Throughline - Abortion Before Roe

Episode Date: June 19, 2025

Abortion wasn't always controversial. In fact, in colonial America it would have been considered a fairly common practice: a private decision made by women, and aided mostly by midwives. But in the mid-1800s, a small group of physicians set out to change that. Obstetrics was a new field, and they wanted it to be their domain—meaning, the domain of men and medicine. Led by a zealous young doctor named Horatio Storer, they launched a campaign to make abortion illegal in every state, spreading a potent cloud of moral righteousness and racial panic that one historian later called "the physicians' crusade." And so began the century of criminalization. This episode originally ran as Before Roe: The Physicians' Crusade.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

This message comes from NPR sponsor, Subaru. During June, as part of the Subaru Loves to Care initiative, Subaru and its retailers partner with the Leukemia and Lymphoma Society to give warm blankets and messages of hope to patients. Learn more at Subaru.com slash care. A note before we get started. This episode contains graphic descriptions of abortion and suicide. If you or someone you know may be considering suicide

or is in crisis, call or text 988 to reach the suicide and crisis lifeline. [♪ music playing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, wind blowing, The police were startled by the announcement that the well-known Madame Restelle had been found dead earlier this morning in the bathroom of her mansion on Fifth Avenue. She rose in the night and went into the bathroom where she suicided. The coroner's physician examined the body and found that a deep gash had been cut across the front of the throat, severing the jugular vein. The water had been left running in the bathtub, and hence there was but little blood in the water, which still filled the tub. The body was cold, and it was evident that the woman had been dead for some hours.

Read all about it. Morning paper. Read all about it. Morning paper. In the early hours of Wednesday, April 1, 1878, the death of a woman named Madame Rustell, known to some as the wickedest woman in New York, Read all about it. rocked the country.

The Morning Herald, Wilmington, Delaware. Madame Rastelle found dead. Madame Rastelle left the fortune estimated at from $1 million to $1,500,000. The New York Times. Having for nearly 40 years been before the public as a woman who is growing rich by the practice of a nefarious business She yesterday came to a violent end by cutting her throat Year to year the Cincinnati Daily Star

Cincinnati, Ohio Another story is that Madame Ristel was murdered through the instigation of wealthy people who had patronized her in her criminal business Clarksville Weekly Chronicle, Clarksville, Tennessee. Crimes of this wretched woman were not hers alone. They were the crimes of a splendid, profligate society, of which she was simply the paid agent. She has simply done upon herself the vengeance which the law should have inflicted many years ago.

Systematic murder was her trade. The murder of the unborn perpetrated to shield the guilty lusts of the living. We are using language which will be blamed as shocking to society, but society needs to be shocked. Madame Restelle was one of the key targets of a moral crusade that had swept the country. A crusade that started in the 1800s and led to a century of criminalizing abortion. A century that came to an end in the early 1970s. Good evening.

In a landmark ruling, the Supreme Court today legalized abortions. The majority said that the decision to end a pregnancy during the first three months belongs to the woman and her doctor, not the government. Thus the anti-abortion laws of 46 states were rendered unconstitutional. Roe versus Wade. People I think still think that abortion was never practiced and was always illegal until the Supreme Court decision in 1973. And they think that the decision created the practice of abortion and expanded it. And that is completely wrong. That is not true. That is completely wrong. That is not true. It was legal under common law in the colonial era in what is now the United States,

and in the early United States. It was not made criminal in the way that we think of it from conception on until late 19th century. And throughout all that time, abortion was practiced by many people and really accepted in a certain way by Americans. This is historian Leslie Wigan. She's a professor at the University of Illinois Urbana-Champaign and author of the book When Abortion Was a Crime, Women, Medicine, and Law in the United States. In the country's early days, people like Madame Rustell were thriving. When she began her practice around the 1830s, she wasn't hiding her practice at all, but nor was anybody else. She just was

much, she was, she was a very good businesswoman and made a lot of money and was very rich and obvious in New York City. But by the end of her life in 1878, Madame Ristelle was facing criminal prosecution and some had branded her a monster in human shape. Her name had become synonymous with abortion. Over the course of a couple decades, the country had moved from thinking of abortion as a personal matter, a common practice that happened everywhere, albeit quietly and in private, to a criminal offense outlawed across the country. The question is, how and why did that change happen? I'm Rand Abdel Fattah.

I'm Ramtin Arablui. And on this episode of Throughline from NPR, we're looking back at how and why laws outlawing abortion in every state were put on the books in the first place. Coming up, a moral crusade is born. Hello, this is Emily from Lompoc, California, and you're listening to Throughline from NPR. This message comes from WISE, the app for doing things and other currencies. With WISE, you can send, spend, or receive money across borders, all at a fair exchange rate.

No markups or hidden fees. Join millions of customers and visit WISE.com. T's and C's apply. This is Ira Glass with This American Life. Each week on our show, we choose a theme, tell different stories on that theme. All right, I'm just going to stop right there. You're listening to an NPR podcast.

Chances are you know our show. So instead, I'm just going to stop right there. You're listening to an NPR podcast, chances are you know our show. So instead, I'm going to tell you, we've just been on a run of really good shows lately. Some big epic emotional stories, some weird funny stuff too. Download us, This American Life. In the latest through-line bonus episode, we'll hear about the history of Corridos,

a type of song that first arose during the Mexican-American War and that are still very popular in music today. Sign up for ThruLine Plus now to listen and get sponsor-free listening too. Go to plus.npr.org slash ThruLine to find out more. emailing howto at npr.org or calling 1-800-424-2935 Part 1 The Quickening Dear Father, I did not sail before half past eight last night as the vessel had to wait for a passenger. After we had started a fog came up and we had to anchor in the narrows.

I never was out in such rough weather in my life. On deck nearly all the time and yet was not so sick as I was the other day. In 1849, when he was 19 years old, Horatio's stores sailed from Boston to the wilds of Labrador, Canada on a research expedition alongside a naturalist, an expert in the natural world. They were interested in the process of reproduction, which they hoped to learn more about by studying the embryos of birds and fish. Hundreds of fish are strewed on the shore among which I noticed menhaden, herring, goosefish. It was the early days of embryology, a branch of biology focused on prenatal development

of embryos and fetuses. Charles Darwin, a naturalist himself, would soon publish his theory of evolution, drawing a direct line between man and beast. Horatio's story was fascinated by all of it. Embryos, nature, the circle of life. So when he got back home to Boston, he decided to enroll in medical school, following in his father's footsteps, who was a doctor who specialized in obstetrics, a modernizing field of medicine focused around childbirth. It was a time in which there was the burgeoning professionalization of obstetrics by white men of medicine. This is Michelle Goodwin, a professor of law at Georgetown Law.

She's written a lot about the legal history of abortion, including policing the womb, invisible women, about the legal history of abortion, including policing the womb, invisible women, and the criminalization of motherhood. These are the people who were leading the way in terms of the professionalization of this new thing, obstetrics. And at the same time, they were articulating their insecurities and really a level of high disregard for midwives. There are different theories on why some doctors began to get interested in childbirth. Some historians believe it was a money grab. If you delivered the baby, the family would call you back for all the falls and fevers that came after that.

Others believe these doctors genuinely thought they could make childbirth safer for women. In the early 1800s, around 500 in every 100,000 births ended in the death of the mother. Today, that number has dropped by 95%. So it was a lot more deadly then. And doctors like Horatio Stor thought they were helping women at a time when women didn't have much of a say. But women didn't necessarily want their help.

For tens of thousands of years, Childbirth and pregnancy was all in the domain of women. Historian Leslie Wiegen again. Midwives delivered babies and they did it surrounded by her friends, her mother, her sister, potentially her daughters, neighbors. There was a crowd of women involved in the delivery along with a midwife. But in the early 1800s, as more doctors- Male doctors, doctor equal male.

Entered the delivery room. Which is in the woman's, you know, in her own home, in her own bedroom or her mother's bedroom. That began to shift a millennia-old dynamic. And as you can imagine, having a man in the room suddenly introduced some awkwardness. Especially a brand new doctor. Sometimes they've never seen a childbirth at all.

New doctors like Horatio Storer. So they could be coming in and they're surrounded by older women who know what's happening. And there are these stories, doctors' diaries of, you know, they've been taught you need to shave the woman's pubic hair, you know, for sanitation before you deliver the baby. And they pull out that shaver and they're kicked out of the room. They're like, you aren't out of here. You're not doing this. Stor and his fellow specialists in women's health didn't just face skepticism from women in those delivery rooms. Other doctors also looked down on them. Because as you think about it, they were entering a profession where nearly 100% of it had been

done by women. More than 50% of that had been done by Black women. Some even referred to the specialty as man-midwifery. It was a time when modern medicine was still in its early days. There were no antibiotics, no pregnancy tests, no ultrasounds. People didn't really go to hospitals. C-sections were rarely done and even more rarely successful. Not to mention, some considered it improper, even offensive, for a male doctor to perform a pelvic exam, especially as the

field of medicine was still trying to establish itself as a bona fide profession, mainly in the United States and Europe. For the most part, up until the 1870s in the US, there were no laws regulating who was a doctor. Then some states began passing medical licensing laws. More medical schools opened up. And in 1847, a small group of doctors started the American Medical Association, the AMA. They explicitly do not include women, and African Americans are not part of their medical profession. Chapter one, of the duties of physicians to their patients and of the obligations of patients to their physicians. And they laid out an elaborate code of ethics.

Physicians are enabled to exhibit the close connection between hygiene and morals. Physicians as conservators- Despite their best efforts, the AMA wasn't having much luck convincing people to take them seriously. The editor of the Cincinnati Medical Observer described physicians as a body of jealous, quarrelsome men whose chief delight is in the annoyance and ridicule of each other. By the time Horatio Storer came along in the 1850s, they were desperate for ideas about how to make their profession more respectable.

And Storer set his sights on abortion. Just as women had overseen childbirth for most of human history, they'd also been on the front lines of ending unwanted pregnancies, of carrying out abortions. But in early America, they wouldn't have been using the term abortion. At the time, it was referred to as restoring the menses, trying to get your period again. You know, taking herbs, taking teas, riding horses,

falling downstairs, trying, trying to get their menses back. It was considered acceptable for women to restore their menses up until the moment of quickening, when... When they felt quickening, when they felt movement. Which for some women doesn't occur until the fifth month of a pregnancy. So people didn't wrestle with this as a moral or ethical or even a legal question if a woman engaged in that practice

before about the fourth or fifth month of pregnancy. There were no laws in place to prevent abortions before quickening. And so the conception of when life began really began at the moment of quickening. By some estimates, in the late 19th century, around 2 million abortions were performed each year, which means the number of abortions per capita was several times higher than it is today. Keep in mind, birth control options were very limited then, so there was less you could do to prevent a pregnancy in the first place.

You know, quickening is recognized, and the law and churches and the general community understands that this is in women's purview. In terms of what's going on with their bodies, they know their bodies. In other words, it was your call as the woman to say when or if you felt movement. So I think one thing that people misunderstand about the opposition to abortion is that people assume that there's always been a vibrant religious or moral opposition to abortion. And that in fact that's actually relatively recent. It's not something rooted in ancient history. This is Carissa Helgeberg. I'm an associate professor of history at Tulane University. And author of the book, Women Against Abortion, inside the largest moral reform movement of the 20th century.

The question is, how does this go from being a personal, private decision either among women or between couples to one that the state becomes invested in? This question brings us back to Madame Ristel, the so-called abortionist of Fifth Avenue. Get your morning paper, read all about it. Madame Ristel, female physician, office in residence 148 Greenwich Street

between Courtland and Liberty, where she can be consulted with the strictest confidence on complaints incidental to the female frame. Years before Horatio's stores started building up his name in medicine, advertisements for Madame Restelle's services filled the papers. $5 for a packet of preventative powder, $1 for female monthly pills.

And if those didn't work, she offered surgical abortions. $20 for poor women, $100 for the rich. She called herself a doctor, just like many others in the business did. Dr. Dow advertised, Dr. Carswell, sleeping Lucy in Vermont. They were all creating a persona, a brand, like Madame Restell.

She arrived in New York City from England in 1831 with her husband and newborn baby. Back then, she went by Anne Tro's Summers. But within months, her husband died of fever and she was left on her own. Looking around, she saw that the marketplace for helping women prevent and end pregnancies was thriving. So she changed her name to Madame Ristelle and opened up shop. The pills sold in this marketplace turned traditional folk remedies that had been around for centuries into commercial products. They didn't always work and sometimes produced harmful side effects.

Some women died. The American health marketplace in general was kind of dangerous. People were routinely sending away for herbal remedies to cure all matter of maladies. Some states began passing poison control laws. It was a desire to protect women from ingesting poisons that might harm them. Madame Ristelle and others began to be charged under these laws, but the penalties were never too harsh. And though it earned Madam Rustel some critics in the papers, she continued to celebrate her abortion business loudly, living a life of luxury. 1847, The Sunday Dispatch, New York City.

Madam Rustel is showy enough for a princess. She likes fine carriages, handsome horses, and expensive living. Her pew is one of the pleasantest in a very fashionable church. She has fortified herself too strongly ever to be overthrown. At that point, no one, least of all Madame Rustel herself, believed her reign would ever end. But those poison control laws were just the start of a moral tide that was sweeping the country. It has been said that misery loves companionship. This is nowhere more manifest

than in the histories of criminal abortion. And it would lay the foundation for a campaign to make abortion not only immoral, but illegal. A campaign that would eventually take down Madame Ristelle and the entire abortion marketplace. A campaign led by Horatio Storer. If we had proved the existence of fetal life before quickening has taken place or can take place. We are compelled to believe unjustifiable abortion always a crime. Coming up, Horatio Storr launches

the Physicians' Crusade against abortion. Hi, this is Tobias Dwyer from Ann Arbor, Michigan, and you're listening to Through Life from NPR. Here on The Indicator from Planet Money, we fanned out across the country to ask how you are feeling about the 2025 economy. Anxious. Uncertain. Unfair.

Turbulent. Crazy. We don't just recite the headlines, we show you how the economy is affecting your life in 10 minutes or less. Each weekday, listen to the indicator from Planet Money, wherever you get your podcasts. The news can feel like a lot on any given day, but you can't just ignore it when big, even world-changing events are happening. That's where the Up First podcast comes in. Every morning in under 15 minutes, we take the news and pick three essential stories so you can keep up

without getting stressed out. Listen now to the Up First podcast from NPR. We asked and you delivered what is the best Pixar movie of all time. Thousands of you voted and we've got the results. Where did Inside Out, Toy Story, and Finding Nemo land in the top five? Listen to Pop Culture Happy Hour on the NPR app or wherever you get your podcasts. Part two, a century of criminalization. The moral guilt of criminalization. actual and various proof that the child is alive from the moment of conception.

— In 1860, governors of every single state in the U.S. received this letter from the recently established American Medical Association. — The evil to society of this crime is evident from the fact that its instances in this country are now to be counted by hundreds of thousands. — But there was really only one guy holding the pen. — Horatio Storer. — Carissa Helgeberg again,

who studied the formation of the anti-abortion movement. — Basically, he ghost-wrote a letter from the president of the AMA, so it looked like it was coming from the president, but Storer was actually the one who wrote it, saying that the AMA. So it looked like it was coming from the president, but Storer was actually the one who wrote it, saying that the AMA opposes abortion and he used the language of morality. In reality, there is little difference between the immorality by which a man forsakes his home for an occasional visit to a house of prostitution, that he may

preserve his wife from the chance of pregnancy, and the immorality by which that wife brings herself willfully to destroy the living fruit of her womb. The letter was pivotal to what historians call the Physician's Crusade against abortion. And Storer was making a few key arguments for why abortion should be illegal across the country. First, he introduced a new idea. The child is alive from the moment of conception. That life began at conception.

Remember, up till now, people generally agreed that life began when a woman could actually feel life move inside her, at quickening. But that wasn't enough for Storer. He campaigned on a moral argument that also tapped into the racial fears of the moment. Fears that would eventually inspire a pseudoscientific field of quote racial improvement and planned breeding of the population. American eugenics. These

racial fears would inspire forced sterilization programs to decrease certain populations, whereas Storer's anti-abortion campaign was trying to increase other populations by focusing on Protestant white women. Because elite Protestant white women were often the ones going to people like Madame Ristelle, and people like Horatio Storer were realizing that that had consequences. The birth rate for Protestant white women had been declining over the course of the

19th century. So he had fears of what was commonly referred to as race suicide, that the Anglo stock wasn't going to replenish itself fast enough to keep up with the swells of new immigrants to the United States. And who is going to have power and populate this country and populate the Great Plains and the Great West? Well, it is going to be Chinese migrants, it's going to be African Americans, newly freed people, and Catholics. They are not the ones using abortion. It's our Yankee women who are using abortion,

trying to get into medical school, trying to do politics when they should be at home having babies and taking care of them. They began to say, we need white women to use their loins because they're concerned about the blackening and the browning of what is now, what at that point became the United States. And this real concern that when black people become free,

what will this mean for white people? And white women become a key to that. So part of Soros' thinking was that criminalizing abortion would help rebalance the scales of who was being born into this country. But there was more to his strategy. He saw this as a way to finally knock out the competition, midwives and people like Madame Ristel. And so if the AMA could wrest control over the marketplace of abortion, it would be lucrative

to this growing cadre of university educated, mostly male physicians who were beginning to specialize in things like obstetrics and gynecology. So midwives were slandered in this campaign. Described as unsanitary, unclean, as unmoral. And as clueless as the mothers themselves. Saying women do not know, they don't know when they quicken and really makes fun of women's own sensations and

knowledge and says, you know, some of them quicken at one month, some of them never quicken at all, and then they have a baby. They may very constantly be recognized by the physician in cases where no sensation is felt by the mother. So there's this scoffing at women's knowledge, saying this is a sin. This is murder, you're killing children. By the moral law, the willful killing of a human being at any stage of its existence is murder. And the general public and women don't get it, they don't

know that, and we need to change the laws. So to help people get it, Storer wrote. Articles, books, reports, speeches, all to make his views on abortion and women clear. In one lecture called The Origins of Insanity in Women, he advocated for ovaryectomies for women who, quote, have become habitually thievish. Profane or obscene, despondent or self-indulgent, truish or fatuous.

The solution, as he saw it, Remove the cause. A woman's reproductive organs. He was really hostile to women. And that hostility was starting to gain traction. A few years into the campaign, some states began to pass laws outlawing or restricting abortion. Perhaps the harshest was in Connecticut in 1860. The law got rid of the

quickening rule and made abortion a crime for which the abortionist and the woman getting the abortion could be fined and jailed. And over the next few decades, most states across the country would adopt similar laws, thanks in part to another campaign that was going on at the same time, that was getting even more attention. It was led by a Union Army Civil War veteran named Anthony Comstock, who's well known for leading the anti-birth control crusade of the 19th century. Anthony Comstock was a descendant of some of the earliest Puritans in New England. He took that ancestry to heart and went on to work with the Young Men's Christian Association, the YMCA, in New York City, and founded the New York Society for the Suppression of Vice. And he dedicated his life to exactly that. Suppressing

vice. In 1873, Comstock began lobbying Congress to pass anti obscenity laws. There had been a rise of prostitution and new forms of birth control like diaphragms and rubber condoms, all of which triggered a powerful backlash, a backlash that culminated in the Comstock Law. The criminalization of sending materials through the mail that could be seen as obscene. That no obscene, lewd, or lascivious book, pamphlet, picture, paper, print, or other publication of an indecent character or any article or thing designed or intended for the prevention of conception or procuring of abortion, nor any article or thing intended or adapted—

The law made it illegal to mail sex toys, pornography, contraception, abortion drugs, or even information about contraception and abortion. Including some medical books that had pictures of anatomy, right? It's just how deep it went. But here's the thing. Comstock conflated birth control with abortion. He saw no difference between the two, which meant that abortion was wrapped up into this new law, making it a federal offense to send or order material about abortion by mail with punishment

of up to $5,000 in fines, which is over $110,000 today and up to 10 years in prison. The law was the first of its kind in the Western world. Between Comstock's laws and Horatio Storrs' crusade by 1880 every single state had a law outlawing abortion on the books. These laws launched a century of criminalization. So in the terms of the way the laws are written, there is always an exception written into the laws that allow for medical professionals, for doctors, to perform abortions if they, in their medical judgment, believe it is necessary to save a woman's life or to save her

health. This is clearly written from the perspective of a specific group of the medical profession and they're really claiming abortion as theirs. It is the procedure that doctors can perform if they believe it is medically necessary. And that medically necessary is not defined in the law. But it does mean that they can kind of control this and also say, you know, other people, midwives, you know, Madame Restell, immigrants, bad people are doing this procedure. And it's's immoral and now it's illegal. Unless it's done by us, doctors. In the end, Horatio's story and the AMA's campaign against abortion, aided by Anthony

Comstock's anti-contraception campaign, was a success. And although not all doctors agreed with or followed the new laws, midwives and entrepreneurs like Madame Ristelle were still sidelined as male gynecologists and obstetricians took over. But they didn't just lose business. They were in danger now that their very livelihoods were illegal. Things were especially dire for Madame Ristel, since she had been so public and bold about her services. Her clientele were mainly upper-class white

women, though women's store believe she'd be having more kids. All eyes were on her as these laws took hold. And Comstock made it his mission to end her. In 1878, he rang her doorbell on East 52nd Street, pretending that he was a married man seeking an abortion for his wife who already had too many children and wasn't in good enough health to birth another. She sold him some pills, and he was on his way. But the next day, Comstock returned with a police officer who arrested Ristel. As always, Ristel went to the press.

He's in this nasty detective business. There are a number of little doctors who are in the same business behind him. They think if they can get me in trouble and out of the way, they can make a fortune. If the public are determined to push this matter, they will have a good laugh when they learn the nature of the terrible items of the preventative prescriptions. Of course, if there's a trial, it will all come out. But there was never a trial. Restelle became distressed.

She paced around her house asking her servants why she was persecuted time and time again. And on the morning of the day she was supposed to appear in court, one of her chambermaids walked into her bathroom to find her dead in her bathtub. She had slit her own throat. When Comstock found out, he took out his file on her and wrote, quote, a bloody ending to a bloody life. As for Horatio Storer, he co-founded the Gynecological Society of Boston, which focused on diseases that affected women and

reproductive health, and came to be known as a pioneer in the field of OBGYN, obstetrics and gynecology. When we think about this, is there any wonder why for so long medicine looked white and male in the United States. What explains that? It's certainly not because women aren't intellectually curious about medicine. It's not because women don't know how to read books. It is because the American Medical Association, through the tools of all of this time, very specifically, very specifically, made sure that women would be cut out. Coming up, abortions go underground.

Hi, my name is Ben Corso. I'm a teacher from Tampa, Florida, and this is Throughline from NPR. President Trump has spent the first few months of his term testing the limits of presidential power. He's tried to upend decades of established trade policy and foreign policy, and taken over powers long ceded to Congress. NPR's podcast, Trump's Terms, curates the network's coverage of the Trump administration. It helps you follow the latest and understand what it means. Trump's Terms.

Listen in the NPR app or wherever you get your podcasts. Part Three. Into the Shadows. I still remember the sound. When Joan Lester was 19 years old, she found herself in a dark room with a doctor whose name she didn't know. I don't even know if he was a gynecologist. Alone at midnight, getting an illegal abortion. What happened next was really common and really graphic.

So he told me to lie down on the table, you know, take my pants off first. I lay down on this table. He inserted a curette, which is basically a razor, uterus to scrape out the fetus. And I still remember the sound. In addition to the pain, I don't think he gave me any painkillers. And so I began to moan, and then I think I screamed. He clamped his hand over my mouth. He said, shut up. And that's mostly all I remember about it. At the end of the procedure, the doctor gave her a couple of towels. Blood was just coming down my legs and I remember soaking through the one or two towels that I had.

It hurt like hell. I was probably crying. A few weeks later, Joan was still in a lot of pain. So she went to the closest hospital, looking for answers, looking for help. I got to the hospital emergency room and there was a doctor there who was the admitting doctor. She told him she'd had an abortion.

And there I am, writhing in pain. When suddenly, his whole demeanor changed. And he said, you're an abomination, this is God's punishment to you for your sin, for what you've done. And you're never going to have children, your tubes are going to be sealed up because you have this huge pelvic inflammatory infection. And he was just screaming at me. Joan was admitted into the hospital and put on antibiotics. If she'd waited, she might have gone into septic shock, when an infection causes your blood pressure to drop to life-threatening levels. Over the next week, she began to recover.

And I have to say that this was probably not one of the most extreme examples of what happened to women. They were just all kind of horror stories because we were just completely vulnerable because we had done something illegal. And, you know, we basically had no rights. For decades after Horatio Storer and the AMA got those laws on the books in every state, women continued to quietly seek out abortions and the private practices of doctors who disagreed with or simply worked outside of the laws, which there were plenty of. Those doctors rarely faced criminal charges unless a woman died. It wasn't until the middle of the 20th century that the horror stories of botched illegal

abortions like Joan Lester's began skyrocketing, a byproduct of a changing world. The hospitals, designed to serve thousands at a time, are equipped with the most modern devices and specialists and expert technicians. By World War II, everybody is in the hospital. John Rogers Jr., white, six pounds. Mother's name, Clara. Ninety, ninety-five% of the entire population goes to hospital to deliver babies. That's exactly the reverse of the

figures when John Sr. was born. There had been a revolution in medicine. Things like x-rays, antibiotics, and sterile surgeries made hospitals important like never before. Childbirth and abortions were theoretically safer than ever. And so abortion too is increasingly going to be done in the hospital. And this really changes things. Many OB-GYN doctors moved into hospitals where they had a lot more oversight. And hospital administrators

who are worried about violating state laws and getting sued formed abortion review committees that would review whether an abortion was medically justifiable or not. And they made it really hard for a woman's abortion request to get approved. Women are subject to multiple exams usually by both psychiatrists, obstetricians, and then often three other physicians. This is an era when many women don't have health insurance, certainly when there aren't federal programs to help women pay for these services. Certified OB-GYN doctors who would have done abortions before

were terrified of getting caught now, especially because this shift in medicine collided with another massive change. Babies all over the map. After World War II, we had the baby boom and there was enormous pressure put on American women to have children. During the Second World War, women had staff jobs in factories and other parts of society as the men went off to battle. When the men came back, You like to cook, don't you, pet? Well, it's accomplishing something. women were pressured to return into the home and to have children.

Get married, have children, and live with a white picket fence. And abortion was at odds with this. City officials, motivated by the social messaging of the time and looking for ways to boost their public profile in the face of growing racial tensions and accusations of corruption. Begin enforcing these laws that have been on the books. They start to go after people who've been practicing for 10, 20 years and they raid them. So we see an explosion of the illegal marketplace for abortion in the 1940s and 1950s.

You're thrown underground and into the shadows. As the illegal marketplace flourishes, a whole host of people fill that vacuum. Some doctors risked losing their license to practice, risked going to jail, and continued providing abortions to women in secret. But... The vast majority of women sought to self abort. I heard of people throwing themselves downstairs or drinking Clorox or various kinds of poisons.

There were women who died in motel rooms, sitting on top of clumps of towels, people coming home and finding daughters dead in bathtubs, bleeding out, coming home and finding wives on the top of dining room tables having used hangers and things like that. Many women of all social classes, many women of color were getting abortions. The real story here is the difference in outcomes. If you had the means, which usually meant you were an upper middle class white woman,

you could pay off someone with a little more training to do the abortion. You know, it was African-American women who were most likely to end up in the clutches of the so called back alley butchers. This is Carol Jaffe. I'm a professor at the University of California, San Francisco. It's hard to pinpoint exactly how many illegal abortions were being carried out in this period. Estimates range from 200,000 to 1.2 million per year. There was a cone of silence around it. Many women were too afraid to talk about their experiences, fearing both legal and social consequences.

We have to remember what it was like in the 1950s and the 1960s and the shame that was brought about by being a single mother. Women were not supposed to have babies out of wedlock. They were not supposed to divorce their husbands if they experienced domestic violence. I mean, it was legal to rape your wife. So in the United States, we're talking about a time in which states laws protected men who raped their wives. More and more women like Joan Lester in which states laws protected men who raped their wives.

More and more women like Joan Lester were showing up in emergency rooms with infections and injuries caused by botched abortions. Five, 10, 20 a day, hundreds coming in on the weekends. Doctors and medical students were scrambling to help them all. And they're holding their hands while they bleed and die. And this just is, for many people, is intolerable. Abortions, if done in sterile conditions by a trained professional, were rarely deadly

at this point. But the illegal marketplace was creating an epidemic. So that drives a lot of doctors to support the decriminalization because they personally know what the results are. And they see it as a public health problem. Doctors teamed up with like-minded lawyers and set out to reform abortion laws at the state level. And the hope is, you know, these doctors will be able to perform more of the abortions that they think are necessary.

In cases where women had been raped or the mental or physical health of the fetus was at risk, a group of doctors had been responsible for getting laws against abortion rights on the books. And now doctors were on the other side of the fight, pushing to get those same laws off the books. More than a dozen states passed reform laws in the late 1960s and early 70s. And four states legalized abortion outright. New York, Alaska, Washington, and Hawaii. Almost immediately as states revised their laws, anti-abortion activists began to mobilize.

And most of them were Catholic. So they were really the only stalwart opponents to abortion. On and off for centuries, the Catholic Church had declared all abortion murder. And in the 1960s, a movement began to form around that idea. At this time, as the movement is emerging, would they have been self-identifying as anti-abortion or pro-life? They would have used the language, the descriptor, pro-life.

Catholics who were coming out of anti-war activism, civil rights activism, anti-nuclear proliferation activism, they believed that life should be protected from conception to death. So they opposed the death penalty. They supported a more generous welfare state to enable women to be able to support families. They saw all of this as a part of a broader movement to protect life at all stages, a quote, pro-life movement. But outside of this Catholic opposition, the pushback to these reform laws was minimal. Mainline Protestant institutions even came out in support of expanding access to abortion,

seeing first-hand the toll of illegal abortions on women and their congregations. A new movement for women's liberation is launched. And once again, protesters take to the street to support their demands for total freedom economically, politically, socially. In the 1960s, the women's liberation movement began to advocate for what one organization called, quote, true equal partnership with men. Equal rights to have a job, to have respect, not be viewed as a piece of meat. We just want what men have had all these years.

Those of us like myself who were involved were just living and breathing, you know, liberation, liberation, liberation. But pretty soon, the mostly white, mostly middle-class leaders of the movement shifted their focus. What is it you're pioneering? What do you want to say?

The sexual revolution. I feel we're going into the, you know, beginning of an emotional revolution. They wanted to get rid of the shame and silence that had surrounded women's bodies and sexuality for so long. It's we don't just take our clothes off and say, look, I am nude, you know. We are, it's all very natural. Abortion became a top priority for the movement, and they encouraged women to speak out about their illegal abortion stories.

And it was pretty shocking. It was shocking to me, I think it was shocking to everybody how widespread this was. Respected professionals and mothers, oh my god, they had an abortion? It really changed the conversation. What's so interesting is that so much of the feminist movement of that time in general was very focused on health and was very anti-doctor. There was a tremendous critique of gynecology. You know, the image of a woman in the stirrups became sort of this emblem of female passivity and male power. And suddenly they found themselves on the same side as these doctors, forced to work with them

whether they liked it or not. I have referred to them as, quote, uneasy allies. Who didn't always see eye to eye. It was a clash of style. Feminists wanted sweeping change. Some called for repeal of all laws restricting abortion. They were saying, we don't need to be told when it's appropriate to have an abortion

by a doctor or anyone else. It should be a private personal decision. But some people who supported abortion rights worried that framing the issue within the context of the feminist movement and pushing a national agenda might create a backlash. So for the women who opposed abortion beginning in the late 1960s,

they understood the sexual revolution as a threat, a threat to the family, something that might cause men and women not to get married and have children in the orderly way that they should. They believed that they were suddenly being criticized as being stupid or being dupes for having that lifestyle. And there was a fear that abortion was just the beginning of the end of that lifestyle.

That this is part of a moral decline, wrought by the sexual revolution. Some of these women began joining the pro-life movement, a movement that was still in its infancy, a movement that was poised to enter a new era. Today we find it the center of a gathering storm as women and men argue the question of abortion, the right to life or the woman's right to choose. In 1970, while all this was happening, a small group of lawyers took on a case in Texas, the plaintiff, a woman named Norma McCorvey, who was listed as Jane Roe in court records to protect her identity, the defendant, Henry

Wade, the district attorney of Dallas County, Texas, where Jane Roe lived. The issue? Jane Roe was pregnant with her third child and wanted an abortion on the grounds that it should always be a woman's right to choose. Under Texas law, abortions were only allowed when necessary to save a woman's life. By 1973, the case had made its way to the Supreme Court. Jane Roe had already had her child, but the stakes were much higher by then. If the court sided with Jane Roe,

abortion would become legal nationwide. Good evening. In a landmark ruling, the Supreme Court today legalized abortions. Roe v. Wade was a 7-2 opinion. Five of those seven justices who struck down laws criminalizing abortion were Republican appointed. The court ruled that the state could not regulate abortion in the first trimester at all. Only in the third trimester, once the fetus could live outside the womb, could states ban abortion entirely. And the court stopped short of giving women total control over the decision. in consultation with his patient is free to determine without regulation by the state

that in his medical judgment the patient's pregnancy should be terminated. Doctors remained a central part of the decision and at the heart of the issue. Still, this was a huge sweeping change and abortion was now legal in all 50 states. and abortion was now legal in all 50 states. And everybody thought the problem was done. It wasn't. So what happened right after Roe? What happened right after Ro? Check out our episode after Ro to learn more.

That's it for this week's show. I'm Ramtina Arab-Louis. I'm Randabdil Fattah, and you've been listening to Throughline from NPR. This episode was produced by me and Lawrence Wu, Lane Kaplan-Levinson, Julie Kane, Victor Ibeyes, Anya Steinberg, Yolanda Sanguine, Casey Miner. Fact checking for this episode was done by Kevin Voelkel. Thank you to Turner Ross, Blaze Alder-Ivanbrook, Lawrence Wu, Julie Kane, Benjamin Swift, Owen Perry, Sam Klague, Shaheer Khan, Eric Liu,

and Bergen Hoff for their voiceover work. And a special thanks to Deb George for her editing support. Thanks to Sarah McCammon, Tamara Charney, and Anya Grunin. This episode was mixed by Josh Newell. Music for this episode was composed by Ramteen and his band, Drop Electric, which includes Anya Mizani, Naveed Marvi, Sho Fujiwara. If you have an idea or like something you heard on the show, please write us at throughline

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