We have hitherto discussed abortion in the abstract, as a crime, and in
its relations to the community at large. We have seen its heinous nature,
and its awful extent.[94]
The division of the subject now to be examined naturally presents itself
under a fourfold aspect, numerical, relational, social, and medical;
representing respectively the multitude of the victims of abortion, their
character as parent and child, their standing in the community, and the
degree, whether unto death or otherwise, of their suffering.
So far as statistics will at present allow, the numerical relations of
the victims of abortion have already been fully discussed, the yearly
thousands of fœtal and the frequent maternal deaths; one sacrifice at
least, that of the child, being implied in every case.
Various incidental questions suggest themselves in this connection,
curious, and by some, though erroneously, thought to be of judicial
importance. Two of them will be here adverted to; they are the age or
the mother and that of the fœtus.
It was formerly supposed, as in infanticide, that criminal abortion was
seldom resorted to save for the concealment of shame; and as seductions,
confessedly frequent in comparison with adultery, are most common in
youth, it was laid down as probable that wilful abortions are most
frequent between the years corresponding, from sixteen to twenty-five.
Subsequent experience, however, has disproved this conclusion, and it is
evident that the only real limit to its later occurrence is the menstrual
climacteric. In many instances of marriage, abortions are resorted to at
once, in others after the family has reached a certain point, and are
thence regularly continued.
The age of the fœtus is of much more interest; not, as will ultimately
appear, for the same reason as in cases of infanticide, but as proving to
a certain extent one of the facts we have already considered, the error
prevalent regarding the commencement of fœtal life.
It was Orfila’s opinion that criminal abortion was most frequent in the
two first months of pregnancy. This would naturally have been supposed
the case, as then some doubt might always obtain regarding its existence,
and the excuse that the measures resorted to were for the purpose of
preventing ill effect from an abnormal menstrual suppression would be
more available. Devergie, on the other hand, was inclined to put the
limits of greatest frequency at from three months to four and a half;
while Briand and Chaudé thought the crime more common in the third month
than the fifth, and in this last month much more frequent than even in
the first or second. Tardieu also came to a similar conclusion.[95] He
ascertained, that of 34 cases investigated by himself, 25 were in from
the third to the sixth month, most in the third; 5 in the first two
months; 4 in the seventh and eighth; or that the cases in the third
month, or shortly after, were five times as numerous as at either an
earlier or a later period, and nearly three times as numerous as in both
combined.
Upon examining the Register of the Morgue, we find its statistics
strikingly corroborative of these deductions. We have already seen that
from 1837-54 there had been deposited at the Morgue 692 fœtuses of less
than nine months. Of these,
23 were from the first to the second month;
79 ” ” second to the third;
108 ” ” third to the fourth;
158 ” ” fourth to the fifth;
150 ” ” fifth to the sixth;
97 ” ” sixth to the seventh;
48 ” ” seventh to the eighth;
29 ” ” eighth to the ninth.
It has been stated that 519, or five-sixths of them all, were not over
six months, and it now appears that on a scale twenty times larger
than that given by Tardieu from his own experience, nearly two-thirds
of the fœtal deaths induced by abortion were in from the third to the
sixth month of pregnancy; the three periods included giving a much
larger proportion than any others, and the two last of them being almost
identical. The extreme paucity shown by the above table in the first
and ninth months, and the decrease in the seventh and eighth from those
preceding, are worthy of remark. It is probable that the sudden increase
may be attributed to mental reaction after the first shock occasioned
by the absolute certainty of pregnancy is past; and the subsequent
decrease to the fact that in many attempted criminal abortions during the
later months children are born alive, the mother’s courage then proving
insufficient for infanticide and its greater and more probable punishment.
The truth seems to be that while frequently the crime is committed in
the very earliest period of pregnancy, in the belief that possibly all
alarm may be false, in most cases the woman waits a month or two to be
sure that she really is pregnant. After the sixth month the comparative
rarity of the crime is undoubtedly owing to the fact that fœtal life is
then rendered certain by the perceived movements of the child, the more
strongly as pregnancy advances.
It was formerly thought that the induction of criminal abortion was
confined to the unmarried alone; there exists, however, abundant proof
to the contrary. Had such been the fact it would be reasonable to
suppose that with the increase of marriages, the number of premature
and still-births would have lessened. In proportion, however, as the
number of marriages has increased, so has the number of fœtal deaths,
and in similar ratio the number of living births has declined; proving,
as Husson was compelled to acknowledge of Paris, “a decrease in the
fecundity of legitimate unions,”[96] explainable in nowise but by a
criminal cause. Direct statistics on this point are still wanting, and
must come, almost entirely, from medical men. The writer’s published
experience has been already referred to; subsequent practice has only
confirmed it.
Again, the victims of abortion are not confined to the inhabitants of
cities. Of the prosecutions in France during 1851-53, it appears that but
little more than a tenth of the whole number occurred in the Department
of Seine.[97] But we have already furnished much stronger evidence on
this point.
Finally, though the excessive extravagance of the day, entailing as it
does to so many an annual expenditure incommensurate with their income,
is accountable in no small degree for the crime, yet it cannot always be
alleged. There is too much reason to believe that with our communities
it is as with others. In France it appears that the poor and uneducated
have on the whole the largest families, contrary in some respects to
established hygienic rules; while, on the other hand, the rich are
inclined as far as possible to restrict the number of their children,
often indeed stipulating beforehand, at marriage or previously, that such
shall be few or none.[98]
But not only must we believe that this crime prevails in our midst
to an almost incredible extent among the wealthy and educated and
married; we are compelled to admit that Christianity itself, or at least
Protestantism, has failed to check the increase of criminal abortion. It
is not astonishing to find that the crime was known in ancient times, as
shown by evidence previously given, nor that it exists at the present
day among savage tribes, excused by ignorance and superstition; but that
Christian communities should especially be found to tolerate and to
practice it, does almost exceed belief.
In the previous remarks, the French have been compared with our own
people, not merely because of their published statistics, but because
from their loose morals and habits of life they might be thought to
represent the extreme to which the crime would be likely to obtain among
civilized nations. We have shown reason to suppose that we equal them
in guilt, if we do not exceed them. Now it must be borne in mind that
the French are Catholic; that the rules of that church do not, as has
been generally supposed, permit abortion in the earlier months,[99] but
that they rigidly exercise over fœtal life throughout pregnancy the
most absolute guard and supervision;[100] instances of this in cases
where craniotomy is supposed to be indicated, are familiar to every
practitioner. The church, here omnipotent against the physician, and
desiring that every created human being should receive the benefit of
baptism, demands that fœtal death must have taken place previously to
the operation proposed. It does not seek for the signs of fœtal life,
but takes this for granted, and requires that its absence must be proved
before allowing the removal of the child, even though this is necessary
to save the mother’s life.
The rule runs thus: “Sedulam operam dent sacerdotes, ut quantum poterunt,
impediant nefandum illud scelus quo adhibitis chirurgicis instrumentis
infans in utero interficitur. Omnis fœtus quocumque tempore gestationis
editus baptizetur, vel absolute, si constet de vitâ; vel sub conditione,
nisi evidenter pateat eum vitâ carere.”[101]
In cases where instrumental delivery is absolutely necessary, the
ceremony of baptism as ordinarily administered is of course impossible.
But as this is deemed so important by the Catholic Church,[102] even to
the sacrifice of the mother, any means of overcoming this obstacle, fatal
to countless maternal lives, should be accounted, if found practicable,
of the utmost importance. For this purpose, therefore, I do not hesitate
to recommend intra-uterine baptism, the consecrated element being carried
to the child, if too high to be reached by the hand, by a sponge and
staff, or if necessary, by a syringe, as was long ago sanctioned by the
theologists of the Sorbonne;[103] in the absence of a clergyman, if the
case is urgent, the rite accounted so sacred being performed by the
physician in attendance rather than to allow the death of the mother. I
know that many of the profession, from fear of ridicule or dislike to
sanction what they do not believe in, would shrink from such a duty. Is
it not, however, due to humanity in every way to prevent this frequent
murder? for such, by our apathy and neglect, the mother’s death in these
cases becomes. Can we, as Christians, refuse _any_ aid? I am not ashamed
to acknowledge that for myself, though no Catholic, I have performed this
intra-uterine baptism, where delivery without mutilation was impossible.
I could neither conscientiously assert the child’s death, nor allow the
mother to linger till it should occur, while the friends, in the absence
of a priest, whose presence it was impossible to procure for many hours,
would not permit the operation. Remonstrance was useless; had I refused I
should have been morally responsible for the almost inevitable death of
the woman; it was, therefore, simply my duty.
I shall now quote from an admirable letter I have lately received from
the Catholic Bishop of Boston. The extracts are couched in so forcible
language, and their spirit is so thoroughly Christian, that I need not
apologize for their length, or that they recapitulate arguments I have
already advanced.
“The doctrine of the Catholic Church,” remarks Bishop Fitzpatrick, “her
canons, her pontifical constitutions, her theologians without exception,
teach, and constantly have taught, that the destruction of the human
fœtus in the womb of the mother, _at any period from the first instant
of conception_, is a heinous crime, equal, at least, in guilt to that
of murder. We find it distinctly condemned as such even as far back as
the time of Tertullian, (at the end of the second century,) who calls
it _festinatio homicidii_, a hastening of murder. The Pope, Sixtus the
Fifth, in a bull published in 1588, subjects those guilty of the crime to
all the penalties, civil and ecclesiastical, inflicted on murderers. It
is denounced and reprobated in many other canons of the church.
“The reason of this doctrine (apart from the authority of the church)
must, it seems to me, appear evident upon a little reflection. The very
instant conception has taken place, there lies the vital germ of a man.
True, it is hidden in the darkness of the womb, and it is helpless;
but it has sacred rights, founded in God’s law, so much the more to be
respected because it is helpless. It may be already a living man, for
neither mothers nor physicians can tell when life is infused; they can
only tell when its presence is manifested, and there is a wide difference
between these two things. At any rate, it is from the first moment
potentially and _in radice_ a man, with a body and a soul destined most
surely by the will of the Creator and by his law, to be developed into
the fullness of human existence. No one can prevent that development
without resisting and annulling one of the most sacred and important laws
established by the Divine Author of the universe, and he is a criminal,
a murderer, who deals an exterminating blow to that incipient man, and
drives back into nothingness a being to whom God designed to give a
living body and an immortal soul.
“From this it follows that the young woman whose virtue has proved an
insufficient guardian to her honor, when she seeks by abortion to save in
the eyes of man that honor she has forfeited, incurs the additional and
deeper guilt of murder in the eyes of God, the judge of the living and
the dead. Who can express what follows with regard to those women, who,
finding themselves lawfully mothers, prefer to devastate with poison or
with steel their wombs, rather than bear the discomforts attached to the
privilege of maternity, rather than forego the gaieties of a winter’s
balls, parties, and plays, or the pleasures of a summer’s trips and
amusements?
“But abortion,” the Bishop continues, “besides being a direct crime
against a positive law of God, is also an indirect crime against society.
Admit its practice, and you throw open a way for the most unbridled
licentiousness, you make woman a mere instrument for beastly lust. Every
woman is somebody’s mother or daughter or sister or wife; or she bears
all these relations at once. Whatever protection, therefore, we would
claim for a woman because she stands in any of these relations to us,
we should also extend to all women, because they bear some one of all
these relations to others. Most assuredly, then, we should remove none
of the safeguards that protect female virtue. But if we take away the
responsibility of maternity, we destroy one of its strongest bulwarks.
“It affords me pleasure,” he concludes, “to learn that the American
Medical Association has turned its attention to the prevention of
criminal abortion, a sin so directly opposed to the first laws of nature,
and to the designs of God, our Creator, that it cannot fail to draw down
a curse upon the land where it is generally practiced.”[104]
Such being the doctrine of the Catholic Church, and statistics
nevertheless proving that its so stringent statutes against the
destruction of fœtal life, enforced alike by denouncement and
excommunication, are constantly broken in Catholic France, it is more
than probable, from the existence of this fact, in addition to all the
various causes of the crime we have seen equally prevailing there and
in this country, that the actual number of abortions is much greater
with ourselves; at least with the American and native portion of
our population. We have indeed shown that this is really the case in
Massachusetts.[105]
Viewing this subject in a medical light, we find that death, however
frequent, is by no means the most common or the worst result of the
attempts at criminal abortion. This statement applies not to the mother
alone, but, in a degree, to the child.
We shall perceive that many of the measures resorted to are by no means
certain of success, often indeed decidedly inefficacious in causing the
immediate expulsion of the fœtus from the womb; though almost always
producing more or less severe local or general injury to the mother, and
often, directly or by sympathy, to the child.
The membranes or placenta may be but partially detached, and the ovum
may be retained. This does not necessarily occasion degeneration, as
into a mole or hydatids, or entire arrest of development. The latter
may be partial, as under many forms, from some cause or another, does
constantly occur; if from an unsuccessful attempt at abortion, would
this be confessed, or indeed always suggest itself to the mother’s own
mind? Fractures of the fœtal limbs prior to birth are often reported,
unattributable in any way to the funis, which may amputate indeed, but
seldom break a limb. A fall, or a blow, is recollected; perhaps it was
accidental, perhaps not, for resort to these for criminal purposes is
very common. In precisely the same manner may injury be occasioned to
the nervous system of the fœtus, as in a hydrocephalic case long under
the writer’s own observation, where the cause and effect were plainly
evident. Intra-uterine convulsions have been reported; as induced by
external violence they are probably not uncommon, and the disease thus
begun may eventuate in epilepsy, paralysis, or idiocy.
To the mother there may happen correspondingly frequent and serious
results. Not alone death, immediate or subsequent, may occur, from
metritis, hemorrhage, peritonitic or phlebitic inflammation, from
almost every cause possibly attending not merely labor at the full
period, comparatively safe, but miscarriage,—increased and multiplied by
ignorance, by wounds and violence; but if life still remain, it is too
often rendered worse than death.
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. But if, taking
into account the patient’s constitution, her previous health and the
period of gestation, the abortion has been criminal, these risks are
infinitely increased.[106] Those who escape them are few.
In thirty-four cases of criminal abortion reported by Tardieu, where
the history was known, twenty-two were followed, as a consequence, by
death, and only twelve were not. In fifteen cases necessarily induced by
physicians, not one was fatal.[107]
It is a mistake to suppose, with Devergie, that death must be
immediate, and owing only to the causes just mentioned. The rapidity
of death, even where directly the consequence, greatly varies; though
generally taking place almost at once if there be hemorrhage, it may
be delayed even for hours where there has been great laceration of the
uterus, its surrounding tissues, and even of the intestines;[108] if
metro-peritonitis ensue, the patient may survive for from one to four
days, even indeed to seven and ten. But there are other fatal cases,
where on autopsy there is revealed no appreciable lesion; death, the
penalty of unwarrantably interfering with nature, being occasioned by
syncope, by excess of pain, or by moral shock from the thought of the
crime.[109]
That abortions, even when criminally induced, may sometimes be safely
borne by the system, is of little avail to disprove the evidence of
numberless cases to the contrary. We have instanced death. Pelvic
cellulitis, on the other hand; fistulæ, vesical, uterine, or between
the organs alluded to; adhesions of the os or vagina, rendering liable
subsequent rupture of the womb, during labor or from retained menses, or,
in the latter case, discharge of the secretion through a Fallopian tube
and consequent peritonitis; diseases and degenerations, inflammatory or
malignant, of both uterus and ovary; of this long and fearful list, each,
too frequently incurable, may be the direct and evident consequence, to
one patient or another, of an intentional and unjustifiable abortion.
We have seen that in some instances the thought of the crime, coming upon
the mind at a time when the physical system is weak and prostrated, is
sufficient to occasion death. The same tremendous idea, so laden with
the consciousness of guilt against God, humanity, and even mere natural
instinct, is undoubtedly able, where not affecting life, to produce
insanity. This it may do either by its first and sudden occurrence
to the mind; or, subsequently, by those long and unavailing regrets,
that remorse, if conscience exist, is sure to bring. Were we wrong in
considering death the preferable alternative?