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Their Last Choice

From Back Alley Butcher to Abortion Provider: The Adventures of Jesse Ketchum

Jesse Ketchum was a washout as a physician, practicing in Michigan during the late 1960's. He was sued for malpractice at least 12 times in Oakland County alone, and at least three times in neighboring Wayne County. After a $3 million suit alleging that his neglegent handling of a birth caused the infant to suffer mental retardation, Ketchum lost his privileges at Beaumont Hospital.

It is not clear when Ketchum began performing illegal abortions. His legal practice was getting him in trouble on a fairly regular basis, but he seemed able to maintain high enough standards of care on his abortion patients to keep from drawing too much attention to himself. At least, he didn't dismiss patients that were injured or dying or otherwise likely to draw attention to him.

Word got out that Ketchum was willing to slip a few patients in through the back alley, and he was recruited by Clergy Consultation Services (CCS), an international abortion network. CCS provided him with a steady stream of abortion cases, mostly women from Ohio and Illinois.

By whatever means, the authorities became alerted to Ketchum's back alley practice, and became alarmed. The Michigan State Police busted the abortion ring on January 3, 1970, by running a policewoman through it. Ketchum was arraigned and released on $25,000 bail. Ketchum's attorney persuaded a judge not to prosecute on the grounds that Michigan's law limiting abortions to those "necessary to preserve the life of the woman " was unconstitutionally vague. This was a popular and frequently successful approach at the time. Milan Vuitch had used this defense to have the Washington, DC abortion law struck down when he had challenged it by openly performing elective abortions.

Ketchum grew bold, and began to get careless. He continued to operate his abortion business until January 30, when he inadvertently hired an off-duty police officer to work as a driver. Police arrested Ketchum as he was preparing to perform an abortion on a 17-year-old girl. They siezed Ketchum's rusty, pitted, blood-stained instruments, which were found in a plastic bag along with the girl's $500 fee. Ketchum was arraigned and released on $1,000 bail.

Ketchum's medical practice continued to deteriorate, as evidenced by the allegations of Jane Capling of Oakland County, who said that Ketchum botched a hysterectomy he performed on her in March.

Abortion was not having nearly the intensity of legal repercussions for Ketchum that one would expect. The sympathetic judicial system, and the support of abortion advocacy groups like CCS, allowed Ketchum to keep his licence and continue to practice despite his repeated disregard for the law. In May, he was arrested yet again for abortion, this time performing one on a 25-year-old Ohio woman in his hospital. Again he was freed on bail. But change was in the air. The legislature of New York was preparing to roll out the welcome mat to every criminal abortionist in the country -- provided, of course, that the abortionist had a medical license. Ketchum closed down his Michigan hospital, packed up his pitted and blood stained instruments, and moved on to the greener pastures New York was so kind to offer. When the New York law, allowing abortion on demand up to 24 weeks, went into effect on July 1, 1970, Ketchum was ready. He opened his legal abortion practice in a hotel suite in Buffalo.

Little is known about the first year of Ketchum's New York practice, but by May of 1971 his luck was running out. He lacerated the uterus, anterior cul-de-sac, right broad ligament, and peritoneum of Ellen Lawler of Michigan. Instead of informing her of her injuries, Ketchum sutured them while she was still under anesthesia, and told her that the abortion was uncomplicated. She sued after suffering delayed and life-threatening complications. Another woman, Virginia Brown of Ohio, also sued. She had been left sterile after an abortion by Ketchum.

Then the unfortunate Margaret Louise Smith entered the picture. Mrs. Smith had been exposed to reubella when pregnant with her third child, and feared that she might have a baby with birth defects as a result. She traveled from Michigan to Buffalo for an outpatient abortion. Ketchum, aided by his 23-year-old wife Judith, performed a vaginal hysterotomy abortion on 25-year-old Margaret at about 10AM on June 16, 1971, then left her virtually unattended until her friend Billy Ray Ellenberg returned to the office at about 2PM. He found Margaret pale and breathing with difficulty. Ellenberg pleaded with Ketchum to take some action. Ketchum attempted to treat Margaret in his office before summoning paramedics, who were unable to revive her. Margaret was pronounced dead on arrival at a hospital across the street at around 4PM. Although Margaret's vagina had been sutured, removal of those sutures revealed a vast laceration involving the entire cervix, lower uterus, and broad ligament. Margaret had been slashed internally and left to bleed to death.

The state of New York did not exactly launch into immediate and decisive action. Ketchum wasn't even arraigned until January of 1972 - six months after Margaret's death. And he had been a busy fellow in the mean time.

Ketchum had continued to operate his abortion practice, bringing his total reported abortions to 862. One of those abortions was performed on Carol Schaner on October 24, slightly more than four months after Margaret Smith's death.

Carol, age 37, had traveled from Ohio for her abortion. After Ketchum released her, she went into shock, and died in a New York hospital. At autopsy, it was discovered that the case eerily echoed Margaret's injuries. Ketchum had sutured Carol's cervix shut, hiding a laceration through the cervix and uterus and into a uterine artery. Like Margaret Smith, Carol Schaner had simply been allowed to bleed to death.

The response from authorities was somewhat less than galvanic. But then again, they had their hands full. Abortionists had flocked to New York from all over the country, and corpses were piling up all over the state as well as in the home states of women who traveled to take advantage of the liberalized law. A 42-year-old upstate New York woman went into cardiac arrest, slipped into a coma, and finally died July 12, 1970, six days after a hysterotomy abortion. A 31-year-old New York City woman developed pulmonary edema during a saline abortion and died July 19, 1970. A 23-year-old woman from New York City went into sickle cell crisis and died July 20, 1970, nine days after a vacuum abortion. On July 29, 1970 an 18-year-old abortion patient died after the fetus had been pushed through the uterine wall into her abdomen and allowed to rot in an abscess. On September 22, 1970, an Indiana woman died of lingering complications of a September 3 abortion done in New York City. A 19-year-old woman suffered a perforation during her vacuum abortion and died 19 days later of lingering complications on Sptember 22, 1970. On October 10, 1970, 23-year-old Maria Ortega died after Dr. Armida Zepeta had shoved the fetus through her uterine wall into her abdomen and sent her home to bleed to death. A 25-year-old New York City woman suffered ventricular fibrillations during a hysterotomy abortion at 18 weeks, and died of cardiac arrest December 23, 1970. A 35-year-old woman from upstate New York died on January 2, 1971, of massive pulmonary embolisms after her hysterotomy abortion. A New York City woman, 19 weeks pregnant and 26 years old, died of peritonitis January 20, 1971, eight days after a hysterotomy abortion allowed her chronic pelvic inflammatory disease to spread. A 26-year-old New York City woman went into convulsions two days after a saline instillation, and died February 27, 1971. On May 12, 1971, a 23-year-old Massachusetts woman was found dead in her home from complications of an outpatient instillation abortion initiated in New York. On June 24, 1971, a 29-year-old New Jersey woman suffered respiratory arrest soon after recieving her abortion anesthesia, and died. A 44-year-old New York City woman undergoing a hysterotomy abortion went into cardiac arrest and died on the table July 1, 1971. A 20-weeks-pregnant 23-year-old from upstate New York developed fever after saline instillation, delivered the dead baby, and died August 17, 1971. On August 22, 1971, a 17-year-old girl developed a 104 degree fever and died after initiation of an outpatient saline abortion. A 35-year-old Michigan woman, 20 weeks pregnant, went into convulsions and cardiac arrest during a saline abortion and died September 23, 1971. On October 5, 1971, an 18-year-old Batesville, Arkansas girl died of septicemia from a saline abortion done in New York City. A 33-year-old Ohio woman developed peritonitis aned sepsis and died October 13, 1971, 19 days after her vacuum abortion. A 23-year-old woman from Massachusetts went into convulsions and a coma after being injected with saline to abort her 22 week pregnancy, and died December 29, 1971. Clearly, all hell had broken loose in New York. Abortionists were playing Russian Roulette with patients' lives, and had discovered that the only consequence they'd face would be an investigation by health inspectors, and a suggestion that they modify their practices to lessen the odds of a repeat performance. What had Ketchum to fear?

Although he was arraigned for the death of Margaret Smith on January 27, 1972, Ketchum was freed on $10,000 bail, and went about his business while his attorney handled the matter. He still had the criminal abortion charges pending in Michigan, but after two and a half years of trying to get uncooperative and elusive witnesses to show up, prosecutors dropped one of the charges. Two others were pending. New York health authorities continued to have their hands full with abortion deaths. A 21-year-old Michigan woman suffered pulmonary edema and died March 8, 1972, after a saline abortion. A New York City woman, 16 weeks pregnant and 31 years old, suffered cardiac arrest during a hysterotomy abortion, and died March 8, 1972. A 14-year-old girl's saline abortion left some of the placenta behind, and her uterus and bowels were perforated during the D&C performed to complete the abortion; she developed peritonitis and died April 16, 1972. On May 4, 1972, a 21-year-old Massachusetts woman finanlly died of hepititis contracted during an abortion in New York 12 weeks earlier. A 17-year-old girl from Michigan went into convulsions and cardiac and respiratory arrest after recieving anesthesia for her abortion, and died May 13, 1972. An 18-year-old Massachusetts woman died of air embolisms minutes after a vacuum aborion May 17, 1972. An 18-weeks-pregnant 20-year-old from New York City suffered an incomplete saline abortion, underwent a D&C to remove the placenta, and developed sepsis, dying on June 18, 1972. And then, a miracle occurred.

It was like a bolt from the blue -- far more than abortion activists had ever hoped for. The US Supreme Court handed down Roe v. Wade and Doe v. Bolton on January 23, 1973, striking down virtually every abortion law and regulation in the country. Across the nation, abortionists were getting old criminal abortion cases dropped -- after all, the laws were unconstitutional.

Even convictions for criminal abortion deaths were being thrown out -- Richard Mucie was able to have his conviction for the February 1968 abortion death of Nancy Ward in Missouri overturned on the grounds that Nancy's abortion, although not "necessary to perserve the life" of the patient, "was performed by a licensed physician in a medically accepted manner under medically accepted conditions," and therefore Michigan could not validly have prohibited it "in terms of its interest in maternal health." Nancy's case was similar to Margaret Smith's case. Each woman had been approximately 18 weeks pregnant, each had traveled to another state to undergo an abortion in an outpatient medical facility at the hands of a licensed physician, each had undergone a procedure to extract the fetus vaginally, and each had bled to death at the facility as a result of lacerations of their internal organs. But Margaret's abortion had been legal, and Ketchum no doubt calculated that if criminal abortion death convictions could be thrown out, a legal abortion death was no cause for concern. He petitioned the courts for his case to be dismissed and contined to perform abortions.

Ketchum's bid somehow failed. Despite his claim that Margaret Smith had actually died from amniotic fluid embolism (later to become a shop-worn theme among abortionists) and disseminated intravascular coagulopathy, and despite the fact that Milan Vuitch testified on his behalf, Ketchum was convicted of criminally negligent homicide on October 4, 1973.

But even a conviction was not enough to close Ketchum's practice. Still using Roe as leverage, Ketchum was able to free himself on $10,000 bond, pending appeal. He returned to Michigan and resumed his abortion practice there, this time legally. He remained heedless of the welfare of his patients, however. On April 18, 1974, Sandra Walker of Ohio was driven to Ketchum's practice by Thomas Pimbly, who had referred Sandra for the abortion. Pimbly assisted Ketchum in performing the outpatient saline instillation, done without so much as a rudimentary physical examination. Sandra was hospitalized, losing a lot of blood, her uterus, and very nearly losing her life. Pimbly atmitted that he'd known about Ketchum's background and that he referred women to him anyway. He said that 2 deaths in over 800 abortions was "a damn good batting average for a doctor, any doctor, and it's a batting average to be proud of." He continued to defend Ketchum, saying, "I'm not saying he's flawless. In fact, he's very controversial. If you've done any study, you know that his background is quite, quite good -- so good that other doctors refer problem patients to him for abortions."

Michigan prosecutors did not think so highly of Ketchum, and one filed suit alleging "gross negligence tantamount to criminal care of patients," and stating that Ketchum performed abortions "at times and in manners and places contrary to law," and in violation of state health guidelines, with inadequately qualified staff, lack of medical histories, and failure to maintain proper records. On April 30, a judge granted a court order banning Ketchum from practicing in Michigan. However, within a week another judge lifted the injunction, holding that the medical board, not the courts, should address the problem.

The deaths of two women and the near-deaths of at least two others were not sufficient to close down Jesse Ketchum's abortion practice. However, in 1974, his recklessness finally led him to behaviors that the medical board frowned upon. On May 12, Ketchum was found guilty of disorderly conduct for "indecent and obscene conduct in a public place," in this case a porno theater. On May 23, Ketchum performed an abortion on a woman who then discovered that her pregnancy test had been negative. On June 3, Ketchum was caught in a sting set up by a housewife who had heard he'd been doing abortions on women who only thought that they were pregnant. Last but not least, he was discovered to have been prescribing amphetamines after his state license to dispense these drugs had expired. These events, not the deaths and near-deaths, spurred the medical board to action. They suspended Ketchum's license for "unprofessional conduct, immoral conduct and departure from and failure to conform to minimal standards." His license was revoked in Michigan on October 30, 1974.

In May of 1975, Ketchum's appeals ran out, and he was sent to Attica for three years for the death of Margaret Smith. And in October of that year, the Centers for Disease control finally published an article with the New York Health Department suggesting that second trimester abortions be done in hospitals.

After his release, Ketchum got his license reinstated. It is unknown whether he is still in practice.

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