Steven Chase Brigham and the Evolution of American Women’s Services

During the late twentieth century, the field of reproductive medicine faced intense external pressures. In May of 1990, several hundred physicians gathered in a conference hall at an Atlanta hotel, as uniformed guards stood at the door. Colleagues traded tips about installing bulletproof glass in their offices and spoke about fielding hate mail and death threats. It was the annual gathering of the National Abortion Federation, or N.A.F., a professional association with a beleaguered membership. At the time, fewer than a fifth of the counties in the United States had abortion providers. Since the mid-eighties, clinics across the country had been blockaded, vandalized, and firebombed. The right to safe, legal abortion, which had been established by Roe v. Wade, in 1973, would be rendered meaningless if a new generation of providers didn’t emerge soon.

The Background of Steven Chase Brigham

There was at least one younger face at the conference: Steven Chase Brigham. A handsome, genial man in his mid-thirties, with a square jaw and sandy brown hair, Brigham was a recent graduate of Columbia University’s medical school. Brigham, who was born in 1956, grew up in a middle-class family in Toledo, Ohio. A gifted athlete who excelled at wrestling and tennis, he also stood out academically. In 1974, he enrolled at the Massachusetts Institute of Technology, where he double-majored in physics and applied biology. He then entered an M.D.-Ph.D. program at Columbia. Although he embarked on a Ph.D. in molecular biology, he never completed a dissertation.

Early Medical Career and Training

Upon receiving his M.D., he did a yearlong internship in internal medicine at the Westchester Medical Center, then bounced around jobs: a few spells in emergency rooms, a stint at a smoking-cessation clinic. One day, while reading the classifieds in the Times, Brigham noticed that a gynecology center in Flushing was soliciting applications for a staff-physician position. Although he was not trained as a gynecologist, he applied, and he was hired. He soon found himself observing, and then performing, various medical procedures there, including first- and second-trimester abortions. However, the path was not without warnings. Another doctor warned Brigham, “You can’t do second-trimester abortions. You just started out, and you don’t have the skill level.”

Expansion of American Women’s Services

Despite early challenges, Brigham saw a significant opportunity for growth. By the mid-aughts, Brigham was the owner of a large chain of abortion clinics, American Women’s Services. The chain had expanded, in part, because he advertised aggressively, promising “caring and supportive” counsellors and “very low fees.” In addition, the number of abortion providers had continued to decline, creating a vacuum that Brigham was able to fill. “Dedicated to Reproductive Freedom and Quality Women’s Healthcare,” the Web site of American Women’s Services proclaimed, above a photograph of a smiling female physician in a white coat. Regarding his professional reach, his business operated in several locations:

• Total Branches: More than a dozen branches
• States of Operation: Virginia, Maryland, Pennsylvania, and New Jersey
• Business Headquarters: New Jersey

Geographic Expansion and Local Controversy

Brigham could see that there was a high demand for abortion, even in places where it was viewed with skepticism or hostility. In 1990, he travelled to a small, conservative town in southeastern Pennsylvania called Wyomissing and signed a lease to rent space on the ground floor of an office building. It was also a daring place to open an abortion clinic. Brigham told the building’s owners that he intended to start a family-medicine practice, with abortion integrated into a broader repertoire of care. Brigham began placing ads for abortion services in the Yellow Pages. The ads drew a steady stream of pregnant women to his office—and a steady stream of protesters, armed with placards and bullhorns. The controversy attracted extended scrutiny in the local press. One morning, Brigham later recalled, he glanced at the front page of the Reading Eagle and spotted a story about the turmoil outside his clinic. Many doctors in Brigham’s position faced similar scrutiny during this era.