The doctor who performed the abortions on three teen-agers who had been raped by their father said yesterday that he did only five, not 10, abortions on the girls and that he never had any reason to suspect anything was amiss in the family.
"When these patients came to my office, they came with a mother, and you, as a doctor, feel comfortable that the family knows," said Dr. Julio C. Novoa, who also said "they never, never made a mention or a hint" that anything was wrong.
Records of the Greater Baltimore Medical Center, where the abortions were performed, show that five -- not 10 as initially reported by a prosecutor -- were performed on the three daughters between November 1983 and March 1987. Now 17, 20 and 23, they were between 13 and 19 at the time of the abortions.
The parents each pleaded guilty Monday in Baltimore Circuit Court to three counts of first-degree rape and sexual child abuse. The crimes covered a nine-year period during which the father raped the three with the full knowledge of their mother, who sometimes brought the daughters to him. The parents will be sentenced in early December.
The three daughters are now living with relatives. The two eldest are daughters of the mother by a previous marriage. The third is the child of both defendants.
"None of these cases was reported as rape, and under the circumstances, with the mother's presence, there was a supportive atmosphere which gave the medical personnel no reason to suspect rape or incest," said Vivienne Stearns-Elliott, a GBMC spokeswoman. "We do whatever we can to work on suspected child-abuse cases, and there was nothing with this case that would have urged us to bring this to light."
Wanda Robinson, who prosecuted the case, said the young women told her that they had had a total of 10 abortions and that all had been performed by the same doctor at GBMC. She requested copies of the hospital's records concerning the girls to corroborate the story she was told. The case file in Baltimore Circuit Court contains information about five abortions.
"The children say that there were 10, and that's what I relied on, as well as the medical records," Ms. Robinson said.
The prosecutor also said she found no record of the state Department of Social Services ever having received complaints about the family or reports of child abuse.
"There doesn't appear to be anything in the medical records to indicate that Dr. Novoa was told by anyone that there was sexual abuse going on in the household," Ms. Robinson said. "It was not disclosed until the child wrote the note."
Last March, the youngest of the daughters scrawled a note at the bottom of a high school history test in which she said she hated life and wanted to die. Her teacher read the note, talked with the young woman and then called the Department of Social Services. The father was arrested two days later.
That years of incest and sexual child abuse could go on in a family without it being reported is not really unusual, said Nancy Kassam-Adams, clinical coordinator of the Sexual Assault Recovery Center.
"If [the children] try to tell, it's very difficult for adults to believe it," she said. "A lot of people never tell. They're telling us for the first time 20 years later."
According to a 1986 publication, "The Secret Trauma: Incest In The Lives Of Girls And Women," as many as 25 percent of all young women have experienced some form of incestuous abuse. But only 10 percent of all sexual assaults are ever reported, with the number being even lower when incest is involved, Ms. Kassam-Adams said.
The dynamics involved in a family often work to maintain the secret and the family's structure, she said. Most important is the process of denial.
The children also may feel responsible for what is happening and sense that by remaining silent they are helping to keep the family together, Ms. Kassam-Adams said. Then there is the shame and embarrassment caused by the situation. It is made even worse when there seemingly is no one to turn to.
A mother involved in such a situation has her own pressures, Ms. Kassam-Adams said. Concern for keeping the family together and fear of being left alone to raise the children also could conspire to make a parent knowingly look the other way.
In a letter introduced in court as evidence in this particular case, the mother expressed her concern over having to raise her children alone: "There were times when I ignored what was happening and believed things had stopped, and there were periods that things had actually come to a halt. I tried to justify my being aware of what was happening by saying that the kids are in a family unit. . . . I didn't want my husband's sickness to become public."