What Americans Have Forgotten About The Era Before Roe v. Wade


Dr. David Grimes, who has been providing abortion care for four decades, is worried that the time period before abortion was legalized in the United States is becoming a distant memory.

“I’m 67 now, and people younger than me don’t remember what the bad old days were like. That’s why people seem so complacent about allowing those days to return,” he said in an interview with ThinkProgress.

Grimes, who currently works as a clinical professor in the Department of Obstetrics and Gynecology at the University of North Carolina School of Medicine, was in his final year of medical school when Roe v. Wade was handed down. When he was a young doctor, he treated some of the women who were injured by the unsafe abortions that were still being performed in the 1970s.

People younger than me don’t remember what the bad old days were like.

He still remembers some of the extreme cases he encountered. One patient, for example, was running a 106 degree fever after having a rubber catheter inserted in her uterus in an attempt to terminate a pregnancy. Another arrived at the hospital in a state of antiseptic shock with a dead fetus inside of her.


In his new book — entitled Every Third Woman in America: How Legal Abortion Transformed Our Nation — Grimes returns to those days. And he uses the stories from that time period to argue that medical historians will put legal abortion on par with antibiotics, vaccinations, and modern contraception as one of the most meaningful advances of the 20th century.

Particularly as politicians make appeals to keep abortion “rare,” and discuss the issue in the context of always being a “difficult decision,” it remains somewhat more unusual to hear an unabashed case for framing abortion as a social good. But that’s the case Grimes is making.

In the decade when Grimes was born, the 1940s, there were records of more than 1,000 women dying each year from unsafe and largely self-induced abortions. Every large municipal hospital in the U.S. had a “septic abortion ward,” and treatment for the complications from so-called “incomplete abortion” was the single leading cause for admission for OB-GYN services across the country. National Opinion Research Center surveys conducted in the 1960s found that hundreds of women were attempting to self-abort by penetrating themselves with knitting needles, coat hangers, bicycle spokes, ballpoint pens; others tried to swallow chemicals like turpentine, laundry bleach, and acid.

When the laws began to change, almost overnight, deaths from septic abortion disappeared.

“When the laws began to change, almost overnight, deaths from septic abortion disappeared,” he told ThinkProgress. “Any way you look at it, abortion has been an astounding public health success.”


To drive that point home, Grimes used to show all of his medical students a documentary featuring women talking about their own illegal abortions, as well as the family members who lost women who died from unsafe procedures.

Still, he’s worried those stories are slipping away. “The medical profession is at risk of losing its collective memory of the era,” he writes in Every Third Woman in America.

So in his new book, he has a broader proposition even for the people who aren’t pursuing a career in medicine: Start thinking about legal abortion as one of the greatest public health triumphs of our generation.

Research from countries across the world that have had major changes in their abortion laws have all documented the same thing: When abortion is accessible, maternal mortality rates decline. While harsh abortion bans have no association with the number of women who choose to end their pregnancies — as Grimes puts it, “abortion has always been with us, and always will be” — they do have a troubling link to heightened injuries and deaths from unsafe procedures.

More than 40 years after abortion was legalized, the inverse relationship between women’s health and abortion bans is yet again becoming evident within the United States’ borders. Even as Roe stands, its protections have been chiseled away under an increasing number of state-level restrictions. Women and children are less healthy in the states with stringent abortion laws. Just as poor women and women of color couldn’t access safe procedures before 1973, Grimes is worried about history repeating itself today.

For instance, the rate of self-induced abortions in Texas’ Rio Grande Valley — an impoverished border community that lacks access to basic health services — is one of the highest in the country. Now that Texas has been allowed to enforce a harsh law that’s forcing abortion doctors out of business, the issue is expected to get worse.

The current juggernaut of laws are designed to drive women back into the back alley.

“An entire generation of Americans has grown up expecting safe and legal abortion to be there, and it may not be — as we’ve seen with this recent skirmish in Texas,” Grimes said. “The current juggernaut of laws are designed to drive women back into the back alley. But people don’t really understand what the implications are.”


Some of his fellow medical professionals have also recently raised alarm about this issue. Last year, a group of 100 OB-GYNs published an op-ed warning that abortion access has undergone a political regression that doctors who were alive during the 1970s did not think possible.