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An abortifacient ("that which will cause a
miscarriage Miscarriage, also known in medical terms as a spontaneous abortion, is an end to pregnancy resulting in the loss and expulsion of an embryo or fetus from the womb before it can fetal viability, survive independently. Miscarriage before 6 weeks ...
" from
Latin Latin ( or ) is a classical language belonging to the Italic languages, Italic branch of the Indo-European languages. Latin was originally spoken by the Latins (Italic tribe), Latins in Latium (now known as Lazio), the lower Tiber area aroun ...
: '' abortus'' "miscarriage" and '' faciens'' "making") is a substance that induces
abortion Abortion is the early termination of a pregnancy by removal or expulsion of an embryo or fetus. Abortions that occur without intervention are known as miscarriages or "spontaneous abortions", and occur in roughly 30–40% of all pregnan ...
. This is a nonspecific term which may refer to any number of substances or medications, ranging from herbs to prescription medications. Common abortifacients used in performing
medical abortion A medical abortion, also known as medication abortion or non-surgical abortion, occurs when drugs (medication) are used to bring about an abortion. Medical abortions are an alternative to surgical (also called procedural or instrumentation) a ...
s include
mifepristone Mifepristone, and also known by its developmental code name RU-486, is a drug typically used in combination with misoprostol to bring about a medical abortion during pregnancy. This combination is 97% effective during the first 63 days (9 wee ...
, which is typically used in conjunction with
misoprostol Misoprostol is a synthetic prostaglandin medication used to prevent and treat stomach and duodenal ulcers, induce labor, cause an abortion, and treat postpartum bleeding due to poor contraction of the uterus. It is taken by mouth when used ...
in a two-step approach. Synthetic oxytocin, which is routinely used safely during term
labor Labour or labor may refer to: * Childbirth, the delivery of a baby * Labour (human activity), or work ** Manual labour, physical work ** Wage labour, a socioeconomic relationship between a worker and an employer ** Organized labour and the labour ...
, is also commonly used to induce abortion in the second or third trimester. For thousands of years, writers in many parts of the world have described and recommended herbal abortifacients to women who seek to terminate a pregnancy, although their use may carry risks to the health of the woman.


Medications

Because "abortifacient" is a broad term used to describe a substance's effects on pregnancy, there is a wide range of drugs that can be described as abortifacients or as having abortifacient properties. The most commonly recommended medication regimen for intentionally inducing abortion involves the use of
mifepristone Mifepristone, and also known by its developmental code name RU-486, is a drug typically used in combination with misoprostol to bring about a medical abortion during pregnancy. This combination is 97% effective during the first 63 days (9 wee ...
followed by
misoprostol Misoprostol is a synthetic prostaglandin medication used to prevent and treat stomach and duodenal ulcers, induce labor, cause an abortion, and treat postpartum bleeding due to poor contraction of the uterus. It is taken by mouth when used ...
1–2 days later. The use of these medications for the purpose of ending a pregnancy has been extensively studied, and has been shown to be both effective and safe with fewer than 0.4% of patients needing hospitalization to treat an infection or to receive a blood transfusion. This combination is approved for use up to 10 weeks' gestation (70 days after the start of the last menstrual period). Other drugs with abortifacient properties can have multiple uses. Both synthetic oxytocin (Pitocin) and
dinoprostone Prostaglandin E2 (PGE2), also known as dinoprostone, is a naturally occurring prostaglandin with oxytocic properties that is used as a medication. Dinoprostone is used in labor induction, bleeding after delivery, termination of pregnanc ...
(Cervidil, Prepidil) are routinely used during healthy, term
labor Labour or labor may refer to: * Childbirth, the delivery of a baby * Labour (human activity), or work ** Manual labour, physical work ** Wage labour, a socioeconomic relationship between a worker and an employer ** Organized labour and the labour ...
. Pitocin is used to induce and strengthen contractions, and Cervidil is used to prepare the
cervix The cervix (: cervices) or cervix uteri is a dynamic fibromuscular sexual organ of the female reproductive system that connects the vagina with the uterine cavity. The human female cervix has been documented anatomically since at least the time ...
for labor by inducing softening and widening of this opening to the
uterus The uterus (from Latin ''uterus'', : uteri or uteruses) or womb () is the hollow organ, organ in the reproductive system of most female mammals, including humans, that accommodates the embryonic development, embryonic and prenatal development, f ...
. When used this way, neither medication is considered an abortifacient. However, the same drugs can be used to induce an abortion, particularly after 12 weeks of pregnancy. Misoprostol (discussed above) is also used to treat
peptic ulcers Peptic ulcer disease is when the inner part of the stomach's gastric mucosa (lining of the stomach), the first part of the small intestine, or sometimes the lower esophagus, gets damaged. An ulcer in the stomach is called a gastric ulcer, while ...
in patients who have had gastric or intestinal damage from use of NSAIDs. Because its use in treatment of ulcers makes it easier to access, misoprostol alone is sometimes used for self-induced abortion in countries or regions where legal abortion is not available or readily accessible. Not all abortifacient agents are taken with the intention to end a pregnancy.
Methotrexate Methotrexate, formerly known as amethopterin, is a chemotherapy agent and immunosuppressive drug, immune-system suppressant. It is used to treat cancer, autoimmune diseases, and ectopic pregnancy, ectopic pregnancies. Types of cancers it is u ...
, a drug often used for management of
rheumatoid arthritis Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects synovial joint, joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and h ...
, can induce abortion. For this reason contraception is often advised while using methotrexate for management of a chronic condition. Sometimes
herbal medicine Herbal medicine (also called herbalism, phytomedicine or phytotherapy) is the study of pharmacognosy and the use of medicinal plants, which are a basis of traditional medicine. Scientific evidence for the effectiveness of many herbal treatments ...
s are used in an attempt to induce abortion. In general, a dose sufficient to be effective poses a risk to the mother because of potential
liver The liver is a major metabolic organ (anatomy), organ exclusively found in vertebrates, which performs many essential biological Function (biology), functions such as detoxification of the organism, and the Protein biosynthesis, synthesis of var ...
and
kidney In humans, the kidneys are two reddish-brown bean-shaped blood-filtering organ (anatomy), organs that are a multilobar, multipapillary form of mammalian kidneys, usually without signs of external lobulation. They are located on the left and rig ...
damage; failed attempts may require a follow-up clinical abortion because the uterus did not evacuate completely. Some drugs that are not abortifacients, such as
levonorgestrel Levonorgestrel is a hormonal medication used in a number of birth control methods. It is combined with an estrogen to make combination birth control pills. As an emergency birth control, sold under the brand names Plan B One-Step and Julie, ...
, are referred to as abortifacients.


History

The medical literature of
classical antiquity Classical antiquity, also known as the classical era, classical period, classical age, or simply antiquity, is the period of cultural History of Europe, European history between the 8th century BC and the 5th century AD comprising the inter ...
often refers to pharmacological means of abortion; abortifacients are mentioned, and sometimes described in detail, in the works of
Aristotle Aristotle (; 384–322 BC) was an Ancient Greek philosophy, Ancient Greek philosopher and polymath. His writings cover a broad range of subjects spanning the natural sciences, philosophy, linguistics, economics, politics, psychology, a ...
, Caelius Aurelianus,
Celsus Celsus (; , ''Kélsos''; ) was a 2nd-century Greek philosopher and opponent of early Christianity. His literary work '' The True Word'' (also ''Account'', ''Doctrine'' or ''Discourse''; Greek: )Hoffmann p.29 survives exclusively via quotati ...
,
Dioscorides Pedanius Dioscorides (, ; 40–90 AD), "the father of pharmacognosy", was a Greek physician, pharmacologist, botanist, and author of (in the original , , both meaning "On Materia medica, Medical Material") , a 5-volume Greek encyclopedic phar ...
,
Galen Aelius Galenus or Claudius Galenus (; September 129 – AD), often Anglicization, anglicized as Galen () or Galen of Pergamon, was a Ancient Rome, Roman and Greeks, Greek physician, surgeon, and Philosophy, philosopher. Considered to be one o ...
,
Hippocrates Hippocrates of Kos (; ; ), also known as Hippocrates II, was a Greek physician and philosopher of the Classical Greece, classical period who is considered one of the most outstanding figures in the history of medicine. He is traditionally referr ...
, Oribasius,
Paul of Aegina Paul of Aegina or Paulus Aegineta (; Aegina, ) was a 7th-century Byzantine Greek physician best known for writing the encyclopedia, medical encyclopedia ''Medical Compendium in Seven Books.'' He is considered the “Father of Early Medical Writing ...
, Pliny, Theodorus Priscianus,
Soranus of Ephesus Soranus of Ephesus (; 1st/2nd century AD) was a Ancient Greek medicine, Greek physician. He was born in Ephesus but practiced in Alexandria and subsequently in Rome, and was one of the chief representatives of the Methodic school of medicine. Se ...
, and others. In ancient
Babylonia Babylonia (; , ) was an Ancient history, ancient Akkadian language, Akkadian-speaking state and cultural area based in the city of Babylon in central-southern Mesopotamia (present-day Iraq and parts of Kuwait, Syria and Iran). It emerged as a ...
n texts, scholars have described multiple written prescriptions or instructions for ending pregnancies. Some of these instructions were explicitly for ingesting ingredients to end a pregnancy, whereas other
cuneiform Cuneiform is a Logogram, logo-Syllabary, syllabic writing system that was used to write several languages of the Ancient Near East. The script was in active use from the early Bronze Age until the beginning of the Common Era. Cuneiform script ...
texts discuss the ingestion of ingredients to return a missed
menstrual period The menstrual cycle is a series of natural changes in hormone production and the structures of the uterus and ovaries of the female reproductive system that makes pregnancy possible. The ovarian cycle controls the production and release of eg ...
(which is used repeatedly throughout history as a coded reference to abortion). The ancient
Greek Greek may refer to: Anything of, from, or related to Greece, a country in Southern Europe: *Greeks, an ethnic group *Greek language, a branch of the Indo-European language family **Proto-Greek language, the assumed last common ancestor of all kno ...
colony of Cyrene at one time had an economy based almost entirely on the production and export of the plant silphium, which had uses ranging from food to a salve for feral dog bites. It was also considered a powerful abortifacient used to "purge the uterus". Silphium figured so prominently in the wealth of Cyrene that the plant appeared on
coin A coin is a small object, usually round and flat, used primarily as a medium of exchange or legal tender. They are standardized in weight, and produced in large quantities at a mint in order to facilitate trade. They are most often issued by ...
s minted there. In the Bible, Biblical scholars and learned Biblical commentators view the ordeal of the bitter water (prescribed for a ''sotah'', or a wife whose husband suspects that she was unfaithful to him) as referring to the use of abortifacients to terminate her pregnancy. The wife drinks "water of bitterness," which, if she is guilty, causes the abortion or miscarriage of a pregnancy she may be carrying. The Biblical scholar Tikva Frymer-Kensky has disputed the interpretation that the ordeal of the bitter water referred to the use of abortifacients. The medieval Islamic physician
Ibn Sina Ibn Sina ( – 22 June 1037), commonly known in the West as Avicenna ( ), was a preeminent philosopher and physician of the Muslim world, flourishing during the Islamic Golden Age, serving in the courts of various Iranian peoples, Iranian ...
documented various birth control practices, including the use of
rue ''Ruta graveolens'', commonly known as rue, common rue or herb-of-grace, is a species of the genus '' Ruta'' grown as an ornamental plant and herb. It is native to the Mediterranean. It is grown throughout the world in gardens, especially for i ...
as an abortifacient. Similarly, 11th-century physician Constantine the African described multiple abortifacient herbs, which he classified by order of their intensity, starting with abortifacients that had weaker effects on the body and ending with the most potent substances.Riddle, John M. (1992). ''Contraception and Abortion from the Ancient World to the Renaissance.'' Cambridge, MA: Harvard University Press .
Carl Linnaeus Carl Linnaeus (23 May 1707 – 10 January 1778), also known after ennoblement in 1761 as Carl von Linné,#Blunt, Blunt (2004), p. 171. was a Swedish biologist and physician who formalised binomial nomenclature, the modern system of naming o ...
, known as the "father of botany", listed five abortifacients in his 1749 ''Materia medica''. According to the historian of science Londa Schiebinger, in the 17th and 18th centuries "many sources taken together – herbals, midwifery manuals, trial records, ''Pharmacopoeia'', and ''Materia medica'' – reveal that physicians, midwives, and women themselves had an extensive knowledge of herbs that could induce abortion." Schiebinger further writes that "European exploration in the West Indies yielded about a dozen known abortifacients." For Aboriginal people in Australia, plants such as giant boat-lip orchid (''Cymbidium madidum''), quinine bush (''Petalostigma pubescens''), or blue-leaved mallee (''Eucalyptus gamophylla'') were ingested, inserted into the body, or were smoked with Cooktown ironwood (''Erythrophleum chlorostachys''). Historically, the
First Nations First nations are indigenous settlers or bands. First Nations, first nations, or first peoples may also refer to: Indigenous groups *List of Indigenous peoples *First Nations in Canada, Indigenous peoples of Canada who are neither Inuit nor Mé ...
people of eastern Canada used ''
Sanguinaria canadensis ''Sanguinaria canadensis'', bloodroot, is a perennial, herbaceous flowering plant native to eastern North America. It is the only species in the genus ''Sanguinaria'', included in the poppy family Papaveraceae, and is most closely related to ' ...
'' (bloodwort) and ''
Juniperus virginiana ''Juniperus virginiana'', also known as eastern redcedar, red cedar, Virginian juniper, eastern juniper, red juniper, and other local names, is a species of juniper native to eastern North America from southeastern Canada to the Gulf of Mexico an ...
'' to induce abortions. According to Virgil Vogel, a historian of the indigenous societies of North America, the
Ojibwe The Ojibwe (; Ojibwe writing systems#Ojibwe syllabics, syll.: ᐅᒋᐺ; plural: ''Ojibweg'' ᐅᒋᐺᒃ) are an Anishinaabe people whose homeland (''Ojibwewaki'' ᐅᒋᐺᐘᑭ) covers much of the Great Lakes region and the Great Plains, n ...
used blue cohosh (''Caulophyllum thalictroides'') as an abortifacient, and the Quinault used
thistle Thistle is the common name of a group of flowering plants characterized by leaves with sharp spikes on the margins, mostly in the family Asteraceae. Prickles can also occur all over the planton the stem and on the flat parts of the leaves. T ...
for the same purpose. The appendix to Vogel's book lists red cedar (''Juniperus virginiana''), American pennyroyal (''Hedeoma pulegioides''),
tansy Tansy (''Tanacetum vulgare'') is a perennial, herbaceous flowering plant in the genus ''Tanacetum'' in the aster family, native to temperate Europe and Asia. It has been introduced to other parts of the world, including North America, and in ...
, Canada wild ginger (''Asarum canadense''), and several other herbs as abortifacients used by various North American Indian tribes. The anthropologist Daniel Moerman wrote that calamus (''Acorus calamus''), which was one of the ten most common medicinal drugs of Native American societies, was used as an abortifacient by the
Lenape The Lenape (, , ; ), also called the Lenni Lenape and Delaware people, are an Indigenous peoples of the Northeastern Woodlands, Indigenous people of the Northeastern Woodlands, who live in the United States and Canada. The Lenape's historica ...
,
Cree The Cree, or nehinaw (, ), are a Indigenous peoples of the Americas, North American Indigenous people, numbering more than 350,000 in Canada, where they form one of the country's largest First Nations in Canada, First Nations. They live prim ...
,
Mohegan The Mohegan are an Indigenous people originally based in what is now southeastern Connecticut in the United States. They are part of the Eastern Algonquian linguistic and cultural family and historically shared close ties with the neighboring ...
,
Sioux The Sioux or Oceti Sakowin ( ; Dakota/ Lakota: ) are groups of Native American tribes and First Nations people from the Great Plains of North America. The Sioux have two major linguistic divisions: the Dakota and Lakota peoples (translati ...
, and other tribes; and he listed more than one hundred substances used as abortifacients by Native Americans. Following a tradition among European and English authors, colonial Americans were advised by
Benjamin Franklin Benjamin Franklin (April 17, 1790) was an American polymath: a writer, scientist, inventor, statesman, diplomat, printer, publisher and Political philosophy, political philosopher.#britannica, Encyclopædia Britannica, Wood, 2021 Among the m ...
to use careful measurements in his recipe for an abortifacient that he used as an example in a book he published to teach mathematics and many useful skills. The historian Angus McLaren, writing about Canadian women between 1870 and 1920, states that "A woman would first seek to 'put herself right' by drinking an infusion of one of the traditional abortifacients, such as tansy, quinine, pennyroyal, rue, black hellebore, ergot of rye, sabin, or cotton root." During the American slavery period, 18th and 19th centuries,
cotton Cotton (), first recorded in ancient India, is a soft, fluffy staple fiber that grows in a boll, or protective case, around the seeds of the cotton plants of the genus '' Gossypium'' in the mallow family Malvaceae. The fiber is almost pure ...
root bark was used in folk remedies to induce a miscarriage. In the late 19th century, women in the UK and US increasingly ingested lead to abort pregnancies, sometimes in the form of pills made of diachylon or lead plaster. It would often cause the women to become ill and could kill them. In the 19th century Madame Restell provided mail-order abortifacients and surgical abortion to pregnant clients in New York. Early 20th-century newspaper advertisements included coded advertisements for abortifacient substances which would solve menstrual "irregularities." Between 1919 and 1934 the U.S. Department of Agriculture issued legal restraints against fifty-seven "feminine hygiene products" including "Blair's Female Tablets" and "Madame LeRoy's Regulative Pills."


Quickening

For much of history, ending a pregnancy prior to " quickening" (the moment when a pregnant woman first feels fetal movement) did not have the type of legal or political restrictions and taboos found in the 21st century. Early medieval laws did not discuss abortion prior to quickening. The early Catholic church held that human life began at "ensoulment" (at the time of quickening), a continuation of Roman norms and positions on the use of abortifacients prior to quickening."Abortion and Catholic Thought: The Little-Told History"
Abortion and the Politics of Motherhood
by Kristin Luker, University of California Press
In English law, abortion did not become illegal until 1803. "Women who took drugs before that time uickeningwould describe their actions as 'restoring the menses' or 'bringing on a period'." At that time, abortion after quickening became subject to the death penalty. In 1837, the significance of quickening was removed, but the death penalty was also abandoned.


References


External links

* {{Authority control Medication abortion