Abortion; Take Time to Get the Facts

Before you decide to have an abortion or advise someone else to have one, get the facts straight. There are alternatives that may be safer and healthier -- both physically and emotionally -- for both you and your child.

No doubt an unwanted pregnancy can cause intense stress and hardship in a variety of ways, but, as you’ll read in this booklet, the medical evidence is clear -- the physical and psychological consequences of abortion can be far worse. Nine short months of pregnancy is a relatively small cost to pay in light of a lifetime of potential physical and mental health problems.

Think about it.

Informed Choice

Are you thinking about having an abortion or do you know someone who is? Perhaps that’s why you picked up this booklet or maybe you’re simply curious. Whatever the reason, you’ll find the information that follows straightforward and factual regarding the medical aspects of induced abortion.

When people talk about abortion, one is likely to hear a great deal about the social, moral, and even religious reasons for having or not having an abortion, but little about the basic medical details. In fact, many women make the decision to have an abortion without ever discussing either the medical procedures or the health considerations with anyone. Perhaps no other procedure is performed with this degree of patient ignorance.

It doesn’t have to be that way.

American citizens have a right to be informed about things that might affect their health.

There is no reason why any woman should go through surgery of any kind, especially induced abortion, or take powerful drugs that induce abortion, and not even be informed about potentially serious side effects. Inside this booklet, you’ll find factual, yet easy to understand information about induced abortion taken from the latest medical texts and journals. That should help you have a better idea of the risks involved. Before making a decision that could change your life forever, it only makes sense to get all the information you can on the procedure and its potential effects on you and the child you carry.

"As American citizens, we have a right to be informed about things that might affect our health..."

Defining "Abortion"

The term "abortion" actually refers to any premature expulsion of a human fetus, whether naturally spontaneous, as in a miscarriage, or artificially induced, as in a surgical or chemical abortion. Today, the most common usage of the term "abortion" applies to artificially induced abortion, which is the subject of this pamphlet.

In 1973, the Supreme Court handed down its Roe v. Wade and Doe v. Bolton decisions legalizing abortion in all 50 states during all nine months of pregnancy, for any reason, medical, social, or otherwise. The vast majority of all abortions performed today are done for social, not medical reasons -- because a woman doesn’t feel ready for a baby at the time, because her partner wants her to have an abortion, etc. Approximately 93% of all induced abortions are done for elective, non-medical reasons such as these.

Abortion ends a pregnancy by destroying and removing the developing child. That baby’s heart has already begun to beat by the time the mother misses her period and begins to wonder if she might be pregnant (about 31 days after the mother’s last menstrual period or LMP). Surgical abortions are usually not performed before seven weeks, or 49 days LMP. By that time, the baby has identifiable arms and legs (day 45) and displays measurable brain waves (about 40 days). During the seventh through the tenth weeks, when the majority of abortions are performed, fingers and genitals appear and the child’s face is recognizably human.

Abortion Techniques

Surgical First Trimester

Suction Aspiration

Suction aspiration, or "vacuum curettage," is the abortion technique used in most first trimester abortions. A powerful suction tube with a sharp cutting edge is inserted into the womb through the dilated cervix. The suction dismembers the body of the developing baby and tears the placenta from the wall of the uterus, sucking blood, amniotic fluid, placental tissue, and fetal parts into a collection bottle. Great care must be taken to prevent the uterus from being punctured during this procedure, which may cause hemorrhage and necessitate further surgery. Also, infection can easily develop if any fetal or placental tissue is left behind in the uterus. This is the most frequent post-abortion complication.

Dilatation (Dilation) and Curettage (D&C)

In this technique, the cervix is dilated or stretched to permit the insertion of a loop shaped steel knife. The body of the baby is cut into pieces and removed and the placenta is scraped off the uterine wall. Blood loss from D & C, or "mechanical" curettage is greater than for suction aspiration, as is the likelihood of uterine perforation and infection.

This method should not be confused with routine D&C’s done for reasons other than undesired pregnancy (to treat abnormal uterine bleeding, dysmenorrhea, etc.).

Chemical First Trimester

RU 486

While many people focus solely on RU 486, the so-called "French abortion pill," the RU 486 technique actually uses two powerful synthetic hormones with the generic names of mifepristone and misoprostol to chemically induce abortions in women five-to-nine weeks pregnant. The RU 486 procedure requires at least three trips to the abortion facility. In the first visit, the woman is given a physical exam, and if she has no obvious contra-indications ("red flags" such as smoking, asthma, high blood pressure, obesity, etc., that could make the drug deadly to her), she swallows the RU 486 pills. RU 486 blocks the action of progesterone, the natural hormone vital to maintaining the rich nutrient lining of the uterus. The developing baby starves as the nutrient lining disintegrates.

At a second visit 36 to 48 hours later, the woman is given a dose of artificial prostaglandins, usually misoprostol, which initiates uterine contractions and usually causes the embryonic baby to be expelled from the uterus. Most women abort during the 4-hour waiting period at the clinic, but about 30% abort later at home, work, etc., as many as 5 days later. A third visit about 2 weeks later determines whether the abortion has occurred or a surgical abortion is necessary to complete the procedure (5 to 10% of all cases). There are several serious well documented side effects associated with RU 486/prostaglandin abortions, including prolonged (up to 44 days) and severe bleeding, nausea, vomiting, pain, and even death. At least one woman in France died while others there suffered life-threatening heart attacks from the technique. In U.S. trials conducted in 1995, one woman is known to have nearly died after losing half her blood and requiring emergency surgery.

Long term effects of the drug have not yet been sufficiently studied, but there are reasons to believe that RU 486 could affect not only a woman’s current pregnancy, but her future pregnancies as well, potentially inducing miscarriages or causing severe malformations in later children.

Chemical First Trimester

Methotrexate

The procedure with methotrexate is similar to the one using RU 486, though administered by an intramuscular injection instead of a pill.

Originally designed to attack fast growing cells such as cancers by neutralizing the B vitamin folic acid necessary for cell division, methotrexate apparently attacks the fast growing cells of the trophoblast as well, the tissue surronding the embryo that eventually gives rise to the placenta. The trophoblast not only functions as the "life support system" for the developing child, drawing oxygen and nutrients from the mother’s blood supply and disposing of carbon dioxide and waste products, but also produces the hCG (human chorionic gonadotropin) hormone which signals the corpus luteum to continue the production of progesterone necessary to prevent breakdown of the uterine lining and loss of the pregnancy. Methotrexate initiaties the disintengration of that sustaining, protective, and nourishing environment. Deprived of the food, oxygen, and fluids he or she needs to survive, the baby dies.

Three to seven days later (depending on the protocol used), a suppository of misoprostol (the same prostaglandin used with RU 486) is inserted into a woman’s vagina to trigger expulsion of the tiny body of the child from the woman’s uterus. Sometimes this occurs within the next few hours, but often a second dose of the prostaglandin is required, making the time lapse between the initial administration of methotrexate and the actual completion of the abortion as long as several weeks. A woman may bleed for weeks (42 days in one study), even heavily, and may abort anywhere -- at home, on the bus, at work, etc. Those found to be still pregnant in later visits (at least 1 in 25) are given surgical abortions.

Even doctors who support abortion are reluctant to prescribe methotrexate for abortion because of its high toxicity and unpredictable side effects. Those side effects commonly include nausea, pain, diarrhea, as well as less visible but more serious effects such as bone marrow depression, severe anemia, liver damage and methotrexate-induced lung disease.

The manufacturer warns in the package insert that while methotrexate has shown itself useful in treating certain types of cancer and severe cases of arthritis and psoriasis, "deaths have been reported with the use of methotrexate," and recommends that its use be limited to "physicians whose knowledge and experience includes the use of antimetabolite therapy." Though researchers performing methotrexate abortions have dismissed such concerns because of the low dosage used, other doctors in the abortion trade have disagreed, and the package insert clearly warns that "toxic effects may be related in frequency and severity to dose or frequency of administration but have been seen at all doses" (emphasis added).

Surgical Second Trimester

Dilatation (Dilation) and Evacuation (D&E)

Used to abort unborn children as old as 24 weeks, this method is similar to the D&C. The difference is that forceps with sharp metal jaws are used to grasp parts of the developing baby, which are then twisted and torn away. This continues until the child’s entire body is removed from the womb. Because the baby’s skull has often hardened to bone by this time, the skull must sometimes be compressed or crushed to facilitate removal. If not carefully removed, sharp edges of the bones may cause cervical laceration. Bleeding from the procedure may be profuse.

Dr. Warren Hern, a Boulder, Colorado abortionist who has performed a number of D&E abortions, says they can be particularly troubling to a clinic staff and worries that this may have an effect on the quality of care a woman receives. Hern also finds them traumatic for doctors too, saying "there is no possibility of denial of an act of destruction by the operator. It is before one's eyes. The sensation of dismemberment flow through the forceps like an electric current."

To see an illustration of this abortion method, produced a professional medical illustration firm, click HERE.

Abortion Techniques: Instillation Methods

Chemical 2nd and 3rd Trimesters

These methods involve the injection of drugs or chemicals through the abdomen or cervix into the amniotic sac to cause the death of the child and his or her expulsion from the uterus. Several drugs have been tried, but the most commonly used are hypertonic saline, urea, and prostaglandins.

Salt Poisoning

Otherwise known as "saline amniocentesis," "salting out," or a "hypertonic saline" abortion, this technique is used after 16 weeks of pregnancy, when enough fluid has accumulated in the amniotic fluid sac surrounding the baby. A needle is inserted through the mother’s abdomen and 50-250 ml (as much as a cup) of amniotic fluid is withdrawn and replaced with a solution of concentrated salt. The baby breathes in, swallowing the salt, and is poisoned. The chemical solution also causes painful burning and deterioration of the baby’s skin. Usually, after about an hour, the child dies. The mother goes into labor about 33 to 35 hours after instillation and delivers a dead, burned, and shriveled baby. About 97% of mothers deliver their dead babies within 72 hours.

Hypertonic saline may initiate a condition in the mother called "consumption coagulopathy" (uncontrolled blood clotting throughout the body) with severe hemorrhage as well as other serious side effects on the central nervous system. Seizures, coma, or death may also result from saline inadvertently injected into the woman’s vascular system.

Urea

Because of the dangers associated with saline methods, other instillation methods such as hypersomolar urea are sometimes employed, though these are less effective and usually must be supplemented by oxytocin or a prostaglandin in order to achieve the desired result. Incomplete or failed abortion remains a problem with urea methods, often precipitating the additional risk of surgery.

As with other instillation techniques, gastrointestinal side effects such as nausea or vomiting are frequent, but the most common problem with second trimester techniques is cervical injuries, which range from small lacerations to complete detachments of the anterior or posterior cervix. Between 1% and 2% of patients using urea must be hospitalized for treatment of endometritis, an infection of the lining of the uterus.

Prostaglandins

Prostaglandins are naturally produced chemical compounds which normally assist in the birthing process. The injection of concentrations of artificial prostaglandins prematurely into the amniotic sac induces violent labor and the birth of a child usually too young to survive. Often salt or another toxin is first injected to ensure that the baby will be delivered dead, since some babies have survived the trauma of a prostaglandin birth and been born alive. This method is used during the second trimester.

In addition to risks of retained placenta, cervical trauma, infection, hemorrhage, hyperthermia, bronchoconstriction, tachycardia, more serious side effects and complications from the use of artificial prostaglandins, including cardiac arrest and rupture of the uterus, can be unpredictable and very severe. Death is not unheard of.

Surgical 2nd and 3rd Trimesters

Partial-Birth Abortion

Abortionists sometimes refer to these or similar types of abortions using obscure, clinical-sounding euphemisms such as "Dilation and Extraction" (D&X), or "intact D&E" (IDE) which mask the realities of how the abortions are actually performed.

This procedure is used to abort women who are 20 to 32 weeks pregnant -- or even later into pregnancy.* Guided by ultrasound, the abortionist reaches into the uterus, grabs the unborn baby’s leg with forceps, and pulls the baby into the birth canal, except for the head, which is deliberately kept just inside the womb. (At this point in a partial-birth abortion, the baby is alive.) Then the abortionist jams scissors into the back of the baby’s skull and spreads the tips of the scissors apart to enlarge the wound. After removing the scissors, a suction catheter is inserted into the skull and the baby’s brains are sucked out. The collapsed head is then removed from the uterus.

Surgical 2nd and 3rd Trimesters

Hysterotomy

Similar to the Caesarean Section, this method is generally used if chemical methods such as salt poisoning or prostaglandins fail. Incisions are made in the abdomen and uterus and the baby, placenta, and amniotic sac are removed. Babies are sometimes born alive during this procedure, raising questions as to how and when these infants are killed and by whom.

This method offers the highest risk to the health of the mother, because the potential for rupture during subsequent pregnancies is appreciable. In the first two years of legal abortion in New York State, the death rate from hysterotomy was 271.2 deaths per 100,000 cases.