In fact, the whole term, "back-alley abortion" referred not to the location where the abortion was done, but where the woman entered the doctor's office. She went in through the back alley rather than through the front door.

It is silly to suppose that all those criminal abortionists would somehow lose interest after legalization. Their reasons for doing criminal abortions -- concern for women, greed, the inability to practice any legitimate field of medicine, whatever -- would not vanish with legalization. Legalization could not be expected to change whether these characters would do abortions. Of course they still would. What legalization would change was how they did abortions.

In 1959, Planned Parenthood abortion advocate Alan Guttmacher wrote of criminal abortionists, "They have to be good to stay in business, since otherwise they would be extremely vulnerable to police action." What would happen to the quality of care if the vulnerability was no longer there?

In 1959, we would have had to guess what would happen if the threat of police action suddenly vanished. Today, we do not have to guess. We have tried the experiment. Let's look at the results.

One of the first criminal abortionists to flee the oppression of police supervision was Jesse Ketchum of Michigan. Although Ketchum's criminal abortion practice wasn't the best in the world, he evidently maintained some standards and protocols for screening patients. No patient deaths have been attributed to Ketchum's criminal practice.

When New York legalized abortion on demand in 1970, Ketchum set up shop in a Buffalo motel suite. For Ketchum, New York must have seemed like the Promised Land. Abortionists were flaunting safety standards with impunity. Practices such as injecting patients with saline then sending them home to abort raised eyebrows, to be sure, but they didn't get anybody thrown in jail. Ketchum, who had managed to keep his nose clean as a criminal abortionist, foud a way to call attention to himself as a legitimate abortionist.

Ketchum had decided to do hysterotomy abortions in his office. It didn't take long for this practice to turn deadly. In the second half of 1971, Ketchum caught the eyes of the authorities by allowing two hysterotomy patients -- Margaret Smith and Carole Schaner -- to bleed to death.

Ketchum was verily astounded when he was charged with homicide in Margaret Smith's death. Abortion, after all, was legal. How could one be prosecuted for doing something legal? Ketchum tried various legal moves to stay out of prison. When Roe v. Wade was handed down and assorted criminal abortionists started getting their old convictions thrown out, Ketchum tried Roe for leverage. He got nowhere.

But to my knowledge, Ketchum is the only New York abortionist to be prosecuted for reckless endangerment resulting in the death of an abortion patient until David Benjamin was tried for the death of Guadalupe Negron in 1993. The rest just blithely went about their business, letting the women live or die, without fear of more than a slap on the wrist from the medical board or a lawsuit by the woman's survivors.

The New York State Assembly took away the realistic threat of punishment for seedy abortionists in 1970. The Supreme Court took it away from the rest of the country in 1973.

And the women continue to die. And two other former criminal abortionists that I know of -- abortionists who had never been linked to a patient death in their illegal practices -- went on to kill two women. Milan Vuitch allowed Wilma Harris and Georgianna English to die under his care. Linda Padfield and Yvonne Mesteth died after safe, legal abortions by former criminal abortionist Benjamin Munson.

Related Links at About.com
Abortion Practice Before Legalization
Changing Face of Abortion in the 20th Century
Who To Thank For Public Health Miracles

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