The book I am about to publish began, quite literally, in a file cabinet in late 2019.
Not in Washington. Not in a university archive. Not in the Supreme Court. It began in the office of Allegheny County’s longtime coroner, Dr. Cyril Wecht — a man who spent his life moving between the clinical and the constitutional, and who practiced a discipline that now feels almost monastic.
Cyril read five newspapers a day.
He clipped them.
He saved them.
And for decades, he clipped stories about abortion.
When I first approached him, I was not looking for a national narrative. I was trying to write a local feature about something that had nearly slipped from public memory: that before Roe v. Wade, coroners in Pittsburgh performed autopsies on women who died from illegal abortions. Wecht had done so himself. He remembered the coat hanger. The turpentine. The clandestine operator who perforated a uterus.
Those cases were not abstractions. They were forensic realities.
I went to him for that story.
The rest, I found in his folders.
When he opened his cabinet, what emerged was not a single file but an argument unfolding across decades. His box did not contain relics from the 1940s — that earlier history I would later excavate in archives and medical journals. What Cyril had preserved was the modern debate as it happened around him.
There were letters from pre-Roe feminist organizations urging him to speak publicly in favor of abortion reform. They appealed to his authority not as an activist but as a medical examiner who had seen the cost of criminalization. They asked him to tell the public what illegal abortion had done to women’s bodies.
There were photocopied legal review articles dissecting cases across the country — including the prosecution of Dr. Ken Edelin in Boston, whose conviction for manslaughter after performing an abortion later in pregnancy became a national flashpoint before being overturned. There were debates about viability, about neurological death, about the limits of prosecutorial discretion.
There were flyers from Zero Population Growth — ZPG — whose environmental and demographic concerns were deeply intertwined with abortion reform in the late 1960s and early 1970s. In that moment, abortion was framed not only as autonomy but as public health, poverty policy, and even ecological necessity.
And then, in one of those folders, I found the Leonard Laufe case.
It was not why I had come. It was something Cyril had saved.
The 1974 coroner’s inquest into Dr. Leonard Laufe involved an abortion later in pregnancy performed on a woman who said she had been raped. Prosecutors accused him of manslaughter. The allegation was that a viable child had been born alive and allowed to die.
The Pittsburgh Post-Gazette headline was stark: “Dr. Laufe Cleared As Inquest Finds Baby a Stillborn.”
After seven days of testimony — unusually long for Allegheny County — the jury deliberated less than an hour.
The central question was definitional: What constitutes life? What constitutes death? Wecht explained to jurors both cardiopulmonary standards and the newer neurological criteria — brain death — which had only recently been formalized.
Only later did we sit down and speak about it in depth. He recalled the atmosphere, the testimony, the absence of sustained public outcry.
He remembered how the inquest functioned — not as a political rally but as a structured inquiry.
That structure matters.
A coroner’s inquest is an old common-law mechanism, largely abandoned in modern America. A jury is empaneled publicly. Witnesses testify under oath. Evidence is presented in an open forum. The coroner presides. The jury does not indict; it renders a factual finding and may recommend charges to the district attorney.
Wecht believed deeply in that transparency.
He used inquests more aggressively than almost any other coroner in the country.
During his two decades in office, he convened them in every police-related death. Black men killed by police officers in Allegheny County did not vanish quietly into prosecutorial discretion. Officers testified publicly. Evidence was aired. Findings were recorded.
That made him a divisive figure.
In some segments of the white population and within law enforcement circles, he was despised — accused of grandstanding, of undermining police authority. In many Black communities, he was admired, even beloved, for insisting that deaths not be buried in bureaucratic silence.
The inquest, in his hands, became a civic instrument — a way of forcing the state to explain itself.
Seen in that light, the Laufe file was not merely an abortion case. It was part of a larger philosophy: that contested deaths — whether in a hospital room or on a city street — deserved public scrutiny.
That discovery altered my trajectory.
What began as a local feature about back-alley autopsies became a six-year research project. Cyril then suggested I write a 12,000-word chapter for his forensic science compendium about how abortion had historically been investigated as a crime. That assignment forced me into the procedural architecture: autopsy reports, chain of custody, evidentiary standards, jury instructions.
The chapter became scaffolding.
From there, the work expanded backward into nineteenth-century criminal statutes and the professionalization of medicine; forward into Supreme Court doctrine, federalism, and contemporary state bans.
Abortion in America has never been a single argument. It is constitutional, medical, political, cultural and deeply personal. It has involved physicians and prosecutors, activists and theologians, legislators and juries.
Cyril’s file cabinet captured one crucial layer: the moment when feminism, environmentalism, criminal law, medicine and constitutional doctrine collided in the early 1970s.
I had not gone looking for that story.
I found it in his folders.
And from that discovery — from letters, law reviews, flyers, inquests, and verdicts — emerged a work far larger than the article I had first intended to write.
That work eventually became Given No Choice.
What began in a Pittsburgh coroner’s office expanded outward across centuries and continents. The book traces abortion not only through Allegheny County courtrooms or American Supreme Court decisions, but through ancient law codes, medieval theology, early modern medicine, nineteenth-century criminal statutes, and twentieth-century constitutional revolutions. It follows how societies have defined pregnancy, personhood, maternal risk, and state authority for millennia, long before the words “pro-choice” or “pro-life” entered the vocabulary.
The story moves from English common law to colonial America, from Victorian moral reformers to physicians seeking professional legitimacy, from the feminist movements of the 1960s to contemporary international human rights debates. It examines how abortion has been shaped not only by moral conviction but by demography, religion, technology and political realignment.
Pittsburgh is where the thread was first pulled.
But the tapestry it revealed stretches far beyond Western Pennsylvania.
As the research widened, so too did its modern dimensions.
The contemporary history of abortion in America is not a single event but a succession of strategic campaigns — legal, political, cultural. After Roe v. Wade, the argument did not end; it reorganized. Restrictions multiplied. Parental consent laws. Waiting periods. Targeted Regulation of Abortion Providers statutes. Funding bans. The fight migrated from the Supreme Court to state legislatures, from federal doctrine to incremental attrition.
In tracing that modern arc, I interviewed physicians who continued performing abortions later in pregnancy despite harassment and legislative hostility. I spoke with litigators who defended clinics in courtrooms where the legal terrain shifted year by year. I interviewed national figures in the reproductive rights movement who had spent decades crafting constitutional arguments designed to withstand an increasingly skeptical judiciary. Some had argued before federal appellate courts; others had stood outside clinic doors absorbing protest and threat. Still others had organized quietly, drafting briefs, filing injunctions, tracking hostile legislation line by line.
The modern history also required confronting the anti-abortion movement not as caricature but as a disciplined political force — one that understood federalism, judicial appointments and long-term strategy. The story of Dobbs v. Jackson Women’s Health Organization did not begin in 2022. It began decades earlier, in law school seminars, in judicial clerkships, in carefully cultivated state test cases designed to chip away at precedent until the foundation fractured.
My work on this history began several years before Roe was overturned. At the time, the possibility seemed theoretical to many. The precedent had survived repeated challenges. Yet as I examined the structure of the Court, the pipeline of judicial nominees, and the increasingly aggressive state legislation aimed directly at provoking review, it became clear that something foundational was shifting.
Research slowly became engagement.
I did not set out to become an activist. I set out to document a history. But history has a way of narrowing the distance between observation and participation. As the prospect of reversal moved from abstraction to probability, I found myself traveling — first for reporting, then for solidarity.
As the legal landscape shifted and the threat to Roe became more concrete, I launched a Substack newsletter called Repro Rights Now to document what I was witnessing in real time. What began as a place to share research notes evolved into a sustained chronicle of court rulings, legislative maneuvers and the lived consequences of abortion restrictions. It allowed me to move beyond the confines of traditional newsroom assignments and follow the story continuously, as it unfolded.
The writing blended journalism with advocacy in a way that felt unavoidable. I reported on hearings, quoted transcripts and analyzed judicial opinions with the discipline of a reporter. But I was also transparent about what I believed was at stake. The line between observer and participant did not vanish; it became explicit. I was covering a historic rollback of rights while arguing that the rollback itself demanded attention and resistance.
In that space, long-form legal analysis lived beside dispatches from protests and interviews with litigators and physicians. Repro Rights Now became a real-time companion to Given No Choice — a forum where history and breaking news converged, and where documentation itself became a form of engagement.
I stood in London outside Parliament Square as demonstrators gathered in the shadow of the Palace of Westminster, watching how abortion rights were framed in a different constitutional culture — one without a written constitution, one where parliamentary sovereignty, not judicial review, defined the debate.
I traveled to Jackson, Mississippi, to the modest, unassuming clinic on State Street that had become the epicenter of Dobbs. There was nothing monumental about the building. No marble columns. No sweeping steps. Just a clinic ringed by protest and prayer, police cruisers idling nearby, patients slipping quietly inside. That structure, so ordinary in its architecture, had become the instrument through which half a century of constitutional law would be undone.
Moving through those spaces — Parliament Square and Jackson, Mississippi — underscored something the archival work had already suggested: abortion is never merely local. It is always nested inside larger frameworks of power — national identity, judicial philosophy, religious tradition, demographic anxiety.
The work that became Given No Choice, therefore, evolved beyond narrative history. It became a witness. It records the legal strategies, the human stories, the political machinery and the global reverberations of a debate that did not end with Roe and did not begin with it either.
If the file cabinet in Pittsburgh provided the point of origin, the road carried the argument outward — across oceans, across courtrooms, across communities divided by conviction but united by the fact that the question will not disappear.
The book reflects that journey: from the archive to the interview, from the courtroom transcript to the public square.
And it tells a story far larger than any single case, city or country.
Given No Choice tells the story of how abortion became one of the most enduring and combustible questions in human history — not because it is modern, but because it is ancient. Not because it is partisan, but because it sits at the intersection of biology, law and power.
The coroner kept the record of one era.
The book attempts to follow the argument across all of them.
