Abortion refers to the purposeful termination of a pregnancy. Millions of girls and women have sought and received abortions during the two eras when the procedure was legal (eighteenth century to mid-nineteenth century, and 1973 to the present), and during the criminal era (mid-nineteenth century to 1973). Legislative, medical, judicial, religious, political, and popular responses to abortion have constrained or enabled access to abortion services in both legal and criminal eras. Across the history of the United States, females have obtained abortions in very large numbers, no matter what the prevailing legal status and public attitudes toward the procedure. For example, during the 1950s, when abortion was illegal, U.S. public-health experts estimated that as many as one million criminal abortions were performed each year.
In the first decades of nationhood, the legal status of the procedure was governed by British common law that viewed abortion before quickening as a legal act. ("Quickening" referred to the sensation of fetal movement felt and reported by the pregnant woman.) After quickening, destruction of the fetus without cause was considered a crime. Many women of that era were aware of and employed herbal and other remedies that caused abortion, sometimes with the assistance of midwives or physicians who consented to remove "menstrual blockages." Enslaved African American women used abortion to resist coerced reproduction and slavery itself, employing the knowledge of African-based midwifery culture and folk medicine.
Connecticut was the first state to criminalize abortion, in 1821. This legislation was apparently concerned in part with protecting women from dangerous substances and techniques associated with pregnancy termination. The early state laws were not enacted in response to popular objections to abortion. Rather, they were expressions of an innovative collaboration between legislators and physicians interested in consolidating the authority of university-trained medical doctors ("regulars") in the area of obstetrics.
Over the course of the nineteenth century, as women's lives were shaped by urbanization, industrialization, and the experiences of migration and immigration, abortion became more common and more visible. By mid-century, observers estimated that 20 to 25 percent of all pregnancies ended in abortion. The combined growth of urban newspapers and advertising enabled broad dissemination of information about abortion providers and abortifacients. Young white women beginning to enter the work force and married women concerned about adjusting family size to urban settings took advantage of this information. While leaders of the emergent women's rights movement publicly expressed negative views of abortion, it is likely that the new visibility of abortion, combined with the feminists' goal of controlled conception (through "voluntary motherhood," or sexual abstinence), encouraged many white, native-born women to use abortion to resist traditional reproductive experiences, including serial childbearing.
Having worked successfully with a number of state legislatures to enact antiabortion laws, medical doctors intensified their campaign after the founding of the American Medical Association in 1847. Dr. Horatio Robinson Storer led efforts that resulted in antiabortion statutes in every state by the end of the nineteenth century. The new laws were a triumph for physicians now fully invested with scientific authority; midwives and "irregular" doctors were excluded as legitimate abortion practitioners, and the women-centered "quickening" doctrine was abandoned. The new laws were sharply moralistic; for example, they deepened the stigma attached to abortion by associating it with "obscenity." In addition, the laws reflected a triumph for sexual conservatism and medical doctors' determination to block middle-class women from employing abortion as a tool for resisting traditional roles and facilitating new ones. Despite the criminalization of abortion, however, many women of every class and race, married and unmarried, continued to use abortion to limit their childbearing.
In the early twentieth century, women found midwives, physicians, and various lay practitioners to perform illegal abortions. Increasingly, cities and towns were home to abortion providers who had full-time abortion practices, worked semi-openly, and were highly proficient. These practitioners probably rarely caused complications or deaths, which usually occurred in the case of self-induced abortions or abortions performed by the relatively small number of untrained lay practitioners who exploited some pregnant women's desperation.
Periodically, journalists and police forces in this era, often in league with politicians and medical doctors, orchestrated local exposés of abortion practices. The exposés typically targeted and tainted midwives—who chiefly served immigrant women and women of color—but not physicians. Antiabortion campaigns combined a mix of agendas, all of which were incorporated into antiabortion rhetoric. They championed medical prerogatives, demanded female sexual purity and conformity, opposed women's rights, and enforced eugenic and demographic goals.
Many contemporary observers and historians have noted that these campaigns did not halt the practice of abortion, nor did they stir public indifference to the crime of abortion, although the salacious content of raids and trials did engage the newspaper-buying public. Nevertheless, the campaigns effectively promoted the agendas noted above and successfully warned all women of the dangers that could beset any woman who tried with abortion to control her own fertility.
Interestingly, during the Great Depression of the 1930s, a massive number of women who could not afford babies obtained abortions, but the number of exposés and prosecutions of abortion providers declined. In this era, doctors spent more time debating which conditions warranted therapeutic abortions than they spent collaborating with police and politicians to stamp out abortion. Poor women and women without information or other resources continued to resort to self-induced abortions. One study in the early 1930s showed that 76 percent of these involved complications.
The response to abortion changed in the World War II and postwar era. After some years of unofficial tolerance, in which most law enforcement entities employed the principle of "no death, no prosecution," politicians and police forces once again engaged in exposés, arrests, and trials more frequently than before, even in cases where there was no evidence of abortion-related damage or death. Historians have argued that this crackdown was similar to, or a feature of, the postwar anti-Communist fervor. It aimed to eradicate "the enemy within," to demonstrate that the United States was a vigilant, virtuous country, and to enforce a conforming, conservative code of female sexual behavior, just as the seeds of "the sexual revolution" and the women's liberation movement were beginning to sprout.
At the same time, medical doctors began to construct hospital abortion boards charged with implementing group decision making regarding which women applying to the boards to end their pregnancies would be granted permission and on the basis of which physical symptoms. These committees were antithetical to women's interests. They reinforced medical authority and forged a protective, fraternal relationship between doctors and a legal system that acknowledged only board-sanctioned abortions as legitimate. They also significantly reduced the number of in-hospital abortions. This situation, coupled with the effects of the antiabortion crackdown, increased many pregnant women's desperation. Many women without the resources to leave the country to obtain an abortion or to pay a private U.S. physician willing to perform an illegal procedure resorted to self-abortion. Not surprisingly, this era saw a rise in abortion complications and death, particularly among poor women and women of color.
Abortion boards did permit some women to obtain an abortion. For example, women seeking abortions, together with psychiatrists, constructed the "psychiatric indication" for abortion, which forced some women to define themselves as suicide-prone or unfit to be a mother in order to get board permission.
By the 1960s, many observers acknowledged that antiabortion statutes could not be enforced. Moreover, the conditions of women's lives were changing in ways that intensified their need for fertility control, including access to safe and legal abortion. For example, female labor-force participation and college attendance rates were increasing; age at first marriage was rising. Many liberal physicians, clergy, academics, and others, recognizing the inevitability of abortion, began to advocate abortion reform.
In addition, politicians concerned about welfare expenditures and "ghetto unrest," and population controllers worried about the "population bomb," spoke out in favor of abortion reform. The American Law Institute published guidelines for reform in 1960, and the American Medical Association endorsed reform in 1967, a year in which one study indicated that 87 percent of physicians favored liberalization. The National Association for the Repeal of Abortion Laws was formed in 1969.
Some leading African American activists in the late 1960s and early 1970s opposed abortion reform, associating abortion with other white-sponsored attempts to limit or otherwise control the fertility of African American women. Over time, as African American women used abortion in their own interests, and Black feminists supported reproductive rights, their outspoken opposition abated.
Small groups around the country formed, each with a specific focus: The Society for Humane Abortion, in California, claimed that abortion was a woman's right, fought for the repeal of antiabortion statutes, and educated women about their bodies and abortion. Carol Downer and Lorraine Rothman's project in Los Angeles taught women how to perform "menstrual extraction." The Jane Collective, in Chicago, helped women contract with doctors to provide illegal abortions and later to perform abortions on their own. Some "doctors of conscience" around the country performed abortions and referred patients to others because they were convinced that women should have access to this service.
By the mid- to late 1960s, national feminist leaders and grassroots feminist organizations were focusing on abortion as the key to women's liberation. The Redstockings, a feminist group in New York City, held the country's first "speak out" on abortion in 1969, during which women publicly described their experiences obtaining illegal abortions. In following years, several state legislatures, including those of New York, Colorado, and North Carolina, liberalized their abortion statutes.
These developments—demographic trends, the rise of the population-control movement, the emergence of feminism and grassroots support of abortion reform, the persistence of abortion, the actions of a few state legislatures, and the climate of the era that supported "rights" claims—pushed the medical and legal communities to support formal legalization. Roe v. Wade, the 1973 Supreme Court decision legalizing abortion, was, in part, a pragmatic response to this complex range of developments.
The years since legalization have been marked by millions of women obtaining safe abortions. These years have also been marked by unemployment, a rise in female labor-force participation and wages, changes in family composition, and other economic and cultural shifts that sparked the rise of the New Right and the antiabortion movement. Using demonstrations, clinic blockades, legislative strategies, judicial appointments and legal challenges, and violent tactics such as clinic bombings and even murder of abortion practitioners and their colleagues, various segments of the antiabortion movement have significantly reshaped the abortion arena.
At the end of the century, abortion is still legal, but access to services is more limited than in the 1970s as a result of such legislated obstacles as the Hyde Amendment, which denies Medicaid funding for abortion, and parental notification provisions for teenagers, and because the number of practitioners has dwindled. The successes of the antiabortion movement have sharply constrained access of poor women and young women to safe abortion. Middle-class women are still able to exercise "choice" relatively unimpeded, although abortion rights proponents have had to assume a defensive stance. The Supreme Court seems committed at this time to sustaining legal abortion, but significant numbers in the U.S. Congress and state legislatures are determined to pass laws further reducing access and constraining rights, despite the fact that a majority of Americans support "a woman's right to choose."
Marlene G. Fried, ed., From Abortion to Reproductive Freedom: Transforming a Movement (Boston: South End Press, 1990); Laura Kaplan, The Story of Jane: The Legendary Underground Feminist Abortion Service (New York: Pantheon, 1995); Rickie Solinger, The Abortionist: A Woman Against the Law (New York: The Free Press, 1994); Rickie Solinger, ed., Abortion Wars: Fifty Years of Struggle, 1950-2000 (Berkeley: University of California Press, 1997).
Rickie Solinger
See also
Abortion Self-Help Movement;
Pro-Choice and Antiabortion Movements;
Reproductive Rights;
Roe v. Wade.
