What is Abortion?

The British NHS defines ‘Abortion’ as:

‘[T]he medical process of ending a pregnancy so it does not result in the birth of a baby. It is also sometimes known as a ‘termination’ or a ‘termination of pregnancy’.’

The key aspect here is the reason why pregnancy is ended, and the means by which it is ended. Abortion ends pregnancy “so that it does not result in the birth of a baby”. It achieves this by directly killing the unborn child. It thereby always violates her inalienable right to life.

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In Britain, there are roughly four forms of abortion procedure, though in some cases they can overlap. They are either chemical or surgical in nature, and which one is employed depends on how many weeks a woman has been pregnant. Below is an account of these procedures, based on information from the UK NHS, private healthcare and abortion provider Spire, the 24th (latest) edition of Williams Obstetrics (pp. 350-376), and the Reproductive Review (the house journal of BPAS, the largest organisation in the British abortion industry; formerly the Abortion Review):

Vacuum Aspiration with Curettage

(7-15 weeks) 

‘Vacuum aspiration’, or ‘suction termination’, is a procedure that aims to remove the unborn child from the womb by using suction to break her body into pieces. The procedure usually takes 5-10 minutes and can be carried out under either a local or general anaesthetic. In 2015, 40% of all abortions in England and Wales involved vacuum aspiration.

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In order to gain entrance to the uterus, the pregnant woman’s cervix (the muscle ring that forms the entrance to her uterus) must first be ‘dilated’ (widened) to allow the surgical instruments to pass through it. This is difficult because the cervix is hard or “green”, and not ready to open – it is naturally closed to protect the baby from miscarriage. A tablet may be placed inside the mother’s vagina, or given orally, a few hours before the abortion, to soften the cervix and make it easier to open.

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VA1

Once the cervix is sufficiently dilated, the abortion surgeon then inserts a hollow plastic suction tube, which is connected to a pump and has a knife-like edge on the tip, into the uterus. When the suction begins, which is many times more powerful than a household vacuum cleaner, it tears the body of the unborn child into pieces and at the same time sucks these remains into a bottle. The abortion surgeon must then cut the deeply rooted placenta from the inner wall of the uterus.

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VA2

Great caution must be taken to prevent the uterus from being punctured during this procedure, which may cause haemorrhage and necessitate further surgery. Also, infection can easily develop if any fetal or placental tissue is left behind in the uterus. This latter fact means that curettage may also also have to take place. This is when a long-handled curved blade known as a curette is used to scrape the lining of the womb, removing any remaining parts of the baby and her accompanying tissue.

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VA3

Women who go through a vacuum aspiration abortion, are usually able to go home the same day. They will usually experience bleeding, however, which can last for up to 21 days. The average length of bleeding is about 9-10 days, being in most cases quite heavy for 2-3 days before settling down. This can be accompanied with mild or moderate cramps.

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For a video presentation on the process of vacuum aspiration abortion with curettage, see (note: minor details, though not essential ones, may differ from British abortion practice):

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Dilation and Evacuation (D&E)

(15 weeks +) 

‘Surgical dilation and evacuation’ (D&E) is a major abortion procedure carried out under general anaesthetic. It is carried out particularly in late term abortions, such as those where the baby has a disability, and so in 2015, 5% of all abortions in England and Wales involved D&E.

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As with vacuum aspiration abortions (see the section to the left), D&E first requires dilation of the cervix. Instead of a suction catheter however, forceps with sharp metal jaws are used to grasp parts of the developing unborn child, which are then twisted and torn away.

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D&E1

This pliers-like instrument is used because the bones of the fetus are calcified, as is the skull. The surgeon inserts the instrument up into the uterus, seizes a leg or other part of the baby’s body, and, with a twisting motion, tears it out.

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D&E2

D&E3

This is repeated again and again. The spine must be snapped, and the skull crushed to remove them. The nurse’s job is to reassemble the body parts to be sure that all are removed. If not carefully removed, sharp edges of the bones may cause cervical laceration, and consequent bleeding would be profuse.

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D&E4

After 18 weeks, in order to make dismembering the baby easier, D&E will often be preceded by feticide (see the section below).

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Surgical D&E usually takes 10-20 minutes to perform and as with vacuum aspiration, women on whom it is performed may experience some bleeding for up to 21 days.

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For a video presentation on the process of D&E abortion, see (note: minor details, though not essential ones, may differ from British abortion practice):

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Chemical (‘Medical’) Abortion

(Early: 0-9 weeks; Late: 9 weeks +) 

Chemical abortion (generally signified with the misnomer ‘medical abortion’, despite its lack of any medicinal effect) is the use of drugs to cause an early miscarriage. In 2015, 55% of all abortions in England and Wales were by chemical means, making it the most common abortion procedure practised for the first time ever. ‘Medical’ abortions can be classified as ‘early’ or ‘late’, but regardless of when it takes place, this type of abortion always involves the same basic process, and the taking of two different chemicals 36-48 hours apart at two different clinical visits.

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In the first visit, a pregnant woman is administered an abortifacient (a drug that causes the miscarriage of a baby) called mifepristone. This blocks progesterone, the hormone produced in the ovaries that makes the endometrium (the lining of the womb) suitable for the unborn child to be ‘gestated’: given necessary nutrients from her mother, whether in the form of ‘histiotrophe’ – the so-called ‘uterine milk’ – in the first 11 weeks, or else directly from the maternal blood through the umbilical cord during the rest of pregnancy. The blocking of progesterone causes the lining to break down, which breaks the baby’s attachment to her mother, essentially starving (and later in the deprivation of oxygen, suffocating) her to death.

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In the second visit, the woman is administered a prostaglandin (an artificial hormone that causes uterine contractions) called mifoprostol. Within 4-6 hours of taking this drug, the broken down womb lining and embryonic unborn child will pass out of her uterus through bleeding from her vagina, much like a heavy period. In some areas, this is administered on an outpatient basis, which means the woman can expel the womb lining and remains of her child at home.

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During this process, the woman may at various times experience some pain, nausea, and even diarrhoea.

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The difference between an early medical abortion and a later medical abortion is the length of time the abortion takes place and the amount of mifoprostol needed. When medical abortion is carried out from 9 weeks to 20 weeks, more than one dose of prostaglandin may be needed to expel the remains of the endometrium and baby.

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If a very late medical abortion takes place (20 weeks +), this is similar to a very late natural miscarriage or stillbirth. Prostaglandin is injected directly into the uterus, making it contract strongly (as in labour), with contractions lasting up to 6-12 hours. The woman remains awake during the procedure and is given painkillers to help control the pain if necessary. D&E may then be used to ensure all the remains of the baby are removed entirely (for details on D&E, see the section above and to the right).

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For a video presentation on the process of early medical abortion, see (note: minor details, though not essential ones, may differ from British abortion practice):

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Feticide

(18 weeks +) 

Later abortions will most commonly be preceded by so-called ‘feticide’. All abortions are ‘feticidal’ of course, in that they always involve the deliberate destruction of a human being at the fetal stage of her development. The procedure specifically termed ‘feticide’ in surgical parlance, however, is when the baby is killed prior to her body being delivered or removed from her mother’s womb. This is accomplished by injecting a saline solution (potassium chloride – salt) into the child’s heart, causing her to have a fatal heart attack.

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This happens because potassium is a mineral that possesses an electric charge, and it disrupts the electrical conduction of heart muscle, preventing heart cells from preparing for their next contraction. This means that the baby’s heart is forced to stop beating, causing her death.

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In 2015, of the 1,284 abortions performed at 22 weeks and over, 44% were reported as preceded by a feticide and a further 52% were performed by a method whereby the fetal heart is stopped as part of the procedure. Only 4% of abortions at 22 weeks or beyond were confirmed as having no feticide. In 2012, BPAS’ Medical Director Patricia Lohr reported in Abortion Review that:

At BPAS, we routinely perform intra-cardiac potassium chloride injections before D&E at 22+0 weeks and greater.

The reasons for this procedure differ depending on context. As Lohr reported in a 2008 edition of Abortion Review:

‘Feticide is recommended by the Royal College of Obstetricians and Gynaecologists for medical abortion at 22 weeks’ gestation or greater to avoid the possibility of a live birth’.

So, since abortion takes place to prevent a baby being born, the Royal College of Obstetricians and Gynaecologists (RCOG) in the UK counsels that feticide take place to ensure that a baby is not born alive accidentally after 22 weeks (when greater viability makes that possibility more and more likely).

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Lohr goes on to say that:

‘Feticide is also used before D&E by some surgeons, though the true incidence of use is not known. The gestational age at which feticide is employed before D&E differs among practitioners, but it is typically reserved for terminations above 18 weeks’ gestation. The softening of bone that occurs after fetal demise is proposed to reduce the amount of cervical dilation necessary and to make the procedure easier and faster, thus reducing the risk of complications’.

In other words, whilst during the the standard D&E procedure (see section above) the baby may be killed by this process of gradual dismemberment alone, it is difficult to perform after 18 weeks gestational age due to the toughness of the baby’s bones. Killing the baby beforehand causes her bodily tissues to soften, making dismembering her easier for the abortionist.

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For a video presentation on the process of late term feticidal abortion followed by induction and D&E, see (note: minor details, though not essential ones, may differ from British abortion practice):

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