A Glimpse Into Abortion’s PastMaryCalderone, illegalabortion, legalabortion
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.