The Sh for an Abortionist: The Classic Study of How American Women Coped with Unwanted Pregnancy before Roe v. Wade

226 Pages·2014·3.35 MB·English

by  Lee

The Search for an Abortionist
The Classic Study of How American Women
Coped with Unwanted Pregnancy Before Roe
v. Wade
Nancy Howell Lee
With a New Introduction by the Author
Contents
Series Introduction
Preface, 2014
Preface, 1969
1 The Social Structure of Abortion in America
2 The Design of the Research
Channels of Recruitment
The Data Collection
3 The Characteristics of the Volunteers
Age and Marital Status
Household Composition
Residence
Education
Occupation
Religion
Attitudes toward Abortion
Personal Histories
Motivation for Volunteering for This Study
4 The Unwanted Conception and the Decision to Seek Abortion
The Sexual Relationship in Which Conception Occurred
Contraceptive Practice
Recognition of Pregnancy
Methods of Abortion Considered and Attempted
Confirming the Pregnancy and Consulting a Doctor
Consulting the Man Involved in the Pregnancy and Reasons for
Terminating the Pregnancy
Persons Consulted about the Decision
Summary
5 The Search for an Abortionist
Criterion for Inclusion
Units
Relevant Information per Unit
Inclusion of Abortionists
Length of Chains
Multiple Suggestions
Contacts Mentioned after the Abortionist Was Located
Results of the Searches
Summary
6 The Abortion
Self-induced Abortions
Catheter-type Abortions, Not Self-induced
Illegal D. and C. Operations, without Anesthesia
Illegal D. and C. Operations, with Complete Anesthesia
Legally Performed “Therapeutic Abortions”
Comparison of the Types of Abortion
Summary
7 Aftereffects of the Abortion and the Return to Normality
Physical Recovery
Psychological Recovery
Routine Medical Aftercare
Changes in Contraceptive Use
Changes in the Relationship with the Man Involved in the Pregnancy
Changes in Other Relationships
Coming to Terms with the Experience
Control of Communication
The Schedule of Recovery from Effects of the Abortion
Second and Higher-Order Abortions
Summary
8 The Flow of Information through the Population as a Whole
The Social Structure of Acquaintance Networks
The Social Structure of Abortion Communication
The Scope of Message Transmission
The Channels of Message Transmission: Barriers to the Flow of
Information
Communication through Formal Channels
9 Differential Access to Abortion and Abortionists
When Is a Pregnancy Defined as Unwanted?
The Choice of Abortion as Opposed to Alternative Responses to
Unwanted Pregnancy
Social Class and the Outcome of Unwanted Pregnancies
Access to Various Kinds of Abortions
Access to Legal Hospital Abortions
Access to D. and C. Abortions Performed by a Physician with
Anesthesia
Access to D. and C. Abortions Performed without Anesthesia
Access to Medically Untrained Abortionists
Access to Self-induced Abortions
Access to Abortion and Abortionists: Conclusion
Appendix of Research Instruments
Model of Letter to Referring Agencies and Individuals
Model Questionnaire Form
Bibliography
List of Tables and Figures
Index
About the Author
Preface, 2014
The Search for an Abortionist was originally published in 1969, and is now
being reissued as an ebook in 2014. After such a long period and such radical a
radical shift in the way abortions are obtained, it seems necessary to say
something about these changes.
Abortion was illegal in 1969, and this study documents an underground
network of information and people who made it possible for a complex, large-
scale, and sometimes dangerous network of actors and activities to be carried on
almost invisibly in the United States. When the Supreme Court overturned all
the restrictive state laws on abortion in the Roe v. Wade case in 1973, just a few
years after this study was published, it took me by surprise. I thought that the
laws criminalizing abortion were wrong, but I didn’t foresee the massive social
change in attitudes toward women’s rights to control their own reproduction. In
a short period of time, the elaborate methods of contacting illegal abortionists—
involving passwords, pickups in hotels or on street corners, being driven to
unknown locations, paying in cash, etc.—became irrelevant, soon to be replaced
by referrals from doctors, new clinics staffed by reputable health providers, ads
in the telephone book, and so on. One of the primary values of my book, almost
fifty years after its initial publication, is its elucidation of how abortions were
obtained when they were illegal across the United States. It can serve as one of
the “before” pictures of the study of the consequences of Roe v. Wade, helping
us to appreciate the advantages of legalization.
Attitudes toward abortion involved a great deal of anxiety, hypocrisy, and
ambivalence in the 1960s. It was, famously, a time of sexual liberation, in
attitudes and behavior. The birth control pill was approved for general
distribution in the United States in 1960, replacing less effective and less
convenient methods. Within a few years, something like ten million US women
were “on the pill,” and hopes rose that unwanted pregnancies would be routinely
prevented, eliminating most of the need for illegal abortion. In 2014 the Alan
Guttmacher Institute released its most recent research report, showing that the
US abortion rate has been reduced by almost half since 1981, to 16.9 (legal)
abortions per one thousand women ages fifteen to forty-four. The rates and the
numbers of abortions have been reduced overall in the past fifty years, and the
Guttmacher Institute makes it clear that the injuries, infections, costs, and
anxieties due to abortion have been greatly diminished during the same period.
But, of course, only slightly behind the provision of new facilities for legal
abortions, anti-abortion forces (who quickly came to call themselves “pro-life”)
and supporters of women’s rights (who adopted the label of “pro-choice”)
initiated a divisive conflict. This ideological clash has continued and even
accelerated over the decades that followed. Protest marches and demonstrations
at abortion clinics have escalated to threats of violence and even lethal attacks on
healthcare providers, all committed by people who claim the moral high ground
of religious conviction. That ugly and violent social conflict is not covered in
this book because it was carried out in a very different time. The pre–Roe v.
Wade decision period described here was no golden age. Perhaps the time before
legalized abortion was as ugly as the current murderous attacks on providers,
with its forced secrecy and hypocrisy, some irresponsible, greedy doctors, and
callous disregard for the suffering of the searchers. But for most people most of
the time, this network allowed abortion to be carried out almost invisibly, almost
silently, and this description of how that system worked serves as an example of
how complex societies manage their contradictions.
Even after more than forty years, there is no social peace in the United States
when it comes to the issue of abortion. On the contrary, the pro-life opinions and
objections have become more focused and polarized. Providers and seekers of
legal abortions have been harassed, threatened, and murdered by self-righteous
anti-abortion activists. And politicians on both the state and national levels find
that they can gain financial contributions and votes by campaigning against
abortion, and many do. States cannot prohibit abortion but have been passing
restrictions on abortion clinics since the landmark case was adjudicated, and the
Guttmacher Institute notes that the rate of such anti-abortion state legislation has
greatly increased during the past decade. States enacted two hundred five
abortion restrictions between 2011 and 2013, mostly in the form of regulations
that make it difficult, if not impossible, for these clinics to operate. Notably, the
researchers did not find any clear association between abortion restrictions and
declines in abortion rates. State laws that close clinics may indicate a return to
the previous century, when long-distance travel was necessary to obtain an
abortion, but so far they don’t seem to actually be preventing much. Rather,
these laws only inconvenience those who seek and provide abortions. The
continued pressure to change the laws leads one to consider the possibility that
abortion may again be made illegal in the United States, and that the old kinds of
sub rosa methods of illegal abortions may return, in which case this exploration
of how they were done may serve as a valuable resource.
While the topic of abortion continues to be a mainstay in contemporary
political debate, it was not the rising tensions between pro-and anti-abortion
forces that led to the rerelease of this document. Rather, it was the suggestions of
my younger sociological colleagues, who tell me that the value of my old book
is that it is considered a classic of the methodology of studying underground
communication. Using this research strategy, one attempts to make contact with
as wide-ranging as possible a group of “nodes,” or individuals, who can help one
understand the process of communication—in my case, women who have had
abortions. Because abortion was illegal, there was no possible way to draw a
random sample of the population, but I made a concerted effort both to locate a
diverse and substantial number (one hundred fourteen) of starting places, each of
whom was a volunteer who had had a recent abortion, and to document the
process revealed by each of these starting points in considerable detail. As I
reread the old book, I see that it set the methodological pattern I have followed
throughout my career: gathering the available data to explore the problem and
writing the report by outlining that empirical evidence, leading the reader
through my own steps constructing the problem and collecting information. The
report is sprinkled with mental experiments that can’t necessarily be carried out
but are valuable in helping to clarify the problem at hand. I’ve always liked what
I call “small-population problems” and attempts to bring invisible processes into
the light of day.
I learned social network analysis at Harvard University, where Professor
Harrison C. White was electrifying my generation of graduate students with his
original and unexpected series of concepts of networks in the place of categories.
His work emphasized “who you know” rather than “who you are” as the central
way of understanding how complex societies work. I continue to value the
mental tools he gave me long ago.
Professor Barry Wellman has provided leadership in the area of social
network analysis for many decades, and I appreciate his ability to include me
and hundreds of others in his detailed and complex mental map of the field. I
acknowledge the valuable contributions that lifelong colleagues have had to my
work. I would like to thank Bonnie Erickson, Mark Granovetter, Leslie Howard,
Joel Levine, Mike Schwartz, and Barry and Bev Wellman. And I appreciate the
opportunity to see this old work reborn, thanks to Open Road Media and
Forbidden Bookshelf’s editors Philip Rappaport and Mark Crispin Miller.