How Thousands of Americans Received Abortion Care Abroad before “Roe V. Wade”

This story was originally published on January 19, 2018.

In 1968, 17-year-old Alyson Williams-Cheung embarked on a three-day trip to Japan. She wandered Ginza, an upscale shopping district in Tokyo, wearing the stylish mini dresses of the era and window shopping for kimonos and tea sets. She also got an abortion. “I don’t even remember feeling any stress,” said Williams-Cheung, now a retired nurse and mother. “I think it was more: This is what you have to do. In the middle of a hurricane, this is what you have to do.” Williams-Cheung was one of thousands who, prior to the passing of Roe v. Wade, traveled to places like Japan, Sweden, and Great Britain where abortion was legal and safe. Others went to Mexico and Puerto Rico, where abortion wasn’t legal, but was more accessible and affordable. Much of this underground abortion railroad was facilitated by the Society for Humane Abortions (SHA), which helped approximately 12,000 women travel the world for reproductive healthcare services.

In addition to distributing literature on trustworthy American abortion providers, the San Francisco-based nonprofit helped women on the West Coast travel to Japan, which legalized abortion in 1948. Although international trips were a small percentage of the abortions that took place prior to legalization in 1973, they highlight the extremes women took to control their health and bodies. After Williams-Cheung’s female doctor in Washington State discouraged her from ending the pregnancy, her sister called their brother, a Dartmouth student who knew a Seattle travel agency facilitating abortion trips for $1,000. Last year, Williams-Cheung’s daughter Alexis interviewed her for The Cut about the abortion. She described it as “privileged” because she didn’t have to worry about her safety. Williams-Cheung said that when telling her story to friends, she is surprised to contrast her doctor’s office procedure to their back-alley abortions that often resulted in health complications.

The Society for Humane Abortion’s document on “rush” abortions (Photo credit: Schlesinger Library)

Although travel agencies around the country offered abortion deals, which often included sightseeing, they were only available for those with financial resources and social networks to support the cost and time away from responsibilities. SHA’s document on “rush” Japanese abortion trips leaving from San Francisco includes tips for negotiating with doctors, such as telling them “you are a student or a poor working girl and don’t have much money.” SHA’s class-conscious work was rooted in the experiences of founder Patricia Maginnis, an Army nurse who saw the consequences of botched abortions. Historian Leslie Reagan noted that as Maginnis was working class, she understood international abortions were luxuries and also coordinated domestic procedures. Maginnis said those she helped represented “a very widespread cross-section of economic strata, from destitute to rich.”

Recognizing the radical steps needed to legalize abortion, Maginnis founded the Association to Repeal Abortion Laws (ARAL), a sister group to the education-focused SHA. ARAL drafted instructions for seeking abortions in Mexico, including buying souvenirs and dressing conservatively to not cause suspicion crossing the border. Reagan wrote this started “the first open (and illegal) abortion referral service in the United States.” In 1967, Maginnis was arrested for writing and sharing information on abortions, a vital practice during a time when they accounted for 17 percent of deaths attributed to pregnancy and childbirth. For low-income women, the situation was especially dire: A study of poor women in New York City during this era found that physicians were involved in only two percent of their abortions. As Reagan said of the pre-Roe era: “the criminal status of abortion, which left the practice open to anyone, skilled or not, and patients unprotected and fearful, made the regulation of practitioners essentials.”

Around this time, Maginnis caused a media stir when she led classes on self-induced abortions, which hundreds flocked to. Reagan argued Maginnis foreshadowed the feminist movement’s emphasis on “the personal is political” by sharing her abortion story and providing accurate medical information. Yet Maginnis told attendees to keep their abortions secret to avoid legal action and social stigmatization, reflecting the era’s cultural attitudes.

Sherri Chessen on Romper Room (Photo credit: KPAZ)

In 1962, Sherri Chessen—a mother of four and host of Phoenix, Arizona’s edition of the kid’s show Romper Room—found out she was pregnant. She was elated, but everything changed when she learned the thalidomide she took to curb morning sickness caused birth defects. Although she won approval for an abortion in the United States, the public nature of the case—she landed on the cover of Life magazine—made doctors hesitant to provide the procedure. The Japanese Conciliate even denied her a visa to obtain an abortion there. Following weeks of interrogations, she finally received an abortion in Sweden. After returning, she lost her job because she was “no longer fit to handle children.” 

“Then they found out the baby had no arms,” Chessen told “On the Media” last year. “I asked, like I’d asked four times before, if the baby were a boy or a girl, and the doctor said—I’ve never forgotten that—‘it was not a baby. It was abnormal growth that never would have been a normal child.’ That’s the way I helped heal myself.” Chessen added that because she represented a nuclear family and needed an abortion for medical reasons, she was more empathetic to mainstream audiences than those who aborted because they didn’t want children.

As the 1960s progressed and the medical traumas associated with illegal, back-alley abortions became more known, groups across the country became part of the underground reproductive healthcare network. In Chicago, the Abortion Counseling Service of Women’s Liberation, also known as the Jane Collective, was active from 1969 to 1973 and facilitated more than 11,000 abortions. When New York State legalized abortion in 1970, the Clergy Consultation Service on Abortion, a group of Protestant and Jewish religious leaders, formed to coordinate trips there for abortion-seekers. The original 21 members grew to around 1400, helping provide hundreds of thousands of procedures.

While Roe v. Wade made these groups seemingly no longer necessary, the persistent attack on abortion access means grassroots efforts are still essential in addressing growing inequities in reproductive healthcare access, especially for underage women, women of color, and poor and rural women. In 2014, the median distance traveled to an abortion clinic was about 11 miles, according to a report published in The Lancet Public Health journal. But researchers found this “concealed sizable minorities of women who would have had to travel substantial distances to reach an abortion provider,” including the 20 percent who traveled more than 43 miles.

Even though it’s a legal right, many women still have the same challenges of coordinating “abortion trips” as before Roe v. Wade. Twenty-seven states require a waiting period, often at least 24 hours, between an initial consultation and a procedure. This arguably unnecessary practice is an extra burden, particularly for the increasing number who must travel. Consequently, there are renewed fears about the return of unsafe self-induced and illegal abortions. Mirroring their predecessors, groups like the Midwest Access Coalition provide housing and coordinate travel for women who can’t see abortions in their area and need financial and other support.

Compounded with the expense of abortions is that low-income and rural areas have some of the least access to reproductive healthcare. Limited funding and draconian laws applying the safety standards of ambulatory surgical centers to abortion clinics have attributed to the closures of at least 162 providers since 2011. Six states have only one provider, and Kentucky may become the first with none. There’s even a new online game called Trapped that not only highlights the difficulty of obtaining an abortion, but also the fact that the cost often goes up the further a pregnancy progresses.

Still from Trapped (Photo credit: Women’s Health Specialists in Redding and the Abortion Access Hackathon)

International procedures still occur. In Texas—where in 2014, only 4 percent of counties had abortion clinicswomen regularly cross the border for misoprostol, one of two medications for a self-administered, medical abortion. Taken together, the success rate is 95 percent. In Mexico, it’s cheaper and doesn’t require a prescription. Statistics aren’t available on how many women are going to Mexico for abortions. But the demand is clear: The border town of Nuevo Progreso, with a population of just over 10,000, has an estimated 200 pharmacies.

Now, under the anti-choice Trump administration, the attack on reproductive healthcare services could have impact both in the United States and abroad. Just after taking office, Trump signed his first piece of anti-abortion policy, prohibiting foreign organizations receiving U.S. family planning funding from providing counseling or referrals for abortion and participating in advocacy work on the issue. As the fight continues, Pat Maginnis wrote in an email that there’s a lesson to be learned “from the era of horror…when the fate of women and our fertility suffered at the hands of the male- dominated systems.”

Following Roe v. Wade, she donated SHA’s records to Harvard University. In an interview conducted for the collection, she said she only felt “some sort of satisfaction” in abortion legalization, highlighting the remaining work to be done to create equity in urban-rural abortion access disparities. She also predicted the decades-long attack on women’s reproductive healthcare, saying, “it’s going to take all of the brains, and all of our wits working together to constantly remind people that this human female with biological equipment for reproductive purposes is a human being.”

by Hannah Steinkopf-Frank
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Hannah Steinkopf-Frank is a Chicago-based freelance writer and photographer. Her work has appeared in the Chicago Tribune, Atlas Obscura, Columbia Journalism Review, In These Times, JSTOR Daily, Jewish Currents, and Paper Magazine, among others.

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