Methods of Illegal Abortion

I’ve written about the methods of legal abortion: procedures performed by licensed medical professionals in a clean, sterile environment, with clean, sterile tools. But what about illegal abortions?

Those who push for more restrictions on abortion access - really, those who push for abortion to be made illegal - seem unwilling to acknowledge the disastrous alternatives. Many who are anti-choice have no memories of what life was like before Roe v. Wade in 1973. We know abortion rates stay fairly steady, regardless of legality. How are these illegal abortions procured? What options are there for those without the money or connections to a discrete physician?

To answer these questions, I’ve compiled a list of methods of illegal, or “back-alley” abortions.

Waldo L. Fielding, M.D. wrote an article for the New York Times in 2008, describing what he saw while working as a gynecologist in New York City from 1948 to 1953.

The familiar symbol of illegal abortion is the infamous “coat hanger” — which may be the symbol, but is in no way a myth. In my years in New York, several women arrived with a hanger still in place. Whoever put it in — perhaps the patient herself — found it trapped in the cervix and could not remove it. … Almost any implement you can imagine had been and was used to start an abortion — darning needles, crochet hooks, cut-glass salt shakers, soda bottles, sometimes intact, sometimes with the top broken off. Another method that I did not encounter, but heard about from colleagues in other hospitals, was a soap solution forced through the cervical canal with a syringe. This could cause almost immediate death if a bubble in the solution entered a blood vessel and was transported to the heart. The worst case I saw, and one I hope no one else will ever have to face, was that of a nurse who was admitted with what looked like a partly delivered umbilical cord. Yet as soon as we examined her, we realized that what we thought was the cord was in fact part of her intestine, which had been hooked and torn by whatever implement had been used in the abortion. It took six hours of surgery to remove the infected uterus and ovaries and repair the part of the bowel that was still functional.

A case report from 1911 describes a self-induced abortion using a knitting needle.

In the afternoon the day before her admission she had attempted to pass into the uterus a bone knitting needle…During the attempt the needle broke off short, leaving about half of it inside her body…During the next four days the temperature gradually rose, until on the fifth day after admission it was 102.2 F, and the pulse rate 100. On the evening of this day uterine hemorrhage occurred…and at 6:30 next morning the patient aborted, a fetus some 4 in. in length…The needle had just missed the right border of the rectum, the wall of the bowel being slightly torn superficially…

A case study from 1972 goes into greater detail about the use of a soap solution.

A case report from 1964 describes a woman’s attempt to self-abort with turpentine.

Believing herself to be pregnant she had, on the afternoon preceding admission, injected into her uterus the contents of a rectal syringe filled with turpentine and water. Immediately thereafter, she experienced a sharp burning sensation which “went all through me up to my chest.” This was followed by a convulsive seizure. Two hours later she began to have paroxysms of coughing productive of a bloody sputum.

A case history from 1961 describes two women’s attempts to self-abort with Lysol. One woman survived. The other did not.

The second patient was a 26-year-old French Canadian woman, married, but separated from her husband. She was…3 ½ months pregnant. She had used a vaginal douche of concentrated Lysol solution 25 hours before admission…On examination there was erythema of the thighs and vulva. Pieces of placental tissue were passed but the abortion remained incomplete. The day after admission renal shut-down became apparent…A full-blown picture of lower nephron nephrosis [kidney disease] developed rapidly in this case…The patient’s condition deteriorated rapidly and she died on the sixth day in acute pulmonary edema [fluid in the lungs].

Those who got them done by others didn’t fare much better (PDF). (1964)

…this 21-year-old single girl…went to an abortionist who inserted a catheter and wire into her cervix. The wire was removed after four days when chills, fever, crampy lower abdominal pain, nausea, and vomiting developed. Symptoms persisted until she came to the emergency ward with a temperature of 103 F (39.4 C) and a shaking chill…Her abdomen was rigid, with diffuse tenderness and absence of bowel sounds. There was tenderness, also, on pelvic and rectal palpation, the uterus was enlarged with necrotic [dead] tissue extruding from the cervix…She was discharged to her home after 17 days, only to return 10 days later with a temperature of 105 F (40.6 C)…Two days later…a laporotomy was done…and total hysterectomy [removal of the uterus]…She was…sterile at the age of 21. …this 25-year-old married woman was given a soap-and-bleach douche by an abortionist. Following the douche, fever and chills developed with vaginal bleeding and crampy lower abdominal pain. On admission she had a temperature of 103 F (39.4 C), which rose to 106 F (41.4 C)…an emergency hysterectomy was done, following which she had a cardiac arrest. She was resuscitated, but arrested a second time and did not respond to resuscitation.

Some women attempted to induce miscarriage by drinking poisons such as aloe, ergot of rye, savin oil (derived from a juniper plant), teas made from tansy, pennyroyal, rue, and nightshade, high doses of vitamin C, and other natural “remedies.”

Dr. Garson Romalis, who survived two attempts on his life, gave a speech in 2008 in which he described what he saw in med school.

The first time I started to think about abortion was in 1960, when I was in second year medical school. I was assigned the case of a young woman who had died of a septic abortion. She had aborted herself using slippery elm bark…The young woman in our case developed an overwhelming infection. At autopsy she had multiple abscesses throughout her body, in her brain, lungs, liver and abdomen. I have never forgotten that case. … I will never forget the 17-year-old girl lying on a stretcher with 6 feet of small bowel protruding from her vagina. She survived. I will never forget the jaundiced woman in liver and kidney failure, in septic shock, with very severe anemia, whose life we were unable to save.

Some women were also told that they could induce miscarriage by undergoing physical stress, such as vigorous exercise, jumping off tables, bellyflopping onto a hard surface, receiving punches, kicks or other blows to their stomachs, or throwing themselves down the stairs.

None of these methods were guaranteed to work. Women would be left injured, ill, sterile, or dead.

Was that hard to read? It should be. That was the reality of pre-Roe America, and for some, it is still their reality. Those who can’t afford abortions, can’t get to clinics, or can’t tell anyone about their situation, turn to these methods, and worse. In countries where abortion is illegal, this is what people are offered.

Lysol, carbonic acid, coat hangers, stairs, and fists are not surgical instruments. Back alleys, kitchens, and motel rooms are not operating rooms.

Regardless of your opinion on abortion, this is what happens when abortion is no longer available. Keeping abortion legal is the only moral option.