Although abortion was illegal, it was nevertheless the most widespread form of birth control in use.[4] Used predominantly by working-class women, the procedure was used not only as means of terminating pregnancy, but also to prevent poverty and unemployment. If a woman died or became ill from an abortion, the abortionist could be imprisoned or even sentenced to death. Those who transported contraceptives could also be legally punished.[4] As the standard of living increased, so did the prevalence of contraception and abortion. People did not want to provide for larger families, but rather to have smaller families and more money. Contraceptives became more expensive over time and had a high failure rate.[4] Unlike contraceptives, abortion did not need any prior planning and was less expensive. Newspaper advertisements were used to promote and sell abortifacients indirectly.[5]
Not all of society was accepting of contraceptives or abortion, and the opposition viewed both as part of one and the same sin.[4] Abortion was much more common among the middle classes than among those living in rural areas, where the procedure was not readily available. Abortion was a risky endeavor that could lead to illness or death. Those who used lead pills often had ongoing sickness, headaches, and in some cases paralysis of the hands. Women were often tricked into purchasing ineffective pills.[4] In addition to fearing legal reprimands, many physicians did not condone abortion because they viewed it as an immoral procedure potentially endangering a woman's life.[5] Because abortion was illegal and physicians refused to perform the procedure, local women acted as abortionists, often using crochet hooks or similar instruments.[4]
Feminists of the era focused on educating and finding jobs for women, leaving aside the controversial issues of contraceptives and abortion, which in popular opinion were often related to promiscuity and prostitution. The Church condemned abortion as immoral and a form of rebellion against the child-bearing role women were expected to assume. Many considered abortion to be a selfish act that allowed a woman to avoid personal responsibility, contributing to a decline in moral values.[4] Abortion was often a solution for women who already had children and did not want more. Consequently, the size of families decreased drastically.