Back Alley Butcher? Not a Butcher, Not Heartless

Lauren has an excellent review up of the new Romanian movie "4 Months, 3 Weeks, and 2 Days." It's rumored to have been overlooked at the Oscars because abortion is a central to the story, and this is a climate in which films tend to assume that a woman cannot be a empathetic character while actively desiring an abortion for too long. This column won't discuss the movie, which I haven't seen, but I will note that one of the characters in the film is the famous archetype that symbolizes the entire era of criminalized abortion: the Back Alley Butcher. It sounds like the movie uses this character in an interesting way, though, so in no way, shape, or form should this be construed as a criticism of the movie.

I just so happened to read Lauren's review while also reading Rickie Solinger's classic book arguing for the use of the concept of "reproductive rights" over "choice," Beggars and Choosers, in the abortion rights movement. The book has a really interesting argument begging pro-choice activists to quit talking about the Back Alley Butcher as a reason abortion needs to be kept legal. For one thing, Solinger is a historian and therefore prioritizes the need for accuracy. And, as she notes, even in the days when abortion was a crime, the vast majority of abortion providers were competent, caring professionals who entered the illegal field in no small part because they believed in justice. Far more interesting than the mythical character of the Back Alley Butcher, for instance, is the story of the Jane collective, a feminist organization in Chicago that provided abortions to area women as a protest against misogynist laws.

But there's another reason to avoid resorting to the Back Alley Butcher arguments. You know how anti-choicers run around saying that we have to ban abortion in order to protect women? Doesn't that make you insane, because it implies that women are basically children who can't be trusted to know what they really want? And that women have one uniform desire, to have one child after another? In the litany of things that make you wonder if anti-choicers have ever had contact with the real world, this belief that women need to be protected from themselves is one of the most mind-bogglingly out of touch. And the field of "mind-bogglingly stupid beliefs" is not an underpopulated one when it comes to the anti-choice philosophy.

The most egregious example of this kind of "Womenz is teh stoopid" thinking as of late is Mississippi's recent attempt to ban women in order to protect women's right not to have rights. The bill is worded as such:

A pregnant mother possesses certain inherent rights that are natural intrinsic rights which enjoy affirmative protection under the Constitution of the United States, and under the laws or Constitution of the State of Mississippi; that among these rights are the fundamental rights of the pregnant mother to her relationship with her child; her fundamental right to make decisions that insure the well-being of her child; and her interest in her own health and bodily integrity.

Anti-choicers invest in this nonsensical philosophy for political reasons. Voters don't want to imagine sending women to jail for terminating pregnancies, and this philosophy that states that women are the victims of their own rights. So, in a bit of logical ju-jitsu, anti-choicers claim that they want to criminalize a behavior that women participate in, but punish someone else entirely for it.

But we pro-choicers have ourselves to blame, at least in part, for this sorry state of affairs, and all because we have proliferated this stereotype of the Back Alley Butcher. The image of the sleazy abortion provider who mutilates women for the cold, hard cash that we imagine when we think of the Back Alley Butcher has been updated by the anti-choice movement to discredit modern day abortion providers. (According to Solinger, and I agree.) Pro-choicers perpetuated the image of the illicit abortionist with the air of criminality to him, and anti-choicers argue that there's no reason to think that such people would suddenly become professionals and heroes just because the law changed, anymore than we should think that pimps become upstanding citizens when prostitution is legalized or that drug dealers become caring professionals when drugs are legalized.

It's understandable that feminists are drawn to the Back Alley Butcher argument. Talking about the danger to women's bodies helps keep the focus on women, and we're winning as long as we're talking about women. Sure, anti-choicers talk about how abortion "hurts" women, but they'd mostly prefer to ignore women altogether and pretend that abortion is an assault on innocent fetuses floating somewhere in space, or imprinting their adorable little feet on your "pro-life" checks and jewelry. Confronting them with the damage to actual human women with actual lives puts them in a perilous situation. The image of women dying from being mutilated by Back Alley Butchers gives lie to the anti-choice argument that they're "pro-life."

But there are ways to talk about the dangers that come to women when abortion is criminalized without resorting to lurid myths that slur the good name of those who risk life, limb, and freedom to provide this necessary service to women. Solinger argues that we should talk about how the law itself becomes a danger to women. Talk about women being pulled off tables mid-operation at clean, serviceable clinics and hauled off to jail. Talk about women who can't get a miscarriage treated at the hospital because the doctors fear she might have had an abortion. Talk about the women sitting on the stand being grilled about their sex lives during abortion trials. Talk about women douching with bleach because they can't find a decent provider. Ask an anti-choicer to tell you how much time a woman should do for seeking abortion.

You can help thank the front line heroes of the pro-choice movement, those who actually provide the service we all spend so much time protecting, by donating to the National Network of Abortion Funds. Most abortion providers try to keep their prices as low as they can (giving lie to anti-choice accusations that they're in this all for the money), but they still have to charge something in order to keep themselves in business. For women who can't afford the prices, this becomes a huge barrier. The NNAF helps bridge the gap, offering money to low-income women seeking abortion. A gift to them helps two people–a woman who needs an abortion and a doctor who risks his or her personal safety to provide that service.

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  • invalid-0

    You know I never thought of going about it this way. I was raised in a big prochoice family and we always focused on what you said that women would be butchered if “back alley” abortions would come back and therefore die. I myself am a big prochoice person as is my husband and I am going to share this post with him cause I think it is great. Thanks Amanda you really have a great voice for the movement!

  • brady-swenson

    The wording of that Mississippi bill is an Orwellian accomplishment to be sure. Wowza.

    This is a great article and I hope others take note of your suggestions for re-framing the pro-choice arguments to exchange the back alley butcher argument for the criminalization of women, or, as Anna Quindlen (and Journey!) put it, the 'How much time should she do?' argument.

    Thanks, Amanda.

  • invalid-0

    Amanda–thanks for writing such a thoughtful piece. I quite agree with you that there is a danger of focusing too much on the “butchers” of the pre-Roe era, especially as it risks demonizing contemporary abortion providers who are genuine heroes and who provide very safe services. However, it is not the case that these “butchers” were “mythical” as you suggest a few times. They really did exist and did horrible things–medically and ethically. They were one part of a much larger universe of providers in the pre-Roe era–besides the “butchers,” there were those whom I have called in my own work “doctors of conscience”–that is, competent doctors who risked jail and losing their licenses because they felt so strongly that women needed good care; they were laypeople, like the Jane collective, and the Portland abortionist that rickie solinger writes about who had remarkable safety records, also a cateogry of providers who were not “butchers” in the sense of being unethical, but who sometimes got in over their heads medically and injured women, and sometimes not.
    If Roe is overturned, will we once again see “butchers”? Probably to some extent. And just like in the era before Roe, there will be varying outcomes for women, depending mainly on social class. that is, those with resources will find competent providers, even if it means flying across the country or going to canada or europe. those without resources will take matters into their own hands–often with tragic consequences (we already have seen stories of women shooting themselves in the belly, of a teenager asking her boyfriend to beat her with a baseball bat, etc), and some desperate women very likely will end up in the hands of inept and unethical people–though hopefully not at the same rate as in the pre-Roe era. I think one of the most powerful messages of our movement is the remarkable drop in death and injury resulting from abortions that occurred immediately after Roe. carole

  • amanda-marcotte

    I think that we can invoke the septic abortion image without slurring the good names of the vast majority of abortion providers pre-Roe who did fine work. Maybe there was a butcher or two, but this is about epics and myths, and we need to concentrate on dispelling those.


    Most women who suffered or died of septic abortion were self-aborters. That famous picture of the woman hunched over dead and naked in a pool of her own blood was trying to abort herself. The famous coat hanger image refers not to the tools of the illegal abortionist, but to the last resort of a desperate woman. So you're right that there was death and injury. But I would remember when you tell that story that it was women doing it to themselves. That's a more powerful story anyway; it reminds your audience that women will do what they have to in order to survive.


    The brave and caring workers who provided abortion both before and after Roe were largely influenced by the understanding that if women can't get help from someone else, they'll do it themselves. It's critical to reinforce that performing abortions is a service to women, done out of caring. I had a bunch of right wing nuts slurring the good name of Dr. George Tiller on my blog the other week, and Dr. Tiller has one of the most caring, comprehensive practices out there. But their abuse of him works in no small part because people think of The Abortionist as a bad person. I prefer the term "hero".

  • invalid-0

    amanda–sadly, there are “back alley butchers” at work today, mainly preying on low income minority communities. Note this very disturbing article, below, from today’s LA Times. The description of alcoholism, sexual abuse, medical incompetence reads like it could have happened 40 years ago before Roe. I don’t think our proper response as a abortion rights community is to deny these things happen. Rather I think we have to say that as long as abortion care is so stigmatized, and so marginalized from mainstream medicine, and the truly competent and compassionate providers like George Tiller (whom I am very proud to call my friend) are so relentlessly persecuted for political reasons, there will be a void into which these “butchers” will step and it is the most vulnerable women who will suffer. Done under proper conditions, abortion is one of the safest medical procedures there is. It is unconscionable that these women were subjected to this treatment. carole
    LA Times: Abortion clinics operator is charged


    Abortion clinics operator is charged

    Bertha Bugarin, 48, allegedly ran medical facilities where improper
    procedures were performed. She has pleaded not guilty.

    By Tiffany Hsu, Los Angeles Times, February 8, 2008

    By the time paramedics arrived, the patient was lying in a pool of her
    own blood, her pulse racing and her blood pressure dangerously low.

    The woman, identified only as Angela P. in records of the Medical Board
    of California, had gone to the Clinica Medica Para la Mujer de Hoy in
    Santa Ana in the summer of 2004 for an abortion.

    Dr. Phillip Rand, then in his early 80s, performed a vaginal suction
    procedure, despite having determined that Angela was about 20 weeks
    pregnant, well into her second trimester. She was given no anesthesia or

    According to the National Abortion Federation, vacuum aspiration
    procedures are normally performed on women who are up to 14 weeks
    pregnant. After 14 weeks, a more complicated procedure, known as
    dilation and evacuation, is standard.

    “A suction abortion is not appropriate at 20 weeks,” said Vicki Saporta,
    president of the federation.

    Angela P.’s experience was cited in a 2004 medical board accusation
    against Rand as “barbaric” and a “severe departure” from a reasonable
    standard of care. Rand surrendered his license in 2005.

    Rand was one of at least six doctors with histories of malpractice
    complaints, addiction or medical board actions who were employed by a
    chain of Southern California abortion clinics, according to court and
    medical board records.

    Now Bertha Bugarin, 48, who authorities say manages the clinics, has
    been charged with practicing medicine without a license on five patients
    in February and March 2007, according to a statement from Los Angeles
    County Dist. Atty. Steve Cooley’s office. Her sister Raquel Bugarin, 49,
    is accused of helping with the procedures. Both have pleaded not guilty.

    The two sisters were arrested last summer, but a protective order filed
    in the case has made information difficult to obtain. Bertha Bugarin’s
    attorney, Rickard Santwier, declined to comment, as did her sister’s
    attorney, Christopher Chaney.

    The prosecutor, Deputy Dist. Atty. Carolyn Nakaki, would not discuss the
    case or details of the sisters’ connection to the clinics.

    A fictitious name statement from 1991 filed for the business lists
    Bertha Bugarin as the person behind Clinica Medica Para La Mujer de Hoy,
    although paperwork filed with the medical board lists Nicholas Braemer,
    a Torrance doctor who lost his license in 2000, as the sole registrant
    of the clinics between 1991 and 1999.

    The clinics, which according to an associate of BerthaBugarincatered
    primarily to low-income Latinas, operated in several Southland

    Cooley’s statement refers to offices in Baldwin Park, Huntington Park,
    Los Angeles and Panorama City, operating either under the name Clinica
    Medica Para La Mujer de Hoy or Community Women’s Medical Clinic. Public
    records contain references to four more locations, in Chula Vista, North
    Hollywood, Torrance and Santa Ana. One clinic doctor said in a
    deposition for a 2002 malpractice suit that there were nine clinics.

    Since the early 1990s, at least 12 personal injury and malpractice
    lawsuits and one wrongful death suit have been filed in Los Angeles
    County against Bertha Bugarin, the clinics or both. The defendants in
    the suits denied most of the allegations.

    At least six of the 13 cases ended in settlements or judgments against
    the defendants, according to court records and attorneys. The records of
    one case have been disposed by the court, and another case was dismissed
    when the plaintiff failed to hire an attorney or show up for a status
    conference. In the remaining cases, resolutions were not clear from the
    court files, and several attorneys involved in the lawsuits said they
    didn’t recall the outcomes.

    According to a letter from Bertha Bugarin’s accountant contained in a
    court file, Bugarin developed the clinics herself, hiring the doctors to
    work on an on-call basis.

    Bertha Bugarin was arrested Aug. 1 and released on $500,000 bail. Her
    sister was arrested Sept. 6 and released on $100,000 bail. Each could
    face up to six years in state prison if convicted.

    Some doctors associated with the clinics have had repeated problems with
    the medical board. Braemer, the Torrance doctor who appears on some
    public records as owner of the clinics, admitted to the board in 1994
    that he performed an abortion in 1987 that removed only one arm of the
    fetus. The patient expelled the rest of the fetus the next day.

    The board put Braemer on probation for five years, but then accused him
    at least three times of violating the probation terms, which included
    only performing abortions in approved facilities. Clinica Medica was not
    an approved facility under his probation terms.

    In 1999, the board accused Braemer of leaving a fetus’ cranium and
    placenta inside a patient during a 1996 abortion at the Panorama City

    The woman eventually spent a month in a Torrance hospital having her
    bowel repaired and multiple abscesses drained, the board said.

    Braemer surrendered his license in 2000, after a medical board
    investigation of several Clinica Medica clinics. Without a physician
    present, unlicensed receptionists performed ultrasounds on undercover
    investigators posing as patients, according to medical board records. In
    the board’s record of the surrender, Braemer also admitted gross
    negligence in the 1996 abortion. Braemer could not be reached, and calls
    to several of his former attorneys were not returned.

    Other doctors who performed abortions at the clinics include:

    * Torrance-based Mohamed Dia, who surrendered his license in 1999. He
    admitted to the medical board that he used a van to bring a bleeding
    patient to a hospital after perforating her uterus and leaving part of
    the fetus in her body during a 1996 abortion at Clinica Medica.

    * San Diego-based osteopath Laurence Reich, who surrendered his license
    in 2006 after pleading no contest to misdemeanor criminal charges of
    sexually exploiting two patients during abortions in 2000 at clinics not
    associated with Bugarin. His conviction was expunged in 2004 after he
    completed a yearlong probationary period and paid the court a $100
    restitution fine, according to a Van Nuys court file.

    One of the patients, Sherman Oaks resident Yvette Chambers, 43, said in
    a phone interview that Reich groped her breasts and asked explicit
    questions during an abortion at a Van Nuys clinic.

    An earlier board accusation in 1982 had accused Reich of sexual abuse in
    three cases in 1981 and 1979. Reich asked the women to masturbate and
    rubbed their genital areas, according to the accusation, which led the
    board to put Reich on probation for 10 years until 1994. Reich could not
    be reached for comment, and his attorney, Santwier, declined to comment.

    * Santa Monica-based Glenn Edward Miller, an admitted alcoholic whose
    license was revoked by the medical board in 2005 due to repeated

    stance abuse relapses. Miller was on probation for performing
    obstetrical procedures while under the influence of alcohol when he
    began working in Bugarin clinics in about 2003, according to board

    That same year, Miller and Rand settled a malpractice lawsuit filed by a
    woman who said they gave her an abortion at a non-Bugarin clinic in 2002
    even though she was not pregnant, rupturing her uterus in the process,
    court records said. Miller could not be reached for comment.

    * George Dalton Flanigan, who was hired as an independent contractor at
    five Bugarin clinics in 2002, according to court documents. That same
    year, at an unnamed hospital, he delivered a dead baby using a vacuum
    procedure after refusing to perform a cesarean section, according to a
    board accusation that led to a 2007 decision to put him on probation for
    five years. Both Flanigan and his former attorney Arthur Selesnick
    declined to comment.

    Times staff writer Daniela Perdomo contributed to this report.