Dead-of-the-night emergency phone calls were nothing new for the Nashville, Tennessee household of surgeon Dorothy Brown. But her daughter, Lola, remembers one particular woman who showed up at their home, which also housed her mother’s medical office, sometime between two and three in the morning.
“‘Who is it?’ [A shaky woman’s voice asked]: ‘Is Dr. Brown here? I’ve got snakes in my stomach, and I don’t know what to do about them.’” Lola Brown believes she was not much older than 10 when she spoke to the frantic woman. She can date it approximately because such nocturnal visitations of women — distraught, determined, sometimes delusional, often pregnant — increased after 1967. That year, her mother, Tennessee’s first Black woman lawmaker, proposed reforming the state’s abortion ban.
It was a courageous move for Brown, who was hypervisible and vulnerable as the only African American female in the statehouse and part of the first cohort of Black legislators to win statewide office since Reconstruction. She also was one of several Black state legislators, including New York’s Percy Sutton and Wisconsin’s Lloyd Barbee, to push abortion law change before Roe v. Wade in 1973.
It was one of many firsts she racked up during a career. First single adoptive parent in Tennessee (of Lola); first Black woman to complete a surgical residency in the South, which she did at Meharry Medical College; and first Black woman inducted into the American College of Surgeons.
As an infant, Brown was handed over to relatives and then placed in a New York State Methodist orphanage when her mother couldn’t care for her any longer. Her single mother was a day worker, an itinerant domestic who got work when and where she could — not ideal for parenting.
A kind physician who took out Brown’s tonsils made her yearn to be a doctor at age five. Brown remained at the orphanage for most of her youth, running back to it during the short periods her mother reclaimed her. During one of those times, Brown’s mother sent her out to do domestic work at age 14. Not able to work and study, Brown left school. Eventually, Brown landed in a stable home with caring foster parents and earned a scholarship to Bennett College, one of the nation’s two women-only historically Black colleges.
Along the way, she said she developed a belief that “if you don’t want to have a baby, you shouldn’t have to.” But when she talked about abortion legislation she sponsored (and the 1967 bill failed), she talked more about her work experiences than her personal ones.
Abortion had been banned in Tennessee since 1883 except “to preserve the life of the mother.” But those abortions — vetted and performed by physicians — were rare and limited to those who had money and connections.
The women who begged her for abortions, and there were many who came to Brown, often called Dr. D or “The Lady Who Cuts.”
“Every day in my office, I see two or three women who are pregnant and don’t want to be,” she said. And then there were the patients who were conceived through sexual abuse. “I also know the psychological damage that can be done to a child who is told he was born as a result of rape.”
Abortion had been banned in Tennessee since 1883 except “to preserve the life of the mother.” But those abortions — vetted and performed by physicians — were rare and limited to those who had money and connections. In 1964 and 1965, a Chattanooga hospital reported it only allowed seven abortions for women with conditions its committee of doctors concluded were legitimate reasons to end a pregnancy: colitis, radiation exposure, severe depression, meningitis, and a brain tumor.
But by and large, legal abortion didn’t exist for the average Tennessean, and anyone who performed one could go to jail from one to five years under the law’s penalties. A lucky abortion seeker would find a doctor or someone skilled enough to do an abortion that was illegal but safe; others reported quacks who sexually assaulted women seeking abortions or maimed — even killed — them with unsanitary and dangerous practices. Statistics from that same Chattanooga hospital showed a relatively small number of women who died from sepsis (blood poisoning or infections commonly associated with unsafe abortions), but listed women admitted for complications of abortion via “mechanical interference,” doses of quinine, ingesting turpentine, hot douching, and other unspecified means.
Brown argued for change. Her proposed bill suggested abortion be permitted in cases of pregnancy as a result of rape or incest. The “rape and incest” provision became the most common and palatable reform concept around the country. It conceded to critics who saw abortion as a moral failing — only victimized, blameless women had a right to it — while expanding the law. The standard also had legs because it followed a model bill written by the American Law Institute in the late 1950s, and the organization was vigorously promoting it in states around the country and shilling for local sponsors.
Gradual change or not, Brown’s bill rankled some colleagues at the Capitol. “You would have thought I opened the gates of Hell,” she remembered. Warned to withdraw the bill, she didn’t. Critics predicted her first historic term might be her last.
Defending a second, more detailed abortion bill she introduced with the support of the Tennessee Medical Association, Brown came ready with stories to counter growing opposition to the bill. A 17-year-old had been gang-raped by six men and impregnated. The girl’s mental health was shattered. Such cases forced doctors to consider their definition of health, their Hippocratic Oath to “do no harm” and whether they wanted to follow the law.
Those doctors included Brown herself. She knew very well that doctors made arbitrary decisions about who deserved those rare, physician-approved abortions. She had performed approved abortions under the pre-Roe ban: “I don’t think I broke the law. What was in the book of statutes was that a woman could have a termination if it would spare the mother.”
Brown’s second attempt at an abortion bill would be parried by other House legislators, who introduced a counterproposal for a commission to study the issues in her bill. It effectively blocked the reform measure. Brown’s bill — even with the support of the state medical association — couldn’t drum up the votes in the House and was routed to a Senate committee, where it languished.
As she launched a bid for a seat in the more influential state Senate, mention of her abortion advocacy was notably absent in her own platform, which plugged her medical career and pledged support for workers and public education.
She knew very well that doctors made arbitrary decisions about who deserved those rare physician-approved abortions. She had performed approved abortions under the pre-Roe ban.
Whispers dogged her candidacy. Rumors speculated that she did abortions — and not just ones to save lives — in her North Nashville office. Others cast aspersions about her lifelong unmarried status, hinting she was a lesbian.
Critics, both Black and White, criticized her abortion advocacy more openly — none more so than her opponent, a well-connected civil rights attorney who had a talent for the turn of phrase and damaging arguments.
Avon Williams repeatedly painted Brown as an establishment candidate who was more interested in “meeting with the [U.S.] vice president than having lunch with me in the ghetto.” In an July 1968 Nashville NAACP forum that Brown left early to treat a patient, he railed at her claims that her more conciliatory approach — she spoke of wanting to represent all of her North Nashville constituents, not just the Black ones — did more to sway White legislators and voters than his brand of battle-hardened confrontation. He quipped pointedly: “Did it take persuasion for her to take an abortion bill put in her hands by the lily-white Tennessee Medical Association that would possibly kill poor Negro children?”
Conciliatory style aside, when it came to religion, Brown defied Williams’ attempts to frame her as a “get-along” type who’d mindlessly side with the establishment.
In spite of — or perhaps because of her own religious convictions — Brown dismissed Christian arguments against abortion in writing and guest talks at church meetings and women’s circles. “I cannot go along with the church fathers who traditionally believe the soul is inviolate and indestructible and is present from the moment of conception,” she wrote in an essay. What happened when a fertilized egg splits in two to become identical twins? “Is the soul also split in half?” Stopping short of ridiculing religion itself, she asserted that “scientific reasoning will not allow me to accept this bit about the soul’s being present at conception.”
Willing as Brown was to joust with those church fathers, Williams trumped Brown at big-tent strategic alliances within their home state. He won the backing of the Tennessee Right to Life Committee, which had pushed the abortion study commission measure over Brown’s. That was no surprise, but Brown may have felt bruised when he also drew endorsements from many of her Black male physician colleagues at Meharry. And, finally, Williams harnessed Black Power rhetoric that abortion was a racist conspiracy targeting African Americans.
Brown didn’t back down from sparring with those militants who thought that the key to Black survival was an expanding African American population. “It’s important that my own people,” she said in an interview, “the black people, should not allow groups to make us feel that abortion legislation is race genocide. Those who feel that way have been pressured and brainwashed.”
Pilloried as out of step with her district’s Black voters, someone who pandered to Whites, and an “abortionist,” Brown lost the race.
For years afterward, she’d refer to her abortion bills as her Waterloo, the decisive finale to a short political career. And that may be why, in 1971 after her failed Senate run, she spoke to the students at her beloved alma mater, Bennett College, with a touch of disdain for the sexual revolution. Brown labeled modern morality as bankrupt and libertine. The woman who’d become Tennessee’s first single adoptive parent asserted that the best family to give a child a decent start featured a mother and father. Admonishing the young women not to dismiss her due to age and her unfashionable red lipstick, she opined that the erosion of values would lead to a “formless, futureless mess of our society.”
When Roe v. Wade made abortion legal nationwide two years later, Brown told a newspaper that she was mulling whether she’d do abortions. The Supreme Court ruling had changed the game for pregnant people — and doctors who had risked arrest and professional ruin when they helped women end unintended pregnancies. By 1978, Dr. D was performing abortions — the procedure she once did in secret, advocated for in the state assembly, and the very service that helped eject her from public office.