October 23, 1913: Why Did the Midwife Confess?

Emma Bickel, a 59-year-old St. Louis midwife, was charged with second-degree manslaughter in the death of 19-year-old Emily Nohavec of St. Louis. Bickel had been a midwife for 28 years, and had a reputation for "uprightness" and honesty.

Emily, age 19, was single, and had been living with her sister in St. Louis, where she worked as a clerk in her sister‘s vegetable store. On October 18, 1913, she first reported feeling ill. On Monday, October 20, a Dr. Reber was summoned to see her. He diagnosed her with septic peritonitis. The next day, her condition was critical and she was admitted to Rebekah Hospital. There, Dr. Garcia was called in for consultation. Drs. Reber and Garcia agreed that an immediate laparotomy was needed to try to save Emily‘s life.

The doctors found Emily‘s abdominal cavity inflamed. A cyst about the size of a pear surrounded her left ovary, her right ovary was surrounded by pus, and there was pus in her fallopian tubes. The doctors removed these purulent organs and inserted drainage tubes.

Dr. Reber also curetted Emily‘s uterus and packed it with iodoform gauze. Emily‘s uterus noted an ulceration about the size of a hazelnut inside the cervix. The edges of this ulceration were ragged and torn, and Reber concluded that this was caused by instrumentation. Reber also believed that swelling near where the fallopian tube entered the uterus was caused by instrumentation. Reber believed that an abortion had been performed a week to ten days before he was first called to examine Emily.

Dr. Garcia, on the other hand, agreed that Emily had recently been pregnant, and that the pregnancy had ended at about two months, but noted "there were no direct punctures or cuts, scratches, or anything of that kind in the uterus, or in the abdomen." He agreed with Dr. Reber that the sepsis was caused by an abortion, but he disagreed about the abortion having been induced. Dr. Garcia concluded that Emily might merely have miscarried.

Despite the efforts of both doctors, Emily died the following day, October 23.

That same day, Dr. Hockdoerfer performed an autopsy. He made the same findings as Drs. Garcia and Reber, except that he also found a section of placental implantation about the size of a quarter. He agreed that retained placental tissue had caused the sepsis, but did not find any signs of damage from instruments. Emily had been in good health prior to her final, fatal illness.

While Emily was hospitalized, police officer William H. Coates arrested St. Louis midwife Emma Bickel and brought her to Emily‘s bedside. Coates testified that he asked Bickel if she knew the girl, and Bickel said yes, she did know her. Coates testified that he then said, "You performed an abortion on  her, didn‘t you?" To which, he testified, Bickel replied, "Yes."

Coates took Bickel to the police station where she made a statement. Coates wrote out the statement as follows:

Department of Police, City of St. Louis.
7:16 P. M., Oct. 22, 1913.

To whom it may concern I herein state that on or about October 13th, 1913, Emily Nohavec came to my house in the evening and said she was in trouble and wanted me to help her out. I told her it was dangerous for to do a thing like that, and she said, ‘You need not be afraid,‘ that ‘I won't tell on you.‘ I then inserted a catheter into the private parts and opened her womb. She then paid me about five or seven dollars; I don‘t remember which. She came back in two days, and I again put the catheter into the womb. She left, and I never saw her until I saw her this evening at the hospital.

The above statement was made of my own free will, and not by any threats or promises or violence to me.

[Signed] Emma Bickel.
Witnesses: Off. W. H. Coates; Off. David J. O‘Connor.

When called upon to testify in court, however, Bickel denied having performed an abortion on Emily. She said that she never knew Emily until the girl came to her house, saying that she was "in trouble." Bickel said that she asked Emily, "How far along?" To which Emily replied that her period was two weeks late. Bickel said that Emily told her that she was married, and that she had taken some medicine to cause an abortion, and had also taken a box of pills. Bickel said that she told Emily, "Well, if you are only two weeks gone they ought to bring you by your next monthlies." Bickel said that she then sent Emily away.

Bickel said that about two weeks later Emily, who had still not given her name, returned, saying that she was ill, and willing to pay $7 for an examination. Bickel said that she used a speculum to examine Emily, and found her cervix open and exuding a foul discharge. Bickel testified that she told Emily to consult a doctor. She said that this took place about two weeks prior to Emily‘s death, and that she‘d not seen the girl between the examination and being brought to the hospital by Officer Coates.

Bickel testified that she had confirmed that she knew Emily, and that the girl had come to her house, but that Coates did not ask her at the hospital if she had performed an abortion. She said that she was taken to the police station, that Coates had written out the statement and told her to sign it, so she‘d complied.

Bickel said that she‘d never told Coates that she‘d inserted a catheter, that she‘d tried to discourage abortion, telling Emily "that it was a dangerous thing to do a thing like that." She said that she‘d only signed the statement because she was excited and confused and was merely doing what she was told.

Despite her protestations of innocence, Bickel was convicted of second degree manslaughter. She was sentenced to three years in prison. She unsuccessfully appealed her conviction and was paroled in June of 1915.

View the video on YouTube: The Midwife's Confession

Newly added sources:

• Death certificate
• "Woman Gets 3 Years for Girl's Death," St. Louis Post-Dispatch, March 25, 1914
• "Emma Bickel Paroled," King County (MO) Democrat, June 25, 1915