Article III: On Ligation of the Arteries

I. Ligation of the arteries, or of the tube, happens to be performed in order to prevent hemorrhage in the mother. In a case in which dangerous hemorrhage has arisen, such as one which indicates a rupture, this operation appears licit if it would also be performed in the absence of pregnancy and is necessary for preserving the life of the mother. For then the fetus is killed only indirectly, because he is deprived of oxygen and nourishment and thus perishes by asphyxia; but the mother is not bound to minister oxygen or nourishment to the fetus with danger to her own life.¹

¹ Cf. Bouscaren, Ethics of Ectopic Operations; Werner Moore, Principles of Ethics; and Ecclesiastical Review, 1935.

This is so provided that the hemorrhage is: a. grave, because there are also slight hemorrhages;² and b. the operation is necessary, so that otherwise the mother would perish. Consequently, for the life of the infant, one must wait before performing it as long as possible.

² Thus Antonelli, op. cit., I, n. 247: "Often, in the second or third month, the membranes of the fetus are torn and hemorrhage occurs, which can bring the mother's death by anemia; or, if the flow of blood occurs in small cavities of the abdomen, the mother's death ordinarily by no means follows, because the small cavities, when they are filled with blood, exercise pressure upon the lacerated blood vessels, which prevents further hemorrhage; nevertheless tumors arise from the coagulated blood.... When the membranes have ruptured, the fetus dies and is gradually resorbed. If the membranes are torn outside the place where the placenta is inserted, the mother's death generally does not follow, and the fetus passes into the abdomen, where he can attain perfect development, or he dies. But if the membranes are not torn, the fetus likewise dies, and then is resorbed, or undergoes several particular changes, or induces suppuration...."

II. Corollary. Therefore, in two cases that ligation can be performed licitly:

1. as an operation preparatory to the immediately following excision of a diseased organ of the mother, so that the ligation itself does not yet per se and actually bring immediate death to the fetus, but his death follows from the removal of the maternal organ, as we said in q. 3, a. 1, n. IV;

2. as an operation necessary of itself and sought for saving the life of the mother from hemorrhage.