The historic role of medicine in the abortion debate is as controversial as the subject itself, with early doctors' groups in the United States among the first to advocate laws banning such procedures.
There were exceptions to that early abortion policy, such as a New York City law passed in 1716 that prohibited midwives from aiding women in any abortion.
Britain made all abortions illegal in 1803, but the United States was slow to follow suit, based on a tradition of individualism in the expanding nation.
As the anti-abortion laws became more common in the 1800s, they were designed to deal with poisonous drugs and dangerous procedures. Identified mostly with untrained doctors and druggists, these remedies were opposed by trained physicians who came together in 1847 to form the American Medical Association. The AMA got a few state legislatures to outlaw certain drugs and procedures, and in 1859 the AMA convention urged a "general suppression" of all abortions.
The campaign had strong roots in AMA self-interest: by refusing to perform abortions, trained physicians could solidify their attempt to control the practice of medicine. Yet doctors had a difficult time attracting allies, for they were a minority among health practitioners. Protestant clergy shunned the crusade, as did the general public. The Catholic Church, although opposed to abortion, gave priority to other issues in a nation in which Catholics were often viewed suspiciously.
Then the popular press took an interest in the issue, especially in terms of sensational stories about abortion-related incidents. "Females are daily, nay hourly, missing from our midst to never return," reported the Police Gazette. "Where do they go?"
Doctors and the newspapers also stressed that middle-class women could use abortion as a means of birth control, perhaps to cover up extramarital activity.
A report of the AMA Committee on Criminal Abortion in 1871 complained: "She yields to the pleasures -- but shrinks from the pains and responsibilities of maternity . . . Let not the husband of such a wife flatter himself that he possesses her affection. Nor can she in turn ever merit even the respect of a virtuous husband. She sinks into old age like a withered tree, stripped of its foliage; with the stain of blood upon her soul, she dies without the hand of affection to smooth her pillow."
Accounts by individual physicians also helped to sway public opinion, as illustrated by one in 1890: "Many otherwise good and exemplary women would rather part with their right hands or let their tongues cleave to the roof of the mouth than to commit a crime, yet they seem to believe that prior to quickening {the fetus moving} it is no more harm to cause the evacuation of the contents of their wombs than it is that of their bladders or their bowels."
The combined media-medical attack left all states, except Kentucky, with anti-abortion laws by 1900. Most statutes had two purposes: first, trained medical practitioners were the only professionals allowed to decide on the rare times that an abortion should be given (in "therapeutic" instances when the life of the pregnant woman was in jeopardy); second, the penalties for violating the laws were often severe.
In Connecticut, a woman who underwent an unlawful abortion was guilty of a felony. In California, the abortionist, the woman and anyone providing materials were indictable. In Maryland, one half the fine imposed on a convicted abortionist could go to the informant.
Florida's 1869 legislation was one of the most severe; among other provisions, it made an attempted abortion at any stage of pregnancy, even without harm to the female, subject to a maximum seven-year prison term and a $1,000 fine.
Such laws brought little controversy until the 1960s, when courts began to invalidate some on the grounds of constitutional vagueness and violation of the right to privacy. In the interim, physicians were faced with an expanding definition of therapeutic abortions: in the 1930s, tuberculosis was a frequent reason for such procedures; in subsequent decades, mental health factors became significant, even though doctors could not agree on their validity.
In one sense, the Supreme Court, in striking down a Texas law in Roe v. Wade (1973), provided legislators and physicians with more specific guidelines for legal abortions, with the court imposing a three-stage gestation model that gave the state a "legitimate interest in potential life" only in the third and final trimester.
But the high court's Webster decision in 1989 upheld a Missouri law that extended fetal "viability" into the second trimester, thereby muddying the medical waters as to the parameters of legal abortion.
Thomas V. DiBacco is a historian at The American University.
