Abortion

Abortion (from the Latin word aboriri , "to perish") may be briefly defined as "the loss of a fetal life."

In it the fetus dies while yet within the generative organs of the mother, or it is ejected or extracted from them before it is viable; that is, before it is sufficiently developed to continue its life by itself. The term abortion is also applied, though less properly, to cases in which the child is become viable, but does not survive the delivery. In this article we shall take the word in its widest meaning, and treat of abortion as occurring at any time between conception and safe delivery. The word miscarriage is taken in the same wide sense. Yet medical writers often use these words in special meanings, restricting abortion to the time when the embryo has not yet assumed specific features, that is, in the human embryo, before the third month of gestation; miscarriage occurs later, but before viability; while the birth of a viable child before the completed term of nine months is styled premature birth. Viability may exist in the seventh month of gestation, but it cannot safely be presumed before the eighth month. If the child survives its premature birth, there is no abortion -- for this word always denotes the loss of fetal life.

It was long debated among the learned at what period of gestation the human embryo begins to be animated by the rational, spiritual soul, which elevates man above all other species of the animal creation and survives the body to live forever. The keenest mind among the ancient philosophers, Aristotle, had conjectured that the future child was endowed at conception with a principle of only vegetative life, which was exchanged after a few days for an animal soul, and was not succeeded by a rational soul till later; his followers said on the fortieth day for a male, and the eightieth for a female, child. The authority of his great name and the want of definite knowledge to the contrary caused this theory to be generally accepted up to recent times. Yet, as early as the fourth century of the Christian era, St. Gregory of Nyssa had advocated the view which modern science has confirmed almost to a certainty, namely, that the same life principle quickens the organism from the first moment of its individual existence until its death (Eschbach, Disp. Phys., Disp., iii). Now it is at the very time of conception, or fecundation, that the embryo begins to live a distinct individual life. For life does not result from an organism when it has been built up, but the vital principle builds up the organism of its own body. In virtue of the one eternal act of the Will of the Creator, Who is of course ever present at every portion of His creation, the soul of every new human being begins to exist when the cell which generation has provided is ready to receive it as its principle of life. In the normal course of nature the living embryo carries on its work of, self-evolution within the maternal womb, deriving its nourishment from the placenta through the vital cord, till, on reaching maturity, it is by the contraction of the uterus issued to lead its separate life. Abortion is a fatal termination of this process. It may result from various causes, which may be classed under two heads, accidental and intentional.

Accidental causes may be of many different kinds. Sometimes the embryo, instead of developing in the uterus, remains in one of the ovaries, or gets lodged in one of the Fallopian tubes, or is precipitated into the abdomen, resulting, in any of these cases, in an ectopic, or extra-uterine gestation. This almost invariably brings on the death of the fetus, and is besides often fraught with serious danger to the mother. Even if an ectopic child should live to maturity, it cannot be born by the natural channel -- but, once it has become viable, it may be saved by a surgical operation. Most commonly the embryo develops in the uterus; but there, too, it is exposed to a great variety of dangers, especially during the first months of its existence. There may be remote predispositions in the mother to contract diseases fatal to her offspring. Heredity, malformation, syphilis, advanced age, excessive weakness, effects of former sicknesses, etc. may be causes of danger; even the climate may exercise an unfavorable influence. More immediate causes of abortion may be found in cruel treatment of the mother by her husband or in starvation, or any kind of hardship. Her own indiscretion is often to blame; as when she undertakes excessive labours or uses intoxicating drinks too freely. Anything in fact that causes a severe shock to the bodily frame or the nervous system of the mother may be fatal to the child in her womb. On the part of the father, syphilis, alcoholism, old age, and physical weakness may act unfavourably on the offspring at any time of its existence. The frequency of accidental abortions is no doubt very great; it must differ considerably according to the circumstances, so that the proportion between successful and unsuccessful conceptions is beyond the calculation of the learned.

Intentional abortions are distinguished by medical writers into two classes.

• When they are brought about for social reasons, they are called criminal abortions ; and they are rightly condemned under any circumstances whatsoever. "Often, very often," said Dr. Hodge, of the University of Pennsylvania, "must all the eloquence and all the authority of the practitioner be employed; often he must, as it were, grasp the conscience of his weak and erring patient, and let her know, in language not to be misunderstood, that she is responsible to the Creator for the life of the being within her" (Wharton and Stille's Med. Jurispr., Vol. on Abortion, 11).
• The name of obstetrical abortion is given by physicians to such as is performed to save the life of the mother. Whether this practice is ever morally lawful we shall consider below.

It is evident that the determination of what is right or wrong in human conduct belongs to the science of ethics and the teaching of religious authority. Both of these declare the Divine law, "Thou shalt not kill". The embryonic child, as seen above, has a human soul ; and therefore is a man from the time of its conception; therefore it has an equal right to its life with its mother; therefore neither the mother, nor medical practitioner, nor any human being whatever can lawfully take that life away. The State cannot give such right to the physician; for it has not itself the right to put an innocent person to death. No matter how desirable it might seem to be at times to save the life of the mother, common sense teaches and all nations accept the maxim, that "evil is never to be done that good may come of it"; or, which is the same thing, that "a good end cannot justify a bad means". Now it is an evil means to destroy the life of an innocent child. The plea cannot be made that the child is an unjust aggressor . It is simply where nature and its own parents have put it. Therefore, Natural Law forbids any attempt at destroying fetal life.

The teachings of the Catholic Church admit of no doubt on the subject. Such moral questions, when they are submitted, are decided by the Tribunal of the Holy Office. Now this authority decreed, 28 May, 1884, and again, 18 August, 1889, that "it cannot be safely taught in Catholic schools that it is lawful to perform . . . any surgical operation which is directly destructive of the life of the fetus or the mother." Abortion was condemned by name, 24 July, 1895, in answer to the question whether when the mother is in immediate danger of death and there is no other means of saving her life, a physician can with a safe conscience cause abortion not by destroying the child in the womb (which was explicitly condemned in the former decree ), but by giving it a chance to be born alive, though not being yet viable, it would soon expire. The answer was that he cannot. After these and other similar decisions had been given, some moralists thought they saw reasons to doubt whether an exception might not be allowed in the case of ectopic gestations. Therefore the question was submitted: "Is it ever allowed to extract from the body of the mother ectopic embryos still immature, before the sixth month after conception is completed?" The answer given, 20 March, 1902, was: "No; according to the decree of 4 May, 1898; according to which, as far as possible, earnest and opportune provision is to be made to safeguard the life of the child and of the mother. As to the time, let the questioner remember that no acceleration of birth is licit unless it be done at a time, and in ways in which, according to the usual course of things, the life of the mother and the child be provided for". Ethics, then, and the Church agree in teaching that no action is lawful which directly destroys fetal life. It is also clear that extracting the living fetus before it is viable, is destroying its life as directly as it would be killing a grown man directly to plunge him into a medium in which he cannot live, and hold him there till he expires.

However, if medical treatment or surgical operation, necessary to save a mother's life, is applied to her organism (though the child's death would, or at least might, follow as a regretted but unavoidable consequence), it should not be maintained that the fetal life is thereby directly attacked. Moralists agree that we are not always prohibited from doing what is lawful in itself, though evil consequences may follow which we do not desire. The good effects of our acts are then directly intended, and the regretted evil consequences are reluctantly permitted to follow because we cannot avoid them. The evil thus permitted is said to be indirectly intended. It is not imputed to us provided four conditions are verified, namely:

• That we do not wish the evil effects, but make all reasonable efforts to avoid them;
• That the immediate effect be good in itself;
• That the evil is not made a means to obtain the good effect; for this would be to do evil that good might come of it -- a procedure never allowed;
• That the good effect be as important at least as the evil effect.

All four conditions may be verified in treating or operating on a woman with child. The death of the child is not intended, and every reasonable precaution is taken to save its life ; the immediate effect intended, the mother's life, is good -- no harm is done to the child in order to save the mother -- the saving of the mother's life is in itself as good as the saving of the child's life. Of course provision must be made for the child's spiritual as well as for its physical life, and if by the treatment or operation in question the child were to be deprived of Baptism, which it could receive if the operation were not performed, then the evil would be greater than the good consequences of the operation. In this case the operation could not lawfully be performed. Whenever it is possible to baptize an embryonic child before it expires, Christian charity requires that it be done, either before or after delivery; and it may be done by any one, even though he be not a Christian.

History contains no mention of criminal abortions antecedent to the period of decadent morality in classic Greece. The crime seems not to have prevailed in the time of Moses, either among the Jews or among the surrounding nations; else that great legislator would certainly have spoken in condemnation of it. No mention of it occurs in the long enumeration of sins laid to the charge of the Canaanites. The first reference to it is found in the books attributed to Hippocrates, who required physicians to bind themselves by oath not to give to women drinks fatal to the child in the womb. At that period voluptuousness had corrupted the morals of the Greeks, and Aspasia was teaching ways of procuring abortion. In later times the Romans became still more depraved, and bolder in such practices; for Ovid wrote concerning the upper classes of his countrymen:

Nunc uterum vitiat quae vult formosa videri,
Raraque, in hoc aevo, est quae velit esse parens.

Three centuries later we meet with the first record of laws enacted by the State to check this crime. Exile was decreed against mothers guilty of it; while those who administered the potion to procure it were, if nobles, sent to certain islands, if plebeians, condemned to work in the metal mines. Still the Romans in their legislation appear to have aimed at punishing the wrong done by abortion to the father or the mother, rather than the wrong done to the unborn child. The early Christians are the first on record as having pronounced abortion to be the murder of human beings , for their public apologists, Athenagoras, Tertullian, and Minutius Felix (Eschbach, "Disp. Phys.", Disp. iii), to refute the slander that a child was slain, and its flesh eaten, by the guests at the Agapae, appealed to their laws as forbidding all manner of murder, even that of children in the womb. The Fathers of the Church unanimously maintained the same doctrine. In the fourth century the Council of Eliberis decreed that Holy Communion should be refused all the rest of her life, even on her deathbed, to an adulteress who had procured the abortion of her child. The Sixth Ecumenical Council determined for the whole Church that anyone who procured abortion should bear all the punishments inflicted on murderers. In all these teachings and enactments no distinction is made between the earlier and the later stages of gestation. For, though the opinion of Aristotle, or similar speculations, regarding the time when the rational soul is infused into the embryo, were practically accepted for many centuries still it was always held by the Church that he who destroyed what was to be a man was guilty of destroying a human life. The great prevalence of criminal abortion ceased wherever Christianity became established. It was a crime of comparatively rare occurrence in the Middle Ages. Like its companion crime, divorce, it did not again become a danger to society till of late years. Except at times and in places influenced by Catholic principles, what medical writers call "obstetric" abortion, as distinct from "criminal" (though both are indefensible on moral grounds), has always been a common practice. It was usually performed by means of craniotomy, or the crushing of the child's head to save the mother's life. Hippocrates, Celsus, Avicenna, and the Arabian school generally invented a number of vulnerating instruments to enter and crush the child's cranium. In more recent times, with the advance of the obsteric science, more conservative measures have gradually prevailed. By use of the forceps, by skill acquired in version, by procuring premature labour, and especially by asepticism in the Caesarean section and other equivalent operations, medical science has found much improved means of saving both the child and its mother. Of late years such progress has been made in this matter, that craniotomy on the living child has passed out of reputable practice. But abortion proper, before the fetus is viable, is still often employed, especially in ectopic gestation; and there are many men and women who may be called professional abortionists.

In former times civil laws against all kinds of abortion were very severe among Christian nations. Among the Visigoths, the penalty was death, or privation of sight, for the mother who allowed it and for the father who consented to it, and death for the abortionist. In Spain, the woman guilty of it was buried alive. An edict of the French King Henry II in 1555, renewed by Louis XIV in 1708, inflicted capital punishment for adultery and abortion combined. Later French law (i.e., early twentieth century) punished the abortionist with imprisonment, and physicians, surgeons, and pharmacists, who prescribe or furnish the means, with the penalty of forced labour. For England, Blackstone stated the law as follows:

Life is the immediate gift of God , a right inherent by nature in every individual ; and it begins, in contemplation of law, as soon as an infant is able to stir in its mother's womb. For if a woman is quick with child, and by a potion, or otherwise, killeth it in her womb, or if any one beat her, whereby the child dieth, and she is delivered of a dead child; this, though not murder, was by the ancient law homicide or manslaughter. But the modern law does not look upon this offence in so atrocious a light, but merely as a heinous misdemeanour.

In the United States, legislation in this matter is neither strict nor uniform, nor are convictions of frequent occurrence. In some of the States any medical practitioner is allowed to procure abortion whenever he judges it necessary to save the mother's life.

The Catholic Church has not relaxed her strict prohibition of all abortion; but, as we have seen above, she has made it more definite. As to the penalties she inflicts upon the guilty parties, her present legislation was fixed by the Bull of Pius IX"Apostolicae Sedis". It decrees excommunication -- that is, deprivation of the Sacraments and of the Prayers of the Church in the case of any of her members, and other privations besides in the case of clergymen -- against all who seek to procure abortion, if their action produces the effect. Penalties must always be strictly interpreted. Therefore, while anyone who voluntarily aids in procuring abortion, in any way whatever, does morally wrong, only those incur the excommunication who themselves actually and efficaciously procure the abortion. And the abortion here meant is that which is strictly so called, namely, that performed before the child is viable. For no one but the lawgiver has the right to extend the law beyond the terms in which it is expressed. On the other hand, no one can restrict its meaning by private authority, so as to make it less than the received terms of Church language really signify. Now Gregory XIV had enacted the penalty of excommunication for abortion of a "quickened" child but the present law makes no such distinction, and therefore it must be differently understood.

That distinction, however, applies to another effect which may result from the procuring of abortion; namely, he who does so for a child after quickening incurs an irregularity, or hindrance to his receiving or exercising Orders in the Church. But he would not incur such irregularity if the embryo were not yet quickened. The terms "quickened" and "animation" in present usage are applied to the child after the mother can perceive its motion, which usually happens about the one hundred and sixteenth day after conception. But in the old canon law, which established the irregularity here referred to the "animation" of the embryo was supposed to occur on the fortieth day for a male child, and on the eightieth day for a female child. In such matters of canon law, just as in civil law, many technicalities and intricacies occur, which it often takes the professional student to understand fully. In regard to the decisions of the Roman tribunal quoted above it is proper to remark that while they claim the respect and loyal adhesion of Catholics, they are not irreformable, since they are not definitive judgments, nor do they proceed directly from the Supreme Pontiff, who alone has the prerogative of infallibility. If ever reasons should arise, which is most improbable, to change these pronouncements those reasons would receive due consideration.