Chemical substances that interrupt pregnancy after implantation
A historical advertisement for "Dr. Reynold's Lightning Pills". The advertisement uses coded language to refer to the pills' supposed abortifacient properties, including its ability to resolve female "irregularities."
An abortifacient ("that which will cause a miscarriage" from Latin: abortus "miscarriage" and faciens "making") is a substance that induces abortion. This is a nonspecific term which may refer to any number of substances or medications, ranging from herbs[1] to prescription medications.[2]
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.
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 followed by misoprostol 1–2 days later.[5] 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[6] 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).[7]
Other drugs with abortifacient properties can have multiple uses. Both synthetic oxytocin (Pitocin) and dinoprostone (Cervidil, Prepidil) are routinely used during healthy, term labor. Pitocin is used to induce and strengthen contractions,[8] and Cervidil is used to prepare the cervix for labor by inducing softening and widening of this opening to the uterus.[9] 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.[4][10] Misoprostol (discussed above) is also used to treat peptic ulcers[11] 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.[12]
Not all abortifacient agents are taken with the intention to end a pregnancy. Methotrexate, a drug often used for management of rheumatoid arthritis, can induce abortion. For this reason contraception is often advised while using methotrexate for management of a chronic condition.[13]
Sometimes herbal medicines 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 and kidney damage; failed attempts may require a follow-up clinical abortion because the uterus did not evacuate completely.[14][15]
Some drugs that are not abortifacients, such as levonorgestrel,[16] are referred to as abortifacients.[17]
In ancient Babylonian 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 texts discuss the ingestion of ingredients to return a missed menstrual period (which is used repeatedly throughout history as a coded reference to abortion).
"To make a pregnant woman lose her foetus: ...Grind nabruqqu plant, let her drink it with wine on an empty stomach, [then her foetus will be aborted]."[19]
Ancient silver coin from Cyrene depicting a stalk of Silphium
The ancient Greek 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".[20] Silphium figured so prominently in the wealth of Cyrene that the plant appeared on coins 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.[21][22][23][24][25][26][27] The Biblical scholar Tikva Frymer-Kensky has disputed the interpretation that the ordeal of the bitter water referred to the use of abortifacients.[28]
The medieval Islamic physician Ibn Sina documented various birth control practices, including the use of rue as an abortifacient.[29] 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.[30]
Carl Linnaeus, known as the "father of botany", listed five abortifacients in his 1749 Materia medica.[31]:124 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."[31]:124–125 Schiebinger further writes that "European exploration in the West Indies yielded about a dozen known abortifacients."[31]:177
According to Virgil Vogel, a historian of the indigenous societies of North America, the Ojibwe used blue cohosh (Caulophyllum thalictroides) as an abortifacient, and the Quinault used thistle for the same purpose.[34]:244 The appendix to Vogel's book lists red cedar (Juniperus virginiana), American pennyroyal (Hedeoma pulegioides), tansy, Canada wild ginger (Asarum canadense), and several other herbs as abortifacients used by various North American Indian tribes.[34]:289–290,339,380,391 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, Cree, Mohegan, Sioux, and other tribes; and he listed more than one hundred substances used as abortifacients by Native Americans.[35]
Following a tradition among European and English authors, colonial Americans were advised by Benjamin Franklin 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.[36]
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."[37]
During the American slavery period, 18th and 19th centuries, cotton root bark was used in folk remedies to induce a miscarriage.[38]
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.[39][40]
In the 19th century Madame Restell provided mail-order abortifacients and surgical abortion to pregnant clients in New York.[41]
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."[42]
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.[42] 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.[43][44][45]
In English law, abortion did not become illegal until 1803.[46] "Women who took drugs before that time [quickening] would describe their actions as 'restoring the menses' or 'bringing on a period'."[47]
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.
Related Research Articles
Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion"; these occur in approximately 30% to 40% of all pregnancies. When deliberate steps are taken to end a pregnancy, it is called an induced abortion, or less frequently "induced miscarriage". The unmodified word abortion generally refers to an induced abortion. The most common reasons women give for having an abortion are for birth-timing and limiting family size. Other reasons reported include maternal health, an inability to afford a child, domestic violence, lack of support, feeling they are too young, wishing to complete education or advance a career, and not being able or willing to raise a child conceived as a result of rape or incest.
Emergency contraception (EC) is a birth control measure, used after sexual intercourse to prevent pregnancy.
Herbal teas, also known as herbal infusions and less commonly called tisanes, are beverages made from the infusion or decoction of herbs, spices, or other plant material in hot water; they do not usually contain any true tea. Often herb tea, or the plain term tea, is used as a reference to all sorts of herbal teas. Many herbs used in teas/tisanes are also used in herbal medicine. Some herbal blends contain true tea.
Mentha pulegium, commonly (European) pennyroyal, or pennyrile, also called mosquito plant and pudding grass, is a species of flowering plant in the mint family, Lamiaceae, native to Europe, North Africa, and the Middle East. Crushed pennyroyal leaves emit a very strong fragrance similar to spearmint. Pennyroyal is a traditional folk remedy, emmenagogue, abortifacient, and culinary herb, but is toxic to the liver and has caused some deaths. European pennyroyal is related to an American species, Hedeoma pulegioides. Though they differ in genera, they share similar chemical properties.
Mifepristone, also known as RU-486, is a medication typically used in combination with misoprostol to bring about a medical abortion during pregnancy and manage early miscarriage. This combination is 97% effective during the first 63 days of pregnancy. It is also effective in the second trimester of pregnancy. It is taken by mouth.
Abortion is a divisive issue in the United States. The issue of abortion is prevalent in American politics and culture wars, though a majority of Americans support continued access to abortion. There are widely different abortion laws depending on state.
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 to prevent gastric ulcers in people taking nonsteroidal anti-inflammatory drugs (NSAID). For abortions it is used by itself or in conjunction with mifepristone or methotrexate. By itself, effectiveness for abortion is between 66% and 90%. For labor induction or abortion, it is taken by mouth, dissolved in the mouth, or placed in the vagina. For postpartum bleeding it may also be used rectally.
An adverse effect is an undesired harmful effect resulting from a medication or other intervention, such as surgery. An adverse effect may be termed a "side effect", when judged to be secondary to a main or therapeutic effect. The term complication is similar to adverse effect, but the latter is typically used in pharmacological contexts, or when the negative effect is expected or common. If the negative effect results from an unsuitable or incorrect dosage or procedure, this is called a medical error and not an adverse effect. Adverse effects are sometimes referred to as "iatrogenic" because they are generated by a physician/treatment. Some adverse effects occur only when starting, increasing or discontinuing a treatment. Using a drug or other medical intervention which is contraindicated may increase the risk of adverse effects. Adverse effects may cause complications of a disease or procedure and negatively affect its prognosis. They may also lead to non-compliance with a treatment regimen. Adverse effects of medical treatment resulted in 142,000 deaths in 2013 up from 94,000 deaths in 1990 globally.
Emmenagogues are herbs which stimulate blood flow in the pelvic area and uterus; some stimulate menstruation. Women use emmenagogues to stimulate menstrual flow, when menstruation is absent for reasons other than pregnancy, such as hormonal disorders or conditions like oligomenorrhea.
A self-induced abortion is an abortion performed by the pregnant woman herself, or with the help of other, non-medical assistance. Although the term includes abortions induced outside of a clinical setting with legal, sometimes over-the-counter medication, it also refers to efforts to terminate a pregnancy through alternative, potentially more dangerous methods. Such practices may present a threat to the health of women.
Letrozole, sold under the brand name Femara among others, is an aromatase inhibitor medication that is used in the treatment of breast cancer.
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 pregnancy, and in newborn babies to keep the ductus arteriosus open. In babies it is used in those with congenital heart defects until surgery can be carried out. It is also used to manage gestational trophoblastic disease. It may be used within the vagina or by injection into a vein.
The practice of induced abortion—the deliberate termination of a pregnancy—has been known since ancient times. Various methods have been used to perform or attempt abortion, including the administration of abortifacient herbs, the use of sharpened implements, the application of abdominal pressure, and other techniques. The term abortion, or more precisely spontaneous abortion, is sometimes used to refer to a naturally occurring condition that ends a pregnancy, that is, to what is popularly called a miscarriage. But in what follows the term abortion will always refer to an induced abortion.
Prostaglandin E1 (PGE1) is a naturally occurring prostaglandin and is also used as a medication (alprostadil).
John Marion Riddle is an American historian and specialist in the history of medicine. He is Alumni Distinguished Professor emeritus of History at North Carolina State University.
Women on Web (WoW) is a Canadian non-profit organization that aims to increase access to safe abortion known for its online abortion service accessible in multiple countries. The organization was founded by Dr. Rebecca Gomperts, a Dutch physician, in 2005.
Ulipristal acetate, sold under the brand name Ella among others, is a medication used for emergency contraception and uterine fibroids. As emergency contraception it should be used within 120 hours of vaginally penetrating intercourse. For fibroids it may be taken for up to six months. It is taken by mouth.
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 abortions such as vacuum aspiration or dilation and curettage. Medical abortions are more common than surgical abortions in most places around the world.
Aid Access is a nonprofit organization that provides access to medication abortion by mail to the United States and worldwide. It describes its work as a harm reduction strategy designed to provide safe access to mifepristone and misoprostol for those able to become pregnant in the United States who may not otherwise have access to abortion or miscarriage management services. People are able to manage their own abortion with remote access to a physician and a help-desk for any questions. The website is available in English, Spanish, and Dutch.
Estrone/progesterone (E1/P4), sold under the brand name Synergon, is a combination medication formulation of estrone, an estrogen, and progesterone, a progestogen. E1/P4 is used as an injectable preparation to induce withdrawal bleeding in women with non-pregnancy-related amenorrhea . It has also sometimes been used off-label as an abortifacient. The medication comes in a three-ampoule pack, contains 1 mg estrone and 10 mg progesterone per ampoule, and is administered by intramuscular injection. The usual dose of the medication is three injections, each two days apart, with the treatment duration not exceeding one week. E1/P4 is or has been available in France, Monaco, and Turkey, as well as in some French-speaking African countries such as Benin and Cameroon. The medication has been marketed since at least 1952.
↑ Romm A (2010). "Chapter 11: Pregnancy and Botanical Medicine Use and Safety". Botanical Medicine for Women's Health. Churchill Livingstone. pp.321–324. doi:10.1016/B978-0-443-07277-2.00013-1.(subscription required)
↑ Anderson IB, Mullen WH, Meeker JE, Khojasteh-BakhtSC, Oishi S, Nelson SD, Blanc PD (April 1996). "Pennyroyal toxicity: measurement of toxic metabolite levels in two cases and review of the literature". Ann. Intern. Med. (Review). 124 (8): 726–34. doi:10.7326/0003-4819-124-8-199604150-00004. PMID8633832. S2CID24375611.
↑ Prioreschi, Plinio (1995). "Conception and Abortion in the Greco-Roman World". Vesalius. I (2): 78.
↑ BÖCK, Barbara (2013). "Medicinal Plants and Medicaments Used for Conception, Abortion, and Fertility Control in Ancient Babylonia". Journal Asiatique. 301 (1): 37. doi:10.2143/JA.301.1.2994459. ISSN1783-1504.
↑ Frymer-Kensky, Tikva (1 January 1984). "The Strange Case of the Suspected Sotah (Numbers V 11-31)". Vetus Testamentum. 34 (1): 11–26. doi:10.1163/156853384X00025. ISSN1568-5330.
↑ Riddle, John M. (1991). "Oral Contraceptives and Early-Term Abortifacients During Classical Antiquity and the Middle Ages". Past and Present. 132 (1): 3–32. doi:10.1093/past/132.1.3. ISSN0031-2746.
↑ Riddle, John M. (1992). Contraception and Abortion from the Ancient World to the Renaissance. Cambridge, MA: Harvard University Press ISBN0-674-16876-3.
1 2 3 Schiebinger, Londa (2004). Plants and Empire: Colonial Bioprospecting in the Atlantic World. Harvard University Press. ISBN9780674014879.
↑ Delâge, Denys (2006). "Aboriginal Influence on the Canadians and French at the time of New France". In Christie, Gordon (ed.). Aboriginality and Governance: A Multidisciplinary Approach. Penticton Indian Reserve, British Columbia: Theytus Books. p.37. ISBN1894778243.
1 2 Vogel, Virgil J. (1970). American Indian Medicine. University of Oklahoma Press. ISBN0465030297.
↑ Moerman, Daniel (1998). Native American Ethnobotany. Timber Press. pp.46–48, 782–801. ISBN978-0881924534.
↑ McLaren, Angus (1981). "Birth Control and Abortion in Canada, 1870-1920". In Shortt, Samuel E.D. (ed.). Medicine in Canadian Society: Historical Perspectives. McGill/Queens University Press. p.295. ISBN0773503560.
This page is based on this Wikipedia article Text is available under the CC BY-SA 4.0 license; additional terms may apply. Images, videos and audio are available under their respective licenses.
