Spontaneous abortion

“ Hegar reckoned one abortion to every eight full-term deliveries. Lusk, Marsais, Siebold, Gallard, and other equally prominent but more modern obstetricians and gynæcologists present about the same testimony. From criminal abortion death is very frequent. To tear out the living products of conception by the roots is, in most cases, to give the pregnant woman gratuitous transportation for eternity. Tardieu alone records seventy women who died out of one hundred cases. Even in spontaneous cases, as we have seen, death may occur from hæmorrhage, shock, peritonitis, septicæmia, etc. ”

“ Uterine hemorrhage, contractions, and expulsion of the ovum in consequence of neurotic influences are more likely by far to occur during the existence of predisposing causes. Fright, a nervous shock of any kind which in no way affects healthy gestation in a healthy woman, will result in abortion in a person afflicted with uterine disease or in a system otherwise weakened. ”

“ We begin with the common law, under which abortion was a crime at least after "quickening"—i.e., the first felt movement of the fetus in the womb, which usually occurs between the 16th and 18th week of pregnancy. ”

“ Therapeutic abortions are resorted to when the patient’s condition is so grave that it is apparently necessary to empty the uterus in order to save her life. Such a condition may exist, for example, when pregnancy is complicated by pulmonary tuberculosis, heart disease, toxemia, hemorrhage or some condition which is inherent to pregnancy. An abortion induced under these circumstances is countenanced by law, as it is performed to prevent the loss of life from disease; but an abortion is not legal if brought on to save the woman from suicide, because of her unwillingness to become a mother. ”

“ When the fetus dies within the womb of the mother, it is usually expelled spontaneously within a few days or even a few hours. Some women suffer from certain weakness which result in habitual miscarriage; such women seem unable to carry the child for the full natural term, and lose it at some time during the period of gestation. Like results often arise from certain diseases, principal among which is syphilis. In some cases the physician produces what is known as "therapeutic abortion," for the purpose of saving the life of the woman—this is sanctioned by medical custom and by law. ”

“ In many cases of sterility it will be found that the number of abortions in a single patient have been almost innumerable; and, it may be added, in a large proportion of the cases of uterine disease occurring in the married, inquiry as to their past history will reveal abortions, unsuspected perhaps even by the family physician, as the cause. It is not so much the general practitioner, the hospital attendant, or the accoucheur, as such, who can testify as to the true frequency of abortion ”

“ Of this last class of causes, obstinate vomiting, puerperal convulsions, which are by no means confined to the full period of pregnancy, dropsies, irreducible displacements of the uterus, varix of the external labial vessels, sometimes fatal by laceration from tension, are all instances in point. With regard to each, the necessity of the abortion must be determined with the greatest caution, and resort be had to it, the child still living, with reluctance ”

“ Certain abnormalities of the developing fetus are inconsistent with life, and are, therefore, a frequent cause of abortion. Dr. Mall, of Johns Hopkins University, showed after years of investigation that at least one-third of the embryos obtained from abortions were malformed and would have developed into monstrosities had they lived to term. It is often a great comfort to the expectant mother who loses her baby early in pregnancy to realize that had she carried her baby to term it might have been a monster, and that, therefore, she has not lost a beautiful, normal child. ”

“ Any medical man who gives even the most harmless medicine where he suspects the possibility of pregnancy may render himself liable to grave suspicion should the woman abort. [43]
In medicine, an abortion is said to occur when the fœtus is expelled before the sixth month; after that it is premature birth. In law, however, any expulsion of the contents of the uterus before the full time is an abortion or miscarriage. ”

“ The direct and reliable means of inducing abortion, in the physician’s possession, are only instrumental. Draughts of all kinds, whether purgative, emmenagogue, or so-called specific,—aloes, ergot, or savin,—or energetic poisons, expelling the fœtus through a sudden and profound disturbance of the whole maternal system, as arsenic or cantharides, are too unreliable, unscientific, or dangerous either to mother or child. The justifiable methods are confined to those acting directly on the uterus and its contents, by dilating the os or detaching the membranes. ”

“ I In the almost 30 years since Roe, this Court has never described the various methods of aborting a second- or third-trimester fetus. From reading the majority's sanitized description, one would think that this case involves state regulation of a widely accepted routine medical procedure. Nothing could be further from the truth. The most widely used method of abortion during this stage of pregnancy is so gruesome that its use can be traumatic even for the physicians and medical staff who perform it. ”

“ Artificially produced abortions are not an infrequent cause of sterility; the young wife becomes pregnant, and has an abortion produced because she is not yet ready to give up all her pleasures; and eventually when she does become very anxious to have a child such an extent of uterine disease has been produced by the abortions that she cannot conceive. ”

“ A complete abortion, as the term suggests, is one in which all the products of conception are expelled. The treatment and care are exactly the same as are given after a normal delivery. This point cannot be stressed too strongly, for it is because so many women fail to appreciate the necessity for adequate post-partum care, that abortions are so often followed by ill health and invalidism. ”

“ Adhesions of varying situation and extent are not uncommon as the result of an abortion. They may be slight, and merely tilt or draw the womb to one side, giving rise only to severe local or distant neuralgias, and rendering the occurrence of a subsequent pregnancy somewhat dangerous ”

“ Naturally, therefore, the physical effects of abortion will depend in direct ratio on the causation thereof, and the comparative malignity or benignity of such causation. In any case, abortion is fraught with serious consequences, direct and indirect; and is a sad miscarriage of nature's plan, greatly to be deplored, and earnestly, strenuously, and conscientiously to be avoided. ”

“ Could the test of confession be always applied, as is, however, manifestly impossible, so many women die during or in consequence of an abortion, without the attendance of a physician and without making any sign, it would be found that many of the cases now reported upon our bills of mortality as deaths from hemorrhage, from menorrhagia, from dysentery, from peritonitis, from inflammation of the bowels or of the womb, from obscure tumor, or from uterine cancer, would be found in reality to be deaths from intentional abortion. ”

“ The dangers resulting from abortion are blood poison, hemorrhage—even lockjaw has been known to be 58the result of abortion, also the danger that one miscarriage is likely to follow another, and disables a woman to carry a child to the full term.
If there is the same care and treatment given the woman who aborts as the woman in childbirth, she will naturally be less likely to suffer serious results than if no medical attention were given her. ”

“ The signs of delivery that are well marked at the full period, the general symptoms then obtaining, the size of the uterus, ascertained by the hand and sound, lacerations of the perineum and cervix, the lochia, the state of the breasts, abdomen, vagina, and vulva, all of little value except in conjunction with each other, are proportionately less defined as we go back, until near the commencement of pregnancy it becomes impossible to distinguish the abortion from severe hemorrhage or from menorrhagia, unless by detecting the impregnated ovum. ”

“ The vast majority of babies killed during partial-birth abortions are alive until the end of the procedure. It is a medical fact, however, that unborn infants at this stage can feel pain when subjected to painful stimuli and that their perception of this pain is even more intense than that of newborn infants and older children when subjected to the same stimuli. Thus, during a partial-birth abortion procedure, the child will fully experience the pain associated with piercing his or her skull and sucking out his or her brain. ”

“ The results of abortion from natural causes, as obstetric disease, separate or in common, of mother, fœtus, or membranes, or from a morbid habit consequent on its repetition, are much worse than those following the average of labors at the full period. If the abortion be from accident, from external violence, mental shock, great constitutional disturbance from disease or poison, or even necessarily induced by the skilful physician in early pregnancy, the risks are worse. ”

“ Inflammations and displacements of {49} the womb cause most of the abortions in the first four months, and after that time syphilis and Bright's disease are the chief forces at work.
If a woman in early pregnancy begins to lose blood from the uterus, and has pain in her back and lower abdomen, abortion is threatened; if this hemorrhage is marked, and the cervix is dilated, the abortion will very probably occur; and the escape of the liquor amnii renders the abortion unavoidable. ”

“ An opinion is very prevalent that if abortion be produced before the movements of the foetus are felt, there is no crime committed. It should be remembered that life begins with conception, and, at whatever period of pregnancy abortion is committed, life is destroyed. Whoever disobeys the Divine injunction cannot escape his own consciousness of the deed, and the anguish and bitter remorse which ever after disturb the soul.
Treatment. In threatened abortion, there is pain in the back or lower part of the abdomen, and later some flow of blood. ”

“ If the abortion is passed easily, the patient rarely keeps her bed, pays little or no attention to the occurrence, certainly none to her getting up, and subinvolution, by far the most frequent sequence to abortion, follows. Abortion is altogether the most prolific cause of uterine disease, in consequence of the indifference with which it is treated, not only by the patient, but by her physician. With the expulsion of the ovum and the cessation of hemorrhage the case is considered finished ”

“ Abortion is, in many cases, accompanied by the most serious results. The operation is dangerous; death not infrequently occurs; often the result is a permanent impairment of health. "The troubles of troublesome pregnancy and child-birth are infinitely less than the sufferings [Pg 111] consequent upon artificial abortion." ”

“ The entire abortion process takes place within the mother’s home, without physician oversight, potentially leading to undetected ectopic pregnancies, failure of rH factor incompatibility detection, and misdiagnosis of gestational age — all leading to severe or even fatal consequences. ”

“ It is probable that in but few of the fatal cases really occurring, is foul play ever thought of, especially if the standing of the victim, and her previous history, have been such as to prevent or disarm suspicion; and on the other hand, while immediate death is undoubtedly a frequent result of induced abortion, it is, in proportion to the cases of its later occurrence, or of confirmed and chronic ill health, comparatively rare. From which it must be granted, that for every case thus made known, very many others must necessarily exist. ”

“ Physical shocks, such as falls, blows upon the abdomen, jumping, tripping over carpets, jars, jolting or overexertion, may be the exciting cause of an abortion where there is a marked irritability of the uterine muscles. This factor is largely influenced by individual stability, however, as a slight jar will cause an abortion in one woman, and violent experiences will have no effect upon another, at the same stage of pregnancy. ”

“ Subinvolution, chronic uterine lesion, and sterility are a common result of the first abortion in young married women, and in most instances it is the neglect of after-treatment to which these results must be ascribed; it is the underrating of abortion by the laity, and even by the profession; and as natural, healthy labor with too rapid getting up is liable to result in evil consequences slowly developing, so it is true to a far greater extent of simple abortion. The usual termination is in subinvolution, chronic cervicitis, and endometritis. ”

“ When caused by an accident, the disturbance is often of a secondary character, the vitality of the ovum being destroyed, or the activity of the maternal circulation checked, before the separation of the two beings from each other finally takes place. But in a forced abortion there is no such preservative action ”

“ Parties have written to us and others have made personal application under circumstances when it might have been right for their family physician to have induced abortion. We wish to have it distinctly understood that we will not under any circumstances prescribe medicines or perform any operation to relieve women of pregnancy.
Mechanical means are resorted to by abortionists, and many women produce abortion upon themselves. It always terminates in lasting injury and sometimes in speedy death. Certain medicines will sometimes produce abortion but they are very unsafe. ”