V. On the Procurement of Abortion

What is abortion? Abortion is commonly defined: the ejection of an immature fetus. Immature, that is, not yet fit for vital birth, in such circumstances of the time of gestation that the fetus, although still living when it comes forth into the light, nevertheless must necessarily die soon. Therefore abortion is not really the same thing as mere acceleration of birth. In acceleration of birth the fetus is not immature, and although it comes forth into the light before the completed time of gestation, nevertheless it can naturally live. Abortion properly has place in the first seven months of gestation; in the remaining two months it is mere acceleration of birth, commonly speaking and according to the general rule. The ejection of the fetus; hence abortion is properly distinguished from any action which is not per se primarily ejective of the fetus, but injurious to that same fetus, such as that surgical operation which is called craniotomy and embryotomy, because it is the cutting of the cranium of the infant, or fetus, in order to extract him from the mother's womb.

E. M. According to the general rule. Absolutely speaking, the fetus can live outside the womb after six months, six and a half months, and even before this term, if extraordinary means for nourishing the fetus are present. But in order that the moral danger of the death of the fetus be excluded, the term of seven months must be awaited. Cf. here 663.

How many kinds of abortion are there? - The ejection of the fetus can be procured in two ways: 1. Directly and per se. 2. Indirectly and per accidens. Direct procurement of abortion or of the ejection of the fetus is had by applying a means or medicine per se efficacious and per se primarily ordered to expelling the fetus, as are those local causes which have an action on the womb for ejecting the fetus; such is the perforation of the secundina, or of that leathery membrane in which the fetus is enclosed and swims in fluid, which, when removed, he can no longer live there, but is necessarily ejected. Therefore direct procurement of abortion here is understood not only by direct intention, insofar as someone intends the ejection of the fetus, but also by direct exterior action, insofar as this per se primarily tends efficaciously to expelling the fetus.

Indirect procurement of abortion is had by applying a means or medicine per se primarily ordered to conferring health on the mother, from which, however, the expulsion of the fetus also follows, or also by using a means or medicine from which equally the health of the mother and the expulsion of the fetus are had. Of the former kind are certain irritating and violent drugs, which per se primarily tend, by their own efficacy, to correcting bad humors and bad dispositions of disease, but consequently also procure abortion. Of the latter kind are those remedies which cause relaxation of the fibers, such as a bath, flow and emission of blood; whence at the same time that health is being provided for, abortion is produced, by one and the same cause. This indirect procurement of abortion is indirect both in action and at the same time in intention. But someone can, with a direct intention for procuring abortion, use a means indifferent in itself and per se ordered to another honorable end. Antonelli, Medicina Pastoralis, ed. 2, vol. 2, p. 193, n. 396.

Is indirect procurement of abortion lawful? - It is sometimes lawful indirectly to procure abortion, or rather to permit it, namely by supplying to a mother laboring under grave disease remedies per se suitable for curing the disease, even if consequently abortion can follow, or remedies equally per se suitable for curing the disease and harmful to the fetus.

This is proved first from the common doctrine of theologians. L. l. 3, n. 394; Struggl tr. 7, q. 3, n. 15; Sanchez de Matr. l. 9, d. 20, n. 13 seqq.; Diana tr. 6, de Abortu, r. 38 seqq. Besides, when some remedy, by itself and with one and the same efficacy, can produce both effects at once, namely of healing the mother and killing the offspring, whether primarily the health of the mother and consequently abortion follows, or whether these effects are parallel to each other, one is not necessarily assumed in reality or intention as a means for procuring the other. Therefore there is then the case of a good or indifferent action, from which a double effect follows, one good and the other evil, which it is lawful to posit, if the end of the agent is honorable, namely if he does not intend the evil effect, and if there is a proportionately grave cause. It is lawful sometimes; namely if the matter concerns a lethal disease of the mother, whose life to be preserved is a proportionately grave cause with respect to the temporal life of the offspring. "It is certain," says St. Alphonsus, l. c., "among all, that it is lawful to give a remedy to a pregnant woman directly for curing her, even with danger of abortion, if the disease is mortal, but otherwise if it were not such." And below: "If the remedy tends directly to preserving the life of the mother, as would be purging of the body, cutting of a vein, a bath, etc., these are certainly lawful, when otherwise it is judged morally certain that the mother will die with the offspring," namely if the remedy is not used; or when the danger of abortion would be equal, whether the remedy is used or not; or when it is morally certain that the fetus is not yet animated, as at least for the first days of conception can be held. 1 Kings 1:19, 20. The reason is that then the safety of the mother is provided for without a greater danger to the offspring; and because, in equal necessity, the mother can provide more for herself than for the offspring. And the necessity is equal, for there is no hope of procuring baptism for the offspring in the first and third case; but that hope in the second case is equal. Antonelli, Medicina Pastoralis, ed. 2, vol. 1, p. 1, c. 19, p. 2, c. 4.

On the contrary, the necessity is not equal when the death of the mother is indeed certain if she does not take the medicine; but, if she takes it, the death of the offspring is certain not only temporal, but also eternal, because baptism will not be able to be administered to him, which certainly could be administered to him if the mother abstained from the medicine, because the offspring of the certainly dead mother will survive her; and then "the mother is certainly bound from the order of charity to abstain from the medicine, and to prefer the spiritual life of the offspring to her own bodily life." L. l. c. And "so also from the same charity she is bound to abstain, when there is doubt concerning the safety of the mother and the offspring." L. l. c.; namely when there is doubt whether, the medicine being neglected, the mother can be healed; and whether, the mother perishing, the offspring can survive and be baptized. "And even if the death of the mother were morally certain, if she does not take the remedy, not even then would I dare to permit her the medicine, if some reasonable hope shone forth that, the mother having died, the offspring might survive and be baptized; because it is lawful for no one, for protecting his own temporal life, positively to expose a neighbor constituted in necessity to the danger of eternal death. But otherwise I think one must say, if there were no reasonable hope concerning the life of the offspring after the death of the mother, so that he could be led to the grace of baptism, because then charity does not seem to oblige the mother placed in extreme necessity to neglect her own life by abstaining from remedies, because of a slight and very remote hope of the life of the offspring." L. l. c. And here, as regards practice, the Holy Doctor, l. c., observes that "physicians, as to drugs to be supplied to mothers, are not to be troubled scrupulously, because it is most probable that the case is exceedingly rare, and morally impossible, so that it is almost a miracle, that, the mother perishing, the offspring survive so that he can receive baptism." Nevertheless this matter is not to be so neglected; because it has happened more than once that, because of the skill of surgeons, as soon as the mother breathed out her spirit, the mother's womb was opened, and the offspring was extracted alive and baptized. Consequently mere acceleration of birth is lawful, namely when the fetus will be able to live outside the womb from ordinarily occurring things, and provided that seriously and suitably, as much as can be done, provision is made for the lives of the fetus and of the mother, and that there is grave necessity for that acceleration, whether this is on the part of the life of the mother, or on the part of the life of the offspring itself. E. M. 742, 745.

Is direct procurement of abortion lawful? - In no case ever, or for any cause, is it lawful directly to procure abortion, even if the fetus were supposed still unanimated. Proof: For if the discussion is about direct procurement of abortion improperly so called, namely through means or medicines by which one tends directly to injuring and killing the fetus or infant, as, for example, when physicians with the help of forceps crush the cranium of the little infant in the mother's very womb, in order afterward violently to extract the dead fetus, there is had a very true homicide, directly intended and directly exercised, which is never lawful.

If the discussion is about direct procurement of abortion through means or medicines which directly cause only premature acceleration of birth, from which the offspring, necessarily, by the very laws of nature, must succumb to death, "after animation this would be directly to kill the infant, which is never lawful"; for by a positive action to eject an immature infant outside the womb is positively to withdraw from him the means instituted by nature itself for the conservation of his life, which is directly to kill someone. "But before animation it is not lawful directly to procure this either, just as it is not lawful to procure the emission of seed even to save life, in which case Tertullian seems to speak in Apol. cap. 3; for he gives a universal reason: he who will be a man is a man, he says, for the fruit is in the seed." Lugo de Iust. et Iure d. 10, n. 130. Therefore, since even the non-animated fetus is ordered to forming a man, its ejection is anticipated homicide. Hence Ithur. Cas. 21, n. 5 says, "it is most certainly always infected with grave malice, direct procurement of abortion."

There are indeed grave and many doctors, whom Sanchez de Matr. l. 9, d. 20, n. 9 and Struggl tr. 7, q. 3, n. 16 follow and report, who judge that directly procured abortion, where nevertheless the matter concerns only the mere premature ejection of a non-animated fetus, is not so intrinsically unlawful that at least in the case of preserving the life of the mother, extremely endangered from present disease, it is not lawful. Indeed doctors are not lacking who defend the direct procurement of abortion even of an animated fetus in the aforesaid case, "which opinion once the illustrious D'Annibale judged not improbable," p. 2, n. 284, ed. 4. But this opinion is altogether excluded by the Decrees of the Holy Office concerning the unlawfulness of craniotomy. Indeed, between the killing which is had through craniotomy and abortion of this sort there is in fact no difference. For who would deny that he equally kills a man who pierces him through, and who casts him down from a tower, and who drowns him in the sea? Besides, that opinion is rejected by the Decree of the Holy Office, 24 Jul. 1895, by which the unlawfulness of abortion itself is expressly declared. E. M.

Hence it is clear that laparotomy also is unlawful for extracting from the bosom of the mother ectopic or extrauterine fetuses, still immature. On the contrary, necessity compelling, laparotomy is lawful for extracting from the bosom of the mother ectopic conceptions, provided that the lives both of the mother and of the fetus are seriously and suitably cared for, as much as can be done. Since they cannot be born, they often carry death with them also for the mother. E. M.