History of Abortion in Healthcare and
The United States Supreme Court made
a historic decision in Roe v. Wade regarding
legal right of a woman to an abortion. This majority decision of 7 to 2 changed
the entire scenario about debate on the issue of abortion. The decision is,
however, regarded as one of the most controversial ever made by the apex court.
Americans who favor either side of the debate are divided into two camps
generally called as pro-life and pro-choice. In the years following this
decision, some serious attempts have been made by the states to pass laws that
criminalize abortion even in cases of incest or rape. The controversy on the
issue of abortion is also not new and can be traced to the history of the act
to terminate pregnancy. In this context, this paper will discuss the history of
abortion as it relates to nursing. A section of the paper will also discuss the
effects of abortion on society and the nursing profession.
A General Overview
A human pregnancy usually lasts nine
months, the period divided into three trimesters with each period comprising
three month. A spontaneous abortion is also referred to as a miscarriage. If
this takes place in the later than the first trimester, it is referred to as a
preterm birth. An induced abortion is done for a purpose at any particular
gestational age. It may be performed to save mental health or life of the
mother. For example, a woman after becoming pregnant may find that she has a
disease that might lead to her death if she decides to continue the pregnancy.
Abortion may be performed to stop a pregnancy that is the outcome of incest or
rape. Abortions may also be done when it is known that the expected child will
have a mental or physical deformity. In most cases of induced abortions, the
decision is made due to economic or social reasons that make women reluctant to
continue with pregnancy thus aborting the process (Mohr 17-18).
A Historical Perspective
Abortion and birth control were at
times and under conditions acceptable even in the ancient Greco-Roman world.
This is specifically the situation in Jewish and Christian theology. Abortion
is also described in the Hippocratic Oath. There is also some evidence that
suggests the prescription was not practiced. Abortions at that time were,
however, very dangerous. Abortion methods, through the centuries, have included
several herb mixtures and stabbing the womb using a knife or sharp object.
Women who wanted to abort the process of child birth also did so by performing
exercises, for example jumping, carrying heavy objects, horseback riding, and
walking. Women also ingested laxatives and diuretics. Other ways of performing
abortion included inserting vaginal suppositories comprising agents like
wallflower and myrtle (Mohr 51-55).
History of Abortion in the
Pregnancy in the Middle Ages,
according to English law, was said to start at quickening, when a movement in
the fetus was felt by the woman. The law did not consider a woman as being
pregnant prior to that feeling as such, ending the pregnancy was not a crime.
Knowledge of antifertility methods did exist in classical text, it is not clear
whether an average person did have this information. Church fathers condemned
abortion as well as the use of contraception. Sources dealing with
contraception and abortion suggest that these topics in medieval times were not
safe to discuss openly in the general public. Medieval writings comprise a
general deal of content about herbal remedies but do not state their
abortifacient features (Mohr 51-55).
Traditional knowledge about abortion
during the seventeenth and eighteenth centuries continue to decline with the
passage of time. The Ellenborough Act of 803 declared abortion and illegal act
in the British Kingdom. This particular development signified the commencement
of the criminalization of abortion. Accordingly, Dr. Pascoe was convicted in
England in 1852 for administering oil of savin to a pregnant abortion. Such
convictions made doctors reluctant to indulge in practices related to abortion (Mohr
History of Abortion during
Medical advancements during the
nineteenth century made abortions somewhat safer. Most of the states were still
resistant to allow abortion and passed laws to ban the procedure. In 1829, for
example, New York imposed a ban on anyone, including physicians, for indulging
in abortion at any time and for any reason except for the purpose of saving
life. Well into the nineteenth century, more and more states in the United
States passed some legislations to place restrictions on abortions. The woman
performing abortion was considered a criminal in New Jersey, Texas, South
California, Oregon and Kentucky (Judd 67-70).
Although most of the states showed
their resentment on allowing abortion, medical conditions continued to improve.
Abortion was, however, still risky and dangerous despite significant
advancements made. Passing of laws to ban abortion at one hand while medical
advancements made to improve the process created confusion among public and
healthcare staff, including nurses. Abortions, during most part of the
nineteenth century, were therefore performed with more secrecy. Women confronted
great danger and problems in obtaining services of nurses or physicians to
perform abortion. Resultantly, women had to pay a higher price for abortion.
This situation lawed well into the twentieth century (Judd 67-70).
History of Abortion during Twentieth
During the early years of the twentieth
century, women were entering the workforce in large numbers, which many men in
particular considered a threat to their status. Working women criticized the
idea of her role in the family as producing and caring individual. This
perspective was reinforced by the ‘American Medical Association’ when it issued
a report in the year 1871 that declared abortion against the actual role of a
woman. The Comstock Act of 1873 also showed this attitude about women’s role.
This law was the outcome of strong lobbying by Anthony Comstock who considered
himself a protector of the national’s morals. This passionate reformer
continued to wage war for almost four decades against those whom he regarded to
be obscenity in literature. He was especially against liberals whom he
considered free in their conduct of sex. The last section of the Comstock Act
prohibited sending obscene materials through mail that were intended to induce
or prevent abortion. Those charged with the act were convinced and could spend
up to a maximum of ten years in prison at hard labor and also pay a penalty up
to five thousand dollars (Judd 67-70).
It is pertinent to mention that
abortion, similar to other main social issues, had been impacted by the climate
of the era. In the nineteenth century, many laws were passed to ban abortion as
a general belief prevailed at the time that the main role of a woman was to be
a mother and caregiver. Times had, however, changed when Roe v. Wade was passed in1973 (Judd 67-70).
Margaret Sanger, an obstetric nurses
who practiced in New York City, became more and more concerned by the high
mortality rate from botched, illegal abortions. She initiated a birth control
campaign in the United States. She firmly believed in the right of women to end
any unwanted pregnancy. She also supported other controversial position, such
as her view that marriage should not have the right to parenthood or those
physically unfit should have fewer children. As soon as Sanger opened her first
birth control clinic in New York in 1916, she was instantly arrested. This was
followed by more arrests as many in the general public started favoring the
stance taken by Sanger (Nelson 102-103).
Through the work of Sanger and increasing
pressure from other groups in the society, the federal courts ultimately
allowed doctors to provide their professional advice on the methods dealing
with birth control. The interpretation of the Comstock Law was changed,
allowing doctors to import and provide contraceptives to prevent pregnancies.
The ‘National Birth Control League’, founded by Sanger in 1916, was renamed in
the year 1921 to be called as the ‘American Birth Control League. It was then
merged into the ‘Planned Parenthood Federation of America’ in 1942. Birth
control was legal by the year 1960 in forty-eight states. Sanger also took her
campaign of birth control to foreign countries such as India and Japan (Nelson
History of Abortion:
Developments in other Countries
Most countries, as in the United
States, have a varied history of abortion. For example, Chinese folklore talks
about Emperor Shennong who used mercury for abortions almost five thousand
years ago. Soranus, a Greek physician, had discussed details about performing
abortions in his text Gynecology,
written in the second century. Documents dating back to the twelfth century
discuss the ways of performing abortion in Japan (Nelson 133-134).
Pregnancy was declared as immoral in 1869 by
Pope Pius IX. Soviet leader Vladimir Lenin declared pregnancy legal in the year
1920. This order was, however, reversed by Joseph Stalin in 1936 to increase
the population. Abortion had become legalized throughout the Western World in
the late 1960s and during 1970s. China literally promoted the abortion process
on a large scale in an effort to control the growth in its population (Nelson
the issue of Abortion Affects the Profession of Nursing?
Many people are of the view that
legalized abortion ethically justified as it saves lives of mothers. Those
opposing abortion emphasize life of a fetus equally valuable and needs to be
protected. Nurses, as healthcare professionals, are directly involved in the
controversies among differing beliefs about pregnancy. Nurses have their own views and beliefs about
choosing the option of ending a pregnancy and subsequently respond in certain
ways that shows the complexity of the issue as well as the ambivalence that it
Considering the importance of the issue, nurses
have responsibilities that must be fulfilled. Nurses must be well-informed
about the issue of induced abortion from an ethical and legal standpoint and
know the laws and regulations in their state. Nurses should also acknowledge
the fact that abortion is an ethical and moral issue and certainly not a
Personal values and thinking of each
nurse contribute to what nurses want to do if confronted by the needs of a
woman for nursing care when having an abortion. Some nurses, for example, have
no reservations on participating in the act of abortions. Others, however, do
not assist with the termination of pregnancy but may care for pregnant woman
after the conclusion of the procedure. Some nurses participate in the abortion
process during first-trimester but may object to abortion in later stages. Many
nurses are uncomfortable in other conditions and circumstances. On the other
hand, some nurses do feel that they are unable to provide care before, during,
and after pregnancy has been terminated and that they are bound by conscience
to discourage a woman from the decision of abortion (Alexander, Lewis &
LaRosa 112-113). Nurses have no
obligation to take a specific stance with which they agree. Many states have
passed laws that allow nurses to reject participation in the termination of
pregnancy if pregnancy violate their religious, ethical, or moral beliefs.
Nurses have, however, an ethical obligation to inform the institution where
they want to work before joining it.
the issue of Abortion Affects Society?
The issue of abortion is
controversial as society is divided whether the act should be allowed or not.
Proponents of abortion consider it a right of woman to decide whether she wants
to have a baby. The woman may make decision with or without consultation of
others, for example a family member. It is her body and she should have the
control of it. It is people, and not fetuses or eggs that have ‘rights’.
Opponents criticize this approach and argue that the right do as a woman wants
to do with her body must by curtailed by other people’s rights. In many cases,
the right to do as a person wish to her body is overruled, for example drug
laws protect a person to make himself/herself a danger to others by changing
his/her mind with drugs. In the case of abortion, the right of the mother are
overruled by those of the unborn’s rights (Pollitt 121-122).
Proponents argue that if abortion is
not allowed on the demand of the woman, she will then seek help from
abortionists working in back-street where lack of sterile conditions and
expertise can present a serious threat to health. This argument is challenged
by opponents who argue against banning any act on the basis that people will be
compelled to do it in backstreet (Feinberg & Feinberg 78-79).
The paper has discussed in detail the history
of abortion as it relates to nursing and healthcare profession. The controversy
on the issue of abortion is also not new and can be traced to the history of
the act to terminate pregnancy. The paper was divided into different sections,
for example history of nursing in the Middle Ages and during seventeenth and
eighteenth centuries. The discussion has shown that abortion was considered a
taboo and strictly prohibited in the society. Methods to abort pregnancy were
unsafe and brutal, causing serious harms to health and life of the women.
Medical advancements have, however, made abortion a safe act. Views and
perspectives on the issue of abortion have changed with the passage of time.
Society has become more liberal and tolerance as a segment now believes women
should be allowed to abort pregnancy, as per her desire. Another segment still
opposes it and criticize the approach that allow abortion, based on certain
arguments as discussed in the paper. The issue of abortion is, thus, controversial
and remains unresolved. American society is, however, moving in the direction
where women would be allowed to perform an act as per their choice.