Question Five: Concerning the Procuring of Abortion

I. The procuring of abortion¹ (kunstmatige vruchtafdrijving) is the artificial expulsion from the mother's uterus of an immature fetus who thus cannot live, or of a fetus capable of uterine life and incapable of extrauterine life.

¹ Cf. Eschbach, Disp. Phys.-Theol., disp. 2, p. 2, c. I, art. 1.

The fruit must be capable of uterine life; whence a) a dead fetus can be expelled: this is not abortion, but the legitimate relief of the woman; b) a fetus separated from its union with the uterus by a morbid cause, e.g., by rupture of the uterus or by blood admitted into the uterus, can be expelled: it is the consequence and remedy of an abortion already had. For by accident one thus separated or killed remains in the uterus. Whence, in the definition of abortion, expulsion is understood not so much of external expulsion as of the tearing away and separation of the fetus from the maternal uterus before he is viable.

Moreover, the procuring of abortion is distinguished as twofold:²

² Direct and indirect abortion are not always defined rightly and clearly. Hence there are equivocations, obscurity, and uncertainty in the doctrine.

1. direct, if means are employed which immediately and of themselves kill or expel the fetus, although further and mediately they procure a good effect;

2. indirect, if means are employed which immediately and of themselves are ordered to a good effect, e.g., the health of the mother, although also apart from the intention or by accident they can at the same time expel the fetus.

II. Abortion is provoked by the induction of contractions in the muscular coverings of the uterus, which are able to expel the fetus. There are many causes capable of effecting this:

a) some act directly upon the whole body, but reflexively upon the uterus, such as hellebore, ergot of rye (seigle ergote, brandige of bedorven rogge), venesections, excessively hot baths, washing the feet in cold water or in water mixed with salt and mustard, etc.; by these there is caused a relaxation of the fibers, by which it happens that the fetus, pressed by his own weight, is born prematurely;

b) others are only local and, since they have a stronger and direct action upon the uterus, induce expulsion more certainly. Such are incision of the amnion or perforation of the membranes of the fetus, by which it happens that, the fluid in which the fetus swims having been removed, he cannot live there for long but is necessarily expelled; intrauterine dilation; occlusion of the female genital canal; electric force transmitted through the uterus which kills the fetus, etc.;

c) others are indirect, such as compressions of the abdomen, blows, vehement fright, and all physical or moral causes which bring about great nervous exaltation in the woman, from which uterine contractions arise. Likewise, some expulsive medical potions, subcutaneous injections of morphine, certain injections into the female genital canal, even masturbation, too frequent copulation, causes provoking inflammation of the vulva, the wearing of garments too tightly constricting the uterus, etc.

III. Directly procured abortion, by whatever way it is obtained, is illicit, as being intrinsically evil and unjust, even if the fetus otherwise certainly is going to die, while now provision is made for his salvation since he can be baptized, and there is no other means for saving the mother.³ The reason is that it immediately produces nothing except the separation of the fetus from the mother and thus directly brings death to the fetus, who is a man or on the way to man; whence it is the direct killing of a man, or equivalent to it. And therefore in the case the principles which hold concerning the killing of a man must be applied. Namely, abortion deprives the fetus of the office of the placenta, by which he adheres to the mother and receives nourishment and purification of the blood; and these two things are altogether necessary for life to the fetus; therefore to deprive the fetus of such things is truly to kill him, just as to kill a man by hunger. Thus the Holy Office responded, 14 Aug. 1889; 24 Jul. 1895; and 4 May 1898.⁴

³ Whence not only abortion which is customarily held criminal, procured for a non-legitimate end, e.g., for avoiding infamy or the inconveniences of gestation, is illicit; but truly also that which is called medical. Physicians employ it for saving the mother: 1) when they notice that the mother, because of narrowness, cannot bring forth the infant, that she shrinks from Caesarean section, and that acceleration of birth is impossible, preventive abortion; 2) when they foresee that the sick mother, e.g., from pulmonary phthisis, very probably or certainly is going to die on account of the pregnancy itself unless the fetus is expelled; or for another cause from the presence of the fetus the life of the mother is endangered, e.g., on account of uncontrollable vomiting, repressive abortion.

⁴ Before the Roman decisions, certain theologians, such as Ballerini and Lehmkuhl, in certain cases considered abortion more benignly.

They object: It is not killing, but a cessation from the preservation of the fetus, by which the mother allows him to fall out from her womb and so permits him to perish; but the mother is not bound to preserve the offspring with the loss of her life.

Resp. It is not a mere cessation or omission by which it is indirectly permitted, or not impeded, that the fetus is not preserved, in the same way as if, in spontaneous abortion, nature ceases from preserving the fetus; but it is a positive death-dealing action which breaks off and impedes the preservation of the fetus by nature, and a violent disturbance of the natural condition. It is positively to act so that the fetus is separated from the mother and thus placed in a state of necessary death. Whence death is not merely permitted but directly procured, and therefore the action is directly destructive and intrinsically evil.

IV. Indirectly procured abortion is generally illicit; nevertheless sometimes it can be licit from a proportionately grave cause. Whence it is licit or illicit according to diverse circumstances.

A. It is illicit:

1. if someone intends the very expulsion of the fetus in itself, whether as an end or as a means for procuring a good effect;

or 2. if there is not present a just proportionate cause, e.g., if there is another sufficient means for procuring the good effect, or if not all things are employed for impeding abortion, or if the good effect does not equal the evil;

or 3. if the good effect is procured through the mediation of the evil, i.e., not immediately from the means employed, but from the expulsion of the fetus and the cessation of pregnancy. Then, however, the abortion becomes not indirect but direct: abortion would be the remedy from which the safety of the mother would arise, and would be directly chosen as a means, e.g., that she herself might be preserved from vomiting by means of abortion.

B. It can be licit from a just cause, if at the same time the following conditions are verified:

1. the means employed are in themselves good or indifferent;

2. the good effect, and not the evil, is willed in itself;

3. the good effect compensates for the harms of the evil effect; whence abortion is altogether illicit if it would impede the infant's Baptism or if he also would be deprived of a reasonable hope of receiving this sacrament; and therefore it is always necessary that provision be made for Baptism in the better way;⁵

⁵ Nevertheless it rarely happens that abortion impedes Baptism: for almost always the fetus, in a perplexing case, will die before the mother, so that he cannot be baptized; otherwise for the most part the infant will be able to be baptized in the uterus, or after abortion has followed.

4. the good effect is caused immediately and not by means of the evil effect; whence the means of themselves and directly cure the mother's illness or turn away danger from her, not mediately through abortion;

5. there is no other means of obtaining the good effect;

6. all precautions are employed for impeding the evil effect insofar as it is possible, and therefore that no more be done than is necessary for saving the mother.

In one word: if it is done on account of a just, good, proportionate cause, and all care is employed that abortion be avoided as much as can be done.

V. Corollaries. From the foregoing it is understood:

1. That generally it is licit to employ medicines necessary and suitable for saving the life of the mother, namely those which directly and immediately tend to the cure of the disease even if there were no pregnancy, although it were established by experience that the same things can effect abortion, yet not necessarily but sometimes and by accident: the probable or certain life of the mother equals the probable danger of the infant. To this belong potions, but in that quantity which is required for healing other diseases, baths, venesections, injections into the female genital canal, subcutaneous injections, etc. Nevertheless it is illicit if, the remedy being employed, Baptism of the offspring becomes impossible, while otherwise he would survive the mother herself and could be baptized: for the mother is bound to prefer the eternal life of the offspring to her own temporal life;⁶

⁶ "Even in a lethal disease it is not licit to offer the mother such a remedy, if, the remedy being employed, the offspring is deprived not only of temporal life but also of eternal life; on the contrary, if the remedy is not employed, the death of the mother is indeed certain, but on the other side the salvation also of the offspring is certain, who, going to survive the mother, can be baptized: for the mother is bound to prefer the eternal life of the offspring to her own temporal life. Ordinarily nevertheless, the offspring dies before the mother, so that he cannot be baptized, even if the mother is allowed to perish." Noldin, Th. Mor., II, n. 343, 2.

2. that it is illicit if the evil of the mother is grave but not mortal, unless the medicine is a necessary remedy and the danger of abortion very remote and slight, or the fetus is certainly going to die: the probable or certain notable good of the mother compensates for the possible danger of the fetus;

3. likewise that it is illicit to procure abortion for avoiding infamy or another grave temporal inconvenience (prop. damn. 34, Innocent XI),⁷ both because the good effect is not proportioned to the evil, and because it is obtained through the mediation of the evil;

⁷ "It is licit to procure abortion before the animation of the fetus, lest a girl detected as pregnant be killed or defamed."

4. likewise that it is illicit on account of some infection by poison, or disease of the heart or lung, or otherwise vomiting that will not cease, because the good effect is procured by means of the evil, namely by the cessation of pregnancy. Moreover, today such a means is not necessary, because very rarely is it the only one;

5. that the rupture of the membranes and the evacuation of the amniotic fluid are illicit, because the good effect is obtained by means of the evil, namely by harm to the fetus; also, as it seems, in the case in which the pregnant uterus cannot be replaced in the too-narrow abdomen.⁸ For this case certain authors made the sole exception, because, they said, the danger is not in the pregnancy but in the dilation of the uterus; this is removed so that the uterus can be replaced in its own place, and the danger of death turned away, and this before abortion; therefore the expulsion itself is not chosen as a necessary means for turning away the danger of the mother.⁹ But against this: the very dilation of the uterus is from pregnancy; however, it is removed by means of the removal of the fluid necessary for the life of the fetus; therefore the evil effect itself seems to precede.¹⁰ The case, moreover, is most rare;

⁸ It would have to be said otherwise if puncture, by means of a little siphon or injection instrument, could be made altogether thin, so that it would not necessarily bring with it rupture of the amnion and expulsion of the fetus. This, according to the testimony of P. Salsmans, certain excellent physicians judge possible. But practically, is there not danger of widening the puncture and provoking rupture? And then it is illicit, because it exposes the fetus to the danger of death.

⁹ Thus also Illustrious Waffelaert after Capellmann; on the contrary De Smet, Vermeersch, and others.

¹⁰ Even in extreme necessity it is illicit to deprive another of a good which he absolutely needs.

6. that excision of the pregnant uterus is licit when it is infected with corruption, or in which tumors are generated which sometimes so grow that they induce danger to the life of the mother, myoma: for the danger is not from the pregnancy, and is not turned away by its cessation, but from the very excision of the uterus, which would be done even if there were no pregnancy; whence the good effect follows immediately;

7. that it is licit to expel a dead fetus: for it is not abortion, but legitimate purification; death, however, ought not to be presumed, but proved;

8. on the contrary, that it is illicit directly to expel a fetus likely living but corrupted, whatever some may say, because it is directly to hasten his death; whence the good effect follows by means of the evil. Nor can the fetus be reputed an unjust aggressor, since he wills and does nothing, but conducts himself merely passively. Nevertheless the case is rather fictitious, because a corrupted fetus ordinarily is dead or shortly going to die;

9. nevertheless probably it is licit to perform purification of the uterus and removal of all things which are in it, even the fetus if he is present, if there is imminent danger of hemorrhage and infection together with fever for the mother,¹¹ provided that this danger does not arise solely from the pregnancy itself or the condition of the fetus. For the operation would be done even outside pregnancy, and immediately effects not the removal of the fetus alone, but the cleansing of the uterus by removing whatever it contains, e.g., a mole or mucous covering (vliezige omhulsels).

¹¹ It is the case in which the mouth of the uterus is widely open, and pregnancy is irreparably disturbed, so that abortion is going to follow shortly.

VI. Observations. 1. "In practice it is not always easy to discern whether some medical action is the direct or indirect killing of the fetus. Let this be the rule: If from such an action or drug the fetus is directly reached, it seems it must be called direct procuring, e.g., incision of the amnion, which today is the most customary mode of procuring abortion. But if from such an action or drug there arises indeed a greater or lesser danger of abortion, it seems to be only indirect procuring" (Prummer, Theol. Moralis II, n. 141).

2. There is an obligation, first of all for the mother, but also for all others, diligently to avoid the causes, occasions, and dangers of abortion, which are most frequent, especially in the first times from conception; and this not only so that the fetus may be saved corporally and spiritually, but also on account of the mother, because abortion is not without danger for her. Whence they sin gravely:

a) at least by evil intention, women who, thinking themselves pregnant, in various ways provoke menstruation again and attempt abortion, e.g., by taking expulsive potions or things harmful to the fetus, by washing the feet in cold water or in water mixed with salt or mustard, by excessive dancing, by compressing the abdomen or striking it forcefully, etc.;

b) likewise those who by grave imprudence in various ways place proximate danger of abortion, or do not avoid it with ordinary diligence, e.g., by doing hard labor, carrying or lifting heavy weights, undertaking journeys on foot, by travel in a carriage or on a longer journey by railway, by indulging a vehement passion of joy, sadness, or anger, by riding horses, by moving with the feet a sewing machine, by taking excessive spirituous liquor in the first months, etc.¹² Therefore let them not wish to be present in a great concourse of men, at military exercises, in theaters, in circuses;

¹² Genicot notes (Th. Mor., I, n. 378): As to the fact, "if evil intention is lacking, they are not easily to be accused of grave sin, because often it cannot be established whether the actions to be placed are able to exercise a grave influence in inducing abortion... For several causes, such as violent commotions of the mind, a blow to the abdomen, excessive fatigue, travel in a carriage, etc., often effect nothing, even if they are employed frequently and deliberately. On the contrary, sometimes the smallest causes, such as carrying a moderate burden, excessively hot baths, etc., induce abortion, especially in very excitable women, such as towns-women are accustomed to be." This is true; but the conclusion is false; for to expose oneself to the merely probable danger of abortion is already a grave sin.

c) likewise those are gravely guilty who strike or terrify a pregnant woman so that abortion can follow;

d) likewise the husband, physician, and midwife who, even when asked, try to procure abortion, or counsel those things which likely induce it, or bring means for this. Especially the physician, in caring for a pregnant woman, is bound as far as possible to avoid those things which can procure abortion, and to teach her the precautions necessary for this, e.g., regarding journeys, occupations, use of foods, etc. For a physician from whom an abortive medicine is sought, it is illicit and unworthy to give a fictitious and harmless one, both because it is deception, and because he himself plays the part of one approving and cooperating. Moreover, rarely is such a manner of acting efficacious, since other means are easily sought. Rather, let him show his aversion to abortion and the danger for the mother; besides, let him assign honest means of withdrawing herself from infamy;

e) likewise, for pharmacists, to sell abortive means is not licit, unless it is likely that they are sought for a good use, e.g., because an upright physician prescribes them.

3. Women pregnant from a delict, just as men who have fornicated, for the most part are to be questioned cautiously in confession about an attempt at abortion.

4. Just as it is illicit to expel the fecundated ovum, so also the seed before conception; not only for the woman who knowingly and willingly had the act of copulation, because this is directly opposed to the natural end of copulation, but also, as it seems, for her who was oppressed by force or fraud. For man does not have dominion over the seed, and it is a greater injury against human generation and the common good to expel the seed from its final seat destined by nature for this, than to procure pollution by which it is expelled from its instrumental seat. Nevertheless, the oppressed woman can and must turn herself and in every way impede and interrupt the act of copulation lest she receive the seed, although it is to be poured out, because she has the right and obligation of impeding the copulation, and the pouring out of the seed is to be ascribed to the malice of the man alone. It is certain, says Saint Alphonsus (Th. M., l. IV, n. 394, q. 1), "that it is licit for an invaded woman to repel the seed, lest it be introduced; but not to cast it out, if it has already been introduced."¹³

¹³ Likewise, l. VI, n. 954, dub. 1; H. A., tr. 18, n. 50. Lessius, Marc, and Aertnijs can also be consulted.

Certain authors nevertheless say that in this case, immediately after copulation, before conception has been made, the seed conducts itself after the manner of an unjust aggressor, whom it is licit to repel. This is true during the aggression, namely the action of copulation, but not when copulation has ended, because then the aggression has ceased and the seed is already in its proper place;¹⁴ moreover, copulation is already ended by the very introduction of the seed into the female genital canal, and not by fecundation itself,¹⁵ as the adversaries suppose, because, the seed having been ejaculated, the work of man ceases and the work of nature begins, which it is illicit to break off; by this it happens that the emitted seed, by its own natural inclination as well as by the attraction of the female body, penetrates more deeply the organs of the woman unto fecundation.

¹⁴ Otherwise it would also be licit to expel after conception, because it would still be more an aggressor.

¹⁵ Otherwise impossibility of generating would make one not only sterile, but impotent, and would render marriage invalid.

Therefore it is illicit to perform any washings and injections of the female genital canal in the first hours after copulation, because no reason is present for doing them then, except for the sake of preventing and impeding generation. And besides, a slight reason, e.g., a rush of blood with itching, does not suffice, because it is not proportionate.

VII. Warning. Three principles of Catholic moral doctrine are altogether to be placed in safety: first, that it is never licit to do evil for procuring good; second, that the fetus, and the amnion, is not a part of the mother, and therefore is not ordered to the good of the mother in the way in which a part is ordered to the good of the whole, but, on the contrary, rather the mother is ordered to the good of the fetus; third, that man does not have dominion over the seed or over the fetus, and therefore cannot exercise a directly harmful action upon them. Whoever would recede from these principles even in the least would be cast into the most depraved consequences.