She chose the name because it sounded French. When she took out her first newspaper ad, in 1839, she wanted to cultivate an air of mystery and sophistication. In time, her pseudonym, Madame Restell, would be furnished with a backstory for the women who arrived at her office door. The Madame, they were told, had been trained in Europe, at the continent’s famous lying-in maternity hospitals. She’d been taught by her grandmother, a French midwife, and her “preventative powders” had been used in Europe for decades.

None of it was true. The woman her clients knew as Madame Restell had been born Ann Trow, in rural England, grown up in poverty, and never received any formal medical training. But these origins were supposed to be comfortingly credentialled to Restell’s customers, the women who made her into one of the wealthiest—and most notorious—businesswomen in New York City. They came to her seeking abortions.

“The Trials of Madame Restell,” a new book by Nicholas L. Syrett, a gender historian at the University of Kansas, traces Restell’s nearly forty-year career as an abortion provider in nineteenth-century New York, and the rapid changes in the medicine, morality, and law of pregnancy that shaped it. Syrett’s meticulously detailed account comes on the heels of another biography, “Madame Restell,” written by the popular historian Jennifer Wright, which evokes the moral stakes of Restell’s very public life. Together, the books offer a portrait of a formidable woman navigating an era that, in several important respects, bears an unnerving resemblance to our own.

Abortion in 1839 looked a lot like it does today. Then, like now, most abortions occurred during the first trimester. Like now, many were achieved not with surgical procedures but with medicines. And, also like now, in a growing number of jurisdictions, abortion had recently become illegal. New York State passed its first criminal abortion ban in 1829, a decade before Restell began her practice, making it a felony to perform a later abortion and a misdemeanor to induce an early one.

New York was one of several states that introduced prohibitions on abortion in the opening decades of the nineteenth century. Midwives had long performed abortions with the same regularity with which they attended births, and abortion was not necessarily understood as different from birth control. In part, this was because it was sometimes difficult to tell if a woman was pregnant at all. In a time before pregnancy tests, early pregnancies existed in a state of ambiguity, when a missed period could mean any number of things. In the new age of criminalization, providers like Restell did a brisk traffic in emmenagogues, a then popular class of drug intended to “restore” the menses—abortifacients with plausible deniability built in.

From her home office at 148 Greenwich Street—then a cramped and unglamorous neighborhood, now a glassy office building across the street from the September 11th memorial—Restell sold emmenagogues in the form of pills, powders, and tinctures. Her practice would eventually include manually induced miscarriages, along with a range of other midwife services. She treated S.T.D.s, sold various kinds of contraception, and frequently provided for the discreet delivery of illegitimate babies.

But, at the beginning, Restell seems mainly to have been selling concoctions she made herself. She worked from a repertoire of ingredients like pennyroyal, ergot, oil of tansy seed, and turpentine resin. Some of these, such as ergot, worked by stimulating contractions in the uterus; others, like turpentine, were little more than glorified poisons, designed to make a woman so ill that she would miscarry. Dosage was critical: if too little of the active ingredients were taken, they wouldn’t be effective; if too much, the patient could die.

These treatments had long been available from midwives. What was novel was their emergence as a commodity in mass commerce. By the time Restell began her practice, urbanization and mass print media had revolutionized the business of medicine. Suddenly, abortion drugs could be obtained not just from trusted local women but from strangers in the anonymous city, people who knew they would never see their customers again. This new market of medical providers contained few credentialled experts and a large constituency of quacks. Often their products did nothing; sometimes they were deadly.

Part of Restell’s early success appears to have been due simply to the safety of her products. Both Syrett and Wright note that no patient of Restell’s ever died as a result of one of her abortions. The quality of her work helped her gain the trust of her clients. It also helped her avoid conviction, as the new abortion laws were rarely enforced against providers unless their patients died. Her skills meant that—at least for a while—she could evade New York’s abortion ban.

Another reason for Restell’s popularity was her unusual boldness. Despite the high demand for abortion, practitioners were usually secretive. Contraceptives and emmenagogues were advertised in newspapers, but the bulletins tended to be written in code. One professional rival of Madame Restell, a midwife who called herself Mrs. Bird, marketed “Female Renovating Pills.” Others were so cautious that they used asterisks in place of the letters for words like “menses,” “pregnancy,” and “abortion.” The idea was that savvy women would read between the lines. Restell did not play these word games. In an ad from May, 1839, she advised readers of the Sun that her “FEMALE MONTHLY REGULATING PILLS” were an effective treatment for all cases of “stoppage of the menses . . . from whatever cause produced.” She also noted that she could be “consulted with the strictest confidence.” Readers had little doubt as to what she was selling.

Restell was no mere opportunist; she genuinely believed in abortion. This much is clear from “To Married Women,” an essay-advertisement that functioned as a manifesto for her practice. “Is it not but too well known that the families of the married often increase beyond the happiness of those who give them birth would dictate?” Restell asked in one version, published in 1840. “In how many instances does the hardworking father, and more especially the mother, of a poor family remain slaves throughout their lives?” Abortion and birth control, she reasoned, were not sins but ways to cultivate health and human thriving. “Much of the suffering, misery, wretchedness, and vice existing around us can be attributable to our ignorance of the capacity granted to us for a wise end to control, in no small degree, our own destinies,” she wrote.

Advertisements like “To Married Women” brought Restell infamy. The new tabloid press made outrage at her practice a recurring theme in its pages. The Sunday Morning News called her a “notorious pander to the profligate,” in 1839. George Washington Dixon’s Polyanthos wailed, in 1841, “Madame Restell tells your daughter how she may defile her body and debase her mind without fear or hesitation.” Moral indignation, in these diatribes, mixed with prurient speculation about all the illicit sex that Madame Restell’s abortions must have been enabling. Part of what caused the scandal, according to Syrett, was Restell’s “steadfast refusal to admit that she was doing anything wrong.”

Another kind of woman might have responded to her detractors with dignified silence. But that was not Madame Restell; she flourished under hostile confrontation. Syrett writes that “Restell regularly addressed New Yorkers via the press,” responding to her critics with detailed rebuttals. At the end of each dispatch, after enumerating why everyone who criticized her was wrong, she would reiterate to readers that she was open for business. Interested parties could inquire at her office, 148 Greenwich Street.

Despite the flurry of bad press—or because of it—Restell’s business boomed. But the attention also made her a target of the law. The early-nineteenth-century state of affairs, in which abortion was illegal but de-facto tolerated, relied upon discretion, plausible deniability, and carefully maintained pretexts on the part of all parties involved. Providers could perform abortions—what they couldn’t do was flaunt it. But a midwife like Restell, who courted publicity, upset this delicate balance. In August, 1839, just months after she began advertising, Restell faced her first arrest. She would spend the better part of the next decade in and out of New York’s criminal courts.

At first, Restell dodged conviction, escaping imprisonment through a combination of procedural technicalities and the favorable testimony of witnesses. She could afford to spend extensively on aggressive lawyers. But judges who arraigned Restell frequently denied her the customary right to post bail, meaning that she had to spend humiliating stints in New York’s infamous jail complex the Tombs.

In the nineteenth century, when a character had premarital sex, you held your breath not for an abortion but for a wedding. Think of “Pride and Prejudice,” where Lydia’s child marriage comes as a great relief. The marriage plot relegates the actual having of children to the last page, just after the rice is thrown and the reader assured that our heroine will be happy and rich. If great Western literature of the time does allude to abortion, it does so subtly or with plausible deniability. The first time I read “War and Peace,” I managed to miss the suggestion that Hélène died of an overdose of abortifacient drugs. In “Middlemarch,” when Rosamond goes horseback riding against the explicit wishes of her doctor husband and subsequently miscarries, Eliot hastens to explain that this was a “misfortune” and that “there were plenty of reasons why she should be tempted to resume her riding.”

Of course, plenty of nonfictional women in the nineteenth century were having abortions. In the U.S., at least, contraception was crude, childbirth was dangerous, food was expensive, and abortion before quickening—the moment when the fetus is first felt to move—was less legally controversial than it is now, though also apparently less likely to be named outright. (Euphemisms included “taking the trade” and “restoring the menses.”) American literature took a while to say the unsayable. Writing students today still learn about understatement from Ernest Hemingway’s “Hills Like White Elephants,” a brief conversation between two lovers who refer only to “an awfully simple operation” that will “let the air in.” In 1917, Edith Wharton dipped a toe in the abortion plot with “Summer,” a novel about a young woman named Charity who visits a money-hungry doctor for an abortion—the actual word is never said—before quickly deciding that “it was impossible to tear asunder strands of life so interwoven.” Keeping the fetus would typically doom Charity to a life of poverty and prostitution, but, at the last minute, Wharton saves the day by marrying her off to her foster father.

By the nineteen-fifties, abortion was not only named in literature, but debated at philosophical length. In Saul Bellow’s “The Adventures of Augie March” (1953), the question is whether or not life in general is worth living. “You don’t know how lucky you are,” Augie’s pregnant roommate imagines saying to her aborted fetus. “What makes you think you would have liked it?” In Richard Yates’s “Revolutionary Road” (1961), Frank Wheeler describes the moment that he persuades his wife, April, not to abort her first pregnancy as his life’s greatest “proof of manhood.” But he is unable to convince her that she shouldn’t abort her third. “Don’t ‘moral’ and ‘conventional’ really mean the same thing?” April asks, a few weeks before she dies of an at-home abortion. Yates gives us April’s calm preparations: her boiling of the syringe, her writing down of the hospital’s phone number. But we are not privy to the ins and outs of the abortion itself: Yates draws a decorous curtain around the rest of the scene.

In the following years, the literary taboo on putting a desexualized vagina on the page would weaken, notably with the portrayal of a diaphragm fitting in Mary McCarthy’s “The Group” (1963) and a tampon insertion in Doris Lessing’s “The Golden Notebook” (1962). McCarthy’s scene, first published as the short story “Dottie Makes an Honest Woman of Herself,” is famous not only as literature but as sex education: in “Goodbye, Columbus,” Philip Roth’s young protagonist explains that, though he’s never before procured birth control, he has “read Mary McCarthy.”

“Cleaned Out,” Annie Ernaux’s 1974 fictionalization of her own illegal abortion, points to the lack of an equivalent literary handbook for abortion, even as it is one. Denise, the well-read protagonist, has her feet against the wall with a tube deep inside her; every hour she does scissor movements to bring on the abortion. Nothing she’s read up to now seems to offer any guidance. “There is supposed to be a prayer to suit every occasion,” she laments. “There should be one for a girl of twenty who’s just had a backstreet abortion, what she thinks as she comes out, walks home, and throws herself onto her bed. That one I’d need over and over again.”

“January,” by the Argentinean author Sara Gallardo, is just what Denise wanted to read, though the novel—which was originally published in 1958, never translated into French and appears only now in English, is unlikely to have reached Ernaux. It was, however, influential in Latin America: Gallardo went on a book tour to Chile, Peru, Mexico, and Cuba. Argentinean feminists, who in 2020 won the right to legal abortion nationwide during the first fourteen weeks of pregnancy (a slightly more restrictive line than the one at issue in Dobbs) still reference “January” as a turning point in the nation’s consciousness. Gallardo, a writer of terrifying intelligence, wrote the book when she was in her early twenties.

Our unlikely hero, Nefer, is a sixteen-year-old living under feudal conditions in rural Argentina. Dimly, she recalls being raped at her sister’s wedding: having dolled herself up to impress Negro, a milk-monger who takes no notice of her, she was instead taken, crying, into the woods by a drunken older man. (In Argentina, “el negro,” pronounced with a short “E,” can be a friendly way to refer to a man with darker hair or skin.) Now Nefer is stuck between the childish delusion that the pregnancy will somehow make Negro love and marry her and the desire to get rid of the thing “growing inside her like a dark mushroom.”

The abortion plot frequently uses months or seasons to locate a pregnancy along a symbolic time line of unwanted ripening. (Consider Wharton’s “Summer,” or Yates’s April, or the protagonist of the movie “Never Rarely Sometimes Always,” who is eighteen weeks along and named Autumn.) Here, January—summer in the Southern Hemisphere—represents Nefer’s last chance to interrupt the seed’s growth. Soon it will be harvest time, and “there’ll be no turning back.” Nefer, who for most of the book is unable to remember the word “abortion,” nevertheless attempts to induce one several times. In the horse-centric culture of the Pampas, her first idea is to gallop hard. This failing, she sneaks out during the siesta to visit the local witch doctor but, once there, finds herself unable to ask for what she wants. “People have told me that my characters don’t fight for anything, that they are defined by inertia,” Gallardo said in a 1977 interview with the Argentinean novelist Reina Roffé. “They just know that one can’t fight against adversity or a broken heart.”

Gallardo herself was not so powerless. Born in 1931 in Buenos Aires into a storied lineage of intellectuals—her great-great-grandfather, Bartolomé Mitre, was a President of Argentina—she spent much of her childhood surrounded by books. At twenty-one, against the wishes of her father, she declared her intention to write for La Nación, one of the country’s leading newspapers. She married twice and had four children, including one who died very young. “Motherhood was so important,” she later said, “that it made the arrival of the book seem like a plain fact.” She died at fifty-six, of an asthma attack, leaving behind a body of work that has recently enjoyed a revival in the Spanish-speaking world. Her fiction includes “Los galgos, los galgos,” a novel of decadent love that has not yet been translated into English, and “Land of Smoke,” a collection of dystopian stories, whose blasé violence and clipped lyricism are a clear influence on the contemporary Argentinean writer Samanta Schweblin. Among American writers, Gallardo has been compared to Lucia Berlin or Shirley Jackson, two writers whose work is also undergoing a posthumous reëvaluation.