In 1975, he opened the Boulder Abortion Clinic, a blunt name meant to convey his philosophy that he had nothing to hide. Hern soon became a prominent figure in the abortion debate, attracting patients from across the country.
He wrote a textbook, "Abortion Practice," in the 1980s. After the first printing, he said, the publisher bowed to public pressure and declined to reissue the book. Hern then paid to have it published himself.
In time, he began to focus on more difficult abortions performed in the later weeks of pregnancy -- typically, he said, because of medical complications or fetuses with abnormalities. Such abortions now make up the bulk of his practice.
Each of his patients, Hern said, receives counseling to explain the procedure and to make sure she wants it. Women seeking later abortions usually have already made the decision with their own doctors, he said.
Hern recalled a disturbing situation his staff encountered 15 years ago during the counseling phase. The parents of a 14-year-old girl wanted her to terminate her pregnancy. The girl did not. As she was filling out a form, she wrote, "I think you should all be killed."
The clinic manager called in Hern and, after more discussion, the doctor refused to perform the abortion. He has no idea what the family decided to do.
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Even early on in his practice, Hern did not shy away from confrontation. When people protested outside his office, he stood in the parking lot and wrote down their license plates. When they shouted during his speeches, he shouted louder. When a protester hurled a rock through a clinic window, Hern hung up a sign: "This window was broken by those who hate freedom."
But his fear grew along with his defiance. When people called his mountain home with death threats, he started keeping a rifle by the bed. "You think, 'Is it OK to go for a hike? What about walking my son to school? What about going skiing?' " he said.
In 1988, a gunman fired five shots into his clinic's waiting room, prompting Hern to install four layers of bulletproof glass and an electronic security system. That year, Hern and his wife of six years divorced, a breakup Hern attributed in part to the stress of his work.
The ever-present threats made it hard to develop relationships, Hern testified at a 1999 trial in which he and other doctors sued an antiabortion group for placing their names and personal information on a "Deadly Dozen" list. "It has made me feel a great sense of personal isolation, and that has been the most painful part of this experience," Hern said, according to the Associated Press.
