In Montana, abortion access has been at times illegal, legal, and stuck in limbo. Providers have weathered bombings and arson, advocates and opponents have battled it out in court, and citizens have passed a constitutional amendment affirming a woman's right to choose. One listener wants to know more about the history of reproductive rights in Montana. MTPR's Aaron Bolton reports on the underground networks, political violence and landmark court cases that got us to where we are today.
Welcome to the Big Why, a series from Montana Public Radio where we find out what we can discover together. This is a show about listener-powered reporting. We’ll answer your questions — large or small — about anything under the Big Sky.
Nick Mott: I’m your host Nick Mott, standing in for Austin Amestoy this week. This week I have health care reporter Aaron Bolton with me.
Aaron Bolton: Hey, Nick.
Nick Mott: You’ve mentioned in the past that we really don’t get health care-specific questions for The Big Why, but it sounds like we’re diving into a health topic today.
Aaron Bolton: Yeah, we’ll be talking about abortion access in the state. We got the question from Missoula resident Jess Allred.
Jess Allred: Just really curious about the history of reproductive rights in the state of Montana. So I think I really am interested in how that happened in a state like Montana.
Aaron Bolton: Allred recently started working at Blue Mountain Clinic in Missoula, which provides abortion services as well as other reproductive health care. So she wanted to learn more about the history.
This is a story that follows underground networks, political violence, and landmark court cases to get us to where we are today. But I want to add that we’ll be telling this story from the perspective of abortion advocates and providers, since that is what Allred is asking for. Since this is such a personal and controversial topic for people, I just wanted to make that note.
Nick Mott: So where do we want to start?
Aaron Bolton: I think it’s best to go back to the late '60s. The U.S. Supreme Court didn’t rule in Roe v. Wade until 1973.
Nick Mott: That’s the case that legalized abortion across the country.
Aaron Bolton: Right. So back in the '60s, the legal landscape for abortion looked a lot like it does now. Abortion was legal in some states and not in others. It was also a time of big social change.
Diane Sands: The beginnings of the civil rights movement, I was involved in. I was in Chicago with Martin Luther King.
Aaron Bolton: That’s Diane Sands, a former state senator. Sands was a student at the University of Montana. She was getting involved in the political movements of the day.
Nick Mott: I’m guessing this is when she got exposed to reproductive rights as a political issue?
Aaron Bolton: Yeah. Abortion wasn’t legal in Montana. And it wasn’t just abortion as an issue Sands and her fellow students were rallying over. They were also upset about access to the birth control pill.
Diane Sands: Which was also not available unless you were engaged or married.
Aaron Bolton: So, Sands and a group of women started the Women’s Resource Center on campus in 1968.
Nick Mott: So was this some sort of political activist group for students? What did the resource center do?
Aaron Bolton: It was a service spreading information about all things reproductive health for women. They would talk to women who were pregnant and wanted to put their child up for adoption, or keep the child as well. But at its core, the center was an illegal abortion-referral service.
Nick Mott: So they’d help women find access to abortion, even though it was illegal in Montana?
Aaron Bolton: Exactly. Abortion was legal in Washington, and the nearest clinic was in Spokane.
Diane Sands: Sometimes we drove women over to Spokane. Sometimes we went around campus and raised $10 at a time to get a woman money so she could go over by herself. Whatever services she might need, we were there for her.
Nick Mott: So they were doing this right on campus? I imagine this was super high stakes. There must have been some major consequences if they got found out?
Aaron Bolton: Yeah, what they were doing was a felony. But they weren’t quiet about their existence either. They would even put ads in the paper.
Diane Sands: It didn’t say 'abortion.' It said 'pregnancy referral services.' It sort of skittered semi-under the radar.
Nick Mott: So they were helping women go across the border to Spokane to get abortions then. Was that the only way women were accessing abortion?
Aaron Bolton: No, there were also illegal abortions happening in Montana. Sands says the resource center would find the people doing them, but you couldn’t guarantee that care would be safe.
She remembers one friend who went to a provider in Shelby.
Diane Sands: But he was kind of the classic horrible-bloody sponges-alcoholic physician. She got in there and looked around and saw what his practice looked like and she got up and left.
Aaron Bolton: Another provider would only agree to do the procedure if women were blindfolded.
Nick Mott: So this is all before the U.S. Supreme Court decided the Roe v. Wade case in 1973. That ruling created the constitutional right to an abortion. What happened to the referral service after that?
Aaron Bolton: It dwindled as legal abortion care slowly became available in the state.
Nick Mott: So after Roe, were there a lot of providers suddenly jumping in?
Aaron Bolton: Sands and others say access increased slowly. There were OBGYNs that would offer them to patients, but there wasn’t a dedicated abortion clinic in the state until Dr. Jim Armstrong started one in the Flathead Valley.
Nick Mott: So this was Montana’s first abortion clinic and it was up in the Flathead?
Aaron Bolton: Right. Susan Cahill worked as a physician’s assistant performing abortions under Armstrong, and later took over the clinic.
Susan Cahill: And when he was in residency, he watched women die of illegal or self-induced abortions every day. In fact, one night he stayed with a woman who was alone, who was dying and bleeding out. They wouldn’t take care of her. And the police were demanding that she tell them who did this to her. She refused. And Jim stayed with her all night, held her hand, and she died.
Aaron Bolton: Cahill says that’s why Armstrong started offering abortions shortly after the Roe ruling. He couldn’t do that and keep up with his regular medical practice. That’s why he brought on Cahill.
Shortly after, in 1977, Blue Mountain opened in Missoula.
Nick Mott: So in the 1970s we had these legal abortion clinics cropping up in the state. What was the response?
Aaron Bolton: I was curious myself, because I’ve always known abortion as this controversial political issue. But Cahill and others say there really wasn’t much fuss over these clinics back then. That was until about 1980 when president Ronald Reagan came into office.
“The interruption of a pregnancy, in my opinion – and a great deal of medical opinion – is you are taking a human life," Reagan said in one interview.
Nick Mott: So with Reagan, we had anti-abortion views now coming into the mainstream political discussion. How did that change things for abortion clinics on the ground?
Aaron Bolton: That’s when you started seeing protests outside clinics. Cahill said that didn’t prevent women from coming in.
Susan Cahill: Women who came into my office – who picketed my office a month before, or two months before, and then came into my office and said their situation was different.
Aaron Bolton: But it wasn’t just protestors. The anti-abortion movement became violent. There were a handful of abortion providers and clinic staff that were murdered around the country in the early ‘90s.
That’s when abortion related violence came to Montana as well. In March of 1993, Richard Andrews firebombed the Blue Mountain Clinic in Missoula.
Willa Craig was the director of the clinic at the time. In an interview for an oral history of feminism in Montana, she remembers getting a late-night call that the clinic was on fire.
"I quickly got dressed and raced over there and it was fully engulfed by the time I got there," she said.
Nick Mott: Sounds like the clinic was a total loss then?
Aaron Bolton: It was. Initially, Craig didn’t know what to do.
"We didn't know where we would go. How we would keep our staff together. And where women would go. Where would they go? Because we were, in so many cases, the only people who would even talk with them about abortion, let alone provide the service."
Nick Mott: Blue Mountain still exists today in Missoula. I assume they found a way to survive.
Aaron Bolton: Another medical practice opened its doors to Blue Mountain staff, but they couldn’t perform abortions there. Planned Parenthood, which had a clinic in town, started offering that service.
Nick Mott: This sounds like a particularly violent time in the debate over abortion. Did this violence eventually slow down or stop?
Aaron Bolton: It went on through the '90s and into the 2000s. Cahill’s clinic was burned to the ground twice. But eventually, the anti-abortion movement became more political.
Nick Mott: More political? Do you mean members of the movement were running elected office?
Aaron Bolton: Yeah, it had already become a position political candidates would take. But state lawmakers started passing laws to either increase or decrease access.
In Montana, lawmakers passed a law in 1995 that said only doctors could perform abortions. That meant people like Cahill, who was a physician’s assistant, couldn’t provide that care.
Susan Cahill: People wanted me because I was female, rather than Dr. Armstrong. You know, they felt more comfortable. So sometimes I’d go in to patients and I’d have to tell them that I cannot perform your abortion. I'm going to examine you. I'm going to do the ultrasound. I'm going to tell you all about it. But Dr. Armstrong had to come in a perform it, and then leave. And it was hard for them to understand why.
Aaron Bolton: Cahill and Armstrong sued over the law.
Nick Mott: Ok, so is this the Armstrong case that is still cited today in legal fights over abortion access in the state?
Aaron Bolton: It is. The case was whether a physician’s assistant could perform abortions, but what ultimately came out of the case was bigger.
The State Supreme Court ruled that the state Constitution’s right to privacy ultimately protected abortion access in the state.
Nick Mott: And that precedent still stands today, right?
Aaron Bolton: Yes, for over two decades, that ruling has held – despite the U.S. Supreme Court overturning Roe v Wade in 2022.
As you may know, Montanans last year voted to specifically enshrine abortion access into the state Constitution. So, for now, it’s a settled legal issue in the state.
Nick Mott: That’s a lot of history to take in. What does Allred, who asked about this, think?
Aaron Bolton: Allred knew some of the highlights, but she didn’t know about the illegal abortion-referral service or what illegal abortions looked like in Montana. She says hearing those stories is scary in a post Roe world.
Jess Allred: A fear that, oh my gosh, that’s the direction we’re heading again with so many states banning legal abortions. People don’t stop getting abortions when it is criminalized.
Nick Mott: Thanks for digging up this history Aaron.
Aaron Bolton: Happy to do it.
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