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Abortion Practice Before Legalization

Let's take a good hard look at the pre-legalization horror stories. First, let's visit the abortion advocacy site that tell the most gruesome tales:

Gruesome abortion stories are the mainstay of abortion advocates. But how representative are they of abortion practice in the days before legalization?

Mary Claderone (then Medical Director of Planned Parenthood) and Nancy Howell Lee (a pro choice researcher) both investigated the practice of criminal abortion in the pre-legalization era. Calderone estimated that "90% of all illegal abortions are presently (1960 - ed) being done by physicians." Calderone further estimated that 8% were self-induced and that 2% were induced by someone other than the woman or a doctor. Lee estimated that 89% of pre-legalization abortions were done by physicians, an additional 5% by nurses or others with some medical training, and 6% were done by non-medical persons or the woman herself.

Calderone's numbers came from "43 men and women from the various disciplines of obstetrics, psychiatry, public health, sociology, forensic medicine, and law and demography." Lee interviewed women who had undergone pre-legalization abortions. The discrepancy between Lee's and Calderone's breakdowns of non-physician abortions is probably due to sampling errors.

Lee, who spoke with women who survived abortions, would of course not encounter women whose abortions killed them. Therefore she would not potentially be exposed to the proportionate number of women who chose the most dangerous alternative. Lee's sample also included only willing survey participants, who would be more forthright and complete in divulging information, such as who really performed the abortion, than women being interviewed by health or law enforcement officials.

The Changing Face of Abortion
How abortion practice has changed, and how it's stayed the same.

Pre-Legalization Mortality
Were criminal abortions killing 5,000 to 10,000 American women every year?

Post Roe Practices
Exactly how much change did legalization make?

Safe-n-Legal in the 20th Century
A look at claims of legal abortion's safety.

Abortionists of the 20th Century
Legal, illegal, and quasi-legal.

Dividing the Century
Your gateway to a series of color-coded abortion timelines.

Calderone, on the other hand, spoke with those likely to see the botched and fatal abortions, and therefore they would be exposed to a higher percentage of the most dangerous, self-induced abortions. Also, Calderone's informants would have been investigating botched abortions that could be subject to a criminal investigation. Therefore, women speaking to them would be likely to withhold the true identity of their abortionists to protect them. Also, should the woman die, her family and friends might identify the woman herself as the abortionist, rather than admit their own roles in arranging or performing abortions, in order to close the investigation.

Anecdotal data tends to support Lee's research. Stories of abortions by midwives, orderlies, chiropractors, and assorted lay practitioners like Harvey Karman and the Jane Syndicate are far too common to represent only 2% of criminal abortions. We would probably not err too far if we relied primarily on Lee's numbers and adjusted them slightly to reflect the slight under-reporting of amateur abortions. Thus, a fair estimate of the breakdown of criminal abortions would probably look like this:

What did these look like in practice? There were physicians who ran abortion mills, physicians who did selected abortions on their own patients, physicians who worked patients in through loopholes in the law. In addition to the physician abortionist, there were the professional non-physicians, often operating with training, equipment, medications, and back-up provided by physicians. Here are more representative stories of pre-legalization abortions:

This is the rough profile of who was performing abortions, and how women arranged them. Where, then, does the image of the coat hanger come in?

Lee's interviews with women who had self-aborted found a different picture from the women who had sought professional (however illegal) abortions. These self-aborting women tended to be less rational, and more self-destructive, than the women seeking competent abortionists. Lee also found that the women attempting self-abortion were likely to have had a death wish at the time of the abortion.

This finding is in keeping with psychiatric literature of the time, which treats self-induced abortion as a peculiar manifestation of the self-mutilating behavior common in patients with certain psychiatric disorders. Self-mutilation in patients with these disorders can range from superficial cuts and cigarette burns to self-trepanning (drilling holes in the skull), enoculation (gouging the eyes out), and amputation of limbs.

Mutilation of the genitals is not rare in these patients, and self-induced abortion was often regarded as an extreme form of genital mutilation aimed at attacking the patient's own femininity. It was in the political context, not the psychiatric or psychological context, that self-induced abortions were considered to be the expected behavior of normal women. This politicized view of self-aborting women eclipsed the reality, and case studies stopped showing up in the literature, although occasional stories still do make it into the newspaper.

19th Century Abortion Cases and other cases of self-injury
Self abortion at the turn of the last century.

This is not to say that all women who self-induce abortions are mentally ill. Investigators of post-Roe self-induced abortion injuries and deaths found other factors, such as distrust of the medical profession, a perception of home herbal abortion as more "natural," cultural preferences, and "ideosyncratic" factors nobody could readily explain. These women, however, carefully research abortion methods and use common sense and intelligence to select a method likely to be efficacious and comparatively safe. Let's take some time to look at methods preferred by the woman who is thinking out her abortion plan:

Was legalizing a good idea? Join the debate in the Forum!

Please, don't try these methods at home! I merely wish to illustrate the difference between a woman planning to perform her own abortion and the woman whose abortion is more self-destructive. Women still die from self-induced abortions, even in the age of antibiotics and blood products.

What of the women turning up in emergency rooms and morgues? The things they put into their bodies illustrate that there is something more going on than just an attempt to dislodge an unwanted fetus: pine oil, drain cleaner, curtain rods, ice picks, coat hangers, bicycle pumps, turpentine... Every year or so a self-induced or rank-amateur abortion death will be reported to the Centers for Disease Control, showing that the problem has not just gone away with legalization. But the problem is now swept under the rug because admitting that it exists poses a threat to the abortion agenda.

The self-induced and amateur abortions that showed up in the emergency room and the morgue gave some people a distorted view of criminal abortion. Abortion proponents capitalized on and magnified that distorted view. But the truth is that most women who were making a self-interested decision to abort found a competent person to do the abortion. All that's changed with legalization is that abortionists have been given a new clientele -- women who would never have sought abortions had they been illegal. While that's a boon to abortionists, it's hard to argue that more abortions for ambivalent women is a real gain to society, or to the women themselves.

1. Nancy Howell Lee, The Search for an Abortionist, University of Chicago Press, 1969
2. Alex Barno, "Criminal abortion deaths, illegitimate pregnancy deaths, and suicides in pregnancy: Minnesota, 1950-1965," American Journal of Obstetrics and Gynecology, June 1, 1967.
3. Mary Calderone, "Illegal abortion as a public health issue," American Journal of Public Health, July 1960
4. Leon Fox, "Abortion deaths in California," American Journal of Obstetrics and Gynecology, July 1, 1967

Discuss on the Pro-Life Forum

Related Links:
1900 - 1950: Pre-Paradigm Shift
1950 - 1970: The Transitional Period
Criminal Abortion: The Carnage Begins
Legal Pre-Roe
"More on Illegal Abortion Myths"
PPFA Abortion Conference, 1955
The Truth About Pre-Roe Abortion Mortality
What California Found
What Minnesota Found
Who To Thank For Public Health Miracles

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