Birth control and abortion are constant flash points in contemporary politics, and they’re often described as signs of a rapidly changing society. But women have always had ways (though not always quite as effective) to control family size through contraception, and early American women were no exception. Understanding the role that reproductive rights has played in American history provides critical context to today’s debates. Have we always had these kinds of debates? How did Americans think about abortion in the late 18th century, or the 19th century? We’re here to shed light on some of these questions.
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Transcript for Early American Family Limitation
By Elizabeth G. Masarik, PhD
Elizabeth: Birth control and abortion are constant flash points in contemporary politics, and they’re often described as signs of a rapidly changing society. But women have always had ways (though not always quite as effective) to control family size through contraception, and early American women were no exception. Understanding the role that reproductive rights has played in American history provides critical context to today’s debates. Have we always had these kinds of debates? How did Americans think about abortion in the late 18th century, or the 19th century? We’re here to shed light on some of these questions.
And I’m Marissa
And we are your historians for this episode of Dig.
Marissa: Women have always been able to use various methods to avoid conception or induce very early abortion.
Elizabeth: Right, and it’s also important to understand that birth control was not invented in a lab by doctors or scientists. That knowledge originated from our collective folk culture and from centuries old female knowledge.
Marissa: Essentially women have been practicing birth control since time immemorial. Some of these methods were quite successful. For example, barrier methods like condoms, diaphragms and pessaries have been used for centuries. We have evidence from the 16th century BCE that Egyptian and Mesopotamian women used pessaries made out of balled up linen that was soaked in a mixture of acacia, honey, and ground dates. They inserted these into the vagina, like a tampon. Gum from the acacia tree ferments into lactic acid, which can act as a spermicide so this method of birth control was probably very effective.
Elizabeth: Aristotle advised women to smear olive or cedar oil in their vaginas to prevent pregnancy. Other primitive spermicides included honey, resin, balsam tree juice, and white lead.
Marissa: Women in 1st century CE India inserted a tampon of linen dipped in ghee (clarified butter) and honey into their vaginas to prevent unwanted pregnancies.
Elizabeth: Probably the simplest method of contraception involves the removal of sperm from the vaginal canal. There is evidence that ancient Hebrew women expelled ejaculate from their vagina using forceful contractions of their Kegel muscles. There are women in certain parts of Australia and the South Pacific today that practice contraception in this same way. Ancient Greek women were told to sneeze and jump to expel ejaculate from their bodies.
Marissa: Another method women have relied on is the rhythm method, so that if they could control their partners sexual urges, (which not all women had that power), they could organize their sexual relationship around their fertile and non-fertile days. And then there is the tried and true coitus interruptus, which can have about a 75% success rate, but this also relies on a willing partner and the power to direct his orgasms.
Elizabeth: Other methods of contraception may not have been as effective as one may have liked. After the fall of the Roman Empire, European women were advised to wear the testicles of a weasel on their thigh or a weasel’s foot around their neck to prevent pregnancy.
Elizabeth: So let’s turn our focus to North America. Birth rates in British North America were high compared to fertility rates in England, and many took note of the fecundity of the colonies. In 1698 colonial Pennsylvania it was said that “seldom any young married woman but hath a child in her belly, or one upon her lap.” One 1756 Pennsylvania account marveled at the fruitfulness of the country, writing that a Joseph Cobern “had the blessing to have his wife have twins, his cow two calves, and his ewe two lambs, all in one night.” However, birthrates in what would become the United States drastically dropped among white women after the Revolution. A rural woman of free status in North America could expect to have about eight or nine children in the mid-18th century. By the early 19th century that same woman could expect to have four to six children.
Marissa: As the economy moved to a more industrially based economy, the monetary value of large families decreased. The high cost of urban dwelling and the decrease of monetary contribution that children could give to the family economy, made children cost more than they could contribute. So of course this wasn’t the case everywhere, but we start to see a slowly spreading, general trend over the last really five centuries of decreasing family size.
Elizabeth: Historian Susan Klepp argues that “a historic moment during and after the American Revolution when intellectual, social, and economic change reciprocated with emerging individual, class, and national aspirations to begin a move from lifelong childbearing to truncated fertility patterns.”  The trend toward lower birthrates for free white women coincided with a similar fertility transition in post revolutionary France, leading Klepp to postulate that free white women took the Enlightenment ideals of these two revolutions and literally embodied them.
Marissa: Perhaps the most common form of contraception was breastfeeding. Women are generally less fertile while breastfeeding, so it was exceedingly common for women to breastfeed for at least 2 years. This helped to space children to one every 2 years – in New England in the late 18th early 19th century, this was the demographic norm, which means women were actively doing something to slow their fertility. In 1809 Margaret Izard Manigault advised her daughter that it was “less fatiguing to the constitution to nurse this one, then to bring forth another.” This shows us that white colonial women were thinking about their family size and were actively trying to slow their fertility. It was not an accident that birthrates were falling.
Elizabeth: For the most part – as is true today – women remained largely in control of their fertility. Women were the ones that held the wisdom of how to space their births, how to prevent conception and use birth control, how to restore the menses when necessary, and how to produce an abortion.
Marissa: To understand both birth control and abortion during the 18th and early 19th century, it is imperative to understand what “restoring the menses” meant. Until the mid-19th century, women’s reproductive health was understood in terms of a balance of bodily fluids, based on the Galenic humoral theory of medicine.
Elizabeth: Sickness and ill health was caused by blockages or imbalance in the fluids of the body. To get better, those balances between the humors – blood, black bile, yellow bile, and phlegm – had to be restored by vomiting, bleeding, peeing, voiding the bowels, or menstruating. People living up until the mid nineteenth century still understood the body in this Galenic ideology of bodily balance and flow. Therefore, their experience of illness was different than ours is today because they perceived the body in a different way than we do today. The body was in a state of balance or unbalance, so remedies such as bleeding and purging would be practiced in order to get the individual body back into health.
Marissa: So a blockage of the menses could be a sign of imbalance because the body was not purging itself on its monthly schedule and the backup of menstrual blood could lead to ailments in other areas of the body. In this sense, it’s easier to understand why 18th century patients and doctors might speak of, say, breast milk escaping through the menses, or urine escaping through the saliva – orifices were just points where the body could expel these excess matters or humors.
Elizabeth: Sickness was caused by blockages or imbalance of fluids in the body and it was important to put those things back into balance by vomiting or peeing or voiding the bowels. So, if a woman was pre-menopausal and she didn’t get her period this was often understood as an imbalance, not necessarily a pregnancy. Being pregnant was simply not considered as a real option until “quickening,” or when the women experienced the fetus began to move in the womb. This meant that a pregnancy was considered more of a blockage of menses until somewhere around 15-24 weeks gestation when quickening.
Marissa: Quickening was believed by the Greeks as the point of ensoulment, when the fetus became another person, formed enough to be inhabited with a soul. By the 18th century quickening was understood as the point when the fetus became more than an inanimate object. Once movement happened, the fetus was now “alive.” It is at this moment of quickening that a woman could feel the fetus moving inside of her and be sure that she was in fact pregnant. This put the domain of pregnancy specifically in how women experienced their bodies. The large, hard stomachs of the dropsical or worm infested or malnourished could very much look like the stomach of a pregnant woman. And so when a woman didn’t have her monthly menses and didn’t feel the quickening it could be contributed to rheumatism, consumption, pleurisy, intestinal worms, or a host of other really fun ailments attributing to an unnatural stoppage of the menses. To get the body back to a normal state, a resumption of the menses was in order.
Elizabeth: To restore this balance, women took herbal remedies and medicines that were designed to “remove the blockage” and restore the menses. These are called emmenagogues. These herbal remedies, like the contraceptive methods we spoke about at the top of the show, were passed from healer to healer and mother to daughter for centuries. For example, the Barbasco wild yam has been eaten by generations of Mexican women to prevent pregnancy. Modern scientists used this folk knowledge to extract progestin from Barbasco yams to make the first birth control pill. Hippocrates wrote down herbal recipes to induce menstruation that he had gathered from women whose traditions of medicine were already thousands of years old. Methods for inducing menstruation for contraception were published by Peter of Spain before he was made Pope John XXI in 1276.
Marissa: In the Americas, the Hopi and Tewa used the Indian Paintbrush plant as a contraceptive. Paiute, Washo, and Shoshone tribes drank a tea made from false hellebore root to prevent pregnancy. Blue cohosh was perhaps the most commonly used among many tribes as an abortifacient, as well as to induce labor. It’s still touted among present-day herbalists as a tea that can bring on labor, as well as easing period cramps and bloating.
Elizabeth: During the 18th and 19th centuries the emmenagogue or recipe to restore menses most commonly mentioned in health manuals read by Euro-Americans was European Savin or the American juniper or red cedar plant. Aloe, rue, pennyroyal, tansy, mint, lavender, ginger, and many other abortifacient herbs were also recorded. Seneca snakeroot became a commodity for its emmenagogue benefits and was harvested in the south and shipped to Philadelphia where it was sold by Benjamin Franklin and others in the 1740s. Most of these herbs were dried and steeped to make tea, or ground up to powder form.
Marissa: Starting in the middle of the 18th century, commercial emmenegogues were sold as Hoopers Female Pills, Dr. Ryan’s Worm Destroying Sugarplums “highly serviceable to the female sex” and other such marketable names. Health manuals written in English listed emmenagogues specifically as a means to restore or unblock the menses. German language health manuals from Pennsylvania printed between 1762-1778 listed the same emmenagogues for restoring the menses but these identical recipes could also “expel dead fruit.” Midwifery manuals later in the century from Pennsylvania gave the same recipes in expelling the fetus “be it alive or dead.” Common books listing emmenagogues could easily be found during the 18th and 19th centuries. William Bukins “Domestic Medicine” first published in 1792 listed several ways a missed menstrual period could be restored. He also listed numerous causes of abortion later in the book. Samuel K. Jennings book, “The Married Ladies Companion” had its second printing in 1808 and listed several emmenegogic abortifacients. In 1910 Joseph Brevits’ “The Female Medical Repository” was published in Baltimore and listed many emmenegogues after cataloging multiple external causes of abortion such as falls and jumping. He added an asterisks and a footnote in the American edition deploring the “horrid depravity of human weakness to procure abortion by these means.” And the fact that he had to make this aside stresses the fact that women were using these means in these books to induce abortion.
Elizabeth: So we learn a lot about early American ideas about abortion in America from printed books and pamphlets and the advertisements for these abortifacients. And we also glean a lot of information about early birth control and abortion from early court records. The 1745 Connecticut case of Rex v. Hallowell provides a rare and well documented look at abortion in New England. In this case, Sarah Grosvenor became pregnant by her lover Amasa Sessions in 1742. They were both children of well-to-do families in the town of Pomfret and needed to cover up their illicit affair. Sessions procured an abortifacient potion from the self-proclaimed “practitioner of physick,” John Hallowell. Later that month, Sarah Grosvenor admitted to her younger sister that she was pregnant but had been “taking [the] trade to remove it.” The trade was a commonly used word for an abortifacient in New England, and the fact that Sarah and her sister understood what this word meant sheds light on the commonality of abortion in this era. After taking multiple doses of the “potion,” Sarah believed she was still pregnant and did not want to take more as she “Thot it an Evil.” John Hallowell convinced her that she would die if she did not restore her natural balance of humors, and that the fetus most certainly was dead. She agreed to let Hallowell deliver her but told him to stop if he detected any sign of life in the fetus.
Marissa: I’ll just pause for a second here and just point out that its 1742, so mid-18th century, we see in this court record of ideas of quickening changing. Sarah is trying to return her menses but she had an inclination that she’s pregnant but she hasn’t felt the quickening yet, nor has she passed any “fruit.” But she still asks Hallowell to stop if he detects any life.
Elizabeth: Right, so you -there’s a lot there. I mean, it seems like she sort of believes she is pregnant even though she hasn’t felt the quickening but she still needs to restore her menses. And I think it’s really interesting that its him saying, “you’re going to get sick.” So, he either is generally concerned about her health, assuming the “fruit” is still in her womb and needs to come out or she’s going to get sick. In modern words- she’s going to get a nasty infection and needs a D and C. Or that he wants to get rid of this problem ASAP.
Marissa: Court testimony by Sarah’s sister Zerphia Grosvenor, states that Hallowell took an “instrument” from his bag and inserted it inside Sarah. The record is unclear on what type of instrument he used. The curette, a metal instrument used to induce abortion, was invented in France in 1723. It is possible Hallowell used a curette in this instance, but he also could have used any number of implements such as a sharpened piece of slippery elm. The ensuing graphic testimony accused Hallowell of trying to “take the child away” through force which triggered Sarah to faint and caused Hallowell to leave town. Two days later Sarah delivered a stillborn infant. Ten days later Sarah became sick with convulsions and fever and died shortly thereafter.
Elizabeth: Two and a half years after Sarah’s death, rumors began to spread about a murderous abortion, which piqued the interest of two county magistrates who brought the case of Sarah Grosvener’s death to trial. There were no statute laws on abortion in either America or England at this time, so the charges were brought because of Sarah’s death, not necessarily the abortion. If Sarah hadn’t died, no one would be the wiser. The trial initially went forward charging all parties in the murder of Sarah Grosvenor but failed on technical grounds. In a separate trial in 1747, John Hallowell was convicted of the “highhanded Misdemeanor” of attempting to destroy both Sarah Grosvenor’s health and the “fruit of her womb.” Hallowell was sentenced to 29 lashes and two hours of public humiliation at the town gallows. Rex v Hallowell allows us to explore the use of abortifacients. This case does not explicitly say what kind of physick or potion Sarah took, just that it was in powder form. It is evident from the court documents that the individuals involved with the case were familiar with abortifacients, even if they were unsure of how to make them.
Marissa: In another court case in 1812 the Massachusetts Supreme Court ruled in Commonwealth v. Bangs that an abortion before quickening was not a crime. In this case, Isaiah Bangs prepared and administered an abortifacient potion to a woman. He was freed by the justices because it could not be proven “that the woman was quick with child at that time.” Quickening was part of a woman’s understanding of her own body. There was no pregnancy there because the woman had not experienced the quickening, or movement of the fetus.
Elizabeth: However, the precedent set by Commonwealth v. Bangs began to be challenged throughout the nineteenth century as lawmakers began to make the sale of abortifacients illegal. However, women, continued to grow their own herbs like pennyroyal, tansy, and rue and concoct their own remedies, passing that knowledge through chains of interconnected women. Additionally, home remedies to “cleanse the womb” and “restore the menses” were commonly printed in home health manuals. Massachusetts doctor Charles Knowlton advised women to douche with a syringe filled with a solution of alum and infusions of oak, hemlock bark, or raspberry leaf after intercourse in his 1832 manual, The Fruits of Philosophy; or the Private Companion of Young Married People. Dr. Frederick Hollis’s book, The Marriage Guide, printed continuously 1850-1875, touted the benefits of douching after intercourse.
Marissa: Enslaved women also had contraceptive knowledge but were under increased pressure to not use them because babies benefited their masters by increasing their wealth. Masters were constantly concerned that their slave women were using methods to stop pregnancies. However, some enslaved women were able to control their fertility on their own terms. Historian Deborah Gray White chronicled how several women whose masters deemed them infertile went on to have multiple children after emancipation. Historian Deidre Cooper Owens cites the example of an enslaved woman who assured her master’s doctor that the baby she had recently given birth to was a “planned pregnancy” and she had decided it would be her final one. Scholar Liese Perrin has found that formerly enslaved people spoke often about the use of cotton root as a contraceptive. Additionally, Black midwives were important in the gynecological and obstetrical care of enslaved women and carefully passed their knowledge on to the women they took care of.
Elizabeth: Midwifery was the domain of women for centuries and it was not uncommon for midwives to be skilled in preventing pregnancy alongside their skills in caring for laboring women. However, during the nineteenth century the medical profession was becoming progressively specialized and self-regulated. Physicians increasingly attempted to separate themselves from lay healers, midwives, and folk doctors by taking on the name “Regulars.”
Marissa: Regulars tended to be graduates of medical school or those that practiced with them. They regarded their advancing position as important as the field of law or theology, and they intensely opposed what they considered quack theories. In a Foucauldian sense, the medical knowledge that the regulars claimed became a source of power in the larger system of nineteenth century civilization. It wasn’t until the fight between the regulars and irregulars that gynecological medicine was masculinized. In other words, as long as women maintained control over this aspect of their lives, doctors had less professional power; they did not have a corner on the medical market.
Elizabeth: In addition to fighting for a level of prestige, Regulars were also concerned with the numbers of “irregulars” that were cutting into their livelihoods. One study of Rochester, NY during the mid-nineteenth century, found that many physicians had to work in additional areas of employment in order to earn a respectable living. In an attempt to protect their medical ideals and sources of revenue, Regulars began pressing for increased legislation pertaining to medical practice. As a result, between the years 1821 and 1841, ten of the twenty-six states in the union enacted statutes in regard to abortion. However, these laws outlawed abortions after quickening and penalized the medical practitioner, not the woman. Legislators, pushed on by Regulars, were concerned that Irregulars were performing risky operations and directing women to take toxic substances, which put their lives in danger.
Marissa: Connecticut became the first state to enact a law specifically pertaining to abortion in 1821. Between section 13 pertaining to “intent to kill or rob,” and section 15 dealing with the “secret delivery of a bastard child,” section 14 stated “every person who shall…administer to…any deadly poison, or other noxious and destructive substance…thereby to murder, or thereby to cause or procure the miscarriage of any woman, then being quick with child, … shall be thereof duly convicted.” This prescribed into law what had already been practiced in common law and upheld in Commonwealth v. Bangs, that a woman quick with child, could not be given anything that would purposely cause abortion.
Elizabeth: By 1841, ten states and one territory had enacted laws pertaining to abortion. Five states explicitly stated abortion was illegal after quickening. The other five stated abortion was illegal at any time during pregnancy. In reality, the laws were unenforceable as there were no pregnancy tests at that time. Four of the ten states listed their abortion laws under “poisoning.” Every abortion law during this period was enacted within omnibus “crime and punishment” bills. These were large revisions of criminal code that held many alterations to current laws. There was no major coverage of the enactment of these laws and revisions in either the popular press or the religious press during this time.
Marissa: Beginning in the 1840s there was a perceived surge in the volume of abortions being performed in the United States. Historian James C. Mohr estimates one abortion for every five or six live births occurred during this time. One reason was the increasing commercialization and advertisement of abortifacients in popular papers and magazines. However, it is really impossible to know if in fact more abortions were being performed or just if more people were paying attention.
Elizabeth: The infamous Madame Restell began her abortion business in New York during the 1830s. She was arrested for the first time in 1841 and New York papers printed her name and occupation, giving her great publicity. By the late 1840s, Madame Restell’s abortion practice had branches in New York, Boston, and Philadelphia. Street peddlers would sell her abortifacient pills throughout neighborhoods and they were available by mail order as well. But by no means was Madame Restell alone. A quick look through most any paper in the 1840s would show multiple advertisements for abortion providers and abortifacients. Dr. Peter’s French Renovating Pills were sold as a “blessing to mothers’…and although very mild and prompt in their operations, pregnant females should not use them, as they invariably produce a miscarriage.”
Marissa: The rise in sales of abortifacients may have only produced a low amount of actual abortions yet the number of pills sold indicates that women were trying them in high numbers, and then possibly resorting to surgical means if the abortifacients didn’t work. A study by a physician-pharmacologist in Syracuse, NY in the late 1860s, found six out of ten different abortifacient pills he purchased to have high abortifacient properties, two of the ten to be mild laxatives, and the other two were inert drugs. Thus, women could achieve an abortion through commercial abortifacient pills if they knew where to look or were lucky (or unlucky) enough to happen upon the right ones.
Elizabeth: A second possible cause of the increased abortion usage during this time was a trend among white, married, Protestant women to utilize abortion as a means of limiting family size. The white, Protestant American family had been decreasing in size since the Revolution and the 1840s saw an upsurge in deliberate family planning by middle-class women. This prompted a serious backlash by Regulars and nativists. Married women who sought abortions were criticized for abandoning the self-sacrifice required of motherhood. Young, single women who sought abortions had been pitied as helpless and troubled dependents, but married women seeking abortions had “no excuse…for their heartless depravity,” as the editor of the Boston Medical and Surgical Journal stated in 1844. Dr. Horatio Storer, a leading opponent of abortion, equated a childless marriage as legalized prostitution.
Marissa: So why was there an increase in laws outlawing abortions during this period beginning in the 1840s and continuing to the 1860s? Well, what really freaked people out was that the woman who began to get abortions in higher numbers were white, middle and upper-class Protestant women. The mid-nineteenth century was a time of increased immigration which spurred nativist sentiments. As native-born, Protestant birth rates were declining, Catholic immigrant population numbers were on the rise. This led to grave fears of the white “race suicide,” or “the demographic failure of the American family.” Native Protestants feared that Catholic immigrant populations would surpass them and the “Puritan” bloodline of ’76 would be diminished. Essentially native-born Americans worried that their “good stock” would be overrun by immigrants. The fact that white, native-born women were procuring abortions doubled nativist anxiety.
Elizabeth: The American Medical Association (AMA) formed in 1847 as a professional, nationwide organization for physicians. This group of Regulars continued with increased fervor the push for enacting more abortion and general medical legislation. Horatio Storer, one of the most outspoken opponents of abortion, spearheaded the AMA crusade in 1857 against criminal abortion. The campaign gained momentum among Regulars across the country and put enormous pressure on lawmakers to enact more abortion legislation.
Marissa: It should be noted that not all physicians were on board. One Boston physician stated anonymously that Storer “seems to have thrown out of consideration the life of the mother, making that of the unborn child appear of far more consequence, even should the mother have a dozen dependent on her for their daily bread.” As this quote suggests, not all Regulars viewed abortion in the hard and fast lines that the outspoken majority did.
Elizabeth: The AMA set out to influence legislation and public opinion. Regulars bemoaned the country’s “general demoralization” as attributed to the public’s ignorance on quickening, doctors and irregulars performing abortions to make money and retain patients, and lax laws against abortion. The AMA determined to deconstruct the prevalent quickening ideal among the general populace by lecturing their patients and producing books and manuals debunking the quickening doctrine.
Marissa: They largely succeeded and by 1868, thirty of the thirty-seven states in the union had abortion laws and the common discourse on abortion was changing. Only three of the state laws deemed abortion after quickening a crime. Almost all of these laws held the woman receiving the abortion liable as well as the practitioner, but it is important to point out that these crimes always carried lesser sentences than homicide cases. Mohr also found that abortions tended to be rather costly, which further enraged those physicians who refused to practice them. He found that Regulars repeatedly testified that the abortion business was lucrative. Even when women turned to the commercial abortifacient trade, cost could still vary wildly, from $5 up to $300.
Elizabeth: Between the years 1841-1868, the country made a dramatic change from one that listened to women’s perceptions of their bodies in relation to their pregnancy and fetal movement, to one that specifically rejected that concept and insisted all pregnancies be carried to term. The AMA declared that pregnancy and childbirth were now the domain of physicians and became medical conditions to be monitored and controlled by doctors, rather than the purview of women alone. Outlawing abortion was directly related to the attempt of the AMA to place medical knowledge in the hands of elite professional physicians as well as to stop those who practiced abortion from getting rich off of it.
Marissa: By roughly 1870, most states had made it illegal to end a pregnancy after quickening. The legislation push by Regulars continued and by 1880 every state in the Union except Kentucky had laws making abortion illegal at any stage except when deemed necessary for the women’s health by a respected physician. These laws changed when a pregnancy began: Quickening stopped being the turning point of pregnancy, and instead pregnancy began when menses stopped. Most laws also made the advertisement of abortion services or abortifacients illegal. The Comstock Act of 1873 drastically increased the regulation of advertising “women’s services.”
Elizabeth: Abortions were by no means eliminated as they were gradually pushed underground. At a time of increased scientific knowledge and ability to make abortions safer for women, physicians were refusing to perform them, making illegal abortion increasingly more dangerous for women who needed them.
Marissa: As abortions were being pushed underground with increasing regularity, discourse on the matter grew hyperbolic. Physicians still complained about the public’s acceptance of abortion before quickening and they increasingly used more shocking vocabulary and stories to repulse the public. By the 1870s professional and popular journals were filled with the abortion issue. The New York Times continually ran salacious stories highlighting the “Evil of the Age.”
Elizabeth: In 1888 the Chicago Times ran a month-long undercover story charging that abortion was widely available in the nation’s second largest city, despite a strict Illinois state law against it. Undercover journalists posed as married women who were seeking abortion services from doctors and midwives. They found that most physicians and midwives were willing to perform abortions, and if they did not, most were willing to refer the undercover journalists to someone that did.
Marissa: Dr. George M. Chamberlain, one of Chicago’s most prestigious doctors, member of the AMA, and the Illinois State Medical Society, agreed to perform an abortion on one undercover journalist. Dr. Milton Jay, dean of the Bennett Medical College also agreed to perform one. The paper named forty-eight physicians who agreed to help the undercover journalist obtain an abortion. Thirty-four agreed to do it themselves, twelve referred her to another doctor who would perform an abortion, one referred her to a midwife, and one sold her abortifacient pills and sent her to another doctor. Thirty-two of the forty-eight doctors were Regulars, several belonged to the AMA. Many others belonged to the local medical society.
Elizabeth: Overall, the story highlighted that “respectable” physicians with close ties to “respectable” ladies were frequently performing abortions. The undercover journalist commented on her surprise that it was “married society” women more than poor shop girls and immigrants who were procuring abortions. But this shows the conflicting relationship many Regulars had with abortion and despite the AMA rhetoric, these physicians treated abortion as a medical procedure in agreement with their Hippocratic oath.
Marissa: Middle and upper-class women had access to private doctors who relied on them for payment. Plus, women were normally the access to the rest of the family. If a private doctor wanted to be a physician to the family, he needed to give the mother the care that she was asking for, and often physicians agreed that careful family planning helped their patrons to lead healthier and longer lives.
Elizabeth: The Chicago exposé also went into working-class neighborhoods where most obstetrics were performed by midwives. There the journalists also found abortion was accessible. The paper published the names of sixteen midwives who agreed to perform an abortion or who would refer the undercover journalist to someone that would. Some of the midwives that refused offered to keep the undercover journalist posing as a pregnant woman with them until she delivered and would aid in finding a foundling house for the baby.
Marissa: Regardless of the fact that both working-class and middle/upper-class women were all using abortions, midwives who catered to a largely working-class, immigrant, and Black clientele came under strict scrutiny from Regulars. In their further push to masculinize obstetrics and gynecology, Chicago specialists in obstetrics won increased state supervision over midwives in 1896, 1908, and 1915 largely by identifying midwives as abortionists.
Elizabeth: Yet, a 1917 study at the Washington University Dispensary in St. Louis found that physicians and midwives attributed in equal amounts to the illegal abortions they tracked. In a New York study of 111 convictions for illegal abortions between 1925 and 1950, investigators found that midwives were responsible for 22.5 percent of the cases and physicians for 27.9 percent. Although these numbers do not give definitive results for rural and urban populations, it is a good indication that abortions were being performed by doctors and midwives in equal numbers.
Marissa: Most of the available numbers on abortions are from deaths and criminal cases or from hospitals admitting women with complications from illegal abortions. It is unknown how many abortions were executed safely and without comment. Most discourse on abortion happened in private spaces between families, and among networks of females.
Elizabeth: Records of the earliest European and American birth control clinics of the early 20th century show that a majority of the patients who visited the clinics for the first time had previously used contraception. So even though some doctors and politicians railed against family planning, women were doing it anyway. For example, in 1907, President Theodore Roosevelt succinctly expressed the feeling of the times when he said that a white Protestant woman who avoided pregnancy was “a criminal against the race.” But let’s not lose sight of the racism and xenophobia at play in these freak-outs – they were freaked out because the white “old stock” of the country were the ones that were most successful at managing their fertility- because their race and class privilege allowed them to do so.
Marissa: So we are going to end this discussion here. We pick up on this topic in our episode entitled “Abortion and Birth Control before Roe v. Wade.” You can search your feed or the website for that episode. Please remember to leave us a five-star review. You can also become a patron of the show at patreon.com/digpodcast for as little as $1 a month. We really appreciate all of our current patrons, you keep the lights on!
Elizabeth: Thanks for listening.
Show Notes & Further Reading
Chesler, Ellen, Woman of Valor: Margaret Sanger and the Birth Control Movement in America, (New York: Simon and Schuster, 1992).
Dayton, Cornelia Hughes. Women before the Bar: Gender, Law, and Society in Connecticut, 1639-1789 (Chapel Hill: University of North Carolina Press, 1995).
D’Emilio, John & Estelle Freedman. (1988). Intimate Matters: A History of Sexuality in America. New York: Harper and Row
Duden, Barbara. The Woman beneath the Skin: A Doctor’s Patients in Eighteenth-Century Germany (Cambridge, Mass.: Harvard University Press, 1991).
Gordon, Linda. The Moral Property of Women: A History of Birth Control Politics in America. 3rd edn (Urbana and Chicago: University of Illinois Press, 2002).
Laveaga, Gabriela Soto, Jungle Laboratories: Mexican Peasants, National Projects, and the Making of the Pill, (Durham: Duke University Press, 2009).
Mohr, James C. Abortion in America : The Origins and Evolution of National Policy, 1800-1900 (New York: Oxford University Press, 1978).
Owens, Deidre Cooper, Medical Bondage: Race, Gender and the Origins of American Gynecology, (Athens, GA: University of Georgia Press, 2017).
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 Quoted in Klepp, 917.
 Klepp article
 Quoted in Klepp, 938