Missouri now prohibits almost all abortions, following the overturning of Roe v. Wade, and many other Midwestern states are likely to follow. It’s a return to a time when states could ban abortion with few exceptions.
Missouri lawmakers first passed a law restricting abortions in 1825 — becoming the second state in the U.S. to do so. In 1907, they expanded the penalties, making it a felony offense.
But whether or not abortion is criminalized, that hasn't stopped people from trying to terminate their pregnancies.
"Doctors could face fines or jail time for performing an abortion. So they wanted to fly under the radar so as not to be arrested," says Dr. Evan Hart, an assistant professor of history at Missouri Western State University.
As a result, we don't know much about the doctors who provided these health care services. With one major exception: Doctor Annie Smith.
And only because she's the subject of a popular ghost story around the town of Poplar Bluff, Missouri.
Macabre tales
If you were around Poplar Bluff in the 1970s, you might have heard a tale about a mysterious witch-like woman known as “Doc Annie.”
As high schoolers told it, she was infamous for performing abortions.
“A group of us as teenagers would go out there and tell ghost stories about abortions and dead babies and all kinds of macabre things,” a local resident told KBIA's podcast Show Me The State in 2019.
Rumor had it Doc Annie was building an abortion clinic at her now-abandoned property just outside town; she supposedly kept babies in jars of formaldehyde and threw fetuses in her well.
Most of these details were total fabrications.
But they are rooted in some truth. Doctor Annie Smith was a real physician in the early 1900s.
Originally born in Iowa, Smith graduated from osteopathic school in Kirksville, Missouri, in 1902. Shortly after, she and her husband moved to Poplar Bluff — which sits in the southwest corner of the state — and opened Smith Hospital.
There's no longer any evidence of Smith Hospital today. But at the beginning of the century, the large, white house sat near a historic art deco movie theater.
There, they treated women and children for all kinds of health problems: tuberculosis, appendicitis, arthritis. They offered therapeutic treatments like "Sun Baths" and "Complete Electro-Therapy."
And over her long career, Smith also provided a number of illegal abortions. Mostly, she was helping to save women from their own, botched abortions.
"One of the cases that Doc Annie had, the woman had done something to herself, and she was trying to fix it," says Kati Ray, a board member at the Poplar Bluff Museum.
Twice, Smith was charged with felony manslaughter after her patients died. She was one of many Missouri doctors to face charges for abortion before the 1973 Roe v. Wade decision that legalized abortion nationwide.
“It was rare that those cases didn't make their way into the courtroom," Hart explains. "What this suggests is that Doc Annie probably performed many abortions safely. Thus everyone kept it quiet, and either the authorities knew and turned a blind eye, or the authorities didn't know she was doing this."
Smith was eventually exonerated of both manslaughter charges by the Missouri Supreme Court — in 1934 because the procedure was performed in a life-or-death situation (the sole exception for Missouri's abortion ban), and in 1939 because there wasn’t enough evidence that proved she did it.
Despite being cleared of wrongdoing, however, these cases came to define Smith's reputation as a "spooky-looking humped over woman" and "baby killing nut."
At some point, Smith started building a large house outside of Poplar Bluff where she could be self-sufficient. The house had a well and room to pasture livestock (she thought preservatives in food were giving people cancer).
But she died in 1962, before the home was finished — fodder for an urban legend to spread of Doc Annie's "haunted hospital."
“She is still a very controversial figure around town. And if you talk to anybody about it, it runs the gamut of horrible butcher to champion for reproductive rights," Ray says.
'What she thought was right'
By and large, though, Smith's work was ordinary. She was just a doctor, trying to help women however she could.
In addition to treating your run-of-the-mill illnesses and diseases, Smith also facilitated a number of adoptions. Once, she even adopted a child herself from a patient.
"It was interesting to see just the different ways that she cared for her patients," says Parker Smith, her great-grandson.
Parker Smith first learned about his great-grandmother in 2014, when he was a college freshman. But he didn't think much of it until four years later, when he dug into the family story for a paper he was writing while pursuing a master's degree in public health at the University of Missouri.
Almost all of what we know about Doc Annie today, in fact, is because of Parker Smith's research. He's spent hours interviewing family members and digging through his own family history.
The first thing that stood out to Parker Smith was how controversial Doc Annie was even in her own family. His dad refused to talk to him about her — and multiple family members had faced professional repercussions in town because of their association with her.
Parker Smith learned about her skills, too. Doc Annie was famously ahead of her time when it came to women's health, advising pregnant patients not to eat for two people to prevent associated issues, and encouraging new mothers to get moving as soon as possible after birth to prevent blood clots.
His family told him Doc Annie was known for being a bit "cold." But Smith says that didn't extend to how she treated her patients.
"I believe that she did what she thought was right. And did the best that she could for her patients at the time," Smith says.
Today, Doc Annie's legacy takes on a new poignancy for Parker Smith as he starts his second year of medical school at the University of Missouri. He was considering going back to Poplar Bluff to practice medicine after he graduated, after seeing what a difference his great-grandmother made there.
But now, he's not sure there's a future for him there anymore.
"I think all of these new outright bans as well as restrictions are dehumanizing, strip autonomy from people who need abortions, and serve as nothing more than a furthering of a crusade to strip power from people who don't have a lot of it," Smith says.
It's also hard for Smith not to see the parallels between what his great grandmother dealt with in the 1930s and the kinds of conversations that physicians are having today.
When the U.S. Supreme Court overturned Roe v. Wade in June, Missouri only had one remaining abortion provider for the entire state. But after the state's trigger ban took effect, that service is now only an option in cases of a medical emergency to save the patient’s life.
Just like Doc Annie experienced nearly a century ago — in the criminal cases that brought her before the Missouri Supreme Court — those circumstances aren’t always clear.
This month, Colleen P. McNicholas — the chief medical officer at Planned Parenthood of the St. Louis Region and Southwest Missouri — told Congress that Missouri’s law is putting patients’ lives at risk because doctors have to wait for guidance from lawyers.
"In order for doctors to avoid prison time, doctors must now contemplate how sick is sick enough before providing life-saving abortion care," McNicholas testified.
Still, the subject of abortion remains touchy in Doc Annie’s adopted hometown of Poplar Bluff, where she's been mostly erased from the public history. At the Poplar Bluff Museum, there's a "medical room" that documents the area's former hospitals and physicians — but no mention of Doc Annie at all.
Ray, for one, would like to see Smith's story incorporated into the museum, and acknowledged by the town. She proposed an exhibit on Doc Annie years ago, but the museum board decided it was too controversial.
"It's kind of a fine line we walk as a local museum," Ray says. "We don't want to be a platform for controversy... but yet, history is history. We can't get rid of our history."
A People's History of Kansas City is hosted by Suzanne Hogan. This episode was produced and mixed by Mackenzie Martin and edited by Gabe Rosenberg. For more stories like this one, subscribe on Apple Podcasts, Spotify or Stitcher.
This story is being distributed in partnership with Harvest Public Media, a collaboration of public media newsrooms in the Midwest. It reports on food systems, agriculture and rural issues. Follow Harvest on Twitter: @HarvestPM.
The excerpt from KBIA’s Show Me The State podcast was produced by Jamie Hobbs with supervising producer/reporter Kristofor Husted and managing editor Ryan Famuliner.
