Historical Perspective: The Career of Dr. R. Nuran Turksoy and the Evolution of Women's Health

In the late 1950s, a young resident physician spent her days and nights caring for gynecology patients at the Graduate Hospital of the University of Pennsylvania, which served a low-income community in Philadelphia. Many of those women were there because of an “incomplete” induced abortion—a malady the resident, Nuran Turksoy, described as a “perpetual problem” in an era when the procedure was illegal. ¹

Dr. Turksoy was my mother. She had come to the United States in 1953, after graduating from the University of Istanbul Medical School, with the plan of honing her obstetrics and gynecology skills before returning to her native Turkey. In the aftermath of World War II, she viewed the United States as a beacon of state-of-the-art medicine. But her journey was more difficult than she expected. She was hindered by her status as a female foreign medical graduate, in an era when fewer than 6 out of 100 physicians were women, and virtually none in obstetrics and gynecology. ²

She served 3 years in separate internships at urban hospitals in Chicago, Baltimore, and the Bronx. An Israeli friend told her about a 1-year program at the University of Pennsylvania's Graduate School of Medicine. She enrolled, excelled academically, and earned an obstetrics and gynecology residency spot at the Graduate Hospital of the University of Pennsylvania's obstetrics and gynecology training program, where she was the sole female physician.

In a 1958 article, ¹ she reviewed the cases of 335 women admitted to Graduate Hospital's gynecology service for incomplete abortion—the leading reason for admission to the inpatient gynecology service at the time. ¹ All had clinical and/or pathological evidence of an infection, and in more than a third of cases, their infection had spread beyond the uterus. More than a third required transfusions. Two developed pulmonary emboli, and one died. ¹

My mother and other physicians were able to save many of these women's lives because of advances in transfusions and antibiotics, which were both relatively new at that time. ³ Despite those advances, 266 women were officially classified as dying from the complications of illegal abortions in the United States in 1955, ⁴ according to the National Office of Vital Statistics. ⁴ These numbers are a gross underestimate, since many such deaths were commonly misclassified due to the stigma of abortion and unwed pregnancy.

In one highly publicized 1955 case, the family physician of a supermarket heiress, Doris Silver Oestreicher, initially reported that she had died of an allergic reaction, leading the Philadelphia medical examiner to agree to release her body without an autopsy. ⁵ It was not until a tenacious newspaper reporter began asking questions that the Philadelphia District Attorney revealed that she had died of an “illegal operation”—code words for an abortion. ⁵ The hairdresser who performed her abortion was sentenced to 22 months in prison, and the hairdresser's husband, a bartender, was sentenced to 11 months. ⁶

The words my mother used in her report hinted at patients' reluctance to disclose that they had sought to end their pregnancies. The article stated that none of the women “confessed” to using a foreign body, though it did not specify how many of the women admitted to having tried to induce an abortion. Of the women who did reveal that they had tried to end their pregnancy, most stated that they had used high pressure douching. Nearly a third of the women told the medical staff that they had not missed any menses. Half said this had been their first pregnancy. Reflecting the mores of its time, the article reported that more than a third of the patients were unmarried. It did not report the patients' race and ethnicity. ¹

My mother never forgot the women whom she saw suffer the consequences of illegally performed abortions; decades later, she told me that she had seen many women die. Her years as a front-line obstetrics physician also taught her that pregnancy itself was inherently risky. Her training experiences shaped her decision to focus on the then-nascent field of reproductive endocrinology. A military coup derailed her plans to return permanently to Turkey. ⁷ After residency, she became a Barnes Foster fellow at Columbia University, ⁸ where, under the mentorship of Drs. Raymond VanDeWiele and Anna Southam, she investigated factors influencing ovulation. ^9,10

With funding from the Population Council and Ford Foundation, she performed early research on the Copper T IUD. ¹¹ She established the reproductive endocrinology laboratory at Tufts New England Medical Center and was the first physician in Boston to use menotropin to induce ovulation. ¹² She later served on the U.S. Food and Drug Administration's Obstetrics and Gynecology Drug and Device Advisory Committee, ¹³ reviewing IUD safety. In the 1970s. she was the first woman inducted into the century-old Obstetrical Society of Boston. ¹⁴ For the following two and a half decades, she mentored hundreds of young physicians, including many who became leaders in the field.

Having lived through World War II, and having witnessed enormous advances in medical care, she firmly believed in the United States as a force for scientific progress for the benefit of all humans, especially in the field of contraception and family planning. She died in 2019, unaware that in large swaths of her adopted country, that progress might be ephemeral. She would have been disheartened to know that seven decades after her residency, young U.S. physicians would again face the prospect of caring for people whose health had been threatened because of laws denying them the right to determine their reproductive destiny and the ability of their doctors to provide them with appropriate life-saving care.