His daughter, Janine Weathersby, said he had an aggressive form of liver cancer.
Dr. Carhart at times described himself as an activist — expanding his clinics beyond Nebraska to other parts of the country including Germantown, Md. — but said his views were shaped unexpectedly while at medical school in Philadelphia in the early 1970s, before Roe v. Wade in 1973 granted the right to abortions.
He described his shock at seeing women with potentially fatal infections or hemorrhaging after self-induced abortions and procedures obtained through underground networks. “Some of these were the back-alley abortions that we’ve all heard of,” Dr. Carhart told NPR.
While third-trimester abortions are unusual, he defended the need for them in cases such as malformed fetuses, a pregnancy through rape or a woman in severe mental distress or contemplating suicide. He would, however, refuse many elective abortions after 24 weeks, when a fetus is generally considered viable.
In 2009, a woman went to Dr. Carhart’s seeking an abortion in her 28th week of pregnancy. Dr. Carhart asked what she would do if she carried the baby to term, according to a Newsweek account. She said she planned to put the child up for adoption. Dr. Carhart declined to perform an abortion.
“Even though you feel like you’re alone in the world, it’s good to find out that there’s … people like you out there, that are alone with you,” Dr. Carthard told The Washington Post in 2011.
For those who oppose abortion, however, Dr. Carhart was viewed with special disdain. His openness to the media and his methodical explanations of the need for some late-term abortions brought withering condemnation.
“He knows that he kills babies for a living,” said a commentary in the National Catholic Register. In Montgomery County, Md., protesters in 2011 unfurled a banner saying “Please STOP the Child Killing” with the photo and phone number of the landlord of Dr. Carhart’s Germantown clinic.
Acts of violence came, too. On Sept. 6, 1991 — just as Nebraska passed a law requiring parental notification before a minor could undergo an abortion — buildings on Dr. Carhart’s farm burned down, killing 17 horses and his dog and cat. Dr. Carhart said he received an anonymous letter calling the fire retaliation for abortions, which were then only part of his medical practice.
“I decided I wasn’t going to just be a provider. I was going to be an activist,” he told The Post.
He opened his clinic the following year. As he built ties in the wider medical community, he rekindled bonds with George Tiller, a doctor in Wichita. In the late 1990s, Dr. Carhart began making the five-hour drive regularly from Nebraska to assist at Tiller’s reproductive clinic.
Dr. Carhart would never stay at the same hotel twice. He learned to check to see whether he was being followed. Tiller’s clinic had been previously bombed, and he was shot in both arms in 1993 by an assailant.
On May 31, 2009, Tiller was handing out the bulletin at his Lutheran church in Wichita when a gunman opened fire, fatally wounding Tiller. Dr. Carhart said he found out about the attack in a phone call to Nebraska from Tiller’s nurse crying “George is dead.” (The attacker, the self-described antiabortion activist Scott Roeder, was convicted of premeditated first-degree murder in 2010, and his sentence was later reduced to at least 25 years before eligibility for parole.)
“They’re at war with us,” Dr. Carhart said after the killing. “We have to realize this isn’t a difference of opinions. We need to fight back.”
One way was through the courts. Dr. Carhart challenged a 1997 ban in Nebraska against what antiabortion groups call “partial-birth” abortions, usually performed in the second trimester. In 2000, the U.S. Supreme Court found the law was unconstitutional, citing Roe in a 5 to 4 opinion that had ramifications for similar laws nationwide.
Dr. Carhart led another challenge to a 2003 federal law, signed by President George W. Bush, outlawing “partial-birth” abortions but under more limited instances than in the Nebraska case. The Supreme Court, in a 5 to 4 opinion in 2007, said the federal law was not “unconstitutionally vague” and did not infringe on the right to an abortion.
In advance of the Supreme Court’s June 2022 opinion that overturned Roe, Dr. Carhart appeared ready to pass to the baton. He anticipated the new landscape of varying state laws and potential legal questions for doctors and their patients, some traveling over state lines for abortions.
“I’m looking for doctors to replace me right now or to help me,” he told CNN a month before the Supreme Court decision. “The biggest problem is finding somebody who is willing to take the target off my back and put in on theirs.”
LeRoy Harrison Carhart Jr. was born Oct. 28, 1941, in Trenton, N.J., and graduated from Rutgers University in 1964. He studied medicine at Hahnemann Medical College in Philadelphia (now Drexel University College of Medicine), receiving his degree in 1973.
Dr. Carhart, who studied medicine while in the Air Force, served as a surgeon at Offutt Air Force Base near Omaha and retired in 1985 as a lieutenant colonel. After leaving the military, he opened a walk-in emergency clinic in Omaha.
Dr. Carhart began splitting his time between his clinics in Nebraska and Maryland after Nebraska in 2010 made it illegal to perform most abortions beyond 20 weeks.
In February 2013, a 29-year-old pregnant woman in her third trimester died a day after an abortion at Dr. Carhart’s Germantown clinic. The Maryland Board of Physicians found that Dr. Carhart was not responsible for the death, saying there were “no deficiencies” in his care. The report found, however, some operational shortfalls at Dr. Carhart’s clinic and 11 other abortion providers in Maryland.
In addition to his daughter, survivors include his wife of 59 years, the former Mary Clark, who assists at the clinics; son LeRoy Carhart; and one grandson.
A 2013 documentary on Tiller’s slaying, “After Tiller,” featured Dr. Carhart and the handful of other doctors providing late-term abortions at the time. As he repeated in an interview with NPR, he believed the country was engaged in a fight in which no one except the person who was pregnant could decide the lines.
“I don’t think I know when life begins,” he said. “I don’t think any of us know when life begins; certainly the scientists don’t. I don’t believe the religious scholars do. I do know the only person who knows when life begins is the mother of the life that she’s carrying.”