Abortion and Contraception
Trigger Warning: Bodily Autonomy, Medical Care, Medical Mortality
Timeline of Abortion Laws in the US – Planned Parenthood
Bullet-Point timeline of events and shifts.
TLDR; Following the formation of the American Medical Association in 1847, scrutiny of the skilled, largely female field of reproductive healthcare workers took place and the AMA asserted itself as the (male dominated) authority on what procedures could be conducted and by whom. Stigma grew and peaked in 1910, when abortion was illegal at every stage of pregnancy, in almost every case, in every state. Unsafe abortion was the cause of death for almost one out of every five recorded maternal deaths in 1930. Abortion Law reform was called for in 1955 due to the media coverage of termination-related mortality rates, led by some Chicago-based publications.
​
​
History of Abortion in the US – The Atlantic
A more narrative form of the culture and events surrounding abortion in the US.
​
TLDR;
-
Abortion was largely legal before “quickening” (about the fourth month of pregnancy) until about 1870.
-
17th-19th century, home guides for herbs and commercial drugs were largely available – but often fatal
-
Early 19th Century, the first “abortion” laws were closer to that of poison control. For example, terminating pregnancy was not illegal, but the sale of certain abortive drugs were. Even so, the sale of these drugs still boomed through the 19th Century.
-
Abortion in communities of color and immigrant communities was a fundamentally different conversation in the early 20th century, because the largely white, male medical field held anxieties about the birth rates of white, Protestant women being surpassed by women of other groups.
-
During the Great Depression, abortion rates surged and clinics filled with access to abortion care weren’t uncommon. Community funds were also not uncommon for women who needed the service.
-
In the 40’s and 50’s, organized medicine and law shut down these clinics, clubs, and organizations, disrupting access to the safer and more community supported birth control services. Doctors were prosecuted for carrying out abortions, and less medically-experienced practitioners became the only options for most women
-
Abortion in this time became the secretive, dangerous, back-door operation that we’re more familiar with when it comes to unsafe and illegal abortions.
-
Well connected white women, though, still had access to “therapeutic” abortions, a category that remained legal if nebulously defined.
​
https://www.theatlantic.com/magazine/archive/1997/05/abortion-in-american-history/376851/
​
Medical Morbidity and Abortion
Methods behind and mortality rates of unsafe abortions
​
TLDR;
-
When abortion is legalized, the mortality rate of those terminating a pregnancy plummets because of the medical care (and follow-up) that’s criminalized
-
Most common cause of mortality was sepsis from the use of nonsterile instruments in the vagina and uterine cavity.
-
The effects of poor medical practice exacerbated by women not seeking medical care out of fear that their procedure would be discovered and reported to authorities, or offering spontaneous miscarriage as a reason behind their injuries, resulting in improper care.
Methods of Unsafe Abortions
-
Excessive cold on the abdomen was a popular at-home method, leading to hypothermia in some cases.
-
Improper use of medication (like sleeping pills) were another, often fatal method at-home method.
-
Excessive heat (often causing other complications/burns)
-
Air embolisms (air pockets created in vascular [blood] pathways, but specifically in uterine pathways in this case) and vaginal enemas were other methods that often caused fatal complications.
-
Most common forms of unsafe abortions seem to be Chemical (ingested drugs or vaginal enemas), Instrument (insertion of items to physically remove or damage the fetus to the point of miscarriage), Air Embolisms (creating air pockets or forcing air into the uterus to the point of termination)
Women of Color and Immigrant Communities
-
“As Karissa Haugeberg, a historian of women and medicine at Tulane, explained to me, women of color, immigrant women, or even those new to town, such as young women in college, were the most vulnerable because they did not know the trusted networks. “There have always been very brave physicians and nurses who have stepped up and performed illegal abortions safely and ethically,” Haugeberg said. “The problem is, when it’s illegal, a vast entrepreneurial class rises to fill the vacuum.”
​
https://www.nejm.org/doi/full/10.1056/NEJMp1910010
Timeline of Contraception
Bullet-point events and shifts related to contraception in the US
​
TLDR:
-
In 1930, birth control is accepted (with limitations) by most Protestant denominations, but still staunchly opposed by the Catholic Church
-
Laws expressly against the use possession of birth control products are starting to disappear (though not entirely gone from some states).
-
Many states still have laws against the sale or advertisement (or advised use) of birth control.
-
In the 40’s and 50’s, condoms become more reliable and popular. People are becoming more aware that other popular forms, like commercial douches, rhythm method, are less effective. Diaphragms are one of the more effective forms, but are expensive and require doctor’s consent.
-
Work towards the Pill is starting to receive approval and funding, though not commercially available.
​
pbs.org/wgbh/americanexperience/features/pill-timeline/