ABORTION

Abortion. It’s a word that grips us when we hear it—sometimes with anger, sometimes with fear, and often times with pain. Most people avoid the subject. According to the Alan Guttmacher Institute, approximately 1 out of 3 women in the United States will have had an abortion by age 45. It’s fair to say that the majority of Americans have either had an abortion or know someone who has experienced one. 

 Since the Supreme Court handed down its 1973 decisions in Roe v. Wade and Doe v. Bolton, states have constructed a lattice work of abortion law, codifying, regulating and limiting whether, when and under what circumstances a woman may obtain an abortion. 

Abortion is a life changing event that affects many individuals emotionally, spiritually, and physically. Abortion is a traumatic pregnancy loss – and that loss is real. Mothers, fathers, grandparents, siblings, friends, doctors, peers, and whole communities are impacted. With today’s open abortion laws, society does not provide a public way to grieve this loss. With no way to process this loss, the wound caused by abortion often remains unhealed and becomes a secret sorrow carried alone and without support. Source: www.helpafterabortion.org/you-are-not-alone

Some women describe being in an almost altered state of mind at the time of the decision and during the abortion. When women are pregnant and frightened, the instinct for self-preservation takes over. The pregnancy may be seen as a life-threatening problem, and pregnant women who feel this way will do whatever is necessary to escape the problem. Source: Project Rachel Ministry Resource Manual, 2009.

Worldwide in 2014, 1 in 4 pregnancies ended in abortion (Guttmacher Institute March 2018 Fact Sheet.)

45% of abortions are repeat abortions (CDC 2013.)

Fact Sheet: FDA rejects safeguards used by other countries.

Dangers inherent in method evident in precautions used in France:

After women are given prostaglandin (e.g., misoprostol), they are monitored on site for approximately four hours so that allergic reactions, cardiopulmonary "events," hemorrhaging and the like can be treated promptly before they become life-threatening. A 1990 directive jointly signed by the French Republic's Director General of Health, Director of Hospitals and Director of Pharmacy and Medication, states that whenever prostaglandins are given "in association with RU 486" the "following technical conditions ... are indispensable and are to be followed: ... b) The doctor must ensure that diagnostic instruments and machines are close by, such as electrocardiogram equipment and particularly resuscitative cardiopulmonary equipment (including nitrous oxide and injectable calcium antagonists and a fibrillator). ... c) [C]linical observations and blood-pressure readings every half hour are indispensable for several hours following the administration of these drugs. d) Whenever there is chest pain, an electrocardiogram should be taken on the suspicion of rhythm troubles and in case of significant lowering of blood pressure" (April 12, 1990 letter from the French Republic, Department of Solidarity, Health and Social Protection, reprinted in Child & Family21:102-103, 1990).

In Sweden, women are "supervised by the midwife for 4 to 6 hours at the outpatient clinic" (M. Bygdeman et al., "Medical Termination of Early Pregnancy: The Swedish Experience," Journal of the American Medical Women's Assn. ["JAMWA"], Supplement 2000, 55:3; 195, 196).

In China "the emphasis on close medical supervision is well accepted. ... It is stressed that misoprostol should be taken in the clinic and followed by several hours of observation" (S. Wu, "Medical Abortion in China," JAMWA, Supplement 2000 at 197, 199). The long observation is one reason staffs in some large hospitals in China are growing reluctant to prescribe the drug combination: "The number of medical abortions has decreased recently in some of the large hospitals. The staffs were too busy to handle the procedure (more counseling, more visits, and observation), and they also have to manage the referred cases with serious side effects and complications" (Id. at 199).

Searle, which manufactures misoprostol under the brand name Cytotec, has consistently opposed the use of Cytotec for labor induction and for abortion. An August 23, 2000 letter from Searle, posted on the FDA's website (http://www.fda.gov/medwatch/safety/2000/cytote.htm), reiterates its opposition to these off-label uses and lists "serious adverse events" that have been reported: "maternal and fetal death; uterine hyperstimulation, rupture or perforation requiring uterine surgical repair, hysterectomy or salpingo-oophorectomy; amniotic fluid embolism; severe vaginal bleeding, retained placenta, shock, fetal bradycardia and pelvic pain." The Cytotec patent expired in July 2000.

FDA Proposed Modest Precautions: The private, less regulated health care system of the U.S. cannot offer women taking M/M the same level of safety unless the drugs are given, and women monitored, in settings like hospital out-patient facilities. It was widely reported in June 2000 that, nodding to these safety concerns, the FDA proposed making mifepristone available only to licensed physicians trained in surgical abortion, trained and certified in ultrasonography and in the use of M/M under an FDA-approved curriculum. Prescribing doctors also would need to maintain admitting privileges at a hospital no more than one hour from their main office. (See July 24, 2000 Release, American College of Obstetricians and Gynecologists.)

Inexplicably, the FDA-proposed protocol did not mandate on-site observation after taking misoprostol, although this protocol is followed in France, China, Sweden, the United Kingdom and is the common practice virtually everywhere the drug combination is used.

Final Approval Ignores Safety Concerns: Between June and September 2000, something caused the FDA to relax even these modest precautions. Under the final approval issued September 28, 2000, prescribing doctors need only sign an agreement with a distributor of mifepristone that he/she can do the following: assess pregnancy duration accurately; diagnose tubal pregnancy; provide surgical intervention OR have a referral arrangement with an abortion provider; assure patients access to medical facilities equipped to provide blood transfusions and resuscitation. Additionally, doctors must see patients at 14 days and report all on-going pregnancies, serious adverse events, hospitalizations and transfusions. (Mifeprex Prescriber's Agreement).

Risks to U.S. Women under Relaxed Controls

Bleeding: In U.S. trials conducted by Population Council ("PC"), 9% of women reported bleeding after 30 days and 1% were still bleeding after 60 days. "Excessive bleeding necessitated blood transfusions in four women and accounted for 25 of 27 hospitalizations (including [ER] visits), 56 of 59 surgical interventions, and 22 of 49 administrations of [IV] fluid" (I.M.Spitz, et al., "Early Pregnancy Termination with Mifepristone and Misoprostol in the United States," The New England Journal of Medicine, April 30, 1998, 338:18, 1241-47, hereinafter "NEJM"). In a Columbia University study, 20% of women bled or spotted for 5 to 6 weeks (A. Davis et al., "Bleeding Patterns After Early Abortion with Mifepristone and Misoprostol or Manual Vacuum Aspiration," JAMWA, Supplement 2000, 141, 143).

Dr. Mark Louviere treated a Waterloo, Iowa woman who had participated in Population Council trials. Two weeks after her M/M abortion, she was taken to a hospital emergency room where Dr. Louviere found her "in obvious shock" having "lost between one-half to two-thirds of her blood volume. ... It was my clinical opinion that she would die soon. ... Without even doing the routine preparation we normally do for surgery, I realized that I had to take her immediately to surgery to save her life" (FDA Reproductive Health Drugs Advisory Committee, Hearing Transcript, July 19, 1996 at 224). The next day, he advised Planned Parenthood of Greater Iowa which in turn informed Population Council. Both organizations, however, reported "no complications," and "no adverse events ... during the course of this trial" (Id. at 19-20).

Two patients in Des Moines, Iowa trials told a TIME magazine journalist that their bleeding was "like turning a jug of water upside down" and "like a faucet was turned on. There was a steady stream of blood. I passed a golf ball size blood clot that scared me" (Sachs, "Abortion Pills on Trial," TIME, 12/5/94, p. 45).

Allergic reactions: The FDA warns that M/M abortion is contraindicated in women with known allergies to either drug. (Mifeprex Package Insert ["MPI"]). But how would one know of such an allergy in advance? Dr. Wu Shangchun, with the National Research Institute for Family Planning in Beijing reports: "The common complications of medical [drug-induced] abortion are profuse bleeding and allergy. ... Allergic reactions to mifepristone or misoprostol were not uncommon, manifesting in facial edema, skin rash and itching, numbness of feet and hands, and even a serious case of allergic shock. The potential for such reactions is one reason to keep clients for observation" (Wu, op. cit., at 198).

Infection: Four percent of women in PC's U.S. trials had fever, viral infection and vaginitis associated with the abortion. Ten cases of study-related endometritis (inflammation of uterine lining) also occurred. (NEJM, op cit. at 1244). A recent review of M/M regimens around the world reports on a trial involving 2000 cases (P.W. Ashok et al., "An Effective Regimen for Early Medical Abortion: A Report of 2000 Consecutive Cases," Human Reprod. 1998; 13:2962-2965): "The most common problems reported at follow-up were continued pain, vaginal bleeding, and offensive discharge. Antibiotics were prescribed for 5% of the 1322 women for presumed genital infection" (H. Von Hertzen, "Research on Regimens for Early Medical Abortion," JAMWA, Supplement 2000, 133, 136). A World Health Organization study recommended giving antibiotics to women for six weeks following M/M abortions, finding an infection rate of 29.4% among women who had incomplete abortions. (World Health Organization, "Pregnancy Termination with Mifepristone and Gemeprost: A Multicenter Comparison Between Repeated Doses and a Single Dose of Mifepristone," Fertil. Steril., 56:1, 1990, 32-40).

Failure Rates: Mifepristone alone was effective for only 6% of women in PC's U.S. trials in the 48 hours preceding misoprostol administration. About half of the women studied expelled their embryo within four hours of taking misoprostol, and a total of 69% had completed abortions within 24 hours of taking misoprostol. Many of the remaining 31% faced up to two weeks of pain, nausea and bleeding. Eight percent of women in the PC trials needed surgery, due to incomplete abortions (4.7%), ongoing pregnancies (1%), and medical reasons, usually excessive bleeding (1.6%); an additional 0.6% requested surgery. (NEJM, op. cit., at 1242).

Accuracy in determining gestational age is critical because failure rates increase dramatically after 49 days LMP—17% at 50-56 days and 23% at 57-63 days. (Id. at 1243). Untreated, incomplete abortion can result in infection, sterility and death.

Additional Dangers to Women under Lax Standards Set by FDA: Failure to diagnose an ectopic pregnancy can result in maternal death. (Wu, op cit., 198-199) "Some recent adverse events resulting from undiagnosed ectopic pregnancies have led providers to pay more attention to ultrasound examination. One study found that 84% of providers in Beijing used ultrasound routinely..." (Id. at 197). The FDA has dropped the reported requirement that prescribers be certified in the use of ultrasound.

The nature of abortion practice in the United States is that nine out of ten abortions take place free-standing abortion clinics or in doctors' offices (Alan Guttmacher Institute, Facts in Brief) with minimal government supervision. There are no guarantees that doctors prescribing mifepristone and misoprostol to U.S. women will adequately screen for medical conditions that make use of these drugs dangerous, among which are: adrenal insufficiency; coagulation disorders; use of steroid medications; known allergies to the drugs; liver, respiratory, renal or cardiovascular disease, thromboembolism, hypertension, anemia and insulin-dependent diabetes mellitus. (Source: MPI and NEJM, op. cit.)

Women in the U.S. often do not return to abortion clinics for the required follow-up appointment. Suzanne Poppema, a Seattle abortion provider, has said they are "lucky if 30-40% of patients" return. In PC's U.S. trials, despite stringent counseling standards, 5% of women failed to return for the day 14 checkup. Not only do women with incomplete abortions or hemorrhaging risk death, but those with ongoing pregnancies are also at risk. Eight malformations to children were reported in 71 cases of continuing pregnancy in France, Sweden and the United Kingdom between 1987 and 1998. (Von Hertzen, op. cit. at 136).-

 What is partial-birth abortion?

Partial-birth abortion (PBA) is the term Congress has used to describe a procedure that crosses the line from abortion to infanticide.  The doctor delivers a substantial portion of the living child outside his mother's body --- the entire head in a head-first delivery or the trunk past the navel in a feet-first delivery --- then kills the child by crushing his skull or removing his brain by suction. 

Some abortion doctors use PBA in the middle and last months of pregnancy, when dismembering a child becomes more difficult due to the child's stronger bones and ligaments.  After the mother undergoes two to three days of cervical dilation (increasing her risk of infection and subsequent preterm births), the doctor in minutes can partially deliver the child "intact" before killing him or her and completing delivery.  In the more commonly used dismemberment method, the mother's cervix is dilated manually only enough to remove the child's severed body parts; dismemberment and removal takes the doctor longer to complete. 

In Carhart I the Supreme Court treated PBA as just another method of abortion, largely ignoring the fact the the child is almost completely delivered when he or she is killed.  Yet even when the Court struck down Texas's abortion statute in Roe, it had left standing a provision of Texas law that prohibited killing a child in the process of being delivered. 

Such laws exist in most states but they generally have two deficiencies.  First, they apply only after "viability" --- when the child if delivered could survive indefinitely outside the womb --- and PBA is used to kill mostly-delivered children before this stage.  Second, as required by Roe and Casey, even laws restricting abortion after viability allow abortion when it is deemed necessary to preserve the mother's "health" and "heath" was defined in Roe's companion case Doe v. Bolton to include "all factors" --- emotional, familial, age, and so on --- related to "well-being."  This "heath" loophole allows abortions to be performed on request during all nine months of pregnancy for virtually any reason.

 Others may approach you with questions about how to facilitate healing for the post-abortive woman or man. Although you can never force a person to seek healing, you can casually share information about post-abortion healing and point them in the direction of where to find help. If a friend has just told you about their abortion experience for the first time, they may fear being rejected or a breach in confidentiality. Assure your friend this won’t happen. Affirm the person’s courage and humility in reaching out to you. 

Ask God what your friend needs…someone to listen? A shoulder to cry on? We can’t make their suffering go away in one conversation but you can reassure them that you will be there through the journey of healing with them. Suggest they seek out a priest or Project Rachel program.

It is indispensable in a person’s healing journey that they understand that God…and their child…can forgive them. That the pain will diminish and healing is possible. There are excellent resources you can also read to be better able to respond in a way that brings your friend closer to healing the wounds in their heart & soul:

1. Download “How to Help Others After Abortion – A Guide to Helping Those in Your Life Who May Be Hurting” by Elliot Institute at: http://www.afterabortion.org/churchawarenessproject/howtohelp.pdf
2. Read the posting “How to talk to someone hurt by an abortion” at Project Rachel Ministry website: http://hopeafterabortion.com/?page_id=211.

 There are many negative emotional reactions that have been associated with abortion. While some mothers report relatively little trauma following abortion, none come away truly unscathed. Some women experience ‘impacted grieving,’ which includes an inability to complete the grieving process. Others experience specific self-destructive tendencies, intense fear, feelings of helplessness or loss of control.‘After my abortion I felt terribly confused,” Sue writes. ‘I had difficulty concentrating and getting a task done. I had what I now refer to as a cluttered mind.” “At first I denied it and repressed it and tried to escape from it,” Laura writes. “It was a family secret. I dove heavily into drugs and sex, and was constantly having pregnancy tests for fear that I was pregnant.”Source: “Post Abortion Syndrome Are You at Risk?” by Dr. David Reardon. Heritage House ’76, Inc., 2015.During a post abortion healing program, many participants are surprised at how they became a different person since the abortion experience. Post Abortion Syndrome (PAS) manifests in many ways. Some notice symptoms soon after the abortion, others take decades:

• Guilt
• Addictions
• Broken Relationships
• Failure to bond with existing children
• Irritability
• Suicidal thoughts
• Grief
• Eating Disorders
• Repression or denial of feelings about the abortion
• Flashbacks
• Isolation
• Anxiety
• Low self-esteem
• Depression
• Aggressive behavior
• Nightmares/Sleeping Disorders
• Outbursts of Anger or rage
• Fear of punishment from God
• Atonement or replacement baby
• Impotence in men

Source: “Post Abortion Syndrome Are You at Risk?” by Dr. David Reardon. Heritage House ’76, Inc., 2015. 

Clergy are encouraged to request a copy of the USCCB Project Rachel Ministry Resource Manual. The Respect Life Office has copies to give to pastors/priests/deacons free of charge, while supplies last. Pastors may also order additional copies directly from the USCCB store.

For additional questions, please contact the Archdiocesan Project Rachel Coordinator, Angela Curatalo, at the Respect Life Administrative Office (954) 981-2922 or via email acuratalo@theadom.org. 

Roe v. Wade is the 1973 Supreme Court case which struck down existing state laws nationwide that had heretofore made abortion illegal. Roe v. Wade effectively legalized abortion throughout a woman’s 9 month’s of pregnancy. 

The USCCB developed the “Second Look” national education campaign, providing facts vs. myths about the Supreme Court decisions that legalized abortion nationwide, to members of Congress, the media, and other key public interest groups.