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The Physicians' Crusade for the Unborn

Frederick N. Dyer

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Fascinating history of doctors defending the unborn during the Civil War period.

In 1857, while much of the nation was consumed with the issues that would soon lead to civil war, a young Boston doctor took action on another matter of life and death. Dr. Horatio Robinson Storer's effort, dubbed the "physicians' crusade against abortion," was wonderfully successful. As a result of diligent lobbying by Dr. Storer and his colleagues, state and territorial legislatures enacted stringent laws against unnecessary abortions, most of which remained in effect with little or no change for more than a hundred years. Perhaps just because it was so successful in placing abortion outside the pale, the physicians' crusade was largely forgotten until the 1970s, when it was exhumed from the archives and cited in amicus curiae briefs submitted to the Supreme Court. However, the people citing the physicians' crusade in these briefs were not pro-lifers but pro-choicers, and they used it in a most ingenious and disingenuous way.

Concern for the unborn child, they claimed, was not an important factor motivating these physicians to seek stringent abortion laws. These laws, the briefs argued, were passed primarily to protect women from a dangerous operation. Since physician-induced abortion was no longer dangerous in the 1970s, there was no reason to retain the laws against abortion. A majority of Supreme Court justices accepted these and other false claims in Roe v. Wade and subsequent cases with the res ults we have lived with ever since.

In 1989, as the Supreme Court was preparing to hear Webster v. Reproductive Health Services, a group of 281 professional historians provided an amicus curiae brief that extended the list of reasons why the nineteenth-century physicians opposed abortion. In addition to concern for women's health, their list included putting the "quacks" who performed many of the abortions out of business; increasing the numbers of "Americans," i.e. native-born citizens, who were having many fewer children than Catholic immigrants; and keeping women in traditional child-bearing roles. The brief acknowledged that "physicians were the principal nineteenth-century proponents of laws to restrict abortion," but it denied that concern for the unborn was one of their reasons. The life of the fetus, according to the brief, "became a central issue in American culture only in the late twentieth century."

The authors of this 1989 friend-of-the-court brief found much of their ammunition in a history of nineteenth-century abortion published in 1978 by the historian James C. Mohr. Mohr's Abortion in America was much more honest than the amicus brief based on it. For example, Mohr wrote:

The nation's regular doctors, probably more than any other identifiable group in American society during the nineteenth century, including the clergy, defended the value of human life per se as an absolute. Scholars interested in the medical mentality of the nineteenth century will have to explain the reasons for this ideological position. . . . But whatever the reasons, regular physicians felt very strongly indeed on the issue of protecting human life. And once they had decided that human life was present to some extent in a newly fertilized ovum, however limited that extent might be, they became the fierce opponents of any attack upon it.

Mohr discussed this "personal" reason for physicians' opposition to abortion after discussing "professional" reasons such as eliminating "quacks" and controlling the practice of legitimate members of the profession. As a result, concern for the unborn appeared to the casual reader, perhaps including the three law professors who actually wrote the historians' brief, to be less important than these other concerns. Numerous subsequent authors would use the historians' brief as a guide and stress the incorrect claim that the nineteenth-century physicians opposed abortion for professional reasons rather than concern about the unborn child. (See Ramesh Ponnuru, "Aborting History," National Review, October 1995, 29-32. Reprinted in the Winter, 1996 issue of this journal.) However, anyone who reads Mohr's book carefully--or, better yet, reads the original articles and books by these pioneer pro-life physicians--can see that concern for the unborn was the major factor motivating the physicians' crusade against abortion. Mohr himself noted that "many fervent writings" by these physicians expressed their belief that abortion was "morally wrong," although Mohr provided few examples of these "fervent writings" in Abortion in America. In his chapter, "The Physicians' Crusade Against Abortion," he provided a single extended quote from an Illinois physician, James S. Whitmire, written in 1874:

Many, indeed, argue that the practice is not, in fact, criminal, because they argue that the child is not viable until the seventh month of gestation, hence there is no destruction of life. The truly professional man's morals, however, are not of that easy caste, because he sees in the germ the probable embryo, in the embryo the rudimentary fetus, and in that, the seven months viable child and the prospective living, moving, breathing man or woman, as the case may be.

That is clear enough, but not very fervent. Here, from the same article, is a more typical passage by Whitmire:

Persons who engage in this crime, whether they are professional or self-abortionists, have lost all the natural instincts of humanity; they have neither principle nor good morals, and are, hence, an eyesore to society, a plague-spot upon communities where they exist--lepers, whose infectious breath undermines the very foundation of the morals of the people, and should not be tolerated for a single day, when and where they are known.

Mohr recognized the key role of Dr. Storer in launching the physicians' crusade and even included a picture of Storer in Abortion in America. However, Mohr provided only brief quotes from Storer, despite the fact that Storer wrote two committee reports, twelve articles, four books, and several editorials condemning criminal abortion. One Storer passage surely deserved repetition by Mohr, since Storer himself regarded it as his strongest statement of the essential issue. First used in his first article on abortion, published in the January 1859 North-American Medico-Chirurgical Review, it read:

If we have proved the existence of fetal life before quickening has taken place or can take place and all by analogy, and a close and conclusive process of induction, its commencement at the very beginning, at conception itself, we are compelled to believe unjustifiable abortion always a crime.

And now words fail. Of the mother, by consent or by her own hand, imbrued with her infant's blood; of the equally guilty father, who counsels or allows the crime; of the wretches who by their wholesale murders far out-Herod Burke and Hare; of the public sentiment which palliates, pardons, and would even praise this so common violation of all law, human and divine, of all instinct, of all reason, all pity, all mercy, all love,--we leave those to speak who can.

storer repeated that long last sentence in his 1865 American Medical Association Prize Essay which in 1866 became the popular book Why Not? A Book for Every Woman. He repeated it again in his second popular book, Is It I? A Book for Every Man, published the following year. Thousands of these books were sold to the public, and many copies of Why Not? were distributed by physicians to their women patients. These popular books no doubt contributed much to the success of the physicians' crusade, which according to Mohr, produced a substantial decrease in the number of abortions, at least among married women.

If Storer was the first to organize a lobbying effort against abortion, he was far from the first to speak out on the subject. One of the earliest physicians to address the epidemic of criminal abortion was Hugh Lenox Hodge, Professor of Obstetrics at the University of Pennsylvania. Hodge spoke the following words to his medical students in 1839 and again in 1854, and the address was published on both occasions:

Would, gentlemen, that we could exonerate the moderns from guilt in this subject! It is, however, a mournful fact, which ought to be promulgated, that this crime, this mode of committing murder, is prevalent among the most intelligent, refined, moral, and Christian communities. We blush while we record the fact that in this country, in this city, where literature, science, morality, and Christianity are supposed to have so much influence; where all the domestic and social virtues are reported as being in full and delightful exercise; even here, individuals, male and female, exist who are continually imbruing their hands and consciences in the blood of unborn infants; yea, even medical men are to be found who, for some trifling pecuniary recompense, will poison the fountains of life, or forcibly induce labor to the certain destruction of the fetus, and frequently of its parent.

So low, gentlemen, is the moral sense of the community on this subject--so ignorant are the greater number of individuals--that even mothers, in many instances, shrink not from the commission of this crime; but will voluntarily destroy their own progeny, in violation of every natural sentiment, and in opposition to the laws of God and man.

Storer praised Hodge's anti-abortion efforts in his January 1859 article, and a few months later he selected Hodge to be a member of the American Medical Association's Committee on Criminal Abortion, which Storer chaired.

In January 1851, the Rhode Island physician John Preston Leonard published in the Boston Medical and Surgical Journal a long letter that included this passage:

Besides these bills of mortality, the records of criminal courts will furnish sufficient proof that this crime is every day becoming more prevalent. It is humiliating to admit that there are a class of physicians who, Herod-like, have waged a war of destruction upon the innocent. Though their motives are not the same as those which instigated that cruel king, they are no less murderers for that. If there is any difference, they are worse than Herod. He was influenced by popular clamor and bigotry; these quacks do all for money, and such could be hired to burn out the eyes of infant princes.

In his letter, Leonard recommended that the American Medical Association deal with the problem of criminal abortion and that the states pass strong laws against it. In many respects, Leonard's letter was a blueprint for the crusade Storer launched six years later.

Horatio Storer's father, David Humphreys Storer, was Professor of Obstetrics and Medical Jurisprudence at the Harvard Medical School. In November 1855, he gave a lecture at the Medical School whose final section dealt with criminal abortion. In 1859, Horatio cited his father's lecture as a major stimulus for his anti-abortion "undertaking." In that lecture, David Storer had said:

To save the life of the mother we may be called upon to destroy the fetus in utero, but here alone can it be justifiable. The generally prevailing opinion that although it may be wrong to procure an abortion after the child has presented unmistakable signs of life, it is excusable previous to that period, is unintelligible to the conscientious physician. The moment an embryo enters the uterus a microscopic speck, it is the germ of a human being, and it is as morally wrong to endeavor to destroy that germ as to be guilty of the crime of infanticide.

In January 1860, the New York physician Augustus Kinsley Gardner published what may have been the first popular article dealing with criminal abortion. The article, "Physical Decline of American Women," was published in the Knickerbocker, a New York literary magazine with national circulation. Gardner first dealt with the bad effects women experienced from lack of exercise, late hours, improper clothing, and "sins against one's own self," i.e. masturbation. He then moved on to criminal abortion:

This is a theme from which we would gladly shrink, both from the delicacy of the subject and from conscious inability to treat it as it deserves; to bring before you the most horrid social enormity of this age, this city, and this world, and to hold it up to you in such a light as to make you all feel it, in its craven cowardice, its consequent bodily, mental and moral degeneracy, its soul-destroying wickedness. We look with a shudder upon the poor ignorant Hindu woman who, from the very love of her child, agonizes her mother's heart, when in the fervor of her religious enthusiasm she sacrifices her beloved offspring at the feet of Juggernaut or in the turbid waves of the sacred Ganges, yet we have not a pang, nor even a word of reprobation, for the human sacrifices of the unborn thousands annually immolated in the city of New-York before the blood-worshipped Moloch of fashion. From no excess of religious faith in even a false, idolatrous god are such hecatombs of human beings slain, but our women, from a devotion to dress and vain pride of outward show, become murderesses of their own children, and do literally in their own bodies become whitened sepulchers, pallid, with the diseases consequent upon such unrighteous acts, and sepulchral in thought and tone of voice from the remorse which always follows a guilty action.

Gardner's jeremiad against women who sought abortions continued for three full pages. He further condemned abortion and abortion seekers in a popular book, Conjugal Sins Against the Laws of Life and Health and Their Effects upon the Father, Mother and Child, published in 1870. Several other physicians published books for the general public with chapters condemning criminal abortion. One exceedingly popular book was Plain Facts For Old and Young, by John Harvey Kellogg, M.D., the inventor of Corn Flakes. Kellogg quoted extensively in his abortion chapter from Gardner's 1860 article and from Horatio Storer's books. Kellogg also described the following conversation he had had with a woman patient who had requested an abortion:

A number of years ago, a woman called on the writer, stating that she had become pregnant much against her wishes, and earnestly desired that an abortion should be produced. The following conversation ensued:--

"Why do you desire the destruction of your unborn infant?"

"Because I already have three children, which are as many as I can properly care for; besides, my health is poor, and I do not feel that I can do justice to what children I now have."

"Your chief reason, then, is that you do not wish more children?"

"Yes."

"On this account you are willing to take the life of this unborn babe?"

"I must get rid of it."

"I understand that you have already borne three children, and that you do not think you are able to care for more. Four children are, you think, one too many, and so you are willing to destroy one. Why not destroy one of those already born?"

"Oh, that would be murder!"

"It certainly would, but no more murder than it would be to kill this unborn infant. Indeed, the little one you are carrying in your womb has greater claims upon you than the little ones at home, by virtue of its entire dependence and helplessness. It is just as much your child as those whose faces are familiar to you, and whom you love."

Other physicians related similar conversations in which they offered to kill an existing child, since it would be safer for the mother than having the abortion she requested. Most indicated that this approach--which vividly reminded their patients that abortion both constituted murder and was dangerous to the mother--was effective in persuading the woman to bear her child.

Several Catholic physicians argued in published papers, articles, and books that even when the mother's life was endangered, the fetus must not be sacrificed. Typically, these received short shrift from other physicians, including some who also were Catholic. The latter doctors refused to sacrifice both the fetus and the mother when there was a chance the mother could be saved by an abortion.

Discussions of society's loss from abortion abounded in physicians' writings. The Illinois physician H.A. Pattison read a paper in 1907 in which he made the claim that abortion at any period after conception was "a crime against life and against society." He cited as "proof" the hypothetical case of "an obscure family named Lincoln" living in a Kentucky log cabin.

The mother of this family had many duties and cares. At a certain time she became pregnant. Suppose that for some reason she felt it too much to go through the long period of gestation, the perils of maternity, and the cares of motherhood, and had submitted to an abortion. Abraham Lincoln would never have been born, and that obscure woman would have committed the greatest crime ever perpetrated against this republic.

Physicians' concern for the unborn continued throughout the nineteenth century and well into the twentieth. Hundreds of physicians published articles, letters, and editorials in medical journals that defended the unborn from earliest conception and condemned the seekers and providers of unnecessary abortions. Many of these physicians also expressed concern about dangers to the mother and about changes in the national character as a result of the higher birth rates of immigrants, who were not seeking abortions. But for almost all of them, these concerns were subordinate to their concern about the killing of unborn human beings. Storer and many others recognized that some women would not be persuaded by moral arguments and recommended that their physician readers appeal to women's concerns about their own health as a way to persuade them to have their children. The issue of the national character was also viewed as a means to influence legislators who might not be fully convinced of the immorality of abortion. As to eliminating "quacks" and controlling the practice of legitimate members of the profession, when these were mentioned, it was as tactics for reducing the number of criminal abortions, not as strategies that were served by opposing abortion.

It might be asked whether there were any physicians who called for legalization of abortion. The New Jersey physician Isaac Skillman Mulford urged in 1855 that abortion before quickening should be allowed--or more correctly, continue to be allowed, since many states at that time did not make early abortion a crime. Mulford argued this point in a letter to the New Jersey Medical Reporter in April 1855, in which he claimed that "nature sometimes fails in her purposes; her attempts to attain a certain result proving to be abortive, a true conception does not take place; a living, growing being is not produced in the womb, but instead thereof there exists a mere rude, unformed, unorganized mass of matter." Mulford indicated that only after the contents of the womb are definitely known to be a living being must abortion be avoided. For Mulford, it was "quickening"--the point in the pregnancy when fetal motion could be felt by the mother--that established that life existed. In 1889, a call for general legalization of abortion was published in the New York-based Medico-Legal Journal; however, the author was probably a lawyer and not a physician.

In an 1892 article, Charles H. Harris, M.D., of Cedartown, Georgia, proposed exceedingly liberal indications for abortion and described a pair of devices for snaring the embryo or fetus. In March 1893, Dr. F.W. Higgins, of Cortland, New York, published a call for legalization of early abortion while the form of the embryo "still remains that of a cat or dog." There may have been one or two others advocating legal abortion in general or early in pregnancy before 1900, but our attempt to comprehensively review all articles on abortion in medical journals has located only those mentioned above.

Calls by physicians for legalization of early and even late abortion became slightly more prevalent in the early 1900s. A New York City gynecologist, M. Rabinovitz, called for legislation in 1914, although he maintained that every effort should be made to persuade the woman to have her child. Another New York City physician, Morris H. Kahn, published a paper advocating "The Legalization of Abortion" in 1927. Abraham Jacob Rongy argued in 1931 that legal abortion was a "social necessity." William J. Robinson advocated legal abortion in 1933 in an article and a book. Frederick J. Taussig switched from opposing all unnecessary induced abortions in 1910 to recommending socioeconomic factors as indications for abortion in the 1940s.

However, even in the 1940s and 1950s there were fervent pleas by physicians on behalf of the unborn and fervent condemnations of unnecessary abortions. The New Jersey obstetrician Samuel A. Cosgrove might have been a reincarnation of Horatio Robinson Storer. He believed the unborn child was being inappropriately sacrificed in almost all therapeutic abortions. At an American Medical Association symposium in June 1947, Cosgrove spoke of the need to instill high ethical standards in the medical profession. His discussion included the following statement:

Nowhere does this ethical sense have more direct bearing than in relation to abortion. Widespread and indiscriminate abortion is a major factor in puerperal mortality. It is believed to be best controlled by retention of the ethical recognition that the fetus is a human being with all the potentialities of every human being; that its destruction is murder, only justifiable in the most extreme circumstances involving direct and imminent threat to the mother's life.

Cosgrove's articles and symposium discussions caused a sharp reduction in the high rate of therapeutic abortion in hospitals across the country. A Samuel A. Cosgrove Memorial Lecture is presented each year by the American College of Obstetricians and Gynecologists. However, the organization that annually honors Cosgrove, in view of other of its actions and pronouncements, apparently no longer honors his view of the fetus.

When physicians like Rabinovitz, Kahn, Robinson, Rongy, and Alan Guttmacher wrote in favor of liberalized abortion laws, they did not mention the pleas for the unborn by Hodge, Storer, or the other pioneer pro-life physicians. They typically did not even mention their existence. Taussig was an exception. In his 1936 book, Abortion, Spontaneous and Induced, Medical and Social Aspects, Taussig admitted that Hodge had decried abortion as "one of those unnatural and horrible violations of human and divine law which cannot be too severely stigmatized and deserves condign punishment." However, the reason Taussig mentioned Hodge was that Hodge "advised induction of abortion in cases of contracted pelvis where a viable child cannot be born." Taussig did not qualify this by mentioning that, at the time Hodge was writing, the caesarean section was fatal to the mother more often than not.

Alan Guttmacher was guilty not only of overlooking history, but of distorting it. He repeatedly claimed that the "Father of Medicine," Hippocrates, while instructing physicians to not perform abortions, contradictorily advised a woman how to achieve the same res ult herself. Guttmacher did this fully knowing that the ancient Greek physician who prescribed jumping up and down to empty the uterus was not Hippocrates of Cos, who wrote, according to one translation: "I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect. Similarly, I will not give to a woman an abortive remedy."

It must be conceded that even at the height of physician opposition to abortion, unnecessary abortions continued at a high rate, with the bulk of these being obtained by married Protestant women.

The reasons for the continuing prevalence of induced abortion are complex. Many newspapers, including some religious newspapers, carried thinly veiled advertisements for drugs that were presumed to cause miscarriages, and these ads made women aware that abortion could be induced and led them to believe that this was no major crime. Protestant clergy typically were unwilling to raise the issue in their sermons.

However, high as abortion rates were, they would have been even higher if it weren't for the laws that dissuaded some women from seeking abortions and restrained many physicians who might otherwise have provided them. Of even more importance was physicians' persuading women seeking abortions to continue their pregnancies. Dozens of physicians echoed John Harvey Kellogg in describing how it was the physician's duty to convince women that they should not have abortions. Many reported large successes, including Frederick Taussig, who claimed that he was able to persuade almost one-half of the married women requesting abortions to have their babies instead. If you, the reader, are of Protestant stock going back 100 years in this country, the odds are good that you have at least one ancestor who was born alive because his mother heeded such counsel.

Not the least factor in keeping the rate of unnecessary abortions from being even higher was the Catholic clergy. Catholic readers can thank their grandmothers', great grandmothers', and great great-grandmothers' priests for their own existence. Storer noted the rarity of abortion among Catholic women in 1859 and reported that there had been no change when he wrote in 1868. He gave credit for this fact to the Catholic confessional, as did numerous other physicians, including Alfred A. Andrews, of Windsor, Ontario. In a paper published in the Canada Lancet in June 1875, Andrews noted the similarities between the Catholic confessional and the doctor's private office:

I had for many years noted and wondered at the fact that, of the married women who sought my co-operation, nearly all were Protestants. Being myself a Protestant of the broadest Orange stripe, and not ready to acknowledge any marked moral inferiority in my co-religionists, I was for a long season puzzled, but I think the solution is this. The Pulpit is debarred, but the Roman Catholic Priesthood have in their confessional an opportunity of instructing and warning their flock. Protestant women do not go there, but we, and we only, have the private confidential ear of the whole sex, and it is, I conceive, our duty to lose no opportunity of diffusing the information we possess in this regard. Let us purify the moral atmosphere. Let us make the whole sex know that it is murder, when the embryo is but four weeks old, as completely as if the nine months of fetal life had been reached or passed. We have a duty to perform, and we have countless opportunities of doing it.

The essays and speeches quoted in this article are a minuscule fraction of the fervent defenses of the unborn written by physicians between 1839 and 1947. James Mohr immersed himself in this sea of fervency and at least mentioned its existence. It is unfortunate that he did not quote more of these examples himself, and that he did not name Chapter 6 of his Abortion in America "The Physicians' Crusade for the Unborn," instead of "The Physicians' Crusade Against Abortion." This might not have affected the outcome of Roe v. Wade and subsequent Supreme Court decisions, given the prevailing mindset in political and judicial circles in the 1970s and '80s. But it would at least have made it impossible to maintain that a majority of physicians who wrote on this subject were primarily motivated by a desire to protect women from a dangerous operation, or by a desire to protect themselves from competition. Their primary goal was to awaken men and women alike to the powerful claims that unborn children have upon their parents and upon the community.

Read this article on the Human Life Review website.



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