News that a Philadelphia doctor had murdered hundreds of babies delivered alive during illegal late-term abortions received scant press coverage when it came to light in 2011. Ditto for the movie that tells his story, Gosnell: The Trial of America’s Biggest Serial Killer, which opened in October, three years after filming finished. That’s how long it took producers Phelim McAleer and Ann McElhinney to find a distributor. Not only has the press ignored the film—just a handful of mainstream reviews as of this writing—venues like Facebook and NPR, by refusing to run ads, have actively suppressed it. Theaters too. Despite Gosnell’s successful opening—it was in the top ten at the box office the weekend of Oct. 12—nearly a third of the 668 theaters where it showed dropped it after a week, including AMC Kips Bay here in Manhattan, where it was the sixth highest grossing picture (out of 15 screens) that weekend.

McAleer and McElhinney, Irish journalists whose work includes documentaries on fracking and global warming, arrived at Kermit Gosnell’s 2013 murder trial, shocked to see that the courtroom wasn’t packed with reporters. Gosnell, a true crime drama, recounts how the media was Twitter-shamed—when a photograph of rows of empty courtroom benches with “Reserved for Press” signs went viral—into showing up. Which it did for about a minute. McAleer and McElhinney, while not pro-life advocates, were appalled at Gosnell’s butchery and the media’s indifference to it, and have spent the better part of five years working to take the story mainstream. (Gosnell: The Untold Story of America’s Most Prolific Serial Killer, a bestselling book they developed in conjunction with the film, was published in 2017.)

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I wrote about the Gosnell grand jury report when it was released in 2011 (“A Philadelphia Story,” HLR, Winter/Spring 2011). The report is a finely crafted document, one could almost say a literary one—a harrowing tale which proves truth can be scarier than fiction. It can also be a challenge to filmmakers, especially when the subject is abortion. The producers never would have found a distributor had they recreated on screen the grisly killings that took place for decades at Gosnell’s back-alley “Women’s Medical Society,” where, the grand jury report tells us, police found putrid “surgical procedure rooms [that resembled] a bad gas station restroom.” There was “blood on the floor” and “equipment was rusty and outdated.” The “remains of fetuses,” many over 24 weeks old, were “scattered throughout, in cabinets, in the basement, in a freezer . . . in bags and plastic jugs.” Tiny severed feet were preserved in jars. One employee told grand jurors “how he had to lift the toilet so that someone else—he said it was too disgusting for him—could get the fetuses out of the pipes.”

The viewer isn’t spared the gore. But mostly we see it in our mind’s eye. The film uses language out of the grand jury report (as I am doing here) and subsequent trial transcripts to conjure images of near-term babies executed by Gosnell, who, his employees testified, “routinely cracked jokes about babies whose necks he had just slit.” In one scene, Earl Billings, the actor playing Gosnell, looks down on a baby he has killed (out of shot), and tells his assistant it was “big enough to walk me to the bus stop.” Billings, who even looks like Gosnell, gives an eerie performance as the sociopathic killer who fancies himself a Renaissance man. In another scene Gosnell plays a romantic Chopin etude (“No Other Love”) on the piano while police search his Victorian mansion—a trash-filled, flea-ridden hoarder’s den—for fetal remains.

The film makes much use of the reaction shot, the camera examining the faces of ordinary people—police officers and forensic experts, DAs and lawyers, judges and jurors—as they apprehend the extraordinary crimes that took place in what the grand jury called a “baby charnel house.” And in one powerful scene, we see the strained reaction of an “ordinary” abortionist, who testifies she has performed 30,000 procedures, as Gosnell’s attorney (played by the film’s director Nick Searcy) describes in excruciatingly precise detail the legal method commonly used in mid- and late-term abortions. It’s practically the same as Gosnell’s, except the child has been killed by lethal injection beforehand.

Though he had no OB-GYN training, Gosnell specialized in late-term abortion—“the bigger the baby, the more he charged,” the grand jury reported. (He made $2 million a year.) His MO was to have his staff administer labor-inducing drugs to women during the day and then show up at night to deliver and dispatch their babies. Apparently, sometime after the Supreme Court upheld the partial-birth abortion ban (in 2007), Gosnell did attempt to kill babies with poison before aborting them. But, according to the grand jury, he “was not skillful enough to successfully administer digoxin,” and “babies continued to be born alive, and he continued to kill them by slitting their necks.”

But babies weren’t his only victims. Gosnell’s clients were low-income girls and women, mostly minorities and immigrants; some were brought there against their will (the grand jury said he routinely “performed forced abortions”), some referred by doctors who wouldn’t do late-term procedures. “Numerous patients of Gosnell,” the report states, were injured when he “would attempt to remove the fetus himself.” Many ended up in hospitals, “infected, with fetal remains still inside them; and with perforated uteruses, cervixes, and bowels.” At least two of them, 41-year-old Karnamaya Mongar and 22-year-old Semika Shaw, ended up dead.

Ms. Mongar, whose story the film relates, died from an overdose after Gosnell told unlicensed staff members—they were all unlicensed—to “med her up” when she started experiencing severe pain. According to the grand jury report, she was given “repeated unmonitored, unrecorded intravenous injections of Demerol, a sedative seldom used in recent years because of its dangers.” Gosnell’s employees were a motley crew—one started working for him when she was 15—accustomed to dishing out powerful drug “cocktails,” as they called them, to keep women in labor from making too much noise. “He didn’t like nobody calling the police or anything,” one staffer testified. They all knew that Gosnell was killing viable babies; some of them, if the doctor wasn’t around when a baby unexpectedly “fell out,” killed them too. But, as the grand jury report observes, “Everyone there acted as if it wasn’t murder at all.”

Which was pretty much the way health officials acted as well. The film can only begin to cover the alarming findings laid out in the last chapter of the grand jury report, “How Did This Go On So Long?”—a scathing 80-page indictment of virtually every agency charged with overseeing the well-being of Pennsylvania residents. Well, not actually an indictment. While Gosnell and several of his employees faced criminal charges, not one state employee was charged with anything. Not those at the Pennsylvania Department of State, who “took no action to suspend or revoke” Gosnell’s license—even after having been notified, in 2002, of the death of Semika Shaw, and having learned, “eight years before Karnamaya Mongar died,” of Gosnell’s “illegal practice [of having] unlicensed workers anesthetizing patients when he was not at the clinic.” Nor those at the state’s Department of Health (DOH), who ignored numerous complaints about the “reckless” abortionist and let his dangerously substandard facility go uninspected for “16 plus years.” One figure in the film, whose character is an amalgam of several public officials the grand jury called out for malfeasance, mouths the bureaucratic defense: “People die.” These were the exact words the chief counsel of the DOH used when testifying about the death of Karnamaya Mongar.

“Most appalling of all,” the grand jury pronounced, was that “the Department of Health’s neglect of abortion patients’ safety and of Pennsylvania laws [was] clearly not inadvertent: It is by design.” “We have no idea,” they concluded, “how many facilities like Gosnell’s have remained out of sight, out of mind of DOH for decades—since they were first ‘approved.’” Seven years after their report was issued, can any Pennsylvania health official speak to the grand jury’s concern? Have there been any investigative reports, any “spotlight” teams assigned to ascertaining whether other renegade abortionists are still in operation? I wonder.

—Anne Conlon is the managing editor of the Human Life Review.