Comstock, 1873

Another instrument in the diagnostic kit

I did not train in history. I trained as an engineer, a scientist, and a physician. I was educated to understand systems by measuring them — to take the body apart to its molecular components and put it back together, to reduce a problem to its variables and solve for x. History was never part of that training. But I have come to understand, over the course of the work that produced this series, that history is another lens for understanding the present — another instrument in the diagnostic kit — and that the present we are living through cannot be understood without it. Alongside the legal and medical and cultural and societal work we do at Labora Collective, we go back into history to understand the context. This is what this is.

The attack on women's reproductive autonomy in the United States is not new. None of what we are watching in the spring of 2026 is new. It is so deeply rooted in the American legal and medical infrastructure that to understand it you have to go all the way back — to the statutes that were never repealed, to the professional campaigns that were never honestly reckoned with, to the demographic panics that are ringing again now in different language but with the same operational logic. The Long War names that continuity. This series is its documentation.

The conservative legal movement has built its current assault on reproductive rights on a claim about history. Justice Alito's majority opinion in Dobbs v. Jackson Women's Health Organization rests on the assertion that the right to abortion is not "deeply rooted in this Nation's history and tradition." It is a claim about what the historical record shows. What they forgot is that we can read too. We understand history as well as they do — better, in fact, because we are willing to read the parts they leave out. The history of this country does not belong to the faction that quotes it most selectively. It belongs to all of us. And it is important for all of us to understand how it has produced the present.

What the actual historical record shows — as this essay and its companion essays on midwifery, on the American Medical Association, and on the legal architecture of Dobbs will detail — is that women's reproductive health used to be the domain of women. When men found a way to make money from it, they did two things: they removed women from the profession, and they criminalized and punished the reproductive behavior they did not approve of. We see the same behavioral pattern today. It should not be a surprise. If OB/GYN were still a male-dominated specialty, would the profession be under this attack? The answer is the devaluation pattern that shows up every time women enter a profession in numbers: the profession gets devalued, and the infrastructure that holds it up gets devalued with it. That is what is happening to obstetrics and gynecology right now.

The federal statute that the current administration is preparing to use as the legal vehicle for a national abortion ban — and for a national contraception ban after that — was signed into law in March 1873 by President Ulysses S. Grant. Its principal author was not a physician. He was a dry-goods salesman, an evangelical, and a postal inspector named Anthony Comstock, who had spent the preceding years building a private moral-policing apparatus in lower Manhattan, the New York Society for the Suppression of Vice, and who walked into Congress that winter with a draft bill in his coat pocket and walked out, four months later, with the authority to read the mail.

The Comstock Act has never been repealed.¹ It has been narrowed by courts, ignored by enforcers for fifty years, contradicted by Supreme Court rulings on contraception in 1965 and on abortion in 1973, but never struck from the United States Code. As of the spring of 2026, the statute that prohibits the mailing of any "article or thing designed, adapted, or intended for producing abortion" sits in 18 U.S.C. § 1461 in plain text, exactly as it was written in the second year of Grant's first term. The administrative apparatus that the current administration would need to revive it — postal-inspection authority, customs-inspection authority, a Department of Justice willing to prosecute — already exists. The question is not whether the apparatus is in place. The question is whether the political and legal conditions to use it are.

This essay is about the statute, the man who wrote it, the medical-professional faction that handed him the cultural authority to write it, and the through-line that runs from his 1873 mail-fraud bureaucracy directly into the 2026 federal government's posture toward mifepristone, contraceptive counseling, and the digital surveillance of reproductive health. The companion essays in this series — on midwifery, on the American Medical Association, on the Dobbs decision — will trace the other threads. This one traces the statute. The dismantling we are watching is sequential. Comstock is the first sequence. He is also, again, the most operationally relevant one.

The Setup

Before 1873, the regulation of abortion in the United States followed a legal framework inherited from English common law that had been settled for several centuries. Under that framework, abortion before "quickening" — the moment the pregnant woman first felt fetal movement, which typically occurs between sixteen and twenty weeks — was not a criminal offense.² William Blackstone, whose Commentaries shaped Anglo-American legal reasoning more decisively than any single nineteenth-century treatise, described abortion after quickening as a heinous misdemeanor but made no provision for prosecuting pre-quickening abortion at all. The colonies inherited this framework intact. The early American republic inherited it from the colonies. By 1850, every state in the Union still operated under some version of the quickening doctrine.

What this meant in practice was that for the first three-quarters of the nineteenth century, a missed menstrual period was, in the legal imagination of the American medical and judicial system, ambiguous. It might indicate pregnancy. It might indicate any number of other physiological conditions — undernutrition, illness, stress, the entirely common pattern of irregular menstruation in women whose lives were governed by physical labor and food insecurity. A woman who suspected she was pregnant before quickening and who wished to "restore her menses" had a range of available preparations, most of them herbal, all of them widely advertised in the popular press. Tansy. Pennyroyal. Savin. Black cohosh.³ These preparations were sold in apothecaries and through the mails. Their advertisements appeared in the back pages of religious newspapers. The transaction was unremarkable.

The clinical setting for this transaction was, in most cases, not a physician's office. It was a midwife's. Midwives — most of them women, many of them immigrants, a substantial portion of them women of color in the urban North and free Black women in the antebellum South — were the primary providers of pregnancy care in nineteenth-century America. They attended deliveries. They managed postpartum recovery. They prescribed herbal remedies for irregular menses and provided abortion services through quickening with no more legal consequence than a barber providing a shave. Reproductive health, in other words, was women's work — managed by women, for women, within a clinical infrastructure that women had built and that served women's needs on women's terms. The professional infrastructure of obstetrics as it would be reconstituted in the late nineteenth century — hospital-based, physician-led, exclusively male in its credentialing — did not yet exist. The American Medical Association had been founded only in 1847, and it had spent its first decade and a half as a professional advocacy group without meaningful regulatory power.⁴ The companion essay in this series on the destruction of American midwifery will trace the mechanism by which that women's infrastructure was systematically dismantled — not because it was clinically inferior, but because it was commercially inconvenient.

The other piece of the setup that the standard telling tends to omit is demographic. In the second half of the nineteenth century, the white Protestant native-born population of the American Northeast was reproducing at rates substantially lower than the immigrant Catholic populations arriving from Ireland, Germany, and Southern and Eastern Europe. The pattern was visible in census data. It alarmed a particular faction of the American professional class — men who would later be described, accurately, as nativists — and it gave their campaign against abortion a demographic argument that the moral and religious arguments alone could not generate.

The man who articulated this argument most explicitly was a Boston gynecologist named Horatio Robinson Storer, the son of an obstetrician, a graduate of Harvard Medical School, and the principal architect of the AMA's nineteenth-century anti-abortion campaign.⁵ Storer's argument, made in print across the 1860s, was that white Protestant native-born women were terminating pregnancies at rates substantially higher than immigrant Catholic women, and that the failure to restrict abortion would, within two generations, produce the demographic eclipse of the population whose interests Storer understood himself to represent. The AMA awarded Storer's anti-abortion essay its highest prize in 1865. The argument was nativist. The argument was, in modern terminology, explicitly racial. The argument was also extremely effective at moving state legislators. And the argument is the same one being made today. The demographic panic that Storer voiced in the 1860s — that the wrong women are reproducing and the right women are not — is the same demographic panic that animates the post-Roe assault on reproductive rights in 2026. The target population has shifted. The rhetorical framing has been updated. But it is the exact same argument, rinsed, washed, and repeated across a hundred and sixty years.

By 1873, in other words, three forces had converged in the American legal and cultural landscape that had not been converged in 1850. The medical profession had organized itself into a national lobby with a coherent agenda — the elimination of midwives, the criminalization of abortion, the consolidation of all reproductive care under physician authority. The Victorian moral framework had transformed female sexuality from a topic discussed openly in popular medical literature into a topic that could not be discussed in print without legal consequence. And a federal political environment, in the aftermath of the Civil War and during the early Grant administration, had produced an unusually pliant Congress willing to pass moral-policing legislation that an earlier generation of legislators would have rejected as a violation of the First Amendment. The companion essay on the history of the AMA will trace how that professional lobby operated — and how its institutional descendants continue to carry the organizational DNA of the campaign that produced the Comstock Act. Into this environment walked Anthony Comstock.

The Mechanism

Anthony Comstock arrived in Washington in early 1873 with a draft bill, the financial backing of the Young Men's Christian Association, and a portfolio of seized obscene materials that he displayed to members of Congress in private meetings throughout the winter session.⁶ His framing was straightforward. The United States Post Office, as the only national distribution network with a federal monopoly, was being used to deliver obscene materials — pornographic photographs, contraceptive devices, abortifacient preparations, and the printed information that taught women how to obtain any of the above — directly to American homes. The remedy he proposed was to make the use of the federal mail for any of these purposes a federal felony, and to vest in the Post Office Department itself the authority to inspect, seize, and prosecute.

The bill that passed Congress on March 3, 1873, and that Grant signed the same day, did exactly that.⁷ Section 2 of the Act prohibited the mailing of "every obscene, lewd, or lascivious book, pamphlet, picture, paper, print, or other publication of an indecent character" — language that on its face read as a pornography statute. But the same section, in its enumeration of prohibited categories, listed "every article or thing designed, adapted, or intended for preventing conception or producing abortion" and "every written or printed card, letter, circular, book, pamphlet, advertisement, or notice of any kind giving information, directly or indirectly, where, or how, or of whom, or by what means any of such mentioned matters" could be obtained. The effect was to make federal felonies not only of the mail-order distribution of contraception and abortifacients but of any printed reference to where contraception or abortion services might be obtained.

The enforcement mechanism was the part that made the statute operationally durable. The Act granted Anthony Comstock himself — appointed within weeks of its passage as a special agent of the Post Office Department — sweeping authority to open mail, seize materials, and arrest the senders and receivers.⁸ Comstock spent the next four decades using the authority. He arrested an estimated four thousand people. He destroyed an estimated fifteen tons of printed material. He drove medical publishers, pharmaceutical wholesalers, and physicians who had previously corresponded freely with patients about reproductive matters into a posture of fearful self-censorship from which the American medical profession would not fully emerge for nearly a century. The chilling effect was the operational point. The arrests were the demonstration.

Twenty-four states passed parallel state-level Comstock laws between 1873 and 1885, extending the prohibition from federal mail to intrastate commerce.⁹ The AMA's parallel state-by-state campaign to criminalize abortion at all stages of pregnancy, which had been moving in fits and starts since the 1857 founding of the Storer-led committee, accelerated rapidly after 1873. By 1880, abortion had been criminalized in every state and territory in the Union — not merely after quickening, as the older common-law framework had specified, but from the moment of conception, with criminal penalties that applied not only to the practitioner but, in many states, to the woman herself. The criminalization of contraception followed the same path, often through the same statutes.

The most analytically important feature of the Comstock mechanism, for present purposes, is what it did to the medical profession. Before 1873, the open discussion of contraception and pregnancy management between a physician and a patient — in person and in writing — was a routine feature of clinical practice. After 1873, any physician who put any of that discussion into a letter that crossed state lines, or into a printed pamphlet for patient education, or into a textbook that included contraceptive technique, was a federal criminal under the plain text of 18 U.S.C. § 1461. The statute did not require enforcement to operate as a chilling device. The existence of the statute was sufficient. Medical textbooks of the 1870s and 1880s were systematically purged of reproductive content. Patient-counseling correspondence was systematically destroyed. A generation of American physicians was trained in a regulatory environment in which the management of pregnancy was, formally, a topic that could not be put into writing without criminal exposure. The professional norm that emerged from this training — the assumption that reproductive decisions were the property of the state and the physician, not the patient — outlasted the active enforcement of the statute by half a century.

The Aftermath

The most immediate aftermath of the Comstock Act was the underground migration of an entire category of medical practice. Abortion did not stop. It moved. The estimate most frequently cited by reproductive-rights historians — that between 200,000 and 1.2 million illegal abortions were performed annually in the United States during the mid-twentieth century — describes the steady-state condition of the system that Comstock and the AMA's parallel state campaign built.¹⁰ The deaths produced by that underground system — most often from sepsis, hemorrhage, and uterine perforation — fell, with the regularity that public-health statistics produce when the underlying social architecture is stable, disproportionately on Black women, on poor women, on women in the rural South, and on women without the financial means to travel to a Northern city where a discreet physician would, for a fee, perform a procedure in his office. The wealthy were not bound by Comstock. The poor and the dark-skinned were. This is the same division that the post-Dobbs landscape of 2026 reproduces with high fidelity.

The first serious legal challenge to the Comstock framework did not come from physicians. It came from a former obstetrical nurse named Margaret Sanger, whose mother had died at forty-eight after eleven live births and seven miscarriages, and who had spent the early 1910s working in the tenements of New York's Lower East Side watching the same pattern play out in the lives of her patients.¹¹ Sanger opened the first birth control clinic in the United States in Brownsville, Brooklyn, in October 1916. She was arrested within ten days, charged under the New York Comstock statute, and sentenced to thirty days in the workhouse. The publicity from the arrest produced the national conversation that the underground system had successfully suppressed for forty-three years. The legal architecture that Sanger and her successors built over the following half-century — the American Birth Control League, the case-by-case judicial narrowing of the Comstock Act, the eventual founding of Planned Parenthood — was, in its entirety, a response to a statute that had never been repealed.

The Reckoning

A fact that the standard narrative of the Comstock era tends to omit — because the standard narrative is written by the professional descendants of the men who built the system — is the degree to which the medical profession itself is responsible for the legal architecture we are now watching revive. Physicians are responsible for where we are. The American Medical Association, through its nineteenth-century campaign to criminalize abortion at all stages of pregnancy and to destroy the midwifery infrastructure that had provided reproductive care for centuries, built the professional and political framework that Anthony Comstock exploited and that the post-Dobbs legal movement is now reactivating. The AMA owes women an apology. It is that straightforward. We would not be here without those framings. We would not be here without the destruction of midwifery. We would not be here without the political alliance between a professional medical lobby and a moral-policing apparatus that between them produced a legal regime under which women's reproductive decisions became, simultaneously, a matter of criminal law and a matter of professional jurisdiction from which women themselves were excluded.

People within the profession may be allies now. Many of them are. But we cannot forget where this profession was born, because it still carries the markers that produced today's crisis. And the profession's current leadership is not stepping up. OB/GYN leadership's job right now — the central responsibility of every professional organization that claims to represent the interests of women's health — is to be in front of Congress advocating for the legislative protections that would make the Comstock revival impossible. Instead, they are writing practice bulletins. A self-funded team of roughly ten people is making more noise on this issue than the professional organizations with budgets, lobbyists, and institutional access. That is, in my judgment, unforgivable. If you do not think that this fight is your job, you should not be in leadership. Leadership means preparing the people under your protection for what the profession actually demands. And what the profession demands right now is not another clinical guideline. It is political action.

The Constitutional Ceiling

The Supreme Court began to narrow Comstock in the 1930s. In United States v. One Package (1936), the Second Circuit, in an opinion by Augustus Hand, held that the Comstock Act did not apply to the mailing of contraceptive materials to physicians for legitimate medical use.¹² In Griswold v. Connecticut (1965), the Supreme Court struck down a Connecticut state-level Comstock statute as applied to married couples, articulating for the first time a federal constitutional right to privacy in matters of contraception. Eisenstadt v. Baird (1972) extended that right to unmarried couples. Roe v. Wade (1973) extended it to abortion. None of these decisions repealed the Comstock Act itself. They constructed a constitutional ceiling above it, on the theory that the statute could not be enforced against any conduct that the constitutional right to privacy now protected.

The Dobbs decision in June 2022 removed that constitutional ceiling.¹³ The Comstock Act, sitting unaltered in the United States Code, became a federal statute whose substantive prohibitions on the mailing of "every article or thing designed, adapted, or intended for producing abortion" were no longer foreclosed by a constitutional right that the Supreme Court had now formally rescinded. Within months of Dobbs, conservative legal scholars and anti-abortion litigation organizations began openly arguing that the Comstock Act was, in its full original force, the legal mechanism by which a national abortion ban could be implemented without any new legislation at all. The Department of Justice under the current administration has, as of the spring of 2026, declined to clarify its enforcement posture. The administrative posture is the threat. The statute is the weapon. The mechanism for revival is, in the analytic sense the Comstock framework taught American physicians to fear, already in place.

This is not an accident. Dormant statutes like the Comstock Act are not legislative oversights — they are deliberate traps, standing checks on society that the conservative legal movement has preserved precisely because they are available for reactivation when political conditions permit. And they are fundamentally incongruent with the conservative movement's own rhetoric about rights and freedoms. Conservatives pass laws that directly conflict with the rights they claim to champion. The resolution of that incongruence is the thing this series will make visible: when they say rights, they implicitly mean the rights of citizens — and they do not regard women, and they do not regard people of color, as full citizens. In their framework there is no conflict, because we were never part of the discussion.

The Apparatus

What carries forward from 1873 into 2026 is not a single statute, although the statute is the load-bearing element. What carries forward is the architecture of a federal-administrative posture that treats reproductive decisions as a category of correspondence the state has the authority to read, intercept, and prosecute. The current Critical Infrastructure essay on The Privacy — Essay 5 in the companion series — describes how the digital-surveillance descendants of Comstock's postal-inspection authority are being assembled inside the 2026 federal government, with period-tracker subpoenas, geofence warrants on abortion-clinic visits, and the post-2024 narrowing of the HIPAA reproductive-privacy rule supplying the data layer that Comstock would have needed a network of postal inspectors to provide.

But the 2026 version of the apparatus has a capability that Comstock's did not, and it changes the calculus entirely. These laws — which were always draconian — become outright dystopian in the age of artificial intelligence, because AI enables the kind of complete, continuous surveillance that makes the selective enforcement of a restrictive penal code into a mechanism of total social control. The historical constraint on the Comstock apparatus was economic. Constant surveillance required people — human beings who physically opened mail, read letters, inspected packages, and filed reports. That cost created a natural limit on how oppressive enforcement could be. You cannot hire enough postal inspectors to read every piece of mail in the country. You cannot hire enough agents to monitor every reproductive-health conversation. The enforcement bottleneck was a structural protection, and for a century and a half it functioned as one.

AI removes that bottleneck. The cost of surveillance drops to near zero. The capacity for pattern-matching, keyword detection, behavioral prediction, and cross-referencing across datasets that include health records, location data, search history, and financial transactions becomes, in the relevant operational sense, unlimited. And the current federal government has already demonstrated that it wants this capability and is willing to coerce the private sector to obtain it. The confrontation between the Department of Defense and Anthropic — one of the leading American AI companies — was, at its core, a fight over exactly this: the government's demand for unrestricted access to AI capabilities that would enable the kind of surveillance the Bill of Rights was designed to prevent. Even the line that conservatives historically would not cross — messing with the profits and autonomy of one of the most valuable technology companies in the country — they crossed to get this. That should tell you how seriously they take the opportunity.

What keeps most Americans out of jail is not that most Americans do not break laws. The penal code is extraordinarily restrictive. What keeps most Americans out of jail is that most laws are never prosecuted. Selective enforcement is the norm. Full enforcement — the capacity to detect, charge, and prosecute every violation of every statute on the books — would give the state a precise coercion lever over every citizen: anytime the government needs you to comply, it has the legal basis to compel you. The Comstock Act, sitting unrepealed in the United States Code, is one such lever. An AI-enabled surveillance state that can monitor every American's reproductive health data in real time transforms that lever from a theoretical possibility into an operational capability. If they get this capability, it is game over for our freedoms. That is not a partisan statement. Every American — regardless of their position on reproductive rights — has a vested interest in ensuring they do not.

What You Can Do

Every essay in this series ends with action, because action is the reason to join and the answer to the question people always ask: what can I do? We need to give people playbooks. They want action. And the work starts now.

Where they wrote Project 2025, we write Project 28. The specifics are stackable, concrete, and ready-to-govern. First: voting rights. The 2026 midterm — five Senate races, the House majority — is the proximate determinant of whether the Comstock revival happens in the next administration or whether it is delayed by appropriations and confirmation politics. Every lever named in this essay and in the companion Critical Infrastructure series runs through the same mechanism: elected representation. Vote. Fund. Write.

Second: shore up reproductive rights in every manner of the law. Do not depend on a single constitutional decision, because a single Supreme Court opinion can reverse it. Stack the law. Federal Right to Contraception Act. Federal Women's Health Protection Act. Explicit state-level repeal of every dormant Comstock-equivalent statute. If we come back into power, these must be ready. We cannot just finagle a bagel and think it's going to happen. The legal architecture of reproductive protection needs to be drafted, costed, and politically sequenced before Election Day 2028.

Third: strengthen the medical profession's infrastructure so it can respond to the crisis it is in — a crisis it helped create — and to the crises it will face inside and outside the healthcare system over the next decade. The profession that was built in the nineteenth century by destroying midwifery and criminalizing reproductive autonomy needs to be rebuilt into something that can actually serve the population it claims to protect. That rebuilding is a project, not a wish.

This is the first essay. The Long War continues.