Science and Christianity: November 2008

By Dr. Penny Girard:

Some issues related to abortion

We briefly considered some topics related to abortion. A PowerPoint presentation prepared by the director of Christian Medical and Dental Associations was used for a guide. Below is the outline given out in class with some additional comments. Included are internet links outlining fetal development and books and resources for those interested in further research on this topic, as well as resources for those seeking to help both women and men who have participated in abortion or have been impacted by it.

Definition: The premature expulsion of the human fetus. It usually refers to an artificially induced abortion caused by surgical or chemical means. A spontaneous abortion is often called a miscarriage.

Statistics

In the United States, statistics related to abortion are collected annually by the Centers for Disease Control. Reporting is done on a voluntary basis. At least five states were not included in the most recent statistics. For this reason, overall statistics may under represent numbers of procedures being performed as well as the types of procedures women are undergoing. Statistics also likely underestimate the occurrence

of complications in women undergoing abortion.

Embryo/Fetal Development by Trimester

First Trimester Development (0-12 Weeks)

Days of Gestation	Development of embryo/fetus
18-21	Heart beats¹
32	Eyes are formed²
38	Upper lip formed³
Markers of pain perception are present at 7 weeks 40	Brain waves are measurable⁴
44	Arms and legs formed⁵
48	Beginnings of all internal structures present; baby is moving⁶
56	Embryo now called a fetus⁷
63	Sucking thumb, teeth forming⁸
84	Cries, feels pain

**Most surgical abortions occur between 49 to 70 days**

Second Trimester Development

Weeks of age	Development of fetus
13	3 inches long, weighs half oz., reflexes active
14	Fingerprints present
15	Has ability to grasp, smile, grimace, squint
16	6 inches long, weighs 6 oz., somersaults, mother feels movement
17	Gets hiccups, plays with umbilical cord
18	Hair and eyebrows are growing
20	Hears, recognizes mother’s voice
22	Responds to stories, music, etc.
Definition of viability age 23-24 weeks in 2004 24	Weighs 1 lb., has 85 percent survival rate
26	Responds to light, weighs 1.5 to 2 lbs.

Third Trimester Development

Weeks of age	Development of fetus
24 Definition of viability age 28 weeks in 1973	Weighs 2 lbs. and is practicing breathing
30	Grows rapidly, sleeps 90 percent of time, has dreams
32	Weighs 4 lbs., urinates
34	Weighs 5 lbs., 19.5 in. long, head begins to drop into mother’s pelvis
36	Now has 99 percent survival rate
38	Is 1,000 times its original size, gains an ounce a day
40	Average weight: 7.5 lbs.

Abortion Methods by Trimester

First Trimester

o Dilation and Curettage

o Suction Aspiration or “Vacuum Curettage”-the most common procedure in the first trimester

o RU-486-A two part procedure with a progesterone (hormonal) agent which causes the uterine lining to shed followed by a prostaglandin which causes the uterus to contract, thus expelling its contents. Much controversy surrounded the “fast track” approval process which ended with its approval as an agent for “medication abortion” in 2000. The

accepted procedure for its use in the U.S. has eliminated some of the safety features such as ultrasound dating of the fetus as well as close medical supervision which were essentials in the original research done on the agent in France, where it was developed. Complications include heavy bleeding and severe infection. It was believed to be responsible for at least four deaths in California in recent years, although this was never reported in the media nor reflected in data regarding complications of abortion.

o Methotrexate

Second and Third Trimesters

o Saline Abortion

o Urea

o Prostaglandins

o D & E or Dilation and Evacuation

o D & X or Dilation and Extraction (Partial Birth Abortion)-performed from week 20 until full term

o Hysterotomy

History of Abortion in the United States

In 1967, Colorado was the first state to liberalize abortion law. In 1970, New York allowed abortion on demand at less than 24 weeks gestation. In 1973, the Supreme Court ruled in Roe v. Wade that the fetus was not considered a “person” until the time of viability, then considered 28 weeks. This opened the door to abortion on demand throughout the U.S. through the second trimester. Another decision, Doe v. Bolton, the same year, essentially permitted abortion for any reason throughout pregnancy. Prior to these decisions, abortion had NOT been illegal in cases where the mother’s life was in danger. In 1992, the Supreme Court in Planned Parenthood v. Casey upheld the right to abortion and prohibited any laws or practices that might “hinder” a woman from seeking an abortion if she desired to do so. RU-486, the “abortion pill” was approved in the United States in 2000.

Who Gets Abortions? Statistics are for 2005, the most recent year available (Guttmacher Institute)

o Almost half of pregnancies occurring in the U.S. each year are unintended. One in five of these end in abortion. 89% of women at risk for an unintended pregnancy report using a contraceptive method; 14% report using the method perfectly.

o Approximately 1.2 million pregnancies are terminated by abortion in the U.S. (This accounts for 3% of the abortions performed worldwide)

o 2% of all women age 15 to 44 had an abortion

o Of those having an abortion, 43 % identified themselves as Protestant, 27% as Catholic, 22% gave no religious preference, and the remainder were of other religions

o Abortion is one of the most common surgical procedures in the U.S.

o Worldwide, 22% of abortions were early medication abortion (RU-486)

o By age 20, one in seven women in the U.S. have had at least one abortion (14%) and 43% of women in the U.S. have had one abortion by the time they are 45 years old.

o 50% have no other children

o 44% had a previous abortion

o 20% are married

o 20% are under 19 years old

o Abortion is 6 times more common in unmarried women.

o 1% or abortions are for rape or incest.

o Minority (African-American and Hispanic) women have much higher rates of abortion than Caucasian women. Women living in poverty also have much higher rates than more affluent women.

Reasons for Abortion

Want to postpone childbearing 25.5%
Wants no (more) children 7.9%
Cannot afford a baby 21.3%
Having a baby will disrupt education or job 10.8%
Relationship problem or partner does not want 14.1%
Too young-parents or others object 12.2%
Risk to maternal health 2.8%
Risk to fetal health 3.3%
Other 2.1% (www.guttmacher.org)

Abortions by gestational age

Most abortions are performed before 9 weeks gestation. 1.4% are done after 21 weeks gestation.

Abortion providers and regulation

Most abortions are performed in abortion clinics, although some are done in hospitals and private offices. Since the Supreme Court’s ruling in Roe v. Wade, there have been several attempts to bring the abortion industry under that same scrutiny and regulation as other health care entities, but these attempts have been repeatedly resisted. Opponents of regulation have cited concerns regarding limiting women’s access to abortion. Some states, such as Michigan, have ordinances treating these clinics as “outpatient surgery facilities;” however, several “waivers” exist in many of these states to allow abortion clinics to operate without the same oversight as other outpatient surgery facilities. A typical surgery facility could be shut down if it failed to comply with health standards until correction was made; however, this could cause problematic “hindrances” to a woman’s right to seek an abortion and could be seen in violation of federal statutes. Thus, many have concerns about the safety of women seeking procedures in these clinics.

Abortion Fallacies

Abortion is painless
Abortion is safer that childbirth-A Finnish study “Pregnancy-associated deaths in Finland 1987-1994 published in Acta Obsetricia et Gynecolgica Scandinavia in 1997 showed that women undergoing abortion were four times more likely to die of suicide, risky behavior or homicide in the year following abortion than women who gave birth. Some of the problems with U.S. statistics were discussed, including voluntary reporting only, death coding under “cause” (bleeding to death) rather than a result of a procedure (abortion). Statistics for complications of abortion from hospitals performing abortion procedures suggest that the true rate of complications may be significantly higher than reported data might suggest.
Every child should be a wanted child-Two million couples dealing with infertility would like to adopt a child. Some have turned to foreign adoption due to the long waits to adopt a U.S. child.
There is no post-abortion syndrome-A study published in the Archives of General Psychiatry in August 2000 confirmed negative reactions of women related to past abortion. The emotional and psychological effects suffered by some women following abortion may occur years after the procedure.

Complications of abortion

Because a woman is likely to be unknown to the physician performing the abortion procedure and is unlikely to return to the abortion clinic following a complication, statistics are unlikely to reflect the true incidence of complications. Women would be expected to seek hospital care or care from their private physician should difficulties occur. Data also suggest that minority women and poor women may experience higher rates of complications.

Minor complications

Minor infections
Minor bleeding
Fever
Intestinal disturbance and/or vomiting
Chronic abdominal pain
Rh blood factor sensitization

Major complications

Infection Hospital data found that 27% of women having abortions develop infection lasting at least 3 days
Excessive bleeding
Blood clots
Ripping or perforation of the uterus. Several documented deaths have been related to this.
Anesthesia complications Some procedures are most comfortably done with general anesthesia
Convulsions
Cervical injury
Death

Later complications

Women with previous abortion may have a 58% greater risk of dying in a subsequent pregnancy than women who have not experienced an abortion
Sterility in 3-5% of women undergoing abortion
Tubal pregnancy From 1970 to 1983 rates of tubal pregnancy increased by four times
Incompetent cervix with possible miscarriage, premature birth and labor complications in future pregnancies. This is increased 300 to 500 times over women without previous abortion. It is thought that 100,000 “wanted babies” may be lost each year due to the side effects of a prior abortion.
Post-abortion emotional crises

(From testimony in opposition to Senate Bill 398 by Dr. Timothy Deering www.cmda.org)

Rights of conscience

This has been a controversial area in recent months related to the practice of medicine. Many states have laws allowing doctors to object to performing or referring for abortions on the basis of personal moral convictions. The American College of Obstetrics and Gynecology has made several attempts in recent years to require doctors practicing Obstetrics and Gynecology (Ob/Gyn) to perform or refer for abortion or risk forfeiture of their certification. Medical students have also reported pressure to participate despite moral objections. For this reason, some physicians have chosen to leave the field of Ob/Gyn and Christian medical students have reported choosing against the specialty of Ob/Gyn.

Infanticide?

A brief mention was made of the difficulty of deciding when “personhood” begins. Steven Pinker, a professor of psychology at MIT has suggested that parents should be allowed to “try out” their baby at home for a period of time. If dissatisfied, he supports the idea of returning the child to the hospital to be killed.

Selling baby parts

o The Health Revitalization Act of 1993 allows fetal tissue research and requires consent separate from that for the abortion.

o ABC-TV’s 20/20 exposed the selling of baby parts: human brain <>

o A congressional investigation occurred, but went no where. Therefore, the practice continues.

Human life and Biblical perspectives

Some of the Biblical issues related to human life discussed in other classes were reviewed.
Humans are made in God’s image Genesis 1:26-27
Children are a gift from God

Psalm 127:3 “Behold, children are a gift of the Lord; The fruit of the womb is a reward.”

Each person was created and known by God even before our earthly parents knew us

Jeremiah 1:5 “Before I formed you in the womb I knew you, and before you were born I consecrated you; I have appointed you a prophet to the nations.”
Psalm 139:13-16

John recognized Jesus when he was still in his mother’s womb

Luke 1: 41-44

God demands an accounting for the blood of man

Genesis 9:5-7

In Old Testament times, there was punishment for someone who intentionally caused a miscarriage

Exodus 21:22-25 “If men who are fighting his a pregnant woman and she gives birth prematurely but there is no serious injury, the offender must be fined whatever the woman’s husband demands and the court allows. But if there is serious injury, you are to take life for life, eye for eye, tooth for tooth, hand for hand, foot for foot, burn for burn, wound for wound, bruise for bruise.”

Child sacrifice is condemned

Leviticus 18:21, 20: 1-5 and Deuteronomy 12:31

There was some discussion of whether it should be our objective to attempt to reverse legislation (Roe v. Wade). A complete ban may be unrealistic at the present time.

So, what can be done?

o Support those who are faced with an unexpected pregnancy. We may be able to convince them to choose life. The example was given of former pastor Matt Mabey and Joelle offering to raise the child of any teenager who chose life for their child.

o Know the alternatives for women and available resources

o Love and support those who have had an abortion. They may have felt that they had no choice for a variety of reasons. We need to accept these women and allow them to share their pain if needed.

o Take a stand for life and consider being involved at a Pregnancy Help Center or in another way. (There are more Crisis Pregnancy Centers than abortion clinics in the U.S.)

o If it is unrealistic to expect a complete ban on abortion, we can still work to ensure safety of women by calling for the same regulation of abortion clinics as outpatient surgical facilities. Generally accepted health standards should be required.

o Abortion should not enjoy “political protection” and women should have the right to informed consent reflecting realistic statistics about the risks of the abortion procedure.

o Work to eliminate second and third trimester abortions which occur when a fetus would be otherwise viable and also are risky for the mother

o Work to recognize the unborn as persons before the law

Resources

Books:

Mortal Lessons: Notes on the Art of Surgery Richard Selzer

Rites of Life: The Scientific Evidence for Life Before Birth Landrum Shettles, MD and David Rorvik

Whatever Happened to the Human Race C. Everett Koop, MD and Francis A. Schaeffer

Aborting America Bernard N. Nathanson, MD

Who Broke the Baby? Jean Staker Garton

Blood Money Carol Everett

Bioethics and the Future of Medicine: A Christian Appraisal edited by John F. Kilner, Nigel M. de S. Cameron and David L. Schiedermayer

Ethics for a Brave New World John S. Feinberg, Paul D. Feinberg