A Glimpse Into Abortion’s Past

A Glimpse Into Abor­tion’s Past­MaryCalderone, ille­gal­abor­tion, legalabortion

Date­line: 2/26/00

Through the mir­a­cle of time trav­el (okay, micro­film at a uni­ver­si­ty library), I was able to imag­ine this inter­view with for­mer Planned Par­ent­hood Med­ical Direc­tor Mary S. Calderone. The micro­forms room at the library can be thought of as a time machine.
Dr. Calderone served as PPFA’s Med­ical Direc­tor from 1953 until 1964, when she became the first Exec­u­tive Direc­tor of the new­ly-launched SIECUS (Sex Infor­ma­tion and Edu­ca­tion Coun­cil of the Unit­ed States). Calderone played a key role in pro­mot­ing Planned Par­ent­hood’s goals and agen­da, through polit­i­cal savvy and pub­lic rela­tions skills.

Come back with me, if you will, to 1960. The spool is on the micro­film read­er. I have my list of ques­tions, and Dr. Calderone’s words glow on the screen before me. What did she have to say about the things we would ask her if we could?*

On the legal sta­tus of abor­tion at the time (c. 1960)
Dr. Calderone: In 46 states legal abor­tion is per­mit­ted to pre­serve the life of the moth­er; three states allow, in addi­tion, preser­va­tion of the health of the moth­er.
So when this arti­cle was pub­lished, 1960, it was pos­si­ble to get a legal abortion.

On the typ­i­cal cri­te­ria for a legal abor­tion.
Dr. Calderone: [T]herapeutic abor­tions are for the most part being done on the word of psy­chi­a­trists that the unwill­ing moth­er will oth­er­wise com­mit suicide.

On the med­ical risks of preg­nan­cy and ther­a­peu­tic abor­tions be for med­ical rea­sons.
Dr. Calderone: [M]edically speak­ing, that is, from the point of view of dis­eases of the var­i­ous sys­tems, car­diac, gen­i­touri­nary, and so on, it is hard­ly ever nec­es­sary today to con­sid­er the life of a moth­er as threat­ened by a pregnancy.

Even today, it’s often pre­sent­ed as “fact” that 5,000 to 10,000 women died every year in the Unit­ed States from crim­i­nal abor­tions in the days before legal­iza­tion.
On abor­tion mor­tal­i­ty before legali­a­tion.
Dr. Calderone: In 1957 there were only 260 deaths in the whole coun­try attrib­uted to abor­tion of any kind.

In the 1955 Planned Par­ent­hood con­fer­ence on abor­tion, Dr. Mil­ton Helpern, Chief Med­ical Exam­in­er of New York City, pre­sent­ed some infor­ma­tion about abor­tion mor­tal­i­ty trends.

On the con­fer­ence find­ings about abor­tion mor­tal­i­ty trends.
Dr. Calderone: In New York City in 1921 there were 144 abor­tion deaths, in 1951 there were only 15.

Yet abor­tion remained ille­gal in New York City.

On how abor­tion deaths were being reduced with­out legal­iza­tion.
Dr. Calderone: [F]irst, chemother­a­py and antibi­otics have come in, ben­e­fit­ting all sur­gi­cal pro­ce­dures as well as abor­tion. Sec­ond, and even more impor­tant, the [1955 Planned Par­ent­hood Con­fer­ence on Induced Abor­tion] esti­mat­ed that 90 per cent of all ille­gal abor­tions are present­ly being done by physicians.

On the char­ac­ter and qual­i­fi­ca­tions of ille­gal abor­tion prac­ti­tion­ers.
Dr. Calderone: Call them what you will, abor­tion­ists or any­thing else, they are still physi­cians, trained as such; and many of them are in good stand­ing in their com­mu­ni­ties. They must do a pret­ty good job if the death rate is as low as it is.

Dr. Timanus, who pre­sent­ed his find­ings at the con­fer­ence, cer­tain­ly seemed to be very com­pe­tent and pro­fes­sion­al. His ille­gal abor­tion prac­tice, if it was typ­i­cal, would explain why the mor­tal­i­ty num­bers were so much low­er than I’d been told they were. But there are also so many sto­ries about women with hor­ri­ble injuries dying or being brought to the emer­gency room.

On reports of grotesque abor­tion attempts and the injuries and deaths they pro­duced.
Dr. Calderone: What­ev­er trou­ble aris­es usu­al­ly comes after self-induced abor­tions, which com­prise approx­i­mate­ly 8 per cent, or with the very small per­cent­age that go to some kind of non-med­ical abortion.

On the need for ade­quate pre-abor­tion coun­sel­ing.
Dr. Calderone: Con­fer­ence mem­bers agreed, and this was backed up by evi­dence from the Scan­di­na­vians, that when a woman seek­ing an abor­tion is giv­en the chance of talk­ing over her prob­lem with a prop­er­ly trained and ori­ent­ed per­son, she will in the process very often resolve many of her qualms and will spon­ta­neous­ly decide to see the preg­nan­cy through, par­tic­u­lar­ly if she is assured that sup­port­ive help will con­tin­ue to be avail­able to her.

The con­fer­ence data from Scan­di­navia were inter­est­ing. A sur­pris­ing num­ber of women went through a lot of trou­ble to request a legal abor­tion, and even con­vinced the agency that an abor­tion real­ly was in their best inter­ests, then changed their minds and decid­ed to give birth. This is in addi­tion to the women who applied for abor­tions but changed their minds before the agency came to a deci­sion in their cases.

On the impor­tance of help­ing women resolve their con­cerns and, if pos­si­ble, avoid abor­tion.
Dr. Calderone: Aside from the fact that abor­tion is the tak­ing of a life, I am also mind­ful of what was brought out by our psy­chi­a­trists — that in almost every case, abor­tion, whether legal or ille­gal, is a trau­mat­ic expe­ri­ence that may have severe con­se­quences lat­er on.

Read­ers might reflect on Dr. Glad­ston’s words dur­ing the con­fer­ence: “I do not con­sid­er it to be the respon­si­bil­i­ty or the oblig­a­tion of the Planned Par­ent­hood Fed­er­a­tion, or of a body such as is rep­re­sent­ed here, pri­mar­i­ly… to strive for the legal­iza­tion and the facil­i­ta­tion of abor­tion. I do rather think that ini­tial­ly it is our social and sci­en­tif­ic oblig­a­tion to search for ways and means where­by the need for abor­tion is reduced to the absolute min­i­mum and then to help legal­ize and facil­i­tate abor­tion for that req­ui­site minimum.”

On what oth­er mea­sures par­tic­i­pants in the con­fer­ence pro­posed for lim­it­ing abor­tion.
Dr. Calderone: “Encour­age­ment, through ear­ly, con­tin­ued and real­is­tic sex edu­ca­tion, of high­er stan­dards of sex­u­al con­duct and a geater sense of respon­si­b­li­ty toward pregnancy.”

Dr. Calderone’s own pro­pos­al for explor­ing the pub­lic health prob­lem of ille­gal abor­tion.
Dr. Calderone: I would like to enlist pub­lic health in an effort to estab­lish bet­ter fig­ures on the inci­dence of ille­gal abor­tion. Acu­tal­ly, of course, we know that the nature of this prob­lem is such that one will nev­er get accu­rate ex post fac­to fig­ures. We will nev­er find out how many ille­gal abor­tions have been per­formed, but how about try­ing to find out how many are being asked for? Sup­pose requests for abor­tion were made reportable? Why not? Sup­pose that every time a woman comes to a doc­tor ask­ing for an abor­tion, he makes a note of it along with some eas­i­ly obtained infor­ma­tion and sends this note to his health offi­cer. Sup­pose that after a few such efforts, physi­cians dis­cov­ered that the sky did not fall in on them in the per­son of the law and that the pri­va­cy of their patients was being respect­ed. At the end of two or three years we might real­ly know some­thing about this dis­ease of society.

More specifics on what Dr. Calderone pro­posed.
Dr. Calderone: Every doc­tor vis­it­ed by such a patient should for­ward to his health offi­cer a report form con­tain­ing the fol­low­ing infor­ma­tion: No name, no iden­ti­fy­ing mate­r­i­al, but age of woman, her mar­i­tal sta­tus, her race, the num­ber of preg­nan­cies and the num­ber and ages of her liv­ing chil­dren, some esti­mate of her socioe­co­nom­ic sta­tus, her stat­ed rea­sons for ask­ing for the abor­tion, the doc­tor’s rea­sons for refus­ing the abor­tion or, occa­sion­al­ly, his rea­sons for grant­i­ng it. And final­ly, one most valu­able bit of infor­ma­tion which in time the doc­tor would feel quite free to answer: “If the law of this state left you com­plete­ly free to exer­cise your med­ical judg­ment, would your opin­ion by that this wom­an’s preg­nan­cy should be terminated?”

On why she con­sid­ered ille­gal abor­tion to be a pub­lic health prob­lem.
Dr. Calderone: [I see] ille­gal abor­tion as a dis­ease of soci­ety, a dis-ease in which the men­tal and phys­i­cal agony of per­haps a mil­lion women every year present them­selves as strong can­di­dates for the pub­lic health work­er’s pro­fes­sion­al and human­i­tar­i­an concern.

Well, folks, there are oth­er patrons wait­ing to use the micro­film machine, so we’ll have to say good­bye to Dr. Calderone for now.

*Dr. Calderone’s “answers,” although edit­ed to fit the Q&A for­mat, are oth­er­wise ver­ba­tim from “Ille­gal Abor­tion as a Pub­lic Health Prob­lem,” pub­lished in the July, 1960 issue of the Amer­i­can Jour­nal of Pub­lic Health (v. 50 no. 7), pages 948 — 954. If you want a copy to read for your­self, con­tact the ref­er­ence desk of your local pub­lic or uni­ver­si­ty library, and the librar­i­an can assist you in get­ting it from micro­film or through Inter­li­brary Loan.