LANSING, Mich. (Michigan News Source) – Planned Parenthood of Michigan recently published a social media post highlighting the history of abortion procedures in the United States. Here’s some brief background on the story’s key facts.
Statement: Before the mid-1800s, abortion was legal reproductive health care in all 50 states.
TRUE: Most held that life began at “quickening,” or when a woman began to feel the child’s movement in her womb, usually 14-26 weeks after conception. The issue of abortion prior to quickening was largely uncontroversial until Connecticut became the first state to regulate abortion in 1821 and explicitly prohibit the procedure after quickening. New York followed in 1829, prohibiting the procedure altogether.
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At the time, it was difficult to accurately determine whether a woman was pregnant. One of the only ways a woman could be certain was by feeling the quickening, at which point it might have been considered “too late” for the abortion procedure.
Statement: In 1847, doctors banded together to form the American Medical Association …. They … launched a criminalization campaign against abortion and female abortion providers.
TRUE: The AMA was created to strengthen public trust in the medical profession, which was denounced in the contemporary paper Reporter as “a stupendous humbug.” AMA physicians wanted to set national standards for the “correct” practice of medicine, and one of their guiding documents was the Hippocratic Oath. Some versions of the oath explicitly prohibited abortion. Consequently, many AMA-approved physicians would not perform the procedure, and many more launched outspoken campaigns against it.
Statement: [The AMA believed] only they should have the power to decide when an abortion could be legally performed.
IT’S COMPLICATED: This implies that the AMA’s campaign against abortion was purely about exerting control over female midwives and abortion providers. In fact, many (if not most) physicians who took part in the AMA’s campaign looked toward the Hippocratic Oath’s explicit prohibition of abortion and genuinely concluded that they were violating their responsibilities as doctors by performing the procedure.
Furthermore, prohibiting abortion—which they felt was akin to murder—seemed like it would put a more positive light on the medical profession they were trying to salvage. (James Madison Undergraduate Research Journal)
… Despite their lack of expertise in pregnancy and reproductive health.
MISLEADING: The leading figure in the AMA’s effort to criminalize abortion was Horatio Robert Storer, an expert in gynecology and obstetrics and one of the first physicians to successfully perform a C-section. Storer was also one of the first American physicians to teach gynecology, as women’s health, separately from obstetrics and the medicine of childbirth. (Arizona State University)
Statement: By 1910, abortion was not only restricted but outright illegal at every stage of pregnancy in every state in the country. Any exceptions to save the patient’s life could only be decided by doctors, 95% of whom were men.
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TRUE: In 1910, and for the next 50 years, about 5% of U.S. doctors were women. Abortion was effectively banned in every state except in some cases when required to save a mother’s life.
Abortion bans were supported by white men in power as a way to counter immigration and get upper-class white women to have more children.
CONTROVERSIAL: No anti-abortion activist of the time would tell the story this way. They would say that true physicians had superior medical knowledge to the unaccredited medics offering abortion services, and that a physician could better determine whether a woman was actually pregnant, how far along she was, and how much risk she would face as a result of the procedure.
Prior to the introduction of antibiotics in the 1940s, abortion had a high mortality rate, becoming the official cause of death for nearly 3,000 women in 1930 alone—almost 1 out of every 5 recorded maternal deaths. Risks were both inherent in the procedure and a result of the ban, which drew only unaccredited physicians to perform the illegal procedure. Arguments over whether the bans directly caused or were intended to reduce maternal mortality rates are ongoing.
Millions are now living in abortion care deserts [after the end of Roe].
TRUE: 14 states have banned abortion at conception with some exceptions, including Alabama, Arkansas, Idaho, Indiana, Kentucky, Louisiana, Mississippi, Missouri, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, and West Virginia.
Maternal … mortality rates are on the rise in states that have banned or severely restricted abortion access.
IT’S COMPLICATED: Preliminary studies suggest that mothers in states with abortion bans are nearly 3 times more likely to die during pregnancy, in childbirth, or soon after giving birth, according to data from the Gender Equity Policy Institute captured in January 2023. In a December 2022 study, the Commonwealth Fund found that maternal deaths were consistently higher in states with abortion restrictions from 2018-2020.
But, as ProPublica writer Kavitha Surana recently pointed out, statistical experts say it’s often difficult to track maternal mortality rates without records collected over many years.
“At least in the short term, it may be difficult or impossible to track the number of lives lost due to limits on abortion access,” Surana wrote. “The quality of data varies vastly by state …. [As of July 2023], many states have only released data through 2019.” (ProPublica)
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