The Great Unspoken Necessity: Madame Restell and the World of Abortion in Nineteenth Century America

To be a poor immigrant in mid-nineteenth century New York was to be a creature almost entirely at the mercy of mammoth social forces and fickle chance. Immigration from Ireland in the wake of the Potato Famine and from Germany following the unrest of 1848 had packed the city with more men and women than there were jobs or apartments to sustain them, a positive boon for industrialists who found that they could reduce wages to near starvation levels and still have plenty of willing workers with whom to staff their factories, but which created a thick soup of misery for everybody else. 

This was a hard enough world for a man to live in, but for a woman it was an exercise in almost constant anxiety. Given that birth control methods were at best inaccessible due to the wall of silence that the medical establishment and society had erected to keep women from knowing about their bodies, and at worst were out and out scams peddled by charlatans, each sexual encounter carried with it the distinct possibility of pregnancy, a pregnancy that was in and of itself potentially deadly for both child and mother in the age before antiseptics were routine in the delivery room, and even if the delivery were survived by both, what followed for the new mother was a litany of seemingly unanswerable Hows. How will we find the money to feed and clothe this child? How will I find somebody to care for it when I go back to work, because I have to go back to work? How will I afford that somebody? 

Looking around at other women in her position, the new mother would see that there were nothing but bad answers to be had - some dropped their children off at children’s centers where the odds were high that they would not live out the month, and others simply used drugs to keep their children in a regular stupor for the ten to fourteen hours they would be at work. While the upper and middle classes could moralize about the virtues of motherhood, safely insulated from its consequences through layers upon layers of money, for the dwellers of the city’s packed tenements, a new pregnancy was a dangerous and frightening thing, and they availed themselves of any number of methods to avoid that barrage of Hows that they had no ready answers to.

While all medicine during this era was largely unregulated, with doctors earning degrees simply on the strength of having paid an institution to give them one, abortion services represented a fundamentally clandestine space which, decade by decade, had to adjust its strategies as waves of pragmatism and moralism swept over the nation. In this arena of apothecaries peddling abortion pills of various lethality, and doctors performing abortions in back rooms and cellars, a practitioner of both conscience and competence represented something of a beacon of hope to the serially pregnant and destitute, and one name for four decades topped the list of those who could be depended on to do a professional job with maximum discretion, whose very name became, and remains, synonymous with the figure of “the lady abortionist” - the woman known as Madame Restell (1812-1878). 

Madame Restell lies at the intersection of a rich host of mythologies - legends she made up about herself, slanders concocted by her enemies, and guesses constructed by her contemporaries in the absence of solid facts about where she came from and where she learned her craft. She portrayed herself as a physician trained in the best French traditions, but that was all of a piece with the loose world of 19th century medical marketing, where fanciful origin stories and broad claims were so pervasive as to be expected. In fact, Restell was born Ann Trow, in Gloucestershire, in 1812. Her father worked at the local wool mill, and her education was likely a minimal one. She was sent off at 15 to be a domestic servant for a butcher and his family, and the regular grinding labor required likely made her in later years the generally generous and understanding employer that she was. 

For a girl of poor family, with limited education, the only real way out of household drudgery was marriage, and at the age of 16 Ann Trow took this step, marrying Henry Sommers, a tailor. This would have been a good match - tailors had a skilled trade that was in relatively constant demand - but unfortunately this particular tailor was an alcoholic who let more and more of the business slide onto his wife’s shoulders. They had a child in 1830, and the next year the small family boarded a boat for New York, where, so rumor had it, the demand for skilled labor was so intense that you would have to actively work diligently not to get rich.

One harrowing boat ride later, the Sommers family found, like so many before them, that the rumors of easy prosperity could not have been more mistaken. Life for an immigrant in the New York of the 1830s and 40s was a chancy thing - there were always more workers than available jobs, and more bodies than beds, and establishing something like a bare minimum of existence was granted only to the lucky or clever few. 

Fortunately, Ann was both of these, gifted with a deft and skilled mind, and perhaps more importantly, with a shrewd business sense that intuitively knew a promising profession, and how to employ advertising to elbow aside her competition. Her family took up residence on Chatham Street, a booze-soaked, prostitution-rife neighborhood where she struggled, like so many others, to turn a profit on the strength of her sewing needle, but was fortunate enough to be offered a way out of that uncertain life by her association with her nearby neighbor, Dr. William Evans. 

Evans was a pill compounder, which meant a wide variety of potential things in 19th century America. Some, perhaps most, pill compounders were simple flim flam men, selling sugar pills as Miracle Medicine, but others were conscientious medical practitioners doing their best with the information they had, and Evans was likely one of these. Ann learned from him, and turned towards manufacturing one of the most popular pill types on the market, those aimed at getting rid of unwanted pregnancies. Her products contained ingredients effective enough to produce a rich crop of repeat customers, but not so extreme that they did permanent damage to their users. In fact, for all of her years of operation as a manufacturer of pills and abortionist, we do not have a single confirmed case of a fatality caused by her operations, a phenomenal enough result in modern medicine, but an almost unworldly level of success for that place and time.

These were years of rapid self-invention. Ann’s first husband died in 1833, and in 1835 she married the free-thinking Charles Lohman, who would be a steady supporter in the decades to come, but was likely not the mastermind of her business empire as contemporary writers, unable to fathom the idea of a woman running a successful business, often claimed. The pair did, however, likely collaborate on coming up with Ann’s marketing persona, Madame Restell. Unlike Ann, the British household servant turned seamstress, Restell was a sophisticated medical practitioner, trained in Vienna and Paris, inheritor of a familial tradition of medication production, itself surrounded and supported by the French reputation for excellence in the ways of forward thinking family control. 

Now as Madame Restell, Ann leapt into the exciting world of medical advertising. This was a battleground of words and ideas that Restell had an instinctive mastery of. There were other individuals advertising abortion pills in the pages of the age’s newspapers, but they overwhelmingly attempted to hide what their products were behind the fig leaf of allusions and euphemisms. Restell would have none of this. Let others advertise their pills as treatments for “female irregularity”, whatever that meant, she would tell her customers exactly what her pills were for and what they did. While others tried to hide their occupation, Restell proudly proclaimed hers, shoving essays into her advertisements about the societal benefits of allowing women to have some manner of control over their reproductive destinies. 

Were large stretches of these essays cribbed unrepentantly from the pages of Robert Dale Owen (1801-1877) and his 1831 work Moral Physiology? Sure. Was that common practice of the era? Absolutely. Most importantly, to newspaper readers of the era, these essays and ads assured them that in Madame Restell they had a medical professional who understood their troubles, and was not ashamed of offering her experience to help them in their hour of need. Restell’s products soon topped the market, shoving aside longer established but more circumspect practitioners of the craft. Over the 1830s, Restell’s door was the destination of choice for young men and women in a desperate situation (or those in an affluent situation eager to avoid scandal), whom Restell would start on her pills and, should they provide insufficient, or if the pregnancy was too far along, she would then offer her medical skills as an abortionist.

Business was good, and Restell was soon easily recognizable on the streets of New York for the splendidness of her carriage and the richness of her fashion. She was an indispensable personage, one who, far from taking the abuse of the city’s morality purveyors in abashed silence, struck back in literary salvos of her own, supported by a cast of colorful journalists and newspaper owners who reveled in the profitable chaos she created. Of course, this only encouraged some newspaper owners to select Restell as a target precisely because they knew she would respond, making them more famous as a result, but by and large those figures came and went without creating permanent waves in the serene progress of Restell’s ascent to the ranks of the city’s wealthiest individuals. 

The triumphant procession of the 1830s, however, soon ran aground on the crackdown on abortion practitioners that swept New York in the 1840s. Newspapers eager to end what they saw as the civilization-ending trend of women controlling their reproduction latched onto some high profile cases involving botched abortions, and used them to whip up momentum for larger scale bans on abortion throughout the state. Restell weathered a series of lawsuits against her in the early years of the decade, when providing abortion was legally a misdemeanor offense, but when a new law was passed in 1845 that categorized abortion past the stage of “quickening” as manslaughter, Restell was in real danger of going to prison. 

Just because a law was passed, however, didn’t mean that women suddenly stopped needing Restell’s services, and she, believing in the importance of her work and enjoying the lifestyle brought in by the fees she could charge thanks to her reputation and record of success, continued to operate more or less as she had before. She was duly brought to trial in 1847, convicted, and sent to prison, though her status as a member of the city’s wealthy elite meant that her experience was generally a comfortable one, with a private room, nice sheets, and plenty of visitors, good food, and reading material. 

Returning home from prison, Restell picked up more or less where she left off, and would not seriously curtail her activities as a producer of pills and performer of abortions until her “death” in 1878. In the intervening years, her wealth grew to profound levels, allowing her to comfortably pay far too much to buy a plot of land just to spite the priest of a nearby Catholic church who had made it his business to rail against her from the pulpit and who dearly wanted the land for himself, and then to build a sumptuous mansion upon it which she wanted to be a new social hub for the city, but which largely just attracted members of the newly rich who did not yet have social reputations to care about losing. 

Meanwhile, she was a complicated figure for the nascent women’s medical movement to grapple with. Theoretically, as a well-paid medical practitioner with a sterling record for patient safety and satisfaction, she could have been an exemplar to hold up for how women could succeed in the medical profession. In actuality, she was an eternal thorn in the side of women like Elizabeth Blackwell or Sophia Jex-Blake who were seeking to broaden women’s access to medical education in the mid 19th century. Papers proclaimed that women who had a medical education would just go on to be new Madame Restells, allured by the easy cash to be had, and deadened to the moral consequences of their actions. The example of Restell gave the medical community the ammunition they needed to publicly and persistently block and bemoan any attempts at expanded women’s access to medical universities or hospitals, and as a result it was a rare female physician indeed who was willing to publicly come to the defense of Restell and what she did.

How much the distancing of her fellow women medical professionals from herself mattered to Restell during these years of plenty it is difficult to say, but she would soon have larger problems to worry about in the form of America’s self-appointed morality czar, Anthony Comstock (1844-1915). This was a man who expanded his shame at his own urge to masturbate into a national campaign against sexual immorality that consumed the lives and careers of countless individuals. The law passed in his name in 1873 gave him oversight of the US mail system, allowing for the arrest of anybody who not only sent birth control methods through the mail, but anything even mentioning the subject of birth control, or female biology, at all. His goal was to keep women in perpetual ignorance of their bodies and options as a way of preventing them from sinning against the natural order as he conceived it, and Restell was a natural target of his wrath.

Using the technique of entrapment, he was able to create grounds for her arrest. The moral fervor whipped up by Comstock ensured that Restell had a difficult time finding people who would publicly come to her aid and post bail, and the prospect of prison loomed large for the now sixty-five year old woman. According to one story, the stress of the proceedings, and the certainty that she would be returning to jail, caused her to take her own life on April 1, 1878, slitting her throat in her bathtub, to be found by a servant, and hastily buried by her family. And that might have been what happened, but another version of the story goes like this: realizing that she was going to be convicted, and that America under Comstock was no longer a place she could live and work, she tapped into her deep financial resources to bribe a few officials, procured a stand-in body, and, with the help of her grandchildren, who were devoted to her steadfastly, faked her own death while escaping to France to live out the rest of her life, comfortable and undisturbed. 

I know which version I want to believe, and there is a decent amount of evidence for the faked suicide plot (her body was later dug up and said to look nothing like her, the method of death was a brutal one for a medical woman who would have known of more pleasant means, later individuals testified to meeting her in France, and so forth). No matter what version you take as canon, she distinctly disappears from the history books in 1878 as a public individual, but lives on to this day as an example, for some of the wickedness of abortion and those who practice it, and for others of the deep medical needs unique to women which have come hard against civilization’s drive to legislate the options that women in desperate situations possess, calling into existence individuals like Madame Restell, skilled in their craft, disdainful of the callousness of society, and willing to operate in the shadows to provide necessary services for a segment of the country whose hardships amounted to little or nothing in the columns of the press and the halls of the lawmakers. She did something she thought was a social good, made a lot of money doing it, and if she ended her days sipping champagne in Paris, far from the struggles that consumed her life for four decades, well, she more than earned the right to it.

FURTHER READING:

Jennifer Wright’s recent (2023) biography of Madame Restell is likely going to be the go-to text for a while now. It is deeply researched, with fascinating glimpses into the war of words waged between abortionists in their advertisements, and between abortionists and anti-abortionists in the era’s newspapers. It is also incredibly engaging in its writing style, with a steady thrum of jaunty irreverence which still conveys the seriousness of the book’s central themes. More technical is Nicholas Syrett’s book (also 2023) focusing on Restell’s trials and the abortion laws of the era, while the earlier biographies by Keller (1981) and Browder (1988) are still pretty easy to find used editions of if you are looking for a blend of secondary sources. 

This has been the 288th entry in the Women In Science Archive series.