The "back alley butcher" is the dominant image that has been used--by both supporters and opponents of abortion--to describe abortion providers in the pre-Roe era. the term is often used synonymously with "criminal abortionist." These phrases, used to refer both to medical and lay providers, evoke greedy, incompetent, and exploitative individuals, who often injured their patients, sometimes sexually abused them, and occasionally, due to their ineptness, even killed them. Along with its other dominant symbol of the "bad old days"--the coat hanger, which represents the lengths women would go to in attempts at self-abortion--the pro-choice movement has used the figure of the "butcher" as a warning of women's vulnerability when abortion is illegal. Neither the coat hanger nor the butcher are invented symbols. Women did in fact try to abort using hangers (among many other similarly dangerous objects), and we have ample accounts of women's harrowing encounters with butchers, both lay and physician. Indeed this book at numerous points adds to the documentation of both the incompetence and the dubious ethics of those who offered illegal abortions before Roe.

But such butchers/criminal abortionists were only one aspect of a more complex reality that formed the culture of illegal abortion. Abortion before Roe also drew the attention of another category of physicians, those I refer to as "physicians of conscience" in contrast to the butchers who had medical degrees, these physicians of conscience were not incompetent medically (and hence unable to function in mainstream medicine), did not appear to have performed . . .