Abortion and Birth Control before Roe v. Wade: 19th & 20th c. Family Limitation

At the Women’s Marches across the U.S. on January 21st, 2017, there were hundreds–maybe thousands–of women in their 60s, 70s, and 80s who held up signs that conveyed their frustration with still needing to fight for rights like birth control and abortion. This is a battle that has waged for so, so long. On this episode, Sarah and Elizabeth look back at the late 19th and early 20th century struggle for women’s rights. After our country finally granted women the right to vote in 1920, the emphasis of the women’s rights movement shifted to focus on another issue: access to methods of family limitation.

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Transcript for: Abortion and Birth Control before Roe v. Wade

Sarah: In the late 19th, early 20th c., the women’s rights movement began to turn its attention more directly at birth control – for such a long time, the focus of feminism had been on winning the right to vote, and there was some debate within the movement itself over what to focus on

Elizabeth: Today, in this second episode of our Women’s reproductive health series, we will be talking about the birth control movement, Margaret Sanger, and abortion in the early 20th century.

I’m Sarah

And I’m Elizabeth

And we are your historians for this episode of Dig.

Sarah: The women’s rights movement had been focused on winning the right to vote. And now the movement was asking, should we focus our energies on the vote? Or do we need reproductive control before we can get or even use the vote?

Elizabeth: They viewed women’s control of their reproduction as an elemental cornerstone to self-determination and the way to overcome the subjugation of women in society. This rested on respect in marriage and laws that protected women from marital rape. A woman’s right to refuse sex from her husband was fundamental to her independence and personhood.

Sarah: During the 1870s, the term early feminists used was “voluntary motherhood.” Npw, not all feminists agreed that birth control was the right thing to advocate for. Almost ALL agreed that abortion was a no-no (although people were obviously still having them in high numbers). In fact many called for voluntary motherhood through contraception as a means of preventing abortion.
Also we must point out that at the beginning, most feminists did not advocate the use of prophylactics, herbs, teas, and the like but advocated for celibacy between couples and the right for a woman to refuse sex to her husband. So early feminist agitation for birth control advocated for periodic or permanent abstinence- either through the mutual decision of a couple or the sole decision of a woman.

Elizabeth: By the 1890s and the turn-of-the-century, mainstream feminists began arguing that sexual intercourse was a form of marital communication, to be enjoyed by both parties,. This was a concept that grew more slowly as many suffragists and mainstream feminists were operating within the realm of respectability – using arguments that did not push the bounds of proper womanhood outside of respectable norms too much. But ideas about sexuality were changing, overcoming the Victorian ideology that women’s sexual functions were only tied to maternal instinct, not pleasure and that only men experienced sexual desire. It is important to remember however, that this sexual communication was still strictly within the bonds of marriage. (an interesting side-note. We often refer to the Victorians as Puritan in their sexual beliefs – being they were prudish. BUT, the Puritans actually advocated for mutual sexual pleasure between a husband and a wife. Good sex was a way to strengthen the god given bonds of marriage and husbands were often instructed to pleasure their wives to have a mutual, pleasurable sex life.) SEE OUR PURITAN SEX EPISODE

Sarah: “Voluntary motherhood” was a pro-motherhood ideology and upheld the belief that a woman’s primary function and joy in life was being a mother. They were not advocating for no children and no marriage, but for well spaced children when the woman was well enough to do so. This is important to separate from our 21st century idea of birth control as a way to have unlimited sexual intercourse without fear of pregnancy. This may help us understand why most early feminists shunned external methods of contraception. Prostitutes were thought to have knowledge and use these types of birth control and wives and mothers needed to firmly separate themselves from prostitutes. During this period a man was a man no matter who he had sex with. A woman was either a daughter, a wife, or a whore. Understanding this may help us understand why the popular public push for external birth control did not gain a foothold until the early 20th century.

Elizabeth: Let’s jump back and talk about the Comstock Act was passed in 1873. We talked about that during the first episode of this reproduction series. The Comstock Act, which made it illegal to send “obscene literature and articles of immoral use” through the US Mail; Anthony Comstock, who helped to write this law, was sort of singularly obsessed.

Sarah: I have this personal belief that Comstock was just this freaky dude. I have no evidence to back that up. [laughter]
Seems silly, but it was a way of cracking down on “immoral” things like birth control and family planning manuals, as well as sex toys & etc.

Elizabeth: After Comstock law passed 1873 – advertisements became euphemistic. Beforehand they were blunt in saying they were to prevent conception.

Sarah: Comstock worked in entrapment. He would write to female syringe purveyors under a false name and arrest whoever sent him the material. Dr. Sara Chase was arrested in 1878 and held on a $1,500 bail (36k) at the Tombs prison in NYC for selling Comstock just two syringes.
Regardless of laws prohibiting the dissemination of birth control, women were using it anyway. And that’s the thing we want to reiterate. Women still used birth control even when it was illegal. Records from early birth control clinics show that almost 90% of first time visitors had previously used birth control of some type.

Sarah: But as mentioned previously, condoms, pessaries, tampons, douches, herbs and chemicals were all used to prevent pregnancy. Even Vaseline mixed with salicylic acid (we most know it as acne medicine) was used as a spermicidal ointment. So even though mainstream feminism wasn’t advocating for external contraceptives, they were still being used in high numbers.
Elizabeth: And coittus Interuptus (commonly known as pulling out) was the most popular technique, although it relied on a willing partner and extreme discipline. Plus many doctors advised their male patients that it would result in impotence or neurotic disorders, so…. not exactly a winning combination.

Sarah: It’s important to point out that although illegal, women who could afford the services of a private doctor had a higher likelihood of obtaining reliable contraception than women who had no access to a doctor or knowledgeable midwife. So it was middle and upper class women who had access to reliable forms of birth control.

Elizabeth: So something we should talk about that was going on at the turn of the century. “Race suicide” fears, we touched on these briefly in episode 1 but I think it’s important to touch upon this subject again. “race suicide” was a catchphrase used by those who feared the European stock of the nation was being overpowered by foreign blood. In 1905, President Theodore Roosevelt gave a speech to The National Congress of Mothers in which he deplored the use of birth control by the white Anglo-Saxon woman, or to keep up with birth rate of ethnic minorities, was to risk race suicide. Essentially the use of birth control was anathema to American nationalism. He did not come up with the term “race suicide” – this fear had been prevalent since the Civil War era- but such a statement by such a popular president gave rise to what came to be known as the “race suicide” controversy. What his words did was embolden many feminists, maternalists, and suffragists who had previously kept silent about birth control to speak out in favor of its use or at least to push back at it. Charlotte Perkins Gilman stated in a speech, “All this talk, for and against and about babies, is by men. One would think the men bore the babies… The women bear and rear the children. The men kill them. Then they say: ‘We are running short of children- make some more.”

Sarah: Early 20th century sexual revolution. Women started being intimate with men who were not their husbands. This of course ran the gamut from premarital sex, free love, or petting and kissing before marriage- but things were changing. In the Victorian ideal, women were to have sex with only one man in their life and if they wanted to limit their family size, they could only have sex periodically. As sex became more understood as a normal human experience, not just the animal instinct of men, this Victorian ideal became unacceptable. A 1925 study of married, white middle-class New York women found that 30 out of 50 women born AFTER 1890 had had premarital sex, while only 17 out of 50 women born BEFORE 1890 had had premarital sex. And this was just one of many such studies that supported findings that women who came of age during the 1910s overwhelmingly were participating in sexual acts outside the bonds of marriage.

Sarah: So we want to switch gears here and talk about one of the pioneers of the modern birth control movement and that is Margaret Sanger. Sanger’s mother was essentially killed for having 18 children in a very short period; it ruined her health; Sanger believed strongly that women needed to have the ability to control their fertility so they could be better mothers and wives, and for their health.

Margaret Sanger began writing for the Socialist Party daily newspaper in 1911 as well as an organizer for the Women’s Commission of the Socialist Party and a member of the Harlem Socialist Society. In 1912 she joined the IWW, an organization that pushed for more direct action, ie physical action not just theoretical, than the Socialist Party. Margaret Sanger opens the first birth control clinic in the US. Published and distributed magazines/newsletters on birth control and feminism: 1914, the Woman Rebel, 1917, the Birth Control Review. Sanger, her husband, and others in the movement were constantly battling Comstock, who was appointed the Special Agent who was in charge of enforcing the law. Sanger was arrested in 1914 for violating the Comstock Act for distributing contraceptives and created a public disturbance; judge stated “women did not have the right to copulate with a feeling of security that there will be no resulting contraception”

Elizabeth: But important to know that women were reading about the birth control debate in papers and magazines. So even if they weren’t in a metropolitan area, they were still seeking information on birth control. The government-run Children’s Bureau began receiving letters from mothers who were desperate for information on birth control. Because it was illegal and the Children’s Bureau had its own issue with the AMA, their answers usually ignored the question or told women they had no information on birth control. One woman wrote in for information on birth control saying, “I have children so fast it is wrecking my life.” Another woman wrote, “Now what I want to know is why can’t we poor people be given birth control as well as Dr.’s and the rich people who could provide for and doctor their families. We need help to prevent any more babies. After the next one comes I’m going to seek advice and if possible so we can live more happy. Don’t you think it better to be parents of 3 which we are willing to work and do all we can for them, to raise and provide food for us all, then to hafeto [sic] have 6 or more for poverty to take and be motherless? I think it unfair that Doctor’s and rich seek birth control and poor can’t seek nothing, only poverty and more babies.”

Sarah: American Birth Control League, 1921; others, Mary Ware Dennett, National Birth Control League. “We hold that children should be conceived in love, born of the mother’s conscious desire; and only begotten under conditions which render possible the heritage of health. Therefore we hold that every woman must possess the power and freedom to prevent contraception except when these conditions can be satisfied.” 1936, the Comstock Laws were overturned in a court case called “US vs. One Package of Japanese Pessaries” Were ordered by Hannah Stone, a doctor at one of Sanger’s clinics, in order to provoke a court case over the availability of birth control; soon after, the AMA voted to consider contraceptives a “normal medical service”

Sarah: In 1946, Sanger helped to found the “International Committee on Planned Parenthood,” which developed into the Planned Parenthood organization that we know today; focused on family planning, birth control and women’s health; did not provide abortion services at all until 1970s
Sanger also helped to raise money for research on the creation of the birth control pill, which was first approved for use in 1960
Note about Sanger and eugenics and how this has been cherry picked by the right as an argument against abortion and birth control. (you prob know more about this than me)

Abortion:
One anonymous medical commentator asked in 1920 if “public opinion in the United states sanction abortion?” and concluded that it did “within the bounds of discreet [sic]secrecy.”

Dying declarations increasingly became the crucial pieces of evidence in the policing of illegal abortions up until the 1930s. Women admitted to hospitals due to complications from illegal abortions were interrogated, often when near death, about their abortions. Because poor women were forced to use cheap and dangerous self-induced measures, or inexpensive but un-reputable abortionists, they were more likely to end up in the hospital with complications.
These women were questioned about intimate details of their sexual life by male police, physicians, and hospital staff, in order to provide prosecutors with information about abortionists. Doctors became an arm of the state in pursuing the criminalization of abortion, yet not all of them agreed with the merging of medicine and the state. Dr. William Robinson lectured that, “the business of the doctor is to relieve pain… not to act as a bloodhound [for] the state.” The dying declarations compromised the private relationship doctors had with their patients, and many physicians refused to cooperate with the state in such matters.
Investigations into abortion-related deaths also caused pain and embarrassment for the women’s families. Police visited the houses on both sides of Francis Collin’s house as well as ladies from her old neighborhood after her abortion related death in order to determine if someone knew who her abortionist was. The coroner asked Marshall Hostetler about his deceased girlfriend, “When did you become intimate with her?…Have any relations with her?…How many times?…Where did that occur?”
Newspapers hungry for scandalous stories would print the names and intimate details of women who had illegal abortions. Papers would sometimes hint that police had uncovered lists of women who had abortions when they confiscated an abortionist’s records during raids. The threat of public shaming exposes the great agency women showed when seeking out an abortion. By controlling elements of their reproduction, women defined how they engaged in the public sphere by choosing when, how, and why they would have children, sometimes at great peril to their health and reputation.
The Great Depression marked a massive upsurge in abortion rates for both working and upper class women. One young teacher whose fiancé was unemployed became pregnant. Her “choices” were not really choices at all. She could marry her fiancé, lose her job (as married women were routinely fired on the assumption that jobs should go to men), keep the baby, and have no means of support. Or she could have the baby, still possibly lose her job and either keep it or put the baby up for adoption. No “choice” was a good one. Her fiancé found a local physician who gave her an abortion at his office. Two years later she married a different man and had seven children.
E.M had three abortions in Depression era Montana during the first years of her married life. E.M. and her husband wanted to postpone childrearing because they felt a moral obligation to be able to provide for their children. Through the use of cold water or turpentine douches, condoms, diaphragms, and abortions they were able to postpone their family for ten years. With the help of a male family pharmacist, E.M. obtained two abortions from a woman in a nearby town that she deduced was a prostitute. Both were done with the insertion of a catheter and sterile packing [with gauze or cotton] of the uterus. The third she obtained with the help of a neighboring ranch women who inserted a sharpened stick of slippery elm, purchased at the local pharmacy, into her uterus and left for several hours. The slippery elm swelled, causing the cervix to dilate and subsequently caused contractions and a miscarriage.
Physician-abortionists performed tens of thousands of abortions in major cities and small towns throughout the 1930s. Dr. Josephine Gabler performed over eighteen thousand abortions at her Chicago office between 1932 and 1941. That comes out to five a day, seven days a week. The increased visibility and availability of abortions brought a severe crack-down on physician-abortionists who had been operating with relative impunity and with a large referral system up until that time. These physician-abortionists also practiced in a relatively gray area as all state laws on abortion had provisions that allowed for medically necessary, therapeutic abortions performed by licensed physicians. These therapeutic abortions would increasingly come under fire in the 1940s and 1950s.
Raids on physician-abortion offices intensified substantially during this period. As the second red-scare increasingly ratcheted up conservative powers, so too did it increase the regulation of women’s bodies. Raids on abortion practices again became commonplace. A raid in 1947 on an abortion practice picked up eight-women as they left the office. The women were each required to submit to a gynecological exam where the police doctor removed the rubber catheter that had been earlier inserted by the abortionist. Later, when police entered the office, they found the abortionist working on a patient. They arrested the abortionist and took the patient and all office records with patient names to the police station.
Hospitals became important regulators in the state’s attempt to suppress abortions. Review boards were established at most hospitals. These consisted of a panel of doctors who acted as “gatekeepers” to safe and legal abortions. Physicians had to petition the review board and provide medical details on why they thought a therapeutic abortion was needed. These boards acted as a deflection to increased legal scrutiny. Also, therapeutic abortion committees provided a way for more conservative physicians to impose their views on their colleagues, thus making therapeutic review boards increasingly conservative in their medical assessments.

Women did not voluntarily talk about abortion in public but two incidents in the 1960s drastically changed the discourse on abortion. In 1961, West German pediatricians noticed that the number of babies born with the deformation of shortened limbs had tripled since the year before. Doctors figured out that thalidomide, a drug used in sleeping pills, cough syrups, and other over-the counter medications sold in West Germany and England was the cause of the deformations. The drug also caused many brain-damaged babies, miscarriages, still births, and early infant deaths. Although not in wide use in America, physicians had handed out over one thousand pills to their American patients. Sherri Finkbine was an American woman who had taken a sleeping pill containing thalidomine and sought a therapeutic abortion after learning of the high risk of birth defects. She was the first woman to publicly share her desire to have an abortion and gained the support (and some ire) of many Americans.
Finkbine was a white, middle-class mother, pregnant with her fifth child who talked openly with the press of her sadness as she learned of damage done to her developing baby. The press followed her story closely and watched as her doctors denied her a therapeutic abortion for fear of prosecution. Finkbine and her husband travelled to Sweden to obtain an abortion. A Gallup poll showed that 52 percent of Americans agreed she had done “the right thing.”
A rubella epidemic hit the West Coast in 1963 and by 1965 had spread across the U.S. and proved to be the largest rubella epidemic in 20 years. Infectious disease specialists warned Americans that pregnant women who contracted rubella within the early stages of pregnancy were at a 50 percent risk of delivering a baby with serious malformations and limited brain capabilities. CBS Television News announced that rubella was “a far more widespread threat to unborn babies” than thalidomide. This again increased the public discourse on abortion and the rights of women to legally obtain them.
These two causes of birth defects increased the public discourse over the authority the state, or doctor’s themselves, had in matters of women’s health. They caused serious questioning of pre-existing laws surrounding medicine and abortion such as patient’s rights, informed consent, disability rights, and racial discrimination in healthcare. More affluent white women with hospital and doctor connections were much more likely to receive a therapeutic abortion than working-class women or people of color. A study in New York found that white women who were private patients at area hospitals received therapeutic abortions in numbers four times greater than women in public hospital wards, whether they were white, black, or Puerto Rican. Class inequality was practically built into the system. For example, a San Francisco hospital allowed private patients to have a therapeutic abortion with the approval of one staff obstetrician, public “clinic cases” on the other hand, required the review of the entire OB-GYN staff and the vote was then taken by nine professors on the staff.
Do you want to talk about disability and abortion here?
The risk of death from illegal abortion was higher for women of color because of their limited access to safe hospital abortions. In New York City between 1951 and 1962, illegal abortion-related deaths for women of color doubled. In Cook County Hospital, Illinois, the number of illegal abortion-related complications treated rose from one thousand per year in 1939 to over three thousand per year in 1959. Government estimates in the late 1960s and 1970s estimated that annual illegal abortion rates each year fluctuated between 200,000 and 1,200,000. Racial discrimination in access to abortion was argued in the 1973 Roe v Wade case. Lawyers claimed that white women were more often able to persuade their private physicians to allow access to abortion. It was also argued that wealthy women had the means to travel to areas where abortion laws were not heavily enforced, while poor women could not. Thus, state abortion laws were argued to be discriminatory.
If women of color were able to gain access to a hospital abortion, many were forced to accept sterilization in return. A Chicago study in the 1940s showed that 67 percent of women who received abortions at a particular hospital servicing low-income patients, were also sterilized. Many black women across the country were sterilized against their will well into the late 1960s. This argument highlighted the racial inequalities and discrimination in healthcare in general.
Many Americans believed that the decision to have an abortion should remain a private one between a woman and her doctor. Ironically, in the twentieth century, physicians became some of the leading voices championing more liberalized abortion accessibility. By 1967 a survey found that 87 percent of American physicians favored a liberalization of the country’s abortion laws. On the contrary, those against access to abortion, especially the Catholic Church, began to form a stronger movement in opposition to relaxed abortion laws.
Feminism and resistance at the grassroots level also became a driving force towards abortion law repeal. Underground movements such as “Jane” in Chicago and The Society for Humane Abortion in California created their own illegal abortion networks in order to provide safe abortions for those seeking them. Between 1967 and 1973, Jane provided approximately three thousand safe abortions per year. By the mid-1960s, women had formed numerous groups across the country organizing to push the repeal of abortion law. Groups planned speak outs where women publicly stood up and spoke about their illegal abortions. This move from private to public discourse greatly shifted the power dynamic in the abortion fight.
The abortion movement would build considerable momentum throughout the 1960s until the Supreme Court in 1973 deemed a Texas abortion law unconstitutional in Roe v. Wade. Within a short period, laws that had stood for one hundred years or more were deemed unconstitutional and voided. That significant occasion began another chapter in the American abortion debate.

Since 1960s, birth control has had a really odd position in our culture
It is intensely common: Guttmacher Institute: 99% of women who have had sex have used some kind of contraceptive
62% of all women of reproductive age are currently using a contraceptive method
77% of married women use contraceptives
90% of cohabiting unmarried women use a method
89% Catholics; 90% Protestants
67% of women use hormonal methods such as the pill, patch, IUDs, etc.
At the same time, it’s still been the subject of debate politically
Religion
It is interesting to note that the religious press did not comment on abortion from the beginning of the nineteenth century through the Civil War. Anti-abortion physicians were bitterly disappointed with religious leaders for not speaking out on their behalf. Medical journals accused religious journals of profiting from abortifacient advertising revenue. In 1869, Catholic Bishop Spaulding of Baltimore issued a pastoral condemnation of abortion but when Pope Pius IX renewed the medieval censures of the Catholic Church against abortion, the American diocesan papers did not mention it. It wouldn’t be until the middle of the twentieth century that anti-abortion Catholic voices began to make an impact in the debate.

“Since the 1980s, the broad religious support for reform (and later, religious support for law breaking and the complete legalization of abortion) has been silenced by the convergence of Catholic, Christian evangelical, and Mormon antiabortion activism, overlooked by the media, and increasingly erased from historical memory. For Rev. Kinsolving and many others, the criminal abortion laws were the “evil” to be fought because they prevented physicians from caring for their patients and prohibited women from making moral choices about their pregnancies and childbearing. When religious opponents of legalized abortion today frame abortion as “evil,” it is worth noticing that religious leaders have used the same word to describe the laws banning abortion. Clergy did more than give sermons in support of legalizing abortion. Within a year of the surprising events in California, clergy and rabbis around the country openly defied the law by giving women the names of physicians who performed abortion through the Clergy Consultation Service (CCS).”

Rush Limbaugh and Sandra Fluke controversy – accused young woman of being sexually promiscuous
“what does it say about the college co-ed Susan (Sandra) Fluke who goes before a congressional committee and essentially says that she must be paid to have sex, what does that make her? It makes her a slut right? It makes her a prostitute.”
“So, Ms. Fluke and the rest of you femenazis, here’s the deal. If we are going to pay for your contraceptives, and thus pay for you to have sex, we want something for it, and I’ll tell you what it is. We want you to post the videos online so we can all watch.”
Conscious Clause, would allow employers to not have to pay for contraceptives in employees health coverage bc of religious exemptions – Hobby Lobby
But Rush Limbaugh doesn’t have 200 children, right? What is this about?
Desire to control women and keep them subjugated
They don’t actually want to be responsible for dozens and dozens of children, necessarily, and they clearly aren’t devoted to religious convictions (according to Guttmacher!)
Instead, it’s about defending a certain ideological worldview that relies on women occupying “traditional” roles
Something that I’d like to come back to talk more about at some point, especially how that comes raging back in the late 70s & 80s with the rise of the New Right and Reagan Revolution

Today, we focused a lot more on abortion because the 18th and 19th centuries were still dominated by the teaching s of Galenic medicine, or the humors. Next time, we’re going spend a lot more time talking about birth control, some names you may be familiar with such as Margaret Sanger, and we’ll focus on the 20th century progression of birth control, the Pill, and the abortion rights fight up until Roe in 1973.

Show Notes & Further Reading

Jean H. Baker, Margaret Sanger: A Life of Passion (New York: Hill and Wang, 2011).

Michel Foucault, The History of Sexuality, Vol. 1: An Introduction (Random House Vintage Books Edition, 1980).

Linda Gordon, The Moral Property of Women: A History of Birth Control Politics in America (Chicago, 2002)

Regina Morantz-Sanchez, Conduct Unbecoming a Woman: Medicine on Trial in Turn of the Century Brooklyn (Oxford: Oxford University Press, 1999)

Diane Sands, “Using Oral History to Chart the Course of Illegal Abortion in Montana,” Frontiers: A Study of Women’s History, Vol. 7, No. 1 (1983)

Learn about the history of contraception in America before Roe v Wade and the Pill. #contraception #history #roevwade #abortion #feminist #feminism