What are we to make of a pre-legalization death?

On October 25, 1922, 24-year-old homemaker Lillian Hulbert died at Chicago's St. Anne's Hospital from complications of a criminal abortion performed on her there that day. The coroner identified a Mrs. M.C. Anderson as responsible for Lillian's death. Anderson's profession is given as nurse or midwife.

Abortion rights groups will blame the deaths of women like Lillian on the legal status of abortion at the time. Seeking out a midwife, ad Lillian did, rather than a doctor, wasn't because of abortion's illegality but because women of that era often went to midwives rather than doctors for all of their obstetric and gynecological issues.

Abortion-rights activists also forget that all surgery, including induced abortion, was riskier in the pre-legalization days. As the 20th century progressed, all maternal mortality, including abortion mortality, fell as medical care improved. Antibiotics and blood transfusions -- along with overall better health due to increasing prosperity -- deserve the credit for falling mortality, which was hardly caused retroactively by the 1973 Roe vs. Wade Supreme Court ruling striking down all the nation's abortion laws.

No doubt there was quackery prior to legalization -- but such quackery persists today. Removing the threat of jail for any but the most egregious behavior does not provide motivation to run a tight ship. Three erstwhile criminal abortionists that I know of -- Benjamin Munson, Milan Vuitch, and Jesse Ketchum -- didn't lose a single abortion patient until after legalization made them less fearful of repercussions and thus far more careless. Each went on to kill two legal abortion patients, not out of simple surgical complications, but due to appalling quackery.

It's time we got real about how little is different between illegal and legal abortion practice: the main difference is how much risk of being shut down or sent to prison the safe-and-legal abortionist faces.