Book Review

Between 1880 and 1973 abortion was illegal in America. Historians once thought this meant that between those years nothing important happened, but thanks to Leslie J. Reagan, we now know better. Using Chicago as a case study, in order to illuminate her nationally oriented research, this book unearths an entirely new history of illegal abortion in which physicians, women seeking abortions, and the state, working sometimes together and sometimes at cross-purposes, transformed the various ways abortion laws were enforced, ignored, and negotiated.	1
The book has two main parts. The first covers the years 1867–1930, which Reagan argues were characterized by continuities from earlier years when early abortion was legal. Drawing on both coroners' inquest records and women's own letters, Reagan documents a widespread popular acceptance of abortion among many Americans. Moreover, she documents that abortion was widely available in Chicago from both midwives and physicians, including members of the AMA. Although other physicians continued to conduct antiabortion campaigns until 1920, they were unable to turn Chicago's public against abortion as a practice.	2
Yet despite abortion's continued availability and acceptance, it was now illegal. Although few abortionists were successfully prosecuted, Reagan demonstrates that the laws against abortion made a profound difference because of the ways they were enforced--that is, by physicians rather than exclusively by the state, and at the expense of dying women. Rather than trying to police the many abortion practitioners in Chicago (which would have been difficult because "bona fide indications" for medical abortions had never been clarified), police and DAs targeted abortionists whose operations had led to a woman's death and who could be prosecuted using women's "dying declarations." Physicians unwilling to coerce ill women into making statements (for instance, by withholding medical treatment) were threatened with prosecution as abortionists' accomplices. The unfortunate women who encountered incompetent practitioners and died, only to have their sexual histories exposed in the courts and the newspapers, served as object lessons in sexual propriety to other women.	3
The second half of the book turns from social history toward politics and provides a fascinating, utterly persuasive history of the social and medical conditions leading to Roe v. Wade. During the 1930s, Reagan shows, as women's demands for abortion grew due to the Depression, so did abortion's availability. As medical practice grew more specialized, big cities like Chicago began to see clinics openly specialized to abortion, run by established physicians or skilled practitioners, and recommended by numerous physicians whose patients needed abortions. Through the 1930s, law enforcement officials tolerated these clinics. After 1940, however, the sexual and cultural McCarthyism that pervaded America led to a novel and dangerous period in the history of abortion. For the first time, the state began to raid even those abortion providers who could boast excellent maternal safety records. They confiscated medical records and called frightened women before grand juries where, like suspected Communists in front of HUAC, they were forced to describe their abortions, name names (of sexual partners), and publicly confess their deviance. During this period, physicians were crucial to law enforcement, just as they had been during the Progressive era; now, however, they went even further, establishing hospital abortion committees in order to police and curtail the activities of other doctors who held more liberal standards for prescribing or performing therapeutic abortions.	4
This new repression of abortion--through police raids and hospital abortion committees--had profoundly dangerous consequences. For the first time in U.S. history, women found it extremely difficult to locate competent abortionists. Repression made abortion both lucrative and secretive. Unscrupulous mechanics and hairdressers set up as abortionists, drove blindfolded women to secret locations where they performed abortions, pocketed their hapless patients' money, and hoped for the best. The numbers of women dying from botched abortions rose dramatically, although medical advances should have made the procedure safer. Hospitals established wards devoted to women ill from septic abortions. A two-tier system of abortion provision arose: white, middle-class women with the money and the connections to convince hospital abortion committees that they were suicidal could sometimes get hospital abortions, while nonwhite, working-class women were disproportionately likely to end up in septic abortion wards. And, Reagan shows, it was in response to this novel and dangerous situation, catalyzed by the new repressions of the 1940s and1950s, that abortion reform and repeal movements arose in the 1960s, led both by women themselves and by physicians, which ultimately led to Roe v. Wade.	5
When Abortion Was a Crime is comprehensive, original, and persuasive. It will long remain the definitive history of abortion in America. Reagan has unearthed nearly every imaginable source on the subject--including medical journals, private letters, newspaper clippings and--most fruitfully and originally--court records, including coroners' reports. As a result, her account provides us with both the experiences of individual women and an overview of national and local trends. She flawlessly blends the histories of law, medicine, and women to provide an efficient, clear, and richly textured account. One quibble: she probably understates the range of Americans' opinions on abortion during these decades. Many Americans surely supported the abortion committees, police raids, and repression of abortion, even though--as Reagan persuasively shows--many other Americans supported women's traditional ability to obtain abortions. But the history of American opinion opposing abortion is not essential to Reagan's main focus, which is more precisely the interactions between the law, medicine, and women who sought abortions.	6
Scholars will find this work essential. Undergraduates will also find it fascinating--I cannot wait to use it in the classroom. My only worry is that Reagan's passionately argued, somewhat polemical pro-choice epilogue (with which I personally agree) may make pro-life readers question her objectivity and therefore her conclusions. This would be understandable but unfortunate. Reagan's historical scholarship--her exhaustive consultation of the sources and judicious weighing of evidence--is impeccable. The story she tells about abortion's availability through 1940, its repression between 1940 and 1973, and the subsequent increase in numbers of the "back alley abortionist" deserves to be considered and weighed by everyone who cares about this most divisive of contemporary American issues.	7
Gail Bederman University of Notre Dame

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