I just finished reading a book on the history of abortion law in 19th century America. This is a part of a general project promoting the usefulness of history for teaching abortion ethics. Right now, though, I just want to blog my impressions of the book. The discussion of its pedagogical importance will be reserved for the forthcoming article itself.
I was drawn to Mohr’s book because it focuses on a question that I had been asking. This is the opening passage of the book:
In 1800 no jurisdiction in the United States had enacted any statues whatsoever on the subject of abortion; most forms of abortion were not illegal and those American women who wished to practice abortion did so. Yet by 1900 virtually every jurisdiction in the United States had laws upon its books that proscribed the practice and declared most abortions to be criminal offences. What follows is an attempt to understand how this dramatic and still intensely debated shift in social policy came about in the United States during the nineteenth century.
Americans typically have a two act understanding of this history of abortion: there are the pre-Roe days, where abortion was taboo and performed only in back alleys, and the post-Roe days, where Planned Parenthood clinics stand off against protestors. Depending on your political persuasion, this is either a story of moral progress or moral decline.
During my minor surgery the other day, I mentioned to the primary doctor that I would be reading this book during my convalescence. The nurse piped in, "Were there abortion laws prior to the 1970s?" I’ve found that most students also have this level of ignorance. (The lead doctor, on the other hand, knew the history of his profession well. The med student was quiet during this part of the conversation, so I couldn’t tell if she was getting any of the history of medicine in her schoolin'.)
In any case, the first step in undoing this historical ignorance is to see how the “pre-Roe” days came to be. As an era, they really only last from 1900 to the 1960s, when state abortion laws began to change again. They are not some historical bedrock, beneath which one cannot dig. Mohr tells a great story about the creation of the pre-Roe era. It has a clear arc, characters that are both familiar and strange, and rich web of actions and reactions, causes and effects.
The story opens, as Mohr said at the outset, in a country with no abortion laws. There is a tradition from British common law that says that the fetus gains legal status at quickening. Indeed, the quickening doctrine is a reflection of an almost universal understanding of when the fetus gains moral status. However prior to quickening, abortion was considered a safe and moral procedure. Indeed, it wasn’t even called abortion, it was called "restoring blocked menses," and Mohr provides generous evidence that women had broad access to methods for unblocking their menstruation.
If I can simply Mohr’s story a bit, I would say that it comes in three acts. The first act is an unsuccessful attempt by the emergent medical profession to ban abortion and reveal the incoherence of the quickening doctrine. (This is chapters one and two of Mohr.) The second act is a massive shift in abortion practice in the United States (chapters three and four of Mohr). The final act is a second, successful attempt by the physicians to change abortion policy, a campaign that created the pre-Roe world we have heard about. (This is the remainder of Mohr’s book, chapters five through nine.)
My driving question in reading this book was causal: what forces created the pre-Roe world. The framework of Mohr’s story lets us split the question in two: (1) what were the motivations of the physicians and (2) what changed in the middle of the century to make the second campaign successful. Mohr answers both these questions with skill and equanimity. Pro-life people will find in the physicians motivations they have themselves, including a reverence for human life. Pro-choice people will also see misogyny and a backlash against feminism in the physicians movement. Both sides will see a lot of factors that we don’t think of much today, including the drive of the doctors to professionalize, and worries about falling birthrates in native born, protestant women.
I have more of an agenda than Mohr does, however. My big historical theory is that the pre-Roe world arose as a backlash to the first wave of feminism, or at least to the social changes that the first wave of feminism brought. Mohr gives me evidence for this. While the doctors may have a complicated set of motivations, both noble and base, the social changes in the middle of the century that made their second campaign successful almost all revolve around women taking charge of their own reproductive lives.
I don’t want to commit the New York Review of Books sin of book reviewing, where the review consists of a chapter by chapter summary of the book. But I do want to show you Mohr’s evidence on two points. First, the physicians had a sincere pro-life outlook driving their campaign. It wasn’t all a desire to stomp out professional rivals. Second, the big shift in the middle of the century that made the success of the second campaign possible was all about women’s emancipation.
Mohr has two discussions of the motivations of the physicians, once in the context of the first campaign (34-37) and once in the context of the second campaign (160-70). In each case the professional motivations of the physicians is emphasized. In the 19th century, scientific practitioners of modern medicine (called "regular physicians" at the time) competed against an array of homeopaths, midwives and folk practitioners in an unregulated arena. The irregulars drew far more of their profits form abortion than the regulars. Banning the practice was a part of a general drive toward establishing legal control over medical practice in America.
But the regulars also had genuine moral motivations for what they were doing. First of all, Mohr emphasizes that they were in a position to see that the quickening doctrine was incoherent. The quickening doctrine depended on a crappy inference. Prior to quickening, there was no way to know for sure you were pregnant, so people decided to act like you weren’t. Thus abortion was just "unblocking menstruation" (4). An epistemological line gets metaphysical significance by sheer will for the conclusion to be true. The regulars, who had begun to learn a lot about development, saw that this was bogus (35). Second, the regulars simply had what we now call a culture of life: "the nations regular doctors, probably more than any other identifiable group in American society in the 19th century, including the clergy, defended the value of human life as an absolute" (36)
The regulars had other motivations. They were openly opposed to women playing social roles other than childrearing (169). After the shift in the middle of the century in who was having abortions, regulars were very concerned that native-born protestant women were not reproducing enough (167). But let’s grant for a second that the doctors had a good faith commitment to a culture of life: is that commitment what changed abortion policy in the 19th century.
Mohr is not an ideologue, and does not attempt to answer that question directly. Nevertheless, the conclusion I get from his story is that the answer is no. When the doctors were campaigning on moral grounds alone, they lost. Their second campaign was only successful because the public became concerned about uppity women. According to Mohr, the mid-century shift I have been alluding to has three main components: first, the perception of the American public that abortion rates were shooting up dramatically (47-50); second, the fact that abortion rates were indeed shooting up dramatically (50-85); and third, the very accurate perception that the women now seeking abortion were married, wealthy, protestant and native born (86-118). The first two factors made sure that abortion would be seen as a significant issue. The third factor made it possible to vilify the women seeking abortion. Because these women were married, they did not have the excuse that they were unable to raise the children. These women were limiting family size not because they had to, but because they wanted to. Why did they want to? Because they had other opportunities. They typically already had a couple children, and wanted to now do other things with their lives. Here is an extract given by Mohr of the writings of an anti-abortion doctor named Montrose Pallen (the material outside the quotations is Mohr’s interpolation):
He considered "the whole country" to be "in an abnormal state" and believe that “the tendency to force women into men’s places" was creating insidious "new ideas of women’s duties" such ideas, which including the notion "that her ministrations in the formation of character as a mother should be abandoned for the sterner rights of voting and law making" were acting and reaction according to Pallen "on the public sentiment, until the public conscience becomes blunted, and duties necessary to women’s organization [i.e. childbearing] are shirked, neglected or criminally prevented" (105)
Most of the time, though, women were accused not of neglecting childrearing duties for politics, but for "fashion", which included any sort of leisure or entertainment typically enjoyed by men as well as the desire to attain higher social standing (107-108).
There are a lot of things that are interesting about this narrative that I can't go into here. One thing that is simply odd from a modern perspective is that the major players in the current debate were on the sidelines in the 19th century. The previous debate was between the regular physicians and their rivals. The churches, with the exception of the Catholics and the Presbyterians, were indifferent. Feminists, although they were sparking the social changes driving the whole debate, could not come out in favor of abortion. Well, if you want to learn more, read the book.
So in conclusion I would say that in sum the bottom line is this: you should read Abortion in America by James C. Mohr.
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