Never mind the obvious disconnect between being “pro-life” and trying to make your point by killing someone in cold blood. Let’s put that to the side for the moment and focus on something else: Dr. Tiller, shot to death this past weekend, was one of only three physicians in the country who provided abortions for women after the 21st week of pregnancy. Now there are two.

Two doctors in a nation of 300 million people. Some people seem to think that seeking an abortion after the 21-week time point is the pastime of lazy, demonic, murderous women and these blood-dripping doctors who abet them. The reality, however, is different. The reality is about gut-wrenching, heartbreaking decisions that have to do with death in the middle of life, of hopes battered and buried.

There are stories popping up now on the Web from people who learned that they needed Dr. Tiller, people who discovered later in a pregnancy that there was something lethally wrong with the pregnancy, with the fetus or the mother or both. Sometimes, even with all of our modern technology, these discoveries don’t happen on a timetable with an arbitrary demarcation at 21 weeks. Sometimes, a happily pregnant woman learns that all the future and her womb hold is pain and death. That’s when we need doctors like Dr. Tiller.

Dr. Tiller had already been shot in the arms for helping women in these situations of desperate need. Yet he returned to what he was doing. Do you wonder why? Here he is, in his own words. Do you wonder why he was shot again?

Of course, the primary blame goes to the murderer who killed him, shot him in cold blood inside of Dr. Tiller’s Lutheran church as the doctor served as an usher. Shot him in cold blood while Mrs. Tiller sat in the choir, unknowing. Left him to die as another usher quietly fetched Mrs. Tiller from her seat in the choir and led her to where her husband lay. Where this father of four and grandfather of ten, this churchgoing Air Force veteran, died.

But who else is to blame? Let’s point some fingers. How about starting with a society where a major presidential candidate feels comfortable mocking, with “air quotes,” the need for women’s health. Where it’s OK to assume that women are lazy, stupid, uninformed, childlike creatures incapable of understanding a decision to terminate a pregnancy without the paternal helping hand of government and men and forced ultrasounds. Where it’s OK to cry “murder” when a woman must make the gut-wrenching, horrific decision to terminate a late-term pregnancy that is lethal to the fetus and/or the mother. When it’s OK for people to intrude themselves on the healthcare decision-making between a woman and her doctor because of an attitude that women simply cannot be trusted–weak, heartless, indecisive, selfish creatures that they are–to make these decisions like a grownup should. And finally, of course, there is the rhetoric of the anti-abortion movement, the bloody, homicidally drenched terminology that leads some of its followers to believe that interfering with these personal, heart-wrenching decisions is some form of holy war.

What do we have left now? For women and couples who learn that their late-stage pregnancy is lethal or destined for a brief life of intense pain and heartbreak, all we have left is two doctors, living under threat themselves. In a nation of 300 million people, is this the best we can do for women in their times of most heartbreaking need?

Emily Willingham, PhD