New to Me: Mystery Death in North Carolina:

A researcher sent me information about a pre-legalization abortion death. To preserve the woman's privacy, I have redacted her death certificate and will refer to her as "Florence Dorland."

Florence was a 21-year-old Black woman, never married. Her occupation was listed as "babysitter." She lived in Granville County, North Carolina

She came into the care of Dr. Robert E. Zipf, Jr. on December 19, of 1970. At some point he admitted her to Duke Hospital in Durham, where she died on January 4, 1971. Her cause of death is listed as cerebral anoxia due to hepato-renal failure due to abortifacient. The manner of death was identified as homicide, and how injury occurred is induced abortion, with the injury occurring on December 9, 1970 in Richmond, Virginia. 

So, what happened to Florence? Let's look at the circumstances. 

Legal status of abortion: Both North Carolina and Virginia followed the American Law Institute Model Abortion Law in 1970: "A licensed physician is justified in terminating a pregnancy if he believes that there is substantial risk that continuance of the pregnancy would gravely impair the physical or mental health of the mother or that the child would be born with grave physical or mental defect, or that the pregnancy resulted from rape, incest or other felonious intercourse." Thus whatever law was on the books would have had no impact on Florence's decision to travel out-of-state. 

Laxity in approving abortions: North Carolina had an abortion ratio of 7 hospital abortions per 1,000 live births, while Virginia had nearly double the abortion ration, with 13 per 1,000 live births. North Carolina did not provide a breakdown of the justification for abortions, but Virginia did, with 357 of 508 hospital abortions (70%) of abortions being done for "maternal mental health." For comparison, 97% of California abortions, 87% of Colorado abortions, 77% of Georgia abortions, 92% of Oregon abortions, and 78% of South Carolina abortions were done for "mental health." Geographically it seems that Florence had double the odds of betting rubber-stamped for an abortion in Virginia than North Carolina, but it's unclear whether she would have been aware of this.

Distance: It's about 122 miles, or about a 2-hour drive, from the area where Florence lived to Richmond, Virginia. Florence had several much closer metropolitan areas to choose from: Durham, Raleigh, and Greensboro. 

Cause of death: The "cause of death" indicates an abortifacient rather than a surgical abortion. It seems unlikely that Florence would have driven nearly two hours to purchase and consume an abortifacient and then travel home again, and more likely that she might have driven nearly two hours to obtain it and then consume it at home. But the location of the injury was an unidentified building in Richmond, not in Florence's home. Whatever the abortifacient was, it was administered in Richmond.

Manner of death: The "manner of death" was homicide, meaning that either the abortion itself was patently illegal, or it was technically legal but performed in such a reckless way that Florence's death would be predictable.

Location of injury: The location was given merely as "building," with nothing more specific such as doctor's office, clinic, hospital, or residence. If Florence had undergone a legal abortion performed recklessly, the physician would likely have listed the location of injury more specifically.

Most likely perpetrator:  Planned Parenthood's medical director, Mary Calderone, concluded in "Illegal Abortion as a Public Health Problem" (American Journal of Public Health, July 1960), that roughly 90% of pre-legalization abortions were performed by doctors, about 8% by the woman herself, and about 2% by non-physicians. Nancy Howell Lee  (The Search for an Abortionist, University of Chicago Press, 1969) concluded that 89% of pre-legalization abortions were done by physicians, 5% by nurses or others with some medical training, and 6% by non-medical persons or the woman herself. Since both sources agree on the approximate 90% perpetrated by physicians, this number is probably fairly accurate. Thus it's most likely that whomever perpetrated the fatal abortion, it was a doctor.

Had Florence undergone the abortion in New York rather than Virginia, I would have suspected that she had travelled to a freestanding, well-advertised, and openly operating clinic, had some sort of abortifacient administered by a doctor (saline injection, prostaglandin, or something like Leunbach's paste), and had been sent home. This is what happened with "Anita" and "April," who died from outpatient saline abortions initiated legally in New York.

The outpatient scenario would account for the cause of death being "abortifacient" rather than "surgical abortion" or "therapeutic abortion."  

My conclusion: It it seems most likely that Florence learned through the grapevine of a doctor willing to administer an abortifacient paste or hypertonic saline on an outpatient basis. The former seems much more likely, since all but the most reckless of abortionists did saline abortions outside a hospital. If Dr. Zipf expressed disapproval (as he likely would have, given that he found the manner of death to be homicide), Florence might have kept the doctor's name to herself to protect him.

Watch Mystery Abortion in 1970 on YouTube.