A self-induced abortion (or self-induced miscarriage) is an abortion performed by the pregnant woman herself or with the help of other, non-medical assistance. Although the term includes abortions induced with legal over-the-counter medication, it also refers to efforts to terminate a pregnancy through alternative, sometimes more dangerous means. Such practices may present a threat to the health of women.[1] If the abortion does not result in termination of the pregnancy, damage to the fetus can occur.[medical citation needed]
Self-induced abortion is often attempted during the earliest stages of pregnancy (the first eight weeks from the last menstrual period).[2][3] In recent years, significant reductions in maternal death and injury resulting from self-induced abortions have been attributed to the growing use of misoprostol (known commercially at "Cytotec"), an inexpensive, widely available drug with multiple uses, including the treatment of post-partum hemorrhage, stomach ulcers, and induction of labor.[medical citation needed] The World Health Organization has endorsed a standarized regimen of misoprostol to induce abortion up to 9 weeks of pregnancy. This regimen has been shown to be up to 83% effective in terminating a pregnancy.[4]
Descriptions[edit]
Women in India are reported to use the following to induce abortion:
- Lifting of heavy weights;
- Consumption of mutton marrow;
- Consumption of dried henna powder;
- Consumption of carrot seed soup;[5]
There are a number of narratives that have described self-induced abortions. Many of the following methods present significant danger (see below) to the life or health of the woman:
- physical exertion designed to bring about a miscarriage
- bellyflopping onto a hard surface, or throwing herself down a flight of stairs
- attempted removal of the fetus with a steel wire coat-hanger or similar device inserted into the uterus through the cervix (the historical use of this method has led to instances of its use as a symbol of the pro-choice movement, illustrating dangers of barring medically-administered legal abortion)[6][7][medical citation needed]
- attempted piercing of the fetus with a knitting needle, crochet hook, hat pin, bobby pin or similar device inserted into the uterus through the cervix
- insertion of a rubber tube or catheter into the uterus and attempting to suck the fetus out, or, alternatively, blowing air into the uterus to cause a miscarriage (if the tube or catheter pierced a blood vessel, this would sometimes lead to air embolism, which could be fatal)
- ingesting abortifacients, vitamin C megadosage, pennyroyal or other substances believed to induce miscarriage
- douching with substances believed to induce miscarriage, such as turpentine, clorox bleach, or lye, all of which could cause intense chemical burns (beginning in the 1960s, many women used Coca-Cola for this purpose, although its utility is at best dubious)
- vaginal pessaries
- yoga
- acupuncture at points linked to miscarriage
- hypothermia (many women would lie for periods of time in snowbanks, which could be fatal to them) or hyperthermia (women would lie in tubs filled with hot or even scalding water for periods of time, often while simultaneously drinking gin)
In a letter to the New York Times, gynecologist Waldo L. Fielding wrote:
The familiar symbol of illegal abortion is the infamous "coat hanger" — which may be the symbol, but is in no way a myth. In my years in New York, several women arrived with a hanger still in place. Whoever put it in — perhaps the patient herself — found it trapped in the cervix and could not remove it...However, not simply coat hangers were used.Almost any implement you can imagine had been and was used to start an abortion — darning needles, crochet hooks, cut-glass salt shakers, soda bottles, sometimes intact, sometimes with the top broken off.[7]
Charles Jewett wrote The Practice of Obstetrics in 1901. In it, he stated, "Oil of tansy and oil of rue are much relied on by the laity for the production of abortion, and almost every day one may read of fatal results attending their use. Oil of tansy in large doses is said to excite epileptiform convulsions; quite recently one of my colleagues met such a case in his practice."
In the 1994 documentary Motherless: A Legacy of Loss from Illegal Abortion, Louis Gerstley, M.D., said that, in addition to knitting needles, some women would use the spokes of bicycle wheels or umbrellas. "Anything that was metal and long and thin would be used," he claimed. He stated that a common complication from such a procedure was that the object would puncture through the uterus and injure the intestines, and the women would subsequently die from peritonitis and infection. Later in the film he mentioned that potassium permanganate tablets were sometimes used. The tablets were inserted into the vagina where they caused a chemical burn so intense that a hole may be left in the tissue. He claimed the tablets left the surrounding tissue in such a state that doctors trying to stitch up the wound couldn't do so because "the tissue was like trying to suture butter." Dr. Mildred Hanson also described the use of potassium permanganate tablets in the 2003 documentary Voices of Choice: Physicians Who Provided Abortions Before Roe v. Wade. She said, "the women would bleed like crazy because it would just eat big holes in the vagina."
Dr. David Reuben's book Everything You Always Wanted to Know About Sex* (*But Were Afraid to Ask) mentions that many African women use a carved wooden abortion stick to induce, which has often been handed down.[8]
Attempts to insert hazardous objects into the uterus are particularly dangerous, as they can cause punctures leading to septicemia. Ingesting or douching with harmful substances can have poisonous results. Receiving blows to the abdomen, whether self-inflicted or at the hands of another, can damage organs. Furthermore, the less dangerous methods – physical exertion, abdominal massage, and ingestion of relatively harmless substances thought to induce miscarriage – are less effective, and may result in the fetus developing birth defects. However, abdominal massage abortion is traditionally practised in Myanmar, Thailand, Malaysia, the Philippines, and Indonesia.[9][10]
The cheap prescription synthetic prostaglandin drug Misoprostol – used in the U.S. to treat gastric ulcers – is often used as an abortifacient in self-induced abortion in Latin American countries where legal abortions are unavailable, and its use has also been observed in immigrant populations in New York.[11] Although proponents of this method deem it to be safer than those using insertion of objects or chemicals into the uterus, they also note that failure to effect an abortion by this method can lead to the child being born with serious birth defects. Furthermore, the drug causes a drastic drop in blood pressure, and women may hemorrhage as a result of misusing the drug for the purpose of abortion.[12]
Current medical procedures are significantly physically safer than traditional at-home methods,[13] and are in fact safer that childbirth as evidenced by a seven-year study conducted in the United States.[14]
. PMID 19609407.