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While new medical technologies will prevent a return to the days of women dying from coat-hanger abortions, a zealous, well-organized antiabortion movement meansthat many more women will probably land in jail than they did in pre-Roe America. The horror stories of the pre-Roe era, replete with women trying to self-abort with coat hangers or going to inept and unethical “back alley butchers,” have become the stuff of myths, repeated ever since 1973 as cautionary tales by abortion supporters (while minimized by abortion opponents). The reality, however, was far more complicated. Illegal though they were, abortions were common, especially in the years immediately leading up to Roe. Some have estimated at least 1 million abortions per year took place in those years — a number, notably,that is higher than the one for 2014, the most recent year we have data.(The decline in abortions has been driven byboth innovations in contraception and increasing restrictions on abortions). Those abortions were not all back-alley affairs: There were also “doctors of conscience,” well-trained individuals driven to provide illegal abortion by compassion, not greed. Who had access to these doctors was often shaped by race and class. Women with means were more likely to know a reputable physician who would quietly perform an abortion, or to be able to travel to places where abortions were available. The “abortion committees” in hospitals, which greenlit only a limited number of abortions, overwhelmingly favored doctors’ private patients over those poorer women who came to hospitals’ clinics. As a result, poorer and minority women suffered the majority of very real horror stories.As one person, who had been a medical resident in the 1940s in Harlem, told me with a sigh, “I have taken everything out of the human vagina that one could imagine ever fitting in there.” We will never know the exact number of women who died from illegal abortion attempts, but some researchers have put it as high as 5,000 deaths per year. Many thousands more were injured, often losing their fertility. Strikingly, even as abortions peaked in the pre-Roe period, the number of prosecutions (and convictions) of either providers or women who sought their help remained quite low.This low prosecution rate stemmed from two factors: Hardly any women filed complaints against abortion providers, and when a provider was on trial, juries were often reluctant to convict. But this would probably change if the court reverses course on abortion rights. The Center for ReproductiveRights lists 23 states, mainly in the South and Midwest, at “high risk” of banning abortion. Assuming that even a handful of them follow through, millions of women will have to travel to other states should they decide to have abortion. That will be true even short of a complete overturn of Roe. A Supreme Court with five justices skeptical of a constitutional right to abortion will allow even more cumbersome restrictions on the practice than already exist.