Are Unsafe Abortions Stopped by Legalizing Abortion?

Before Roe v. Wade led to the widespread legalization of abortion, pro-abortion activists had a problem. The procedure was viewed with extraordinary negativity, and statistics did not back up their various arguments for legalizing abortion. Recognizing that abortion itself was unpalatable to the public, they resorted to a variety of emotional appeals to promote its legalization.

Of all the arguments made, perhaps the most common and effective of these was the allegation that many thousands of women died of illegal, unsanitary, back-alley abortions each year before the procedure was legalized. By portraying it as an everyday horror, already common and pervasive, a horror that could be lessened by legalizing abortion, many of the most disturbing aspects of abortion were utilized to defend it.

These emotional appeals did not end when the United States legalized abortion either. Today, activists use the same arguments to force legal abortion into other pro-life countries.

In the United States, where abortion is widely legal, pro-abortionists continue to make this claim to fight any and all restrictions on abortion “rights.” For example, when the Hyde Amendment limiting federal payments for abortion went into effect in 1976, the American Civil Liberties Union made the absurd claim, “Hundreds of women this year will die because they cannot afford an abortion.”¹ More recently, columnist Ellen Goodman breathlessly proclaimed, “After all, those of us who remember when birth control was illegal and when 10,000 American women a year died from illegal abortions don’t have to imagine a world without choices. We were there.”² Senator Barbara Boxer [D-CA], said:

You have to know that it is estimated that there were up to 1.2 million illegal abortions every year, so this 5,000 is four-tenths of 1 percent. I think it’s actually an understated number. I personally believe it’s higher than that, given the fact that these were back-alley, and a lot of them done in unsanitary situations.³

 

“Back-Alley Abortions” Are a Myth

Despite how frequently they are made, there is absolutely no evidence to back up these ludicrous statements. Even the originators of the myth have described how they knew it was a lie from the very beginning. Reformed abortionist Dr. Bernard Nathanson was one of the original founders of NARAL Pro-Choice America and operated the biggest abortion clinic in the nation for years. He famously said:

How many deaths were we talking about when abortion was illegal? In NARAL, we always said “5,000 to 10,000 deaths a year.” I confess that I knew the figures were totally false, and I suppose the others did too if they stopped to think of it. But in the “morality” of our revolution, it was a useful figure, widely accepted, so why go out of our way to correct it with honest statistics?⁴

 Dr. Nathanson was certainly not alone in his views. Many prominent leaders of the pro-abortion movement attempted to tell the truth about the number of fatalities caused by “back-alley abortions,” but were simply ignored by the corrupt mainstream media. Foremost among these was Dr. Malcolm Potts, Medical Director of the International Planned Parenthood Federation, and one of the original activists who helped promote abortion throughout the world. Dr. Potts said in 1970, “Those who want the [abortion] law to be liberalized will stress the hazards of illegal abortion and claim that hundreds, or thousands, of women die unnecessarily each year―when the actual number is far lower.”⁵

The actual Centers for Disease Control (CDC) figures on deaths caused by abortions, both legal and illegal, for those years immediately before Roe v. Wade (1973) were 90 deaths in 1970, 83 deaths in 1971, and 90 deaths in 1972. In 1974, there were 54 recorded deaths and in 1975 there were 49.

When confronted with these figures, pro-abortionists usually fall back on lurid descriptions of back-alley abortions done by drunk butchers to helpless women before Roe v. Wade. Sherry Matulis raved:

I’d like to see if their smug [pro-life] pseudo-morality would hold up if they had to experience firsthand what a real “abortion mill” was all about: The incredible, indescribable filth and stench. The cobwebs hanging from the ceiling. The blood-spattered floor. The two-aspirin “anesthetic.” The slop bucket at the end of the old enameled kitchen table. The drunken old butcher coming at them, a whiskey glass in one hand and a sharp instrument in the other…. Putting his fist in their faces and saying, “This is gonna hurt and you’d better keep your mouth shut or I’ll shut it for you! Whacking away at their insides for 15 eyeball-popping minutes…. Women young, old, black, white―known to the medical books only by their initials and their perforated or Lysol-damaged wombs and their resultant infections and suffering and eventual deaths…. Women with bent heads and unbent coat-hangers, screaming in the night―dead at 16, 18, 20, 22.⁶

 

What Real Illegal Abortions Were Like

These garish images of back-alley abortions are popular among extreme pro-abortionists but are nowhere near the reality of what really happened before abortion was legalized in the United States.

The typical illegal abortionist was a licensed medical professional (in most cases, a medical doctor) practicing in a clean, spacious, and antiseptic office. He or she enjoyed the respect and the protection of the police and many of the community’s most distinguished citizens.

For example, Ruth Barnett performed over 40,000 illegal abortions in Portland, Oregon without a single fatality. She said:

In the movies, they always depict the fallen woman sneaking up a dirty, rickety stairway to a dismal room—or making her way, furtively, into a dark alley that leads to a decrepit shack where some alcoholic doctor or untutored butcher performs the abortion. A clinic such as mine was not that way at all. It was a bright, cheerful place where women’s problems were handled quickly, efficiently and with dignity, no matter what the circumstances of the patient.⁷

Some of the better-off women would go to Mexico, and the situation was similar there. One Zero Population Growth (ZPG) writer describes a glowing report from a young woman she referred to an abortionist in Mexico City:

Things were really good down in Mexico City. Everything happens so fast there is almost an aura of fantasy. The clinic (more like a mansion really) is very nice and comfortable. There were about seventeen women there the morning I had the D&C done, plus some in the afternoon. They get you up right after and feed you fruit and drink and cookies right away—helps take your mind off the cramping. Some of us went sightseeing that afternoon. Mexico City is really nice, and I had no trouble at all with any facet of the journey or my stay there. You know, in a way it was almost fun.⁸

The evidence that abortion used to be “safe and illegal” extends far beyond the anecdotal. Dr. Alfred Kinsey noted, “about 87 percent of all the induced abortions that we have in our records were performed by physicians.”⁹ Dr. Mary S. Calderone, founder of SIECUS, wrote, “The [1955 Planned Parenthood] conference estimated that 90 percent of all illegal abortions are done by physicians. Call them what you will, abortionists or anything else, they are still physicians, trained as such; and many of them are in good standing in their communities.”¹⁰

While no abortion is truly “safe,” given that abortions kill a preborn child, these statistics expose the lie of back-alley abortions.

 

Legalizing Abortion Services Doesn’t Make Them Safe

While today, many assert that legality turns unsafe abortion services to “safe,” this is far from the truth. Abortions are unsafe even today and they do not “save” women. Unfortunately, Matulis’ vivid description of pre-Roe back-alley abortions more closely fits what happens in many legal abortion mills operating today.

For example, abortionist Kermit Barron Gosnell ran a Philadelphia abortion mill that probably would have been shut down by police had it operated in the illegal abortion era. But since it enjoyed the complete protection of the “pro-choice” Pennsylvania state government and Department of Health, it was allowed to operate without inspection or oversight for nearly two decades.

According to the Grand Jury report, Gosnell delivered hundreds of full-term or nearly full-term babies and then murdered them after they were born by severing their spinal columns. He routinely overdosed his patients with dangerous drugs, spread venereal disease among them with infected instruments, perforated their wombs and bowels―and, on at least two occasions, killed them through his gross negligence. At the time of his arrest, his anesthesiologist was a fifteen-year-old high school girl who administered powerful drugs to patients based on a series of colored dots on a piece of paper Gosnell gave her.¹¹

LeRoy Carhart was another example of an abortionist who had filthy and illegal conditions in his office. His employees admitted that abortions were being performed without proper licensing, and two of them said that they started IVs for Carhart despite not being registered nurses or certified licensed practical nurses.

Some employees also alleged that unsanitary conditions, such as dried blood on instruments, were normal at Carhart’s clinic. One former employee reported that Carhart falsified the viable age of babies so he could get around legal requirements.

Scores of filthy legal abortion mills and sexually predatory and incompetent abortionists have been exposed, and in every single case, pro-abortionists have sided with the (usually male) abortionists against their always female victims. The abortion industry and its largest providers are rife with such disregard for women’s well-being, even as they declare themselves champions of it.

If the so-called “pro-choicers” really cared about the lives and health of women, they would campaign to have these abortionists stopped. But it is quite obvious that they place the “right” to unlimited abortion above the welfare of women.

Finally, “pro-choicers” never mention the many women and girls who still die from “safe” and legal botched abortions.

Incompetent and negligent abortionists, along with domineering boyfriends and sexual molesters who rely on the accessibility of legal abortion to cover up abuse, kill as many women each year as died of illegal abortions before Roe v. Wade. Yet legalized abortion is still sold as a way to “empower” women. It would be better for women, and for all of society, if we were truthful about these abortion statistics.

The increasing usage of the chemical abortion pill endangers women’s health, too. Women are sometimes able to get the abortion pill without an in-person exam – so the doctor won’t know for sure how far along she is – and they are told to take it at home, thus experiencing giving birth to a stillborn child without medical help. This gravely endangers their lives and safety. And the dangers of the abortion pill and the debate surrounding it is not limited to the US.

Additionally, after Roe was overturned, many states enacted abortion limitations or bans. Women in these states are now getting abortion pills – oftentimes illegally and from suspicious sources. Some will point to this tragic reality and claim that this shows that abortion must be made legal to keep these women “safe,” saying that restrictions do not decrease abortions. But as the following section will show, restrictions do decrease abortions. And the abortion pill is anything but safe – putting women at risk for things like hemorrhaging, sepsis, pelvic inflammatory disease, and mental health conditions. Those with certain pre-existing conditions are at greater risk of complications. Simply making the abortion pill legal does not make these life-threatening complications go away.

Some claim that women could not afford abortions before Roe and would end up in the hospital after attempting “home abortions.” They claim that this proves that legal abortion is necessary to keep these women “safe.” Some also claim that safe abortion improves women’s health. But abortion in the modern day can hardly be called “safe” given its horrible effects and risks. As we have seen, legal abortions do not keep women safe, nor do they help women in crisis pregnancies.

Instead, giving women support during and after crisis pregnancies empowers them. A survey conducted between 1996-2020 across six states showed that 96.5% of those abortions were done for social or economic reasons. Thousands of pregnancy centers across the nation give women free material (such as diapers, strollers, car seats, etc.) and psychological help to prepare for and raise her child. Women who do not feel supported in their pregnancies are more likely to feel like abortion is their best option, so these centers are giving women the help and the hope they need to support their families.

 

Restrictions Do Reduce Abortions

Even when pro-abortionists acknowledge that back-alley abortions and the associated dangers are a myth, many still argue that the existence of illegal abortions makes restrictions pointless.

Laws will rarely be entirely effective. Some abortions may continue to occur even if it is made illegal. But laws restricting abortions do reduce the number that occurs.

Research has shown that both modest and severe restrictions on abortion reduce abortion rates drastically. There’s little to no evidence that most abortion restrictions significantly increase illegal abortion rates.

Other recent research has likewise demonstrated that various types of modern state-level anti-abortion legislation significantly reduce the number of abortions that occur.

Ultimately, no law will ever be 100% effective. However, imagine if the logic applied to illegal abortion were applied to other crimes. Just because some individuals may continue to commit horrific acts such as murder or rape, we do not argue that such acts should be made legal for the safety of all involved.

To help women and end abortion – legal or illegal – the work of thousands of pregnancy centers in the nation is crucial. These centers provide material and psychological help for women and families. They give hope to those who feel they cannot provide for their family or who need resources for housing, transportation, or material needs.

Finally, one piece that is hardly ever mentioned in discourse about abortion is the possibility of abstinence. Abstinence is the only 100% effective way to avoid unplanned pregnancies, and it comes naturally without the horrible effects of birth control on women’s health.

If we care about women’s health, happiness, and safety, instead of putting money towards abortion, we should be funding centers that give women what they need to raise their families and to psychologically heal. If they cannot raise their children even with the material and psychological assistance, adoption is always an option that gives joy and hope to the millions of families that are waiting to adopt, and to the child who now has the chance to grow up in a stable and loving home. Women who choose adoption for their child can choose either an open adoption – where they are still part of their children’s lives and get to see them grow up – or a closed adoption – where the records are sealed, and contact is limited.

If we truly want to help women, we must end the dangerous practice of abortion and provide authentic help to moms and babies. Making abortion illegal will not ultimately hurt women. It will protect women from the deadly abortion industry and save the lives of countless preborn children.

 

This article was originally published in March 2022 by Dr. Brian Clowes and was most recently updated in October 2024 by Marisa Cantu.

+ Endnotes

[1] 1987 American Civil Liberties Union pamphlet entitled “The ACLU’s Campaign for Choice,” referring to the Hyde Amendment, page 1.

[2] Ellen Goodman. “Not Just a March on Washington.” The Boston Globe, April 25, 2004.

[3] Senator Barbara Boxer, during the John Roberts Supreme Court confirmation battle in 2005, quoted in Steven Ertelt. “Abortion Advocates Defend Illegal Abortion Claims of Women Dying.” LifeNews.com, July 20, 2005.

[4] Bernard Nathanson, M.D. Aborting America (New York City: Doubleday), 1979, page 193. Believe it or not, some NARAL spokesmen still use these numbers in the face of all evidence to the contrary. One of them has said, “The 5,000 number [of illegal abortion deaths] is one we’ve always been comfortable with” (Ted Miller of NARAL Pro-Choice America, quoted in Steven Ertelt. “Abortion Advocates Defend Illegal Abortion Claims of Women Dying.” LifeNews.com, July 20, 2005).

[5] Malcolm Potts, Peter Diggory and John Peel. Abortion (Cambridge University Press), 1970.

[6] Sherry Matulis. “Why Abortion Must Remain the Law of the Land.” The Humanist, July/August 1992, pages 35 to 37 and 49. Adapted from her 1991 “Humanist Heroine Award” acceptance speech. Emphasis in the original.

[7] Ruth Barnett. They Weep on My Doorstep (Beaverton, Oregon: Halo Publishers), 1969, see especially pages 9, 36, 39, 40, 46, and 70.

[8] Anne Nicol Gaylor. Abortion is a Blessing (New York City: Psychological Dimensions, Inc.), 1975, page 8.

[9] Alfred C. Kinsey, Sc.D., addressing the 1955 conference on induced abortion convened by the Planned Parenthood Federation of America. Quoted in Mary S. Calderone, M.D., Medical Director of the Planned Parenthood Federation of America (editor). Abortion in the United States (New York City: Paul B. Hoeber, Inc.), 1956.

[10] Mary S. Calderone, M.D. “Illegal Abortion as a Public Health Problem.” American Journal of Public Health, July 1960, pages 948 to 954.

[11] “Report of the Grand Jury in the Court of Common Pleas, First Judicial District of Pennsylvania, Criminal Trial Division,” January 14, 2011.