States. She began her business in New York during the 1830s, and, by the 1840s, had expanded to include franchises in Boston and Philadelphia. It is estimated that by 1870 her annual expenditure on advertising alone was $60,000. Because of her reputation, Restellism became a synonym for abortion. One ad for Restell's medical services, printed in the New York Sun, promised that she could offer the "strictest confidence on complaints incidental to the female frame" and that her "experience and knowledge in the treatment of cases of female irregularity, [was] such as to require but a few days to effect a perfect cure". Another, addressed to married women, asked the question, "Is it desirable, then, for parents to increase their families, regardless of consequences to themselves, or the well-being of their offspring, when a simple, easy, healthy, and certain remedy is within our control?" Advertisements for the "Female Monthly Regulating Pills" she also sold vowed to resolve "all cases of suppression, irregularity, or stoppage of the menses, however obdurate". Madame Restell was an object of criticism in both the respectable and penny presses. She was first arrested in 1841, but, it was her final arrest by Anthony Comstock which led to her suicide on the day of her trial April 1, 1878. Such advertising aroused criticisms of quackery and immorality. The safety of many nostrums was suspect and the efficacy of others non-existent. Horace Greeley, in a New York Herald editorial written in 1871, denounced abortion and its promotion as the "infamous and unfortunately common crime– so common that it affords a lucrative support to a regular guild of professional murderers, so safe that its perpetrators advertise their calling in the newspapers". Although the paper in which Greeley wrote accepted such advertisements, others, such as the New York Tribune, refused to print them. Elizabeth Blackwell, the first woman to obtain a Doctor of Medicine in the United States, also lamented how such ads led to the contemporary synonymity of "female physician" with "abortionist". Turning point in abortion legislation Abortifacient advertising was highly effective in the United States, though apparently less so across the Atlantic. Contemporary estimates of mid-19th century abortion rates in the United States suggest between 20% and 25% of all pregnancies in the United States during that era ended in abortion. This era also saw a marked shift in those who were obtaining abortions. Before the start of