Dr. Nathanson, an obstetrician-gynecologist practicing in Manhattan, helped found the National Association for the Repeal of Abortion Laws (now NARAL Pro-Choice America) in 1969 and served as its medical adviser.

After abortion was legalized in New York in 1970, he became the director of the Center for Reproductive and Sexual Health, which, in his talks as an abortion opponent, he often called “the largest abortion clinic in the Western world.”

In a widely reported 1974 article in The New England Journal of Medicine, “Deeper into Abortion,” Dr. Nathanson described his growing moral and medical qualms about abortion. “I am deeply troubled by my own increasing certainty that I had in fact presided over 60,000 deaths.”

His unease was intensified by the images made available by the new technologies of fetoscopy and ultrasound.

“For the first time, we could really see the human fetus, measure it, observe it, watch it, and indeed bond with it and love it,” he later wrote in “The Hand of God: A Journey from Death to Life by the Abortion Doctor Who Changed His Mind” (Regnery Publishing, 1996). “I began to do that.”

Despite his misgivings, and his conviction that abortion on demand was wrong, he continued to perform abortions for reasons he deemed medically necessary.

“On a gut, emotional level, I still favored abortion,” he told New York magazine in 1987. “It represented all the things we had fought for and won. It seemed eminently more civilized than the carnage that had gone on before.”

But, he added, “it was making less and less sense to me intellectually.”

In addition to the 60,000 abortions performed at the clinic, which he ran from 1970 to 1972, he took responsibility for 5,000 abortions he performed himself, and 10,000 abortions performed by residents under his supervision when he was the chief of obstetrical services at St. Luke’s Hospital in Manhattan from 1972 to 1978.

He did his last procedure in late 1978 or early 1979 on a longtime patient suffering from cancer and soon embarked on a new career lecturing and writing against abortion.

“The Silent Scream,” a 28-minute film produced by Crusade for Life, was released in early 1985. In it, Dr. Nathanson described the stages of fetal development and offered commentary as a sonogram showed, in graphic detail, the abortion of a 12-week-old fetus by the suction method.

“We see the child’s mouth open in a silent scream,” he said, as the ultrasound image, slowed for dramatic impact, showed a fetus seeming to shrink from surgical instruments. “This is the silent scream of a child threatened imminently with extinction.”

The film won the enthusiastic praise of President Ronald Reagan, who showed it at the White House, and was widely distributed by anti-abortion groups like the National Right to Life Committee.

Supporters of abortion rights and many physicians, however, criticized it as misleading and manipulative. Some medical experts argued that a 12-week-old fetus cannot feel pain since it does not have a brain or developed neural pathways, and that what the film showed was a purely involuntary reaction to a stimulus.

Dr. Nathanson accused his critics of rationalizing. Responding to a doctor from Cornell’s medical school on the television program “Nightline,” he said, “If pro-choice advocates think that they’re going to see the fetus happily sliding down the suction tube waving and smiling as it goes by, they’re in for a truly paralyzing shock.”

He later produced another film, “Eclipse of Reason,” about a late-term procedure that critics call partial-birth abortion. In the 1980’s he wrote “Aborting America” (Pinnacle Books, 1981), a memoir and social history of the abortion rights movement, and, with Adelle Nathanson, “The Abortion Papers: Inside the Abortion Mentality” (Hawkes Publishing, 1984)

Bernard N. Nathanson, the son of an obstetrician-gynecologist, was born on July 31, 1926, in Manhattan and grew up on the Upper West Side. He earned a bachelor’s degree from Cornell and a medical degree from McGill University in 1949.

After serving as the chief of obstetrics and gynecology for the Northeast Air Command of the Air Force, he established a successful practice in Manhattan.

While interning at Woman’s Hospital in Manhattan, he observed the effects of illegal abortions on the mostly poor black and Hispanic women who came under his care, and he soon became convinced that the laws prohibiting abortion must be changed. In 1967, he met Lawrence Lader, a crusading journalist and the author of “Abortion,” and soon became caught up in Mr. Lader’s plans to organize a movement to agitate for the repeal of laws prohibiting abortions.

Dr. Nathanson earned a degree in bioethics from Vanderbilt University in 1996 and that year was baptized as a Roman Catholic — he described himself up to that time as a Jewish atheist — in a private ceremony at St. Patrick’s Cathedral by Cardinal John J. O’Connor, the archbishop of New York.

His first three marriages ended in divorce. In addition to his fourth wife, Christine, he is survived by a son, Joseph, of New Jersey.

In addressing anti-abortion audiences, Dr. Nathanson often drew gasps by painting himself, in his pro-abortion-rights days, in lurid colors.

© http://www.nytimes.com/ - 21 february 2011