Criminalization woodblock print. 19th-century medicine saw tremendous advances in the fields of
surgery,
anaesthesia, and
sanitation. Social attitudes towards abortion shifted in the context of a backlash against the
women's rights movement. Abortion had previously been widely practiced and legal under
common law in early pregnancy (until
quickening), and it was not until the 19th century that the
English-speaking world passed laws against abortion at all stages of pregnancy. There were a number of factors that contributed to this shift in opinion about abortion in the early 19th century. In the United States, where
physicians were the leading advocates of abortion criminalization laws, some of them argued that advances in medical knowledge showed that
quickening was neither more nor less crucial in the process of
gestation than any other step, and thus if one opposes abortion after quickening, one should oppose it before quickening as well. Practical reasons also influenced the medical field to impose
anti-abortion laws. For one, abortion providers tended to be untrained and not members of medical societies. In an age where the leading doctors in the nation were attempting to standardize the medical profession, these "irregulars" were considered a nuisance to public health. The "irregulars" were also disliked by the more formalized medical profession because they were competition, and often cheap competition. Though the physicians' campaign against abortion began in the early 1800s, little change was made in the United States until after the
Civil War. The English law on abortion was first codified in legislation under sections 1 and 2 of
Malicious Shooting or Stabbing Act 1803. The
Bill was proposed by the
Lord Chief Justice of England and Wales,
Edward Law, 1st Baron Ellenborough to clarify the law relating to abortion and was the first law to explicitly outlaw it. The Act provided that it was an offence for any person to perform or cause an abortion. The punishment for performing or attempting to perform a post
quickening abortion was the
death penalty (section 1) and otherwise was transportation for fourteen years (section 2). In the 19th-century United States, there was little regulation of abortion, in the tradition of English common law, pre quickening abortions were considered at most a misdemeanor. These cases proved difficult to prosecute as the testimony of the mother was usually the only means to determine when quickening had occurred. The law was amended in
1828 and
1837 – the latter removed the distinction between women who were quick with child (late pregnancy) and those who were not. It also eliminated the death penalty as a possible punishment. The latter half of the 19th century saw abortion become increasingly punished. One writer justified this by claiming that the number of abortions among married women had increased markedly since 1840. The
Offences against the Person Act 1861 created a new preparatory offence of procuring poison or instruments with intent to procure abortion. During the 1860s however abortion services were available in New York, New Orleans, Cincinnati, Louisville, Cleveland, Chicago and Indianapolis; with estimates of one abortion for every 4 live births. Anti-abortion statutes began to appear in the United States from the 1820s. A
Connecticut law in 1821 targeted
apothecaries who sold poisons to women for purposes of abortion, and
New York made post-quickening abortions a felony and pre-quickening abortions a misdemeanor in 1829. Criminalization accelerated from the late 1860s, through the efforts of concerned legislators, doctors, and the
American Medical Association. In 1873, the
Comstock Law prohibited any methods of production or publication of information pertaining to the procurement of
abortion, the
prevention of conception, and the prevention of
venereal disease, even to students of medicine. By 1909, the penalty for violating these laws became a $5000 fine and up to five years imprisonment. By 1910, nearly every state had anti-abortion laws; these were unevenly enforced at best. Abortion restrictions are not new, but have increased and spread to places where they were not before. Today, there has been an increase in the amount of laws that restrict abortion care in a greater amount of ways that previously seen, and there has been a trend toward abortion restrictive laws and legislature. Negative framing around abortion has contributed to today's trend toward anti-abortion legislature. The abortion battle in the United States can be seen as largely a battle of competing ideologies. The reasoning for not offering the services stems from many of the institutions that employ these OBGYNs having policies against performing abortions or terminating a pregnancy, which imposes too many legal regulations involving abortion care. The formulation of abortion as a form of family planning for married women was made "thinkable" because both medical and non-medical practitioners agreed on the relative safety of the procedure. Other prices which 19th-century abortion providers are reported to have charged were much more steep. In Britain, it could cost from 10 to 50
guineas, or 5% of the
yearly income of a
lower middle class household. Dr. Evelyn Fisher wrote of how women living in a
mining town in Wales during the 1920s used candles intended for
Roman Catholic ceremonies to dilate the
cervix in an effort to
self-induce abortion. Women of
Jewish descent in
Lower East Side, Manhattan are said to have carried the ancient Indian practice of sitting over a pot of steam into the early 20th century. But others have said that in the 19th century early abortions under the hygienic conditions in which midwives usually worked were relatively safe. In addition, some authors have written that, despite improved medical procedures, the period from the 1930s until legalization also saw more zealous enforcement of anti-abortion laws, and concomitantly an increasing control of abortion providers by organized crime.
Advertising for abortifacients and abortion services as an abortifacient. The text at the bottom notes that the pills "assist nature in her wondrous functions". Despite bans enacted on both sides of the Atlantic Ocean, access to abortion continued, as the disguised advertisement of abortion services, abortion-inducing devices, and abortifacient medicines in the
Victorian era would seem to suggest. Apparent print ads of this nature were found in the United States, the United Kingdom, A
British Medical Journal writer who replied to
newspaper ads peddling relief to women who were "temporarily indisposed" in 1868 found that over half of them were in fact promoting abortion. and "Madame Drunette's Lunar Pills". Beecham's expenditure on advertising went from £22,000 to £95,000 in the 1880s. An 1897 advertisement in the
Christian Herald edition for
Queen Victoria's
Diamond Jubilee said: "Worth a guinea a box. Beecham's Pills for all bilious and nervous disorders such as Sick Headache, Constipation, Weak Stomach, Impaired Digestion, Disordered Liver and Female Ailments. The sale is now 6 million boxes per annum." The text was printed alongside a picture of a young woman at a beach and was captioned "What are the wild waves saying? Try Beecham's Pills." is portrayed as a
villainess in an 1847 copy of the
National Police Gazette. "Old Dr. Gordon's Pearls of Health", produced by a
drug company in
Montreal, "cure[d] all suppressions and irregularities" if "used monthly". However, a few ads explicitly warned against the use of their product by women who were expecting, or listed
miscarriage as its inevitable side effect. The copy for "Dr. Peter's French Renovating Pills" advised, "... pregnant females should not use them, as they invariably produce a miscarriage ...", and both "Dr. Monroe's French Periodical Pills" and "Dr. Melveau's Portuguese Female Pills" were "sure to produce a miscarriage". In the mid 1930s abortifacients drugs were marketed in the United States to women by various companies under various names such as Molex Pills and Cote Pills. Since birth control devices and abortifacients were illegal to market and sell at the time, they were offered to women who were "delayed". The recommended dosage constituted seven grains of ergotin a day. These pills generally contained ingredients such as ergotin, aloes, Black Hellebore. The efficacy and safety of these pills are unknown. In 1940 the FTC deemed them unsafe and ineffective and demanded that these companies cease and desist selling these products. A well-known example of a Victorian-era abortionist was
Madame Restell, or Ann Lohman, who over a forty-year period illicitly provided both surgical abortion and abortifacient pills in the northern United States. She began her business in New York during the 1830s, and, by the 1840s, had expanded to include
franchises in
Boston and
Philadelphia. It is estimated that by 1870 her annual expenditure on advertising alone was $60,000. One ad for Restell's medical services, printed in the
New York Sun, promised that she could offer the "strictest confidence on complaints incidental to the female frame" and that her "experience and knowledge in the treatment of cases of female irregularity, [was] such as to require but a few days to effect a perfect cure". Another, addressed to
married women, asked the question, "Is it desirable, then, for parents to increase their families, regardless of consequences to themselves, or the well-being of their offspring, when a simple, easy, healthy, and certain remedy is within our control?" Advertisements for the "Female Monthly Regulating Pills" she also sold vowed to resolve "all cases of suppression, irregularity, or stoppage of the menses, however obdurate". This era also saw a marked shift in those who were obtaining abortions. Before the start of the 19th century, most abortions were sought by unmarried women who had become pregnant
out of wedlock. But, out of 54 abortion cases published in American medical journals between 1839 and 1880, over half were sought by married women, and of the married women well over 60 percent already had at least one child. In the
post-Civil War era, much of the blame was placed on the burgeoning
women's rights movement. Many feminists of the era were opposed to abortion. In
The Revolution, operated by
Elizabeth Cady Stanton and
Susan B. Anthony, an anonymous contributor signing "A" wrote in 1869 about the subject, arguing that instead of merely attempting to pass a law against abortion, the root cause must also be addressed. Simply passing an anti-abortion law would, the writer stated, "be only mowing off the top of the noxious weed, while the root remains. [...] No matter what the motive, love of ease, or a desire to save from suffering the unborn innocent, the woman is awfully guilty who commits the deed. It will burden her conscience in life, it will burden her soul in death; But oh! thrice guilty is he who drove her to the desperation which impelled her to the crime." To many feminists of this era, abortion was regarded as an undesirable necessity forced upon women by thoughtless men. Even the "free love" wing of the feminist movement refused to advocate abortion and treated the practice as an example of the hideous extremes to which modern marriage was driving women. Marital rape and the seduction of unmarried women were societal ills which feminists believed caused the need to abort, as men did not respect women's right to abstinence.
Abortion law reform campaign The movement to liberalize abortion laws emerged in the 1920s and '30s as part of rising feminist activism that had already resulted in victories in the area of
birth control. Campaigners including
Marie Stopes in England and
Margaret Sanger in the US had succeeded in bringing the issue into the open, and birth control clinics were established which offered family planning advice and contraceptive methods to women in need. In 1929, the
Infant Life Preservation Act was passed in Britain, which amended the law (
Offences against the Person Act 1861) so that an abortion carried out in good faith, for the sole purpose of preserving the life of the mother, would not be an offence.
Stella Browne was a leading birth control campaigner, who increasingly began to venture into the more contentious issue of abortion in the 1930s. Browne's beliefs were heavily influenced by the work of
Havelock Ellis,
Edward Carpenter and other
sexologists. She came to strongly believe that working women should have the choice to become pregnant and to terminate their pregnancy while they worked in the horrible circumstances surrounding a pregnant woman who was still required to do hard labour during her pregnancy. In this case she argued that doctors should give free information about birth control to women who wanted to know about it. This would give women agency over their own circumstances and allow them to decide whether they wanted to be mothers or not. In the late 1920s Browne began a speaking tour around England, providing information about her beliefs on the need for accessibility of information about birth control for women, women's health problems, problems related to puberty and sex education and high maternal morbidity rates among other topics. Other prominent feminists, including
Frida Laski,
Dora Russell,
Joan Malleson and
Janet Chance began to champion this cause – the cause broke dramatically into the mainstream in July 1932 when the
British Medical Association council formed a committee to discuss making changes to the laws on abortion. In its first year ALRA recruited 35 members, and by 1939 had almost 400 members. This court case set a precedent that doctors could not be prosecuted for performing an abortion in cases where pregnancy would probably cause "mental and physical wreck". Finally, the
Birkett Committee, established in 1937 by the British government "to inquire into the prevalence of abortion, and the law relating thereto", recommended a change to abortion laws two years later. The intervention of
World War II meant that all plans were shelved. Another prominent figure in the reform of abortion laws was
Dr. Morgentaler. Although born in Poland he made a name for himself in Canada, opening multiple illegal abortion clinics in Toronto, Ontario.
Liberalization of abortion law Canada Prior to 1969, abortion was considered a crime for which the maximum punishment was life imprisonment for the doctor performing the abortion and two years imprisonment for the woman receiving the abortion. Abortion remained illegal until 1988, when the Supreme Court of Canada overruled the criminal punishments for abortion. Abortion remains a hotly debated topic. As of 2008 in Canada only 1–2% of abortions were pharmaceutically induced. After much controversy, starting in 2017 abortion pills could be used legally in Canada. first legalized abortion in 1920. The
poster warns against
unsafe abortion. Title translation: "Abortions performed by either self-taught midwives or obstetricians not only maim the woman, they also often lead to death."
Russia The
Russian Soviet Federative Socialist Republic was the first government to legalize abortion and make it available on request, often for no cost. The Soviet government hoped to provide access to abortion in a safe environment performed by a trained doctor instead of
babki. While this campaign was extremely effective in the urban areas (as much as 75% of abortions in Moscow were performed in hospitals by 1925), it had much less effect on rural regions where there was neither access to doctors, transportation, or both and where women relied on traditional medicine. In the countryside in particular, women continued to see
babki, midwives, hairdressers, nurses, and others for the procedure after abortion was legalized in the Soviet Union. From 1936 until 1955 the Soviet Union made abortion illegal (except for medically recommended cases) again, stemming largely from
Joseph Stalin's worries about population growth. Stalin wanted to encourage population growth, as well as place a stronger emphasis on the importance of the family unit to
communism.
Spain During the
Spanish Civil War, on 25 December 1936, in
Catalonia, free abortion was legalized during the first 12 weeks of pregnancy with a decree signed by
Josep Tarradellas,
First Minister of the Government of Catalonia, and published on 9 January 1937 (
Diari Oficial de la Generalitat de Catalunya, núm.9).
Great Britain In Britain, the
Abortion Law Reform Association continued its campaigning after the War, and this, combined with broad social changes brought the issue of abortion back into the political arena in the 1960s. President of the
Royal College of Obstetricians and Gynaecologists John Peel chaired the committee advising the
British Government on what became the
1967 Abortion Act. On the grounds of reducing the amount of disease and death associated with illegal abortion, the Abortion Act allowed for legal abortion on a number of grounds, including to prevent grave permanent injury to the woman's physical or
mental health, to avoid injury to the physical or mental health of the woman or her existing child(ren) if the pregnancy was still under 28 weeks, or if the child was likely to be severely physically or mentally handicapped. The free provision of abortions was provided through the
National Health Service.
United States In America an abortion reform movement emerged in the 1960s. In 1963, the
Society for Humane Abortion was formed, providing women with information on how to obtain and perform abortions. In 1964
Gerri Santoro of Connecticut died trying to obtain an illegal abortion and her photo became the symbol of the abortion rights movement. Some women's rights activist groups developed their own skills to provide abortions to women who could not obtain them elsewhere. As an example, in Chicago, a group known as "
Jane" operated a floating abortion clinic throughout much of the 1960s. Women seeking the procedure would call a designated number and be given instructions on how to find "Jane". In the late 1960s, a number of organizations were formed to mobilize opinion both against and for the legalization of abortion. The forerunner of the
NARAL Pro-Choice America was formed in 1969 to oppose restrictions on abortion and expand access to abortion. In late 1973 NARAL became the National Abortion Rights Action League. The American Medical Association, the American Bar Association, the American Academy of Pediatrics, the California Medical Association, the California Bar Association, and numerous other groups announced support behind new laws that would protect doctors from criminal prosecution if they performed abortions under rigid hospital controls. In 1967,
Colorado became the first state to decriminalize a doctor performing an abortion in cases of rape, incest, or in which pregnancy would lead to permanent physical disability of the woman. A bipartisan majority in the California legislature supported a new law introduced by Democratic state senator
Anthony Beilenson, the "Therapeutic Abortion Act". Catholic clergy were strongly opposed but Catholic lay people were divided and non-Catholics strongly supported the proposal.
Governor Ronald Reagan consulted with his father-in-law, a prominent surgeon who supported the law. He also consulted with
James Cardinal McIntyre, the Catholic archbishop of Los Angeles. The archbishop strongly opposed any legalization of abortion and he convinced Reagan to announce he would veto the proposed law since the draft allowed abortions in the case of birth defects. The legislature dropped that provision and Reagan signed the law, which decriminalized abortions when done to protect the health of the mother. The expectation was that abortions would not become more numerous but would become much safer under hospital conditions. In 1968 the first full year under the new law there were 5,018 abortions in California. The numbers grew exponentially and stabilized at about 100,000 annually by the 1970s. 99.2% of California women who applied for an abortion were granted one. One out of every three pregnancies was ended by illegal abortion. The key factor was the sudden emergence of a woman's movement that introduced a very new idea—women had a basic right to control their bodies and could choose to have an abortion or not. Reagan by 1980 found his support among anti-abortion religious groups and said he was too new as governor to make a wise decision. In 1970, Hawaii became the first state to legalize abortions on the request of the woman, and New York repealed its 1830 law and allowed abortions up to the 24th week of pregnancy. Similar laws were soon passed in Alaska and Washington. A law in Washington, D.C., which allowed abortion to protect the life or health of the woman, was challenged in the Supreme Court in 1971 in
United States v. Vuitch. The court upheld the law, deeming that "health" meant "psychological and physical well-being", essentially allowing abortion in Washington, DC. By the end of 1972, 13 states had a law similar to that of Colorado, while Mississippi allowed abortion in cases of rape or incest only and Alabama and Massachusetts allowed abortions only in cases where the woman's physical health was endangered. membership in 1973 at the time of
Roe v. Wade The landmark judicial ruling of the
Supreme Court in
Roe v. Wade ruled that a Texas statute forbidding abortion except when necessary to save the life of the mother was unconstitutional. The immediate result was that all state laws to the contrary were null. The Court arrived at its decision by concluding that the issue of abortion and abortion rights falls under the
right to privacy. The Court held that a right to privacy existed and included the right to have an abortion. The court found that a mother had a right to abortion until viability, a point to be determined by the abortion doctor. After viability a woman can obtain an abortion for health reasons, which the Court defined broadly to include psychological well-being. From the 1970s, and the spread of
second-wave feminism, abortion and
reproductive rights became unifying issues among various women's rights groups in Canada, the United States, the Netherlands, Britain, Norway, France, Germany, and Italy. On June 24, 2022,
Roe v. Wade was overturned by the Supreme Court in a 6–3 decision. The ruling was part of ''
Dobbs v. Jackson Women's Health Organization, a decision of the Supreme Court that also overturned Planned Parenthood v. Casey'', another case of the Supreme Court regarding abortion.
Development of contemporary abortion methods Although prototypes of the modern
curette are referred to in ancient texts, the instrument which is used today was initially designed in France in 1723, but was not applied specifically to a gynecological purpose until 1842.
Dilation and curettage has been practiced since the late 19th century. The paper, originally titled
The Swedish Abortion Pill, was renamed to
The Swedish Postconception Pill, due to the small number of induced abortions that occurred in the trial population. After these efforts were largely unsuccessful with F6103, the same researchers attempted to find an abortion pill with
prostaglandins, capitalizing on the number of well-established prostaglandin scientists working in Sweden at the time; they were eventually awarded the
1982 Nobel Prize in Physiology for their work. Abortions brought about by taking medications, known as
medication abortions, became an alternative to surgical aboritons when
prostaglandin analogs were introduced in the 1970s. One such analog is
carboprost, which was successfully trialed in the United States in 1979. In 1981, French pharmaceutical company
Roussel-Uclaf developed the antiprogestogen
mifepristone (also known as RU-486), which successfully induces abortions. It is typically taken in combination with
misoprostol.
Intact dilation and extraction was developed by Dr. James McMahon in 1983. It resembles a procedure used in the 19th century to save a woman's life in cases of obstructed labor, in which the fetal skull was first punctured with a perforator, then crushed and extracted with a
forceps-like instrument, known as a
cranioclast. Medication abortions became common when mifepristone was approved for use in China and France in 1988. Later it was approved in Great Britain in 1991, in Sweden in 1992, in Austria, Belgium, Denmark, Finland, Georgia, Germany, Greece, Iceland, Israel, Lichtenstein, Luxembourg, Netherlands, Russia, Spain, and Switzerland in 1999, in Norway, Taiwan, Tunisia, and the United States in 2000, and in 70 additional countries from 2001 to 2023. During the mid-1990s in the United States the medical community showed renewed interest in
manual vacuum aspiration as a method of early surgical abortion. This resurgence is due to technological advances that permit early pregnancy detection (as soon as a week after conception) and a growing popular demand for safe, effective early abortion options, both surgical and medical. An innovator in the development of early surgical abortion services is Jerry Edwards, a physician, who developed a protocol in which women are offered an abortion using a handheld vacuum syringe as soon as a positive pregnancy test is received. This protocol also allows the early detection of an ectopic pregnancy. ==Abortion around the world==