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History of Abortion in the U.S.

Abortion has been used to control fertility in every known society, regardless of its legality. It was practiced legally in the United States until about 1880, by which time most states had banned it except to save the life of the woman. Antiabortion legislation was part of a backlash against the growing movements for suffrage and birth control—an effort to control women and confine them to a traditional childbearing role.26

It was also a way for the medical profession to tighten its control over women’s health care,27 as midwives who performed abortions were a threat to the male medical establishment. Finally, with the declining birthrate among whites in the late 1800s, the U.S. government and the eugenics movement were concerned about “race suicide” and wanted white U.S.-born women to reproduce. More than most other medical procedures, the legality of abortion is linked to women’s status and political power, as well as to the population and economic objectives of the society.

Even when it was illegal, abortion was widely practiced. The ability of a woman to obtain an abortion at all, let alone one that was safe, depended upon her economic situation, her race, and where she lived. Women with money could often leave the country or find a physician who would perform the procedure for a high fee. Poor women, for the most part, were at the mercy of incompetent practitioners with questionable motives. Often unable to find a provider, poor women and women of color disproportionately turned to dangerous self-abortions, such as inserting knitting needles or coat hangers into the vagina and uterus, douching with dangerous solutions such as lye, or swallowing strong drugs or chemicals. All women were subject to the desperation, shame, and fear created by the criminalization of abortion.

I had an illegal abortion, which led to infection, and I was close to death. I ended up in a legal hospital with a real doctor who managed to pull me through. Thank god the pregnancy was terminated. All this rubbish about guilt feelings is just that. Ask me if I would do it again knowing the risks—YES—absolutely. Thank heaven it’s legal now, so women don’t have to endure life-threatening situations.

When I was 15 and pregnant, abortion was illegal. I was denied any choice—I had a baby that I gave up for adoption. This experience has been a driving force in my life. I became an ob‑gyn; I do abortions because I am totally committed to making sure that other women have the options that I didn’t have.

Laws prohibiting abortion took a heavy toll on women’s lives and health. Because many deaths were not officially attributed to unsafe, illegal abortion, it’s impossible to know the exact number. However, thousands of women a year were treated for health complications due to botched, unsanitary, or self-induced abortions; many died, or were left infertile or with chronic illness and pain.

Making Illegal Abortion Safer

Before abortion was legalized, some dedicated and well-trained physicians and other medical practitioners risked imprisonment, fines, and loss of their medical licenses to provide abortions. 28 Through word of mouth, women found out how to obtain abortions. By the 1960s, the Clergy Consultation Service on Abortion, a network of concerned pastors and rabbis, and feminist groups had set up referral services to help women find safer illegal abortions.

In Chicago, a group of trained laywomen called the Abortion Counseling Service of the Chicago Women’s Liberation Union went even further, creating an underground feminist abortion service. The group, whose code name was Jane, provided safe, inexpensive, and supportive illegal abortions. Over a four-year period, the group provided more than 11,000 first- and second-trimester abortions with a safety record comparable to that of today’s legal medical facilities. Laura Kaplan, a former Jane member and the author of The Story of Jane, describes the women involved:

We were ordinary women who, working together, accomplished something extraordinary. Our actions, which we saw as potentially transforming for other women, changed us, too. By taking responsibility, we became responsible. Most of us grew stronger, more self-assured, confident in our own abilities. In picking up the tools of our own liberation, in our case medical instruments, we broke a powerful taboo. That act was terrifying, but it was also exhilarating. We ourselves felt exactly the same powerfulness that we wanted other women to feel.29

Throughout the world, wherever abortion is illegal and unsafe, committed people take enormous risks to provide safe abortions clandestinely, to treat women who have complications, and to help women find safe providers.

Organizing to Change the Law

In the 1960s, inspired by the civil rights and antiwar movements, women organized a women’s liberation movement. They fought, marched, and lobbied to make abortion safe and legal. At speak-outs, women talked publicly for the first time about their illegal abortion experiences. The women’s movement, joined by sympathetic allies within the medical profession, made visible the millions of women who were willing to break the law and risk health and life to obtain an abortion. The movement also connected abortion rights to gender equality.

Between 1967 and 1973, about one-third of states reformed (fourteen) or repealed (four) restrictive abortion laws. Changes included allowing women access to abortion in certain circumstances, such as when the pregnancy was the result of rape or incest. In 1970, New York became the first state to legalize abortion on demand through the twenty-fourth week of pregnancy (Hawaii had earlier legalized abortion through twenty weeks, but only for residents of that state). Two other states (Alaska and Washington) followed, and women who could afford it began flocking to the few places where abortions were legal. Feminist networks offered support, loans, and referrals and fought to keep prices down. But for every woman who managed to get to New York, many others with limited financial resources or mobility still sought illegal abortions.

On January 22, 1973, the U.S. Supreme Court struck down all existing criminal abortion laws in the landmark Roe v. Wade decision. The court found that a woman’s decision to terminate a pregnancy in the first trimester was protected under the “right of privacy . . . founded in the Fourteenth Amendment’s concept of personal liberty.” The court allowed states to place restrictions in the second trimester to protect a woman’s health and in the third trimester to protect a viable fetus. However, the Court held that if a pregnant woman’s life or health were endangered, she would not be forced to continue the pregnancy at any stage.

Legality and Accessibility

The positive impact of Roe v. Wade on women’s health in the United States was enormous. Fatal infections and hemorrhage due to abortion complications mostly became things of the past. However, the court did not secure abortion access for all women. Almost immediately after Roe passed, opponents of abortion rights began mobilizing, though it was not a major political issue for the Republican or Democratic parties as it is today.

Though unable to ban abortion outright, abortion rights opponents, through legislation and subsequent Supreme Court decisions, have created hundreds of state restrictions that make it extremely difficult for many women to obtain abortions. These state restrictions, which include excluding abortion from insurance funding, demanding that teens consult with one or both parents, and creating mandatory waiting periods and counseling sessions, have been devastating for the most vulnerable women: young women; women with low incomes, a disproportionate number of whom are women of color; women who live in rural areas; and women who depend on the government for health care.

Some abortion rights opponents go further in their efforts to impede women from having abortions by blocking access to clinics and harassing and intimidating abortion providers, patients and supporters. Operation Rescue gained notoriety in the 1980s for blockading clinic entrances, which provoked tens of thousands of arrests nationwide. Clinics have also been the targets of bombings, arson, anthrax threats, and acid attacks.

The massive protests and invasions of clinics decreased after Congress passed the Freedom of Access to Clinic Entrances Act (FACE) in 1994, but FACE has not stopped the strategy of harassing individual doctors and their families by picketing their homes, circulating wanted posters with their pictures, publicizing their names online, or participating in direct violent attacks against doctors and clinic staff, including murder. Harassment and violence against providers have led to a sharp decrease in services.

In May 2009, Dr. George Tiller, an abortion provider in Wichita, Kansas, became the latest victim of antiabortion extremists when he was shot and killed in his church. Because Dr. Tiller’s clinic was one of only a handful in the United States known to offer later abortions, including third-trimester care for women with serious health conditions or carrying fetuses with anomalies, he had become the most prominent target of antiabortion extremists in the country. His death inspired much reflection and activism around the words he often proclaimed: “Trust women.”

A health care provider speaks about the impact of the violence:

The fear of violence has become part of the life of every abortion provider in the country. As doctors, we are being warned not to open big envelopes with no return addresses in case a mail bomb is enclosed. I know colleagues who have had their homes picketed and their children threatened. Some wear bullet-proof vests and have remote starters for their cars. Even going to work and facing the disapproving looks from coworkers— isolation and marginalization from colleagues is part of it.

Many physicians continue to provide abortions, despite the difficulties, because they deeply believe in women’s right to choose. Dr. Susan Robinson and Dr. Shelley Sella, two physicians who worked with Dr. Tiller in Wichita, say of their ongoing commitment to providing abortions:

Women have always needed abortions and will always need them. A very few will need abortions late in pregnancy. Rather than empathizing with these women and respecting their difficult decisions, society vilifies them and the providers who care for them. We believe it is a privilege to support women’s decisions, to care for them, and to help turn their desperation into relief. Dr. Tiller believed that kindness, courtesy, justice, love, and respect are the cornerstones of the doctor-patient relationship. He believed that women are capable of struggling with complex ethical problems and arriving at the best decision for themselves and their families. We share this belief. We are proud to continue his legacy.

Excerpted from the 2011 edition of Our Bodies, Ourselves. © 2011, Boston Women's Health Book Collective.


26. Leslie Reagan, When Abortion Was a Crime: Women, Medicine and Law in the United States, 1897–1973 (Berkeley: University of California Press, 1997), pp. 11–12.

27. J. C. Mohr, Abortion in America: The Origins and Evolution of National Policy, 1800–1900 (New York: Oxford University Press, 1978).

28. Carole E. Joffe, Doctors of Conscience: The Struggle to Provide Abortion Before and After Roe v. Wade (Boston: Beacon Press, 1996).

29. “Jane,” “Just Call Jane,” in From Abortion to Reproductive Freedom: Transforming a Movement, ed. Marlene Gerber Fried (Boston: South End Press, 1990), p. 100.


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