Uta Landy

“Reproductive control is absolutely the essence of freedom and equality for women.”

Interviewed by Judy Waxman, March 2022

UL:  I’m Uta Landy, and I was born in 1945, six months after the Second World War was over, in a city, at the time, named Chemnitz, which was then later renamed Karl-Marx-Stadt. It was in the zone that was occupied by the Russians after the war.

JW:  I see. What country is it now?

UL:  It was East Germany and now it has reunited with West Germany and now it is all one Germany. Should I tell the story?

JW:  Please tell the story.

UL:  I was born into an incredibly poor environment. Everything was destroyed and there was an enormous shortage of food. For example, just a special treat that a colleague of my mom’s gave me when I visited her at work was a little cup of sugar, because we had no candy. We had nothing. Everything was imitation chocolate. Everything was extremely limited in terms of supply. My family was Catholic, but we were what they call diaspora.

There were not many Catholics there – and when I was in school, my teacher would make fun of Catholics in front of the whole class and it was not a very popular thing to be in a communist country. But as a child, I was not very affected by that outsider status. I did also join the Young Pioneers and wore my blue scarf very proudly. I think that was an early sign of being pragmatic.

Eventually, when I was 10, my family decided to escape to the West. That was before the wall was built and we were able to. My parents decided to take a very busy day and take a train that was still going above ground from East Berlin to West. We could not be checked thoroughly during that busy holiday time. We hid the two suitcases that they brought along for a family of four, that was it, under our legs with several coats draped over them. We wound up in the West – very poor for the first few years of our lives.

My father eventually was able to get a position as a primary school teacher which was not his position in the East. He actually worked for a special academy that prepared children of workers and farmers for university who did not have that chance before. That was a communist ideology for everyone to be able to pursue a secondary education and to go to the university, which he himself actually did also after the war. In the West, one of his first positions was in a tiny little village, in a one-class school house.

I was one of my father’s students. I was the only one in my grade. We had to do a lot of things, like get the wood stove going in the morning and heat it up before the students came. He always punished me because I was a chatterbox, and so he would send me out of the classroom. I would just go across the hall, which is where my family actually lived, and my mother would say, “Oh, did you get in trouble again?”

JW:  Again? Moving on, you had one sibling?

UL:  Yes. I had a younger sister and we were very close. I would say from an early age on, there was a very definitive order to life in the village. At that time, and my father changed that, nobody went to secondary school, but I did. What happened in the village is that as a young woman, you would eventually marry, and the majority of women who got married in the village were actually pregnant, so they “had to” get married. I knew that that was not the trajectory I wanted to pursue.

From a very early age on, once I learned that there was the big wide world out there, I collected photographs from the equivalent of a National Geographic Magazine and I put them on my wall beside the bed – the Sahara Desert, the Taj Mahal, Wall Street, and on and on. I clearly had this dream that I was going to go out into the world and explore it.

One of these opportunities came because I wanted to study psychology and I only had French and Latin in school. I needed to learn English because psychology was a new field and a lot of the research was being done and published in English. I went to Scotland to be an au pair girl, but that fell through and instead I wound up being a nurse’s aide in a big public hospital. It was actually my first introduction to the world of medicine and incredible urban poverty at that time in Glasgow. I worked on a children’s ward. It was profound to see the condition they came in. Some were in accidents. It was a surgical ward. One of my jobs was to look for lice and clean them up.

After having gone to secondary school and being prepared to go to university, this was a very important moment in my life. And I, not for the first time, had an outsider status: in the East because we were Catholics, in the West, because we were refugees with this strange accent and poor. And then in Scotland, of course. I had a very heavy accent. I didn’t know how to speak English very well. Some of the children started to say, “Oh, she’s German,” and they started to pretend to  shoot at me.

That was the first time that I experienced being outside of my country, of my culture. We were brought up with a lot of information about what happened during the Nazi time, the holocost. Lots of plays and movies, learning about it in school. There was a tremendous amount of historical education during my youth, of awareness, but I didn’t realize what kind of historical burden, as a German, I would face just from encountering these children there. So that was a very thought-provoking experience for me at a very young age.

JW:  How old were you?

UL:  I was 19. Then I met my first husband, who was there on a Rotary fellowship, who was a law student at NYU, and we fell in love. He said, “Do you want to get married?” And I said, “Sure, why not?” My mother was terribly upset.

JW:  Your parents did not come to the wedding?

UL:  No. I was all by myself, and truly, I did not know what I was getting myself into. I had only spoken English for one year. I was poised to go to university in Germany. My mother had arranged all my papers. It was really a shock. It happened toward the end of that year in Scotland. Of course, I always say I got off the boat in New York City, but actually, it was a prop jet plane.

Now I’m 20 and I’m landing in New York City. My new husband, whom I hardly knew, picked me up with the subway. Of course, we were very poor. He was a law student, and he was on a limited scholarship. He was a Southerner, actually. Then I realized that there I was in this huge city, I didn’t know how to navigate it, I didn’t know a soul and he was extremely busy with his law studies.

The most important point of that time was that he was taking a constitutional law class with a very brilliant constitutional law scholar, and he decided that he would write his paper about a constitutional argument for legalizing abortion.  He prepared a paper to develop privacy arguments based on Griswold v. Connecticut to challenge the abortion laws. I had learned to type, and I was helping him out by typing some of the footnotes, up into the late hours of the evening.

Then we started to have this discussion about abortion, which was something that I was never exposed to when I was growing up in these small Catholic villages in Germany. When women got pregnant, usually they got married, and there was never any mention of abortion. We started to argue about it because I did bring in that religious point of view in terms of life and the start of life.

And then my own personal background: I was born right after the war, but I was what they called an illegitimate child. My mother was not married at the time. Of course, I thought, oh, my gosh, what he’s arguing for is going to talk me out of existence, so to speak. I took it very personal in a way and then I was able to transcend that part because I’m here. What really mattered to me was as a woman, I wanted to be able to determine my own destiny, and it became very, very clear to me right at that time that reproductive control is absolutely the essence of freedom and equality for women.

From then on, I got involved in this movement. I was referring women out of the country when abortions were still illegal and had some very harrowing kinds of experiences, just in terms of hearing the pleading, needing to find out how far along they were in their pregnancies. So many times they were too far along to be referred to a particular country. One of those moments happened when a woman was too far along. I had heard that there was an illegal abortionist, actually a doctor that I knew. I also knew that he was doing illegal abortions some of the time.

That was the only time I referred someone for an illegal abortion and something went wrong during that abortion: nonstop bleeding, likely due to D&C. He was so scared that he waited too long to call the ambulance, and then by the time he called, she was in a life-threatening condition. There was an investigation into what happened to her. She did live. But there was a grand jury investigation, and I thought, oh, my gosh, they are going to find out because I referred her to him, that I was guilty in this process.

I was really frightened because you could be imprisoned during that time. Just in the nick of time, so to speak, for my own personal moment there, New York State changed its law because of that one fabulous hero of a legislator. That solved all these problems for all those illegal abortionists and my own personal situation and the physicians who were actually in prison.

JW:  Were you part of an organization?

UL:  Yes. It was a small private group that my ex-husband was also involved with. Then as soon as the law changed, the emergence of these clinics happened very quickly. It was quite surprising, actually and I became involved in working in one of those clinics as a counselor and then later as an administrator. That’s how Frances Kissling and I crossed paths. She was the administrator in the clinic where I started as a counselor and spent about a year as a birth control counselor and holding many hands during the abortion. 

Women came from all over the country. Most of our referrals came from the Clergy Consultation Service. Sometimes, women couldn’t fly home after the abortion. Maybe it was done too late in the day or maybe they needed to be watched because they were still bleeding. I took some of these women home with me to my apartment. It was a very profound time of really understanding the urgency that abortion presents.

JW:  Were you involved in starting Catholics for a Free Choice, as it was called then?

UL:  No, I was not involved in that. I was very much on the medical services side. I had not gone back to graduate school to pursue my studies. The counseling gave me some taste of providing emotional support and, of course, education and information about birth control methods and all of that. But after New York legalized and the clinics were very active, I decided that this was the time for me to go back to school and pursue my graduate studies in psychology.

JW:  Mom was happy about that, I bet.

UL:  Finally. But what was interesting about this story is that I thought abortion was going to be on its natural trajectory of being legalized in the rest of the states, and I knew that, by then my ex-husband, was working on preparing for the Roe decision. He was a brilliant scholar. I met Sarah Weddington during that time because she spent the whole summer prepping because she was not versed in the constitutional arguments that he had been working on for years. It felt like it was just a matter of time, which it was.

Then my new area of inquiry was another topic that I felt very strongly about: human sexuality and especially women’s sexuality. That was the time when the topic was very much in the forefront through the women’s movement, Shere Hite, Kinsey, and all sorts of interesting books. It was an opportunity for women to come out about being sexual human beings, and it seemed to me that that should be part of any kind of university education. So I proposed a course during my graduate school years on human sexuality for psychologists because it seemed to me that not only should physicians know about that aspect of their patient’s life and should be prepared to be comfortable discussing it, but certainly, psychologists should be.

JW:  It might come up in their work with patients, right? Where did you teach that?

UL:  This was in my graduate course in my program. I proposed this as a course for the graduate students, and it was a lot of fun, but it was not something that was maintained. I also taught a class in the City College system at that time. I was particularly interested in self-image and body image for women. That’s also something that we really haven’t held onto in terms of how embattled women are about their body image and at the time, it seemed like we were going to get a hold of that. We were not going to be oppressed in that way.

I was part of a women’s group in New York City before I started graduate school. It was very interesting because we talked a lot about our bodies. That was a very important topic – how self-conscious we were and how sometimes ashamed we were of our bodies. It’s also part of the stigmatization that has always been an aspect of human beings.

JW:  Was this a consciousness raising group?

UL:  Yes, it was a consciousness raising group. Some years later, when I moved back to California, I started one of those groups here when it wasn’t that popular anymore. This was in the mid 80’s, but it still seemed like it would be a nice opportunity for me to meet other women here in San Francisco where I didn’t know anyone and to talk about our lives. This group is still functional. We still meet once a month during the pandemic, virtually, twice a month even.

JW:  What year did you move?

UL:  I started it in 1985.

JW:  Oh, my gosh. So that’s getting on 40 years.

UL:  That’s a very long time. Now we’re all becoming old ladies together, so our topics have changed. Just to come back to my trajectory, after I finished the PhD, I moved back to New York City and I was looking for a job. I had this idea that maybe I could join an academic department and teach a human sexuality course, a one-on-one human sexuality course, which were actually starting to sprout up at that time. There were some textbooks available, and so it just seemed like that would be a possibility, although it would be hard to really push into that realm.

Then I was back with all my colleagues and professional connections that I had made in New York, and that was the abortion rights movement. It so happened that when Frances Kissling left the National Abortion Federation after its merging, I applied for this position and became the first, in that sense, director of the organization. This was the organization that had been formed to bring together all the freestanding clinics in the country and develop and enforce standards.

Those were the things that I feel very proud of having worked toward during my six-year tenure with the National Abortion Federation. I also feel very proud of having established a national referral network through these clinics, the NAF Hotline, because we did not have a national referral system, and there was no opportunity for women to learn how to choose a clinic.

That was still a time when there was a lot of controversy about the clinics and whether they were fly-by-night places. There was a huge scandal in Chicago that actually was aired in a 2020 show. But luckily, they got in touch with us and despite the New York City bureaucracy, we were able to get an 800 number showing during the airing of that program. That was an incredible moment of national visibility, and, of course, the phones were ringing off the hook, and we were not at all prepared for that. I only had a staff of three people, and we were all answering the hotline, which was also a very profound experience.

JW:  Also countering the story of some kind of awful situation, like, no, here’s where you can get good advice.

UL:  Yes. And good care.

JW:  It’s valuable for the women who called, but also for whoever was watching.

UL:  Yes. There was legitimacy because I think when a country goes from having a procedure that is illegal and that is considered dangerous, dirty, illegitimate certainly, to make that culture shift to one where people have confidence in the providers of care and confidence in the way that care is delivered, I think that is a very big shift, and we’ve been working on that for the last 50 years.

JW:  Were Planned Parenthoods part of the Federation also?

UL:  Planned Parenthood during that time was really focused on family planning, on contraception. There were some where the Boards felt reluctant actually to embrace abortion services. They thought contraception is not controversial, at least by that time it wasn’t controversial anymore. But abortion still was considered a controversial service for them to embrace. But there were some fabulous affiliates around the country that did provide abortions. Certainly, New York City was one of them and they had very impressive leadership. So anyway, those Planned Parenthoods joined the National Abortion Federation.

Then we also had a specific group that was called the Feminist Clinics. There was a lot of tension from the very beginning between the Feminist Clinics and the more mainstream regular clinics, because the Feminist Clinics really believed that women should be able to do everything themselves and ultimately should be able to self-abort. Certainly, there was a lot of movement during that time also in terms of self-examination, that whole period. Then when the manual syringe was brought into the market and discovered as a very easy tool of emptying the uterus as opposed to scraping the uterus with a curette, they thought, we can handle this, and we do need doctors, but the role of the doctor was supposed to be minimized.

That attitude was not always taken very well by the physicians who were the majority of members. They were passionately devoted to their work, which became more and more controversial because of the anti-abortion movement, actually paying for their work with their lives. I have this very profound and deep respect for all of the physicians who have devoted themselves to providing abortion services and in certain areas of the country putting up with tremendous controversy and persecution.

JW:  When you were in the midst of developing standards, can you tell us what some of them were about, maybe what some of the controversies might have been about the standards?

UL:  I think the standards were just very basic pieces of what anesthesia should be used and where the local anesthesia injections should be placed. Very much focused on medical procedure. We didn’t at that time focus so much on providing information about pregnancy prevention. There was controversy about how much that should be demanded as a standard of care. That part of a woman’s visit to a clinic, learning about the procedure and being prepared for the procedure, she would also learn how to not be pregnant and how to prevent an unintended pregnancy in the future.

There were some controversies around that, and I’d say that was probably the strongest. Some clinics were profoundly and impressively devoted to the counseling aspects of providing care and were very innovative in their medical care in general. We had this idea during that time, and obviously, as a psychologist, I was very much of a proponent of the importance and the profound value of counseling and emotional support in conjunction with an abortion.

The counseling could be done in a very time-consuming way, and that could potentially interfere with the efficiency of the service. How many women could be seen and what kind of qualifications the counselor should have in order to provide educational and emotional support. We really did dream at that time that the way the services were provided in these outpatient freestanding clinics, at a reasonable cost, with counseling, with patient education, and also being sensitive to providing emotional support would serve as a model of medical care. Making the lighting perhaps less glaring in the room, playing music during the procedure, having flowers there. We had all sorts of wonderful ideas about what good patient care should look like.

JW:  What year was this again?

UL:  This was in the early ’80s. So late ’70s to mid ’80s when I was involved, and that continued.

JW:  As you know, over time, states start adding all sorts of procedures. Did stuff come up about parental involvement?

UL:  Yes. That was a very big topic. All these legal restrictions that started to come up in terms of, as we said, the most vulnerable groups in our society which are the young and the poor, and those were the groups that the legislators were able to discriminate against, if you will, deprive their access to care.

JW:  You had to deal with some of those?

UL:  Yes. That also was the time when the anti-abortion movement became more violent and perhaps more desperate. They started to harass the clinics, their staff and patients. They became much more aggressive, including using  arson. While I was still the director of NAF, I started a database of collecting information from all the different clinics about what was going on, documenting that and getting that information out to the press so that at least the public would understand and realize what this movement is about, so-called Pro-Life Movement. What kind of tactics they thought were perfectly acceptable, eventually leading to several murders.

But I also wanted to say I was very interested in connecting the physicians in the field in the clinic world to the academic departments to connect the two worlds. That goal eventually led me to imagine that we could develop hospital-based abortion services again so that residents can be trained to then create this perpetual workforce and education of the future physician providers, certainly OB-GYNs in this country.

We had special workshops for faculty to address new developments in the science of medical care, for example, regarding the use of ultrasound. That was just the beginning of ultrasound use, to actually use ultrasound as part of the procedure was a tremendous step forward. Another one was the advent of the D&E, the dilation and evacuation procedure. Up to that time, second trimester abortions were inductions, where women were given prostaglandins. They stayed in wards, and they labored until they passed the fetus.

It seemed very inhumane to force this childbearing process on a woman who did not want to give birth and did not want to have a child or couldn’t for whatever physical reasons. The advent of this new D&E procedure was very exciting. We had workshops and special meetings to address these big new advances in medicine. For example, we had input from various academic physicians who were doing research and connected the two worlds of strict service provision and the academic world that was working on medical advances, documentation and research.

JW:  That work continued for you, right?

UL:  Yes. Then I took a break in my professional life because I met my current husband, Dr. Philip Darney, who was a faculty member for one of our workshops. Somebody suggested his name and I invited him. He, by that time, was working at UCSF and ran the Women’s Options Center there, an in-hospital outpatient clinic. The San Francisco General Hospital is a very outstanding public hospital in the city. I moved to San Francisco and I became pregnant unintentionally. I like to joke about that.

I joined Planned Parenthood and eventually became President of the Board. My daughter and I were the cover girls on one of the brochures, which was very sweet. That was a time when, oh, my gosh, there were so many board members of this Planned Parenthood that were actually Republicans. I also became President of the lobbying organization for all of the Planned Parenthoods here in California.

I took a break. I had my daughter. I devoted myself to painting also.

I had read about this concern about the decline or the lack of a future generation of abortion providers in the country. That was something picked up by the press. The National Abortion Federation had a special meeting about this and there were recommendations. I realized from my experience of working with NAF and all these clinics that the education of the physicians did not take place in these clinics.

The education of the physicians takes place in the teaching hospital, and what’s interesting, when we legalized abortion in this country, we were very concerned with access to care. The clinics sprung up everywhere, and we did a beautiful job, but we didn’t focus on how to integrate that piece into medical education so that we can mainstream abortion care and education into the physician education system. I proposed to launch this special national initiative through UCSF and the Bixby Center and was able to get an anonymous donor to support that initiative. That was how the Ryan Residency Training Program in Abortion and Family Planning came about.

There was a mandate, actually, that had been passed by the medical education organizations for training in 1995. But it’s one thing to pass a mandate and it’s another thing to actually put that into action and reality. My idea was to basically work with the leadership with department chairs and reach out to them, find out what kind of support they needed in order to either designate someone already on the faculty who had trained to do abortions and who was interested in contraception and pregnancy termination, or to hire someone on the faculty who could create a training program in the OB-GYN department. It had to do with expertise. It had to do with bringing in that expertise in family planning to the department and also creating services within the teaching hospital in order to provide abortions there.

Historically, at first, the hospitals did provide abortion services. They changed from their wards, where they saw all these terrible complications of abortions. Many physicians, which is not so much now a part of the narrative, but many physicians who witnessed that suffering in these hospitals were really moved to become passionate supporters, learn how to do abortions once it became legal and also work toward that legalization – to turn these wards into basically abortion services in the hospital.

There was a group of physicians in those early days who were taught, but eventually, the clinics did a much better job of providing this efficient outpatient care that was less bureaucratic, and more reasonably priced. Then came the passage of the Hyde Amendment and no more funding, especially since a lot of these hospitals have patients who rely on that public funding, federal funding. Of course, some were happy to not continue that service anymore because by that time, abortion certainly was still, well, it still is, controversial. So that was a way of not pursuing this controversial service.

But what we have done is to create an incredible culture shift in medicine, so that now we have really mainstreamed this field. Now there are so many medical students who go into medicine because they want to be part of abortion and contraceptive care. They want to be trained only at OBGYN departments with a Ryan program. They say this very specifically. We have a booth at Medical Students for Choice meetings, and our booth is always swamped with medical students who say, “Where do you have Ryan Programs?” Now we have Ryan Programs in over 100 OB-GYN departments around the country. It’s just a tremendous success in that way. They are so eager to embrace that part of healthcare and they want to be advocates, they want to be providers of care, they want to be researchers.

Then the second program that I helped launch in a specific direction is the Fellowship in Family Planning. So that is even further education in the field of family planning and abortion. Some medical students come into medicine because they want to do this Fellowship in Family Planning, which has now been officially recognized by the medical education bodies in this country, which is also an enormous success. They want to become fellows in family planning because they want to provide care, they want to do research in the field, they want to be advocates and they want to teach.

They will then populate the departments in other parts of the country and become the experts in the department where they teach and inspire the next generation. We’ve set this incredible process into motion. I don’t believe that the access to medication abortion is going to decrease that kind of interest in advanced care and that research, for example, came out of our community, the Fellowship in Family Planning.

JW:  Right. One more tool.

UL:  Exactly. Once they do the fellowship, the abortions that they really become expert at, are the more complex cases that cannot be seen in a clinic, that cannot be easily terminated. These women need special care, and certainly, anyone who is more than 12, 13 weeks pregnant needs to have other kinds of abortions. Even though we now say, well, that’s not the majority, but those are actually significant. Those are also oftentimes the really heart wrenching cases.

JW:  Are the majority of the applicants for this fellowship women?

UL:  Yes, the majority are women by far. But also, in terms of the whole field of OB-GYN, it’s getting to be a majority of women who are going into it.

JW:  Your work has been incredible with long lasting effects. I would ask, what are you most proud of, but I don’t know if you could pick.

UL:  No, but I was prepared for that question. There are two things right now. I’m very proud of this book, Advancing Women’s Health Through Medical Education: A Systems Approach in Family Planning and Abortion by Cambridge University Press. They approached me because of what we have accomplished through these two programs in the United States. Also, by the way, we have served in a global inspirational role with various countries. But I feel very proud because this is a documentation of the work that has been done in the medical education realm, and I call that the quiet revolution. It’s not in the media.

Even while I was working these last 20 years in these programs, we couldn’t go out into the press and say, “Oh, look, we just started a program in Alabama. We started a program in Texas. We started a program in these conservative states.” We had to be under the radar because of these legislators, especially for state-affiliated institutions. But despite that, we have succeeded. I feel very proud of that. Then I want to show you this cup here. Can you see this cup? I don’t make lambs, I make soldiers.

This is something that one of the fellows had made for me at one of our celebratory dinners during our Annual Meetings. That message is what I want to exhort them to be now that we are facing this incredible threat, almost like turning back the clock, but we’re not turning back the clock because we have made enormous progress and we have brought abortion into the mainstream certainly as far as the professional and medical world is concerned. I also feel like we have so many professionals now, medical professionals, who have been taught and inspired to be advocates. I feel like they will also stand up for their right to act in accordance with their professional responsibilities.

This is the most important thing to me, is to remind everyone that there is a private morality and then there’s a professional responsibility, and that professional responsibility is something that the government cannot and should not interfere with. It’s an essential aspect of healthcare. I think we have proven that, but we need to be very clear about it.

I’m also proud of being a member of the Board of Catholics for Choice. I’m very proud of reconnecting with that aspect of my religious identity, if you will.