ABORTION

Although most abortions are performed for birth control, they are by no means contraceptive. Abortion involves ending the life of a developing human being by a number of techniques.

There are medical risks associated with surgical abortion which increase with subsequent terminations and gestational age of the fetus. As the physician cannot see what he is doing during the abortion procedure complications may include cervical laceration, perforation of the uterus, and hemorrhaging which can be life-threatening. Medical abortion, performed using mifepristone (formerly RU486) or similar drugs can also result in prolonged hemorrhaging and other long term effects which are not yet known.

Common abortion-related problems include pain, infection, emotional distress, and problems in future pregnancies--such as miscarriage and prematurity leading to infant disability. Because of scarring to the uterus which can result from surgical abortion, a woman who has had an abortion is up to five times more likely to have an ectopic pregnancy if she conceives again. Ectopic pregnancy requires surgery to correct and can be fatal if not caught in time. There is also evidence that a first trimester abortion may increase the risk of breast cancer ( see box), especially among women who have not had children.

ABORTION METHODS

Vacuum Aspiration (6 to 9 weeks): A powerful suction tube is inserted through the cervix and into the uterus. The fetus is torn apart by the force of the suction and sucked into a collection bottle, along with the placenta and amniotic sac. Since the doctor cannot actually see what he is doing, several possible complications can occur, including infection (if any portion of the fetus or placenta remains in the womb), uterine perforation (if the tube punctures the womb) and cervical laceration.

Dilation and Curettage (8 to 16 weeks): A steel loop-shaped blade is inserted into the uterus through the cervix. It is used to scrape clean the walls of the uterus, removing the fetus and placenta. As with the aspiration method described above, the doctor is working blind, and may be followed by suction aspiration. It carries an increased risk of uterine perforation, infection, and serious blood loss.

Mifepristone or RU-486 (5 to 7 weeks): This drug blocks the action of progesterone, a naturally occurring hormone which sustains the nutritive uterine lining. As this lining withers, the embryo starves to death. Administration of mifepristone is followed 36-48 hours later by misoprostol, a synthetic prostaglandin, which causes uterine contractions that expel the unborn child. Some women will deliver while still at the clinic, while others will do so later, at home or at work. Bleeding can be quite heavy and lasts for an average of nine days. This method of abortion fails 5-10% of the time, and must then be followed by a surgical abortion.

Methotrexate or "M&M" (5 to 9 weeks): Methotrexate is normally used for treatment of certain cancers, rheumatoid arthritis, and certain dermatological conditions. It is not approved for abortions by the FDA. This drug is given by injection; it interferes with the growth process of rapidly dividing cells. Like RU-486, it is followed by misoprostol (hence the "M&M" nickname) to expel the fetus. This method fails at least 4% of the time. Methotrexate can potentially cause serious side effects, including severe anemia, ulcers and bone marrow depression. (See box below)

According to an October 22, 1993 article titled "Existing Drugs Induced Abortions but Some Warn about Toxicity," appearing on p. 7 of Newsday (New York), the medical director of Planned Parenthood of New York, Dr. Hakim Elahi indicated the side effects were so unpredictable he would not use it as an abortion drug in any dose. In a letter to the editors of the New York Times (April 8, 1996, at p. A14), abortion provider Don Sloan warned that methotrexate can produce severe anemias, ulcers, and bone marrow depressions that can be fatal, even at the doses used for abortion and said "many of us in the abortion trade, as I am, are recoiling at the stark irresponsibility of those who are parading this medication in such cavalier fashion."

Herbal Abortifacients: Though touted as natural ways to do-it-yourself, such herbs are powerful drugs with potentially fatal consequences. Unregulated by the FDA, herbal abortifacients can vary in potency and effect. Pennyroyal, Black or Blue Cohosh and other similar herbs are toxic in excess and can easily overtax the liver and kidneys, causing headaches, extreme nausea, bleeding, or even death. Never take an herbal abortifacient.

Eastside Hospital obstetrician-gynecologist Dr. Sandra Sultan treated a woman who said she drank Pennyroyal Tea "three times a day for a week to end a six-week pregnancy." Sultan: "Within hours after I first saw her, she was bleeding from every orifice. I've never seen anything like it." The woman then went into kidney and liver failure and was in a coma for weeks. Sultan says she is now recovering, "but may still need treatment for potential neurological damage from bleeding in the brain." Sultan says the woman still required a surgical abortion. AP/Seattle Post-Intelligencer, 10/27/96

D&E (13 to 20+ weeks): In this late term abortion the cervix is dilated, either mechanically or with laminaria. The physician uses forceps to dismember the fetus, which must then be reassembled to confirm that no parts have been left inside. Possible complications include infection, cervical laceration and uterine perforation.

D&X (20 to 32+ weeks): This late in the pregnancy it is very difficult to dismember the fetus in the womb. Therefore the physician begins, but does not complete, a breech (feet first) delivery, taking care to leave the head inside the uterus. The physician then punctures the base of the skull and suctions out the brains. The child dies, the head collapses, and the delivery is completed. This unsafe procedure has been denounced by the AMA as "bad medicine".

"... partial-birth abortion is never medically indicated to protect a woman's health or her fertility. In fact, the opposite is true: The procedure can pose a significant and immediate threat to both the pregnant woman's health and her fertility." The Physicians' Ad Hoc Coalition for Truth, Wall Street Journal of September 19, 1996.

Hysterotomy (24 to 38 weeks): The procedure is simply an early Caesarean section. After an incision is made through the abdomen and uterus, the unborn child is lifted out and allowed to die. The risks are the same as for a normal Caesarean section.

Prostaglandin (16 to 38 weeks): This synthetic hormone is administered via injection or suppository. It causes powerful uterine contractions similar to labor. Live births are a common result. Possible risks include convulsions, vomiting, and cardiac arrest.

Digoxin Induction (20 to 32 weeks): To avoid the live birth complication described above, digoxin is first injected into the child's heart, killing it. This is followed by a prostaglandin induction.

Saline (16 to 32+ weeks): A needle is inserted through the abdomen to remove amniotic fluid. A strong salt solution is then injected, which poisons the fetus and badly burns the lungs and skin. The child is usually delivered within 24 hours. This method is rarely used any more, since it can present serious, even fatal risks to the mother.