NEVER AGAIN: Reflecting on Illegal Abortions in the US Fifty Years on From Roe v Wade 

Written by Naomi Wallace

Content Warning: This article discusses abortion, death, and graphic injury.

“NEVER AGAIN” were the words that accompanied the photograph of Gerri Santoro, naked, alone, hunched over in a pool of her own blood in a dirty motel room, dead because of an illegal abortion in 1964. When Ms. magazine printed the image in April 1973, they were empowered to declare “NEVER AGAIN” about unnecessary deaths like Gerri’s thanks to the Supreme Court ruling Roe v Wade, that had made a woman’s right to choose constitutional in January of that year. Fifty years after Roe v Wade, and just months after it was overturned in an unprecedented ruling by the Supreme Court in June 2022, this article examines the state of illegal abortions in the US prior to 1973 and discusses what history reveals about the implications and consequences of criminalising abortion. 

Gerri Santoro was a twenty-eight-year-old woman from Connecticut who had fled her abusive husband with her two daughters and later fallen pregnant with the child of her lover, Clyde Dixon, whom she had met at the institution where they both worked. Using instruments that he had borrowed from a colleague whose wife was a doctor, and a medical textbook, Dixon attempted to perform an abortion by inserting a catheter into the woman’s cervix but fled the scene as she began to bleed heavily. Gerri died completely alone, helpless in the motel room, not to be found until the next morning when a chambermaid discovered her body.  

Gerri Santoro. Accessed via ABC News.

There was nothing particularly remarkable or unique about the circumstances of Gerri’s death, but the police photo of her, first published by Ms. magazine, has reverberated through women’s rights and pro-choice spheres ever since. It is an unforgettable image (that can be found online but I have chosen not to include as it is graphic and deeply distressing), one that shows the bloody reality of unsafe, illegal abortions in the US before Roe v Wade. Gerri’s face is obscured, pressed into the filthy carpet, so she could be any woman, in any part of the country, who died attempting to terminate a pregnancy that they could not end legally. As stated in the magazine, Gerri came “to represent the thousands of women who have been maimed or murdered by a society that denied them safe and legal abortions”.  

Gerri was one of many women who were forced to turn to extreme and dangerous measures where medically safe abortion was not an option. Ms. magazine collected stories from various women who recalled how illegal abortion impacted themselves and those around them. Evelyn H tells the story of her fourteen-year-old friend who, after being raped by a sports coach, died in the school bathroom following an illegal abortion, stating “she was just a baby herself”. Bonnie B remembers she and her friends putting their money together to fly their sixteen-year-old friend alone to Mexico for an abortion. Carolyn Young similarly told the LA Times that when she fell pregnant and pursued an illegal abortion, she “would rather have died than have the baby”. The testimonies of women who lived in a pre-Roe world highlight how likely one was to encounter illegal abortions in some way, proving that though it was not legal or accessible, intentional termination of pregnancy was occurring ubiquitously across the country. 

Not all abortions that occurred illegally were dangerous back-alley abortions; young women from wealthy backgrounds who had connections to physicians were more often able to privately acquire an abortion, at a high fee. As is the case today, when abortion was illegal access to it was inherently unequal. Poorer women suffered the greatest in the pre-Roe climate, as the illegal abortion providers they sought out were less likely to operate in medically safe conditions, and for some women, attempting to perform the abortion themselves was the only option. It was these women who wound up in hospitals, seriously ill due to complications from dodgy or botched procedures. 

An eye-opening insight into the severity of illegal abortions comes from the recollections of medical residents, collected by Carole Joffe, who reveal the horrors they witnessed working in hospitals in the decades before Roe. Many women attempted to induce a miscarriage in order to receive a D&C (dilation and curettage), using dangerous methods like consuming Clorox or turpentine. Alice Wilkins, a resident doctor in the 1940s, recalled a disturbing case in which a woman’s partner had used animal blood from the slaughterhouse where he worked to make it appear as though she was miscarrying so she could obtain an abortion. Others would place potassium permanganate tablets into their vaginas, which caused bleeding in the uterus and often resulted in massive haemorrhages. Most commonly, various sharp objects, including “the proverbial coat hanger” were inserted into the uterus in an attempt to end the pregnancy. This frequently caused uterine perforation, which was extremely serious and often deadly. 

Renee Giardino described how the wards in the New York hospital at which she completed her residency were always full due to admissions from illegal abortions. This was so often the case at hospitals across the country that there were wards known as “septic tanks” that were almost exclusively for women suffering from septicaemia or septic shock following unsafe abortions. There was an influx of patients once a week known amongst doctors as the “Monday morning abortion line-up”; women received their paycheques on a Friday and spent them on abortions, and by Monday, many of them would end up in hospital seeking urgent medical attention for the resultant complications. It is incredibly difficult to collect specific figures for illegal abortions as it is unclear just how many took place, with many going unreported. What is evident, from the direct accounts and oral histories of those in the medical field pre-Roe, is that these risky, unsanitary, “back-alley” abortions were injuring and, in some cases, killing American women. 

Ms. Magazine covers, Fall 2006, Winter 2010, Spring 2013. (Ms. Magazine via Wikimedia Commons)

Roe v Wade was therefore a major turning point when the Supreme Court, based on the Fourteenth Amendment right to privacy, ruled that a woman’s right to choose was upheld by the Constitution. Immediately, illegal abortions began to decrease in frequency and consequently so did the number of women who died from them. Cates and Rochat estimated the number of illegal abortions declined from 130,000 in 1972 to only 17,000 in 1974 (an estimate as many went unreported). Following earlier abortion reform in California in 1966, there was a 75% decline in septic abortion in Los Angeles, and in the period following Roe the mean length of hospital stays for abortions decreased significantly. This was likely due to the decrease in serious complications caused by illegal abortions.  

Ms. magazine, echoing the sentiment of the women’s liberation movement, felt that Roe v Wade marked the end of the deadly climate of illegal abortions sought out of desperation. Fates like that of Gerri Santoro, the dead woman on the motel floor, would become a thing of the past. The Supreme Court decision was a triumph for women’s rights in the eyes of many, and even during the Reagan administration, which saw an upsurge of right-wing ideology, attempts to pass new anti-abortion legislation failed. Roe v Wade was upheld when the 1992 Supreme Court ruling Planned Parenthood v Casey reasserted the constitutional right to abortion. David J. Garrow, reflecting on this in 1999, stated “there is simply no going back” and emphasised “how strong an unbreakable an institutional commitment the Supreme Court has made to constitutional protection for women’s right to choose.” 

Clearly, Garrow and Ms. magazine were wrong; reversing Roe v Wade was not merely a “pipe dream” for anti-abortionists. This became evident when it was overturned, almost half a century after the initial ruling, in June 2022, in one of the biggest blows to women’s rights activism in recent history. The decision triggered immediate abortion bans across many states, some of which make no exceptions for case of rape or incest. In some states, those who seek as well as deliver abortions risk prosecution for homicide. T. McGovern argues that, through this ruling, “the Supreme Court has unleashed large scale terror on the provision of reproductive healthcare”. 

Our Future March for Abortion Access, St Paul, Minnesota, July 27, 2022. (Fibonacci Blue via Wikimedia Commons)

Overturning Roe v Wade has alarming implications for all people with uteruses in the US; however, it is a decision that will have a profound effect specifically on marginalised groups across the country. Available data suggests that over half of all abortions are performed on women of colour. A higher proportion of these women are uninsured than white women, and as the Hyde Amendment prohibits the funding of abortions through Medicaid (with the slim exception of rape, incest, or threat to the mother’s life), their access to abortion is disproportionately limited. Additionally, though the overall rate of maternal mortality in the US is already the highest of any developing country, it is far higher for Black women and therefore those women forced to endure unwanted pregnancy are at a greater risk of serious complications.  

The history of abortion in America before Roe v Wade tells us two things; first, that abortion occurs whether it is legal or not, and secondly, abortions carried out illegally can be highly dangerous and life-threatening. Overturning Roe does not bring an end to abortion – it just means that those in areas where abortion bans have been enacted will be driven to the same extreme, risky measures that can be observed prior to 1973.  

It is harrowing to read the words “NEVER AGAIN” in Ms. magazine fifty years on and know that their meaning is now empty. It is chilling to see the confidence and certainty of women’s activists across the country that Roe v Wade marked a turning point in the history of reproductive rights, knowing that it has been turned back. For five decades, women across the US had relatively free access to abortion, and the horror stories of the mid-twentieth century, of coat-hangers and alleyways and dead women on motel floors, became memories of a recent, darker past. In order to imagine the future of abortion in the US without the protections of Roe v Wade, all one must do is look to its history. The photograph of Gerri Santoro is as tragically pertinent in 2023 as it was in 1973; I only hope that one day we can say the words “NEVER AGAIN” and they will hold true.  


Amy Erdman Farrell, and Inc Netlibrary. Yours in Sisterhood : Ms. Magazine and the Promise of Popular Feminism. Chapel Hill: University Of North Carolina Press, 1998. 

Artiga, Samantha, Latoya Hill, Usha Ranji, and Ivette Gomez. “What Are the Implications of the Overturning of Roe v. Wade for Racial Disparities?” KFF, July 15, 2022. 

Bracken, M B, D H Freeman, and K Hellenbrand. “Hospitalization for Medical-Legal and Other Abortions in the United States 1970-1977.” American journal of public health (1971) 72, no. 1 (1982): 30–36. 

Cates Jr, W., and R.W. Rochat. “Illegal Abortions in the United States: 1972-1974.” Family planning perspectives 8, no. 2 (1976): 86–92. 

Garrow, David J. “Abortion before and after Roe V. Wade: An Historical Perspective.” Albany law review 62, no. 3 (1999): 833–. 

Glenza, Jessica, Martin Pengelly, and Sam Levin. “US Supreme Court Overturns Abortion Rights, Upending Roe v Wade.” the Guardian, June 24, 2022. 

Hallett, Stephanie, Baker, Carrie N. “Eight Stories That Show What Abortion Was like before Roe v. Wade.” Ms. Magazine, January 19, 2016. 

Los Angeles Times. “‘I Have Two Stories to Tell — One of an Illegal Abortion, the Other Legal,’” July 9, 2022. 

Joffe, Carole E. Doctors of Conscience: The Struggle to Provide Abortion before and after Roe v. Wade. Boston: Beacon Press, 2001. 

Leona’s Sister Gerri. PBS, 1995. 

McGovern, Terry. “Overturning Roe V Wade Has Had an Immediate Chilling Effect on Reproductive Healthcare.” BMJ 377 (June 30, 2022): o1622. 

Reagan, Leslie J. When Abortion Was a Crime: Women, Medicine, and Law in the United States, 1867-1973. University Of California Press, 1998. 

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Rosenfeld, Megan. “THE DEATH of an ORDINARY WOMAN.” The Washington Post, November 6, 1995. 

“The Morning Record – Google News Archive Search,” 2023. 

Personal PAC. “The Tragedy of Illegal Abortion: Gerri Santoro.” Accessed January 6, 2023. 

Featured image credit: Ms. Magazine, Summer 2022 Issue. Accessed via: Used under fair use policy.

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