An illegal abortion is an abortion which is performed implicitly or explicitly contrary to the law.
In the United States, since the famous decision of Roe v. Wade, abortion has been legal. However, many states have began to enact mandates and laws on a local level to prevent abortion. In some states, abortion is illegal after certain time periods, such as Nebraska, and in others, such as Oklahoma, mothers are required to see certain information before they can receive an abortion.
Pro-choice advocates argue that part of the reason abortions should be made legal is to allow for pregnant women to terminate their pregnancies in safe conditions. This, however, is not a valid basis for legalizing abortions. Abortion is murder, and thus it is illogical to provide the killers of unborn children with a safe place to do it in.
The Illegal Abortion Era in the United States
The pre-legalization era is typically painted by pro-choice advocates as a time of horror and death, as we can see in this example of abortion-advocacy writing:
ABORTION WAS criminalized throughout the U.S. between the late 1800s and 1973. But during that time, millions of women sought and obtained abortions anyway.
Of these, tens upon tens of thousands died from illegal abortions or complications arising from them. One 1932 study estimated that illegal abortions or complications from them were the cause of death for 15,000 women each year. Current, more conservative, estimates of the death toll still stand at between 5,000 and 10,000 deaths per year.
These gruesome tales stress two unquestioned assumptions: that pre-legalization abortion was the work of filthy, untrained "back-alley butchers", and that the death toll among the women seeking their services was staggering.
Illegal Abortion Practitioners
Mary Claderone (then Medical Director of Planned Parenthood) and Nancy Howell Lee (a pro choice researcher) both investigated the practice of criminal abortion in the pre-legalization era. Calderone estimated that "90% of all illegal abortions are presently (1960 - ed) being done by physicians." Calderone further estimated that 8% were self-induced and that 2% were induced by someone other than the woman or a doctor. Lee estimated that 89% of pre-legalization abortions were done by physicians, an additional 5% by nurses or others with some medical training, and 6% were done by non-medical persons or the woman herself.
Calderone's numbers came from "43 men and women from the various disciplines of obstetrics, psychiatry, public health, sociology, forensic medicine, and law and demography." Lee interviewed women who had undergone pre-legalization abortions. The discrepancy between Lee's and Calderone's breakdowns of non-physician abortions is probably due to sampling errors.
Lee, who spoke with women who survived abortions, would of course not encounter women whose abortions killed them. Therefore, she would not potentially be exposed to the proportionate number of women who chose the most dangerous alternative. Lee's sample also included only willing survey participants, who would be more forthright and complete in divulging information, such as who really performed the abortion, than women being interviewed by health or law enforcement officials.
Calderone, on the other hand, spoke with those likely to see the botched and fatal abortions, and therefore they would be exposed to a higher percentage of the most dangerous, self-induced abortions. Also, Calderone's informants would have been investigating botched abortions that could be subject to a criminal investigation. Therefore, women speaking to them would be likely to withhold the true identity of their abortionists to protect them. Also, should the woman die, her family and friends might identify the woman herself as the abortionist, rather than admit their own roles in arranging or performing abortions, in order to close the investigation.
Anecdotal data tends to support Lee's research. Stories of abortions by midwives, orderlies, chiropractors, and assorted trained lay practitioners like Harvey Karman and the Jane Syndicate are far too common to represent only 2% of criminal abortions. We would probably not err too far if we relied primarily on Lee's numbers and adjusted them slightly to reflect the slight under-reporting of amateur abortions. Thus, a fair estimate of the breakdown of criminal abortions would probably look like this:
90% performed by physicians 5% performed by trained non-physicians (medical and lay) 3% performed by an untrained accomplice 2% performed by the woman herself
What did these look like in practice? There were physicians who ran abortion mills, physicians who did selected abortions on their own patients, physicians who worked patients in through loopholes in the law. In addition to the physician abortionist, there were the professional non-physicians, often operating with training, equipment, medications, and back-up provided by physicians.
This is the rough profile of who was performing abortions, and how women arranged them. Where, then, does the image of the coat hanger come in?
Lee's interviews with women who had self-aborted found a different picture from the women who had sought professional (however illegal) abortions. These self-aborting women tended to be less rational, and more self-destructive, than the women seeking competent abortionists. Lee also found that the women attempting self-abortion were likely to have had a death wish at the time of the abortion.
This finding is in keeping with psychiatric literature of the time, which treats self-induced abortion as a peculiar manifestation of the self-mutilating behavior common in patients with certain psychiatric disorders. Self-mutilation in patients with these disorders can range from superficial cuts and cigarette burns to self-trepanning (drilling holes in the skull), enoculation (gouging the eyes out), and amputation of limbs.
Mutilation of the genitals is not rare in these patients, and self-induced abortion was often regarded as an extreme form of genital mutilation aimed at attacking the patient's own femininity. It was in the political context, not the psychiatric or psychological context, that self-induced abortions were considered to be the expected behavior of normal women. This politicized view of self-aborting women eclipsed the reality, and case studies stopped showing up in the literature, although occasional stories still do make it into the newspaper.
This is not to say that all women who self-induce abortions are mentally ill. Investigators of post-Roe self-induced abortion injuries and deaths found other factors, such as distrust of the medical profession, a perception of home herbal abortion as more "natural," cultural preferences, and "ideosyncratic" factors nobody could readily explain. These women, however, carefully research abortion methods and use common sense and intelligence to select a method likely to be efficacious and comparatively safe.
Illegal Abortion Mortality
Claims that tens of thousands of women lost their lives annually from criminal abortion persist to this day.
The original source of the claim that 5,000 - 10,000 women died from criminal abortions annually in the US was a book -- Abortion, Spontaneous and Induced—published in 1936 by Dr. Frederick Taussig, a leading proponent of legalization of abortion. Taussig calculated an urban abortion rate based on records of a New York City birth control clinic, and a rural abortion rate based on some numbers given to him by some doctors in Iowa. He took a guess at a mortality rate, multiplied by his strangely generated estimate of how many criminal abortions were taking place, and published his numbers.
Even if Taussig's calculations, by some mathematical miracle, had been correct, they still would have been out of date by the end of WWII. Antibiotics and blood transfusions changed the face of medicine. But not only are the Taussig numbers dated, they were never accurate to begin with. At a conference in 1942, Taussig himself apologized for using "the wildest estimates" to generate a bogus number.
Although it took Taussig six years to reject his own faulty calculations, at least he did admit that he'd been wrong. Other abortion enthusiasts lacked Taussig's compunctions. Bernard Nathanson, co-founder of NARAL, admitted that he and his associates knew that the claims of 5,000 to 10,000 criminal abortion deaths were false:
How many deaths were we talking about when abortion was illegal? In N.A.R.A.L. we generally emphasized the drama of the individual case, not the mass statistics, but when we spoke of the latter it was always "5,000 to 10,000 deaths a year." I confess that I knew the figures were totally false, and I suppose the others did too if they stopped to think of it. But in the “morality” of the revolution, it was a useful figure, widely accepted, so why go out of our way to correct it with honest statistics. The overriding concern was to get the laws eliminated, and anything within reason which had to be done was permissible.
How many criminal abortion deaths were there, then? An excellent question, and a tricky one to answer. Before the Centers for Disease Control began Abortion Surveillance Activities in 1968, and began looking at abortion mortality in earnest in 1972, all abortion deaths were typically counted together: legal (or "therapeutic"), illegal, and spontaneous (miscarriage). However, even without the CDC's intervention, public health officials were watching maternal mortality in general, and abortion mortality in particular, very carefully. After all, abortion itself was a crime, and an abortion in which the mother died could well result in a homicide investigation. This was not petty crime; the police, coroners, funeral directors, and hospital administrators were very attentive to possible criminal abortion deaths.
Peer-reviewed articles published in the decades before Roe gave varied estimates of the number of abortion deaths annually. One study determined that there were approximately 1.3 criminal abortion deaths per year in Minnesota from 1950 through 1965. Commentary on that study pointed out that if researchers combined known criminal abortion deaths with suspected criminal abortion deaths, 4.4 women were dying from criminal abortions per year in Tennessee from 1955 through 1965. A study in California reported 30 total abortion deaths per year during a period studied from 1957 through 1965, and as many as 87% of those abortion deaths were due to criminal abortions. This meant a maximum death rate in California of 26 women per year during that period.
But what can that tell us about mortality nationwide? In 1975 (the first year for which complete numbers are available), Minnesota reported roughly 1.6% of all legal abortions, Tennessee reported about 1.7%, and California about 22%. It is reasonable to assume that the proportion of illegal abortions in each state before legalization would be similar to the proportion of legal abortions in each state after Roe. If each of those states had been representative of the nation at large, that would put the national death rate at 78, 225, and 104, respectively. If we combine the totals, we find 31.7 criminal abortion deaths per year in three states, which represented roughly 26% of abortion deaths. This would mean approximately 123 criminal abortion deaths annually in the decades just before Roe.
Are these numbers realistic at all? Mary Calderone, who was then Medical Director of Planned Parenthood, reported on a conference studying abortion in America. She indicated that in 1957, there were 260 abortion deaths nationwide. That number included all abortions: legal, illegal, and spontaneous. The calculations based on state maternal mortality investigations are fairly close to Calderone's numbers based on national data. These numbers were based on alerting doctors, law enforcement, coroners, and hospital administrators, along with public records officials, of their responsibility to report these deaths. Taussig's estimates of 5,000 to 10,000 deaths would have meant that Minnesota authorities should have found 80 to 160 deaths per year when all their efforts could only find one or two. Tennessee should have been finding 85 to 170, rather than 4 or 5. And California should have been finding 1100 to 2200, rather than roughly 26.
So the final numbers generated by researchers are likely accurate enough for public policy purposes, and they indicate the following mortality from all induced abortions in the United States, both illegal and legal:
- "An era of tragedy for women When abortion was illegal", Socialist Worker, October 21, 2005
- Mary Calderone, "Illegal abortion as a public health issue," American Journal of Public Health, July 1960
- Nancy Howell Lee, The Search for an Abortionist, University of Chicago Press, 1969
- Dear Dr. Spencer: Abortion in a Small Town"
- "The Impact of Illegal Abortion" from Abortoin Access Project
- "A Primer on 'Abortion Distortion'", National Right to Life Committee
- Daniel Callahan, Abortion: Law, Choice, and Morality (New York: Macmillan, 1970)
- Alex Barno, "Criminal abortion deaths, illegitimate pregnancy deaths, and suicides in pregnancy: Minnesota, 1950-1965," American Journal of Obstetrics and Gynecology, June 1, 1967
- Leon Fox, "Abortion deaths in California," American Journal of Obstetrics and Gynecology, July 1, 1967
- Abortion Surveillance -- United States -- 1975, Centers for Disease Control
- Mary Calderone, "Illegal abortion as a public health issue," American Journal of Public Health, July 1960
- Induced termination of pregnancy before and after Roe v. Wade" Journal of the American Medical Association, 12/9/92, vol. 208, no. 22, p. 3231-3239