Nancy’s death on December 16, 1876, at age 35, is among the first to be recorded in the yellowed, leather-bound volumes. The cause, “puerperal peritonitis,” is annotated by a triple-dagger symbol that directs the reader to a line of script rising up the margin like a pointed finger: “Disease caused by abortion at 3 months this was perhaps the 10th abortion all except this followed by smart hemorrhagae.” It’s the longest description of a death in all of those volumes. Maybe Dr. R. H. Delap, who signed her death certificate, instructed the county clerk to copy his notes without omission. Or maybe the clerk felt he couldn’t abbreviate the doctor’s notes in this case. Only one other record mentions abortion.
But on every page of those early volumes, women aged 19 to 47 are listed as dying from puerperal peritonitis, puerperal fever, puerperal septicemia, “inflammation after confinement,” eclampsia, and “giving birth to a child.” I find more dead fertile women than old men.
In Nancy’s time, abortion was a common means of birth control, a way for women of every race and social class to limit family size, manage resources, and protect their health. The procedure was often a safer alternative to childbirth, which some women considered “pathological and frightening” and many others approached with foreboding, according to James Mohr’s 1978 book, Abortion in America. Every woman, including Nancy, would have known friends, sisters, or cousins who died or were debilitated while giving birth. They would have known those who took pains to avoid it.
In the 1700s and early 1800s, conception was considered a disturbance of a woman’s natural balance. Methods of “removing a blockage” or “restoring the menses” were sometimes necessary to reestablish the body’s balance, even if they induced a miscarriage. Abortions that occurred before quickening, which was understood as the time when a pregnant woman could feel the fetus move (usually around the fourth month), were both legally and morally acceptable. Quickening was an indicator based on women’s perceptions, not a medical diagnosis. But in the absence of a scientific pregnancy test, it was recognized as the threshold of human development. Before quickening, no one, not even the Catholic Church, believed that a human life existed, notes Leslie J. Reagan in her 1996 book, When Abortion Was a Crime, reissued earlier this year.
Abortion was so frequent, according to one doctor, that “it [was] rare to find a married woman who passes through the childbearing period, who has not had one or more.” Women spoke of it casually. They might decide to be “put straight,” “opened up,” or “fixed.” (They wouldn’t have said “abortion,” as that term belonged to the medical lexicon, not the vocabularies of ordinary people.) One physician reported that women “talk about such matters commonly and impart information unsparingly.” Although some doctors would perform the procedure, many women, especially in rural areas, induced abortions on their own using drugs or herbs and wisdom passed from one generation to another.