During the third and final presidential debate, Republican candidate Donald Trump made his views on abortion – and Roe v. Wade, the Supreme Court decision that legalized the procedure in 1973 – clear.
“I’m putting pro-life justices on the court,” Trump said about overturning Roe v. Wade. “I will say this. It will go back to the states and the states will then make a determination.” What Trump described was once a reality in the United States. Forty-three years ago, before Roe v. Wade made abortion legal in all 50 states, abortion rights were left to state legislatures. In 1970, just three years before Roe, only four states had legalized abortions. And even where abortion was legal, the lack of a national law allowed states to create severe restrictions that forced women to get permission from a panel of doctors in order to get an abortion, or prove that they were likely to die if they went on with the pregnancy. (Today, states can still make laws restricting the procedure, but many have been challenged, including Texas’s House Bill 2, which reached the Supreme Court. Parts of the bill were struck down as unconstitutional.) The reality was that millions of women were terrified of unwanted pregnancies, because unwanted pregnancies relegated them to seeking out illegal, unsafe abortions from people without any medical practice.
The years before Roe were often described as ” the bad old days.” But because 1973 was so long ago, the number of people who were alive to see how horrible an America without legal abortion nationwide can be is shrinking. Cosmopolitan.com spoke with two physicians who were practicing before Roe v. Wade about what the days before Roe were really like, and why it’s crucial that we never go back there again.
Dr. Curtis Boyd is a 79-year-old ob-gyn and abortion provider who still practices in New Mexico and Texas. As a young physician before Roe, he provided thousands of safe, illegal abortions in East Texas from 1967 to 1973. He is one of the last living physicians who performed abortions before they were legal.
“I started giving abortions in 1967. Some feminist groups began to do menstrual extractions when abortion was still illegal. [ Editor’s note: A menstrual extraction is a process in which a tube attached to a jar is inserted into a woman’s uterus, and then the contents of her uterus are hand-pumped through the tube and into the jar. These extractions were originally used to evacuate a woman’s period and were therefore legal, as long as she was not pregnant.] Since the women were not doctors, they weren’t held to any rule that you had to do a pregnancy test before you could do an extraction. It was don’t ask, don’t tell. There were also some places [to get illegal abortions] that began to develop outside the country in Japan, Puerto Rico, and Mexico. But it turned out that many of these sources were not doctors, they were technicians.
We saw a lot of the complications in the hospitals. I was a doctor in training. Women came in bleeding, with fever, with incomplete evacuations, with perforations. Some of them were quite ill and occasionally someone died. We thought a lot of these were spontaneous abortions – we didn’t realize all of them were induced. The only reason we know that now is that when abortion was legalized, these cases disappeared. There were probably over a million illegal abortions being provided each year in this country, so when it was legalized, it did not increase the number of abortions. It just had a much higher complication rate [before Roe v. Wade], and today, we’ve made it one of the safest medical procedures that there is.
One thing that’s always misrepresented is that all the people providing illegal abortions were back-alley – this is not true. They were midwives and nurses who did what they could with their limited training equipment, but the complication rate was high. They were people of good intention, and I was actually among them.
Howard Moody, who was a Baptist minister from New York, started the Clergy Consultation Service and is probably the reason I ended up in this field of work. I’m an ordained minister. Claude Evans, who was then the university chaplain at Southern Methodist University, started one of those clergy consultation groups in Dallas. When I was in medical school at the University of Texas Southwestern, I joined the Unitarian Universalist congregation in Dallas, and that’s how I came to know Evans.
In the ’60s, there were a lot of young women on campuses like SMU who were asking for help, so I think these clergymen began to see it as their Christian duty to hear their stories. Many university chaplains, like Evans, became sympathetic to the plight of young women who became pregnant when they did not want to be. Evans eventually asked if I would consider providing abortion services.
The referral process in those days was like an underground railroad. Everything went through the ministers – the clergymen in the consultation group. They set up the appointment, the woman came, and then she was not to come back to me. If she had a problem, the ministers took care of it. People don’t realize – these ministers were so fabulous. They did everything they could to make this service available, to work toward getting it legalized, and to take care of me as best they could. They knew that I could go to prison; we broke the law.
They didn’t teach it medical school, so I had to teach myself how to perform abortions. Women would come into emergency rooms and hospitals with complications from the illegal abortions that were being done, and since I took care of these women, I had experience doing DCs and completing the evacuation of the uterus to take care of the complications. [ Editor’s note: A DC, ordilation and curettage, is a gynecological surgical procedure in which the cervix is opened and an instrument is inserted into the uterus for the purpose of removing tissue. They are typically used to treat conditions like abnormal bleeding, or in the cases Boyd is describing, after a woman has miscarried. After Roe v. Wade, they are now also used for some first-trimester abortions.] That gave me enough confidence to believe I knew how to do an abortion, so I started but had to teach myself additional things. I wasn’t in a hospital where I had general anesthesia. But I’m a good student and a good observer, and I was very critical, and I found ways to keep improving and making the procedure better and safer. I also developed techniques to be able to terminate the pregnancy further along in the second trimester.
Women came to me mostly from Texas, Louisiana, Arkansas, and Oklahoma, but also from all parts of the country. It very quickly became apparent that there were too many women – I could not possibly see all of them. My primary care practice disappeared, and I ended up providing abortions full-time. And there was no way there were enough hours in the day. If you didn’t show up for your appointment, you probably weren’t going to get another. It was hard to me to say no, but you have to eat and sleep, so it was necessary. I thought, If it’s ever legalized, and I open a legal clinic, I don’t ever want to have to say no again.
The reason I was moved to provide abortions was to achieve women their rightful place in society – one of respect and equality. When you have a legislature taking over your body when you become pregnant, suddenly you’re relegated to a second-class citizenship. Whether you think abortion is wrong is irrelevant. Whether you think the woman may not be making the best decisions is irrelevant. It’s her life, her body, and she gets to make the decision, not you. That’s the reason I do this work. I’ll retire when I die. When my brain and hands are gone, or when I die – that’s when I’ll retire.
The frightening thing about what Donald Trump said is, yes, reversing Roe v. Wade is a possibility. I hope it’s no more a possibility than Donald Trump being elected president, but there is that possibility. It’s frightening to think, What if that happened? After all we’ve fought for, we’re only one Supreme Court justice away from reversing Roe v. Wade completely. We’ve already lost a lot of it. All these restrictions the states are passing now would hold up if the anti-abortion forces control the Supreme Court appointments. The Supreme Court has already overturned parts of the law here in Texas, and these other state laws will be overturned too. But if we lost the Supreme Court, it would be devastating.”
Dr. David Grimes is a retired ob-gyn who provided abortions for 42 years. Though he’s recently retired from his practice, he still dedicates his life to teaching future generations about the necessity of giving women the right to choose. He was finishing medical school in North Carolina in the early ’70s, before Roe v. Wade but after North Carolina legalized abortion within the state. In the early days of his medical training and practice, he treated women who came into the hospital with life-threatening complications of illegal abortions.
“The decades before Roe v. Wade were the bad ol’ days. It was horrible carnage – and every one of those deaths was preventable. These women weren’t dying of exotic diseases. They were dying of simple things like hemorrhage and infection, and any third-year medical student with adequate equipment could’ve easily handled it. But the reason those women were dying is because the country had not yet made the decision that these women’s lives are worth saving. It’s just one of the ugly manifestations of misogyny, and it needs to be understood as such. It was a profound disdain of women and their autonomy.
Back in the ’50s and ’60s, every major metropolitan hospital in the U.S. had a septic abortion ward. The most common reason for admission to gynecological services in America was complication of abortion. When I was a doctor at L.A. County hospital in 1986, my predecessors who’d trained there told me the septic abortion ward at that hospital was a 20-bed, U-shaped ward, and they had two private rooms. These private rooms were there so women could be alone with their families as they died from complications of illegal abortions, and those rooms were always full. When the California laws changed in 1967 and abortion became legal in the state, those wards emptied, closed, and were converted to other uses.
I started doing abortions as a fourth-year medical student at the University of North Carolina at Chapel Hill in the early ’70s. The laws in North Carolina changed in 1970, before Roe v. Wade, and made abortion legal in the state. But there were restrictions in the state law – you had to have two physicians who sign off their approval for the procedure. It was degrading for a woman to have to go before a panel of physicians to justify what she wants to do. When Roe v. Wade was decided, all the restrictive state laws like North Carolina’s were struck down as unconstitutional. What Roe v. Wade said, essentially, is in the first trimester, you can’t intervene between the doctor and patient.
Things didn’t get better immediately after Roe v. Wade. When I was a young doctor in the early years after Roe v. Wade, I can recall seeing two patients in particular. One patient was called to the emergency room when I was on call, and she reportedly had a fever of 106 or 107 degrees. I thought that was an error, because I had never seen folks with fever that high, except folks with heat stroke. I discovered it wasn’t an error – the patient was desperately ill, and when I did the pelvic exam, I found a red, rubber catheter protruding from the woman’s cervix. It had been put in place by a technician the next town over. She was a well-known illegal abortion provider who was still practicing in the early days after Roe v. Wade.
That was a very effective means of inducing abortion – putting foreign bodies in the uterus. A soft, rubber catheter – like the kind we use to catheterize the bladder – was commonly used in back-alley abortions. They were inserted into the uterus and taped in place, and they would cause infection, which would then induce an abortion. The more invasive the illegal abortion technique of putting things in the uterus, the more successful and the more dangerous it was. But we removed the catheter and saved that woman’s life.
The second case I remember very well. Again, when I was on call one night, I was asked to come to the emergency department to see a young student from the University of North Carolina. She came in near death; she was in septic shock. She had virtually no blood pressure, and when I examined her, I found a dead fetal foot at about 17 weeks gestation protruding through her cervix. The circumstances were suspicious. But I didn’t press the issue, it wasn’t my job to be the inquisitor. We quickly emptied her uterus, gave her antibiotics, and saved her life as well, and sent her home. Those are just two examples, but they were routine back in prior decades.
If abortion became illegal, it would get bad – but it would not be as bad as in the pre- Roe days. We have safer techniques today by which women could self-induce, specifically misoprostol. Women are using them already in places like Texas.
But the point is, why should women be driven to those measures when we have competent health-care providers standing by? Anyone who is opposed to abortion and contraception is, by definition, a misogynist. It shows profound disrespect and disdain for women as autonomous, constitutionally protected citizens. It’s also foolish – it would hurt everyone. No one benefits from restrictions on abortion. Safe, legal abortion has always been a win-win-win. It’s good for the woman, it’s good for her children, it’s good for the family, and it’s good for society.
You’ve got to respect women. If women can’t make such a profound, fundamental decision about whether or not to have a child, that is unconstitutional. To respect women as equal members of society, you have to support their reproductive rights.”
Interviews have been lightly edited for length and clarity. Follow Hannah on Twitter.