Alaska doctor, once the focus of outrage, reflects on past as abortion provider, with questions

Written in large letters across a billboard displayed in the Alaska Right to Life booth at the 1981 State Fair in Palmer was this question: “Does your Doctor kill babies?” Underneath that question was a list of several names — including Dr. carolyn Brown.

This billboard, along with things published in Alaska Right to Life’s newsletter — like calling Brown “baby-killer Brown” — was part of a libel lawsuit that would go on to reach the Alaska Supreme Court. She would lose the lawsuit, which touched on principles central to debates over free speech.

From the late 1970s to the late ‘80s, Brown was a gynecologist and obstetrician in Palmer. She delivered thousands of babies, which she was known and praised for. She also performed abortions, which she was known and praised for — and vilified for. She remembers being told, “how bad it was, how evil it was that I was killing babies, and that God would get me for that and I would burn in hell and all the other stuff that people say to people.”

However, Brown herself has questions. As she reflects on her past as an abortion provider, she struggles with how to define the beginning of personhood. And she’s relieved she no longer has to decide when it’s OK to perform an abortion. But despite this uncertainty, she continues to support a right to an abortion.

A long interest in medicine

Brown was born in 1937 and raised in Hereford, Texas, about 50 miles southwest of Amarillo. Her parents divorced when she was around 9 and her mom left, so Brown and her brother went to live with their grandmother. She knew when she was 10 she wanted to be a doctor.

“I was working in a cotton patch and there were a whole bunch of other people working in that cotton patch and here I am this little kid with a 6-foot cotton sack that I’m pulling behind me and I decided I don’t think I want to do this all my life,” Brown said, adding that she isn’t sure why she chose to be a doctor at that time. “Maybe I’ve been to a movie. I didn’t have any books to read. My growing up and background was a little bit challenging, I will say. But I decided at that point that I really was interested in becoming a doctor.”

When she was introduced to a library at age 12, she read everything in the children’s part of the library.

“I read a lot of biographies and … I was just mesmerized with medicine. That really made more firm what I was going to do,” Brown said.

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She took all the science classes that were possible for her to take in middle and high school, and went to college at Hardin-Simmons University in Abilene, Texas, where she majored in chemistry and biology, and graduated magna cum laude.

When it came to deciding what medical school to go to, Brown was sure of only one thing: “Whatever I have to do, I had to get out of Texas,” she said.

She didn’t want a big medical school and she didn’t want to go too far north, “Because I was too much of a hick. And I knew that. And I was poor as Job’s turkey,” Brown said.

Growing up, Brown did not think highly of herself.

But she got into all the medical schools in Texas at the time. Still, she decided to go outside the state — to Bowman Grey School of Medicine in Winston-Salem, North Carolina.

Brown met her husband George Brown there, and the two doctors came to Alaska in 1965. They worked as public health doctors with the U.S. Public Health Service. They were based out of Anchorage, but traveled all over the state. The two then went to Hawaii where Brown did her first residency in public health and preventive medicine at the University of Hawaii. Afterward, they returned to Alaska.

Brown had a long list of jobs during that time, including working at the Anchorage Municipal Health Department. Brown was inundated with women who had a lot of health questions about women’s issues — questions Brown couldn’t always answer. So, she decided to go back to the University of Hawaii to do a second residency.

One of the boys

Throughout this whole time, Brown didn’t have any strong feelings about abortion. In fact, she didn’t really think about it at all during college, medical school, or her first residency. It wouldn’t come up until her second residency in obstetrics and gynecology.

It was 1975. The U.S. Supreme Court had decided on Roe v. Wade two years prior, ruling that the constitutional right to privacy includes the right to access an abortion.

The University of Hawaii wanted to teach all OB-GYN residents how to perform abortions.

“When I got there, I had a choice,” she said. “You were offered it. They suggested it. And if you didn’t want to do it, and there were some who, based on religious background, chose not to do it, then they were given other kinds of work. Grunt work, we call it.”

Brown said it was an excellent teaching program — but, as one of the first women to go through that program, she said it was also extremely misogynist. So Brown had to make a choice — was she going to be one of the boys and perform abortions, or would she go do grunt work?

She decided to be one of the boys. Even then, she still didn’t have an opinion about abortion.

“I didn’t have a decision about — What did I really think about it? I said, ‘OK,’ because I hadn’t really processed what that really meant,” Brown said.

Brown knew that she wouldn’t have an abortion. She had to ask herself: What am I doing? It weighed on her, but she didn’t have much time to dwell on it.

“Except once in a while I did think about it and I went to church. And I did all of those things that I sort of grew up doing way back in the day. But I had to come to some peace with myself,” Brown said. “But I never could decide for myself that an egg and a sperm was a person because a person is a philosophical definition. A sperm and an egg when they come together, that’s tissue up to a certain point. And then you got the whole philosophical thing is when does the soul enter the sperm and the egg? I didn’t know and I still don’t know. But I’ve struggled with that for all of these many, many years.”

During Brown’s days at the clinic, she did 10 to 14 abortions a day.

Setting up a practice in Palmer

When she was done with her residency in Hawaii, she, her husband George Brown and their two kids returned to Alaska in 1978. The couple started Women and Children’s Health Associates, a nonprofit that operated an obstetric-gynecologic and pediatric practice in the Mat-Su area. Brown’s office was based in Palmer and her husband’s pediatric office was in Wasilla.

Brown initially worked out of the Valley Hospital, though she didn’t have a proper office.

“But the hospital had a little front room, just off of the waiting room when you go into the hospital and it was maybe 16-by-16 square feet. And so we found a table with stirrups on it and a desk and a chair and a screen. And I didn’t have a secretary, I didn’t have an assistant, I had nothing, but the people started coming,” Brown said.

Brown had a very active OB-GYN practice. She eventually moved her office to its own building, just outside the hospital’s parking lot. She said she would work 100-hour weeks and she didn’t make payment a barrier.

“In those days, I gave stuff free. I did free C-sections, I took bear meat, I took salmon. You know, it was the old-fashioned way of doing whatever it is you had to do,” she said.

She also provided abortions. Brown saw all kinds of patients, including Medicaid recipients, and people from all over the state — like Fairbanks, the Aleutians, Kotzebue, Juneau, Utqiagvik — were referred to her.

“Literally every quadrant of the state and people would call the office or they would call whatever practitioner they knew, or from way out in the villages, they would contact the public health nurse,” Brown said.

At this time, Brown said there weren’t ultrasounds. She had to tell how far along someone was from doing a pelvic exam. It was up to her to determine if a woman was, for instance, eight weeks pregnant or 22 weeks.

In the late 1970s, doctors in Alaska could perform abortions up to 150 days, or about 21 and a half weeks. To provide an abortion beyond that, state regulation allowed doctors to use “reasonable judgment.” Brown said she stuck with the 150-day limit and was “worse than OCD on that sort of thing.” This meant she sometimes had to turn people away, like a woman who had traveled from Utqiagvik to Palmer.

“She got there and, bless her heart, when I did the exam … she was more — 150 days is 21 weeks and four days — and that was 22-weeker and I said, ‘I can’t do this. I can’t do this,’” Brown said.

By this time, Brown said performing abortions was as normal as any other OB-GYN medical procedure. Though she performed abortions up to 21 and a half weeks, Brown said more than 90% of the abortions she did were done in the first trimester — the first 13 weeks.

She estimates she did three to five abortions a week in the Valley Hospital, though there were peaks and dips. And she said she had a good safety record.

“I wasn’t having any bad events, any failures, any disasters. I was very, very, very conservative about what I did,” Brown said.

‘There goes the baby killer’

Brown and her family were part of the community. They went to the Presbyterian church. The two kids attended middle and high school in Palmer. It wasn’t a secret that Brown performed abortions. She said the board of her and George’s nonprofit was very supportive, but not everyone in the community was.

Throughout her time in Palmer, starting a couple months after they arrived, Brown recalled being harassed. She received hate mail and phone calls in the middle of the night. Air was let out of her tires. People against abortion rights went to her work place.

“When I would come to work, go in to make rounds, they would hiss and boo. That was still at a time when I had the little office in the hospital there. So they would come in and sit around and say whatever it is they had to say. And line up just like a march as it were,” Brown said.

She heard comments like, “There goes the baby killer. Is that the baby killer?”

“It was awful. It was really awful, but you have to carry on,” Brown said. “I’d come to work and get ready to go down to the other end of the hospital to do a C-section or to do whatever it was I was going to do. Well, it’s got to go on.”

She said that people’s behavior toward her was egregious and filled with vindictiveness. But she never felt unsafe. In the decades after she practiced in Palmer, several abortion doctors were murdered around the country, which led Brown to think that if she had been an abortion provider later, she might’ve been shot.

On the outside, Brown was calm and collected. But inside, she said she was a basket case. Most people didn’t know that, she said.

“Of course I had to be in charge in the operating room. I had to be in charge when a person was in labor, screaming their heads off or whatever. I got to the place where I could almost talk a woman through her delivery, just my soft voice and sitting there. And I knew that was happening and she knew that was happening. And I knew I was very good at that. But nobody knew what was going on inside. The fear of God Almighty, what if this woman dies? What if this baby dies? Oh, my God. All the horrible things that you could possibly think of, I went through them all a great deal of the time,” Brown said.

At the same time Brown was performing abortions and being called a baby killer, she was also delivering lots and lots of babies. And she was really good at it. “We never lost one,” she said.

There were also colleagues at the hospital who didn’t want to work with her.

Brown recalls a person who worked in the lab and refused to draw blood for abortion patients due to his religious objections. There were also nurses who wouldn’t work with Brown when she was providing abortions. “A few of the nurses, religious or otherwise, just simply could not help,” she said.

The lawsuit

In April 1981, Brown submitted her name to Gov. Jay Hammond for appointment to the Alaska State Medical Board. The board regulates the practice of medicine, including abortion procedures.

According to court documents, “The appointment process resulted in some confusion in the governor’s office.” A letter appointing Brown to the medical board dated in May was signed by Hammond’s signature machine. The letter wasn’t supposed to be sent until the governor actually gave his approval and it wasn’t sent; Brown never received this letter from the governor. But the governor’s press secretary announced Brown’s appointment and the lieutenant governor sent Brown a congratulatory letter. It was also reported in local newspapers.

In response, the Alaska Right to Life wrote about Brown in a June newsletter. It said: “Stop baby-killer Brown.” It called her “the Mat-Su Valley’s No. 1 Abortionist,” and instructed its readers to contact the governor to urge him not to appoint Brown to the Alaska State Medical Board.

The newsletter article said, “We cannot believe that Governor Hammond will bow to anti-life pressure to appoint an abortionist whose methods were so horrible as to cause a boycott by every nurse employed at Valley Hospital.”

Hammond eventually sent Brown a letter and apologized for the “erroneous announcement” of her appointment. He wrote that he had decided to follow his past practice of appointing a person recommended by the Alaska State Medical Association. According to court documents, the association had not recommended Brown because it thought that vacancies on the State Medical Board, which previously had been held by Anchorage doctors, should again be filled by Anchorage doctors.

In September 1981, Brown filed a lawsuit against Bill Moffatt, the primary author of the newsletter article, and Alaska Right to Life, alleging they had libeled her. In the lawsuit, Brown said that the defendants intimidated the governor and caused him to withdraw her appointment, resulting in damage to her professional reputation and career. Brown was joined by other doctors in the lawsuit.

The complaint also alleged defamation based on the state fair sign, what was written in the newsletter, and press conferences where they called Brown a “killer of babies.”

“It was very defamatory. That’s why I decided to sue them,” Brown said. “I was so horrified that somebody would say this about me because that wasn’t who I was.”

Sally Mead was horrified too. In September 1981, Mead was pregnant, and a patient of Brown’s. Mead lived in a two-story log cabin that she’d built in Bird Creek, which is south of Anchorage. Which means she’d drive past Anchorage in her hour-and-15-minute drive to Palmer for her appointments with Brown. That’s also where she delivered her baby, at the Valley Hospital.

It wasn’t an easy delivery, Mead said. It took around 12 hours and went through the night.

“And in the end, (Brown) said, ‘I think his head is bumping into your pelvic bone. So I know you didn’t really want to go into the O.R. But let’s just try and see if we can help him get out.’ So she takes me into the O.R. and of course I’m having contractions like crazy and been having them for hours,” Mead said. “she takes the forceps she puts them there, lowers the baby’s head down and — boink — out he comes. That’s all it took.”

In the moments after her son was born, as she was waiting for him to get cleaned and brought to her, Mead had a thought. She knew Brown performed abortions and she had seen the Right to Life display at the state fair. In her mind, Brown was being attacked. Mead had also heard about the lawsuit.

“And it was somewhere in that point of the delivery that I just had a flash. You know, this was something I could do to help. I could help to create a legal fund for her and support this effort.”

Mead started the carolyn Brown Legal Fund — Brown’s legal first name begins with a lowercase “c.” At the time, Brown was paid $36,000 — just over 50% above the typical family income. Today, obstetricians on average make nearly 350% of typical incomes.

Mead made a pamphlet detailing Brown’s position, wrote letters, made phone calls and held gatherings to raise money, which she doesn’t recall as being that difficult.

“There was a large community, particularly of women but some men, who really felt this was an issue that needed to be spoken to. Because you know, we’d all go to the state fair, so we’d all see these exhibits from Right to Life,” she said.

Speech about abortion

But in that court case, Brown started to lose. In 1984, the Superior Court dismissed several of Brown’s claims against Right to Life, but not all of them. Bill Moffatt and Alaska Right to Life pushed for a summary judgment to end the rest of the case. The Superior Court denied the motion, setting up an appeal.

The matter eventually reached the Alaska Supreme Court in the case Moffatt v. Brown, which would have implications for not only Brown, but for free speech.

Besides the two parties and their lawyers, attorney John McKay was also involved in the case as a friend of the court. McKay has practiced law in Alaska since 1978, mainly representing news media. A disclosure: The Alaska Beacon employs McKay when legal issues come up.

McKay represented the Alaska Press Club in Moffatt v. Brown. McKay said the case could have affected the press’s ability to do its job.

“We wanted to basically take the position in the court that whatever way this came out, we wanted the court to be looking beyond the interest of Dr. Brown or the Right to Life. To say that this case, dealing with the standards in libel law, really probably affects us — the press in Alaska — really more than more than the parties in a sense; it’ll have a longer impact,” he said.

McKay said people saw Moffatt v. Brown as a case about abortion, “but I really think this is a case about talking about abortion. So it could be talking about any other issue too, but abortion was then and remains a really, you know, hot-button issue. … And I think that the First Amendment and the same constitutional provision in the Alaska Constitution guarantees free speech, free press. And if you can’t talk freely about these things because you’re worried that people are going to sue you, then you’re going to be less likely to take on those important issues.”

What McKay wanted to ensure was a standard that made it clear that free speech and freedom of the press were protected.

The alleged statement of defamation the Alaska Supreme Court was looking at claimed that Brown’s abortion “methods were so horrible as to cause a boycott by every nurse employed at Valley Hospital.”

That statement was inaccurate. Some nurses wouldn’t work with Brown on abortions, but not all. However, Brown’s side also had to prove that the statement was made with “actual malice,” because according to the courts, Brown was a public figure.

“They said carolyn Brown submitted a letter to the governor asking to be put on the medical board. She put herself in that position of becoming a public figure for at least the limited purposes of dealing with … the abortion question and the issues that came up around whether she should be on the board or not,” McKay said.

In the 1964 U.S. Supreme Court case New York Times v. Sullivan, the court placed certain constitutional limitations on state defamation laws. To recover damages for libel, which is what Brown was suing for, a public figure must prove two things: first, that the statement was false, and second, that the false statement was made with “actual malice.”

Though Bill Moffatt’s assertion about “a boycott by every nurse at Valley Hospital” was not accurate, he said he did not know it was inaccurate, and the court agreed. Moffatt had gotten his information from Robert Ogden, the hospital administrator.

Robert Ogden testified in a deposition that “most, but not all, of the nurses on the nursing staff at Valley Hospital refused to participate in Dr. Brown’s second-trimester abortions.”

He described the situation as escalating gradually, that at first a number of nurses were willing to help and but as time went on, there became fewer and fewer that would help on second-trimester abortions.

Brown’s side was not able to successfully prove that Moffatt wrote the inaccurate statements with malice.

The Alaska Supreme Court sided with Moffatt and the Alaska Right to Life. The opinion again referred to the New York Times case, which stressed a “national commitment to the principle that debate on public issues should be uninhibited, robust, and wide-open, and that it may well include vehement, caustic, and sometimes unpleasantly sharp attacks on government and public officials.”

John McKay said it was a good result from the perspective of the press. He explains what the judge wrote:

“This after all is not a case about whether abortion is acceptable or might be punished but about whether public speech about abortion was acceptable and could be punished.”

Learning to be at peace

In 1988, the Browns sold their Mat-Su practice, gave the profits to their nonprofit’s board and left Alaska for Vermont. There, carolyn Brown was an assistant professor of the OB-GYN department at the University of Vermont medical school, where she trained others to perform abortions.

The couple stayed in Vermont until 2001, when carolyn Brown was asked to be the assistant director for the Alaska Division of Public Health. They returned to Alaska, to Juneau this time. After about a year and a half, the new governor, Frank Murkowski, gave Brown the pink slip, so she moved on.

In 2004, George and Brown went to Kenya for two years to set up a program that cared for HIV patients. When they returned to Juneau, Brown worked at a number of clinics, but was winding down her medical career.

Now, she is very active in the League of Women Voters and AARP, and stays connected with what’s happening in the Capitol on issues like prison health care, suicide prevention and opioid abuse. She’s also a voracious reader.

Brown said she is still learning to be at peace with what is.

“I went through a time of anger, rage, anger, vitriolic hate for the people who were the head honchos of the Alaska Right to Life. It took me a long time to get over that but I was only destroying myself by doing that, but the tincture of time does a lot of things for people,” she said.

These days, she reads a lot of philosophy and is interested in learning about different religions. One thing she doesn’t do is attend abortion-rights rallies.

“I remember when I first moved here in 2001 and we would have those rallies on Roe v. Wade day and I was asked to speak at them. I cannot do that, never could,” Brown said.

Brown said she went one year and just stood there. Brown is clear that she’s pro-abortion rights. But it’s not a simple topic to speak about.

“I don’t know. I still have to ask myself questions. What have I done? What is right? What is right? What is life? I know what life is and I know that this tissue here is human. That I know. Whether it’s a person — that’s my struggle. What’s the difference in humanity and personhood? Potential person? There’s so many unknown questions,” she said.

“I’m just glad that I don’t have to make those decisions anymore. That’s a gift to me for myself. It doesn’t mean I’m against abortions. I just don’t know what is a person. I don’t know. It’s complicated, isn’t it?” she said.

Ultimately, Brown said, abortion and what constitutes a life “is not black and white,” it’s not a yes or no question. Instead, it’s complicated and ever changing, and dependent on so many different factors — like a person’s background, spirituality, family history.

And that decision on what abortion is, what personhood is, is not for her to determine, Brown said. She doesn’t think it’s for the U.S. Supreme Court to determine either, or for all the other people who usually end up getting involved in these discussions and decisions. There’s no simple way to put it, she said; it’s just complex.

Originally published by the Alaska Beacon, an independent, nonpartisan news organization that covers Alaska state government.