Drawing of abortionist Ann Lohman (a.k.a. Madame Restell) based on a photograph, 1888. (Photo courtesy of Amcaja at en.wikipedia)   It is hard to find an anti-choicer today who will acknowledge that when abortion was illegal it was a widespread practice. That’s just pro-choice propaganda, we’re told: laws matter—and besides, people were more moral back then. Ha! Considering that in 1800 the American fertility rate was seven children per woman, and by 1900 it was less than four, it is hard to see how else that decline could have happened, given the primitive nature of nineteenth-century birth control and the popularity of sex. In fact, as James Mohr, Leslie Reagan, Linda Gordon and other historians have established, abortion was extremely common in the nineteenth century, especially among married, middle- and upper-class white women, who resorted to abortion when they’d had all the children they could handle or their bodies could bear. Abortifacients with euphemistic names like Uterine Regulator and The Samaritan’s Gift for Females were advertised in newspapers, sold in drug stores and available through the mail. In most states, ending a pregnancy was more or less legal before quickening—the moment when the pregnant woman feels the fetus move, usually in the fourth or fifth month—until after the Civil War. New York State was an exception: there, abortion, unless deemed necessary to save a woman’s life, was outlawed in 1828. In 1845, it was made a crime to even seek one. But these laws were widely ignored. In the 1870s, The New York Times estimated that 200 abortionists were practicing full time in the city.   Most abortionists were midwives, and the most famous, or infamous, of these was Ann Lohman, a k a Madame Restell, “the wickedest woman in New York.” Originally a poor immigrant from England, Restell performed abortions, delivered babies and ran a thriving trade in contraceptives and abortifacients, with branches in Philadelphia and Boston, from the late 1830s until the late 1870s. Although the popular press attacked her regularly, mobs stormed her offices and at one point she was put on trial, Restell and her husband, who was also her business partner, became immensely wealthy, eventually building a castlelike mansion on Fifth Avenue and 52nd Street. They were unashamed: Restell enjoyed shocking her proper neighbors by driving out in her fancy carriage, dressed to the nines. Eventually due to the tireless efforts of the anti–birth control and anti-“obscenity” crusader Anthony Comstock, who posed as a customer seeking contraceptives, she was arrested—and this time the charges were ironclad. Restell slit her throat in the bath the morning her trial was supposed to begin.

It has taken more than 100 years for Madame Restell to find a champion, but Kate Manning’s rich and vivid novel based on her life is worth the wait. Told as an autobiography secretly written by Axie Muldoon, a k a Madame DeBeausacq—orphan, housemaid, midwife and abortionist—My Notorious Life portrays its slum-born heroine as a defender and savior of women from the horrors of Dickensian poverty, male privilege and their own physiology. Manning’s descriptions of childbirth are gruesome—Axie’s beloved mother dies of hemorrhage and fever after a harrowing delivery: “She paced and squatted and lay down again. Long sounds like the bellows of a cow came from her throat. I stood terrified and useless, watching where she lay in her dark corner.” The scenes of abortion are only a little less agonizing—these were the days when a stiff glass of whiskey was all you got for anesthetic while the practitioner, who had not washed her hands, worked her sharp, unsterilized instrument into your uterus. It took a long time, and if you flinched, you could bleed to death.

For Axie, abortion is woman’s weapon of self-defense against cruel social values. Men control everything: money, property, law, religion, education and the all-powerful double standard of morality. Men determine whether a woman lives in respectability or is thrown into the streets, indeed whether she lives or dies, because it’s not as though men refrained from sex with their wives just because another pregnancy could kill her. Axie learns early to “never trust a man who says trust me.” (It’s in the context of male promiscuity and sexual entitlement that one should see the suffragists’ interest in woman-controlled abstinence, or “voluntary motherhood.” To us, they seem prudish, but having sex cautiously and rarely sounds better when the alternatives include marital rape, being worn to a frazzle by a large brood of kids and a considerable risk of permanent injury or death.)

Men controlled medicine, too: in the 1860s and ’70s, doctors were battling midwives for control of female patients, and accusations that midwives were ignorant, lower-class bunglers were an important part of their brief. In fact, as the medical texts Axie devours make clear, medical men believed a lot of nonsense, like that pregnant women could get something called “milk leg,” caused by breast milk collecting in the lower extremities, and that higher education made women infertile. And it’s not as if the doctors washed their hands, either. Or were interested in taking care of the prostitutes, starving slum dwellers and wayward middle-class daughters Axie helps for little or no money.

Any tale of an adventuress with a notorious life needs a broad social canvas, and Manning does a splendid job with old New York: the stink and filth of crowded Five Points tenements, the bric-a-brac-crammed homes of the nouveaux riches, the giddy excitements of a housemaid’s night out on Broadway. Axie’s manuscript is dotted with wonderful slang—bungstarter, larrikin, cupshot—and curious euphemisms, like “monosyllable” for a woman’s privates. My Notorious Life belongs on the shelf with other novels of the female picaresque, a sturdy genre that includes Moll Flanders and Fear of Flying. And in true picaresque spirit, Axie escapes the sad fate of Madame Restell. That dead body in the bathtub is a look-alike. Comstockery may seemingly triumph—we are not done with it yet—but like the spirit of female independence and resistance she embodies, Axie will live to fight another day. n

The war on abortion providers goes on to this day. As Katha Pollitt wrote in September of this year, Dr. Ann Kristin Neuhaus, a colleague of the murdered Dr. George Tiller, has been targeted by anti-choicers, and she needs our help.