FAQs

Too familiar? To what? Another book? Do tell. In the meantime, here’s a recent longish email I wrote in response to a reader’s doubts about the way I characterize abortion in the 19th century:
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I attach a short CNN article which summarizes some of the research about 19th century birth control and abortion. At the end there’s a citation for a scholarly study which I highly recommend if you’re interested in the details of the way attitudes and laws changed.

To be brief: yes, I am claiming that abortion was common and seen as acceptable for women of all economic and social classes and religions. I know this is hard to imagine, given the ferocity of the effort to end a woman’s right to choose over the last fifty years or so, but it is in fact true. Things didn’t really start to change until the third quarter of the nineteenth century. Not even the Catholic Church was anti-abortion. The church took the position that a fetus did not have a soul in early pregnancy. It was up to the pregnant woman to declare ‘quickening’ and after that abortion was discouraged — but still not illegal, or even a sin until about 1875. Abortions did not stop, even then. Fatalities skyrocketed, but abortions did not.

How the official stance changed is a very complicated question that has primarily to do with women’s suffrage and education. I think of the rise of laws against abortion and female autonomy as backlash. Men who could not cope with women seeking higher education, professions, the right to vote, found different ways to reestablish their dominance. Part of that was male physicians who tried to outlaw midwifery, claiming that they knew more about pregnancy and childbirth after two years of medical training than a woman who had been delivering children for thirty years or more. Some of the case studies are enfuriating.

This is a simplification of a tremendously complex set of social circumstaces, but I think it’s pretty accurate.

From your email it seems you feel that I was unfair to some part of the female population in that I didn’t portray the feelings of those who rejected abortion. Let me assure you that I read — and very widely — looking for women who had been vocal about this issue, without success. Scholars have had more luck documenting how physicians interpreted women’s feelings about birth control and abortion.

I’ll end this email with a quote from Reagan’s book:

We know of some of the talk among women about abortion because doctors described women’s conversations. Physicians were privy to everyday female conversations about reproduction in general, which at times included the topic of abortion. Some medical men were surprised by what they heard of women’s attitudes toward reproduction and remarked on it. For example, in response to newspaper exposure of doctors who did abortions in 1888, Dr. Truman W. Miller defended his profession by exposing female conversation and activity. “I am sure there is no comparison between the number of abortions committed by doctors and the number committed by women themselves,” he charged. “They talk about such matters commonly and impart information unsparingly.” Thirty years later, another physician observed a “matter of fact attitude” about abortions among “women of all ages and nationalities and . . . of every social status.”

At professional meetings and in medical texts, physicians told their colleagues of women’s attitudes toward abortion and detailed the methods women used. The reports in some cases were no more than a sentence or two in an article about another issue or a remark made during the discussion of a paper presented at a meeting and later published. Physicians presented information about women’s abortions as interesting anecdotes, as patient “history” and prelude to their own medical innovation, or as part of a medical discussion on abortion. As medical researchers learned statistical methods, they collected data on dozens or hundreds of cases in order to answer questions about maternal mortality and morbidity or to test and argue for particular treatments in abortion cases. Physicians who acted as reporters of abortion practices for other physicians and the public, whether shocked, sympathetic, or scientific, appear throughout this book. From these different types of medical reports, I glean medical perspectives and practices and read these sources against the grain to grasp the perspective of women having abortions.

Thank you for taking the time to write and ask your question in such a polite and measured way. That’s not always the case, and my replies in those cases are not so detailed.

The CNN article mentioned above:

The surprising history of abortion in the United States | CNN

By Jessica Ravitz, CNN

Mon June 27, 2016

(CNN) — There was a time when abortion was simply part of life in the United States. People didn’t scream about it in protest, and services were marketed openly.

Drugs to induce abortions were a booming business. They were advertised in newspapers and could be bought from pharmacists, from physicians and even through the mail. If drugs didn’t work, women could visit practitioners for instrumental procedures.

The earliest efforts to govern abortions centered on concerns about poisoning, not morality, religion or politics. It was the mid-19th century, long before abortion became the hot-button issue it is now. All of this is according to historian Leslie Reagan, whose 1996 book on abortion history in the United States is considered one of the most comprehensive to date.

On Monday, the Supreme Court issued a decision in Whole Woman’s Health v. Hellerstedt, which has been called the biggest abortion case to hit the high court in two decades. In a 5-3 ruling, the high court struck down a controversial Texas abortion law, giving a victory to abortion rights groups. But it came as many states have clamored to ramp up abortion restrictions.

Since 1973, when Roe v. Wade legalized abortion across the United States, states have enacted more than 1,074 laws to limit access to the procedure, according to the Guttmacher Institute, a sexual and reproductive rights organization. More than a quarter of these laws passed between 2010 and 2015. It wasn’t always like this, says Reagan, a professor of history, medicine, gender, women’s studies and law at the University of Illinois.

So how did we get here?

With the help of Reagan, author of “When Abortion Was a Crime,” and the nonprofit Our Bodies Ourselves, we set out to learn what abortion was like in America before 1973. What we found was full of surprises.

The view from centuries ago

In the 18th century and until about 1880, abortions were allowed under common law and widely practiced. They were illegal only after “quickening,” the highly subjective term used to describe when pregnant women could feel the fetus moving, Reagan said. “At conception and the earliest stage of pregnancy, before quickening, no one believed that a human life existed; not even the Catholic Church took this view,” Reagan wrote. “Rather, the popular ethic regarding abortion and common law were grounded in the female experience of their own bodies.” Though it is considered taboo in Christian traditions, until the mid-19th century, “the Catholic Church implicitly accepted early abortions prior to ensoulment,” she explained. “Not until 1869, at about the same time that abortion became politicized in this country, did the church condemn abortion; in 1895, it condemned therapeutic abortion,” meaning procedures to save a woman’s life.

Abortions would become criminalized by 1880, except when necessary to save a woman’s life, not at the urging of social or religious conservatives but under pressure from the medical establishment and the very organization that today speaks out in support of abortion access, Reagan explained.

In the Supreme Court’s latest case, the American Medical Association voiced disapproval of the Texas abortion law when it joined the amicus brief led by the American College of Obstetricians and Gynecologists. Laws that impede the freedom of physicians to provide care using their best medical judgment are not supported by the AMA.

The association, an AMA spokesman said, “seeks to limit government interference in the practice of medicine and oppose government regulation of medicine that is unsupported by scientific evidence.”

Back when it was still a fledgling organization, however, it began a crusade in 1857 to make abortion illegal, Reagan wrote. The impetus was manifold. Some of it came “out of regular physicians’ desire to win professional power, control medical practice, and restrict their competitors,” namely midwives and homeopaths.

But this was also a time, Reagan said, in which women were lobbying for entrance into Harvard Medical School, in part so they could pursue work in obstetrics and gynecology.

The force behind this 19th-century AMA anti-abortion campaign was Dr. Horatio Storer, a Harvard Medical School graduate who dedicated much of his practice to OB-GYN work before he died in 1922.

The crusade proved to be a form of backlash against the shifting aspirations of women. It was “antifeminist at its core,” Reagan wrote.

The AMA pushed for state laws to restrict abortions, and most did by 1880. Then the Comstock Law, passed by Congress in 1873, banned items including abortion drugs.

But before abortions were banned, a woman known as Madame Restell ran abortion businesses from New York to Philadelphia and Boston. Her main clientele, Reagan wrote, were “married, white, native-born Protestant women of upper and middle classes.” Abortions, birth control and general efforts to manage the timing of pregnancy meant birth rates among white women were falling just as immigrants streamed into the United States. And the idea of being out-populated by “others” worried some anti-abortion activists like Storer. He argued that whites should be populating the country, including the West and the South. Better them than blacks, Catholics, Mexicans, Chinese or Indians, he said, according to Reagan.

“Shall these regions be filled by our own children or by those of aliens? This is a question our women must answer; upon their loins depends the future destiny of the nation,” Storer said, according to Reagan’s research.

“White male patriotism,” she wrote, “demanded that maternity be enforced among white Protestant women.”

During the Depression and beyond

Even after abortions became illegal, women continued to have them; they just weren’t advertised the same way. Practitioners did their work behind closed doors or in private homes. Or women without means resorted to desperate – and often dangerous or deadly – measures.

At times, abortion rates increased in the face of the law. The Depression was a perfect example. Specialists passed out business cards and opened up clinics, Reagan explained, and nobody bothered them. In that era, abortion wasn’t seen as a women’s issue, it was an economic issue.

In the 1950s and 1960s, the estimated number of illegal abortions ranged from 200,000 to 1.2 million per year, according to the Guttmacher Institute.

Inspired by the civil rights and anti-war movements, the women’s liberation movement gained steam in the 1960s – and reproductive rights took center stage.

Women with means had been able to get abortions by leaving the country o paying a physician in the U.S. a large fee for the procedure. Others weren’t so lucky. They sought out back-alley procedures or took matters in their own hands: inserting knitting needles and coat hangers into their vaginas, drinking chemicals or douching with lye. These methods resulted in medical emergencies and, in some cases, death.

Some groups sprouted to help prevent such outcomes.

In the late 1960s, before abortion was legalized again in the United States, concerned pastors and rabbis set up the Clergy Consultation Service on Abortion to help women find safe illegal abortions. An underground abortion service also was established by feminists in Chicago. The Abortion Counseling Service of the Chicago Women’s Liberation Union, better known by the code name Jane, helped provide safe, supportive and affordable illegal abortions – at first just through referrals. But then trained members began performing procedures themselves. Between 1969 and 1973, the members of the group provided more than 11,000 safe abortions, according to Laura Kaplan, author of “The Story of Jane.”

Reagan, Leslie J. When abortion was a crime: Women, medicine, and law in the United States, 1867-1973 . Univ of California Press, 1997.