Consider the Coat Hanger

A twisted piece of wire isn't just a symbol of dangerous abortions; it's a symbol of inequality.

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In the mid-1950s, a woman went to an abortionist. She had been raped and now, pregnant, she sought his help.

As he prepared to perform the procedure, he said to her, "You can take your pants down now, but you shoulda' -- ha! ha! -- kept 'em on before."

For the service, he charged her $1,000, but, as Leslie Reagan recounts it in her essential book When Abortion Was a Crime, "offered to return $20 if she would give him a 'quick blow job.' "

Degrading? Yes. Humiliating? Certainly. And also: Expensive -- very.

Contrast that scenario with some of the at-home remedies undertaken by another woman, seemingly lacking the spare $1,000. "One woman," Reagan writes, "described taking ergotrate, then castor oil, then squatting in scalding hot water, then drinking Everclear alcohol. When these methods failed, she hammered at her stomach with a meat pulverizer before going to an illegal abortionist."

This was in 1954, when abortion was illegal in America. If you are one of the roughly 160 million Americans born after 1973 (the majority of population), abortion has been legal all of your life, though depending on where you live and your resources, actually getting one may not always be easy or even possible.

Earlier this week, Republican party leaders, drafting their party's official position on abortion, proposed language that would make history of the 40-year period since Roe v. Wade. They are calling for a "human life amendment" which, by extending the 14th Amendment to fetuses, would prohibit abortions entirely, even in cases of rape, incest, or to save the life of the mother.

Within short order, an image of a wire clothing hanger (much like the one above) appeared on the homepage of the Huffington Post. Soon, the Tumblr belonging to the magazine Newsweek followed suit, a bit less elegantly, converting the cursor of your mouse on their page into an image of a tiny coat hanger (which, as many people pointed out, was not even the right kind of hanger).

This simple tool is our shorthand for that earlier time, the time of illegal abortions. And if we're going to pull it out of the closet -- and, even more to the point, if the Republicans are going to have a platform that earnestly seeks to pull that legal regime out of its grave -- we can't do it flippantly. I'm sympathetic to those who believe that abortion is legalized murder, but to ban it outright would have victims too (especially, as would in all likelihood be the case, you do not simultaneously increase and ease access to contraceptives and sex ed). Who would those victims be? We need to know what the hanger means.

We all think we know what the hanger means: dangerous, illegal abortions. It is a tool of last resort, a hack of a household object, conjured out of desperation when nothing else would suffice. That alone is significant because the most basic point, as Reagan and other historians have shown over and over again, is that even in the age of illegal abortions, women still had abortions -- many, many abortions. Making something illegal doesn't make it disappear. Abortion, during the century of its criminalization, was common, though its prevalence varied with the generations. 

Of course no official statistics were kept, but Reagan cites some late-19th-century doctors as estimating a rate of about two million abortions per year. Studies confirmed their prevalence: One, of some 10,000 working-class women who visited birth-control clinics in the late 1920s, found that 10 to 23 percent had had abortions. A smaller study at a clinic in the Bronx in the early 1930s found that 35 percent of women -- Catholics, Protestants, and Jews alike -- had had at least one abortion. And of course, because abortion occurred mostly on the black market, they were very dangerous: One estimate placed the annual death toll at 5,000 women.

The numbers point to another lesson that can be drawn from the period: Criminalizing abortion did not persuade Americans that abortion was morally wrong. Reagan reports a physician's observation of a "matter of fact attitude [among] women of all ages and nationalities and every social status." Reagan writes, "The illegality of abortion has hidden the existence of an unarticulated, alternative, popular morality, which supported women who had abortions. This popular ethic contradicted the law, the official attitude of the medical profession, and the teachings of some religions."

So despite the law, abortion persisted. Public policy exists in words, on the books, so to speak. But where it matters is where it is carried out: in city apartments, doctor's offices, women's-health clinics, and, proverbially, back alleys. To seriously consider the meaning of the hanger, or, less abstractly, the outcome of the Republican platform if realized, is to concern yourself with that reality, with the lives of women who had unwanted pregnancies during the century before Roe v. Wade.

That's where the hanger comes in, because that's what the hanger is meant to stand for: Unsafe back-alley abortions that left women dead. But is that an accurate picture of the period?

Yes and no. Here's another portrait of an abortion, this one taken from an article written by a Mrs. X from the August 1965 Atlantic. Mrs. X wrote:

My visit did a good deal to quell the panic which had been building steadily in spite of my efforts at self-control. The office seemed orderly, the tools of the trade were neatly arrayed in the glass cases dear to the hearts of the medical fraternity; the doctor's examination was brief and businesslike, and as far as I could tell identical with those performed on me over the years by obstetricians and gynecologists under different circumstances. He explained in simple and understandable terms exactly how he would perform the operation, how long it would take, that it would be painful, but not intolerably so, for a few minutes. (I gather that except for abortions done in hospitals, anesthetics are almost never used. For obvious reasons, these physicians work without assistance of any kind. They are thus not equipped to deal with the possible ill effects of anesthesia; nor can they keep patients in their offices for any great length of time without arousing suspicion about their practices.) The doctor I was consulting described precisely the minimal aftereffects I might expect. We fixed a date at mutual convenience a couple of days off for the operation.

This particular M.D. was able to strike a nice balance between willingness to help and lack of overeagerness to collect his $500, payable in advance. He stated frankly that he felt the element of physical risk was negligible but that the myths and exaggerations about abortion and the hard fact that it was an illegal procedure created prior apprehensions of sometimes damaging proportions. He urged me to call him and cancel the appointment if my husband and I felt there was any reason to reconsider our decision. Short of physical and fiscal miracles we had no right to expect, I didn't see what could alter our circumstances and told him so, but I agreed wholeheartedly about the apprehensions.

The operation was successfully concluded as scheduled. Forty-five minutes after I entered the doctor's office for the second time, I walked out, flagged a passing cab, and went home. Admirably relaxed for the first time in two weeks, I dozed over dinner, left the children to wash the dishes, and dove into bed to sleep for twelve hours. The operation and its aftereffects were exactly as described by the physician. For some five minutes I suffered "discomfort" closely approximating the contractions of advanced labor. Within ten minutes this pain subsided, and returned in the next four or five days only as the sort of mild twinge which sometimes accompanies a normal menstrual period. Bleeding was minimal.

No meat pulverizers, no hangers, minimal blood. And that's because of this, the crucial thing the symbol of the hanger embodies: The brunt of an abortion ban falls across society unevenly. The hanger does not merely symbolize the dangers of illegal abortions; it symbolizes inequality. 

That twisted piece of wire -- like the meat pulverizer, Everclear alcohol, and God knows what else -- was a hack, a tool repurposed because the proper one was not accessible. Safe abortions were there for those with the means to get them. But for those with less privilege, less money, fewer connections -- black, Latina, and lower-class whites including many Catholics -- there were the hacks.

Part of this was for the obvious reasons: The illegality of abortions drove up costs, and those with more means could pay for better quality. But other reasons were subtle: Women with access to psychiatric care could mimic symptoms to receive diagnoses that would pave the way for "therapeutic" abortions (legal abortions provided in some states for health reasons). Other times, as in the case of Mrs. X, privilege manifested itself in a knowledgeable network of well-off friends, friends who were able to recommend their own high-quality abortion providers.

Unfortunately for poorer women, sometimes their needs for abortions were even more desperate than those who had better access. Reagan writes:

Poor women sought abortions because they were already overburdened with household work and child care and each additional child meant more work. A baby had to be nursed, cuddled, and watched. A baby generated more laundry. Young children required the preparation of special foods. Mothers shouldered all of this additional work, though they expected older children to pick up some of it. A new child represented new household expenses for food and clothing. In 1918, a twenty-two-year-old mother of three despaired when she suspected another pregnancy. Her husband had tuberculosis and could barely work. They had taken in his five orphaned brothers and sisters, and she now cared for a family of ten. She did "all the cooking, housework and sewing for all" and cared for her baby too. The thought of one more made her "crazy," and she took drugs to bring on her "monthly sickness.

Moreover, poorer women had worse access to birth control, meaning that pregnancy was difficult to avoid. Middle-class couples, according to Reagan, "could afford douches and condoms and had family physicians who more readily provided middle-class women with diaphragms. ... Even if poor women obtained contraceptives, the conditions in which they lived made using those contraceptives difficult. For women living in crowded tenements that lacked the privacy they might want when inserting diaphragms and the running water they needed to clean the devices, using a diaphragm would have meant another chore that only the most determined could manage. For the poor, withdrawal was certainly a cheaper and more accessible method, if the husband chose to use it."

This illustrates an important point: Just as access to the illegal service of abortion was unequal, so too was access to perfectly legal resources, such as birth control, sex ed, and health care. This continues to be true in today, a fact highlighted by recent Republican efforts to allow health insurers and employers to exempt contraceptives from their plans. Legally, women may have a right to choose whether to abort an early unwanted pregnancy or take birth control to prevent one, but for many women that choice is elusive, constrained by the limits of their resources, social, financial, or local. The bright line that runs between the twin spheres of legal and illegal is not what makes something available or keeps it out of reach.

All of this sad history is not to say that this is the future the Republican platform heralds. Medical technology, record-keeping, and regulation are all dramatically different now than they were even at the time of Roe. Who knows how the changes of the last 40 years would reconfigure a revived, and even more extreme, legal regime? But the basic lesson of the past, the lesson the hanger, surely remains unchanged: Those with more power suffer less, and those with less suffer more.