Desperate, frightened women. Incompetent and unscrupulous medical practitioners. Poor equipment. Bloody sheets. Filthy conditions. Gruesome fetal and placental remains . . . . For anyone who lived or even has heard pre-Roe abortion stories, the trial and conviction of Philadelphia abortion doctor Kermit Gosnell stirred ugly memories. Gosnell recreated pre-Roe conditions. People who care about reproductive rights have been missing an extraordinary opportunity to hand some of those stories down to young women who never have heard them.

Fifteen years ago, a group of health and choice advocates in Washington State reached out to elders in their community and solicited abortion memories from the 1970s and earlier and compiled them into a book, In Our Own Words. The fear at the time was that an increasingly aggressive Religious Right would drive women away from competent, compassionate doctors and clinics and back into shady operations run by criminals and opportunists.

As the Gosnell scandal showed, that fear was founded. One of the most vocal victims, Davida Johnson reported that she had originally sought an abortion at her local Planned Parenthood but after seeing protesters there, went instead to Gosnell. (She was told there would be no protesters at the Gosnell site because he did abortions outside of regular clinic hours.) Many were poor women of color who couldn’t afford a legitimate medical clinic because Medicaid excludes most abortion coverage.  Other women who sought Gosnell’s dangerous and unsanitary services were “turnaways” from reproductive health clinics, denied abortion care because they had passed Pennsylvania’s gestational limit of (then) 24 weeks. With gestational limits dropping, the number of turnaways seeking extra-legal options can be expected to soar.

As sordid details of the Gosnell case have emerged over recent months, it has become painfully clear that fifty years makes little difference when women are driven to manage their lives and health outside the law and medical establishment. The following descriptions, drawn from Gosnell trial media coverage, In Our Own Words, the 1-in-3 Campaign, and other online sites offer a horrible glimpse of back-alley abortion, then and now.

Filth and Incompetence.

1973 – “In Baltimore I was met at the train station and led to a dilapidated brownstone. Inside was the abortionist, a woman dressed totally in black, watching television and drinking straight from a bottle of Canadian Club.  . . . There was no pretense that this was a medical office. No sterile drape to cover me. No gloves for the abortionist. She refused to answer my questions about the procedure. (IOOW, 10)

1959 – “Directions led us to an alley where rickety wooden steps led up one flight to the doctor’s office door. He smelled of liquor and body odor and his medical jacket was stained.” (IOOW, 25)

1930s – “One abortionist was a plumber, who was written up in a newspaper later.” (IOOW, 76)

1960 – “I let my boyfriend find a contact (an Italian Catholic with six children who claimed Mafia connections, in fact). This person knew an abortionist in another town (an aging and trembling surgeon, later convicted when a girl died), and we rustled up the $700 (1960 [current] dollars) by borrowing from friends.” (IOOW, 95)

1961 – “He was not a doctor, I don’t believe he ever studied medicine. He performed the abortion in an upstairs bedroom in his house using what I remember to be a rubber hose type apparatus. I vaguely remember being blindfolded so I couldn’t see how we arrived at his house or how we returned to meet my aunt and uncle.” (IOOW 125)

2010 – “’The walls appeared to be urine-splattered,’ the Philadelphia district attorney’s office found when it inspected the clinic in August 2010, months after it had closed that February. ‘The procedure tables were old and one had a ripped plastic cover. Suction tubing, which was used for abortion procedures – and doubled as the only available suction source for resuscitation – was corroded.’” (Wa Post)

2010 – “A stench of urine filled the air. A flea-infested cat was wandering through the facility, and there were cat feces on the stairs.” (Wa Post)

2010 – “The people who ran this sham medical practice included no doctors other than Gosnell himself, and not even a single nurse. Two of his employees had been to medical school, but neither of them were licensed physicians. They just pretended to be. Everyone called them “Doctor,” even though they, and Gosnell, knew they weren’t.” (Alternet)

Blood and Guts.

1973 – “Then more pain and too much blood. Something was stuck . . . I tore at the placenta, trying desperately to free it. With dry sobs I crawled back to bed. I woke up to someone shaking me very hard. The woman who had met me at the station was angry with me. “Get up and get out of here!” she yelled. “Look at the big mess you made!” As I slowly dressed, I looked around the room and couldn’t believe all the blood I saw.” (IOOW, 10)

1964 – “He kept scraping and dropping bits of bloody tissue into a metal bucket. . . . at the end he made me look into the bucket to prove he’d cleaned me out.” (IOOW, 105)

2010 – “There was blood on the floor.” (Wa Post)  

2010 – “[F]etal remains [were] haphazardly stored throughout the clinic– in bags, milk jugs, orange juice cartons, and even in cat-food containers…” (Grand Jury Report)

Pain and Fear.

1969 – “I counted nearly a dozen women with me in the waiting room of the dingy second floor apartment in a horrible part of town. They took us one right after the other into a room with an operating table and you could hear what was going on with each procedure.” (1-in-3)

1973 – “For the next 48 hours I was alone in a locked room in her attic. The room contained an iron bed with no sheets, a chair, two magazines and a toilet. I was brought no food or water. I had never felt so alone or terrified in my life. I kept wondering if I would never make it out of that room.” (IOOW, 10)

1961 – “It was the most excruciating pain I have ever experienced and it was without any pain medication or medical attention. He told me if I hemorrhaged to say to the doctor at the emergency room that I had fallen on the ice and started to miscarry.” (IOOW, 125)

19XX – “As he was working on me without anything for pain, he said ‘doesn’t feel as good as a big peter does it?’” (IOOW, 57)

2010 – “Semi-conscious women scheduled for abortions were moaning in the waiting room or the recovery room, where they sat on dirty recliners covered with blood-stained blankets.” (Wa Post)

Infection, Hemorrhage and Shattered Lives.

1960 – “I squirmed on that cold steel table as he probed and scraped without anesthetic. About a week later I began having abdominal pains and a fever . . . Nine months after getting pregnant I had a hysterectomy. I was 21.” (IOOW, 95)

1934 – “Less than a week later she was dead from a botched abortion, leaving two small children motherless and a husband who blamed himself until the day he died.” (1-in-3)

1935 – “Our neighbor was writhing in pain so severe that she was having convulsions and was chewing her lip raw. It took her two days to die of blood poisoning. She left six children behind. (Mildred Hanson)

20XX – “A nineteen-year-old girl was held for several hours after Gosnell punctured her uterus. As a result of the delay, she fell into shock from blood loss, and had to undergo a hysterectomy.” (Life News)

2009 – “Karnamaya Mongar was in severe pain, turned gray and went into cardiac arrest during her abortion procedure, according to the woman who administered her medication that day.” (NBC)

The horror stories from pre-Roe and from Gosnell’s filthy clinic give us a glimpse of the nightmare faced by women around the globe who, in their attempts to take care of themselves and their existing children, seek illegal procedures. At age 91, Dr. Jane Hodgeson said, “Over the course of my 60-year career, I’ve done a lot of volunteer work overseas in countries where abortion is illegal. I’ve seen women who had botched procedures soak their mattresses through with blood. I’ve seen countless other women die.” Stories like these are a graphic reminder why, globally, close to 40 percent of maternal mortality is caused by botched abortions. They stand in stark contrast to the patient care practiced in compassionate and above-board reproductive health clinics. “The difference is a clean sanitary facility with a reputable staff to care for you or a dirty room, unsanitary facilities and a criminal to do the surgery. I know as I have had both—in a hospital with good care and by a drooling 90 year old man in a filthy suit and a dirty bed.” (IOOW, 57).

Not all pre-Roe abortion providers were callous exploiters preying on desperation. In fact, a number were highly ethical mainstream doctors who felt desperate to protect women with ill-conceived pregnancies from the physical and psychological damage caused by clinics like Gosnell’s. In 1964, pictures of a young mother, Gerri Santoro, dead on a motel room floor, left many women and men crying out for safe legal abortion. A growing number of medical practitioners, activists, friends, neighbors and clergy put their freedom on the line to ensure that women could safely terminate unwanted pregnancies. Voices of Choice is a documentary film (available online) in which two dozen doctors and activists who helped women obtain abortions before Roe discuss their experiences and the anguish that drove their activism.

Today, with ever better pregnancy detection, abortions are increasingly simple and safe. In 2008, the most recent year available, over half of abortions (63%) were performed at eight weeks gestation or less, meaning they removed a gestational sac 3 ½ centimeters or less in diameter, smaller than a hard boiled egg. Over ninety percent were performed by thirteen weeks, when an approximately 8 cm (3”) fetus weighs about 25 grams (1 oz) and is still mostly cartilagenous. At this early stage, uterine contents can be suctioned out with a small hand aspirator that costs less than $50 in a procedure that lasts as little as five minutes with minimal risk of the perforation that left so many women of past generations desperately ill, scarred or even dead. When unwanted pregnancy is detected soon enough, women can choose a medication abortion with a less than 1 percent rate of failure or serious complications.

My husband and I have a healthy family thanks in part to a kind and well-trained abortion provider who offered care in an excellent facility. As a mother of two daughters who may someday need similar services, I am ever grateful that advances in contraception and abortion are making it safer and simpler for a woman to have the life of her choosing, including healthy intended children. The awful story of Kermit Gosnell and the stories we inherited from our elders are a reminder of how far we have come and why desperate women should never be driven to seek frightening substandard care in their time of need.

Related:

The Difference Between a Dying Fetus and a Dying Woman
When God Was Pro-Choice and Why He Changed His Mind
Dramatic Drop in Teen Pregnancy Really a Technology Tipping Point
My Abortion was Different:  Why Women Shame and Blame Each Other

Valerie Tarico is a psychologist and writer in Seattle, Washington.  She is the author of Trusting Doubt: A Former Evangelical Looks at Old Beliefs in a New Light and Deas and Other Imaginings, and the founder of www.WisdomCommons.org.  Her articles can be found at Awaypoint.Wordpress.com.