anesthesiology: If you’re really vigilant, you notice something’s amiss well before disaster strikes."
The road from Ellsworth to Madison wasn’t long, and once Nancy traveled it, she rarely looked back. Madison was home to the University of Wisconsin (UW), and on those hallowed grounds she completed her degrees, met her husband-to-be, and, ultimately, found her professional home.
After years of work at hospitals throughout the community, she settled in contentedly seven years ago as one of four full-time anesthesiologists at the Madison Surgery Center (MSC), an outpatient clinic run by a coalition of local medical juggernauts: UW Hospital and Clinics, the UW Medical Foundation (UWMF), and Meriter Hospital (a private facility near the UW Campus).
Somehow, she still manages to squeeze in time to teach as an assistant clinical professor at the nearby UW medical school. She expresses enormous respect and affection for all those she works with, and great pride in what they accomplish, day by day, in their small corner of the medical world.
"We all work really hard," she says. "We help each other. Everybody is a team player."
The team was just getting a new game plan when Nancy returned from vacation in late autumn 2008. She was called into a meeting with other anesthesiologists and the clinic’s medical director, who announced that MSC would soon begin providing late second-trimester abortions.
It was head-spinning news. Previously, abortions had been primarily available through a Planned Parenthood clinic on the city’s east side. Now, that clinic’s primary abortionist was retiring, and offering to "gift" his practice to UW Hospital. A doctor there was willing to take on the business, but reluctant to do such risky abortions so far from the emergency resources of a hospital. Her boss in the OB/GYN department was eager to incorporate abortions into the hospital’s services, but wary of state regulations that prohibited performing abortions on taxpayer-funded property.
The MSC — close at hand but governed by a variety of medical organizations — seemed a likely solution: ready-made staff, quick access to Meriter Hospital in a crisis, and facilities familiar to the UW doctor and the medical students she would be training. A proposal was put together for the three boards governing MSC — even as a strange veil of secrecy descended over the plan.
"I had to come to terms with my own complacency about abortion."
Dr. Nancy Fredericks
At first, that secrecy didn’t concern Nancy much. And, since she had always opposed abortion, the thought of having to help with such procedures herself seemed, at the time, as remote as it did repugnant. Her imagination momentarily leap-frogged that aspect to balk at the prospect of protesters chanting outside the MSC doors, while — inside — women about to have abortions mingled in the waiting rooms with crying children and mothers who’d just suffered miscarriages.
"I thought, ‘We are a peaceful, productive, smooth-running little surgery center that would be thrown into tumult,’" Nancy says. "I couldn’t believe that they were seriously considering this."
"Never fear," the medical director told her. There would be plenty of opportunities to voice her concerns in a meaningful way. "Just don’t say anything to anyone else, right now."
That made sense, Nancy decided. But a month went by, and the promised opportunities for input never came. She learned that her medical director had visited an out-of-state surgical clinic that regularly performed abortions. Then came word that two of the three boards overseeing the MSC had approved the abortion plan — a plan most of the MSC medical staff still had never heard of.
"It became clear this thing was rolling forward," Nancy says, "and that we were not ever going to have any meaningful input. I got frightened. That’s when I called the Alliance Defense Fund."
Lesson 2: Be prepared for a fight.
"As a lifeguard, you approach saving the victim furtively, out of sight, with a surface dive. Grab the knees, turn the person around, and climb up his body. If you let the victim see you and get too close, he’ll climb on your head and you can do nothing. You have to be prepared to roll over and over with the victim, as he tries to climb on top of you as you are bringing him in."
Nancy had first heard of the Alliance Defense Fund on Christian radio, on drives across state to visit her mom. Now, "for some reason, they popped into my mind," she says. "I didn’t know who else to turn to."
"She was faced with the prospect of having her entire work life turned into a horror movie," says ADF Legal Counsel Matt Bowman, who took on Nancy’s case. He quickly realized she was working with "one of the most powerful and pro-abortion university systems in the country" — who were trying to quietly impose this plan while threatening any staff who talked about it.
Bowman warned Nancy that, apart from entrenching late-term abortion services in taxpayer-funded medical entities, clinic administrators were striking a terrible blow against her right of conscience. They were creating a system that would likely require Nancy and her fellow health care workers to participate in abortions, whatever their personal religious convictions or concerns.
At first, Nancy found that hard to believe. She trusted the medical director’s assurances that her own shifts could be scheduled so that she wouldn’t be on call when abortions were being performed, or — if she was — other doctors would be responsible. If abortions had to come to MSC, maybe she could at least avoid being part of them.
But what about "emergencies," a co-worker asked her? In a crisis, every doctor was expected — maybe legally required — to respond. And emergencies, by definition, were unpredictable.
"Do you really think," Bowman finally asked her, "that people who have no qualms about taking innocent pre-born life will have any qualms about trampling on your conscience rights?"
"A light bulb went on," Nancy says. When the UWMF Hospital and Clinics board and UWMF finally called a meeting to announce its intentions to the MSC staff, she made plans to speak.
"We went over what could happen," she says, "the risks I was taking. Matt was very forthright about that." He told Nancy that the board could fire her. She and her husband, Tod, really couldn’t afford that. Nevertheless, she decided, "Whatever happened to me, I was just going to trust God with the consequences on this one."
Standing alone and shaking, though, in a room full of others obviously enthusiastic for the plan, she quickly realized that she was never going to get through her full, prepared statement. "It took every bit of composure I had just to say, ‘I will not be participating in abortions, and neither will my partners. I think abortion is wrong, and this is a really bad idea for the Surgery Center.’"
She sat down, feeling "like a real failure
. . . a coward."
Bowman, though, took a different view.
"You didn’t come out as a strident person," he said. "You presented yourself as reasonable, as calm. This could be very helpful as we go forward." Remembering her desperate prayers for help in the meeting, Nancy decided the Lord had heard her, after all.
Lesson 3: Don't believe every threat you hear from intimidating authority figures.
"I took lifesaving from an instructor who was 6’ 2" and very stern. He greased his body before the lifesaving test and announced that if he had one fingernail scratch it would be an automatic flunk. Well, at the test, this huge man was flailing about and I could not get a solid grip on him. I thought, if this were a real drowning person, I’d use my fingernails. So, I dug in, and brought him in. He passed me."
Once Bowman took on Nancy’s case, one of his first orders of business was to request records of all correspondence between all medical doctors, board members, and Planned Parenthood officials related to the abortion plan. (As a public institution, UW correspondence was open to inspection.) What he found, he shared with the local media — and the response was extraordinary.
"It set off a series of events that really was unprecedented," says Julaine
Appling, director of Wisconsin Family Network [see p. 16]. "Because of the gravity of this, the pro-life community coalesced in unprecedented ways. It brought in every pro-life group across the state in a united voice. And that, quite frankly, is what you had to have to stop this."
"They held one of the largest pro-life rallies in recent history in Wisconsin in the middle of winter," Bowman marvels. "They had over a 1,000 people march through the center of Madison on a freezing cold day to oppose this plan. They organized phone calls to the hospital entities, and letters to their legislators. They put out newspaper ads. They put out television ads. They had people praying and picketing outside the MSC and the UW weekly for two years."
"Word just flew out all over the state, and as a result of it, there were boycotts on many of the UW hospitals and clinics," Appling says. "People were calling their insurance companies and saying, ‘Unless you can get me into some kind of a health care facility that is not associated with the UW, I am going to change my insurance policy.’ There were people calling and boycotting MSC like crazy. And the impact on the bottom line was tremendous."
Weeks after the abortion plan was made public, Appling and major pro-life leaders called a press conference . . . and rolled up dollies bearing petitions with 60,000 names in protest of the plan.
Meanwhile, more of Nancy’s coworkers were calling ADF, asking for help. Bowman worked with all of them, helping the growing group draft legal warning letters to the various boards, create "conscience statements" affirming their right not to participate in abortions, and quietly distribute copies of those statements to staff throughout the MSC.
The response was stunning. Of the nearly 100 professionals on staff at the Surgery Center, all but seven signed a statement refusing to take part in abortions.
"I don’t think any of the planners or administrators had any idea so many people would be against this," Nancy says. "They were caught off guard." But determined not to give in.
At a packed public hearing to decide whether the UW Hospital board would sign off on the abortion plan, Nancy once again stood up to speak for those opposed to it. This time, she read a full statement carefully composed with Bowman and her fellow ADF clients. But despite her efforts — and all the pickets, protests, and petitions — the board OK’d the plan.
"It was a low point for all of us," Nancy says. MSC administrators began hiring additional staff. Abortion instruments were ordered, and arrived. Fighting despair, Nancy and the others joined Bowman in risking one last, earnest, pointed letter demanding that the governing boards pledge their support, in writing, for the health care workers’ conscience rights.
Meanwhile, "churches all over town were praying," Nancy says. "Bible study groups were praying. My small group was praying. Our pastor spoke out very bravely about this and was very supportive. We all had our network of people praying — and those prayers were key."
Days, then weeks, went by with no response. Months passed, and the abortion plan still hadn’t been implemented. The protests, the boycotts, the ads, and the prayers continued. Finally, in the summer of 2010, an ADF allied attorney tried again, writing the state attorney general to ask that he investigate the actions of the boards, the OB/GYN doctors, and Planned Parenthood.
"Do you really think that people who have no qualms about taking innocent pre-born life will have any qualms about trampling on your conscience rights?"
Matt Bowman, ADF Attorney
The attorney general declined to do so — because, he said, the University had already informed him that the plan had been abandoned. A few months later, the hospital confirmed that decision publicly. Nancy and those who’d stood with her had won.
To date, not a single abortion has been performed at the Madison Surgery Center.
Lesson 4: Push yourself.
"As a lifeguard, I never actually had to save anyone. But I took the responsibility very seriously."
If it weren’t for ADF, abortions would be taking place at the MSC," Nancy says. "ADF helped us to stand for our rights in a way that really mobilized the pro-life community — and made it impossible for the boards to implement this plan. We just are very, very grateful.
"There’s a great sense of relief at the MSC now," she says. "It’s palpable. But the battle is not over. I now know a lot about what the agenda is, in terms of undermining conscience rights."
And the battles weren’t all legal, she adds. Some she had to fight with herself.
"I had to come to terms with my own complacency about abortion," she says. "I was a supporter of a crisis pregnancy center, but while abortion was being done over on the far side of Madison, I hadn’t given it too much thought. I had to talk with God about my own sort of apathy about that."
Now, she says, "I think we have to bring our spiritual life, our belief in a holy God, into the public square and not be afraid to stand up for what is right, and be vocal about it."
"Nancy is really an inspiration," says Bowman. "She’s a principled Christian, a brilliant medical doctor , and she was able to put her firmly held beliefs into practice in a really horrific situation. And she was an excellent professional throughout the whole experience. She was able to raise her objections and call attention to this issue in such a manner that the people who were promoting abortion really had no way that they could attack her on medical or moral grounds."
And one more thing. This time, she helped save a lot of people.