Prior to Roe: drunk 'doctors,' gauze packing and deaths from unclean knives

January 22, 1992|By Jonathan Bor and Mary Corey Liz Bowie of The Sun's metropolitan staff contributed to this article.

Single, pregnant and 23, a frightened Jerry Robb opened her front door more than 30 years ago to find the two men she was waiting for, a "doctor" and his assistant. Hers was the second abortion they would perform that night.

The "doctor" looked around the house for a suitable place to do his work. He chose the dining room table. But when he asked her to boil water, she couldn't help but notice that he slurred his words, and that his breath carried the disgusting aroma of alcohol.

Was the doctor drunk? she asked.

"No," she remembers the assistant saying. "We just had a few drinks with dinner." With that, she kicked the two out and, outraged, dialed the telephone. She tracked down the first woman the man and his assistant had visited that night and learned that he was not a doctor, but an auto mechanic.

It was 1959. Now a 56-year-old copyright researcher who lives in Gaithersburg with her two children, Ms. Robb was then a legal secretary in Washington. It was an era when single women clinging to respectability simply didn't have babies.

"In my mind it was totally disgraceful," she said. "The man who was the father did not want to get married. If I had my choice, I would have married the man."

She eventually found an authentic doctor in Washington who agreed to end her pregnancy. "He did a procedure called packing, where they pack you with gauze and that causes a miscarriage. I've had two children, but nothing was as bad as that. I went into labor for a day. I finally had to go back to him. I was so young and dumb. I'm not even sure what he did after that."

Roe vs. Wade, 19 years old today, made abortion widely available to women across America, ushering in an era in which approximately 1.5 million legal abortions are performed annually. But for generations before that, from Maryland to California, an underground movement of doctors performed tens of thousands abortions each year -- in their offices or in hospitals whose administrators often knew of the practice but did little to interfere.

"Often, the doctors were well-known to authorities," said Terry Beresford, a family planning consultant from Alexandria, Va. who has interviewed some 40 physicians in preparing an oral history of abortion in this country. "But abortions were also being done for the mistresses and wives of the mayors and chiefs of police. It was much to everyone's interest not to make it public, not to arrest. In most cases, doctors were not arrested."

Abortion was legal practically everywhere until the latter half of the 19th century. But it wasn't something like today's right-to-life movement that prompted one state legislature after another to pass abortion bans, a domino effect that left no state with lawful abortions.

One pressure came from reformers concerned for the welfare of women who induced abortions by bathing their reproductive organs with caustic solutions advertised widely in newspapers and magazines.

"They didn't want women taking all those dreadful things," Ms. Beresford said.

Another pressure came from the trained physicians just beginning to organize themselves into the American Medical Association. Seeking bans on abortion was part of an effort to reduce the competition posed by midwives and other non-physicians -- the people who assisted women who did not want to induce miscarriages alone.

Historians estimate that upward of 500,000 abortions annually were performed in the decades preceding Roe vs. Wade. Those estimates are based, in part, on the observed deaths of thousands of poor women who resorted to quack abortionists, and on anecdotal evidence of more well-to-do women who found sympathetic doctors to do the service.

Many women died from infection or bleeding after unskilled abortionists scraped the uterus with unclean knives and needles -- or induced miscarriage by inserting a foreign objects like a rubber tube into the uterus, then packing the vagina with gauze.

In the 1940s, in hospitals like Johns Hopkins, "people would be lined up in the hallways because of complications from induced abortions . . . bleeding, cramping and subsequent infection," said Dr. Frances Trimble, former medical director of Planned Parenthood of Maryland. "There would be stretchers in the corridors."

But in cities like Baltimore, competent doctors willing to perform abortions were widely known to middle-class and wealthy families able to pay for the service. One retired physician who declined to be named recalled referring patients to two physicians who routinely performed abortions in their private offices.

Other patients, who felt uncomfortable with the surreptitious atmosphere surrounding abortions in the United States, flew to countries that had made abortion legal.

"I had a man in Havana," the physician said, recalling a Cuban doctor whose competence she trusted. "For $200 you could fly to Havana and get an abortion. If you had money, you could always get an abortion. It was the poor people who suffered."

The "abortion doctors" here performed the "D and C," an age-old procedure in which the physician dilates the cervix and then scrapes the uterus with a spoon-shaped surgical instrument. The technique, used to treat disorders of the uterus, was also useful in removing a developing fetus.

In 1968, the Maryland legislature passed a law allowing abortions in certain instances: in the case of rape, to prevent the mother's death, and to protect a woman from serious physical or mental harm. The abortions had to be performed in a hospital.

Catholic hospitals continued to shun abortions, but institutions such as the City Hospitals (now the Frances Scott Key Medical Center) interpreted the restrictions so broadly as to make abortions available to many women who didn't come close to meeting the legal criteria. Across Maryland, for instance, perfectly sane women were judged to be on the verge of suicide.

And then, 19 years ago, came Roes vs. Wade, which brought abortions completely above ground.

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