The year is 1906. Birth control and abortion are both illegal. What’s a girl to do?

This is the backdrop for my second novel, The Lesser of Evils (working title), exploring this fascinating period of history through the life of Hannah Isaacson, my protagonist, one of the first obstetricians in New York City.

These books are what I now read. Other than my book club selection for the month, my spare time is spent researching the period Hannah lived. It was the earliest years of medicine as we now know it – doctors integrated the harsh lessons of the Civil War, stricter requirements for medical school admission were emerging and not surprisingly, the most sophisticated of the pack – the nurses, kept it all together. After Florence Nightingale revolutionized nursing education and training, they were the ones who safeguarded patients. And, aren’t they still?

It was before antibiotics, but surgeons found alternative ways to kill bacteria. Yes, they had discovered bacteria – otherwise referred to as germ theory and knew it was a major cause of surgical death. They knew germs and disease could be carried in the air and transmit tuberculosis. They knew clean hands (or at least what they viewed as clean) were necessary for medical providers. It was after ether and chloroform were used as anesthetics.

This brings us to the economics of medicine. Once obstetricians began using anesthesia during childbirth, women flocked to the hospital to give birth. They’d had enough pain. Where did that leave the midwife? Overzealous midwives began performing abortions closer to midterm – that’s when medical disasters rose. Performed in home clinics under less than optimal conditions, midwives took big risks, struggling to hang onto their livelihoods.

Instead of falling asleep at night with sugar plum fairies dancing in my head, I imagine the frustrations of suffragette pioneers like Margaret Sanger who fought to make birth control available to women, to the pre-professional realm of midwives, who were both the norm and learned their trade through apprenticeship, and the acceptance of abortion by society as a means to control unplanned pregnancy and the ever-growing poverty in the cities. Yes, for most of the 1800’s, even the churches did not view ‘unblocking’ as a crime – as long as the mother didn’t perceive movement. Can’t believe it? Check one of my reference books above.

It was a very different time.