April 28, 2007
Abortion, in the Nineteenth Century and Today II Posted by Ellen Feldman at 03:25 PM EST John Steele Gordon was quite right in his appreciation of the notorious Madam Restell’s business acumen. She brought modern marketing techniques to the ancient profession of abortionist by opening branch offices, employing a team of traveling salesman, instituting sliding fee scales, and out-advertising the competition to the tune of $60,000 in 1871. But not all practitioners were as innovative or, more to the point, as skilled. At the turn of the twentieth century, the point when abortion should have become medically safer due to knowledge of antiseptics, an increasing emphasis on bacteriology, and other medical advances, laws criminalizing the procedure drove it underground and made it even more hazardous. Statistics on illegal abortion are, for obvious reasons, rare and unreliable, but one study of 111 convicted abortionists revealed that fewer than a third were physicians or former physicians. Other professions, such as clerks, barbers, and salesmen, were better represented. There is, however, a wealth of anecdotal evidence, and it is chilling. Death was not uncommon. Perforation, tearing, and other “mistakes” had lifelong consequences. Kindness or even civility was rare, though one frequently cited case, harrowing in its physical details, tells of a “kind . . . motherly lady . . . who put her arms around me . . . and . . . said, ‘Honey, did you think it was so easy to be a woman?’” Self-induced abortion took the worst toll. Margaret Sanger ascribed her conversion to the birth-control cause to the death of Sadie Sachs, an immigrant Jewish wife and mother, who succumbed to her second case of septicemia from her second self-induced abortion in a single year. Mrs. Sachs may have been a fictitious or at least dramatically enhanced character, but she did exemplify a trend. By 1900, working-class women were having most of the illegal abortions, but these desperate souls were not only single girls “in trouble.” Overburdened immigrant wives and mothers were risking death to avoid giving birth to another child they could not afford to feed or clothe or care for. Middle- and upper-class women who sought abortions, could go abroad, find a physician who would perform the operation quietly, or even persuade a hospital board of the need for a therapeutic procedure, though the last was growing more difficult to obtain. Hospital boards prided themselves on making therapeutic abortions as difficult as possible. One committee ruled to grant one, then reversed itself when it discovered the woman was unmarried. By the 1940s and ’50s, the rate of therapeutic procedures had declined precipitously. Police experts, on the other hand, listed abortion as the third largest criminal activity in the country after narcotics and gambling, though it did occasionally attract a better class of perp. One properly trained physician in a small town in Pennsylvania estimated that he had performed more than 28,000 abortions during his long career, and another in Baltimore said she had received referrals from 350 doctors in two decades. Nonetheless, competent physicians acting on principle were the exception. Most abortionists were untrained at best and venal and menacing at worst. Too many of the people eager to restrict access to abortion forget or never knew the horrors of a world where abortion was illegal. The Supreme Court can hand down paternalistic rulings. Legislatures can outlaw procedures. But government cannot change human nature. It can only return the nation to the realm of back-alley surgery, shady practitioners, and dire consequences.
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