The back-street butchers

She was an ordinary working class woman with five children to feed - and could not cope with another. It was the early 1950s and abortion was illegal, but when the 35-year-old heard of someone who would "help" her for a couple of pounds, she took the chance.

Days later, she lay clutching her stomach in agony in a hospital in London, dying from a huge internal growth which had developed from a perforated abdomen, the result of a bungled abortion.

To this day, her haunted features and subsequent death are etched on the memory of Jennifer Worth, who was then a young trainee nurse.

"I still vividly remember her," says Jennifer, now 69 and living in Hertfordshire. "What I will never forget is the five children who were brought in just before their mother died. It was so sad, the poor soul."

The mother was one of thousands of women who were brought onto the hospital wards with sickening injuries prior to the 1967 Abortion Act. Illegal abortions were the only option for women who were so desperate to be rid of their unborn children they were willing to sacrifice their future fertility and worse, their lives.

"They knew the risks but their desperation was so great that they went ahead anyway," says Jennifer, who worked as a nurse and midwife in Reading and London from 1953 to 1973.

"But to them, they might have lost their lives if they had had the baby. Socially and economically, an illegitimate pregnancy, until very recently, was about the worst misfortune that could occur to a woman."

Some, like the mum-of-five, could simply not afford to feed another mouth. Others faced the deep humiliation of a child born out of wedlock.

Not all pregnant woman had to endure the horrors of a back-street abortion. For around 100 to 150 guineas, says Jennifer, the rich could pay for a private, legal abortion by having a psychiatrist certify that the woman was not mentally fit to bear a child.

It was the poorer, working class women who found themselves desperately scraping together the one or two pounds needed to pay for an illegal and frequently deadly alternative. This was an enormous feat when working women would earn around £2 per week. Often, they would need to save the money in secret and would face the bloody procedure alone. Occasionally, they would tell a friend their guilty secret, but rarely was the man aware.

The abortions tended to take place at the woman's home, primarily because she would be unable to walk afterwards. The operations would be carried out on the kitchen table with crude instruments such as knitting or crochet needles. Because the cervix (the neck of the womb) is clamped tight during pregnancy, the knitting needles with their blunt points would be used to dilate the woman. There was no anaesthetic and little light to see what the abortionists were doing.

"Women with no training would just jab away with knitting needles, hoping to get through the cervix," says Jennifer. "If they missed, they might end up straight through the uterine wall and that is where you saw a lot of injuries. We would see it, down on our theatre list, 'Repair of Uterus Wall' and for what other reason would a uterus need repairing, except because of some forcible object being pushed through it?"

If the abortionists pushed too hard with the needle, they could also damage the abdominal cavity. After entry to the cervix, they would take an instrument - typically a long handle pickle spoon or a crochet hook - to "scrape" the woman, thereby removing the foetus and the placenta. The entire tortuous procedure would take anything from 20 minutes to an hour.

Of the 30 women on Jennifer's gynaecological ward, around four of them at any one time would be admitted with "unexplained injuries".

"There would be injuries to the whole of the vaginal tract and the cervix; sometimes it was perforation of the uterus or rectum, they could even have perforated the bladder leading to kidney problems," she says. "Then there would be cases of unexplained bleeding and thrombosis. Throughout it all we never asked why. If any doctor or hospital got to know of an abortion taking place we were obliged to tell the police, but I never knew of this being done.

"As a professional you just got on with the job. We were there to heal and to care and were not there to make moral judgements."

The abortionists were predominantly female and unqualified, although some were midwives, nurses or medical students and therefore had some medical training. Many were mothers or grandmothers themselves and looked at what they were doing as a service.

"They will have been known in their areas, particularly in remote country areas where there was little supervision," says Jennifer. "I heard that one abortionist worked in some remote village in Essex and she was well regarded in her area because she did the job sufficiently for many years. But then a mother came with her pregnant 14-year-old daughter and begged her to carry out an abortion, even when on this occasion she didn't want to. The child died and the woman was imprisoned for manslaughter."

That story echoes the plotline in the new Mike Leigh film, Vera Drake, which centres on an illegal abortionist working in the 1950s. Vera, played by Imelda Staunton, works as a domestic cleaner who "helps" women by terminating their pregnancies. She is eventually arrested, to the astonishment of her husband and children.

Jennifer has seen the film, and commends it for highlighting what was, and still is, a taboo subject. But she has serious reservations about the way Vera carries out the abortions - namely using a tube, syringe, soap and water - and about her giving the impression the operation can be carried out in minutes.

"There is only one way to terminate a pregnancy and that is by surgery," she says. "Vera Drake goes around with a bit of soap and water and squirts it into the uterus, which is not only nonsense it is dangerous, because if you try and inflate a uterus you will kill a woman instantly.

"There are many countries where abortion is still illegal and many women may watch it and wrongly believe that by inserting a little nozzle and squirting a bit of soap they will create an abortion. That would be extremely dangerous."

Today, according to the World Health Organisation, around 80,000 women die every year from what it describes as "unsafe" abortions. Abortion is still illegal in countries such as Ireland, Portugal, Poland and Switzerland, and in Latin America.

By the time David Steel's Private Member's Bill led to the Abortion Act of 1967 in Britain, Jennifer was a ward sister on a gynaecological ward. Thousands of women had died or been left infertile, and carried the horrific mental and physical scars of their back-street abortions.

"I was asked once if I approved of the act and I always said it's not a moral issue, it's a medical issue," says Jennifer. "There will always be women who need an abortion and they need to be carried out properly."

* Jennifer Worth is the author of Call the Midwife (Merton Books, £14.99), available from bookshops or by mail order from Merton Books, PO Box 279, Twickenham TW1 4XQ (020 8892 4949).

*Vera Drake is released on January 7.