(Image source: VICE)

In January of this year (2025), the state of Louisiana indicted Dr. Margaret Carpenter. Her offense: prescribing mifepristone (an abortion medication) to a resident of that state. In the wake of Dobbs v. Jackson (2022), Louisiana has imposed a near total ban on abortion, offering no exemptions for cases of rape or incest. It treats abortion medication as “controlled dangerous substances.”

What makes Dr. Carpenter’s case notable is that she is based in New York State—where abortion remains legal—and from there runs a reproductive tele-healthcare service dedicated to helping “patients from marginalized and vulnerable communities” who are living in “abortion deserts.” In other words, she serves people from parts of the United States where abortion is now illegal. Currently, Louisiana is seeking to extradite Dr. Carpenter who might face imprisonment, hefty fines, and the loss of her medical license. New York State is refusing to comply with this extradition order.

This case, with its jurisdictional issues, is bringing abortion providers and those who oppose them into uncharted legal waters.

This is not the first time, however, that the fight for reproductive freedom has connected Louisiana and New York. Two weeks after Louisiana indicted Dr. Carpenter, Dr. Horace Hale Harvey III—one of that state’s native sons—passed away at the age of 93. Between 1969 and 1971, abortion seekers traveled–first from New York to Louisiana and then from Louisiana (and indeed dozens of other states) to New York–seeking Dr. Harvey’s medical services.

Thinking about Dr. Carpenter’s current case alongside the pre-Roe moment, when Dr. Harvey provided abortions, is like watching a reverse motion film. Then, as now, the status of abortion was changing rapidly but from illegal to legal. Like now, there were medical deserts where abortion could not be accessed and a few oases of medical provision. But the deserts were shrinking, not growing. Then, as now, women had to travel great distances and often at great expense to reach providers in places like New York and California. Those costs and distances, however, were diminishing, not increasing.

It was against this transitory backdrop that Dr. Harvey offered illegal abortions in New Orleans, not because he was seeking to make a profit, but out of a commitment to reproductive freedom. He helped thousands of women over a two-year period and nearly lost everything.

Dr. Harvey’s decision to offer abortions was rooted in his religious and philosophical commitments. While pursuing his medical degree at Louisiana State University in the early 1960s, Harvey was deeply involved with the Student Christian Association and was the director of adult education for the New Orleans YMCA. These mainline Protestant organizations—aside from offering fellowship and recreation—exposed Harvey to a range of progressive causes including civil rights and reproductive rights.

Mainline Protestants—as in Presbyterians, Episcopalians, United Methodists, among others—were vocal in these years about the Christian duty to separate sex from reproduction within marriage. Support for contraceptive access among the mainline was nearly ubiquitous, and there was a rising tide of support for abortion access. While Harvey attended LSU, it was not uncommon for lay and religious speakers alike to speak at college campuses in favor of sexual responsibility and sexual freedom, not just between married couples, or even straight couples, but between all loving partners. Such talks—which emphasized responsible decision making while affirming the goodness of sexuality—were typical of an era when campus chaplains helped students ethically navigate changing sexual mores.

After receiving his M.D. in 1966, Harvey pursued a Masters in Public Health and a Ph.D. from Tulane University. It was there that Harvey began his work in earnest on sexual health issues. Dr. Harvey’s public health training led him to think about sexual problems on a systemic level. He believed that an epidemic of “ignorance concerning sexual matters” was causing widespread “grief and misery.” To allay this misery, he sought to create an educational and practical resource for everyday people, the Community Sex Information and Education Service (CSIES). Founded in 1969, CSIES was a free telephone hotline staffed by medical and psychological professionals, as well as religious and lay counselors. Its purpose was to allow “adults regardless of socio-economic background… immediate help on all problems of a sexual nature.”

In his quest to educate the public about sexual health, Dr. Harvey’s group distributed sex education materials on a number of college campuses across Louisiana. Doing so raised eyebrows but also garnered media attention and publicity, which the group welcomed in its efforts to reach those in need of information and assistance. CSIES also sent out a survey about sexual practices to thousands of Louisiana college students in an effort to understand and meet young people’s informational needs. One of these needs was information about where to get a safe and affordable abortion.

Even without this survey or the CSIES hotline, it would have been hard for Harvey to have missed the urgent demand for abortions around him and the dangerous state of abortion care. Louisiana newspapers regularly carried stories about illegal abortion rings and botched abortions, many from unskilled, expensive, and shady providers.

Early on, Dr. Harvey believed that sexual knowledge was the precondition for sexual and reproductive choices. Or as he put it, “people can usually make their own decisions if they can obtain the information necessary.” But it quickly became clear to him that sexual information needed to be matched with safe and affordable medical resources. Sometime in 1968 or 1969, Dr. Harvey began providing low-cost abortions out of a suite of offices in a downtown New Orleans hotel.

There was a huge demand for such abortion services and precious few doctors willing to provide them in the United States. Physicians who provided an illegal abortion risked imprisonment, disbarment, and hefty fines. Put slightly differently, Harvey jeopardized his career, livelihood, reputation, and even his freedom.

Harvey’s reputation of providing affordable and safe illegal abortions grew quickly and put him on the radar of the Clergy Consultation Service on Abortion (CCS). This interdenominational religious group devoted itself to helping women access safe and affordable abortions—both illegal and legal—from licensed medical providers. One New York City minister later described Dr. Harvey as knowing, “more about medical techniques in abortions than anyone in the country” and as “a man of high social conscience, who worked out a scale of modest fees scaling down to zero.”

To protect itself and its clients from legal risks, the CCS only worked with licensed physicians. The CCS did not know that Harvey had lost his medical license sometime in 1969. The historical record is patchy about the circumstances surrounding Harvey surrendering his license to the Louisiana State Medical Board. There were no headlines about police raids or botched abortions. Indeed, there is no evidence suggesting that Harvey was anything less than impeccable in his medical technique or his treatment of patients throughout his career. The historical record only shows that the forfeiture of his license came from violating Louisiana’s strict abortion laws. Like other physicians of conscience from that era, Harvey risked his professional standing in order to improve the lives of abortion seekers.

Whether it was out of shame, ambition, or pragmatism is unclear, but Harvey kept quiet about the fact that he was no longer able to legally practice medicine. Had this fact come to light, the CCS would have immediately ended their relationship with Harvey. What is clear is that Harvey continued providing illegal abortions while looking for ways to help abortion seekers on a structural level.

The opportunity to do so arose in early 1970 when New York State legalized abortion. Harvey and his colleague Barbara Pyle approached the New York City branch of the CCS with a proposal to build a legal, freestanding abortion clinic, the first of its kind in New York. Harvey and Pyle had carefully studied and taken inspiration from reproductive healthcare provision in England, which had legalized abortion in 1968. The clinic, they proposed, would serve CCS counselees from across the United States as well as New York City residents. And the mode for delivering this reproductive healthcare, Harvey underscored, would care for “the total person” rather than just terminating a pregnancy. Counseling, sex education, and aftercare were all part of the vision. To this day, abortion clinics use similar models of reproductive healthcare.

The very reasons that CCS clergy utilized Harvey’s illegal abortion services—his compassion, his skills, and his commitment to offering affordable and holistic treatment—caused the clergy to agree to this plan. Harvey provided the seed money to buy medical equipment and establish the clinic, which came to be known as the Center for Reproductive and Sexual Health (CRASH). The day abortion became legal—July 1, 1970—CRASH opened its doors on East 73rd Street in New York City.

Because New York State did not have residency requirements, abortion providers there were deluged with patients from across the United States and Canada. New York’s Health Department reported that 88,000 women from 48 states traveled to New York between July 1 and December 31 of 1970.

An oasis in a vast medical desert, CRASH was inundated with patients who needed relief. Abortion seekers, unable to afford a hotel room, camped out with their sleeping bags, staying in doorways or sleeping in their cars in midtown Manhattan until they could get their procedure at CRASH. “We all had been through illegal abortions, so everybody felt that they would do anything to help the patient,” remembered CRASH counselor Sabra Moore. A “number of people were taking patients home,” she wrote, “Everyone was overdoing it, because we had the feeling that this was her only chance.”

From Dr. Harvey’s perspective, counselors like Moore were vital to enacting a holistic reproductive healthcare agenda. Harvey prioritized hiring and training these female counselors, many of whom had ties to the women’s liberation movement and many of whom had experienced the hardship of obtaining an abortion before legalization. Anne Barry, who worked at CRASH as a counselor, recalled that Harvey “gave us group and individual instruction…We learned about the procedures, about birth-control methods, sterilizing techniques…We learned how best to express our own feelings to patients and to listen to theirs.”

At other facilities across New York state, abortion was far costlier. Many New York hospitals charged upward of $500 for abortions. At first, CRASH charged $200. Within a year, CRASH dropped the price to $150 and then to $125. The clinic charged indigent patients even less: a nominal fee of $25. Whereas private hospitals and other clinics actively resisted working with Medicaid recipients, CRASH welcomed these patients. In a path-setting initiative, the clinic applied for Medicaid reciprocity for out-of-state patients. As a result of these efforts, women from states where abortion was not yet legal, such as Alabama and Mississippi, could have their medical costs covered at Dr. Harvey’s clinic.

Harvey’s time at CRASH was influential but short. In late 1970, less than six months after he arrived in New York City, his professional status came to light. A routine vetting of the clinic by the New York Department of Health uncovered Harvey’s lack of medical license and the fact that he continued to provide abortions. The revelations jeopardized the certification of the clinic and its very ability to stay open. To protect CRASH, Harvey resigned in January of 1971. CRASH’s records, contemporaneous sources, my interviews with the staff, and newspaper coverage do not suggest that Harvey himself faced imminent arrest or prosecution. Officials seem to have wanted to resolve the issue quickly and quietly.

Hale Harvey left the United States in early 1971. He moved to England and eventually settled on the Isle of Wight, a small island off the country’s southern coast. There, he raised a family and devoted himself to a range of social causes including affordable housing.

What are we to make of Hale Harvey’s reproductive healthcare legacy? Harvey’s life and actions, like the historical moment in which he practiced medicine, were not tidy. On a basic level, Harvey provided abortions at a moment when the social meaning and legal status of the procedure and those who provided them were rapidly changing. Those pre-Roe years saw a number of medical providers—many informed by religious beliefs—take legal risks to challenge medical and legal regulations that they felt were unethical and unfair. Some of these doctors retained their licenses or regained them after abortion became legalized. But some, like Horace Hale Harvey III, fell between the cracks of changing legal regimes.

In a sense, Harvey’s desire to provide help—and to help quickly—meant that he undercut his own efforts. Perfect, Harvey seemed to believe, was the enemy of good, often to the frustration of those around him who were more detail oriented about their approach to social change. A colleague in the CCS chastised Harvey in 1970 for his “mania for conquering the whole world by next Monday.” And that assessment was more than fair. But perhaps a more generous view would be to see Harvey’s actions as an act of triage at a moment of medical crisis. Women were literally dying to get the kind of healthcare that Dr. Harvey willingly provided.

The history of abortion activism, after all, is filled with imperfect actors offering compassion and practical help in a system that would criminalize them and shame those seeking their aid. And perhaps that intent and impulse—bearing witness to pain and responding to those in need despite the profound professional and personal risks—is Dr. Harvey’s lasting and most important legacy.

Gillian Frank is an Assistant Professor in the History of the Modern United States at Trinity College Dublin. His book, A Sacred Choice: Liberal Religion and the Struggle for Abortion Before Roe v Wade, is forthcoming with University of North Carolina Press.