The Pacific Coast Abortion Ring

Kelly Therese Pollock  0:00  
This is Unsung History, the podcast where we discuss people and events in American history that haven't always received a lot of attention. I'm your host, Kelly Therese Pollock. I'll start each episode with a brief introduction to the topic, and then talk to someone who knows a lot more than I do. Be sure to subscribe to Unsung History on your favorite podcasting app, so you never miss an episode. And please tell your friends, family, neighbors, colleagues, maybe even strangers to listen too. 

Today, in the third episode of our short series on the History of Reproductive Justice in the United States, were discussing the Pacific Coast abortion ring. In 1934, Reginald Rankin, a California entrepreneur, who didn't concern himself too much with whether he was operating within the law came up with the idea for an abortion syndicate that would stretch all along the Pacific Coast. At the time, abortion was largely illegal in many states, after a spate of laws had been passed in state legislatures in the late 19th century. In California, section 274 of the 1872 Penal Code, stated "every person who provides supplies or administers to any pregnant woman, or procures any such woman to take any medicine, drug or substance, or uses or employs any instrument or other means whatever, with the intent thereby to procure the miscarriage of such woman, unless the same is necessary to preserve her life, is punishable by imprisonment". Whatever the law said, women were still seeking abortions, and Rankin knew there was a lot of money to be made by offering safe and effective abortions. He sought the help of Dr. George E. Watts, a physician in Portland, Oregon, who had developed an innovative abortion technique, the vacuum aspiration technique that made the procedure safer, since all fetal tissue was removed, reducing the risk of sepsis. Watts had been on the verge of retirement, but the opportunity was too good to pass up. And he wanted to support the goal of providing safe abortions. Rankin and Watts, along with an accountant named Joseph Shin headed the Syndicate.  With Rankin providing the business expertise, including knowing how to avoid law enforcement, Watts providing the medical expertise, and Shin handling the finances. Watts moved to Los Angeles, where they set up their headquarters. Over the next two years, Rankin hired abortion specialists and bought up medical practices regularly moving abortion providers up and down the Pacific coast as suited the syndicate and as a way of staying ahead of the law. In time, the syndicate had presence in Seattle (Washington), Portland (Oregon), and San Diego, Long Beach, Hollywood, Los Angeles, San Francisco, Oakland, and San Jose (California). And it employed more than 30 people, which included not just doctors, but also receptionists, nurses, and steerers, who referred women to the Pacific Coast abortion clinics, from doctors offices and pharmacies. All of the abortion providers were trained with Watts's technique, and the clinics all housed the same equipment in the same layout that looked very much like a typical doctor's office. The most valuable thing that the Pacific Coast abortion ring provided for the Abortionists was keeping the law off their backs. Rankin managed to bribe William Burn, a special agent with the California Bureau of Medical Examiners who worked in Los Angeles, and whose job it was to investigate abortion providers.

In addition to destroying evidence in a case against an abortionist that Rankin was trying to recruit, Burn also leaned on competitor clinics making life difficult for them. They If they didn't join the syndicate. In June 1936, the law finally caught up with the syndicate in the form of the San Francisco Police Department. To SFPD officers are authorized to focus exclusively on the Pacific Coast of Abortion Ring and they managed to bring in Rankin's brother in law Marvin Raithel, who acted as a steerer for the ring. During interrogation, Raithel broke down and told them everything about the organization. With that information, the SFPD rated Rankin's apartment and several local clinic locations. Following a tip, they realized that they needed the records from the Los Angeles locations as well. And they coordinated with local law enforcement there to raid three more locations, collecting two truckloads of evidence. Before this, when abortionist came to trial, it was typically because the patient had died as a result of the procedure. But in this case, none of the patients had died, making the trial unusual. Some of the patients who served as witnesses for the prosecution even went out of their way in the trial to say they had appreciated the services of the syndicate. In October 1936, a jury of six men and six women found 11 of the defendants guilty, including Rankin, Watts, Shin and Burn. Rankin, Watts and Burn were sentenced to 10 to 25 years each in San Quentin. Some of the defendants were permitted to file for probation. Additional defendants were tried in San Francisco, that many of those fled and their charges were eventually dropped. The Pacific Coast abortion ring folded, but abortions along the Pacific Coast continued. Some of them performed by former members of the syndicate. In 1969, the California Supreme Court overturned the conviction of Dr. Leon Philip Belous, a physician and surgeon from Beverly Hills, who had with the backing of the ACLU appealed his 1967 conviction for illegally referring patients to Abortionists. The California Supreme Court ruled that the previous state statutes prohibiting therapeutic abortion were "void for vagueness". Four years later, in 1973, the United States Supreme Court ruled in Roe v. Wade, that pregnant people had the constitutional right to abortion on the grounds of privacy, overturning state statutes throughout the country that banned abortion. Joining me now to help tell the story of the Pacific Coast abortion ring is Dr. Alesia Gutierrez-Romine, Assistant Professor of History at La Sierra University and author of "From back alley to the border: criminal abortion in California 1920 to 1969". The source for much of this introduction. Alicia, thank you so much for joining me today.

Alicia Guttierez-Romine  8:48  
I'm happy to be here.

Kelly Therese Pollock  8:50  
Yeah, I think this is such a timely book and such an important topic. We'll talk some about that in a minute. But I wanted to start by talking a little bit about what got you into this topic? Right at the beginning of your book about how this wasn't your original plan for what your dissertation research was going to be about. So could you talk a little bit about that and sort of how you ended up with this project?

Alicia Guttierez-Romine  9:14  
Absolutely. So, I actually did my undergraduate research in European History and my research was on Nazi Germany and the Holocaust and eugenics movements, medical experimentation. And as I got further along in eugenics research, I found a connection to California history. And when I decided to do graduate school, I thought, I thought it was going to be something about comparative eugenics, so very much grounded in medical history, but California as well. And then as I started progressing through my research, seminars and all of these other courses that I was taking, I kind of split away from that and kind of moved towards still this study of medicine but more how it affected physicians and patients, men versus women, so I thought my dissertation was actually going to be about the experiences of physicians of color in Southern California in the interwar years, and how, you know, professional medicine treated them how their relationship was with the professional medical community, but also how any discrimination or segregation levied at these physicians would affect how they were able to care for their patients as well. So that's what I thought I was going to study. And so I ended up going to the California State Archives, I, it was my first real research trip on my own, as I'm starting to, you know, draft the prospectus and everything. And I started looking at physician license revocation files, because I had, maybe this inkling that I would find more physicians of color or more women practitioners there, and that might be a good place to start. But I wanted to do the interwar years. And I forgot to request archivists permission to look at some of the more recent documents that were from the early, you know, the 40, and 39, 38. And so, I wasn't allowed to because that process takes a couple of weeks. So I was a little frustrated, but I just basically told them, alright, well let me look at what I can otherwise this whole week is wasted. And I ended up finding a lot of files that indicated that physicians were getting the medical licenses revoked because they were performing illegal operations. And this was really something that surprised me or that I was confused by, because I'm privileged enough to have this understanding, or at least this idea that if my physician tells me, "Oh, you need surgery for this", you need surgery for this, and that the only, you know, non sanctioned or, you know, non required surgeries or elective ones like "oh, I want a nose job", or "oh, I want to do this" or, you know, and so I didn't really understand what it was that made a surgery illegal or criminal. As I was going through the documents, I eventually found out that illegal operation criminal operation, those were all euphemisms for abortion. And suddenly, it it became really intriguing to me because I had never really considered what life was like before Roe. I knew Roe made abortions legal. But I never really stopped to think about the fact that it meant that they were illegal before that, and there were ramifications for that. Why would physicians continue to perform these procedures? If they were getting their medical licenses revoked? Why would physicians do them at all if they were illegal? And then I just started having way more questions. As you know, I saw these documents, and then I just fell down this rabbit hole. And I loved it. And it was really fascinating to me. So by the end of my first day at the California State Archives is probably maybe 4:15 or four o'clock on the Monday and I know I need to start packing things up soon. And I find this document that mentions the Pacific Coast Abortion Ring. And I was like, What is this? and as I'm, you know, reading through it was like, this is like, Mafia stuff. This is black market stuff, like how have I never heard of this before? So you know, archivists are telling me to start packing up putting things away, I'm doing a very quick Google search, as, you know, trying to pretend like I'm looking, putting my things away. And the only reference to the Pacific Coast Abortion Ring that I found was a footnote in Leslie Reagan's book when abortion was a crime. And that was it. Then I started searching some of the individual names that I was approaching. And nothing I mean, Reginald Rankin is apparently also this like British explorer. So there's a bunch of stuff on that other Reginald Rankin. And so I was like, "Oh, my goodness, no one has written about this". And so I finally pack up I'm walking back to my hotel room. And I'm sending off a quick email that's poorly written terrible grammar on my phone. And I email it to my dissertation advisor. And I asked him, Have you ever heard of the Pacific Coast Abortion Ring? They were performing abortions in California during the Great Depression, and they were headquartered in Los Angeles. And that was basically it. And before I even made it back to my hotel room, he had already emailed me back and he said, I have never heard of this before. You need to find out everything you can. And I was like, Okay, well, this is this is my dissertation then and I want a good dissertation, but I want to done dissertation. And so if no one else had had heard of this, if he had never heard about this, then I just knew that that was what I needed to study. So the next day I went in with so much intention, I need to find out everything about the Pacific Coast abortion ring, I need to find out everything about illegal abortions in California. And let's see where this goes.

Kelly Therese Pollock  15:10  
It's a very fortuitous mistake on your part to that request those other

Alicia Guttierez-Romine  15:14  
yeah, I've never been so happy to make an error.

Kelly Therese Pollock  15:19  
So let's talk some then about sources. Because that's always the trouble. Of course, when you're researching anything that was people breaking the law is where do those sources come from? What is the framing of those particular sources? So could you talk some about that and what you're looking at in, in your dissertation, and then in your book that helps you sort of figure out what was happening and why it was happening?

Alicia Guttierez-Romine  15:44  
Yeah, so I mean, immediately, the sources that I referenced were from the Board of Medical Examiners in the state of California. And so it's this structure or bureaucracy, within professional medicine in the state of California to kind of oversee that everyone's performing medicine correctly and appropriately, there's no quacks. So there were a lot of institutional records there within that bureaucracy itself, because they're trying to maintain control over professional medicine, they're trying to make sure that everything's kind of standardized, and that no one's you know, putting their patients at risk by doing any of these treatments or cures that are not scientifically backed. So within that bureaucracy, there are, you know, internal records about who they need to investigate, there was a whole series of records called abortion investigation files, there's correspondence with law enforcement that's taking place within this bureaucracy, because professional medicine wants to oversee itself. But it's also working with Law Enforcement, because there are certain laws in place regarding medical practices as well. So that was really where a lot of the records that I dealt with, at least initially, and those were really useful to an extent because when we're looking at records from an institution or a bureaucracy, you have a certain type of language and framing and how they're approaching this this subject. And for this particular instance, right, we're talking about abortion, these people within the Board of Medical Examiners, and Law Enforcement are looking at it as a criminal matter, and they're looking at it as a professional practice matter. And that is important, but it's not the complete story. And if I approach the topic from that lens, then I'm neglecting a very important voice, which is the voice of the people who are providing those procedures, but the women who are getting them as well. So in order to try to get a more thorough and complete story, you know, I also use newspapers, there's some instances where particularly for some of the more scandalous or salacious stories or stories that involve fatalities, they interview family members, or they talk to neighbors, or they talk to other people in the victim's life or the abortionist life. And they're trying to kind of understand how they got to this moment. So I know some historians maybe frown a little bit upon using newspapers, I did rely on them heavily. Because, again, when we're talking about something illegal, there aren't that many sources that you can actually reference. So newspapers were important. I also used coroner's records. Because since abortion is something that is so taboo, even today, it's not something that people want to speak about openly. For the most part, I think there are some changes that are taking place where people are becoming more open and willing to discuss these things. But what that means is that successful, illegal abortions are silent in the historical record, we don't have really any documentation of those because people have their procedures, and then they move on with their life and they don't speak about it. But the stories that come to the surface are those of women who die or become incredibly ill, and it becomes this, I don't want to say circus or hoopla, but because it becomes the spectacle or events that then provides documentation that then creates documentation. So coroner's records were important. I struggled using them because they're reiterating this idea that abortions are dangerous because it's a subset of a subset that I'm looking at. But but some of those were important for understanding how long it took people to die from illegal abortions, or I had hoped that maybe at some future time I could kind of map the addresses of where these people lived, and died so that I can maybe understand their socioeconomic status or something I never quite got around to doing that. But, you know, those coroner's records could potentially provide insight into that as well. Or, you know, because of coroner's inquest, did they have interviews are discussions with family members or friends about the procedure or this person's life as well. And so those were really attempts to try to bring women's voices out. And in other instances, I, I posed questions, you know, perhaps she felt this way, perhaps she thought this, perhaps she believed these were her only options. And occasionally, through some of those other documents, you can get little nuggets of information here and there, I recall quite vividly, there was one autopsy that I found, and it was for a woman, I believe she was 36 years old, it was in the middle of the Great Depression. And, you know, the, the, the coroner has a very kind of clinical description of of everything, and what happened to her and why she died. And then he put this added notation that this woman was already on county relief, and that she already had four children. And that wasn't part of the medical reason of why she was dead. But the coroner, I think, understood that this was potentially a motivating factor of why she sought and pursued an illegal abortion, right that in the middle of the Great Depression, this woman already had four mouths to feed, she was already on the county relief rules, she was already essentially on welfare. And so she was probably very concerned about the well being and livelihood of her existing four children. So see, she subjected herself to this illegal procedure. And so those were helpful as well in trying to bring these other voices forward, as we move through the story. And as there are fewer fatalities, there are greater opportunities for some of these women's voices to come out and speak as well. But especially for some of the the pre 1939, pre 1940 abortions, it's really about trying to find our voices and pointing them out. And then eventually, you do hear them sometimes speak for themselves a little bit later.

Kelly Therese Pollock  22:26  
So you mentioned that the the research you were initially considering was about sort of the the relationship of race and gender on the careers of doctors. And that certainly comes out here as well. So can you talk a little bit about what was sort of the different way abortionist are treated and the different opportunities that they have, even at a time when it's illegal? If they are women, if they are Black, white, what that looks like.

Alicia Guttierez-Romine  22:54  
Yeah, so all women, you know, women across socioeconomic status and racial group or classifications sought and pursued abortions. But when we're looking at things like fatalities or risk, or if we're looking at costs or even access to legal abortions, right, because that's also this kind of fuzzy gray thing that's going on the hook the whole time is that abortion itself is not outright illegal. It's the circumstances that dictate whether that procedure is legal or illegal. But none of that is equally distributed access to legal abortion risk or anything like that. It all depends on race and class. So one of the ways that I like to kind of show perhaps some of the disparities in access, or at least in how maybe providers of illegal abortions were treated, is by comparing the stories of Dr. William Fisk and Dr. Mathew Marmillion. I discussed them in different chapters. Dr. William Fisk, he was a physician in Hermoza Beach, and Dr. Mathew Marmillion. He was a physician in Los Angeles. Dr. Fisk was white, Dr. Marmillion was Black. And both of them had encounters with the law for almost identical reasons. Both of the men were, I believe, 70 or 72, at the time, so both of the men were a little bit older. Both of them were trained medical professionals. Both of them were physicians, both of the cases that brought them to the attention of law enforcement involved illegal abortions on 18 year old women. And one of the cases, in Doctor Fisk's case, it was a white young woman. And then Dr. Marmillion's case it was a young Black woman. They're both 18 year olds, both of the young women die on the operating table. And both of the men are basically brought to trial. Dr. Fisk is essentially offered probation and he's allowed to walk away and Dr. Marmillion is sentenced by an all-white jury to seven years to life in prison in San Quentin. And just about every circumstance in the two cases is identical. And we both men become ill at the time of their trial and both request, you know, mercy from the court and it's granted to Dr. Fisk, but it isn't to Dr. Marmillion. And after Dr. Marmillion's sentence, you have this petition that is brought forth by the entire almost entire black community in Los Angeles, they have 1000s of signatures requesting: "Can you at least give them parole? Can you at least offer him some clemency or something he's old, he's sick, he's been a pillar of his community." And it's not granted to Dr. Marmillion but it is to Dr. Fisk. So I argue, I tried to argue, that this relationship to the professional community is much more tenuous for Black providers of illegal abortion as well, for female providers of illegal abortions. Part of that has to do with the way the medical field was organized, it was a primarily male driven occupation. And, you know, there's a certain type of male that kind of typifies the classic 19th, early 20th century physician, and he was classically trained on the East Coast, he was white, he was Christian, and he was basically against abortion. And so we're looking at people who don't really fit within that model for one or two or many different reasons. And so their relationship to professional medicine is strange. There's constantly this concern or battle for legitimacy, and recognition. And there are more risks to be considered and weighed. If you are one of these, you know, women or one of these practitioners of color who has been offering this illegal procedure, you have so much more to lose if you're kind of caught in this legal battle, versus if you are a white practitioner, who was otherwise kind of in line with what these standards are. So for some of the the white positions that I discussed in the book, you know, even if they have legal trouble, within a few years, they are practicing medicine to get medicine, again, they are back within the rules of the LA County Medical Association community, they have their offices reopen, they kind of get their little slap on the wrist, do their do their time, and then they're back in it's fine. Versus for some of these other people, their licenses get revoked or put in prison for long periods of time, and then they're unable to return to professional medicine.

Kelly Therese Pollock  27:35  
So of course, not all illegal abortions are the same. And you talk some about that. And of course, you've mentioned how they get safer over time, when I talk to them about the Pacific Coast Abortion Ring, which was providing really what seems like fairly safe and clean, both in terms of sort of where it happened, the training that people would get the experience that the women had when they would receive these abortions. So can you talk a little bit about that this isn't like what we consider the sort of back alley abortions, this is a fairly professional kind of thing. But as you mentioned, it's criminal mafia kind of so can you talk some about that? And what what that looked like and what that meant for women to be able to have that sort of experience?

Alicia Guttierez-Romine  28:21  
Definitely. So I think there is this tendency, right, if you say illegal abortion, people's minds immediately go to the back alley butcher and they think an incompetent medical provider. And that certainly is possible, but it is not always the case. And so that's why I tried to use the phrase provider of illegal abortion whenever possible, because I believe it encompasses the spectrum that we see where yes, you can have someone who has zero medical skill or training over here who can just completely destroy and maim a woman and kill her. But at the other end of the spectrum, you have trained medical professionals who are performing abortions for reasons that aren't sanctioned. And, and everything in between. So there are definitely people who who should not be providing these procedures who do maim and kill their patients. But there are plenty of physicians as well who want to maintain loyalty from their clients, their patients who want to continue being the family medical service provider, and so they're kind of winking and nodding and doing a favor to do these procedures as well. The Pacific Coast Abortion Ring, kind of I don't want to see it sits in the middle of the spectrum because it's probably more towards the professional side than anything. It's it's this organization that was the brainchild of Reginald Rankin. And Rankin himself is an interesting figure. He was involved in some shady land speculation, maybe some tax issues before the Great Depression. And he decided aids that he wants to open up this abortion mill, this criminal syndicate that provided abortions all along the West Coast. And the very first person that he approaches for this is a physician is Dr. George Watts and Dr. George Watts had been performing abortions for over 40 years, he had not ran into any medical issues. And he was so skilled at what he did that he was able to do these procedures quite well. He was able to keep the women safe while he was doing it. And he developed the vacuum aspiration method, which basically ensured that everything was clean, it reduced the chances of infection. So there are physicians who are part of the Pacific Coast Abortion Ring, who for whatever reason, again, it's during the Great Depression, maybe they're not making as much money as they used to. Maybe, right, if there's a recession or something, if there's any kind of inflation, right, people are going to doctors, when like the wheels are falling off. They're not like oh, I you know, I'm not going for my annual checkup, I feel fine, right, I need the I need the money, I'm not going to waste a $25 copay. If I know I'm good. So perhaps there are these other reasons that, you know, financially, you're making it make sense for some of these ficient physicians to join the ring. But Rankin also brought in people who did not have official medical training, or medical credentials, but if they had been performing abortions, and they were reasonably good at it, and if they could have like a quick little internship with Dr. Watts, and he could kind of retrain them in his method to make sure that they're standardized procedures that are going on. And Dr. George Watts signed off and said, okay, this person is qualified under the way I do it, and they're doing it clean, then they could kind of become part of the syndicate as well. So within the Pacific Coast Abortion Ring, we have physicians with medical licenses, but we also have everyday people who have just been doing abortion so much that they are just as good and just as skilled at this, that they're, they're safe enough to be part of the syndicate as well. So the Pacific Coast Abortion Ring, is very standardized, it was almost like this McDonaldization of abortion care, right? You have all of the offices were designed with the same layout, you know, all of the tools and instruments were in the same drawers. So if they were moved from clinic to clinic, they knew exactly where everything was, and they can get straight to work. Everyone was supposed to perform the procedure the exact same way. And so they were, you know, efficient, but they were also quite skilled, because everyone was overseen, at least initially by Dr. Watts. And because Dr. Watts had been doing this for so long, everyone was trained in in the ways that he was proficient. And so it's kind of this weird in between where it is this essentially assembly line of illegal abortions, but there's so much detail that is put into the way that this Syndicate is going to be run, that they're able to stay safe. They're able to provide reasonably good medical care to all of these women, they're able to provide these procedures. And I found no evidence of a woman dying under their their syndicate. 

Kelly Therese Pollock  33:27  
And they're even able to provide financing. That was a piece of that. Could you talk a little bit about that piece?

Alicia Guttierez-Romine  33:35  
Yeah, so one of the things that was interesting, and perhaps this is a legacy of some of the kind of financial dealings that Rankin had before the Pacific Coast Abortion Ring, they essentially created a credit arm of this of the syndicate. So the pricing for the the abortions in the Pacific Coast Abortion Ring dependent on how far along the woman was. So if it was relatively early in the first six weeks or so it'd be cheaper. After 12 weeks, they were explicitly told, get as much money as you can, the high end for you know, 12 weeks and beyond, we're looking at, you know, 200 to $500 for the procedure. Early on in the pregnancy, we're looking at maybe 50 $70. But if a woman needed the procedure and say the agreed upon price was $50. But she didn't have $50. Then the Pacific Coast Abortion Ring secretary, she would basically escort her to the, to the Medical Acceptance Corporation, right, which was the the financing bureau. She would kind of show her off to that. And she would tell this person at the Medical Acceptance's Court, that she had a $50 medical procedure that she needed financing for and they would say "Sure, no problem. We're going to pay for it. With interest and everything, your out of pocket cost after, you know your payments, is going to be $75." So she gets her procedure, she's able to have it that day. And then now she is paying and financing this procedure through the Medical Acceptance Corporation. And, you know, it's another way to maybe get a couple extra dollars for this procedure. They agreed $50, but she ends up paying $75 because they're, it's a layaway.

Kelly Therese Pollock  35:26  
He's really a master criminal here.

Alicia Guttierez-Romine  35:31  
Yeah. And you know, what's also interesting is that, sometimes they would, you know, take collateral for some of these loans, or these financing agreements, if they were concerned maybe that this woman wouldn't pay. And so for some of the women, it's an opportunity to kind of get out of it as well, because they could put their engagement rings for collateral or for coats for collateral. And if those items were insured, right, she could say, oh, it was lost or stolen, and then she could get her money back, they get the fur coat that they can pawn or sell or do whatever with to pay for the procedure, and everyone kind of wins.

Kelly Therese Pollock  36:11  
Until of course, the ring is taken down by the law because it is in fact illegal. And so for a while they were like paying off police and stuff to sort of look the other way or, you know, go read this other abortionist instead of these providers over here. But eventually they're they're taken down like like all criminal rings are a bit it seems like that's, you know, on the one hand, yes, this is a illegal organization. But on the other hand, like they're providing these safe abortions, so what happens to women who are looking for these services after this no longer exists?

Alicia Guttierez-Romine  36:50  
Yeah, so what's certainly interesting with the Pacific Coast Abortion Ring is that it's, it kind of coincides with this interesting moment, just in general, if we're looking at the history of labor and delivery and, and reproductive health services in the United States writ large. So by the 1930s or so, labor and delivery is moving increasingly to the hospital, it's no longer something that's being done at home, and abortions as well. They're no longer something that is being performed in a doctor's office, right, you're read their regular doctor's office, you just kind of go in for your checkup, get an abortion there, they're moving into the hospital as well. So that transition of basically all reproductive health services is moving towards hospitals, and away from individual doctors within their their own clinics, or offices, and their office might even be at home. So as abortion kind of goes in that trend, as well towards the hospital, there's an opportunity for greater oversight. And we see if we're if we're looking at just California in general, and many other states have similar laws as well. It goes back to this idea that abortion itself is not completely illegal, right. There were basically always exceptions to protect a woman's life in most of the states, but in California as well. And the statute in 1850-1872, all the way up to 1935 in the state of California basically said abortions are illegal, unless a physician performs them because he or she believes that in the course of their treatment, that this is necessary to save a woman's life. So the weight of the lie I'm I'm wording it very clumsily. But the way that the law is written, essentially says that physicians are basically never going to be penalized for performing abortions, because if the physician in their own doctor's office right in their own home, without consulting anyone else, right, because you don't have five other doctors in your home office that you're consulting with really quick. If a woman died or had an abortion, it was found out or something, the doctor who is practicing independently and just say it was necessary to save her life. So I did it, and who's going to challenge that right. But by the time we get to 1935, the wording of the law changes and it basically gets rid of that physician exception part. It just says that abortions are illegal unless found necessary to save a woman's life. By the 1930s. We're moving to the hospital, right? So now hospitals are creating these things called Therapeutic Abortion Committees. And these Therapeutic Abortion Committees are essentially providing the the legal buffer to protect the physicians and the hospital from legal ramifications. Because now if a woman wants an abortion her physician presents her case to the hospital Therapeutic Abortion Committee. This is a hospital where that physician has hospital privileges. And the doctor says this is my client, so and so she's a woman this age, she's this far along in her pregnancy, and this is why she needs an abortion because I found X, Y or Z reason. So can we provide her with this procedure? And the doctors, the people who are on the Therapeutic Abortion Committee are also doctors at that same hospital, possibly a psychiatrist or psychologist, as well, they debate back and forth they discuss and then they tell this physician, okay, yes, your patient can have their procedure, go ahead and get everything situated. Or they say no, that's not a good enough reason your patient cannot have the procedure here. So this way the hospital is is protected, because they said our committee consulted, we have three to five physicians, they found it medically necessary. It's not just one doctor going rogue or doing this as a favor to their patient. So that is an option that is there. Right? Legal therapeutic abortions were always an option. But after the 1930s, they become increasingly inaccessible because of this hospital structure. They were already a little bit inaccessible before that, because accessing illegal abortion required a private physician and and a medical stay. And so that is already something that precludes a lot of women who lack financial means or women of color, who maybe don't have a physician who will treat them or who would not have access to the hospital itself because they're segregated. And then as we move on, right, it is, it's compounding all of that as well. So these procedures are, you know, almost inaccessible to poor women, or to women of color. So that is one of the legal, that is the only legal channel that that women have, if they want an abortion, and what happens if the committee says no, right, you are out of luck. So the other options then are illegal, which would be maybe you can find a physician or someone who can do the procedure in their home in some other place, or you can cross the border, especially after the 1950s we have this kind of thriving black market on the border that is catering to these women who either don't want to deal with the bureaucracy of a hospital Therapeutic Abortion Committee or who have been denied, or who maybe don't have the means to pay for a hospital stay a private physician and a surgery. And then, you know, they're able to kind of take their choices in their own hands.

Kelly Therese Pollock  42:47  
Yeah. So we mentioned there's relevance to today in this work that you're looking at. And I think probably, for me, what was most striking reading your book, right after the Dobbs decision is this idea, you know, we hear a lot, even if abortion is illegal, women will still continue to seek abortions. But sort of seeing that evidence in the book, seeing that, even when it was dangerous, even when it meant traveling, even when it meant breaking the law, that so many women are seeking abortions. I wonder if you could talk a little bit about that, and sort of how you know how we should think about that piece of it as we're looking at increasing restrictions on abortion throughout the country.

Alicia Guttierez-Romine  43:35  
So I hope that the people who read my book do recognize that, that these restrictions won't stop the procedures from taking place. And I always hope that perhaps they'll read these individual stories with a bit of empathy, and an attempt to maybe understand the choices that these these women made. And so if I can get someone to be at least open to trying to understand or broaden their worldview, and maybe it's someone who doesn't agree with abortion, but if you can try to be more empathetic and understand instead of just saying, "Oh, it's wrong, it's immoral", then I hope my book could be an opportunity to open that conversation. But as we're looking at the present day as well, I think there are a couple of distinctions that that are important. And that maybe can, you know, there's some things that are very similar. There's some things that I think are a significant departure. So for one, you know, in the book and the abortions that we're speaking about, they're all surgical. They're all surgical abortions, which inherently have more risks, particularly if we're looking at someone who doesn't have medical skill or training with surgical instruments and you know, internal organs. Now, today, approximately 90% of the abortions that take place are medicated abortions that take place before 12 weeks of pregnancy. So there is much less of a need for surgical interventions, which I think will mean that we're far less likely to see some of these instances where we have women who are subjecting themselves to random people that they meet in search of, of surgical abortions. However, right, the reality is also that we're still going to see those botched procedures, concentrated in the groups that have the least access to resources, were going to see them either self induced, or, you know, again, someone without medical skill or training in people who ran out of time to get the pills or for a medicated abortion. They didn't have the $100 that they needed within the first 12 weeks. And so they couldn't, they couldn't access that means. So now they're trying something later, which even if we're looking at surgical abortions by performed by skilled medical professionals, the further along we go in the pregnancy, the more dangerous they become. So I believe we're going to see this is how, you know, social status and race and all of those things kind of become mapped onto, I don't want to say a body count of illegal abortion, but we're going to see those disparities play out in that way. So perhaps there might be fewer of these fatalities, but we're going to see them in the women with the least resources. I think we're also going to have some interesting discussions about, you know, federalism and states rights versus federal rights and the mail and crossing state lines, which we got a little bit of that in the book, when we're looking at American women who cross the border into Mexico for the procedure, there are attempts for Law Enforcement to try to kind of control movement and redefine what it means to break the law. When it's something in one jurisdiction versus performed in another, I think we're probably going to see some of these battles erupt, particularly if it's someone mailing those abortion drugs across state lines from a state that is friendly to abortion to a state that is hostile to abortion, we've already started to see some of the some of those discussions for young women who are crossing state lines to access the procedure in other states, I think, as well, that we are already seeing the effects of what happens when we have legislators without medical training, crafting laws for medical professionals. So like in some instances, right there is this attempt to try to separate

abortion, from miscarriage from you know, termination, all of these other terms, medically, they're all referred to as abortion, right, spontaneous abortion is a miscarriage or termination. They're all kind of in our medical classification system, they're all referred to as abortion. So when you have, you know, a woman whose whose miscarrying or who has an ectopic pregnancy, and you have this law that they're working with that doesn't parcel out or that is treating all abortions the same, you have medical professionals, hospital administrators, hospital attorneys, who are then concerned about what that will mean for them in terms of their liability. And so we have women, right, who already are facing the consequences of that they, their doctors and their hospitals are essentially forcing them to wait until the very last minute until they know their ectopic pregnancy is going to burst, they know they're about to hemorrhage, then they feel comfortable performing these procedures, because now they're first certain that her life is at risk. And so that kind of covers them. So I think there has to be more nuance if these people are going to create these laws. There has to be more nuanced. And we have to kind of make it clear what a medical exemption is, particularly when in the medical vernacular there they're all the same. But I think some interesting battles over crossing state lines sending things across state lines, we're going to see that as well.

Kelly Therese Pollock  49:33  
Well, I think as people are gearing up to think about all of that they should read your book, so please tell everyone how they can get your book. 

Alicia Guttierez-Romine  49:40  
Yes, so you can find my book anywhere where books are sold. So if that if you like Amazon or if you like supporting your local independent bookseller, you're able to access they're also at the University of Nebraska Press website. The book is called "From Back Alley to the Border: Criminal Abortion in California in 1920 to 1969. And, yeah, just get it wherever books are sold.

Kelly Therese Pollock  50:07  
And I'll put a link in the show notes so people can find it. Despite this sort of heavy topic, it's extremely readable and everyone should go because it is very, very relevant.

Alicia Guttierez-Romine  50:16  
Thank you. I'm glad it I'm glad it's readable.

Kelly Therese Pollock  50:20  
Is there anything else that you wanted to talk about?

Alicia Guttierez-Romine  50:23  
It's a really interesting story, the Pacific Coast Abortion Ring it it's the first thing that brought me into this subject. It's kind of right in the middle of the book it I'm just waiting for someone to make it a movie because it seems like it's an LA noir story. So you have any hiccups to the entertainment industry? Let me know.

Kelly Therese Pollock  50:44  
Yes. I have been saying for a very long time that filmmakers should be listening to this podcast because there are a lot of good.

Alicia Guttierez-Romine  50:51  
Yeah, there's so many of these stories that that they just haven't gotten the attention that they need. 

Kelly Therese Pollock  50:58  
Well, Alicia, thank you so much. This was a terrific conversation, and I am so thrilled to have spoken with you.

Alicia Guttierez-Romine  51:04  
Well, thank you for having me on your show. And if if anyone wants to reach out my my Instagram is @aliciagutierrezrominephd, and I'm happy to chat. If you have any other questions.

Teddy  51:20  
Thanks for listening to Unsung History. You can find the sources used for this episode at UnsungHistoryPodcast.com. To the best of our knowledge, all audio and images used by Unsung History are in the public domain or our used with permission. You can find us on Twitter, or Instagram @unsung__history. Or on Facebook at Unsung History Podcast. To contact us with questions or episode suggestions, please email Kelly@Unsung HistoryPodcast.com. If you enjoyed this podcast, please rate and review and tell your friends.

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