On Thanksgiving eve, 1969, Dr. Adriaan Frans Koome stood in the living room of his Renton home, waited until his family and friends grew quiet, and made a stunning announcement. "Tomorrow, I am going to go to the newspapers and television and tell them about the abortions," he said. "I am going to tell them I have done the abortions" (The Seattle Times, July 11, 1978). He added that he had already mailed a letter to Washington Governor Dan Evans (1925-2024) in which he confessed that he had been performing illegal abortions for three years, committing felony manslaughter under state law hundreds of times.
With his public defiance of the law, the 40-year-old doctor pushed Washington to the forefront of the reproductive rights campaign. One year later, the state's voters approved Referendum 20, making Washington the first – and as of 2003 the only – state to legalize abortion by an act of the people.
An Unlikely Crusader
Born in Amsterdam, the son of a bank clerk, Frans Koome might have seemed an unlikely crusader. He struck some people as debonair and others as gruff. His Catholic family had once thought he would become a priest. He received his medical training in Amsterdam and at the University of Washington, opening a general medical practice in Renton in 1961. He wore his thick, wavy hair swept back in a European style, spoke in softly accented English, and could be imperious and was always opinionated. At the time of his decision to go public, he was married to his first wife, Bertie, and had two young daughters. His elder daughter, Belinda, accepting a posthumous award given to him during the 1996 Abortion Symposium for Northwest Providers at the University of Washington's School of Medicine, described him as "cocky as all hell" (P-I, October 7, 1996).
Koome's belated recognition from the medical establishment was an ironic footnote to the odyssey that began when he shattered the code of silence around a furtive and illegal practice and dared public officials to do something about it. Although a group of medical and other professionals had been promoting abortion reform for two years, most of their work was being done behind the scenes, with as little publicity as possible. Koome forced the issue into public consciousness. "It hit like a bombshell," said Lee Minto, then executive director of Planned Parenthood of Seattle-King County and a member of the reform group. "Dr. Koome wanted to call attention to how desperate women were. It electrified people to know there was this kind of need. It hadn't been talked about" (Interview).
Initially, no one — from other advocates of abortion rights to Koome's next-door neighbor and friend, Renton Police Chief C. S. Williams — knew quite what to make of him. The reaction from Dr. Gilbert Eade, president of the King County Medical Society, was decidedly cool. The Medical Society, already on record as supporting abortion reform, "certainly would not condone a violation of the criminal laws," he said (P-I, November 28, 1969). Governor Evans, also on record in favor of reform, was even more negative. "I think some change in the law is required," he said. "But I don't think this deliberate flaunting of the law by a doctor in Renton is necessarily any great help in getting the change" (P-I, December 11, 1969).
Dr. Samuel Goldenberg, a psychologist and founder of the chairman of Washington Citizens for Abortion Reform (WCAR), the primary organization behind the effort to liberalize the law, guardedly said Koome "isn't the only physician who has taken such a stand" (P-I, November 29, 1969). Marilyn Ward, a liberal Republican and unpaid lobbyist for Washington Citizens for Abortion Reform, thought Koome was "a different kind of person," but also "very compassionate about women" (Interview).
The police chief was ambivalent. "Let's face it," Williams told a Seattle Post-Intelligencer reporter, with a sigh. "The patients involved would be reluctant to testify, unless one of them develops problems. He's providing a service nobody else provides and the hell of it is it's illegal" (November 29, 1969).
Koome was openly violating a 1909 Washington law that made it a felony for anyone, including the prospective mother, to terminate any pregnancy unless necessary to save the life of the mother. Convicted abortionists could be sentenced to up to five years in the state penitentiary or fined up to $1,000. However the fact that abortions were illegal did not mean they were not performed, by licensed physicians as well as by illegal abortionists.
"We Are Putting Our Heads in the Sand"
As Koome told a Seattle Post-Intelligencer reporter:
"Essentially we are faced here with a tremendous underground problem, underground because the women and girls involved are ashamed to talk about it and the physicians involved are scared to be known to have done an abortion. We are putting our heads in the sand" (November 27, 1969).
It is impossible to know how many illegal abortions were performed despite the law. However, just three months before Koome's dramatic confession made him front-page news, a Burien naturopath named Cyrus Maxfield pled guilty to performing an illegal abortion on a 25-year-old woman. Both the patient, who had been hospitalized with complications after the operation, and former Washington Governor Albert D. Rosellini (1910-2011) had asked for leniency for Maxfield, but Superior Court Judge Richard F. Broz was unmoved. "There are many people who disagree with public policy about abortion, but we are concerned with the law as it is," he told the defendant before sentencing him to a year in the county jail (The Seattle Times, August 12, 1969).
Two years earlier, a 61-year-old Seattle man admitted to taking part in a botched abortion that contributed to the death of a 24-year-old neighbor; he pled guilty to manslaughter and was placed on probation for 20 years.
They Rushed to His Defense
Koome, however, was not prosecuted, despite his open defiance of the governor, the Legislature, the Washington State Medical Association, and King County law enforcement officers. He continued performing illegal abortions with impunity, telling reporters the tally any time he was asked: 22 abortions done in the week after the publication of his letter to the governor, 29 the next week, more than 3,000 within a year. King County Prosecutor Charles O. Carroll said his office lacked sufficient evidence to prosecute because he could find no patients willing to testify against the doctor. Indeed, a number of Koome's patients rushed to his defense, including a young college student who was interviewed on camera by KING-TV reporter Mike James. The student described Koome as "a dedicated and principled physician" who had "stuck himself out on a limb for me as well as other girls" (P-I, December 4, 1969).
Koome also supported the abortion rights campaign in a less public manner, quietly giving a donation of $10,000 to Washington Citizens for Abortion Reform to promote Referendum 20. Abortion rights advocates, who had failed in an effort to pass a reform bill in 1969, had convinced the Legislature to put the issue before the voters as a referendum in 1970. "He gave us the money because he really believed women needed to have safe terminations," said Marilyn Ward, chief lobbyist for the group. "He worried about women going in the back alleys" (Interview).
Referendum 20
Referendum 20, approved by a 56.5 percent majority of the voters on November 3, 1970, provided something less than "abortion on demand." It made legal abortions available only to women who had lived in Washington for at least 90 days, were no more than four months pregnant, and had the consent of a parent or guardian (if they were under 18) or husband (if they were living with their husbands). Most of these restrictions were set aside by the Supreme Court's decision in the case of Roe v. Wade, announced on January 22, 1973, which upheld the principle that women had a constitutional right to abortions.
Initially, however, the Supreme Court did not address the issue of parental or spousal consent, and it was this aspect of Washington's 1970 abortion law that put Frans Koome back in the public spotlight. Two years after the law went into effect, Koome was found guilty of performing an unlawful abortion on a 16-year-old girl without the consent of her parents or her legal guardian, Catholic Children's Services, while the girl was a ward of King County Juvenile Court. Superior Court Judge Robert M. Elston said he recognized that Koome was motivated by what "obviously was for him a matter of conscience and principle." But, the judge added, "His decision that the patient-physician relationship justifies the performing of an abortion on any woman regardless of age is not according to the law, and it is one for which there must be consequences" (P-I, December 5, 1972). He sentenced Koome to a $500 fine and one year's probation.
While the case was under appeal, Koome returned to his native Netherlands. When the state Supreme Court overturned his conviction in 1975, he moved back to Renton and opened a quiet practice in a small clinic in his old Highlands neighborhood, saying he now preferred to avoid the limelight. In early 1977, Koome married his second wife, Naomi "Masami" Lee Rolph, who helped run the clinic. On July 9, 1977, Naomi gave birth, two months prematurely, to the doctor's first and only son, Erik Robert Koome.
Sadly, on July 3, 1978, less than a year after Erik's birth, Dr. Koome died after falling from a horse while riding bareback in a pasture near his home. He was only 49. Seattle Post-Intelligencer columnist Susan Paynter later called it "an improbably bucolic death" (October 7, 1996).
A High Price
Koome paid a price for his willingness to stand trial, in a court of law or before the court of public opinion, in defense of reproductive rights. He was investigated for malpractice; he temporarily lost his privileges at the Valley General Hospital in Renton, and his first marriage fell apart. He lost weight and spent sleepless nights imagining himself in prison. Many of his fellow doctors regarded him as a pariah. "I'm sure they were glad he was there and they probably referred patients to him," said Marilyn Ward, "but I'm sure he was ostracized."
Despite the personal costs, Koome never veered from his efforts to uphold what he termed, in his letter to Governor Evans, a woman's right for "self-development and self-determination." His elder daughter, Belinda Koome Kliahu, believes he would not have pulled his neck in, even to avoid the potential dangers facing abortion providers today. The idea, she told columnist Paynter after accepting the posthumous award given to her father in 1996, makes her laugh. "My father always lived on the edge, always pushed himself to limits and lived for the day," she said. Besides, "he had an air of invulnerability" (P-I, October 7, 1996).
A Courageous Man
To Samuel Goldenberg, organizer and chairman of Washington Citizens for Abortion Reform, Koome was both inspiring and unsettling. "I recall that initially I was taken aback by Frans and thought, my gosh, this guy is really off the wall," he said. "But I didn't think in those terms very long." Koome, he added, "was not just an activist who set out to impose his own set of principles on the world. I think he wanted to both understand the problem and act on it; he did not just want people to talk it away. He was a very hard worker and a very courageous man" (Interview).
