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.
Abortion laws and their enforcement have fluctuated through various eras. In much of the Western world during the 20th century, abortion-rights movements were successful in having abortion bans repealed. While abortion remains legal in most of the West, this legality is regularly challenged by anti-abortion groups. The Soviet Union under Vladimir Lenin is recognized as the first modern country to legalize induced elective abortion care. In the twentieth century China used induced abortion as part of a "one-child policy" birth control campaign in an effort to slow population growth.
Premodern era
The Vedic and smrti laws of India reflected a concern with preserving the male seed of the three upper castes; and the religious courts imposed various penances for the woman or excommunication for a priest who provided an abortion. Part of the epic Ramayana describes abortion performed by barber surgeons. The only evidence of the death penalty being mandated for abortion in the ancient laws is found in Assyrian Law, in the Code of Assura, c. 1075 BCE;Ancient History Sourcebook: The Code of the Assura, c. 1075 BC and this is imposed only on a woman who procures an abortion against her husband's wishes. The first recorded evidence of induced abortion is from the Egyptian Ebers Papyrus in 1550 BCE.
Many of the methods employed in early cultures were non-surgical. Physical activities such as strenuous labor, climbing, paddling, weightlifting, or diving were a common technique. Others included the use of irritant leaves, fasting, bloodletting, pouring hot water onto the abdomen, and lying on a heated coconut shell. In virtually all cultures, abortion techniques developed through observation, adaptation of obstetrical methods, and transculturation. Physical means of inducing abortion, including battery, exercise, and tightening the girdle were still often used as late as the Early Modern Period among English women.
Archaeological discoveries indicate early surgical attempts at the extraction of a fetus; however, such methods are not believed to have been common, given the infrequency with which they are mentioned in ancient medical texts.
An 8th-century Sanskrit text instructs women wishing to induce an abortion to sit over a pot of steam or stewed onions. The technique of massage abortion, involving the application of pressure to the pregnant abdomen, has been practiced in Southeast Asia for centuries. One of the bas reliefs decorating the temple of Angkor Wat in Cambodia, dated , depicts a demon performing such an abortion upon a woman who has been sent to the underworld.
Japanese documents show records of induced abortion from as early as the 12th century. It became much more prevalent during the Edo period, especially among the peasant class, who were hit hardest by the recurrent famines and high taxation of the age. Statues of the Boddhisattva Jizo, erected in memory of an abortion, miscarriage, stillbirth, or young childhood death, began appearing at least as early as 1710 at a temple in Yokohama (see religion and abortion).
The Māori people of New Zealand prior to colonisation terminated pregnancies via miscarriage-inducing drugs, ceremonial methods, and girding of the abdomen with a restrictive belt. Another source claims that the Māori people did not practice abortion, for fear of Mākutu, but did attempt abortion through the artificial induction of premature labor.
Greco-Roman world
Much of what is known about the methods and practice of abortion in Greek and Roman history comes from early classical texts. Abortion, as a gynecological procedure, was primarily the province of women who were either midwives or well-informed laypeople. In his Theaetetus, Plato mentions a midwife's ability to induce abortion in the early stages of pregnancy.Plato (1921) []. "149d". Theaetetus. in Harold North Fowler. Plato in Twelve Volumes. 12. Cambridge, Massachusetts: Harvard University Press. It is thought unlikely that abortion was punished in Ancient Greece. A fragment attributed to the poet Lysias "suggests that abortion was a crime in Athens against the husband, if his wife was pregnant when he died, since his unborn child could have claimed the estate."
The ancient Greeks relied upon the herb silphium as an abortifacient and contraceptive. The plant, as the chief export of Cyrene, was driven to extinction; it is suggested that it might have possessed the same abortive properties, as some of its closest extant relatives in the family Apiaceae. Silphium was so central to the Cyrenian economy that most of its coins were embossed with an image of the plant.Pliny, XXII, Ch. 49 Pliny the Elder (23–79 CE) cited the refined oil of common rue as a potent abortifacient. Serenus Sammonicus wrote of a concoction which consisted of rue, egg, and dill. Soranus, Dioscorides, Oribasius also detailed this application of the plant. Modern scientific studies have confirmed that rue indeed contains three abortive compounds. Birthwort, a herb used to ease childbirth, was also used to induce abortion. Galen included it in a potion formula in de Antidotis, while Dioscorides said it could be administered by mouth, or in the form of a vaginal pessary also containing pepper and myrrh.
The Greek playwright Aristophanes noted the abortifacient property of pennyroyal in 421 BCE, through a humorous reference in his comedy, Peace. Hippocrates (c. 460 – c. 370 BCE), the Greek physician, would advise a prostitute who became pregnant to jump up and down, touching her buttocks with her heels at each leap, so as to induce miscarriage. Other writings attributed to him describe instruments fashioned to dilate the cervix and curette inside of the uterus.
Soranus, a 2nd-century Greek physician, prescribed diuretics, emmenagogues, enemas, fasting, and bloodletting as safe abortion methods, although he advised against the use of sharp instruments to induce miscarriage, due to the risk of organ perforation. He also advised women wishing to abort their pregnancies to engage in energetic walking, carrying heavy objects, riding animals, and jumping so that the woman's heels were to touch her buttocks with each jump, which he described as the "Lacedaemonian Leap".Soranus. Gynaecology. 1.59–65. He also offered a number of recipes for herbal baths, rubs, and pessaries. In De Materia Medica Libri Quinque, the Greek pharmacologist Dioscorides listed the ingredients of a draught called "abortion wine"– hellebore, squirting cucumber, and scammony– but failed to provide the precise manner in which it was to be prepared. Hellebore, in particular, is known to be abortifacient.
Tertullian, a 2nd- and 3rd-century Christian theologian, described surgical implements which were used in a procedure similar to the modern dilation and evacuation. One tool had a "nicely adjusted flexible frame" used for dilation, an "annular blade" used to curette, and a "blunted or covered hook" used for extraction. The other was a "copper needle or spike". He attributed ownership of such items to Hippocrates, Asclepiades, Erasistratus, Herophilus, and Soranus.Tertullian (1885) []. "Tertullian Refutes, Physiologically, the Notion that the Soul is Introduced After Birth". A Treatise on the Soul. in Philip Schaff. Ante-Nicene Fathers. 3. Edinburgh: T&T Clark.
Aulus Cornelius Celsus, a 1st-century Roman encyclopedist, offered an extremely detailed account of a procedure to extract an already-dead fetus in his only surviving work, De Medicina. In Book 9 of Refutation of all Heresies, Hippolytus of Rome, another Christian theologian of the 3rd century, wrote of women tightly binding themselves around the middle so as to "expel what was being conceived".Hippolytus (). "The Personal History of Callistus; His Occupation ...". Refutation of all Heresies. in Alexander Roberts and James Donaldson. Ante-Nicene Fathers. 5. Edinburgh: T&T Clark.
Natural abortifacients
Botanical preparations reputed to be abortifacient were common in classical literature and folk medicine. Such folk remedies, however, varied in effectiveness and were not without the risk of adverse effects. Some of the herbs used at times to terminate pregnancy are poisonous.
A list of plants which cause abortion was provided in De viribus herbarum, an 11th-century herbal written in the form of a poem, the authorship of which is incorrectly attributed to Aemilius Macer. Among them were rue, Italian catnip, savory, sage, soapwort, cyperus, white and black hellebore, and pennyroyal. Physicians in the Islamic world during the medieval period documented the use of abortifacients, commenting on their effectiveness and prevalence.
Colonial Americans were advised to use careful measurements in a recipe by Benjamin Franklin for an abortifacient. He used the recipe as an example in a book he published to teach mathematics and many useful skills, and calls the recipe a solution to "the misfortune" of an unwanted pregnancy for "unmarry'd women".Farrell, Molly, Ben Franklin Put an Abortion Recipe in His Math Textbook: To colonial Americans, termination was as normal as the ABCs and 123s, Slate, May 5, 2022 Franklin was following a tradition that had existed in England and Europe.
King's American Dispensatory of 1898 recommended a mixture of brewer's yeast and pennyroyal tea as "a safe and certain abortive". Pennyroyal has been known to cause complications when used as an abortifacient. In 1978 a pregnant woman from Colorado died after consuming 2 tablespoonfuls of pennyroyal essential oilColorado death which is known to be toxic. In 1994 a pregnant woman, unaware of an ectopic pregnancy that needed immediate medical care, drank a tea containing pennyroyal extract to induce abortion without medical help. She later died as a result of the untreated ectopic pregnancy, mistaking the symptoms for the abortifacient working.
For thousands of years, tansy has been taken in early pregnancy to restore menstruation. (Catamenia is blood or other material discharged from the uterus during menstruation.) It was first documented as an emmenagogue in St. Hildegard of Bingen's De simplicis medicinae.
A variety of juniper, known as savin, was mentioned frequently in European writings. In one case in England, a rector from Essex was said to have procured it for a woman he had impregnated in 1574; in another, a man advised his pregnant girlfriend to use black hellebore and savin be boiled together and drunk in milk, or else chopped madder boiled in beer. Other substances reputed to have been used by the English include Spanish fly, opium, watercress seed, iron sulphate, and iron chloride. Another mixture, not abortifacient, but rather intended to relieve missed abortion, contained dittany, hyssop, and hot water.
The root of worm fern, called "prostitute root" in French, was used in France and Germany; it was also recommended by a Greek physician in the 1st century. In German folk medicine, there was also an abortifacient tea, which included marjoram, thyme, parsley, and lavender. Other preparations of unspecified origin included crushed ants, the saliva of camels, and the tail hairs of black-tailed deer dissolved in the fat of bears.
Attitudes towards abortion