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Before the 19th century, abortion as a sociolegal problem was bundled together with other practices aimed at escaping the moral stain associated with illicit sexuality, including the concealment of birth, the abandonment of infants, and infanticide. From a legal perspective, however, abortion was punishable only after quickening, that is, after women start feeling fetal movements. During the 19th century, a number of factors coalesced to turn abortion into a problem primarily pursued by the medical profession. The 19th-century campaign to professionalize medicine was, in large part, waged as a war against competing health practitioners, including not only midwives, who hitherto had provided reproductive care to women, but also the rapidly expanding ranks of commercial abortion providers. Claiming professional expertise that nonlicensed practitioners lacked, the medical profession effectively medicalized women's reproductive lives, appropriated the service domain previously occupied by midwives, and removed the medically dubious quickening distinction that had enabled abortion providers to largely operate with legal impunity. The conclusion of this campaign was a drastically changed landscape in which all abortions became illegal except the ones performed by licensed physicians for the purpose of saving a woman's life (the so-called therapeutic exemption), and women's reproductive lives thus fell almost entirely under the purview of professional medicine. Accompanying this reorganization of the medical context surrounding abortion was a reinterpretation of abortion as a social problem. In short, the doctors argued that abortion was no longer a practice exclusive to the unmarried, no longer an act prompted by social desperation, and no longer a practice engaged in by those women who might be considered unsuitable as mothers. Instead, the doctors emphasized, abortion had turned into a fashionable practice among those upon whom the nation depended for its healthy reproduction, in both numerical and moral terms. In this sense, abortion became increasingly viewed as a moral gangrene of sorts, seducing (by its very availability) middle-class women into abandoning their higher purpose as mothers and moral guardians.

With this definition firmly in place, abortion fell out of the public spotlight and survived for the next several decades primarily as a clandestine and largely invisible practice that operated under the legal radar save for a few widely publicized scandals involving illegal abortion rings. When opposition against restrictive abortion regulations began to mount in the 1950s and 1960s, the impetus for reform was once again spearheaded by doctors and other professionals. Formulated as a set of reforms aimed at bringing the abortion law into greater conformity with modern medical and psychiatric standards, this pressure led to relatively uncontroversial legal reform in at least a dozen states years before Roe v. Wade. These laws expanded the grounds for legal abortion somewhat (rape, incest, mental and physical health), but the authority to make abortion decisions remained with the medical profession. This authority effectively ended when the Supreme Court ruled in Roe v. Wade that the abortion decision rested with the woman, not her doctor. Since then, the position of organized medicine toward abortion has been ambivalent, even as some of its members have long occupied vulnerable frontline positions in the abortion conflict as service providers.

Bibliography:

1) Burns, Gene. 2005. The Moral Veto: Framing Contraception, Abortion, and Cultural Pluralism in the United States. New York: Cambridge University Press.

2) Ferree, Myra Marx, William Anthony Gamson, Jurgen Gerhards, and Dieter Rucht. 2002. Shaping Abortion Discourse: Democracy and the Public Sphere in Germany and the United States. New York: Cambridge University Press.

3) Ginsburg, Faye D. 1989. Contested Lives: The Abortion Debate in an American Community. Berkeley, CA: University of California Press.

4) Luker, Kristin. 1984. Abortion and the Politics of Motherhood. Berkeley, CA: University of California Press.

5) Mohr, James C. 1978. Abortion in America. New York: Oxford University Press.

6) Reagan, Leslie J. 1997. When Abortion Was a Crime: Women, Medicine, and the Law in the United States, 1867-1973. Berkeley, CA: University of California Press.

7) Staggenborg, Suzanne. 1991. The Pro-choice Movement: Organization and Activism in the Abortion Conflict. New York: Oxford University Press.

8) Tribe, Laurence H. 1990. Abortion: The Clash of Absolutes. New York: Norton.

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