When Abortion Was a Crime: Women, Medicine, and Law in the United States, 1867-1973

by Leslie J. Reagan

As we approach the thirtieth anniversary of Roe v. Wade , it's crucial to look back to the time when abortion was illegal. Leslie J. Reagan traces the practice and policing of abortion, which although illegal was nonetheless widely available, but always with threats for both doctor and patient. In a time when many young women don't even know that there was a period when abortion was a crime, this work offers chilling and vital lessons of importance to everyone.

The linking of the words "abortion" and "crime" emphasizes the difficult and painful history that is the focus of Reagan's important book. Her study is the first to examine the entire period during which abortion was illegal in the United States, beginning in the mid-nineteenth century and ending with Roe v. Wade in 1973. Although illegal, millions of abortions were provided during these years to women of every class, race, and marital status. The experiences and perspectives of these women, as well as their physicians and midwives, are movingly portrayed here.

Reagan traces the practice and policing of abortion. While abortions have been typically portrayed as grim "back alley" operations, she finds that abortion providers often practiced openly and safely. Moreover, numerous physicians performed abortions, despite prohibitions by the state and the American Medical Association. Women often found cooperative practitioners, but prosecution, public humiliation, loss of privacy, and inferior medical care were a constant threat.

Reagan's analysis of previously untapped sources, including inquest records and trial transcripts, shows the fragility of patient rights and raises provocative questions about the relationship between medicine and law. With the right to abortion again under attack in the United States, this book offers vital lessons for every American concerned with health care, civil liberties, and personal and sexual freedom.

Genres: History, Feminism, Nonfiction, Politics, Medicine, Sociology, Law

400 pages, Paperback

First published December 31, 1996

Reviews

[Keith Schnell · Rating 5 out of 5]

There are several things that make this book stand out: its unique subject matter, its overall tone and the high quality of original research that obviously went into it.

When Abortion was a Crime deals with the period of just over 100 years when abortion was prohibited by law in most circumstances in the United States. This is something that, surprisingly, has seldom been explored in detail, which is unfortunate given the continued and quixotic efforts of so many state legislatures to return the United States to that time. It is almost as if we are endlessly arguing about whether or not to ban alcohol without ever remembering what happened when we tried. This book goes a long way towards correcting that.

Dr. Reagan approaches the subject with a very professional tone, which should be expected in a work of history but stands out given the politically charged subject matter. All too often, in publications such as The Huffington Post and Salon, the point of an article about abortion is to drum up outrage and, implicitly, money and votes, such that even those who are “pro-choice” must feel disturbingly like they are reading their own side’s shrill propaganda. When Abortion was a Crime avoids this trap, instead dispassionately documenting, in great detail, the abuses brought on by restrictive abortion laws prior to 1973. The author seems to feel that her readers are intelligent enough that she can let the facts speak for themselves, and they certainly do.

Lastly, I would be in remiss if I failed to mention the work that Dr. Reagan has done in bringing to light primary sources such as court cases, witness testimonies and 19th century newspapers describing the ways in which abortion laws were enforced. This 400-page book contains nearly 150 pages of endnotes, many of which are fascinating in their own right and do a great deal to reinforce the text.

The only weak spot in this book is in the epilogue. Having produced several hundred pages of excellent historical documentation of the era 1867-1973, the author seems compelled by her passion for the subject matter to discuss developments since Roe v. Wade. She is unable to do so thoroughly in the ten pages that she has given it. As much as one would like to give her the benefit of the doubt given her evident expertise, the epilogue lacks the thorough exposition and supporting detail that is due of a complex subject. It is a shame that she did not produce a second volume dealing with developments after 1973, which would have been necessary to do the subject justice.

Ultimately, though, the failure to adequately examine restrictions and court cases subsequent to Roe v. Wade does not take away from the fundamental and inescapable conclusion of When Abortion was a Crime. Restrictive abortion laws prior to 1973, which banned the procedure in almost all circumstances, were a public policy disaster on par with Prohibition. The abuses that they inflicted on women, doctors, and, in some cases, even men were remarkably brutal and would simply not be accepted in the more free and civilized society of 21st Century America. As those who were adults during this period gradually die off, it is important that we retain this understanding, and Dr. Reagan’s book is an essential tool in doing so.

[Leah M · Rating 5 out of 5]

When Roe v. Wade was overturned, I came across some social media posts that suggested some books to read, and this one was included on a list. While I kind of expected this one to be a bit dry and boring, I gave it a chance anyway. And I'm so glad I did, because this was anything but. Reagan managed to take over a century's worth of legal, medical, and societal information and present it in a way that was actually interesting.

By focusing on a single city, Reagan was able to find plenty of information in legal and medical records about women and abortions, both legal and illegal. It was clear that women wanted to exert more control over their body and their reproductive rights throughout the period described in this book. Initially, women were able to easily access abortions, but as they became increasingly regulated, women were forced to take increasingly desperate measures. Naturally, this led to dramatically worsening outcomes for the women.

Looking at it through today's lens, it is easy to be horrified by hearing about women having six, seven, or thirteen abortions. But looking at it through the view of those times, abortion was the only form of reproductive control available to women at those times, and often ensured that they were able to care for the children (often many children) that they already had, and in some cases struggled to provide for.

As birth control became increasingly available, the push towards women's rights and legislation protecting women's control over their own bodies was more powerful. This is when we started seeing major changes, and the legal protections that we had in place until recently.

However, with the recent overturning of Roe v. Wade, I couldn't help but be horrified at the steps our country is taking. Instead of moving forward, we are heading backwards, to a time clearly described in the pages of this book:

"If abortion is made illegal, some women will die; many more will be injured. The old abortion wards will have to be reopened, a public health disaster recreated. Making abortion hard to obtain will not return the United States to an imagined time of virginal brides and stable families; it will return us to the time of crowded septic abortion wards, avoidable deaths, and the routinization of punitive treatment of women by state authorities and their surrogates."

Overturning Roe v. Wade isn't a victory - it's a loss for women, for reproductive rights, and for us to have a say over our own bodies. It's a blow especially to the women who are most marginalized in our society: women of color, low-income, rural women, and those who have limited access to healthcare. These are the people who are most affected by lack of control over their bodies and reproductive health, and these are the same people who will turn to unsafe treatments, while people with greater access to care and resources will still be able to get safer care.

By studying the past, this book allowed me a sneak peek into the future of our own country. And it isn't a pretty sight. But this book is done so well.

[LauriAnn · Rating 5 out of 5]

Great feminist read. It really helped me understand the arguments behind legalizing abortion much better. This book also also changed my perceptions about women, sexuality, motherhood, and the pervasiveness of abortion in the past.

[Lindsay · Rating 4 out of 5]

The demand for abortion has always existed and has never waned, but has experienced varying degrees of criminality, legality, and stigma. Reagan's book is testament to the hard truth that abortion has and always will be needed and is a fundamental reproductive right. One of the few books chronicling the long period of illegal abortion in the United States, this book is a well-researched, vital resource for understanding the public and private history of abortion. Using information from doctors, medical associations, legal records, hospital records, and whenever possible, women themselves, Reagan pieces together a landscape of access or lack thereof combined with cultural context and public opinion. Unfortunately, the century before Roe v. Wade doesn't sound all that unfamiliar given the current political climate surrounding abortion. Then, as now, public discourse often centered around a white patriarchy, bogged down in social constricts and dogma, making decisions for women across the country, despite a huge rate of abortion deaths, entire wards dedicated to women healing from illegal abortions, and the clear demand for abortion and obvious reality that women would go to any length necessary to control their reproduction. However, the author does not gloss over the often unspoken reality of compassionate personal relationships between doctor and patient, with many physicians behaving sympathetically toward their abortion-seeking patients and doing what they could to help at personal risk. The attention paid to midwives, who often served immigrant women of their own ethnicity, is particularly interesting, both in its study of their vilification and of the much needed services they provided to their communities. As now, media at all times throughout the century highlighted only the negative outcomes of abortion care, and the fact that for many decades the only archived information about abortion comes from legal proceedings against women, midwives, and physicians, is telling. As midwives and doulas are again organizing on the grassroots level to provide abortion care for women, their stories from the past can provide lessons for our current struggle for access. Glaringly absent until the final chapters, by the author's own admission, are stories from women of color, and less glaring, low-income women, seeking abortion care. This spotlights the inequality of medical care and concern towards these women still prevalent today, as lack of access as well as lack of attention are indicative of the attitudes of, again, a white patriarchal system combined with white upper and middle class women's groups. To be fair, many of these women's groups sought to correct their attitudes. The lessons of the early women's liberation movement, where women of color increasingly refused to be invisible and demanded attention on their own terms, feel familiar, and it is a mistake to think that we don't still have far to go on that front.
While the book ends on a somewhat positive tone, focusing on the legalization of abortion with Roe v. Wade, it seems fitting to end this review with a quote from the epilogue that asks us to look backward and fight against the misguided efforts of the anti-choice to return us to the time when abortion was a crime: "If abortion is made illegal, some women will die; many more will be injured. The old abortion wards will have to be reopened, a public health disaster recreated. Making abortion hard to obtain will not return the United States to an imagined time of virginal brides and stable families; it will return us to the time of crowded septic abortion wards, avoidable deaths, and the routinization of punitive treatment of women by state authorities and their surrogates."

[Lisa · Rating 4 out of 5]

I admit I did not finish this book (I read all but the last chapter). It was literally giving me nightmares. Without getting too politic-y, I'm a pro-choice Democrat, but I don't think I would personally choose abortion. I have felt for a long time that if abortion would be criminalized, there would be serious consequences, and this book and its thorough research bears that out. Very interesting, if horrifying.

[Brad Hart · Rating 4 out of 5]

This was an excellent look into the history of abortion. Reagan successfully debunks a number of the myths surrounding the history of abortion, and illustrates how abortion in recent years has distorted the truth regarding its past. An excellent and well-balanced book.

[Marla McMackin · Rating 5 out of 5]

Leslie J. Reagan’s When Abortion Was a Crime is the first study of the entire period of illegal abortion in the United States. Over eight chapters, Reagan examines “the triangle of interactions among the medical profession, state authorities, and women in the practice, policing, and politics of abortion during the era when abortion was a crime” (p. 1). The result is a multifaceted analysis of the still controversial medical procedure that connects the experiences of women and local medical and legal practice to national policy.

Reagan divides the era of illegal abortion into four periods, which establish the structure of her work. The first, and focus of the first four chapters, begins in the late nineteenth century, when laws passed across the country between 1860 and 1880 prohibited abortion at any point during pregnancy. Each of the four chapters covers a different aspect of abortion through the 1920s – women’s experiences with the procedure, its practice, and political and law enforcement reactions. Reagan argues that despite the ban, abortion was widely accepted and practiced in women’s homes and the offices of both midwives and trained physicians. The prevalence of abortion was possible not only because of this diversity of practitioners, but also because the practice of medicine remained private. Yet, a crackdown on abortion occurred during the same period as specialists in the developing field of obstetrics renewed an earlier campaign against the practice and the medical profession was drawn into the state’s enforcement system.

The second half of Reagan’s work covers the next three periods in a more chronological history of abortion. During the 1930s, economic hardships of the Great Depression led to an expansion of the practice. Trained physicians were more willing to offer “therapeutic” abortions based on social conditions and the practice not only became more widely available, but also moved from private homes to hospitals and clinics. According to Reagan, abortion was a recurring and common need for many women. In 1936, New Jersey police uncovered a “Birth Control Club” of eight hundred members who were entitled to regular examinations and abortions for an additional $75. “These working women bought a form of health insurance through dues paid to this ‘club.’ These women expected to have abortions in the future. The club provided a means of blunting the expense” (p. 134). Although the consolidation of the practice in the hands of trained physicians might have benefitted some women who sought abortions in the 1930s, Reagan asserts the increased visibility accelerated the pace of change in the following decades, especially in the methods of enforcing criminal abortion laws.

The third period begins in 1940, with a backlash against the previous decade’s expansion of abortion. Hospitals adopted a more conservative stance, while police and prosecutors adopted new tactics. Prosecutors no longer focused on abortionists responsible for women’s deaths, instead working “to shut down the trusted and skilled abortionists, many of them physicians, who had operated clinics for years with little or no police interference…This system had created a space in which thousands of women obtained safe abortions from skilled physicians in an environment nearly identical to that of any other medical practice” (p. 161). The women were also at increased risk of being victimized by prosecutors, who could force them to testify about their sexual activity in open court, and by police, who according to Reagan would go so far as to capture women and invade their bodies to investigate illegal abortion. In December 1947, a woman picked up by police in Chicago while leaving the apartment of a midwife was taken to a doctor’s office. Once there, Clara L. “‘submitted’ to a gynecological exam performed by Dr. Janet Towne in the presence of a policewoman. Dr. Towne examined Clara L., determined she was pregnant, and then removed a rubber catheter placed in the cervix” (p. 168) to induce the abortion. Reagan argues that the intensified repression, and an increased demand for the procedure from women of all groups, resulted in a system divided by race and class. It continued with devastating results until methods of suppressing abortion were finally dismantled.

The fourth and final period overlaps with the third and concludes with the 1973 Supreme Court decision in Roe vs. Wade. The movement to decriminalize abortion that developed in this period was in reaction to a system that had fatal consequences for many women. Reagan asserts that during the 1950s, a handful of physicians began to challenge the laws their profession had advocated a century earlier and the progress of that challenge attests to the continuing power of the medical profession to make public policy regarding reproduction. Additionally, as legal reform moved forward, a new feminist movement arose, which radically transformed the movement for legal change. “When the women’s movement described abortion as an aspect of sexual freedom, they articulated a new feminist meaning for abortion; when they demanded abortion as a right, they echoed generations of women” (p. 15-16).

Reagan employs a rich array of primary source material to develop her analysis, including criminal trial and other legal records, medical literature, government documents, newspapers, popular periodicals, hospital records and manuscript collections. In being the first to chart the nation’s enforcement of criminal abortion laws, Reagan gives ample attention to the state’s interest in suppressing the practice and the its alliance with the medical community. She uncovers the circumstances of actual abortions, revealing changing practices and the risks women have been willing to take to assume their reproductive rights. Reagan also effectively argues that the antiabortion campaign was antifeminist at its core, with efforts to restrict or reverse abortion rights sending a clear message that “women cannot be trusted to make moral decisions about children and family, but must be overseen and regulated by men; procreation is a state mandate not a choice; women’s lives, sexuality, and bodies are not their own” (p. 253).

[Susannah · Rating 5 out of 5]

When I was 11 years old, a woman handed me a thick folder stuffed with anti-choice propaganda. I wish that I had been handed this book instead (or as well). Even the introduction to this book would have given me the historical context that was sorely lacking in that folder, which would have given me a context in which to think critically about abortion, rather than adopting the views that were fed to me in that folder.

Whether you are for or against abortion, you should know the history. You should know that the initial outlawing of abortion in the United States was brought on by a combination of regular medical doctors trying to eliminate the competition by discrediting midwives, and by white supremicists who wanted white middle-class women to have more children, so that minorities and immigrants would not outnumber white middle class Americans. It was rooted in racism, misogyny, and the desire to control women. As I read the introduction, I thought, "My goodness, it really IS all about power and controlling women!" (In the past, I had believed that most people who were against abortion, felt that way for the same reasons that I felt that way when I read that folder of propaganda when I was 11: compassion for the fetus; I was wrong.)

This book is a well-researched, well-sourced and documented examination of the history of abortion in American, the changing ways that abortion was viewed by women, by the government, and by the medical community, as well as by men in various roles (as husbands, boyfriends, brothers, fathers, lawyers, police, journalists, and so forth). I highly recommend it to everyone. I believe that we should not make decisions about where we stand on important issues without having adequate, unbiased information, and without understanding the historical and/or cultural context. This book is the best source of such information about abortion that I have ever come across.

[On StoryGraph LizaWren · Rating 5 out of 5]

This is an academic text chronicling the history of abortion during the ~100 years it was illegal in the United States ending in 1973. It draws upon primary sources to paint as accurate a picture as we can get of the underground reality of abortion during this time period. It also illustrates how the intersection of law, public opinion, medicine, religion, and enforcement interacted with this reality in different ways over the years. I learned a lot from this book, and I had thought I was decently literate on the topic to begin with.

In case you ever wondered why and how the midwife profession went away, or thought perhaps abortion was a recent issue, or wanted to know about the entire hospital wards dedicated to treating women who took matters into their own hands… this book may be for you. It’s dense though, and a little repetitive, so read it in chunks.

It’s important to know history, lest we be doomed to repeat it. While this text is not a work of opinion, the implications of this history are still clear to me. 4.5 stars.

[M. Benesh · Rating 5 out of 5]

This book both explores the history of illegal abortion and, in doing so, simultaneously creates a compelling case for its continued legalization. I think it would be impossible to read this book and remain convinced that abortion is anything but a necessary human right, and Reagan also frames this right as central to protecting patient autonomy over their health and bodies.
Most shocking about this history are the different reasons why abortion became increasingly regulated over the years-- I personally thought the narrative of "human being since conception" had a longer history, but it is a relatively recent moral argument. As a whole, this book really influenced my thinking on this topic, despite my original opinions. I hope this book is widely read.

[Ericka · Rating 4 out of 5]

Solid. Academic. Very thin, theoretically speaking. What analysis there was felt dated. You’d need a particular interest in the topic, because the writing itself is not compelling.

[Wade Walker · Rating 4 out of 5]

At the risk of sounding insensitive or condescending, this book made me feel so sorry for any and all people with the capacity for pregnancy and childbirth. It also made me feel angry, sad, sickened, shocked, and enraged. As a liberal, progressively-minded male, I already considered myself a feminist and was on the side of women and birthing people when it came to abortion being and staying legal and accessible to all; but I wanted to understand the fight better. I wanted to learn more about the war that was waged to get to Roe v. Wade, and I wanted to be well informed for discussions and arguments I assumed I would encounter in a post-Roe United States. This was the perfect tool for that.

Reagan has done tremendous research here and I learned a lot; the material was easy to understand (I listened on audiobook) and still very informative. Some of the descriptions of botched illegal abortions and dying pregnant women produced a very real visceral reaction in my gut; it was heart-wrenching, and sickening for me to imagine. The histories of sexism, misogyny, and the sexual double standard in our American culture and in the medical field was staggering and almost inconceivable. Most of my feelings on this book culminate in a general disbelief and awe that we are practically back at square-one on abortion rights, with the recent repeal of Roe v. Wade.

However, in her epilogue, Reagan states in no uncertain terms (at the time of publication, about 20 years ago), that abortion rights will come under fire again, and the legal precedents that we think are final will be threatened; the patterns of discourse and opinion will repeat themselves , and the harm done to pregnant individuals will return. And interestingly, as Reagan states, the arguments against abortion will be similar as in decades past, despite the passing of over 150 years; nothing new will be contrived to fight legalized abortion, and the right to bodily autonomy for child-bearing people will be endangered again. The same groups, organizations, and individuals who rejected legal abortion then, on whatever moral or religious grounds, will continue to attack this fundamental right into the future without changing their tactics in the least. It is one of many similar battles in a long, exhausting war against women and their reproductive rights.

Even with Reagan's prophetic prediction, and the current status of legal abortion in 2023 America, I still can't believe we are here again. But being better informed about abortion history and the struggle of those with uteruses only emboldens my allyship and strengthens my belief that legalized, safe, accessible abortion and reproductive care are a basic human right and an absolute necessity in our society.

[L** · Rating 5 out of 5]

An exciting, well researched look into the history of abortion in the US. Reagan examines the interaction of women, doctors, and social/ cultural/ political/ religious leaders over 106 years in which abortion was illegal in every state. Her focus on Chicago provides an interesting window into the sexual and reproductive politics in a growing and diversifying industrial urban center. Reagan finds that enforcement of the law and prosecution of those who defied the law varied over time. The Depression, for example,was a period in which enforcement was particularly lax, as more people saw abortion as the desperate act of impoverished women and not the immoral act of a sinner, as 19th century critics framed it. What is consistent, she notes, is that making abortion illegal does not stop women from wanting, needing, or seeking it. It makes harder and infinitely more dangerous for the women who have them and creates a division between women with means (who often could find ways to have fairly safe abortions) and those without (who were often exploited by charlatans and unscrupulous people at enormous risk). Turning the tide in the 1960s to strike down anti-abortion laws came from a range of perspectives, much as the 1800s activism to make abortion crime had.

As anti-abortion activism continues in the US, this book is a powerful reminder that regardless of the law, women will have abortions, and the reasons a woman does have them are unique, meaningful, and personal to her. Whether a woman seeks abortion because of devastating fetal defects, poverty, or the pregnancy is the unwanted outcome of birth control failure, millions of woman want to control their bodies and reproductive lives-- even when an illegal abortion means risking their own.

[Aja · Rating 5 out of 5]

Super interesting look at the 100 + years that abortion was officially illegal. I think that the biggest surprise was in regards to public opinion during the first 50 or so years of illegality, when the law did not match the general public opinion of abortion. Intro and Epilogue are very obviously written from one particular side of the story, but the bulk of the book is quite fair in telling the facts of this time period.

[Robyn · Rating 5 out of 5]

This book contains in-depth research into the statutory, regulatory, and professional practice barriers to abortion prior to Roe V Wade and Doe v Bolton. Reagan's analysis is directly relevant to today's climate surrounding abortion. The restrictions that we see today are an extension to pass efforts to control access to reproductive health services.

[Cheryl · Rating 4 out of 5]

I found it sad and discouraging that in all cases where a change in the laws and procedures occurred, women’s voices were silent. Women’s experiences and lives were completely discounted and ignored. Only after Roe did we start to find our voices… but we still have so far to go.

A good and thorough history of an underground and basically undocumented American experience.

[Wealhtheow]

I'm really interested in Reagan's assertion that the German Measles epidemic in the 1960s played a role in legalizing abortion. http://www.eurekalert.org/pub_release...

[Anayim · Rating 5 out of 5]

An amazing history of how abortion has evolved through the years, and such great evidence of why abortion is so crucial to our society today.

[Austin · Rating 5 out of 5]

"the legalization of abortion represented an improvement in maternal mortality that ranks with the invention of antisepsis and antibiotics"

[Sarah · Rating 4 out of 5]

Well-researched. I didn't agree with the author's views, but she put a great deal of research into this book.

[Alex · Rating 5 out of 5]

So. This was the third book I read to understand the Abortion Discourse(TM) from the Supreme Court Leak. I actually cited it in one of my projects, and I thought it was also just a good place to start. As a cis woman, an MPH candidate, and a Leftist, let's get started.

Dr. Reagan holds numerous degrees including a PhD in American History (which is INSANE). The last third of the book is notes and sources, both primary and secondary. She's forced to make inferences from limited data, including medical records, and apply the same patterns to the population at large. Despite this, she constructs a thorough review of the history of illegal abortion in the United States.

And boy, does it twist your stomach.

Starting as an open secret and becoming one of the legitimizing forces for a paternalistic and rapidly centralizing medical profession, abortion is swiftly taken from a necessary and broadly accepted phenomenon (socially) to a place of controversy, police raids, and state mandated reproduction. While people in the United States grossly did not believe that life began until "quickening," a paternalistic, preachy medical profession sought to distinguish themselves from the poor, immigrant, female workforce that currently served the needs of women. Most people were ignorant of birth control practices, and women were forced to submit to the sexual whims of their husbands. Childbearing, as a result, was part and parcel to being married. Of course, if unprotected sex is just.. a continuous thing, women will constantly be pregnant.

This presents a few problems.

1) The economics of providing for numerous children
2) The logistics of doing housekeeping and taking care of numerous children
3) The logistics of doing all of the above while pregnant
4) The overall risk of pregnancy, in and of itself

Abortion served as birth control at this time. While rudimentary forms like diaphragms did exist, it was yet another chore for women to put up with, as it did take some preplanning and finagling. Please look up a picture of a diaphragm if you're short on sympathy for these women. In any case, as medicine ran the purity campaign to establish themselves as morally superior, they expose their thinking. They exposed their belief in eugenics, their suspicion of women and their terror of their independence (sexual and otherwise), and their disregard and hatred for people of color and the poor. Multiple allusions are made by doctors throughout the book of the absolute necessity of abortion, both from doctors and the public, but the bans continued to be perpetuated. From Dr. Rudolph Holmes in 1908:

The public does not want, the profession does not want, the women in particular to not want any aggressive campaign against abortion.

Moreover, the pronatalist sentiment wove in and out of American culture. Abortion stoked the fear white people have of "race suicide," and where Depression-era women garnered more sympathy from physicians, in the 40s and 50s, crackdowns led to an explosion in birthrates. Sterilizations and birth control was pushed on Black women and poor women, oftentimes without their consent. Dr. Reagan states:

In calling for an end to Aid to Families with Dependent Children, or for mandatory sterilization or contraception for poor Black women, conservatives attempt to stop one group of women (stereotyped as poor Black women) from bearing children. In restricting abortion use, they attempt to force a different group (middle-class white women) to bear children.

She also sheds a little light on why women are routinely not taken seriously by male doctors. One of the indications for therapeutic abortion was vomiting, and since women could not access abortion without a reason such as this from the allopathic doctors that forced midwives out of the abortion business, they learned to imitate the symptoms of excessive vomiting. Thirty years later, when physical symptoms were easier to treat, they turned to psychiatrists, alleging suicide ideation and attempts. These, again, required intense scrutiny, and fell into disbelief as women tried to help each other by disclosing what worked to get an abortion through dreaded abortion committees. The draconian crackdowns of the 40s and 50s also led to a deep distrust of women, as the state had a vested interest in enforcing the continuation of a pregnancy. While allowing women to die from septic abortions in a hospital, police would extract "dying declarations" from women, many of whom they deliberately withheld care from unless they disclosed the name of their abortionist. A patient could turn and name you during a raid in an instant, and therefore some doctors resorted to blindfolds and driving women around to disorient them. Combine that with the understanding that these doctors had a "fatherly" view of the women coming to them in desperation, and that they believed that they alone could discern what was best for them, along with the fact that studies conducted often left women out entirely on account of their hormones... yeah.

Another interesting theme the book tackled was the impact of McCarthyism and the inherent suspicion of any values that didn't cooperate with compulsory heterosexuality.

The repression of abortion in this period was not new, not normal, and should be incorporated into our understanding of the multifaceted and dar-reaching effects of McCarthyism. The state's surveillance of abortion in this period is another aspect of the political and cultural attack on critical thought and behavior. McCarthyism was devoted not only to eradicating the Communist Party, but to destroying the labor, peace, and interracial movements. As part of the fervent anticommunism of the postwar period, police and government agents investigated and harassed thousands of people for their political views and frightened many more, while the majority leaned to conform and keep quiet. Deviation from standard gender and sexual behavior came under attack along with political deviance. State authorities labeled gays and lesbians "perverts and national security risks," and police raided their bars. Abortion symbolized subversiveness, as did these other ideas and activities. In fact, abortion was linked to communism at this time, and red-baiting entered the medical abortion discourse. The attack on abortion and women who sought to control their own reproduction and lives was on the dark side of the er'a pronatalist ideology.

Another arm of state violence being.. medicine. In the name of protecting people during the red scare, the government was more than happy to terrorize all number of people they saw as noncomformist. They turned doctors into policemen when they forced them to withhold care and question women and interview them to make sure their cases could pass committee, and they turned policemen into voyeurs and tyrants who were able to raid abortion clinics, arrest women in the midst of an operation, and read through their private medical documents.

Meanwhile, the effects of this violence was obvious. Maternal mortality skyrocketed. The septic abortion wards were full. Hundreds of women were seen for complications associated with an untrained abortionist - an opportunist, usually - causing any number of diseases. By the early sixties, abortion complications accounted for 42.1%, and

Abortion was institutionalized in hospitals in two interrelated structures: the therapeutic abortion committee and the septic abortion ward. Private rooms belonged to a few privileged white women of the middle class; the wards were shared by low-income women of all races, together with some middle-class women who had illegal abortions... The denial of female autonomy lay at the foundation of the medical system's response to reproduction in general and hospital abortion policy in particular. The discriminatory abortion system was built into the hospital structure.

Dr. Reagan creates an excellent dichotomy here of the committee and the septic abortion ward. In their hubris, paternalism, and sexism, doctors fail to understand that the septic abortion ward is a direct consequence of the belief that they should have more control over their patients' bodies than they themselves. The discriminatory abortion system was built into medicine itself: it started with running out the midwives that threatened their practice, it continued with outlawing them and outlawing abortion, and it was perpetuated by a system that continuously looked over their shoulders for three specific procedures: c-sections, abortions, and sterilizations. All of these reveal the attitude of medicine towards women:

Women cannot be trusted to make moral decisions about children and family, but must be overseen and regulated by men; procreation is a state mandate not a choice; women's lives, sexuality, and bodies are not their own.

They did not see it that way - the class of doctors used in the Doe v. Bolton case argued more on behalf of the doctor's right to practice medicine autonomously. In fact, even Roe v. Wade utterly ignores the discriminatory impact of abortion care as it is now - SCOTUS is utterly unable to recognize the impact of economic equity in this case. In so doing, they perpetuate the idea of procreation as a state mandate and not a choice.

However, the passing of Roe v. Wade did

improve public health: overall maternal mortality dropped dramatically. In New York City, maternal mortality fell 45% the year after the state legalized abortion. In 1971, New York City experienced its lowest maternal mortality rate on record... as a public health measure, the legalization of abortion represented an improvement in maternal mortality that ranks with the invention of antisepsis and antibiotics.

It also improved patient's rights. A woman's right to an abortion strengthened her right to not have a c-section or a sterilization without her consent. It strengthened the right of a person to not have a treatment just because it was medically indicated, and strengthened the right to euthanasia and rejecting medical advice and treatment.

But the warning she provided at the end was.. pretty appropriate for the times. Dr. Reagan warned about the surveillance women faced in Romania, in the way that their periods were tracked and they had to submit to mandatory prenatal appointments. She warned that there would be an enmeshment of the state and the medical profession again, and that the raids would begin again. The maternal mortality rate would skyrocket once more, and the septic abortion wards would open once again. Medical mistreatment of women would become routine once again.

Making abortion hard to obtain will not return the United States to an imagined time of virginal brides and stable families; it will return us to a time of crowded septic abortion wards, avoidable deaths, and the routinization of punitive treatment of women by state authorities and their surrogates.

Real reproductive freedom for women requires that all women, regardless of race, class, age, sexual orientation, or marital status, be able to avoid unwanted childbearing through the use of contraception and abortion and be able to bear children without being stigmatized, impoverished, or compelled to give up their education, employment, or children.

We do not have real reproductive freedom. We have not, ever, in the United States.

There's a lot of work to be done.

[Andrew · Rating 2 out of 5]

Right from the introduction, this book made clear that it wasn’t going to be an academic look at the previous years when abortion was a crime, but rather a regurgitation of pro-abortion talking points laced with selected stories and statistics to attempt to prove the talking points.  If you want a comprehensive look at this time period, you will not find it in this book.


The Salient:

Reagan does a thorough job exploring the underground abortion industry in Chicago, the pro-abortion movement, theories underlying the pro-abortion movement, and the stories relating to those who had abortions. There were numerous accounts of unlawful and unmoral conduct towards women, such as warrantless full-cavity searches and humiliation relating to sexual partners and experiences when investigating unlawful abortions. Regardless if the women's actions were unlawful, that doesn’t justify doing or using inappropriate tactics when investigating.


The Dubious:

Even the historical information that was provided was unabashedly one-sided.  Reagan barely (as in only a few times before the conclusion) mentioned the underpinning reasons why the anti-abortion movement: when life begins and what are the moral reasons to take that life. Even Margaret Sanger’s opposition to abortion was based upon this fact.  Instead, Reagan e reduces the argument, both now and then, to misogyny and attempts to control female sexuality and reproduction. While there were, and are, misogynistic statements and attempts to control women’s sexual behavior, this blatantly misrepresents the primary reasoning behind the anti-abortion movement, which is the humanity of the fetus. According to Reagan, initial laws to prohibit abortion were simply a power play by doctors to get control over the abortion process and, of course, misogyny. While improvement of maternal mortality was only briefly mentioned, there was no mention of the significant improvements in social programs and support, destigmatization of out-of-wedlock births (while not entirely, there is certainly tremendously less stigma today), and great improvement in laws protecting women (e.g. rape by husbands, domestic abuse laws).  A huge theme of the book is that the medical profession becomes a third arm of the state is required to “enforce” the laws, but the medical profession (and other professions) also participate in the enforcement of other laws (e.g. child abuse). Another consistent theme of the book involves the humiliation women went through when these crimes were being investigated and prosecuted.  Except as noted above when the state used unlawful or inappropriate tactics, yes, when you commit a crime (even one you don’t think should be a crime), humiliation is involved for yourself and your family. It should be noted that at every opportunity Reagan chose to quote or point out in the text of the book misogynistic and racial statements made by those who are anti-abortion, which were extremely common for the periods discussed, but she failed to point out those pro-abortion proponents’ same moral failures, such as Margaret Sanger’s well-known racial prejudices and eugenic beliefs.


In short, Reagan’s work is plagued by her clear hardline views on the “necessity” of abortion (frequently mentioned) without every actually analyzing the issue other than looking through the eyes of similar-minded persons throughout the time of the book.  She concludes the book with scare tactics her perceptions of what will occur if abortion is prohibited again as well as blatant mischaracterization of the anti-abortion movement.

[Elizabeth · Rating 3 out of 5]

When Abortion Was a Crime: Women, Medicine, and Law in the United States, 1867-1973 (Hardcover)
by Leslie J. Reagan

from the library

https://www.npr.org/transcripts/10997...
...
ARABLOUEI: This is historian Leslie Reagan. She's a professor at the University of Illinois Urbana-Champaign and author of the book...

REAGAN: "When Abortion Was A Crime: Women, Medicine And Law In The United States."




This is Michele Goodwin, professor at the University of California, Irvine, in the areas of law and bioethics. She's written a lot about the legal history of abortion. Her most recent book is "Policing The Womb: Invisible Women And The Criminalization Of Motherhood."
Policing the Womb: Invisible Women and the Criminalization of Motherhood


This is Karissa Haugeberg.
I'm an associate professor of history at Tulane University.
Women against Abortion: Inside the Largest Moral Reform Movement of the Twentieth Century

This is Carole Joffe.
JOFFE: I'm a professor at the University of California San Francisco. My most recent book is called " Obstacle Course: The Everyday Struggle To Get An Abortion In America."
Obstacle Course: The Everyday Struggle to Get an Abortion in America

[Jean · Rating 4 out of 5]

As a midwife and a lawyer I was drawn to this book. The research was phenomenal and put together in a way that really helped the reader understand what was going on for women, families and the medical establishment during the years abortion was illegal. Without access to birth control abortion was quite common and was fairly openly practiced even though it was illegal. As attempts were made to restrict access, regulation of midwives and doctors became more common. Both lost their ability to practice autonomously and doctors were even forced to become arms of the state and interrogate women and turn them over to the government. Eventually abortion committees were created in the hospital system to determine if the woman and the doctor asking for the abortion would be approved. Of course as more regulations happened there were more self induced abortions and higher maternal morbidity. Overall, I think no matter which side of the debate you are on, learning the history of something is essential to your position and this book does a good job of sharing the history of abortion in that time period.

[Eloise Griffin · Rating 4 out of 5]

This book is engaging, heartbreaking, and illuminating in equal measure. Reagan manages to make a century of heavy history extraordinarily interesting.

By focussing on Chicago specifically, Reagan has allowed herself to focus on smaller micro histories in a way that broaden’s my understanding of abortion. After reading many books that focussed more on institutions and the key figures in the abortion movement, it was eye opening to focus more so on specific women.

Dr. Reagan is professional but still regards her subjects with respect and empathy. She highlights the racial and class distinction in the history of abortion in America, a topic which is surprising absent from many similar books. She trusts the ready and lets the facts of the experiences of women seeking abortions speak for themselves.

[Hunter James · Rating 5 out of 5]

"Birth controllers contrasted the danger of abortion to the safety of contraceptives and argued strenuously against abortion."

"The editor (of JAMA) asked the doctor to remember 'that pregnancy is rare after real rape, and that the fright may easily cause suppression of menstruation and other subjective symptoms.'"

"Physicians practiced in the home. There, they primarily interacted with the woman of the house. She called in the doctor for help when her own knowledge and nursing failed and was there when he attended any members of her family. She talked with the doctor about the illness or injury for which he had been called and consulted with him on treatment. It was she who carried out (or not) his orders to feed, bathe, and medicate the patient and continued to care for the sick in her family after he left."

"Over 97% of the city's midwives were foreign born. The few native born white or black midwives practicing in Chicago may have performed abortions as well, but they have not appeared in sources. Immigrant women probably preferred immigrant midwives when they needed abortions for the same reasons they preferred them during childbirth - midwives were female, foreign born, and cheap."

"Indeed, official government agencies and the police relied upon private individuals and agencies to assist in enforcing the laws; in the abortion case, state officials expected the medical profession to act as a leader to repress the practice, particularly within the profession's own ranks."

"Furthermore, birth controllers criticized the medical profession for withholding contraceptives and accused it of being too willing to perform therapeutic abortions."

"The peak years for arrests for abortion coincided with organized efforts against abortion. For example, a peak in 1905 is probably due to the Chicago Medical Society's renewed efforts to eradicate abortion, and the peak in 1912 matches the coordinated, nationwide raids by the U.S. Post Office on people who used the mail to sell contraceptive or abortion instruments or services."

"Affluent women may have avoided official investigations into their abortions because they had personal relationships with private physicians, many of whom never collected or destroyed dying statements or falsified death certificates."

"Dr. Henry Dawson Furniss told a story that encapsulated doctors' worst fears. He had 'absolutely refused' to perform an abortion for a woman who later died from one. Under questioning, she used the opportunity to get even with Furniss for spurning her plea for help by blaming him for her abortion."

"Dr. William Robinson, a political radical who advocated legalized abortion, scorned physicians who 'badgered' sick women to make dying statements. 'The business of the doctor is to relieve pain, cure disease, and save life,' he declared, 'not to act as a bloodhound for the state.'"

"A 1939 poll of the nation's medical students confirmed the medical acceptance of abortion. The majority of the medical students, 68%, were willing to perform abortions if they were legal."

"State authorities labeled gays and lesbians 'perverts and national security risks,' and police raided their bars. Abortion symbolized subversiveness, as did these other ideas and activities. In fact, abortion was linked to communism at the time, and red-baiting entered the medical abortion discourse."

"Physicians and birth control clinics refused to provide contraceptives to unmarried women. In the late 1960s, the health clinic at the University of Illinois in Chicago insisted upon seeing a marriage license before providing birth control."

"Furthermore, the decline in the number of therapeutic abortions between 1951 and 1962 was highest among Puerto Ricans and lowest among whites. Public health officials noted that 'the disparity... between ethnic groups has been widening over the years' and believed it a 'medical responsibility... to equalize the opportunities for therapeutic abortion.'"

"Dr. Hall pointed to sterilization practices as additional evidence of a double standard in the treatment of low income patients. When ward patients obtained therapeutic abortions, they were sterilized more than twice as often as private patients. The propensity to sterilize low-income women of color matched the calls by some public officials for forced sterilization of poor, unmarried mothers. These coercive sterilization proposals, based in racist stereotypes and designed to be punitive, were aimed at low-income black women."

"While black women were being sterilized against their will, others who wanted sterilization found it equally impossible to have their wishes respected."

"Abortion deaths accounted for half of the maternal deaths of women of color, compared to 25% of the maternal deaths of white women."

"This woman's negative reaction may have reflected racial and class differences as well as familial religious opposition to abortion. She was an African American going to a mostly white group she had not graduated from high school, let alone entered college; and her boyfriend's grandmother had been pressuring her to have the baby. An outsider might see the service as a hippie operation, and though essential, distressing despite the counselors and cookies."

"1969 polls found that the majority of physicians supported repeal of the criminal abortion laws and the majority of Americans, including most Catholics, believed abortion should be a private decision."

"Making abortion legal improved public health: overall mortality dropped dramatically. In New York City, maternal mortality fell 45% the year after the state legalized abortion."

[chats · Rating 4 out of 5]

This book took me a LONG TIME, because it is not an easy read! The second half is a bit smoother than the first, but even so, it is a thorough historical text. It is a worthwhile one, though, especially with its focus on Chicago history and its, well, familiarity with the present day. It was written in 1997, but things truly haven’t changed much (except for the worse). I think Reagan did a decent job of acknowledging the movement led by non-white women, but I wish she had centered them more, particularly in the chapters about 1950 and beyond.

[Aisha · Rating 5 out of 5]

5 stars - what an incredible book! I learned so much about the history of midwives, doctors, laws, green, misogyny, and how access to abortion changed with cultural norms, personnel (midwives, Janes, doctors, etc.), and laws/political stances over time.

This work fulfills SPL's summer book bingo prompt - "Recommended by a local bookseller". I went to buy this book for book club at Elliott Bay, and the booksellers had pulled it off the shelf for an Insta? post.

[Irene Wight · Rating 5 out of 5]

Informative

I had no idea how abortions throughout history were looked upon. Outlawing it doesn’t stop it! How can people be against it and also be against social programs that can help once the baby is born. That includes free healthcare, education etc..

[Радостин Марчев]

Аз имам проблем с някои от заключенията на автора, но документалните изследвания, които е събрал са забележителни. като цяло много полезна книга за всеки, който желае да навлезе в историческата фактология.