LeRoy Carhart, a Midwestern physician who became an archenemy of abortion opponents and a leading advocate of late-life abortions, died Friday at a hospice in Bellevue, Neb., a suburb of Omaha. He was 81.

The cause was liver cancer, his daughter Janine Weatherby said.

Dr. Carhart rose to national prominence in the 1990s as an unlikely progressive crusader in one of the country’s most heated moral debates.

He was a soft-spoken Methodist, a 21-year Air Force veteran and a registered Republican. He was married to a woman he had met in grade school and lived on a large farm with a horse stable.

Yet he had a personality trait that proved decisive in his life. He was “stubborn, very stubborn,” his wife Mary Carhart, he told The New York Times in the year 2000.

Dr. Carhart was performing abortions part-time on September 6, 1991, when a fire destroyed his farm, killing his dog, cat and 17 of his 21 horses. That same day, Nebraska passed a law requiring parental notification before minors can obtain an abortion. (It was also his horse-loving daughter Janine’s 21st birthday.) The next day, Dr. Carhart received a letter informing him that the fire was in retaliation for his performing abortions.

“That’s when I decided I wasn’t going to be part-time,” he said he told The Washington Post in 2011. “That’s where my tenacity comes from.”

The next year, he dedicated his family clinic in Bellevue to abortion. “I decided not to be just a provider,” he continued. “I wanted to be an activist.

After the fire in 2000, he told The Times: “Women’s health became my life.

He named his facility the Nebraska Contraception and Abortion Clinic, avoiding euphemisms common in his field. He has adopted the label “abortionist” which is often used as a screed, and he compared Opponents of abortion describe the Taliban and their ethos as “religious terrorism”.

When his friend and colleague Dr. George Tiller, known for performing late-life abortions, was shot in 2009, he started offering them at his own clinic, Dr. Carhart, who previously performed procedures only during regular visits to Dr. Tiller in Wichita, Canada.

Dr. Carhart has been publicly associated with abortion of late since the late 1990s, when the anti-abortion movement found a powerful rallying cry in the phrase “partial-birth abortion.” It was used to condemn a procedure doctors call intact dilation and extraction, which involves removing an intact fetus and typically puncturing or crushing its skull.

About 30 states, including Nebraska, have outlawed the practice. He was the one that Dr. Carhart said he had never used it, which he described as “disgusting.” Still, he believed the law’s wording was so broad that it could make other types of abortions illegal, and he sued Nebraska Attorney General Don Stenberg.

Dr. Carhart became the lead plaintiff in two Supreme Court cases. He won the first, Stenberg v. Carhart in 2000, with the court ruling that the Nebraska law and others like it unconstitutionally barred what in some cases might be the most medically appropriate way to terminate a pregnancy.

When President George W. Bush signed the Partial-Birth Abortion Ban Act of 2003, Dr. Carhart sued again. However, the Supreme Court reversed course when the decision’s author, Justice Anthony Kennedy, arguing that federal law “expresses respect for the dignity of human life.”

Starting in 2010, Dr. Carhart commuted weekly from Nebraska to another clinic he opened in Germantown, Maryland, which specialized in late-term abortions. He was the medical director of both facilities and continued to do so until this month. Opponents of abortion saw him as a major target of criticism, and in 2013 operators posing as patients recorded visits and drew pictures of him wide publicity.

Its Bellevue facility currently lacks a permanent successor. He told CNN last year: “I’m 80. I don’t have to have abortions anymore. Right now I’m looking for doctors to replace me or help me, but the biggest problem is finding someone willing to take the target off my back and put it on theirs.’

LeRoy Harrison Carhart Jr. was born October 28, 1941 in Trenton, NJ His father operated a printing press for a small newspaper in the Trenton area and his mother, Verona (Morgan) Carhart, was a homemaker.

As a young man, Dr. Carhart on becoming a Lutheran minister. He married his high school sweetheart, Mary Clark, in 1964; graduated from Rutgers University with a bachelor’s degree in business administration; and joined the Air Force. He trained as a fighter pilot but never saw combat. He was honorably discharged in 1985.

While still in the military, he began medical school at Hahnemann Medical College in Philadelphia (now Drexel University College of Medicine). He graduated in 1973, the same year as Roe v. Wade. Previously, abortions were not widely available in Pennsylvania.

He often recounted his memories of seeing the side effects of self-induced abortions performed with knitting needles or hangers, some leaving women sterile and some even killing them.

“It was terrible, worse than watching people die in war,” he told The Times.

In 1978, he began working as a surgeon at the military hospital at Offutt Air Force Base, south of Bellevue. That same year he bought a farm, about 65 acres, and never left. His daughter, Mrs. Weatherby, runs a horse business on the property, provides catering, breeding and competitions.

Besides her, Dr. Carhart is survived by his wife; his son, LeRoy; and a grandson.

Dr. Carhart was modest in his philosophical comments about abortion. He thought a perfect world would have no abortions—but also that he didn’t live in a perfect world. He claimed that neither he nor religious scholars or scientists knew when life began, adding that mothers were the only experts on the matter.

He had a specific belief in something else: that abortion was inevitable and that abortions performed unprofessionally could lead to serious injury or death. This motivated him to train his colleagues. His daughter estimated that during his lifetime, Dr. Carhart trained 300 to 500 doctors in how to perform abortions.

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