In Indiana, the group Right to Life obtained thousands of pregnancy termination reports from the state health department. The records are nearly identical to those requested by Bloedow in Washington, but Indiana granted the request, redacting only a few fields.
After analyzing the data, the group filed a litany of complaints with the state, alleging that doctors were violating abortion record-keeping laws, including failure to report abortions involving minors in a timely manner. Four physicians now face disciplinary proceedings.
Such cases can be pursued without violating the privacy of patients, said Cathie Humbarger, vice president of policy enforcement for Indiana Right to Life. "We're not aware of one situation where someone identified a patient by looking at a termination of pregnancy report after it was released by the state," Humbarger said in an email sent through a spokeswoman.
One Indiana doctor, who has acknowledged making an "honest mistake" involving paperwork, faces a misdemeanor criminal charge.
His attorneys have argued that he did not knowingly violate the law and unsuccessfully sought to have the medical board case dismissed before a hearing.
But there have been other instances in which anti-abortion groups have filed unfounded complaints, said Janet Crepps, a senior counsel for the Center for Reproductive Rights. The resulting investigations caused additional details about the patients to be made public, she said.
Operation Rescue and another group filed complaints with New Mexico's medical board against a doctor who works at an Albuquerque clinic after a patient experienced a complication and was taken to a hospital, and they obtained a recording of the 911 call.
Though the board ultimately exonerated the doctor, many details about the patient — her age and her mental state, in addition to her initials and where she lived — came out in a transcript of a hearing.
"The woman clearly did not want her privacy violated," said Vicki Saporta, chief executive of the National Abortion Federation, a professional association for abortion providers. "She didn't want to talk to anybody."
After a Death, All Bets Are Off
Anti-abortion groups typically tread carefully when it comes to living patients.
Operation Rescue's website in March published a photograph of a woman being wheeled out of a St. Louis clinic on a stretcher but put a black bar over her eyes to obscure her identity.
When a patient dies, however, it can be a different story.
In 2013, a different abortion opponent wrote on her blog that an "impeccable informant" told her the identity of a kindergarten teacher who had died after a late-term abortion at a clinic in Germantown, Maryland. Groups including Operation Rescue quickly got the word out, using the woman's name and photos from social-media sites.
The doctor who performed the abortion, LeRoy Carhart, has been a target for protesters because he does late-term abortions that most other practitioners won't. Though abortion opponents blame him for the woman's death, the Maryland medical board found no deficiencies in his care for her.
Saporta said the woman's family did not authorize the release of her identity.
Sullenger said she sympathized with the family's loss but not its demand for privacy. "Look, once a person dies, they don't have any privacy anymore," she said. "I think they should have been more concerned about it happening to another person."
Contacted recently, the woman's mother declined to comment.
'All They Cared About Was Judging Me'
For some patients, the grief they already feel with the end of a pregnancy is compounded by the loss of privacy.
Alicia, who spoke on the condition that only her first name be used, had an abortion in November 2013 after her OB/GYN told her and her husband that the fetus had a severe form of spina bifida, a debilitating birth defect.
During the procedure, she began bleeding heavily from a tear in her uterus. The clinic, located in Bellevue, south of Omaha, summoned an ambulance, which took Alicia to the hospital.
Someone protesting outside the clinic took a photo of the ambulance, and Operation Rescue's website reported the incident, though it did not know Alicia's identity.
Within weeks, the Nebraska health department subpoenaed Alicia's records from the clinic. Alicia had not complained, but the agency had received a tip, she later learned.
"All this happened because I was in the clinic having a legal abortion," she said. "All they cared about was judging me ... and building evidence for their case."
Alicia said while the complication was scary at the time, it had been explained to her in advance as a possibility. She said she didn't blame her doctor, Carhart, who practices in Nebraska as well as in Maryland.
In an interview, Carhart said that several of his patients have had their privacy violated.
After subpoenaing Alicia's records, Nebraska's health department disciplined a nurse at Carhart's clinic for a pattern of negligence and unprofessional conduct involving a dozen patients, including Alicia.
Alicia said she asked state officials to identify who had filed the complaint that provided her name to state officials. To her amazement, she was told that information was confidential.
Marla Augustine, a health department spokeswoman, said in an email that patients are not notified if their records are examined "to protect the process from being contaminated." For instance, a patient so notified could tip off a health provider about the existence of an investigation. That said, Augustine added: "The confidentiality of a patient's medical records is very important to us, and a paramount consideration."
Her explanation provides little comfort to Alicia.
"I don't understand why whoever did this gets to be anonymous while I was the one who was supposed to not have my information leaked," she said. "Why does that person get more rights than me?"
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