Self-abortion

from Wikipedia, the free encyclopedia

A self-abortion (more rarely: self-abortion ) is understood to mean an abortion or a miscarriage that is carried out or brought about by a pregnant woman out of an emergency without the assistance of medical specialists. Since the women concerned mostly have no relevant medical education, self-abortions are extremely dangerous and - like all unprofessional abortions - carry a considerable risk that not only the embryo or fetus , but also the woman will die in agony as a result of the procedure . Leading causes of death are bleeding to death , peritonitis and poisoning . Especially in advanced pregnancy, if a miscarriage actually occurs, there is a risk of bleeding to death through a rupture of the placenta .

Self-abortions are most common in groups of people who have little access to methods of contraception and legal abortions. Proponents of the legalization of abortion repeatedly refer in their arguments to the fate of women who have died in self-abortions. A press photo published in 1973 that shows the American Gerri Santoro, who bled to death after attempting a self-abortion, has achieved sad fame.

Self-abortion is illegal and punishable in many countries.

Definition of terms

Abortions in which the "abortion pill" mifepristone is used are accompanied by a gynecologist so that one does not speak of "self-abortion" in the specialist literature, even if the woman triggers the abortion by taking the pill herself.

Taking the morning-after pill is not a method of self-abortion, but rather a method of contraception. This medication, like the contraceptive pill, prevents the follicle rupture and thus the receptivity.

Methods and Risks

A large number of measures have been handed down around the world with which miscarriages can supposedly be brought about in a targeted manner:

Lifting and exertion

It is widely believed that lifting heavy weights can trigger a miscarriage. The background to this popular belief is the observation that the everyday lifting of heavy loads, which is not exposed during pregnancy and the puerperium , promotes uterine prolapse , which then only occurs around the menopause . In a Swedish study in 1990 it was shown that lifting heavy loads can, under certain circumstances, favor premature births , but rarely leads to miscarriages or stillbirths .

Exercise is also among the measures that are said to cause a miscarriage. An American study from the 1980s showed that such a connection only exists in women who have already suffered miscarriages in the past.

Abortion drugs and self-poisoning from oral ingestion of substances

Chemically

The poisonous oil of polei mint is one of the substances that is said to have an abortive effect.

There is no known drug that, given alone, is certain to cause miscarriage. Even mifepristone only develops its abortive efficacy when used in conjunction with a prostaglandin . In German-speaking countries and in many other countries, women can see a doctor to get access to these drugs.

Popularly, however, many substances (“ abortives ”) are said to have an abortive effect. Because the fetus floats like on a cushion of water in the first few months of pregnancy and the cervix is ​​tightly closed, these do not lead to a miscarriage even if the substance can trigger muscle contractions in the uterus .

The following modes of action are distinguished for the so-called abortive drugs:

  • Uterotonics: Medicines that stimulate uterine contractions. The only really powerful uterotonic - ergot - only exerts its effect on the uterine muscles after the natural contractions have already started. If the substance is used in high doses for abortion purposes, it only leads to poisoning of the woman. Abortions with a combination of quinine and castor oil have been tried repeatedly but do not produce the desired result. In Lafayette , Indiana, a 19-year-old girl narrowly escaped poisoning in the 1990s after taking quinine to terminate her pregnancy. Animal experiments with mice, rats and guinea pigs give rise to the assumption that the oral intake of extracts from the root of the henna bush can also cause miscarriages in humans; however, there is no direct evidence to support this assumption. Commercially available henna products for cosmetic use are by no means obtained from the roots of the plant, but from its leaves. The effect of the seeds of the wild carrot ( Daucus carota ), which was already considered an arbortivum in European antiquity and is still used in India today for self-abortion attempts, is much weaker .
  • Emmenagoga : Herbs that stimulate menstrual flow. Essential oils in particular are used over and over again for this purpose. Like most uterotonics, these oils are also highly toxic. In 1978, an 18-year-old woman died in Denver after ingesting polei mint oil while attempting self-abortion.
  • Even very strong laxatives such as castor oil, coloquin , croton oil and aloe juice can cause slight uterine contractions and are therefore also used by some women with the intention of having an abortion, but in no way produce the desired effect.
  • In many cases, other irritating or harmful agents are also taken that do not fall into any of the groups mentioned up to this point, such as arsenic , mercury or copper compounds, acids , bases , vitamin C , pepper , or unripe pineapple or papaya . In many cases, these result in the death of the woman, but they cannot trigger a miscarriage either.

Biologically

Khohkhar and Gulati, 2000 Frauenschicksale slum in Delhi have studied report that many of these women to abort pregnancies, bone marrow of sheep eating. Eating raw or insufficiently heated bone marrow can lead to the transmission of brucellosis , which causes miscarriage in 43% of women who actually become ill within the first two trimesters of pregnancy. Most brucellosis develop without any further symptoms, but at least 10% of those infected become more or less seriously ill, in isolated cases with serious complications.

Introduction of substances to the portio

Some women try vaginal douches with harmful substances. These rarely lead to an end of pregnancy, but regularly cause severe burns, ulcers or the like. In Boston in 1949, a woman died trying to terminate her pregnancy with potassium permanganate . Some women think they can have an abortion by introducing potassium permanganate into the cervix or vaginal vault; the chemical leads to the formation of ulcers and heavy bleeding there, but in no way leads to a miscarriage. In Maryland , a 31-year-old woman died in 1953 of an infection that she contracted through a vaginal douche with dissolved mustard powder . Other women have attempted an abortion with soapy water, laundry detergent , bleach , caustic soda , household cleaners , disinfectants , pipe cleaners , turpentine , vinegar, or orange juice , often mistakenly mistaking home contraceptive products for abortion.

Trauma or lesion through the abdominal wall

Still other women try to induce a miscarriage with abdominal massages. A study at the University of Port Harcourt in Nigeria has shown that abdominal massages in pregnant women often not only lead to miscarriages, premature births and stillbirths, but also injuries to the genitals (7.14%) and the uterus of women (9.52%) %) or lead to their death, the latter either during pregnancy (4.76%) or perinatally (14.29%). As studies on the consequences of domestic violence show, hits, kicks or stabs in the abdomen of a pregnant woman and deliberate falls on the stomach have similar dangerous consequences; a hysterectomy may be necessary to stop the bleeding .

Lesion through the cervix

In the United States, cheap wire hangers are considered the classic starting material for improvised abortion tools because of their ready availability.

Inserting sharp objects (such as knitting needles, needles or strong wire) through the vagina and cervix into the uterus with the intention of opening the amniotic sac is difficult to do without a speculum and usually requires the help of a second person, but is still considered one classic method of self-abortion. The opening of the bladder usually follows within a few days of labor and a miscarriage or premature birth. In individual cases it also happens that the outflow of amniotic fluid stops and the opening of the amniotic sac has no consequences. The opening of the amniotic sac creates a considerable risk of infection for both the child and the woman. Furthermore, when trying to puncture the amniotic sac, the uterine muscles are often accidentally punctured and the adjacent abdominal organs are injured. Common consequences are internal bleeding, infections, peritonitis and sepsis , sometimes with fatal consequences.

Some women try, following a practice of the Engelmacher , to burst the amniotic sac by pumping fluids into the uterus under pressure with enema syringes or catheters . In 1958, in Pittsburgh , an 18-year-old woman died of sepsis and pneumonia after attempting a self-abortion with a catheter. Other risks of this procedure include a reflexive circulatory arrest ( reflex cardiac inhibition ) resulting in death, which has been observed in isolated cases even at a mere touch of the cervix, but especially when were injected with tools fluids into the uterus. In addition, the injection of fluids can lead to different types of embolism .

In professional medicine, prostaglandins are used in abortions to open the cervix; sometimes Laminaria sticks. For the same purpose, women who wanted to have abortion stuck branches of the red elm into their cervix as early as the European Middle Ages . In 1918, a 24-year-old woman died in Pittsburgh as a result of an infection that she had contracted after attempting an abortion with a red elm branch.

Different feminist and pro-choice approaches

In the United States in the early 1970s, a group of feminists around Lorraine Rothman promoted the self-construction of a simple device (" Del Em "), with which women in the first weeks of pregnancy using a speculum masked - as an alternative method of menstrual hygiene - Aspiration should be able to perform. Unlike a professional application of this method must be considered when menstrual extraction on local anesthesia and medication opening of the very pain-sensitive cervix are indeed waived and Rothman and her women guerrillas hardly found resonance. In the USA, however, some feminists close to alternative medicine later advertised self- abortion and recommended abortion drugs and “methods” such as homeopathy , acupuncture , yoga , abdominal massage, hypothermia and autosuggestion in addition to menstrual extraction .

More recently, organizations have emerged to provide opportunities for low-risk self-abortion, especially women in countries where abortion is illegal, including Women on Web and Women on Waves . A study carried out by the latter organization in 2008 shows that women who have had an abortion with mifepistron and the prostaglandin misoprostol without medical attention in 13.6% of cases because of severe bleeding or because the miscarriage was incomplete afterwards have a suction curettage in Have to claim.

Legal situation and legal cases

German-speaking area

In Germany , women who perform a self-abortion can be punished with imprisonment for up to 1 year or with a fine according to § 218 StGB . Of § 218 provides that many women impunity, women who have abortions without the aid can not benefit, because the abortion was not performed in their case by a doctor. Only attempts at self-abortion remain unpunished.

In Austria , Section 96 (3) of the Criminal Code provides for a prison sentence of up to 1 year for women who perform a self-abortion. Again, there is no impunity according to § 97 because no doctor carries out the procedure.

In Switzerland , self-abortion is not punishable in the first 12 weeks of pregnancy; Self-abortions that take place after this period has expired are punishable by imprisonment of up to 3 years or a fine in accordance with Art. 118 Para. 3 StGB . For the same reasons as in Germany and Austria, the possibility of impunity in the case of self-abortion after the 12th week of pregnancy according to Art. 119 Para.

United States

In the United States, states have different criminal laws. In Oregon and Vermont currently (2020) there are no laws at all that make abortion - including self-abortion - a criminal offense. In others, they are only exempt from punishment if carried out in a hospital or by a licensed doctor. In cases in which women have come to court after attempted or completed self-abortion, the judges have regularly come to the interpretation that with the last-mentioned provision (exemption from punishment only if the abortion is carried out by a doctor), not self-abortions, but abortions by Engelmacher should be penalized:

Example Indiana

In Indiana , according 35-42-1-6 IC all abortion as feticide offense not covered by 16-34 IC (abortion by a doctor in the first trimester) fall. In 2011, a pregnant woman in Indiana was charged with murder and attempted fetocide after ingestion of rat poison and her child died after giving birth prematurely, but was later acquitted. Another criminal case occurred in Indiana in 2016: a woman who had performed a self-abortion with the help of an abortive was acquitted in the second instance because, in the opinion of the court, the abortion law of that state was aimed at criminal behavior on the part of medical personnel, not that of pregnant women.

Example Tennessee

In Tennessee , abortion is punishable under TN Penal Code 39-15-201 unless it is performed by a doctor in the first trimester. In 2015, in Tennessee, a woman was tried for attempted murder after attempted self-abortion using clothes hanger wire. The child was born severely disabled. The lawsuit was later dropped.

Example Florida

In Florida , abortions under the FL Penal Code 390 are only punishable in the third trimester of pregnancy. In 1994, a 19-year-old, who had previously tried in vain to a legal abortion, shot in the second trimester with a gun himself in the abdomen and was then due to manslaughter and murder accused third degree, but in the end acquitted.

Alternatives

In the established health care system, suction curettage or a drug-induced abortion with the “abortion pill” mifepristone are standard. These methods are very low-risk for women. In German-speaking countries and in many other countries in the Western world , abortions that are carried out by a doctor are legal after consultation; In many cases, the costs are covered by health insurers. In Germany, women in need - including teenagers and women without an income - find help from various aid organizations such as Pro Familia , donum vitae or Diakonie ; in Austria there is the ÖGF and in Switzerland Pro Familia Switzerland . These institutions also advise women who do not want to reveal their names.

Self-abortion as a topic in art and culture

Attempted and accomplished self-abortions are a common topic in world literature. Examples of novels are Frederick Philip Groves Settlers of the Marsh (1925), Jean Rhys ' Voyage in the Dark (1934), Rachel de Queiroz ' The Three Marias (1939), John Steinbeck's Beyond Eden (1952), Richard Yates ' Times of Turmoil (1961), Tillie Olsen's Yonnondio: From the Thirties (1974) and, more recently, in the youth field, Berlie Doherty's Dear Nobody (1997) and Jo Knowles' Jumping of Swings (2011). Friedrich Wolf addressed self-abortion in his drama Cyankali (1929).

The theme also appears in films, for example in Mortal Sin (USA 1945) and Embers under the Ashes (USA 1957).

literature

  • Suzanne M. Alford: Is Self-Abortion a Fundamental Right? ( Online ).
  • Georges Devereux : A Study of Abortion in Primitive Societies . Julian Press, New York 1955, doi : 10.1525 / aa.1956.58.1.02a00500 .
  • F. Stöckel: Is instrumental self-abortion possible by a first-time pregnant woman? In: German journal for all forensic medicine . tape 45 , no. 5 , September 1956, p. 376-380 , doi : 10.1007 / BF00663022 .

Individual evidence

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  32. ^ G. Blacker: Portion of Bone Knitting Needle, used to procure Abortion, removed by Operation from Abdominal Cavity; Development of a Pelvic Abscess, Faecal Fistula, Septic Pyelonephritis, and General Septic Infection, with ultimate Recovery. In: Proceedings of the Royal Society of Medicine. Volume 6, Obstet Gynaecol Sect 1913, pp. 107-111, PMID 19977048 , PMC 2006448 (free full text).
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  41. ↑ An Overview of Abortion Laws. Retrieved March 9, 2020 .
  42. ^ State Abortion Laws. Retrieved March 10, 2020 .
  43. ↑ Woman freed after plea agreement in baby's death. In: USA Today. August 2, 2013, accessed September 5, 2016 .
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