Birth Control & Abortion

Introduction                                                                                              

            It is difficult to know where to begin discussion of the when life begins.  Abortion, contraception, infanticide and the basic question of when a bundle of cells become a living being overlap historically, theologically, philosophically and practically leaving us wondering what the right thing, the moral thing, the godly thing is to do when it comes to understanding and especially, controlling, the creation of life. 

In American culture, fundamentalists and even those who are more tolerant and more open turn to the Bible.  For them, scripture is viewed as the guide to answers pertaining to moral ambiguity.  So, problem solved.  We simply need to turn to the Bible and look in the index to see what it says about abortion and contraception and find our answers.  Unfortunately, for those looking for quick and easy answers the Bible is open to wide avenues of interpretation and many times, frustratingly vague.

Even the seemingly unassailable admonition against killing in the Ten Commandments is open to semantics.  Understood as “Thou shall not kill”[1] in the King James Version of the Bible the actual Hebrew wording of  לא תרצח (lo tirtzach) is frequently translated as "thou shalt not murder".  And murder can carry a very different connotation than to kill. 

It goes even farther than a linguistic or semantic debate.  On the one hand, “Thou shalt not kill/murder” seems at first blush an ironclad answer to the issue of taking a life.  The Bible contains much more than ten seemingly clear-cut statements regarding our behavior.  From the very beginning of the history of mankind, the taking of life has been an issue. Cain took the life of his brother Abel out of frustration and jealousy, implying malice of forethought and God punished him for his misdeed.  Cain’s killing of Abel was clearly murder and God clearly disapproved as Cain was banished from his home.  But ensuing events are not so clear.  There are numerous examples of the taking of life in which God’s approval is open to interpretation.  God seemingly approved of the Jews killing their enemies.  Also, there is the question of intentional versus accidental taking of life.  These issues can become morally murky.  With the basic issue of the rights and wrongs being so debatable in terms of morality with living individuals, the question intensifies by an order of magnitude when it comes to life that is yet unborn. Does murder or killing apply to a fetus?  The only reference to a fetus in the Old Testament appears in Exodus 21:22-24, which following the Greek translation of the Septuagint, reads as follows:

If two men are fighting and hit a pregnant woman, and her child comes out unformed, he must pay compensation, according to the demands of the woman’s husband, after an estimate, but if it was formed, he must give a soul for a soul, an eye for an eye, a tooth for a tooth…”[2]

In the Hebrew original and the Vulgate abortion is not treated as a murder. Rather, it is treated more along the lines of a property crime.  In the Latin Vulgate abortion and the killing of a living person are two distinctly different animals. “Abortion” in this sense is punishable by a fine and homicide punishable by death (Kapparis 2002, 47-48).

            But aside from two men having a brawls that leads to a woman miscarrying, there is no discussion in the Bible of the ethics of birth control (whether that take the form of contraception, abortion or infanticide) and so that may lead many to believe that these matters are modern problems for people living in a technologically advanced post-modern world.

In fact, there is a prevalent myth that birth control technology came to us with modern medicine but in truth abortion and contraception practices can be found in the written and physical record of numerous cultures, practiced by the members of the most primitive of societies, and documented in the most ancient of texts. 

 

 

Infanticide

Perhaps the earliest efforts at controlling fertility took the form of infanticide.  Noted anthropologist Joseph Birdsell theorized that during the Paleolithic and Neolithic eras between 15% and 50% of the total number of births resulted in infanticide (Birdsell 1986, 239).  Anthropologist Ralph Linton argued that infanticide met the needs of primitive groups more efficiently than contraception because it allowed the society be certain of the sex of the child, ensure the exact spacing of children and achieve both of these things without physical damage to the mother (Himes 1936).

In early nomadic civilizations women frequently practiced contraception in order to increase their chances of survival.  It was far easier to avoid pregnancy than to resort to abortion or infanticide.  Because small family units could pack up and move in search of better hunting grounds and richer pastures women who were able to stagger their pregnancies and time them to coincide with travel through inhospitable lands were not only more likely to stay alive themselves but were more capable of providing enough for the children they already had.  In the event that a woman became pregnant and carried the pregnancy to full term, the outcome of the pregnancy remained uncertain until the sex of the child could be established.  In primitive societies from ancient times girls were considered burdensome and were far more likely to be killed than boys (Gordon 2002, 15).

This fertility model was vastly different among sedentary agricultural civilizations.  In sedentary, as opposed to nomadic, societies where children contributed more to the economic development and resources of a homestead than they consumed, they were seen as assets rather than burdens.  Further, because the high infant mortality rates of most civilizations prior to the 20^th century meant that a woman was as likely to lose some of her children in infancy as she was to see them live to adulthood meant that they had to give birth to more children than the family needed.  Because of this dynamic, agricultural societies often produced ideologies that entirely banned birth control and stigmatized women who attempted to limit their fertility (Gordon 2002, 8). 

However, this is not to say that the practice of infanticide was only found among primitive nomadic societies.  In Greek society infanticide was not only not considered murder, rather it was a legal and respectable utilitarian practice.  In modern right to life arguments the fetus is as much a living being as a newborn baby but in Greek society the newborn was no more a living being than the fetus and if the child posed a risk to the family’s economic and physical stability it would not be allowed to live (Gordon 2002, 15).  Both Aristotle and Plato advocated infanticide for eugenic reasons (Malthus 1993).  It was considered an act of compassion to practice infanticide when infants were born with severe deformities or disabilities. 

The Romans differed from the Greeks in their view of infanticide in that they legislated against the practice.  However, not for theological, moral or ethical reasons but rather, arguably, because they were desperate to expand their empire and they simply needed the numbers. Whereas, the Greeks tried to limit their population so as not to tax the resources of the Greek archipelago (Gordon 2002, 15). 

 

 

Abortion & Contraception

One contraceptive/abortive method employed by the Greeks and later the Romans was the ingestion of Silphium.  It was the ancient city of Cyrene’s most lucrative export and its image was synonymous with the wealth and power of the city-state.  The plant was so highly sought after that it was literally worth its weight in silver, and a cup from around 560 B.C. shows a Cyrenean king overseeing the weighing of bales of Silphium (Rose 2005, 18).  From the 7^th century BCE until early into the first millennium, Silphium was so valued as a commodity that it is considered to be the first plant species ever recorded as being overharvested to the point of extinction (Parejko 2003, 925).  

In the first century CE physician and pharmacologist Dioscorides described the use of Silphium for pregnancy prevention in his De Materia Medica (Riddle 1994, 31).   Soranus of Ephesus, the second century physician, wrote about the contraceptive and abortifacient properties of Silphium describing how steeping the leaves of the giant fennel and drinking a tea helped to either inhibit ovulation in a woman or serve as an early term abortifacient (Riddle 1994, 25-30).[3] 

Even though the Romans legislated against infanticide it appears there were only rare cases of it being prosecuted.  Tacitus (circa 56-120 AD), the Roman senator and historian, remarked with curiosity at what he perceived to be the questionable judgment of the Jews for not practicing infanticide, writing, "They regard it as a crime to kill any late-born children" (Tacitus 1931).  The Jewish Historian Josephus wrote in the first century, “God forbids women to cause abortion of what is begotten, or to destroy it afterward," (Josephus 1976).

In the first century of the Common Era the Didache, which translates from Koine Greek as “The Teaching of the Twelve Apostles” was written. It is believed to be the oldest surviving written catechism and has three main sections dealing with Christian ethics detailing rituals such as baptism and Eucharist, and Church organization.  Because of the importance placed on the act of baptism for salvation an ideological shift regarding infanticide took place.  It was considered a heinous crime to abort a late-term fetus or kill an infant before the child had been baptized because that child’s eternal soul was considered lost (Blanchard 1994, 14).  Thus, among Christian Romans it was believed that to kill a grown adult was less of a sin than to kill an infant who had not yet had the chance to be “saved”(Gordon 2002, 15). 

 

Early Christian Thought

By the 2^nd century CE several theologians, including Clement of Alexandria, Athenagoras, Turtullian and Cyprian wrote about extending the sinful nature of infanticide to cover the killing of life in the womb.  By the 4^th century CE theologians Jerome and Augustine of Hippo wrote specifically about the evils of inducing abortion.  However, neither the Bible nor the Torah explicitly forbade the act of abortion nor did Jesus explicitly speak about abortion anywhere in the Gospels (Luo 2005, 1-3).  The basis for Augustine’s argument against the practice of abortion stemmed from the Christian stance on the nature of sex.  Christianity promoted celibacy as the ideal but if Christians stopped propagating then the future of the survival of the church would be in jeopardy.[4] 

As it would have been unrealistic to expect lifelong celibacy from all Christians, Augustine revised Christian teaching to allow for sexual intercourse in marriage and marriage only.  However, because celibacy was still the ideal, those who engaged in sexual intercourse in marriage were to do so not for pleasure but for the purpose of procreation.  Therefore, to abort a fetus was defeating the purpose of sex and undermining the special exception the church had made to allow for intercourse (Pence 2008, 79). 

 

Medieval Christian Thought

By the twelfth century the definition of what exactly constituted abortion was further developed to distinguish between the “formed” and the “unformed” embryo.  The form of the embryo did not refer to the physical development of the fetus as much as it referred to the point at which God ensouled the fetus.  In the thirteenth century St. Thomas Aquinas held that God ensouled a male embryo at 40 days of gestation and a female embryo at 90 days.  But how was a person to know when 40 days had passed and ensoulment had actually taken place?  Most Catholic theologians believed that “ensoulment” occurred at the time of the “quickening” or the moment at which the women could first feel movement in her belly (Blanchard 1994, 11).

In the Holy Roman Empire and throughout the Middle Ages in Europe abortion before and after the “quickening” was not recorded.  The practice of infanticide was religiously condemned but not prosecuted and infanticide by exposure was frequently documented owing to the physical evidence (Gordon 2002, 15).[5] 

From the late fifteenth century on the Church’s teaching generally allowed for abortion as long as it was before the quickening or to save the mother’s life, owing to the doctrine of double effect.[6]  Pope Gregory XIII, who occupied the Holy See from 1572-1585, allowed for abortion during the first 40 days of the pregnancy under extreme circumstances. However, his successor Pope Sixtus V said there was no difference between an animated and unanimated fetus and in response issued a papal bull, Effraenatam ("Without Restraint"), in 1588 which declared that the canonical penalty of excommunication would be levied for any form of contraception and for abortions at any stage in fetal development.  However, his successor Pope Gregory XIV overturned the papal bull in 1591 and punished only those who aborted after the 80^th day of gestation with excommunication.  By the 18^th century Catholic theologian Sanchez elaborated on this teaching by arguing that abortion was acceptable in cases of rape or in cases in which a single woman became pregnant out of wedlock while betrothed to another and was at risk of being killed by her family for dishonoring them (Blanchard 1994, 11).

 

Forms of Abortion & Contraception

Regardless of theological and legal prohibitions against contraception and abortion throughout Christendom, from the first century to the 18^th century evidence suggests that the following methods of contraception and abortion we practiced quite widely and without criminal prosecution:

• Infanticide
• Abortion
• Sterilization
• Withdrawal during intercourse[7]
• Suppositories designed to coat the cervix and create a barrier (a.k.a. pessaries)
•  
• Diaphragms
• Caps or other devices to block the cervix that could be removed after intercourse[8]

 

• Intrauterine devices
• Internal medicines (potions and pills)
• Douching (cleanses to kill sperm)[9]
• Condoms[10]
• Various sexual rhythm methods

 

17^th Century

            The earliest documented incident in Colonial America of a court case concerning abortion dates to 1652 in Maryland.  Susanna Warren was a 21-year-old widow who became romantically involved with a “prominent citizen” named Captain William Mitchell who had a wife in London.  When Susanna Warren informed Captain Mitchell that she was pregnant with his child after she experienced the “quickening” he allegedly prepared a “potion of phisick” overnight and in the morning told her to go and prepare a poached egg for him.  He then injected the poached egg with the potion of phisick and told her to eat it presumably so that the potion of phisick, which is a powerful emetic, would cause her to miscarry.  When she refused he forced it down her throat and then told his housekeeper that they were both sick and should be left alone in the bedroom for the next three days (Browne 1891, 175-177).  Susanna Warren subsequently delivered a stillborn child and brought criminal charges against Captain Mitchell for inducing the abortion.  Captain Mitchell pled guilty and waived a jury trial.  His punishment was to pay a heavy fine but he was not sentenced to hard labor or jail time (Riddle 1994, 209). 

            The fact that Susanna Warren brought suit against Captain Williams indicates that she was aware that it was against common law to induce an abortion after the quickening and the fact that Captain Williams was only punished with a monetary fine indicates that the courts found the termination of a pregnancy after quickening to be illegal but did not view the fetus as a life, because if they had the loss of it would have merited a sentence of hard labor, prison or death. 

 

18^th Century

In America during the 18^th and 19^th centuries the term abortion was strictly used to refer to the termination of pregnancy after the “quickening”, which was generally felt around the fourth month after conception.  What we would now refer to as an early induced abortion was referred to frequently in letters of the day as either the pregnancy having “slipped away” or “menses being restored” (Reagan 1997, 8).

Colonial women were known to take savin, a sap derived from the juniper plant, which grew wild throughout North America, in a tea or as medicine to induce abortion.  The African American slave population was known to utilize cotton root to induce early labor that would most likely result in the loss of the pregnancy.  Other less popular, but still well known herbal abortifacients included pennyroyal, tansy, ergot and Seneca snakeroot (Reagan 1997, 9).

By the mid-eighteenth century the most common means of inducing abortion was by taking some sort of pill or elixir.  Early induced abortion was so well known in Colonial America that the popular euphemism “taking the trade” was coined and often used in letters between women to describe the practice[11] (Hughes 1991, 24-25). 

An exception to the general trend of taking herbal or medicinal supplements to limit fertility during this time were the Pennsylvania Quakers who actively taught the married couples among their ranks to “limit carnal desire” and practice abstinence within marriage as much as possible.  As a result of this theological teaching the Quakers were able to drastically reduce their fertility (Reed 1995, 23).

 

The 19^th Century

There were no documented social movements to justify or promote contraception or abortion before the 19^th century (Reed 1995, 23).  At the dawn of the 19^th century United States laws regarding abortion were almost identical to British Common Law, which assessed life at the “quickening” and were based on centuries old Christian theology.  This is to say that abortion after the “quickening” of the fetus was understood by the populace to be morally wrong, theoretically punishable, but not necessarily a prosecutable offense. [12]   This ambiguity existed because there was no way to prove when the “quickening” had occurred. However, in 1821 Connecticut changed this by becoming the first state in the Union to pass a law banning abortion as a criminal offense.  Interestingly, the motivation for this law was not to protect the life of the fetus but rather to protect the mother.  During this period it was common for women to ingest abortifacient potions and pills sold by “snake oil salesman” and medical charlatans.  These elixirs and tonics frequently had permanently disabling or fatal consequences and legislators sought to put a stop to this practice as a matter of public health reform.

Just seven years later in 1828 New York State became the first to permit abortion after the “quickening” in order to save the woman’s life.  The law required that two physicians agree that the woman’s life depended on it before the abortion could be performed (Mohr 1978, 25-26).

Beginning in the 1830s in the United States groups located in intellectual communities in New England that focused on social reform began arguing that family limitation would help the poor by limiting the labor supply and easing the burdens of the overtaxed parents (Reed 1995, 24).  This notion gained some traction in urban centers where children were more of an economic burden than a help but failed to gain much momentum in rural areas.

By 1841 ten states had passed laws regulating abortion as a means to safeguard women’s health rather than to punish them for perceived immoral behavior (Blanchard 1994, 12).  Documents from 1800 to 1910 indicate that the majority of reported abortions were performed on single women rather than married women trying to limit their families. However this statistic would be challenged by the American Medical Association in the years to come.

In 1847 the American Medical Association (AMA) was founded with the aim of creating a political and economic lobby of physicians that would regulate the quality of education and training of medical professionals and establish medical doctors, i.e. people with medical degrees, as the industry standard.  One of the first of the AMA’s goals was to make it illegal for non-physicians, especially midwives, to perform abortions.[13]

 

Midwives

            Prior to the 19^th century female health, birth control, labor and delivery and abortion had been the exclusive domain of the midwife.  Midwives are mentioned in the Old Testament in Exodus, Chapter 1. The Bible describes how the enslaved Israelites numbers multiplied greatly and the rising Jewish population in Egypt frightened the Pharaoh.  Fearful of a potential uprising the Pharaoh commanded the Hebrew midwives Shiphrah and Puah to kill all male children at birth. The midwives, however, "feared God" and disobeyed Pharaoh by allowing the male babies to live. When Pharaoh asked the midwives why they had disobeyed his orders, the midwives told him the Hebrew women had easier labors than Egyptian women and delivered their babies before the midwife arrived. "And God dealt well with the midwives" (Exodus, Chap. 1, verse 20).

            In ancient Egyptian culture midwifery was a recognized female occupation, as documented in the Ebers Papyrus, which dates from 1900 to 1550 BCE. The Westcar Papyris, dated to 1700 BCE, includes instructions for calculating the expected date of confinement and describes different styles of birth chairs. Bas reliefs in the royal birth rooms at Luxor and other temples also attest to the heavy presence of midwifery in this culture (Towler and Bramall 1986, 9).

            In ancient Rome abortionists were called sagae which translated from old the old French Gaulic term sage-femme or midwife (Gordon 2002, 18).  In medieval Europe men were banned from the birthing chamber as it was the exclusive territory of the midwife.  In fifteenth century Belgium a man was fined for hiding behind the stairs to peek in on his wife giving birth.[14]  In the harem of the Sultan of Turkey the official abortionist was one of the Sultan’s own wives but was referred to as the “bloody midwife” as it was her job to regulate the numbers of the household (Gordon 2002, 18). 

            Midwives and not physicians served as supervisors of the labor and delivery process in the American colonies and young nation and by the 1840s the abortion business was booming.  Despite laws forbidding the sale of abortifacients, pills and potions that promised to end a pregnancy were openly advertised in the press and available from pharmacists, some physicians and through the mail.  If a woman could not chemically induce an early abortion then she could go to a practitioner who specialized in performing instrumental abortions (Reagan 1997, 10).  Perhaps the most famous of the abortionists was Madame Restell.

 

Madame Restell

            Madame Restell was the most widely known abortionist of her day, openly advertising her services for over 35 years.  Before she was known as Madame Restell she was Ann Trow, born in Gloucestershire, England in 1812.  She was married by the age of 16, immigrated to the United States by the age of 19 and was widowed by the time she turned 20.  Without a husband to support her Ann took a job as a seamstress and eventually remarried a German-Russian immigrant named Charles Lohman.  Ann’s brother Joseph Trow immigrated to New York and found work as a sales clerk in a pharmacy.  Through a partnership with her husband and brother she was able to develop an extensive knowledge of women’s health and before long the Ann, her brother and her husband began developing and marketing birth control products and selling them under the brand name “Madame Restell”.  Madame Restell’s main product was her abortifacient pills, which were mostly herbal supplements with a “dash of opium.” (Carlson 2009, 117) In the event that her pills failed to result in a miscarriage Madame Restell offered a procedure in her offices, charging $20 for poor women, and as much as $100 as she began to service a more wealthy clientele. She also boarded pregnant ladies, delivered babies, placed infants for adoption and conducted sex education classes (Manning 2009).  Before long “Restellism” became a euphemism for abortion (Carlson 2009, 116). 

            By the late 1830s Madame Restell was quickly establishing herself as the leading abortionist in New York City.  But the mid-1840s she had franchised and had offices in Boston, Philadelphia, and Providence and traveling salesmen who sold her “Female Monthly Pills”.  By the late 1840s she was arguably the most famous abortionist in the country.  Her husband even became a popular abortionist in his own right, taking on the name “Dr. Mauriceau”, to appeal to Francophiles and wealthy clientele who saw the French attitudes towards abortion and open sexual boundaries as being more progressive than the those held in the United States.[15]

            The American Medical Association did not approve of her or her methods and saw her philosophy and business practices to be a threat to the hegemony that physicians were trying to achieve.  The fact that Madame Restell did not have a medical degree nor any formal education for that matter the nature of her clientele was deeply troubling to the leaders of the American Medical Association.  They were primarily married, white, native-born Protestant women of the upper and middle classes. 

            By 1840 there was a decline in the US birthrate, in fact between 1810 and 1890 the birth rate was cut in half.  But by 1850, about the time that the American Medical Association was gaining power and Madame Restell was at the peak of her career, an economic and sociologic shift was taking place.  More and more middle and upper class married white women were being employed outside of the home in wage-earning positions (Blanchard 1994, 14).  As more middle and upper class white Anglo-Saxon Protestant (WASP) women found professional work as secretaries and teachers, which brought them more personal and economic independence, they began having fewer children and birthrates among WASPs dropped dramatically.   At the same time large numbers of Irish, Italian and other non-WASP groups were immigrating to the United States and many WASP men in positions of power, particularly in the American Medical Association, saw abortion among WASP women as a threat to the cultural survival.

            The Lohmans, better known to the public at this time as Madame Restell and Dr. Mauriceau, became New York celebrities.  The press delighted in describing her wardrobe, dresses of silk and velvet, her hat with its red feather, and the couple’s ostentatious five-story brownstone mansion they built in 1862 on the corner of Fifth Avenue and 52nd Street (Gray 2013).  The New York Herald, The National Police Gazette and The Polyanthos called her a “hag of misery,” “a modern Thug of civilized society,” and the lady of “the death’s head and the marrow bones.”   In 1846 anti-abortion activists, led by newspaper publisher George Dixon, organized a riot to protest her “shameless and sinful ways” (Cockrell 1997, 128). The mob surrounded the Lohman’s mansion and chanted, “Hanging’s too good for her!” and “This house is built on babies’ skulls.” (Manning 2009)

            Zealous prosecutors urged on by prominent members of the American Medical Association and wealthy conservative political leaders pursued Lohman almost from the start of her career.  From 1839 to 1877 Lohman was arrested at least five times and jailed for months without bail. She spent countless hours and dollars defending herself against charges and rumors.  One of the most popular rumors was that a sewer had been built between her house and the Hudson River, to dispose of corpses and that she was responsible for the unsolved murder of a cigar girl, a case that Edgar Allan Poe used as the basis for a story, “The Mystery of Marie Rogêt”.[16] 

Madame Restell was arrested on March 22, 1841 and charged with two misdemeanors for performing abortive procedures on Anna Maria Purdy, a young married woman in Newark, on June 2^nd and July 22^nd of 1840.  Mrs. Purdy died the following April from what her husband alleged were complications resulting from the botched abortion in June of 1840.    At the trial the prosecutor said:

“…within a year Madame Restell has procured several hundred abortions; she has committed several hundred crimes, punishable by the laws of man, and condemned by the law of God.  We do not say so, she says it herself.  Preventative powders?  There is no such thing in nature.  There is but one preventative, which is abstinence.  The law of nature, instinct, the canons of the church, the laws of the land, all clearly define the ends and objects of the   marriage vow – the promotion of happiness and procreation of children.  This unprincipled creature knows better than God or man how married people ought to behave!”[17] 

           

Madame Restell was found guilty at trial on July 20, 1841 and George Washington Dixon celebrated the conviction in his newspaper “The Polyanthos” writing, "the monster in human shape . . . has . . . been convicted of one of the most hellish acts ever perpetrated in a Christian land!"            (Browder 1988, 44).  This was Lohman’s only conviction.  She served a year in the penitentiary on Blackwell’s (now Roosevelt) Island. It was widely believed that she escaped harsher punishment by threatening to reveal the names of her patients — the mistresses, daughters and wives of the rich and powerful (Manning 2009). 

            After her release from prison she resumed her work and achieved tremendous financial success for the next thirty years but by the 1870s, Ann Lohman finally met her match in the religious crusader Anthony Comstock, who persuaded Congress to prohibit the sale or distribution of materials that could be used for contraception or abortion, or the sending of such materials by mail. As a special agent of the United States Post Office, Comstock entrapped Lohman by posing as a husband seeking abortion services for a lady. When she provided him with some tablets, he returned and arrested her, accompanied by two reporters, in early 1878.   But Madame Restell would evade the long arm of the law.  Fearing the shame that would come upon her family during a long trial and convinced that another stint in prison would kill her, Lohman climbed into her marble bathtub on the April morning her trial was to start, and slit her own throat. She was 66 years old.[18] 

            Upon her death Comstock is quoted as saying,  “A bloody ending to a bloody life”. The newspapers echoed his sentiments. “The end of sin is death,” wrote the New York Tribune, and the Times editorialized that Lohman’s death was “a fit ending to an odious career.”

 

The Campaign Against Abortion

            In 1857 the American Medical Association began a crusade to make abortion at every stage of pregnancy illegal.  Arguably this political agenda was initially driven by a desire to control the practice of medicine in American and then to see the “Manifest Destiny” of the United States realized by keeping birthrates up.  The leader of this campaign was Dr. Horatio R. Storer who envisioned the spread of civilization to the west and south across the continent by native-born white Americans.  He is quoted as saying, “Shall these regions be filled by our own children or by those of aliens?  This is a question women must answer; upon their loins depends the future destiny of the nation.” (Mohr 1978, 166-168).

 

Horatio Robinson Storer

            Dr. Horatio R. Storer (1830-1922) was born and bred in Boston and attended Harvard for both his undergraduate degree and medical school.  After studying in Europe after graduation he came back to Boston and set up an obstetrics and gynecology practice.  In 1857, he started the "physicians' crusade against abortion" both in Massachusetts and nationally, when he persuaded the American Medical Association to form a Committee on Criminal Abortion. The Committee Report was presented at the AMA meeting in Louisville, Kentucky in 1859 and accepted by the Association. As a result, the AMA petitioned the legislatures of the states and territories to strengthen their laws against elective abortions.  Storer’s personal hostility towards immigrants, Catholics and people of color fueled this campaign to criminalize abortion.  He felt that white male patriotism demanded the maternity be enforced among white Protestant women and he felt that presence of women in the medical profession would undermine male physician’s attempts to prevent abortion. 

            One facet of theology and science that Storer debated was the concept of the “quickening”.  For the last 18 centuries the quickening had been the standard by which the Christian world determined if a fetus was truly alive.  Storer fought to discredit this idea by saying, “[the] Quickening is but a sensation” and thus pregnancy should be determined by a male physician and a male physician only (Reagan 1997, 12-13).  While Storer’s concern crusade for the criminalization of abortion was motivated by a strong desire to prevent middle and upper class white women from decreasing their fertility, changing the law of the land meant that the ramifications of his actions affected women of every race and class.

 

Abortion After the Civil War

            Prior to the Civil War midwives delivered the majority of babies in America, and in doing so competed with physicians for that market share of the economy.  After the war male physicians almost exclusively had the monopoly on labor and delivery.  Feminist historians have argued that the rise in anti-abortion laws that arose after the civil war stemmed from paternalism, misogyny and protecting professional turf and anti-abortion legislation was a part of an anti-feminist backlash to the growing movements of suffrage, voluntary motherhood, and other women’s rights movements (Pence 2008, 80)(Ehrenreich and English 1987, 319-320).  But perhaps it is possible that the distaste felt by so many physicians for abortion was born out of the fact that many of physicians practicing in the first few decades after the Civil War had seen combat in a horrible four-year conflict that had taken the lives of between 650,000 and 850,000 Americans.  After seeing this much death, frequently among soldiers and drummer boys as young as their early teens, it is possible that this massive exposure to death made physicians appreciate, if not cherish, the sanctity of life. 

            Between 1860 and 1880 several laws passed restricting abortion in America.  These laws overturned the long-held law of the land by:

1. eliminating the common law idea of the quickening
2. prohibiting abortion at any point in pregnancy.

Illinois signed a bill into law in 1867 criminalizing abortion unless done for “bona fide medical or surgical purposes” (Reagan 1997, 13).  A few years later Illinois passed another law which criminalized the sale of abortifacients but made an exception for prescriptions from physicians.  Thus, physicians has won the battle to criminalize abortion but retained the right to induce abortions if they deemed it appropriate.  As historian Leslie Reagan said:

 “Through the anti-abortion campaign, doctors claimed scientific authority to define life and death.  In doing so, they claimed the authority of religious leaders.  In leading this moral crusade and thoroughly criticizing the ministry’s lack of interest in abortion, regular doctors set themselves above religious leaders as well as above the general populace.” (Reagan 1997, 13-14)

            Horatio Storer claimed in 1868 that infanticide was still a regular occurance in the United States and not only did abortion need to be criminalized but the authorities needed to crack down on women who practiced infanticide for convenience (Storer 1868, 16, 34-35).  In 1871 Dr. Martin Luther Holbrook wrote that American women were “addicted to the wicked practice” and that it was especially widespread in New England (Holbrook 1871, 16). Storer’s and Holbrooks’ claims were corroborated by Dr. Thomas Low Nichols who speculated a year later that the large quantities of laudanum being sold to young women in both the United States and England was not just so that the women could quiet their crying children but so that they could also euthanize them (Nichols 1872, 21-27).

            During the months that Storer, Holbrook and Nichols were writing about the epidemic of infanticide the New York Times referred to abortion as “the evil of the age” and estimated that there were upwards of 200 full-time abortionists open for business in New York City, not including those who dabbled in the practice or midwives who operated clandestine operations out of their homes (Gordon 2002, 25).  An American Medical Association, also published in 1871, estimated that there were as many as one million induced abortions annually, which meant that approximately 20% of all pregnancies in the US ended in abortion (Blanchard 1994, 15).[19]  While Storer’s, Holbrook’s and Nichols’ names have largely been forgotten by history there is another who was arguably the most well know and influential person in the anti-abortion crusade of the 19^th century:  Anthony Comstock.

 

Anthony Comstock

            Anthony Comstock’s name has gone down in the history books for being the man who as United States Postal Inspector finally took down notorious abortionist Madame Restell in New York City and gave his name to the Comstock Laws, which were a series of statutes and regulations aimed at stamping out vice, obscenity and sin in late 19^th century America.

            But before he was the leading crusader against vice in the United States he was a boy from New Canaan, Connecticut.  Even in his youth his zeal for temperance was evident.  During his teenage years in New Canaan, Connecticut, he developed a preoccupation with religion. Having regularly attended the community's congregational church throughout his childhood, he was very familiar with the Bible, and he tended to view it as a factual and incontrovertible document. Biblical teachings about sin were of particular interest to Comstock. He often worried about his own sinful inclinations, and he was not entirely certain his sins would be forgiven. These concerns led him to take an aggressive approach to resisting sin. For example, not long after he allowed himself to be talked into drinking a friend's homemade wine, he broke into the local saloon keeper's storeroom and spilled all of the kegs of liquor on the floor. Before leaving he wrote a note to the saloon keeper in which he told the man that unless the saloon was closed the building would be destroyed (West 1999, 45).  

In 1863, at the age of nineteen, Comstock enlisted in the Union army, where he continued his battle against drinking. Shocked that whiskey was included among the rations for each soldier, he attempted to convince his fellow troops not to drink it. After this approach failed, he regularly accepted his share of whiskey and then poured it on the ground in front of the other soldiers. Drinking, however, was not the only sin that concerned Comstock during the war years. Lust, masturbation, and the reading of pornography also worried the young soldier.  In the diary that he kept during this period he often confessed to a nameless sin, which, in the opinion of his biographers, was probably masturbation (Broun and Leech 1927, 56).

After he mustered out of the Army in 1865 he moved to New York and first found work in a dry goods store and then worked for the Young Men’s Christian Association (YMCA) before becoming a United States Postal Inspector (West 1999, 46). 

            In 1873, at the age of just 29, Comstock created the New York Society for the Suppression of Vice, an institution dedicated to supervising the morality of the public and later that year he successfully influenced the United States Congress to pass the Comstock Act, which made illegal the delivery or transportation of:

"obscene, lewd, or lascivious" material as well as any methods of, or information pertaining to, birth control and venereal disease.  The law forbade the use of the United States Postal Service to transport obscene art and literature and “any drug, medicine, or article for abortion or contraceptive purpose; forbade their advertisement through the mails, and outlawed their manufacture or sale in the District of Columbia or federal territory.”[20] 

            Historian Dallas Blanchard wrote that as special agent for the post office Comstock had “almost unlimited authority over American vice and set about cleansing society.”    (Blanchard 1994, 13) Immediately after the law was enacted, Comstock was appointed special agent of the U.S. Post Office and given the express power to enforce the statute. Comstock held this position for the next 42 years.

            During his tenure he claimed he drove fifteen persons to suicide in his "fight for the young" (Grazia 1991, 5).  His most notable conquest was the abortionist Madame Restell in New York City which he felt saved the lives of countless children.  He would also go up against perhaps the most famous name in the birth control movement, one Margaret Sanger, which this discussion will return to later.

However, not everyone was a fan.  In his later years his health suffered after an unknown assailant attacked him on the street administering a punishing blow to the head.  Though in his final days he did attract the attention of a young law student by the name of J. Edgar Hoover who admired his tactics and his religious zeal and who would carry on Comstock’s work through his leadership of the FBI. 

           

The 1890s

            By the 1890s every state in the union had laws regulating and outlawing some type of abortion (Blanchard 1994, 15).  Most the predominantly Catholic states like Connecticut and Massachusettes followed Vatican policy and banned birth control as well as abortion.  After some debate between various Popes in the sixteenth century that Vatican took a few new positions in the 19^th century.  Back in 1854 Pope Pius IX elevated Mary by defining the dogma of the Immaculate Conception making women’s ability to bear children sacred and abortion a far greater offense in the eyes of the church than ever before.  Further, in 1869 he decreed that people who performed abortions were to be subject to excommunication. Then in 1895 Pope Leo XIII decreed that abortion was a sin even if it was done to save the life of the mother, overturning Augustine’s doctrine of double effect, and in 1902 he increased the scope to include a ban on abortions even in the case of ectopic pregnancy (Blanchard 1994, 11). 

            In spite of the church and the state’s increasing admonitions against abortion the demand for abortion and birth control continued to increase.  It is possible that part of this increased demand was a byproduct of the sociological changes of the day, mainly industrialization and urbanization.

            Children were becoming a less valuable commodity.  On the farm children were an extra set of hands and helped the family to earn and produce more than they consumed.  In the city children were a liability, costing rather than contributing.  As more and more families left rural life for opportunities in the cities the dynamic of the family changed.  Small apartments with high rents in the nation’s urban centers and inflated food prices at city markets made children an expense.  Urbanization and mass transportation due to the railroad meant more nuclear families moved from their ancestral homes and lost the ability to rely on extended families for childcare. Furthermore, education was becoming more important for both sexes as the manual labor on the farm was being replaced with skilled labor in factories and machine shops.  A college education was displacing the apprenticeship, changing the nature of how families secured professions for their children.  In the 17^th and 18^th centuries a college education was considered a luxury of the elite, a rite of passage, but not a necessity for gainful employment.  However, thanks to the rise in the number of medical schools, law schools, private and public universities and trade schools more and more parents wanted to limit their number of children so that either they could afford to attend school or have the money in the future to send their children to school. 

            It is perhaps not coincidental that while these societal changes were taking place religious fundamentalism began to rise in about 1880 and hit its full stride about 1890.  Arguably, religious fundamentalism is basically a reaction against modernization and it was the primary force in the anti-abortion movement (Blanchard and Prewitt 1993, 14).

            Born out of this social upheaval was the woman who would go down in history as the most famous name in the birth control movement, Margaret Sanger.

 

Margaret Sanger

            Margaret Louise Higgins was born the sixth of eleven children (her mother would have 18 pregnancies in 22 years) to an Irish Catholic working class family in Corning, New York in 1879 (Cooper and Cooper 1973, 219).  Like many women of her generation seeking to advance their station in a rapidly urbanizing country she attended Claverack College and Hudson River Institute, and then in 1900 enrolled in White Plains Hospital as a nurse probationer.  Long hours working at the hospital and caring for her mother exacerbated her chronic tuberculosis and she was advised to go out West to a drier climate to heal but that was not an option and in 1902 she married for love architect William Sanger and ended her formal training (Sanger 1938, 37-60). 

            The couple started their life together in Westchester, New York and Margaret would give birth to three children.  However, when their house burned down in 1911 they moved to the city and Margaret began work as a nurse doing house calls in the slums of the lower East Side.  She joined the Socialist Party, Local Number 5, and began hosting gatherings in her living room to discuss the plight of working class women (Sanger 1938, 75).  In her daily work among the working class, immigrant women she saw women forced into frequent miscarriage, and self-induced abortion because they lacked information on how to avoid unwanted pregnancy (Sanger 1938, 95-96). During this time access to contraceptive information was strictly forbidden by the 1873 federal Comstock Law and a host of state laws. Sanger wanted to find a way to help these women plan their pregnancies and ease their burdens, and began visiting public libraries, but was unable to find information on contraception (Endres and Lueck 1996, 448).

            The seminal moment for Sanger came in 1912 when she claimed she met a Russian Jewish immigrant woman she referred to in her speeches as Sadie Sachs.  Her story may or may not be allegorical or an amalgam of many of the women Sanger treated but Sanger related the details of Sadie’s story in several of her speeches.[21]  She told of how she was called to Sadie Sachs' apartment after Sachs had become extremely ill due to a self-induced abortion.  Sanger treated her and referred her to a physician for further care. Sadie begged the doctor to teach her how she could prevent unwanted pregnancies so that she would not have to endure the pain and infection of another home abortion again.  Her husband Jake was a truck driver and she already had three children and lived in a tiny apartment in a tenement on Grand Street that they could barely afford.  So the story goes, the physician simply advised her to remain abstinent, telling her, “You want to have your cake and eat it too, do you?  Tell Jake to sleep on the roof.” (Sanger 1938, 90-91)   A few months later, Sanger was once again called back to the Sachs' apartment where Sadie was found dead after yet another self-induced abortion (Lynaugh 1991, 124-125).   She wrote, after returning home from seeing Sadie Sachs lying dead in her apartment surrounded by her three little children and distraught husband, “I went to bed, knowing that no matter what it might cost, I was finished with palliatives and superficial cures; I was resolved to see out the root of evil, to do something to change the destiny of mothers whose miseries were vast as the sky.” (Sanger 1938, 92).  She then began her work actively researching and disseminating contraception and abortion literature and materials as widely as she could and set about on a path that would change the course of American history.

 

The 20^th Century

            In 1914 Margaret Sanger founded The Woman Rebel, an eight-page monthly newsletter which promoted contraception using the slogan “No Gods, No Masters” (Kennedy 1970, 22).  It was at this point in time that the phrase birth control entered the lexicon.  Sanger felt that birth control rather than the prevalent euphemism of the day, family limitation, more accurately represented the goal of the movement, to empower women to take control of their own bodies and control the number of children they brought into the world (Chesler 1992, 97).[22]  While Sanger’s ultimate goal was to promote women’s health, she felt that in order to achieve this goal, the first obstacle to overcome was the ban on free-speech that the Comstock Laws presented.  When she started publishing The Woman Rebel, one of her specific goals was to provoke a legal challenge to the Comstock laws which banned dissemination of information about contraception (McCann 2010, 750-751).

            Upholding the Comstock Act the postal authorities prevented five of its seven issues from being circulated but Sanger continued undeterred. During this time she even wrote a second publication called, Family Limitation, an even more blatant challenge to anti-birth control laws. This sixteen-page pamphlet contained detailed and precise information and graphic descriptions of various contraceptive methods.  In August 1914, Margaret Sanger was indicted for violating postal obscenity laws in The Woman Rebel. However, instead of standing trial she jumped bail and fled to Canada. Then, under the alias "Bertha Watson," sailed for England. En route she ordered the release of Family Limitation.

            Margaret Sanger spent much of 1914 in exile in England, where contact with British neo-Malthusianists helped refine her socioeconomic justifications for birth control. She was also profoundly influenced by the liberation theories of British sexual theorist Havelock Ellis.[23] Under his tutelage she formulated a new rationale that would liberate women not just by making sexual intercourse safe, but also pleasurable, a wildly radical notion for the time.

While times were good for Margaret in England, her family was not faring so well.  Early in 1915, Anthony Comstock, in a sting operation highly reminiscent of his bust of Madame Restell in 1878, had an agent entrap William Sanger, Margaret Sanger's estranged husband[24], into giving him a copy of Family Limitation. William Sanger was tried and convicted and spent thirty days in jail, however the ploy backfired on Comstock because the press coverage greatly rallied troops to the side of Margaret Sanger and those like her who saw birth control as a civil liberties issue.

In 1915 while still in Europe Sanger visited a Dutch birth control clinic where she first learned about the diaphragm as a means of contraception.  She became convinced that the diaphragm was a more effective means of contraception than the suppositories and douches that she had been distributing back in the United States and set about importing them from Europe, in open defiance of the Comstock Act.

In October of 1915 Sanger was back in the United States and prepared to stand trial for violating postal anti-obscenity law for her publishing of The Woman Rebel.  She hoped to focus media attention on her trial and use the publicity to generate favorable public support for her movement. However, when her only daughter, five-year old Peggy, died suddenly in November, there was so much public outpouring of sympathy for Sanger that the federal government decided to drop the case.  It was unclear whether this was a blessing or a curse for Sanger. Thought it gave her time to grieve and removed the possibility of her having to serve jail time it also denied her the forum of a public trial.  In response to this Sanger embarked on a nationwide tour to promote birth control. She was subsequently arrested in several cities.  Her confrontational approach and bold tactics earned her far more personal celebrity than it brought attention to her cause.

After returning from a national tour in 1916, Sanger opened the nation's first birth control clinic at 46 Amboy St. in the Brownsville neighborhood of Brooklyn (Katz, Engelman, and Hajo 2002, 115). On October 24, 1916, after only nine days in operation federal agents raided the clinic and Sanger and her staff were arrested. Sanger was convicted, the judge in the trial saying that women did not have "the right to copulate with a feeling of security that there will be no resulting conception."  She was given the option of a more lenient sentence if swore not to violate the anti-obscenity laws again, but she refused, saying, “"I cannot respect the law as it exists today.”  Sanger was sentenced to thirty days in a workhouse (Cox 2004, 65).

The publicity surrounding the Brownsville Clinic brought attention to Sanger and provided her with a base of wealthy supporters from which she was able to garner donations and build powerful a political coalition for birth control reform.  With help from these wealthy supporters Sanger appealed the Brownsville decision in 1918 and although her conviction was upheld, the New York State appellate court exempted physicians from the law prohibiting dissemination of contraceptive information to women (if prescribed for medical reasons) (Engelman 2011, 101-103). This loophole allowed Sanger the opportunity to open a legal, doctor-run birth control clinic in 1923. Staffed by female doctors and social workers, the Birth Control Clinical Research Bureau Links to an external site. served as a model for the establishment of other clinics, and became a center for the collection of critical clinical data on the effectiveness of contraceptives (McCann 2010, 751).

 

American Birth Control League

            In 1921 Sanger founded the American Birth Control League (ABCL).  One of the goals of the ABCL was to expand the birth control agenda to the middle class and make it a mainstream political lobby.  The founding principles of the ABCL were:

1. Children should be conceived in love
2. Born of the mother’s conscious desire
3. And only begotten under conditions which render possible the heritage of health.

 

The credo of the ABCL went on to say, “Therefore we hold that every woman must possess the power and freedom to prevent conception except when these conditions can be satisfied.” (Sanger 1921, 207-208)

            By the late 1920's, Sanger's efforts to broaden support for birth control had redirected the movement's focus away from radical feminism and issues of religious freedom toward more conservative mainstream middle-class values. Within the inner circles of leadership Sanger was starting to be viewed as too radical to be the face of the political movement. In 1928 she angrily resigned as president of the American Birth Control League as younger professionals began overriding her directives. With the merger of the American Birth Control League and the Birth Control Clinical Research Bureau into the Birth Control Federation of America in 1939 (later renamed Planned Parenthood Federation of America) Sanger's role in the birth control movement became largely honorific. By 1942, Sanger was living in Tucson, Arizona in semi-retirement.

 

Planned Parenthood

            In 1946, Sanger helped found the International Committee on Planned Parenthood, which evolved into the International Planned Parenthood Federation in 1952, and soon became the world's largest non-governmental international family planning organization. Sanger was the organization's first president and served in that role until she was 80 years old. During her final years she formed a partnership with two people who together would bring about one of the most influential medical and social advancements in modern history: the birth control pill.

 

The Birth Control Pill

            In the 1950s Margaret Sanger and millionairess Katherine McCormick had a dream, a dream to provide a pill, as easy to take as an aspirin tablet that would allow women to prevent pregnancy.  The dream of helping women regulate their fertility had started when they first met at one of Sanger’s lectures in Boston in 1917 and exchanged information.  Sanger had ideas and McCormick had financial resources. 

            McCormick, from a wealthy family herself, was married to Stanley McCormick the heir to the International Harvester fortune and while she was hesitant to jeopardize her family’s fortune by aligning herself publicly with Sanger’s more radical actions she did help Sanger by smuggling diaphragms into the country when she would return from her numerous trips abroad in the 1920s. 

            McCormick struggled with her husband’s mental illness and believing that his schizophrenia was hereditary she was afraid of ever having her own children which gave her an added personal reason for wanting to help other women regulate their fertility.  In 1947 when Katherine McCormick’s husband died she inherited his vast estate and within a few years inherited millions more from her own family.  At the age of 75 with almost inexhaustible resources Katherine McCormick was finally free to pursue her lifelong passion of developing the birth control pill.

            McCormick had earned a bachelor’s from the Massachusetts Institute of Technology and as a trained scientist she was convinced that biochemistry held the key to her seeing an oral contraceptive pill in her lifetime.

            On June 8^th, 1953 Sanger and McCormick visited a small lab on the outskirts of Worcester, Massachusetts to meet with scientist Dr. Gregory Pincus.  McCormick wrote Pincus a check for $40,000, a small fortune at the time, but pocket change to Katherine McCormick.  It would be the first of many checks.  Pincus began work and not content to be a silent benefactor McCormick moved from her Montecieto estate Riven Rock to Boston in order to actively be involved with the progress of the research.

            In 1954 When Pincus felt that he had successfully synthesized a progesterone compound that would control ovulation he took it to G.D. Searle & Company for them to manufacture in pill form.  Once the pill was ready he approached Dr. John Rock, a professor of obstetrics and gynecology at Harvard Medical School to take the pill to clinical trials.

            John Rock, a devout Catholic, might have seemed an unlikely choice to partner in the development of the birth control pill but he had a unique track record.  In 1930 after the Vatican had approved the rhythm method as the only sanctioned means of birth control for married couples John Rock had opened the first physician-supervised rhythm method clinic in Boston to teach Catholic women about family planning. In 1931 he had been the only Catholic physician to sign a petition urging the state of Massachusetts to repeal its ban on the sale of contraceptives.   Throughout the 1940s he taught contraceptive methods to his students at Harvard despite the taboo nature of the subject and in 1949 he coauthored a book Voluntary Parenthood as a way to explain the basics of birth control to the masses. 

            John Rock accepted the offer to partner with Pincus and the Searle Company and take the new drug, now called Enovid, to clinical trial.  Rock tested Enovid on 50 women in a clinical trial that was disguised as a fertility study.  He then presented his findings to the Food and Drug Administration (FDA) citing that not a single woman had ovulated during his clinical trial.  The FDA gave preliminary approval but required a larger sample size. 

            Because Massachusetts had strict anti-birth control laws Pincus and Rock took the clinical trial to San Juan, Puerto Rico and following that study reported that “Enovid gives 100% protection against pregnancy.”  However because there were severe side effects the formula of the pill had to be tweaked a little.[25]  Once the kinks were worked out Rock selected a high dosage of the compound to be the pill that would go to market so that he could guarantee absolute certainty that Enovid would prevent pregnancy. 

            Finally, in the summer of 1957 Enovid was approved by the FDA and went to market as a treatment for severe menstrual disorders with the listed side effect of “may prevent ovulation”.  Interestingly the news media paid little attention to the approval of the drug.  The New York Times, the leading media outlet in the country, neither reported the approval nor took note of Enovid’s already widely known side-effect: contraception.    In fact the first mention of the pill was not until November 21, 1957, when the New York Times covered a story of a debate between three clergymen in Rochester: a Catholic priest, a rabbi and a Protestant minister.  While it may sound like the set-up for a joke, the three clergymen were zealously debating the theological ramifications of the presence of oral contraceptive pill being made widely available to the women of America. 

            Since 1930 the Catholic Church’s position on birth control had been very clear.  Pope Pius XI had issued an encyclical titled Casti Canubi which translated as “Of Chaste Marriage” stating that birth control was a sin and opposing birth control by any artificial means whether it be a condom or the pill (Arias and Cole 2011).  However the pill carried an extra stigma given that it meant women were actively blocking their sacred ability to bear children.  On August 15^th of 1930 at the World Assembly of Anglican bishops known as the Lambeth Conference, a resolution passed in which the leaders of the church agreed to limited acceptance of birth control for married couples.  This resolution was a watershed moment for the Protestant Church.  The Jewish perspective on birth control was that it encouraged a man to spill his seed, which as was discussed earlier, Onan in the Bible had been struck down by God for doing.

            The next mention of Enovid in the press came on September 19, 1958 on page 25 of the New York Times in an Associated Press dispatch with the headline, “Pill Held Success As Contraceptive”.  John Rock was quoted in the article as saying a “50-cent pill to prevent pregnancy had proved 100 percent effective in a 2 and a half year test.”(Bakalar 2010, 7)  Though Enovid was still only approved by the FDA to be medically prescribed for the treatment of severe menstrual disorders it was not lost on the Searle Company that a suspiciously large number of previously perfectly healthy women had suddenly reported to their doctors with complaints of severe menstrual disorders.  It was estimated that over a half a million women were using Enovid “off label”.

            Searle moved to capitalize on this and on October 29^th, 1959 the pharmaceutical company filed an application with the FDA for approval of the pill as a means of contraception.  In the winter of 1960 the application went to an ethics committee at the FDA who were, in essence, tasked with reviewing the first drug in history that was indicated for a perfectly healthy person to be taken long term as opposed to sick person for a short period of time to treat illness.  FDA Commissioner George Larrick worried about potentially medicating half the population for something that was not a disease (Junod 2000, 36).  While the FDA’s panels and committees were weighing the pros and cons of allowing Enovid to be marketed directly as an oral contraceptive John Rock was drumming up public support by arguing that the pill simply extended a woman’s “safe period” and as such was in keeping with the Vatican’s approval of the rhythm method.  The Vatican was not amused by Rock’s assertions.

            On May 10^th, 1960 the FDA announced that it had approved Enovid as the first oral contraceptive pill, to be prescribed by physicians to healthy women, for the purpose of preventing pregnancy.  By the end of 1961 some 408,000 American women were taking the Pill, by the end of 1962 the figure was 1,187,000, and by the end of 1963 it was 2,300,000 and still rising. Of it Clare Boothe Luce said, "Modern woman is at last free as a man is free, to dispose of her own body, to earn her living, to pursue the improvement of her mind, to try a successful career." (Halberstam 1993)

 

Griswold v. Connecticut[26]

            By December of 1961 the pill was FDA approved for use nationwide however it was still a crime in the state of Connecticut to use any form of birth control.  In open defiance of Connecticut law Dr. C. Lee Buxton, the chairman of Yale Medical School’s department of obstetrics and gynecology and Estelle Griswold, the executive director of Connecticut’s Planned Parenthood partnered together to open four Planned Parenthood clinics which distributed Enovid.  They were promptly arrested.

            The case went to the Supreme Court and on June 7^th, 1965, in a 7-2 decision, the court overruled Connecticut state law and said that the Connecticut’s archaic law violated the “right to marital privacy”. 

            While the Griswold and Buxton case was caught up in the court system two other major developments unfolded in the abortion and birth control debate: (1) John Rock would eclipse Margaret Sanger and establish himself as the de facto spokesman for the pill by authoring The Time Has Come: A Catholic Doctor’s Proposal to End the Battle Over Birth Control and (2) the American public would become aware of the dangers of the drug Thalidomide which would put attention back on the abortion debate.

           

Thalidomide & Sherri Finkbine

            Sherri Chessen Finkbine, known popularly as “Miss Sherri” was the host of the franchised children’s television show “Romper Room” in Phoenix, Arizona.  In 1961 while her husband Bob, a high school teacher, was in London chaperoning students on a class trip, purchased a bottle of Thalidomide pills from a chemist’s shop (Lipton and Armstrong 1992, 77).  Thalidomide was believed to be a magical cure-all for the ills of early pregnancy and by reducing the symptoms of morning sickness prevent miscarriage.  In 1962 when Sherri became pregnant with her fifth child she took 36 of the pills. 

            In November 1961, a German pediatrician, Widukind Lenz[27], observed a pattern of children being born with severe deformities, such as phocomelia, and when he began documenting the cases he found that 50 percent of the mothers coming into his office with infants with severe deformities had taken thalidomide in the first trimester of pregnancy (Bren 2001, 25).  Meanwhile an FDA inspector named Frances Oldham Kelsey read an open letter written by a physician to the British Medical Journal describing a similar phenomenon of babies being born with “flipper-like extremities” and immediately alerted American authorities to the risks of having Thalidomide on the market (Mintz 1962).  Within months Thalidomide was pulled from the market in most European nations and the United States.  More than 10,000 children in 46 countries were believed to have been born with deformities as a consequence of thalidomide use. The damage in the United States was small by comparison, but no less devastating to the 17 children born in America with thalidomide-associated deformities.  Richardson-Merrell, the pharmaceutical company with the patent for Thalidomide, had distributed more than 2.5 million pills to more than 1,000 doctors throughout the United States on what was called an investigational basis. The doctors, in turn, gave thalidomide to nearly 20,000 patients, several hundred of whom were pregnant women.  FDA's field staff located the doctors who had been given thalidomide and urged them to contact patients who had been given the drug. But not all of the doctors kept records of the drug's distribution. Through news releases, FDA warned women of the danger of taking the drug, but it is unlikely that all of these women were reached (Bren 2001, 28).      

Upon learning of the negative side effects of Thalidomide Sherri Finkbine decided she wanted to have an abortion rather than risk having a severely deformed fetus.  The Finkbines scheduled an abortion at the hospital though her physician warned her that they were in murky legal territory as the state of Arizona only allowed therapeutic abortions at that time and there was no reason to believe that the pregnancy posed a threat to Sherri Finkbine’s health.

Sherri Finkbine contacted a friend at the “Arizona Republic” to tell her story so that other women who had taken or were taking Thalidomide might be made aware of the legal and ethical obstacles they potentially faced.  The reporter promised Sherri Finkbine that her anonymity would be protected but because of her celebrity as a children’s show host the newspaper decided to use her name. 

The hospital where Finkbine planned to have the abortion did not want to risk prosecution and when the district attorney did not promise not to prosecute the institution and the staff members who participated in the procedure the hospital cancelled the surgery.  The Finkbine’s physician requested a court order to proceed with the abortion arguing that it was therapeutic but it was denied.  Judge Yale McFate ruled to dismiss the physician’s request because he felt he couldn’t exercise authority in this matter. 

The media coverage of this ordeal made Sherri Finkbine, already a minor celebrity, a major name in the news.  The Finkbines began to receive death threats and the FBI had to step in to offer them protection.  Bob Finkbine was suspended from his job as a high school teacher Sherri was fired from her job as the host of “Romper Room”.  Desperate, the Finkbines looked outside the United States for more options.

The Finkbines initially tried to travel to Japan to obtain an abortion but were denied a visa by the Japanese Consul who did not want to be a part of the scandal.  The Finkbines then flew to Sweden where abortion had been legal since the 1940s.  Once they arrived in Sweden they had to plead their case in front of an abortion panel that considered the social, medical and spiritual ramifications of going forward with the procedure. 

The Royal Swedish Medical Board, which consisted of ten people, physicians, lawyers and a minister, granted the Finkbine’s request for an abortion on August 17^th, 1962.[28]  The abortion was performed “to safeguard her mental health” the next day on August 18^th, 1962.  Sherri Finkbine was at the end of her first trimester.  The Swedish obstetrician who performed the abortion told the Finkbines that fetus had no legs, only one arm, indeterminate genitalia that could only be described as “an abnormal growth”.

The postscript to this story is that Sherri and Bob Finkbine had two more children before they eventually divorced in 1973 and Sherri Finkbine raised her six children on her own.  In 1991 she remarried to an obstetrician/gynecologist who happened to practice at the Scottsdale, Arizona hospital that turned her down for the abortion 30 years earlier.  He would have been the next in line to perform the abortion if her personal physician had refused the procedure and the court order had come through.  Sherri Finkbine’s name was synonymous with the abortion issue for almost a decade until another woman, Norma McCorvey, and the landmark Roe v. Wade case took over the spotlight.

 

Roe v. Wade (1973)

            The most famous legal battle over abortion in United States history is undoubtedly the Roe v. Wade (1973) case which established that women have the right to an abortion until the fetus reaches viability outside of the womb.  The interesting footnote to this case is that the plaintiff Jane Roe, who’s real name was Norma McCorvey never actually had the abortion she sought to obtain.

            Norma Lea Nelson was born in Simmesport, Louisiana on September 22^nd, 1947 into a domestic disaster.  Her mother was mentally and physically abusive, her brother was mentally ill and her father was in and out of the picture.  She was sent away to a Catholic boarding school and then after a series of behavioral issues, including engaging in lesbian relationships, she was sent to a reform school. 

            One night when Norma was 15 years old and working as a roller skating waitress at a carhop she met and drove off with 21-year-old sheet metal worker Elwood “Woody” McCorvey.  Within a year they were married and she was pregnant but they divorced before the baby was born.

            Norma’s mother Mary was largely responsible for caring for the child who they named Melissa.  Norma claimed that her mother tricked her into signing adoption papers giving away her parental rights to Melissa because she did not want a lesbian raising her grandchild.  Norma continued to see both men and women and in 1967 at age 19 she became pregnant again.  This time the baby was given up for adoption.

            In 1969 McCorvey became pregnant for the third time.  She told her obstetrician/gynecologist Dr. Richard Lane that she did not want the pregnancy and that she could not afford to travel to any of the states that offered legal abortions at that time: Alaska, California, Hawaii, New York, Oregon and Washington.  Dr Lane then referred Norma to an adoption lawyer named Henry McCluskey who then referred her to an old classmate of his from law school and her colleague Linda Coffee and Sarah Weddington.

            Sarah Weddington had become pregnant while in law school and had to travel to Mexico because of Texas’ strict anti-abortion laws.  Since that time she had been interested in challenging Texan law and in order to do so she and Coffee needed a plaintiff who could serve as an example of how Texas’ laws were discriminatory and unconstitutional.  The client needed to be, (1) a pregnant woman, (2) impoverished and lacking enough funds to travel to another state where abortion was legal, (3) willing to withstand the potential publicity onslaught and (4) not too far along in her pregnancy so that she would deliver before the case went to trial rendering the issue moot.

            Norma McCorvey was five months pregnant at the time of her first meeting with Weddington and Coffee and so they decided to move forward with the case.  The lawyers filed Roe v. Wade at the Dallas Federal District Courthouse on March 3^rd, 1970 with Norma McCorvey (who was now five months pregnant) listed as plaintiff  “Jane Roe” bringing suit against defendant, Dallas County District Attorney, Henry Wade. 

            Norma McCorvey was six months pregnant before the court reviewed her case and was hoping to become “the first girl in Texas to have a legal abortion”.  Coffee and Weddington decided to amend their case to make it a class-action law suit so that even if the case did not reach resolution before Norma McCorvey delivered her baby the ruling would ensure that all women in Texas would be granted the right to an abortion. 

            The Supreme Court issued its decision on January 22, 1973, with a 7 to 2 majority vote in favor of Roe.  The Court ruled that women in America had the constitutional right to freely choose an abortion for themselves up until the fetus was determined to be viable outside of the womb.  At that time viability outside the womb was assessed at 28 weeks gestation but could be pushed as far forward as 24 weeks in extreme situation.  However, no federal money could ever be used to pay for an abortion. 

            The Court reviewed the history of abortion laws, from ancient Greece to contemporary America.  In researching the history of abortion they identified three major theories that had been used as justification for banning abortions: (1) Victorian social concern that women would engage in reckless sex and abortion needed to be banned to discourage illicit sexual conduct, (2) the need to protect the women’s health and (3) the need to protect prenatal life. The Justices decided that the first two justifications were null and void in 1973 with the evolution of gender roles and medical technology.  Further, no woman who received a back alley abortion was going to be putting herself at less risk than if she had secured an abortion in a sterile environment with a trained and licensed physician.  As for the third justification, that prenatal life needed to be protected the Court argued that prenatal life was not within the definition of "persons" as used and protected in the U.S. Constitution and that America's criminal and civil laws only sometimes regard fetuses as persons deserving protection.  Further, the sanctity of prenatal life was murky legal territory as the question of when life begins was arguably more of a theological matter than legal matter.

            The Supreme Court justices employed the method of legal reasoning so popular in American Constitutional law, resorting to trying to extrapolate what the Founding Fathers would have thought.  American legal history has a way of asking both “What Would Jesus Do?” and “What Would George Washington Do?”  They wrote in their decision:

“It is thus apparent that at common law, at the time of the adopting of our Constitution, and throughout the major portion of the 19^th century…a woman enjoyed a substantially broader right to terminate a pregnancy that she does in most States today.  At least with respect to the early stage of pregnancy, and very possibly without such limitation, the opportunity to make this choice was present in this country well into the 19^th century.”[29] 

 

Controversial from the moment it was released, Roe v. Wade politically divided the nation more than any other recent case.   In no other case has the Court entertained so many disputes around ethics, religion, and biology, and then so definitively ruled on them all. To the political right, critics accuse the Court in Roe of legalizing the murder of human life with flimsy constitutional justifications. To the Left, critics maintain that Roe was poorly reasoned and caused an unnecessary political backlash against abortion rights. Defenders of the decision, however, argue that Roe v. Wade was a disinterested, pragmatic, and ultimately principled decision defending the most basic rights of personal liberty and privacy.  Perhaps the most frequently quoted legacies of the Roe v. Wade decision are the neat and tidy terms to describe those who oppose abortion, Pro-Life, and those who favor the right to abortion, Pro-Choice.

 

Pro-Life Religious Groups

• Roman Catholic Church
• Lutheran Church – Missouri Synod
• Wisconsin Evangelical Lutheran Synod
• Anglican Church of North America
• Eastern Orthodox Church and representative churches in the US
• The Church of Jesus-Christ of Latter-day Saints
• National Association of Evangelicals[30]
• American Baptist Church
  • The General Board of the American Baptist Churches in the United States opposes abortion "as a means of avoiding responsibility for conception, as a primary means of birth control, and without regard for the far-reaching consequences of the act." There is no agreement on when personhood begins, whether there are situations that allow for abortion, whether there should be laws to protect the life of embryos and whether laws should allow women the right to choose an abortion.  The Baptist Church initially was not against abortion.  In fact, the Clergy Consultation Service on Abortion defied the law by finding doctors who would perform abortions and then refer women to them.  It was established at the Judson Memorial Baptist Church in New York City in 1967 (Kaplan 1995, 61).
• The Southern Baptist Church
  • The Southern Baptist Church has changed their stance on the abortion issue as well.  In 1971 a Southern Baptist Convention resolution passed, and was reconfirmed in 1974, which supported “legislation that will allow the possibility of abortion under such conditions as rape, incest, clear evidence of severe fetal deformity, and carefully ascertained evidence of the likelihood of damage to the emotional, mental, and physical health of the mother.”(Greenhouse and Siegel, 71)[31]  However, the Southern Baptist Church revised this position in 2010 with the publication of the Sanctity Credo which is essence discounts the welfare of the mother and her other children in favor of the sanctity of the embryo.  The Sanctity Credo reads:
    • “Procreation is a gift from God, a precious trust reserved for marriage.  At the moment of conception, a new being enters the universe, a human being created in God’s image.  This human being deserves our protection, whatever the circumstances of conception.”[32]

 

Pro-Choice Religious Groups

Though the majority of pro-life activist groups have religious affiliations, most notably the Catholic Church and the National Association of Evangelicals, there are several Christian denominations and non-Christian faith traditions that are openly pro-choice.  We will discuss a select few of them here:

• Unitarian – Universalist Association
• The Episcopal Church
• Reformed Jews
• Quakers
• The United Church of Christ
• The United Methodist Church
• United Synagogue for Conservative Judaism
• The Dalai Lamma
• “Catholics for Free Choice”
• “Evangelicals for Choice”

Abortion-neutral Denominations

            Some religious groups are remarkably vague on the topic of abortion.  Perhaps the most notable of these groups is the Seventh-day Adventist Church.  Their “Guidelines on Abortion” state the following:

Prenatal human life is a magnificent gift of God. God's ideal for human beings affirms the sanctity of human life, in God's image, and requires respect for prenatal life. However, decisions about life must be made in the context of a fallen world. Abortion is never an action of little moral consequence. Thus prenatal life must not be thoughtlessly destroyed. Abortion should be performed only for the most serious reasons.[33]

 

 

Partial-Birth Abortion

            Roe v. Wade guaranteed women the right to an abortion prior to the third trimester or “viability” of the fetus outside of the womb.  Two of the greatest ethical concerns about performing late term abortions are (1) the fear of committing murder if the fetus is technically human being ensouled by God and (2) the abortion resulting in a live birth.

            In 1977 physician Ronald Cornelson testified in a California criminal court that during the process of attempting to perform a saline abortion he inadvertantly delivered a 2.5 lb live baby.  His colleague William Waddill tried choking the infant and when the infant did not die he suggested injecting it with potassium chloride (Lyon 1982, 1).[34]  Waddill was subsequently tried for murder and went to trial twice but both juries were hung (Pence 2008, 90). 

            The case of Dr. William Waddill is perhaps one of the most horrific examples of late-term abortion and because of the lasting stigma associated with his actions physicians rarely perform elective abortions after 23 weeks.  However, a series of reported cases of late-term abortion in the 1990s led to the passage of the The Partial-Birth Abortion Ban Act of 2003.[35]

            The term partial-birth abortion is primarily used by politicians and pundits to describe what the medical community has long referred to as intact dilation and extraction or  (IDX).  IDX is an abortion technique in which the fetus’ head is reduced in diameter to allow vaginal passage.  Typically, over a period of two to three days physicians gradually dilate the cervix and in certain cases the woman is administered pitocin to induce labor.  Once the cervix is sufficiently dilated, the doctor uses an ultrasound and forceps to manually grab hold of the fetus’ leg and turn it to breech position.  Once in breech position the doctor pulls one or both legs out of the cervix, (which some refer to as 'partial birth' of the fetus) and then extracts the rest of the fetus leaving just the head inside the uterus. An incision is then made at the base of the skull and a spreader is inserted into the incision and opened to widen the opening.  Finally, a suction catheter is inserted into the opening and the brain is suctioned out, which causes the skull to collapse and allows the fetus to pass more easily through the cervix. The end result is essentially the delivery of dead baby. 

             From 1995 until 2000, Congress repeatedly passed bills criminalizing these types abortions however each time President Bill Clinton vetoed the bills (Pushaw 2005, 324).[36]  Many states, however, successfully enacted such laws, such as the Nebraska case of Stenberg v. Carhart.[37]  However, the Supreme Court struck down Stenberg v. Carhart because even though it prohibited late term abortions it’s wording was vague and could have applied to early term abortions and it did not make the constitutionally required exception to protect the mother's health.  At the time that Stenberg v. Carhart was struck down the majority of Congress approved a ban on partial-birth abortion, and then President George W. Bush was on board to sign into law a federal ban on partial-birth abortion.  Thus, the Partial-birth Abortion Ban Act was signed into law in 2003.

 

The 21^st Century

            Every election cycle the issue of abortion comes up at least once when during the televised presidential and vice-presidential debates the obligatory question of Where does the candidate stand on Roe v. Wade? is asked.  The politician in the last decade who has instigated more conversation than perhaps any other on the subject abortion has undoubtedly been Sarah Palin.

            In November 2006 when Palin was running for the governorship of Alaska she declared that she would not support an elective abortion under any circumstance, even if it was for her own daughter and her daughter had been the victim of rape.  She did however, concede that exception could be made if the mother’s life was in danger.  However, Palin said that when it came to her daughter, "I would choose life."(Stein 2008)

            At the time of that quote Palin’s daughter Bristol was 14 years old.  By the fall of 2008 Bristol was 16 going on 17 and pregnant out of wedlock and Palin herself had just given birth to a baby with Downs Syndrome.  At the Republic National Convention that year Palin proudly displayed her baby son Trig and introducing the nation to her visibly pregnant eldest daughter (Halloran 2008).  Her actions endeared her to many in the pro-life camp who identified with her belief that despite the fact that she would not go on to be vice president of the United States she remained a fixture on the conservative talk show circuit sharing her views on abortion.

            In May of 2010 Palin was speaking at the Susan B. Anthony List Celebration of Life breakfast and told audience members that when she learned that her fifth child Trig would be born with Downs Syndrome she "had no idea how [she] was going to handle the situation of raising a special needs child” but went on to say that she believed that "God will never give me something I cannot handle," and once Trig was born, Palin said, she understood that "God does know what he's doing."(Montopoli 2010)

            The religious beliefs of politicians like Sarah Palin have brought about further changes in the law.  In 1973 when the Supreme Court handed down their decision in Roe v. Wade fetal viability was assessed at 28 weeks but could be pushed as far forward as 24 weeks in extreme circumstances.  The law allowed a woman a constitutionally guaranteed abortion until the point at which the fetus could exist outside the womb albeit with the assistance of technology.   A later court ruling threw out the trimester system of determining when an abortion was allowed and simply moved to it being a matter of viability (Pence 2008, 82).

            However, using “viability” to determine the morality and legality of an abortion is problematically vague.  Forty years ago many who saw the science of neonatology advancing to a point that where a fetus could survive outside the womb at increasingly earlier stages of embryonic development felt that the use of the term “viability” in the law was a mistake.  What one may consider a viable fetus may seem horrible premature to another.  For example, a baby born at just 23 weeks might have severe developmental disorders including blindness, deafness and cognitive impairment that may require that they spend a lifetime dependent on machines to assist with the functions of life such as feeding and breathing, does that constitute a viable fetus? 

            Currently there are 21 states that have tried to ban abortion at 20 weeks.  Interestingly, the 20-week mark has nothing to do with Roe v. Wade but rather is based on the belief that fetus can feel pain at 20 weeks gestation and therefore it is immoral to injure the fetus (NARAL 2013).[38]  Only time will tell what church and state will agree upon as the appropriate window of time to allow for abortions.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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