Throughline: Abortion Before Roe – A Detailed Summary

Podcast Title: Throughline
Host/Author: NPR
Episode: Abortion Before Roe
Release Date: June 19, 2025

Introduction: The Tragic End of Madame Restell

The episode opens with a somber recounting of Madame Restell's death. Rund Abdelfattah introduces the historical figure Madame Restell, a prominent abortionist in 19th-century New York. Her demise marks a pivotal moment in the criminalization of abortion in the United States.

Rund Abdelfattah [01:36]: "In the early hours of Wednesday, April 1, 1878, the death of a woman named Madame Restell, known to some as the wickedest woman in New York... rocked the country."

Madame Restell: A Pioneering Abortionist

Madame Restell, originally Ann Tro Summers from England, became a renowned figure in the abortion marketplace after her husband's untimely death. She capitalized on the burgeoning demand for abortion services, operating openly and amassing significant wealth.

Carissa Haugeberg [17:10]: "Madame Restell, female physician, Office and Residence, 148 Greenwich street... she can be consulted with the strictest confidence on complaints incidental to the female frame."

Restell's business included selling preventative powders, monthly pills, and performing surgical abortions. Her flamboyant lifestyle and public advertising made her a target for moral crusaders.

The Transformation of Abortion Laws

Originally, abortion was a common and legally accepted practice in early America, regulated by the concept of "quickening" — the moment a woman felt fetal movement. However, by the mid to late 19th century, this perception shifted dramatically due to concerted efforts by the American Medical Association (AMA) and activists like Horatio Storer.

Rund Abdelfattah [02:30]: "Through the instigation of wealthy people who had patronized her in her criminal business... the crimes of this wretched woman were not hers alone."

Horatio Storer and the AMA's Crusade Against Abortion

Horatio Storer, a prominent obstetrician, spearheaded the AMA's campaign to criminalize abortion. Discontented with the AMA's lack of a unified stance, Storer covertly authored a letter to state governors, framing abortion as a moral and societal evil.

Rund Abdelfattah [22:38]: "In 1860, governors of every single state in the US received this letter from the recently established American Medical Association."

Storer introduced the controversial idea that life begins at conception, challenging the longstanding "quickening" standard.

Joan Lester [20:21]: "The child is alive from the moment of conception."

His arguments were not only moral but also intertwined with racial fears of the time, advocating for higher birth rates among Protestant white women to counteract immigration and societal changes.

Anthony Comstock and the Institutionalization of Vice Suppression

Anthony Comstock, a fervent moral reformer, further fueled the anti-abortion movement by conflating it with obscenity. His efforts culminated in the Comstock Law of 1873, which criminalized the distribution of "obscene" materials, including contraception and abortion information.

Michelle Goodwin [29:19]: "The Comstock Law... made it illegal to mail sex toys, pornography, contraception, abortion drugs, or even information about contraception and abortion."

This law not only targeted abortionists like Madame Restell but also silenced the dissemination of reproductive health information, significantly narrowing women's access to safe abortion services.

The Downfall of Madame Restell

Madame Restell's unabashed entrepreneurial spirit eventually led to her downfall. In 1878, under Colonial-era laws and heightened scrutiny from activists like Comstock, Restell was arrested. Facing the pressure of impending trial and relentless persecution, she tragically ended her life.

Michelle Goodwin [33:24]: "He took out his file on her and wrote, 'a bloody ending to a bloody life.'"

Her death symbolized the effective dismantling of the abortion marketplace that had once thrived under more permissive societal and legal conditions.

Abortion Underground and the Rise of Unsafe Practices

With the legalization of abortion systematically stripped away, the practice went underground. Women, lacking safe and legal options, resorted to dangerous methods or sought clandestine services from unlicensed practitioners.

Leslie Regan [36:34]: "He said, 'shut up.' And that's mostly all I remember about it."

This period saw a surge in medical emergencies and fatalities due to unsafe abortions, highlighting the public health crisis resulting from restrictive laws.

Shifts in Medical and Social Perspectives Leading to Roe v. Wade

By the mid-20th century, the dangers of illegal abortions became undeniable, prompting a gradual shift in both medical and public opinion. Advocates began pushing for the decriminalization of abortion, emphasizing its necessity for women's health and autonomy.

Carissa Haugeberg [46:05]: "Doctors teamed up with like-minded lawyers and set out to reform abortion laws at the state level."

The convergence of medical advocacy and the burgeoning Women's Liberation movement led to significant legal reforms in the late 1960s and early 1970s, culminating in the landmark Roe v. Wade decision.

Rund Abdelfattah [53:08]: "The court ruled that the state could not regulate abortion in the first trimester at all... Thus, the anti-abortion laws of 46 states were rendered unconstitutional."

Conclusion: The Legacy of Abortion Before Roe

The episode underscores the complex interplay of medical authority, moral crusades, and societal fears that shaped abortion laws long before the Supreme Court's pivotal decision in 1973. The legacy of figures like Madame Restell and Horatio Storer illustrates how deeply entrenched legal and cultural narratives can influence and restrict women's reproductive rights.

Rund Abdelfattah [54:12]: "What happened right after Roe? Check out our episode After Roe to learn more."

Key Takeaways

• Historical Acceptance: Abortion was once a legal and common practice regulated by the concept of quickening.
• Shift to Criminalization: Influential figures and organizations, notably Horatio Storer and the AMA, played critical roles in redefining abortion as a moral and legal issue.
• Impact of Comstock Law: Anthony Comstock's efforts institutionalized the suppression of abortion information, severely limiting safe access.
• Tragic Outcomes: The persecution of abortion providers like Madame Restell led to dangerous underground practices, resulting in significant public health crises.
• Path to Legalization: Persistent advocacy and changing societal attitudes eventually led to the decriminalization of abortion with Roe v. Wade.

This comprehensive exploration provides listeners with an in-depth understanding of the historical context and key players involved in the struggle over abortion laws in the United States, setting the stage for the transformative Roe v. Wade decision.