History

CHAPTER 8

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Radicalization of Reform

The suppression of abortion in the decades immediately
preceding Roe v. Wade was unique in the history of abortion. That re-
pressive system, and its deadly results, played a crucial role in producing
a movement to legalize abortion. The abortion rights movement arose
out of the deteriorating conditions of abortion and the frustrations of
both women and physicians. As part of their campaign to liberalize
state laws, reformers exposed the new and devastating conditions of
abortion as intolerable and discriminatory. The social movement to de-
criminalize abortion drew upon and brought into the open a long-
standing acceptance of abortion.

Explanations for the transformation of abortion law that point to
media coverage of celebrated abortion cases or changes in medical
technology or emphasize the personalities of the Supreme Court jus-
tices all simplifY the origins of legal and social change. They cannot ex-
plain the strength of popular support for legal change. Nor can they ex-
plain why members of a socially conservative profession, the medical
profession, initiated reform or why the majority of that profession came
to support the radical demand for repeal. The abortion cases reached
the U.S. Supreme Court as a result of a grassroots movement in which
women as well as doctors played a prominent role. The court’s deci-
sions arose out of a particularly repressive period and were rooted in
both the historical acceptance of abortion and in the contemporary re-
sistance to the law.

The discriminatory and dangerous abortion system bred fear, frus-

216

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AN: 6862 ; Leslie J. Reagan.; When Abortion Was a Crime : Women, Medicine, and Law in the United States, 1867-1973
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RADICALIZATION OF REFORM 2r7

tration, and ultimately a movement to change the laws governing abor-
tion. Despite the hazardous character of abortion, women were not the
first to articulate publicly and politically their dissatisfaction with the
law. In the mid-1950s a small group of physicians and public-health
workers initiated the earliest efforts to reform the abortion laws. The
hospital system itself, which prevented doctors from providing abor-
tions to patients and forced them to care for the damages resulting
from illegal abortions, generated physicians’ demands for legal change.
Medical reformers soon linked up with leaders in the legal profession,
and this professional alliance advocated reform of abortion law. For
professionals, the solution to the abortion problem was enlarging the
legal space in which physicians could perform abortions.

As women entered the professional abortion discourse they brought
their own experiences and insights to bear on political analysis. Femi-
nists retheorized the meaning of abortion. Abortion, as the new femi-
nists analyzed it, was more than an individual need, private crisis, or
public-health problem; it was a collective problem for all women. Fur-
thermore, the criminal status of abortion was a fundamental feature of
the subordination of women. Feminists found that the assumptions un-
derlying the law and medical practice toward abortion denied women’s
right to make decisions about their own reproduction, denigrated their
moral judgment, and limited their freedom.

Women and professionals looked at the abortion problem from dif-
ferent standpoints, but women, as patients and political actors, moved
physicians to a more radical political position. As they had for genera-
tions, women insisted that the medical profession listen. Though these
“discussions” often took the form of nasty debates, even pickets, much
of the medical profession heard the feminist message, just as they had
individually heard their individual patients’ demands. Now, however,
communication and negotiation occurred in public forums between in-
stitutions, organizations, and mass movements rather than in conversa-
tions in physicians’ offices. What had been the private problem of abor-
tion had become political, and what had been the subject of personal
discussions had turned into a public debate.

The oppressiveness of the postwar years alone did not produce a
movement to legalize abortion, as oppressiveness had not in earlier
decades. The changing political context of the period helped produce a
mass movement for women’s reproductive rights. A movement for abor-
tion rights developed at a time when many in the Civil Rights and anti-
war movements mobilized for radical change, a time that gave rise to

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218 RADICALIZATION OF REFORM

the second wave of feminism. I examine three phases and several key
actors, each representing different groups, with distinctive perspectives:
first, the professional movement for reform, composed of physicians
and lawyers, which attempted to legislate change; second, the emerging
feminist movement, which introduced new meanings of abortion that
altered the course of political change; and third, social movement law-
yers who challenged the constitutionality of the law and brought to-
gether the complaints and claims of physicians, feminists, and low-
income women. As a dynamic mass movement in opposition to the ex-
isting criminal abortion laws developed, it laid the groundwork for dra-
matic changes in public policy. The legal challenges framed by Illinois
attorneys emphasized the importance of class, race, and gender in abor-
tion. The legal outcome, however, downplayed the significance of race
and class in abortion and played up the rights of professionals and fe-
male patients.

Professional Reform Measures

Psychiatrists were among the first to question the new
structures regulating abortion in the early 1950s. Psychiatrists, the newly
liberal and socially activist wing of the medical profession in the post-
war period, 1 responded sympathetically to the emotional distress of
pregnant women. Their willingness to question the status quo made
them early critics of the abortion committee system. Sessions at psychia-
try meetings in 1951 and 1952 brought out their frustration. Arthur J.
Mandy, a psychiatrist and gynecologist at the Johns Hopkins Univer-
sity, bluntly criticized the therapeutic abortion system as chaotic and dis-
criminatory. Physicians, Mandy declared, found the hospital committee
system a “pathetically complicated mess-a hodgepodge of confusion,
distortion and duplicity.” The lack of clear standards on the indications
for therapeutic abortions and the changing policies made the situation
“anxiety-provoking” for physicians. The review by hospital committees
of honest physicians’ recommendations for therapeutic abortion made
many of them feel, Mandy reported, like “confirmed criminals.” 2

Hospital restrictions on therapeutic abortion generated resentment
among physicians who, as one put it, felt “shackled” by the law. Doc-
tors identified the problem as in the law, not in the structure that had
been created by physicians themselves in hospitals under their control.

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RADICALIZATION OF REFORM 219

The monitoring of medical practice delegitimated therapeutic abortion
and taught practitioners that they acted on the borderline separating
the reputable and the disreputable. Dr. Alan Guttmacher instituted
therapeutic abortion committees at two hospitals, yet, he later re-
marked, those who performed therapeutic abortions had the “haunting
feeling that our acts are half-illegal.” 3 These doctors soon saw the ne-
cessity not of dismantling the hospital committee system, but of chang-
ing the law.

Medical and public-health professionals aired the problems of in-
duced abortion in 1955 at a small, unpublicized national conference or-
ganized by Planned Parenthood. When Planned Parenthood sponsored
this conference on abortion, the organization bravely moved in a new
direction. Planned Parenthood, and particularly its medical director,
Dr. Mary Steichen Calderone, deserve credit for playing a crucial role
in pushing forward a professional movement to reexamine and reform
the abortion laws. 4 The organization promised to keep the event quiet. 5

The cloaking of the conference in secrecy is telling: talking about abor-
tion in public scared professionals. The conservatism of the era, both
political and sexual, colored the conference. Given that two years ear-
lier one physician had been called to the grand jury as a result of his re-
marks about abortion at a Planned Parenthood meeting, participants
had some reason to worry. Association with abortion could be danger-
ous. Professionalism did not protect them; instead, it heightened their
sense of danger because medical careers depended on good reputations.
Conference organizers promised that participants would be quoted
only with their permission and could have their “participation deleted”
from the published proceedings. 6

In spite of anxiety about damage to their reputations, the confer-
ence participants worked on a joint statement calling for a change in
the abortion law, which the majority signed. Professionalism could cut
both ways. Professionals worried about protecting their reputations
and their social authority, but their status allowed them to speak to
controversial matters based on their expertise. “Present laws and mores
have not served to control the practice of illegal abortion,” their state-
ment began. “To keep on the books, unchallenged, laws that do not
receive public sanction and observance,” they declared, “is of question-
able service to our society.” Legal reform was necessary. The partici-
pants believed that if current laws were strictly interpreted, most thera-
peutic abortions would be illegal because they were not induced to
“save” a woman’s life. The laws should be rewritten to allow doctors

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220 RADICALIZATION OF REFORM

greater legal “latitude” to recommend therapeutic abortions for “psy-
chiatric, humanitarian, and eugenic indications.” Liberalizing the abor-
tion laws, the signatories hoped, would expand the practice of legal
therapeutic abortion, lessen the inequality among different classes of
women in access to legal abortion and birth control, and improve the
public health. As a result of the 1955 conference, for the first time in the
United States a group of elite physicians and other professionals collec-
tively advocated reform of the criminal abortion laws. 7

The 1955 abortion conference was a discussion among professionals,
and the professionals’ view of the world shaped their vision of reform.
This is not to say that the efforts initiated by professionals were in-
significant, but to point out the boundaries of this conference. Left un-
spoken at these meetings was the question of whether women could
decide for themselves when an abortion was appropriate without hav-
ing to go through physicians or other intermediaries. The reforms pro-
posed by the group were designed to free physicians from the restraints
of laws and committees and to eliminate the sense that providing ther-
apeutic abortions was a shady, disreputable business. Once the indica-
tions for therapeutic abortion had been liberalized, sympathetic physi-
cians would be enabled to help more women who needed abortions.
Women themselves, however, would still have to obtain medical per-
mission for a legal, therapeutic abortion.

Women’s rights were left out of the discussion at the conference and
out of the final statement, but it could have been different. The birth
control movement had been founded on the principles of female repro-
ductive and sexual freedom, and feminists in England had extended the
argument to abortion, but Planned Parenthood now advocated birth
control in the name of the family rather than female freedom. Confer-
ence participants did not talk about the ALRA in England and its de-
mands for the decriminalization of abortion, though the Bourne case
was mentioned and excerpts of the ruling included in an appendix of
the published proceedings. 8 This entire group could not have been ig-
norant of the ALRA perspective, but they did ignore it. Nonprofes-
sional women did not enter the abortion discourse to speak for them-
selves until later.

The elite of the legal profession heard the complaints of the medical
profession and identified with them as professionals unnecessarily ham-
pered by the law. In 1959, the year after the publication of the confer-
ence proceedings, the prestigious American Law Institute (ALI), made
up of attorneys, judges, and law professors, proposed a model law on

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RADICALIZATION OF REFORM 22r

abortion as part of its larger project to standardize American law. As
the legal scholar who presented the proposal observed, “The abortion
law is out of step with the morals of a substantial, responsible profes-
sional group.” The ALI’s model law clarified the legal exception for
therapeutic abortions along the more liberal lines favored by the physi-
cians at the Planned Parenthood conference. It allowed licensed physi-
cians to perform abortions for physical and mental health reasons, fetal
defects, or when pregnancy was the result of rape or incest. 9

The possibility of permitting abortion solely at a woman’s request
was raised and quickly suppressed. The model law did not allow women
and physicians to decide upon abortions without regulation because “it
would [not] be sensible to propose a general abortion-at-will statute in
this country.” Instead, the ALI model law, Leonard Dubin of Philadel-
phia pointed out, “would go a long way to curing the ill of indefinite-
ness which has plagued … medical practitioners and lawyers trying to
advise them.” It was hoped that, with the model law, physicians and
lawyers would feel less anxiety about therapeutic abortion and, thus,
abortions would become more available. 10

Fearing opposition, the ALI consciously avoided challenging the
sexual norms that forbade sex outside of marriage and that treated
pregnancy and childbearing as punishment for sexually active unmar-
ried women. The idea of allowing pregnant unmarried women to have
abortions provoked a storm. “For us … to place the stamp of approval
on that,” William Marbury explained for the ALI council, “would of-
fend the sensibilities and views of any number of people.” This was not
about rape, he continued, but about “some girl who goes out and gets
herself in trouble and wants to get out of it by an abortion.” If the ALI
accepted this, it would land in a “great deal of hot water.” The speak-
ers expressed little sympathy for the predicament of unmarried women
faced with unwanted pregnancies and a great deal of sympathy with a
public they assumed to be conservative on the question. The motion to
allow abortions in cases of illegitimacy did not receive a second. 11

The only opposition to the proposed model Jaw on abortion at the
1959 ALI meeting came from a Catholic attorney and a Catholic priest. 12

Like his opponents in the ALI, Illinois attorney Eugene Quay took up
abortion as a crucial legal and political question. Quay represented
early religious opposition to abortion reform. In 1960 and 1961, he
published a lengthy treatise in the Georgetown Law Journal in which he
alerted Catholic attorneys to the emerging legal movement to liberalize
abortion law and provided arguments to fight the ALI reform. The

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222 RADICALIZATION OF REFORM

Catholic Church had played a key role in opposing the birth control
movement and would soon lead the fight against legal abortion. 13

Over the next decade, legal and medical organizations promoted the
ALI model law on abortion in state legislatures as well as in the media.
In 1960, the Chicago and Illinois Bar Associations advocated legaliza-
tion of abortion in cases of rape and incest. 14 By 1967, California, Col-
orado, and North Carolina had passed the model law. The Illinois leg-
islature voted down reform bills in 1967 and 1968. Twenty-eight other
states considered similar legislation, and by 1970, twelve states had
passed abortion reform measures based on the ALI modcllaw. 15

The specter of women dying as a result of illegal abortions propelled
activists for legal change. Reformers hoped to protect the lives of more
women by granting more therapeutic abortions. Data amassed by New
York public-health officers had revealed the growing number of deaths
resulting from abortion and shown that most of the women who died
were African American or Puerto Rican. Public-health professionals
joined the earliest calls for reform growing out of the 1955 Planned
Parenthood conference. Dr. Alan Guttmacher, who became the most
visible national advocate of reform, explained that his belief in the ne-
cessity of legal change was the result of having seen women die because
of abortions. 16 The memory and mourning of deaths they could not
prevent, but that could have been avoided, caused many doctors and
other health-care workers to favor reform. On the popular level as well,
awareness of tragic deaths generated support for change. For women,
death ‘s shadow always lurked when they sought abortions, and they
counted themselves among the lucky if they lived through their abor-
tions. As two early supporters of reform in California, Jerome M. Kum-
mer, a physician at UCLA, and Zad Leavy, an attorney and former
prosecutor, vividly observed, “We are confronted with a sea of heart-
ache and confusion and the tragic wastage of more than 5,000 deaths
per year. … How many women must be sacrificed to needless suffering
and death,” they asked, before the laws were reformed? If the profes-
sions did not take the lead in promoting legal change, an “outraged cit-
izenry,” they predicted, soon wouldY

Feminism and Resistance at the Grassroots

Nonprofessional women forged 1:vo early alternatives to
the professional movement to reform abortion law in the early 1960s.

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RADICALIZATION OF REFORM 223

The Society for Humane Abortion in California was one; “Jane” in
Chicago was the other. Both challenged the state in the most funda-
mental way and made obvious what had long been true: illegal abortions
were readily available to thousands, and the state was powerless to stop
them. In creating their own illegal abortion networks, the California and
Chicago projects circumvented the medical establishment and hinted at
the possibility of a health-care system for women run by feminists in
competition with the existing medical system. These initiatives were
not at first identified as women’s liberation efforts-that phrase had not
been coined yet. The second wave offeminism, on the verge of breaking,
would follow the analysis and activism of these innovative organizers.

One of the earliest nonelite supporters of the reform movement be-
came one of the first critics of the professionals’ reform strategy. In
1961, Patricia Maginnis, a San Francisco medical technician, collected
petitions in support of a California bill to reform abortion law. She
soon recognized, however, the practical and political limitations of re-
form. First, Maginnis saw that reform laws would not benefit the ma-
jority of women seeking abortions, and second, she concluded that
writing restrictive “reforms” into law would make it more difficult to
further liberalize access to abortion. As early as 1962, she voiced her ob-
jection to the type of review boards that the reform laws would institu-
tionalize. Maginnis formed an organization to support reform legisla-
tion, but within a few years she and her organization, the Society for
Humane Abortion (SHA), rejected reform. 18

The society put women, rather than physicians, at the forefront. It
exposed the medical review committees, which reform measures would
make permanent legal institutions, as insulting and humiliating to
women. The professionals who initiated the reform movement as-
sumed that physicians would review women’s abortion requests. The
society criticized such a system. A woman’s decision to have an abor-
tion “should not be frustrated and delayed by the complex machinery
oflegislated abortion committees which sit in judgment of the woman,”
the SHA argued. “A decision to obtain an abortion should be treated
just as any other surgical procedure, as a private matter between a pa-
tient and her physician.” 19 In an SHA cartoon, a woman asked a psy-
chiatrist, “How much does a psychosis cost for a legal abortion?” Psy-
chiatrists, who had worked to help women obtain abortions, had come
to be seen as barriers and were vilified for their role. 20

The SHA helped radicalize the abortion discourse when it pro-
claimed abortion as a right and demanded repeal of abortion laws.
“The termination of pregnancy,” the organization declared, “is a deci-

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224 RADICALIZATION OF REFORM

sian which the person or family involved should be free to make as their
own religious beliefs, values, emotions, and circumstances may dic-
tate.” Furthermore, the group argued, abortions should be available,
affordable, and provided in a way that was neither “humiliating nor dis-
criminatory.” SHA’s perspective would be adopted by women’s libera-
tion groups and, ultimately, all sections of the feminist movement. 21

For the first time an American women’s organization had framed
the problem of abortion in terms of women’s right to control their
reproduction. 22

In the mid-196os, Maginnis created a parallel organization designed
to help women obtain illegal abortions. Rather than cultivating friendly
hospital abortion committees or teaching women what to say in order
to get legal, therapeutic abortions, Maginnis challenged the law by
running abortion classes and distributing leaflets on the streets of San
Francisco with the names of abortionists in Mexico, Japan, and Swe-
den. By 1969, SHA’s underground arm reported sending twelve thou-
sand women outside the U.S. for abortion. Furthermore, it worked to
make women who received referrals politically conscious by requiring
them to write letters in support of repeal to their state legislators. 23 The
group not only sent women to abortionists, it regulated the illegal
abortionists. 24 This project turned the tables on the legal abortion sys-
tem: instead of women having to prove to physicians that they deserved
abortions, physician-abortionists had to prove their trustworthiness to
potential patients.

Like the SHA in California, what became known as “Jane” in
Chicago had roots in a prefeminist era. It grew out of an information
network within the Civil Rights and student movements of the mid-
1960s. In 1965, Heather Booth found a doctor in the movement who
agreed to perform an abortion for the sister of a male friend. Booth was
a student at the University of Chicago and an activist; she had partici-
pated in sit-ins at Woolworth lunch counters in New York in support of
black antisegregation efforts in the South and had registered black vot-
ers during Freedom Summer in Mississippi. Like many before her, in-
cluding Guttmacher and Maginnis, Booth ended up giving out the
name of the abortionist repeatedly and was soon overwhelmed by the
demand for help and information. Since she was an organizer, Booth
set out to find a group of women to take over this necessary work. 25 In
1967, several women active in movement politics created “The Service,”
which provided abortions to women without questioning the validity
of their requests. The group included Hyde Park homemakers and

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RADICALIZATION OF REFORM 225

University of Chicago students. As they gained control over the quality
and prices of illegal abortion in Chicago, they formed an alternative,
feminist, health-care system. When the activists negotiated with the
abortionists to lower the price, they collectively imitated generations of
women who had individually bargained with abortionists. They also set
up a “scholarship” fund to help low-income women. Jane members ini-
tially delivered women to abortionists, but when they realized that
some of the “doctors” were not physicians, they decided to learn how
to perform abortions themselves. 26

The Chicago Women’s Liberation Union, a citywide coalition, ad-
vertised its abortion service through underground newspapers, women’s
liberation papers, and school papers. When a woman called the union
about an abortion, she was given a local telephone number and told to
ask for “Jane.” Mter she left a message, a member returned her call,
took her medical history, and arranged for her to talk with a counselor,
who explained the abortion procedure and told her to go to an apart-
ment called “the Front.” There, service members prepared the woman
for the procedure, took her temperature, and gave her antibiotics to
prevent infections and a leaflet telling her what to do if she had compli-
cations. The Front served as a waiting room for the friends, relatives,
and lovers who accompanied women seeking abortions, where they
could talk or watch TV while snacking on cookies and coffee. From the
Front, where by the early 1970s twenty or thirty people might be wait-
ing, members of The Service drove carloads of women to another
apartment where a Jane member gave each woman a local anesthetic
and performed the dilation and curettage. A counselor held the wom-
an’s hand during the procedure. Between 1969 and 1973, Jane provided
eleven or twelve thousand abortions, approximately three thousand per
year. The women who went to The Service represented every age, racial,
and ethnic group and every class. When New York legalized abortion,
wealthier women flew there and The Service’s clientele changed. As
one woman recalled, “about 70 percent were women of color[,] most
of whom were living on a subsistence wage or welfare with very poor
health care.” 27

This abortion service was similar to other illegal abortion clinics, but
different because of its feminist and radical political orientation. Jane
was both a health service and a political education project. Not only did
Jane eliminate the profit in illegal abortion as it brought abortion un-
der feminist control, it eliminated the judgments of male physicians
and the sexual harassment that sometimes occurred. The activists in

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226 RADICALIZATION OF REFORM

The Service provided for women’s health needs within an environment
designed for women. They sought to empower women through knowl-
edge of their own bodies: during appointments, Jane members pro-
vided handmirrors to enable the women to see their cervixes and gave
each woman a copy of Our Bodies, Oursefpes. The activists rejected the
authority and distance adopted by physicians as well as the white lab
coats; instead they wore jeans and talked with their “patients” as sisters
and as equals. 28

Although The Service expanded beyond the movement, it could be
incomprehensible to someone outside the movement that sponsored it.
What was an advance for activists in the women’s health movement-
the rejection of male medical authority and the acquisition of knowl-
edge-disconcerted some patients. One woman later interviewed about
Jane had a negative memory of her abortion experience: it took a long
time; it was painful; she doubted their skill. That she went to an apart-
ment rather than a hospital or physician’s office, that the furniture was
shabby, that the abortion was performed in a bedroom, and that the
woman who aborted her wore jeans bothered her. Medical offices and
white uniforms reassured women that they were getting good medical
care; the lack of these symbols suggested that the whole operation was
dirty, illegal, and probably dangerous. This woman’s negative reaction
may have …