Someone gave me the phone number of a person who did abortions and I made the arrangements. I borrowed about $300 from my roommate and went alone to a dirty, run-down bungalow in a dangerous neighborhood in East Los Angeles. A greasy looking man came to the door and asked for the money as soon as I walked in. He told me to take off all my clothes except my blouse; there was a towel to wrap around myself. I got up on a cold metal kitchen table. He performed a procedure, using something sharp. He didn't give me anything for the pain -- he just did it. He said that he had packed me with some gauze, that I should expect some cramping, and that I would be fine. I left.

-Actress Polly Bergen, discussing the illegal abortion in the 1940s that left her infertile and nearly proved fatal.

Abortion isn't new

Abortion has been widely used in America since its earliest days. In the 1950s, estimates of numbers of illegal, unsafe abortions ranged widely, from 200,000 to 1.2 million per year. The methods used were often ineffective and dangerous. Desperate women were driven into the back alley, where they endured danger and abuse, sometimes sexual.

Tools of the trade

Surveys in New York City in the mid-1960s revealed the variety of methods used. Treatments women took by mouth included turpentine, bleach, detergents and a range of herbal and vegetable teas. Quinine and chloroquine (malaria medicines) were ingested, and potassium permanganate was placed in the vagina, often causing chemical burns. Toxic solutions were squirted into the uterus, such as soap and turpentine, often causing kidney failure and death. This was the technique used by Vera Drake, the protagonist of Mike Leigh's 2004 award-winning movie. Insertion of foreign bodies was common and more effective than oral agents. Objects included a coat hanger, knitting needle, bicycle spoke, ball-point pen, chicken bone and rubber catheter. Some women threw themselves off of stairs or roofs in an attempt to end a pregnancy. As a young doctor, I removed a rubber catheter from the uterus of a woman with fever of 106 degrees. A dietitian in a nearby city had inserted the catheter through her cervix to induce an abortion. Physicians younger than me have not encountered these tragedies.

Dr. Daniel Mishell, Jr., of Los Angeles, remembers conditions before Roe:

They jabbed into their uteruses with knitting needles and coat hangers, which Mishell sometimes found still inside them. They stuck in bicycle pump nozzles, sometimes sending a fatal burst of air to the heart. They'd try to insert chemicals -- drain cleaner, fertilizer, radiator-flush -- and miss the cervix, corrode an artery and bleed to death. Mishell once put a catheter into a woman's bladder and 'got a tablespoon of motor oil.' I'm telling you, it was really an awful situation. It touched me because I'd see young, [otherwise] healthy women in their 20s die from the consequences of an infected nonsterile abortion. Women would do anything to get rid of unwanted pregnancies. They'd risk their lives. It was a different world, I'll tell you.

Septic wards

Every large municipal hospital in the U.S. had a "septic ward," filled with women suffering from infections after these interventions. At Bellevue Hospital in New York City from 1940-1954, more than 7,000 cases of incomplete abortion were treated, and a third were complicated by infection.

Discrimination

Women of means sometimes could find a physician to help, or they could travel to a country like Sweden where abortion was available. In the 1950s, access to safe, hospital abortions was related to socioeconomic status and race. In New York City, the abortion ratio in municipal hospitals caring for the poor was 1 per 1,000 births; the ratio was six times higher in private hospitals. Clearly, safety could be bought. Access to safe, hospital abortions was racist as well. In 1960-62, abortion ratios for Puerto Rican women were 0.1 per 1,000 births, 0.5 for African-American women, and 2.6 for white women.

Safety, then and now

In the year I was born, U.S. vital statistics reported that more than 700 women died from abortion. The true number was substantially higher, and the population of the country was less than half of that today. In 2010, the most recent year with data available, the Centers for Disease Control and Prevention reported 10 deaths from abortion nationwide. Why the profound change? The principal reason was the legalization of abortion in America. Childbirth-related deaths have decreased over the decades, but not so dramatically. To me, it seems clear: Access to safe, legal abortion saved women's lives.

Cruel and unusual punishment

Movie critic Roger Ebert summed it up well:

Vera Drake is not so much pro or anti-abortion as it is opposed to laws which do little to eliminate abortion but much to make it dangerous for poor people. No matter what the law says, then or now, in England or America, if you can afford a plane ticket and the medical bill you will always be able to obtain a competent abortion, so laws essentially make it illegal to be poor and seek an abortion.