Apollo On Call

It’s well known that in the 1980s and 90s, following China’s implementation of the One-Child Policy, a surplus of orphaned Chinese girls became available for adoption. Many were adopted by well intending American households. What’s less well known is that this surplus of orphans eventually created market conditions for the trafficking of Chinese girls, at least some of whom were forcibly removed from their homes.

Barbara Demick explores the consequences of China’s One-Child Policy, its relationship to the trafficking of Chinese babies, and the overall picture of women’s reproductive rights in modern China in Daughters of the Bamboo Grove. 

Join Luki Danukarjanto and me on this month’s Apollo On Call, as we discuss Barbara Demick’s fascinating look at the process of having babies in China.

Web image by Medhum.org

In 2019, a prominent obstetrician/gynaecologist in Toronto was found guilty of administering intravaginal medications to his obstetrics patients for the purposes of inducing labour without consent. He was subsequently dismissed from his position at the hospital and his career ended. The story was covered in detail in an exposé published in Toronto Life magazine. 

The details of the case are lurid. In the modern age, most obstetricians do group call. Gone are the days when an expectant mother would have both her prenatal care and delivery done by the same physician. Newborn babies are wont to arrive in the world at any given moment, and the traditional obstetrician who drops everything they are doing to attend these deliveries, often in the middle of the night and often with a full day of office work the next day, is all but extinct. Obstetricians now share call duties with a team of physicians. Now, when you sign up with a certain obstetrician, there’s no guarantee that that specific doctor will be the one to deliver your baby, only that someone from their group will be doing the delivery. 

In Ontario, obstetricians are paid more for delivering babies on weekends than they are on weekdays. It’s a nice little reward for doctors who usually work long and unpredictable hours. But in this one hospital, the obstetrics department began to notice that one of their staff had a propensity for babies being delivered predominantly on weekends and evenings and began tracking the matter. 

In time, they discovered that this doctor was inserting tablets of misoprostol into the vaginas of late term pregnant patients in order to induce labour on specific days that were to his advantage, often when the date in question was a weekend. Misoprostol has the ability to induce contractions and is often used in medical abortions. It is not considered to be a medication safe to use in pregnant women to induce labour on command. Needless to say, the patients did not give informed consent for the procedure, nor were they offered the option to decline.The doctor in question was a prominent member of Toronto’s Chinese Canadian community. He had a reputation for being a doctor to the rich and chic. Famous Hong Kong celebrities flew to Canada to have their babies delivered by him and my own patients flocked to him in droves. 

In Toronto, getting a referral to a community obstetrician of choice to deliver your baby is like trying to get your child into an elite private school–no doubt, these actions are often being done by the same parents, just a few years apart. Obstetricians have a set number of expectant mothers they can carry for any given month and once that quota is exceeded, they can’t accept any more patients. In those years when I first started working as a family physician, Chinese immigrant women in my community knew to race to our office as soon as they suspected they were pregnant, so as to get into the front of this doctor’s queue. They were then told by the obstetrician’s office that they were expected to pay a three-hundred-dollar administrative fee in order to guarantee this doctor would be present for the delivery, which they gladly paid.^⁠1 

At the time, it seemed reasonable. Three hundred dollars and your doctor would buck the modern trends of group call and shared team duties and promise to come in on his night off to personally deliver your baby. It all seemed legitimate and altruistic, a call back to a simpler time. If only. 

When the story broke, there was the expected furor in the local medical community. Certainly, the salacious nature of the case, the prominence of the doctor in question, the #MeToo movement which was also taking place around this time, gave the story its pull. 

In the local Chinese community, the story had buzz as well. Toronto, with its large Chinese-speaking population, has several Chinese daily newspapers and the story made headlines in the local Chinese newspapers and filtered its way through all of us. It felt like everyone’s mother had heard of this doctor; he was that well-known. 

As I spoke to patients and friends and colleagues, I discovered so many people around me had had their children delivered by this doctor in the preceding decades. As they reflected on their obstetrics journeys, the stories were all the same. Yes, it was true, many of their babies had happened to arrive on a weekend. Yes, the labour started soon after an assessment, right on schedule and with what had seemed like fortuitous timing at the time. Now, in retrospect, it all seemed fishy and possibly sinister. 

But one thing that I noticed was that this doctor’s actions were met with largely a collective sigh of indifference by the Chinese Canadian community. The lack of outrage most people had towards the story felt odd. Remember, this story was occurring near the height of the #MeToo movement. The idea of a doctor administering intravaginal medications without consent should have, in the West, been seen on the level of battery. At the very least, I expected people to think of it as a violation of a woman’s body. But in the Chinese community, amongst the population that knew this doctor the best, the reaction was muted. Most of his patients that I encountered shrugged off the story. When the subject came up, they were quick to point out to me that he was an outstanding doctor who had helped many people and were disappointed to hear that the doctor was no longer practising. 

In China, women’s reproductive rights is an issue with a thorny history, especially over the last several decades, most of which I was oblivious to until I started working with my own patients. 

The most blatant and obvious reproductive rights issue is China’s One-Child Policy, which ran from 1979 to 2015. During these years, families in China were limited to having only one child, except in special circumstances. The One-Child Policy was formulated in response to the Chinese government’s fear of overpopulation. 

In my naive understanding of China, I was taught the official narrative, that people who had more than one child were subject to higher rates of taxation, and it was the punitive toll of this taxation that kept parents in line. 

But the truth was more complex. What were people’s expectations about birth control? What happened when people didn’t agree with the government’s policy? What happened to people who had an extra child on purpose? What happened if they had a child accidentally?  

When I started working, I soon noticed that all middle-aged women from mainland China had intrauterine contraceptive devices implanted in their uterus. Mostly, they had had these devices placed after delivering a baby years earlier. In many cases, these IUCDs had been present in these patients’ uterus for so long that many of them often forgot to mention it to me, only informing me about the presence of these devices sometimes when they were in their late fifties or early sixties, long after the device had ceased to perform any useful function. Often times, we’d discover that these devices were present during a routine ultrasound, and the patient would remember that yes, they had been wearing an IUCD for so long that they had simply forgotten about it–it had simply become a part of them. This wasn’t an entirely benign situation. The longer an IUCD remained in, the greater the chance it would slowly embed into the tissue of the uterus. Albeit rarely, there are case reports of it rupturing the uterus of women after decades being left in. 

Even after I realized that so many of my patients were wearing IUCDs, I still didn’t fully understand what this meant. I had in my mind envisioned the Western model of women’s reproductive care, that the mother had informed her obstetrician in China at some point after the delivery that she would have an IUCD inserted because yes, she was certain she didn’t want to have another child for a few years. I envisioned a long conversation where a medical professional gave the patient a series of options about contraceptive care. Did the patient want an IUCD? Or maybe to try the birth control pill? Or did the patient want to use natural family planning methods? It was only gradually that it dawned on me, that these were conversations we only had in the West, not conversations women had in China. They weren’t given the option of having an IUCD inserted. They were simply told what to do, or had it done unto them. 

But my women patients didn’t seem bothered by this. They never expressed outrage at having an IUCD. It was again, the collective shrug of indifference. It wasn’t that different than being told that they had to pay taxes. Or have a mandatory retirement age. It was just another curious aspect of life in modern China.  

I couldn’t envision what it meant for a society to exist where a government somewhere could decree that all women would be forced to have a copper intrauterine device placed in their uterus upon having a baby, whether they liked it or not, and that it would remain in place indefinitely. It seemed even more preposterous that almost all the decisions said government made were made by men–the Chinese Communist Party is well known for being almost exclusively male at its highest levels. 

The actual IUCDs that the patients wear bear mentioning also. In North America, IUCD devices like the Copper-T, or Mirena, are little metal or plastic objects that are inserted into the uterus, with a trailing piece of string that dangles out of the uterus. The device itself prevents either ovulation or implantation of the embryo, depending on the IUCD in question. The little piece of string is designed to allow the device to be removed easily in a doctor’s office, where a doctor can tug on the string with a pair of forceps and remove the device. 

In China, the IUCD device is inserted without a string, making it deliberately more difficult for people to remove, even with proper medical equipment. 

As a result, many of my patients, after decades of wearing the IUCD, found that the device could not be easily removed. Canadian-trained gynaecologists, used to the simplicity of tugging on a piece of string and changing the IUCD every four or five years as per the manufacturer’s instructions, couldn’t always remove the Chinese IUCDs. Sometimes, it was because the Canadian-trained gynaecologists didn’t have the practice grabbing IUCD’s without the string. At other times, it was because the device had been put in place so long ago that it had shifted position and could no longer easily be removed. Some of my patients had to go under general anesthesia to have the device removed. Others got on airplanes and flew back to China to get the device removed there by the experts. All of this, I gradually realized, was part of the long-term consequences driven by China’s One-Child Policy. 

For a more detailed discussion of the One-Child Policy, see Barbara Demick’s Daughters of the Bamboo Grove. Demick, an L.A. Times journalist, chronicles her two-decade odyssey to help reunite an American-raised Chinese adoptee named Esther with her birth family in China. Esther was abducted as a two-year-old and then trafficked to an orphanage during China’s international adoption industry heyday in the early 1990s. As it turns out, she has a twin sister, Shuangjie, who stayed with her birth family and the story provides a fascinating case study of the entire issue of women’s reproductive rights and the issue of international adoption. 

In the book, Demick lays out China’s One-Child Policy and its ramifications on the grassroots level, where neighbourhoods were policed by local government family planning offices. These units were akin to local mafioso-like organizations, gangs of thugs who were given carte blanche by the local governments to cajole, threaten, and beat people into towing the party line. And, to top it off, they weren’t above kidnapping the children who violated the government’s restrictions on family planning. 

When it comes to the One-Child Policy, there is a tendency for us as Westerners to discuss it as tomfoolery–a straightforward story of failed macro-economic policy, that the One-Child Policy was short-sighted and hastened China’s likely imminent economic decline. And while this narrative may be accurate, it only scratches the surface. The reality of what happened to people on a personal level is much more complicated. 

As Demick describes it, in the nineties, the One-Child Policy essentially created the market conditions for international adoption and the trafficking of kidnapped children. It isn’t a huge leap of logic to understand that the One-Child Policy begets well-meaning people from the West wanting to adopt babies from China and being willing to pay good money to do so. Once money is involved, human traffickers realize that if they can get good money for babies, then all they need to do is to get more and more babies. Now, cue the kidnappings and forced baby abductions and we get to where we were. It’s a frightening cycle, which only illustrates yet again how economic policy can trickle down to the level of the individual in thousand-fold ways. 

There’s another aspect to Chinese family planning worth pointing out here, which is the desire to have more male children. The Chinese culture is by no means alone in this. Historically, many groups around the world prized boys over girls. In China, the reasons for this have long been established. Traditionally, Chinese culture has long placed an emphasis on families having male heirs. According to Chinese culture, family lineages pass through sons, and daughters are raised but then handed over to other families when they marry, unable to continue lineages of their own. At its most basic level, this meant that your son could look after you in your old age but your daughter couldn’t. 

Growing up as an immigrant in Canada, I accepted that the preference for boys over girls was probably one of those older, primitive world views that Chinese people held in the past, but, like binding women’s feet, surely not something anyone still believed in modern times. After all, I had grown up in a North America where women voted, moms were entering the work force en masse, and dual-income households were becoming more and more the norm. I took it for granted that modern people everywhere would value boys and girls equally. 

And while I had read in books about the gender imbalance in China, about how the One-Child Policy had created a nation with a surplus of boys over girls, I took it as just another example of primitive, traditional Chinese thinking, something from the old world, not something that I would have to deal with directly as a doctor in Canada. 

So imagine my surprise, when in my early years of practice, patients started approaching me, forcing me to confront some of these gender issues head on. 

One patient, an older woman who was already the mother of multiple girls, discovered that she was pregnant again. At the eighteen-to-twenty-week ultrasound, to her disappointment, she discovered that she was having a girl, again. A few weeks later, despondent, she came to my office, asking for a referral for an abortion. She explained to me that she wasn’t primitive or old-fashioned. Indeed, she wasn’t against having girls per say. But she already had so many that it seemed fair that she really didn’t want another one. 

By this point in the pregnancy, she was already precariously close to the twenty-four-week cutoff for late term abortions. In Canada, abortions past twenty-four weeks aren’t allowed. Would it be possible for me to change her estimated date of confinement to so that she could squeeze in just within the 24 week window?^⁠2 I refused to do this, and she ended up returning to the clinic multiple times in the next several weeks, each time suggesting that, telling us in fact, that she had remembered her last menstrual period date wrong. And that if we used her revised calculation, her current pregnancy actually fit in the twenty-four-week window. Needless to say, I did not acquiesce and eventually this patient drifted out of my practice. I never did find out what happened to her and her family of girls. 

Fortunately, not all the stories are so odd. Some patients from China have told me that they were pleasantly surprised to discover that in Canada, at the eighteen-week ultrasound, doctors could reveal the gender of their future children to them if they wished. Finally, they could prepare for the upcoming birth of their child knowing what colour to paint the child’s bedroom and what colour clothes to buy in advance. In China, I was told, this information was kept strictly confidential because the government was afraid that people would go looking for abortions if they found they were pregnant with a girl. 

Of course, now the situation in China is flipped. After decades of the One-Child Policy, China suddenly finds itself facing an economic slowdown, the prospect of an aging population and a more educated working class that wants no part of having more children. More and more young people in China are choosing not to even marry, not to mention start families. 

In a twist of dramatic irony, those same family planning units that harassed women for decades into having less children, have suddenly been tasked with the job of encouraging increased reproductive rates. 

What will the Chinese government do when it’s time to raise its low birth rate? What will it do when it realizes it can’t convince its citizens to get pregnant more readily by offering tax incentives? After all I’ve seen and experienced, it’s something I don’t even want to think about but could be just around the corner. 

I’ve long struggled to understand this concept of just how powerful the Chinese government is and how much impact it is able to have on its citizenry. Because my grandparents fled China after the Civil War in 1949 and my parents grew up in Taiwan under martial law, I’ve always had a bird’s-eye view of how Chinese politics can affect the lives of everyday people. I have an aunt who I’ve never met because she didn’t make it out of China in 1949 and became separated from our family–she wouldn’t see my father, her brother, for almost forty years. In recent years, I’ve read countless books about government reforms in China. I saw how China handled Covid-19 in the news. I’ve visited China and seen the gleaming new buildings and multi-lane superhighways humming with electric vehicles. But none of it has spoken to me as loudly as this collective shrug of indifference that I’ve encountered from my patients when it comes to women’s reproductive rights. 

Sometimes, I wonder what the psychic toll of a person doing something they don’t really want to do might be. What if they’re forced to get a tattoo that they don’t want? Or forced to cut their hair in a certain way? 

What if they’re forced into a marriage they don’t want? Or forced to have a baby they don’t want? Or forced to give the baby away against their will? 

They don’t even have the option of agreeing to any of these things. What if these actions are just done to them whether they like it or not? 

But then what about this: what is the psychic toll if they’re to wear an IUCD for the next thirty years, whether they would like to or not? 

What’s the toll if they’re given intravaginal misoprostol so that their baby can be born on an auspicious day? 

What’s the toll if they’re given intravaginal misoprostol so that an obstetrician can deliver the baby on a day convenient for him? 

If all of these decisions are simply made for a person by an aggressive husband, we’d call it abuse and everyone would be screaming bloody murder. But if these decisions are decreed by an even higher authority, an all-powerful political party or an all-seeing authoritarian government, then what? Would everyone just accept it as just another cultural fact of life, like using chopsticks instead of a fork? It seems like they would. 

To hear further discussion about Barbara Demick’s Daughters of the Bamboo Grove, have a listen to my discussion about it on Apollo On Call, the podcast of medhum.org. 

1. In Canada, health care is publicly funded but doctors can charge fees for services not covered by the public health care system. This can take the form of administrative fees as well as fees for certain medical and surgical procedures that the government health insurance doesn’t cover. 
2. The estimated date of confinement is the projected due date for a pregnant mother. It can be calculated as 40 weeks from the date of the pregnant woman’s last menstrual period, or estimated using prenatal ultrasounds. 

Web Image by Medhum.org and Fred Moon 

Additional Chapters from A Chinese City Doctor’s Notebook

When Your Body Isn’t Yours 

01.12.26 788

From Tigers to Otaku

09.16.25 1661

The Happiest Couple

07.28.25 1403

The Things We Don’t Talk About When We Talk About Dying 

05.13.25 1981

Soto explores his uncertain status in relation to his family, and to the larger society in “You’ve Gone Too Far.” Detailing the “evolution” of his siblings and cousins, who “were no longer Mexican rednecks,” but “held down jobs” and “stopped jamming parking meters for free time,” Soto describes how his family nevertheless feels uncomfortable about him. “My family feared that I had evolved too far.” Drunken Christmas horseplay with his brothers reveals their distaste and distrust of his intellectualism and sophisticated clothes. “They tore my book in half, / and stripped me of my Italian belt.” Only when they have succeeded in making him sick/drunk do they accept him (at least temporarily) back into the family fold. The poem illustrates well the difficulties that can arise when one member of a family elects to live life differently from the rest yet wants to maintain a relationship with its members. The situation has resonance for the children of immigrants, for children who are more educated than their parents, or for anyone who has chosen a life unfamiliar to family or friends.  

“TV in Black and White” focuses on the role of television (in the 1950s/1960s) in shaping, reflecting, and failing to reflect American society. Soto remembers his childhood in which “[we] were sentenced to watch / the rich on TV …”. Sitcom characters played golf, ate steak, and dressed fashionably (the Donna Reed Show, Ozzie and Harriet). “While he swung / we hoed / Fields flagged with cotton . . .”  

Now life is for many relatively luxurious, “Piano lessons for this child, / Braces for that one — “ “But if the electricity / fails in this town, / a storefront might / be smashed /” “and if someone steps out / with a black-and-white TV, / it’s because we love you Donna, / we miss you Ozzie.”  

Soto’s critique is still relevant today. The ubiquity of television and streaming, even in low-income households, confers enormous power on the images and narratives presented. Now there are many more options for viewers of different cultural and economic backgrounds. Yet the dominant culture still exerts a major influence. The gap between representation and reality continues to be an important source of social dissatisfaction and unrest. 

Gary Soto 
https://garysoto.com/
https://www.poetryfoundation.org/poets/gary-soto#tab-poems

Mexicans Begin Jogging
Online: https://www.zocalopublicsquare.org/by-gary-soto/  
New and Selected Poems, Chronicle Books, San Francisco, 1995, p. 51

You’ve Gone Too Far 
Published in Junior College, Chronicle Books, San Francisco, 1997, p.24

TV in Black and White 
New and Selected Poems, Chronicle Books, San Francisco, 1995, p.50

Web image by Jr Korpa 

The latter decision unarguably constitutes a significant setback in the struggle for reproductive rights for American women, but the history of access to abortion—and a sense of what the future might hold—may best be understood by taking the long view, across cultures. In Pushback: The 2,500-Year Fight to Thwart Women by Restricting Abortion, historian Mary Fissell does just that. Starting with the story of an enslaved woman in ancient Greece who becomes pregnant after being hired out as a prostitute by her enslaver, Fissell presents a series of case studies. Each one illustrates how women continued to have abortions through the centuries despite changing mores, laws, the influence of the church, and the irregular availability of experienced or qualified providers. The stories also demonstrate a pattern: as women gained more social and economic freedoms, the laws governing abortion became more restrictive, with the pendulum eventually swinging back in the opposite direction to a more liberal stance on abortion.

The enslaved woman in ancient Greece would likely have faced no moral sanction for seeking an abortion—her value lies in her continued availability as a sex worker, and, in her case, a singer. Documents suggest that women in her position would have had the knowledge to end her pregnancy, most likely with an herbal abortifacient, though squatting, jumping and sneezing were also recommended methods of preventing pregnancy immediately after sex. In ancient Rome, the focus on controlling fertility was somewhat different; Roman women had greater freedoms than their Greek sisters, raising concerns about adultery, which Augustus declared as a criminal offense. With  a focus on increasing the number of upper-class Romans who would rule the growing empire, controlling the fertility of elite married women was one way to achieve this end.

Leaving antiquity behind, Fissell nimbly guides us through the Middle Ages. In an era where Christianity is on the rise, and the issue of ensoulment is linked to the experience of quickening (when the pregnant woman first feels the fetus moving), the story of Brigid of Kildare was recorded. Brigid, a holy woman whose historical existence cannot be confirmed, was said to have helped a young woman miraculously end her unwanted pregnancy (a subsequent miracle attributed to Brigid helped a woman preserve her chastity).  The Church’s codified position on abortion was still more than 500 years away and for many of these early Christians, discussions of ensoulment notwithstanding, concerns around abortion as a means of covering up illicit sex appear to have weighed more heavily than any harm to the fetus.

In early modern Europe, in some parts of the continent, abortion had become a capital crime punishable by execution, a development that reflected “a larger cultural shift that sought to control female sexuality in the interests of Church and state.”  The story of Anna Harding who went on trial in 1618 was a case in point. Against the background of a witchcraft panic, Harding  admitted to providing both married and unmarried women with herbal and floral preparations to end their pregnancies. A “confession” under torture to having consorted with a demon led to Harding’s conviction and being burned at the stake. 

Indeed, herbal preparations to end unwanted pregnancies were common to societies as disparate as enslaved women in the Caribbean, who used abortions as an act of resistance, to Victorian women of all classes who sought abortions for many of the same reasons as women do today. Use of one of the herbs best known to induce abortion, pennyroyal, persisted up through the early 20^th century, although not without risk to the pregnant woman.

By this time, the idea that life begins at conception had gained a greater hold in the United States. Hugh Hodge, a professor of medicine at the University of Pennsylvania, argued this “scientifically-based” premise as early as 1839, while the Pope’s 1869 declaration that life begins at conception would have been presented as divine revelation, though Fissell posits that concern on the part of European monarchs in Catholic countries worrying about depopulation and “degeneration” may well have influenced the pronouncement.

The story of Beatrice J, a Baltimore woman, who safely achieved two self-managed abortions in the 1940s through the aid of a catheter and ergot pills to induce uterine contractions, serves as a more modern example of women who had ended a pregnancy going on to administer abortions to others. In Beatrice’s case, after her trusted pharmacist helped set her up as an abortion provider, an undercover police operation exposed her practice. A trial followed, but charges were ultimately dismissed by a progressive judge on the basis that the “client”  who visited Beatrice was not actually pregnant.

In addition, Fissell points out this was not an isolated example by any means. Even in the most restrictive settings and time periods, there appears to have been a fair amount of  tacit acceptance.  In the U.S., for example, “Physicians performed legal abortions for a variety of indications, and the rest, so-called criminal abortions, went largely unremarked. In the 1920s and ‘30s, abortion providers were rarely prosecuted, whether physicians or not, and the former were at risk only if a woman died.” Moreover, once antibiotics and blood transfusions became available in the 1930s and 1940s, the morbidity and mortality associated with these procedures would have been reduced.

The presence of abortion providers who practiced under the radar persisted throughout the ‘30s and early ‘40s, albeit with some providers using their own judgement as to who was morally deserving of their covert services.  But the 1940s and 1950s also brought a more punitive attitude toward abortion in the United States. With an increasing number of arrests of providers administering safe abortions, dangerous practices became more widespread, as did abuses by practitioners, including sexual assault on clients. In turn, these tragic stories led to the underground movement of women and their allies who supported those in need, including the Jane Collective in Chicago, a group of women who risked criminal prosecution to help others obtain safe abortions. 

While the individual stories of women seeking abortions constitute the throughline of Pushback, Fissell consistently addresses the broader factors that affected access in each of the societies she describes, including eugenics, racism, nativism, and concerns about fidelity and heredity. Enslavement and labor demands, the appropriation by physicians in the 19^th century of care that was formerly the domain of midwives, and superstitions linking women’s fertility to fertility of livestock and crops, also come under scrutiny, as does the relatively recent shift of emphasis from the importance of the life of the mother to that of the fetus.

Readers might also consider the role of medical advances as factors that have altered our understanding of pregnancy, development of the fetus, and access to abortion. Among them was the development of simple urine tests that eliminate the uncertainty surrounding pregnancy, a means of confirmation light-years away from those early societies where pregnancy was confirmed by quickening. Sophisticated imaging of the fetus via ultrasound not only confirms pregnancy at an early stage, but packs an emotional punch. Moreover, the availability of medication through pharmacies and online sources for self-managed abortions, while under threat, has created a new landscape for pregnant women. This last means of obtaining an abortion, though formulated in a laboratory, suggests a new iteration of the herbal abortifacients used by so many generations past.

Pushback succeeds at being both highly readable and meticulously researched—the volume includes an extensive list of notes and references for each chapter. Fissell, who is the Inaugural J. Mario Molina Professor in the History of Medicine at Johns Hopkins University, also writes the Substack A is for Abortion: Snapshots from the Past. As a pre-modern historian of the 17^th century, she particularly enjoys the kind of “detective work” that accompanies that study. But she was also pleasantly surprised by how much she enjoyed researching and writing on the modern period, where sources are more readily available, including data she found through Ancestry.com.

Fissell completed her manuscript before the start of the second Trump administration and aside from allusions to Roe v. Wade and Dobbs v. Jackson, Pushback does not explore the ways in which abortion became a flashpoint in our most recent national elections. (A description of politically motivated anti-vice campaigns that targeted abortion practitioners and pregnant women in the late 1940s and 1950s is included in the chapter dealing with that time period.)

But in a discussion with this writer, Fissell weighed in on current data that shows more American women than ever are having abortions despite the 2022 Dobbs ruling. “Restriction has an impact and makes abortion much more difficult and dangerous to access,” she said. “But it never stamps it out.” She also cited data that suggests roughly 66% of Americans think abortion is a decision that should be made between a woman and her doctor.  

Interestingly, Fissell did wonder at the onset of her research for Pushback whether she might change her mind on the issue. In the end, she describes holding the same views as when she started.  “Given that abortion was often shameful and secret if not [completely] illegal, I was amazed by how much I was able find out.” Her appreciation for insights from the reproductive justice movement deepened considerably as well, as it informed her understanding of women in earlier societies and the use of the term “choice,” then and now, for women in untenable circumstances.

“[Choice is] something a white woman with money can afford to have,” Fissell said. “Choice [does not apply to] a struggling waitress in a small Southern town who was raped and has two kids at home, and her wages won’t even cover their care…Casting the decision as choice means we don’t understand many women’s experiences.”     

Pushback by Mary Fissell was published by Seal Press (2025).
Web image by Medhum.org.