Methods and Means

10,255 abortions were registered officially in Switzerland in 2015. Of that, 5% were late abortions after the 12th week of pregnancy. Behind every abortion there are fates - fates of small people who lose their life - fates of mothers and fathers, physicians and others involved, who are responsible for the death of these little people. In the following you will read about the many methods and means that have been found to make abortions possible.

The combined pill

Composition: *gestagen and *oestrogen.

This preparation is available as one-, two- and three-phase pills. The mobility of the fallopian tubes, which are important for ovum and semen transport, is restricted. The build-up of the endometrium is disrupted so that the embryo cannot implant and dies.

The micropill

This is a single-phase advancement of the combined pill, which contains clearly less oestrogen.

The minipill

Composition: *gestagen called Levonorgestrel.

The minipill changes the cervical mucus in order to make permeability more difficult for male sperm. The mobility of the fallopian tubes, which are important for ovum and semen transport, is limited. The build-up of the endometrium is disrupted so that the embryo cannot implant. There is also a risk of ectopic pregnancy.

The morning-after pill

Composition: *gestagen called Levonorgestrel.

The morning-after pill is a high-dose hormone preparation used to prevent pregnancy after sexual intercourse. The morning-after pill has a two-fold effect: Before ovulation, it prevents the ovulation from occurring (ovulation-inhibiting effect); however, if the woman’s ovulation has already taken place and if the ovum was fertilized by a sperm, it prevents implantation of the embryo (implantation-inhibiting effect) and thus also serves as an abortifacient.

RU 486 (Mifepristone)

Composition: Antiprogestogen.

The pregnancy hormone progesterone is crucial to the development of a pregnancy and a baby: it prepares the uterus for the intake and maintenance of the baby, and lowers the contractility of the uterus (prevents cramps that could endanger the child). It strengthens the cervix and is the continuous signal for the maternal body to sustain the baby. Mifepristone blocks the intake of progesterone by the receptors (cells in the uterus) so that the hormone can no longer affect the cells. The result is that the baby cannot be sustained in the uterus. The child dies of starvation and thirst and suffocates painfully over the course of several days. Since mifepristone promotes uterine cramps and opens and softens the cervix, in addition to killing the baby, discharge can also take place.

Coil and the “morning-after coil”

There are two versions of the coil: one works with the permanent release of hormones, the other exclusively in a mechanical way.

The hormone coil (e.g. Mirena)

Composition: made of plastic with a hormone deposit, which delivers a small dose of Levonorgestrel regularly for up to five years.

The hormone coil prevents the build-up of the endometrium. The mobility of the sperm cells is obstructed, *cervical mucus thickens and the embryo is prevented from implanting and it dies.

The mechanical coil

The mechanical copper coil can be used up to five years. It triggers continuous stimulation in the uterus, thereby preventing implantation of the fertilized egg. Up to five days after sexual intercourse, it is possible to prevent implantation of the embryo with the help of the coil.

Curettage

Curettage is used up to the 12th week of pregnancy. The embryo is dismembered in the uterus with a surgical instrument and then scraped out together with the remaining tissue using a spoon-shaped instrument (curette). The cervix must be dilated beforehand.

Suction curettage

A cannula is introduced into the *cervix, and under high vacuum pressure the baby is dismembered and sucked out. Should pieces be missing when the baby and tissue are reassembled, another curettage must be performed. The vacuum method offers the possibility of reusing the embryos. Depending on the size of the embryo, larger cannulae can be used so that the baby’s head can pass through.

Manual vacuum aspirator

Used since 1927. Unlike the suction curettage, the vacuum occurs without electricity, manually, through the creation of mechanical vacuum pressure. Since no anaesthesia is used, the device is used particularly in the developing world. The embryo is removed practically intact - still living - and some are reused immediately.

Dilatation and evacuation

An abortion method after the 12th week. First the cervix is expanded and softened with e.g. mifepristone or misoprostol, after which electric vacuum aspiration occurs with cannulae up to 16 mm in diameter with the aid of forceps.

With the widespread surgical abortion method of aspiration the unborn child is dismembered and vacuumed out. The aspiration method is used up to approximately the 14th week of pregnancy.

Abortions after the 14th week

After the 14th week of pregnancy an abortion is usually accomplished with *prostaglandins. *Prostaglandins are administered first as a means to induce labour. The child is born after a few hours either dead, killed beforehand, or if it survives the abortion, is taken into an adjoining room until it dies.

The latter case is a criminal offence according to Swiss Criminal Code Article 128 (Failure to offer aid in an emergency): «Any person who fails to offer aid to another whom he has injured or to another who is in immediate life-threatening danger, in circumstances where the person either could reasonably have been expected to offer aid, any person who prevents or hinders others from offering aid, is liable to a custodial sentence not exceeding three years or to a monetary penalty.»

Abortions after the 20th week

  1. In order to prevent children from being born alive through induced labour, they are often killed beforehand. For this, either potassium chloride is injected directly into the baby’s heart, or chemical materials like ethacridine lactate, a disinfectant called Rivanol, are injected into the amniotic sac to corrode the baby. It is born with a yellow discoloration like a lemon.
  2. *Prostaglandins are administered first as a means to induce labour. The child is born after a few hours either dead, killed beforehand, or if it survives the abortion, it is wrapped in a blanket and taken into an adjoining room until it dies.
  3. With the histerotomy abortion, the uterus is opened via the mother’s abdomen, the child is killed first (mostly with abortion forceps) and then removed.
  4. With the partial birth abortion the child is born up to the head, then a hole is made in its head with scissors in order to draw out the brain. Afterwards the birth is concluded. The killing of the baby after the birth can take place also via decapitation (separation of the head with Siebold scissors) or via perforation (penetration of the top of the skull).

 

Word explanations

*Oestrogens are female sexual hormones. Oestrogens play an important role particularly in the first half of the female cycle. Oestrogens are responsible for ovulation; they prepare the uterus for a possible pregnancy.

*Gestagens are female sexual hormones. Gestagens inhibit ovulation and increase the viscosity (measure for the stickiness) of the *cervical mucus. They are the dominating hormone during the second half of the female cycle. They prepare the uterus for a possible pregnancy.

*Progesterones are natural gestagens.

*Cervix: neck of the uterus

*Endometrium: uterine lining

*Prostaglandins are tissue hormones that occur in almost all organs. These affect some processes in the body, such as the widening of blood vessels, pain or inflammation. They affect the musculature of the uterus and cervix. Prostaglandins are responsible for the painful contractions of the uterus in the first hours of menstruation.