Abortion Controversy From Time to Time

Carrying a child is an exciting experience for Didi Nurida, a manager of a beauty center in Surabaya. Her eyes gleamed when talking about it. Didi was pregnant several times, but she only bore child once. "I gave birth to a child in 1985," she said. "After the birth, I went to a traditional birth attendant and asked for a walik dadah (abdominal massage). My stomach was massaged to prevent pregnancy."

The birth attendant massaged Didi's stomach from above her chest to her lower abdomen for the purpose of blocking the ovum. If intercourse occurs, the sperm would be less likely to fertilize the egg. The result was effective: she never got pregnant anymore. But one day, Didi missed the feeling of being pregnant, and she eventually ended her contraception in 1997 by returning to the birth attendant. She got pregnant that same year.

Her pregnancy made her elated although the monetary crisis suddenly hit. However, after only six weeks, her stomach suddenly hurt and she began bleeding. The diagnosis later on revealed a myoma in her uterine wall, leaving her a difficult choice: she had to get an abortion or her life would be at risk. Didi chose to keep her pregnancy, whatever the risk. The fetus eventually died on its own, while Didi luckily survived.

"I was sad. I tried to get pregnant again. Even though I miscarried again, I was always happy when I got pregnant, and I hope to have another child," she said. She didn't understand that one of her good friends had an abortion just because she didn't want to have children. She was even more surprised when she learned that her neighbor in Surabaya worked for the late doctor Edward, who practiced illegal abortions from 1980-2010 and was sentenced to three years in prison. 

"For some people, abortion is nothing, but for me, it's horrible," Didi said.

Abortion not only kills the fetus, but also endangers the mother's life, especially abortions that are performed haphazardly. According to data from the World Health Organization (WHO), quoted by the Guttmacher Institute on its website, in 2008 the number of deaths due to indiscriminate abortion reached 43,000.

This figure is down compared to the previous period which reached 56,000 women. The cause of the reduction was the development of medical technology and the issuance of policies in some countries legalizing abortion. At the same time, many people considered legal medical abortion to be much safer. However, it doesn't stop the centuries-long controversy over abortion, including its technical to ethical-philosophical matters.

The Abortion Potion

Abortion was talked about in various manuscripts, with the oldest one coming from China. "The earliest medical manuscript extant, a Chinese herbal five thousand years old, recommends mercury (shu yin) as an abortifacient," wrote Alan F. Guttmacher in Pregnancy, Birth, and Family Planning. However, there is no clear record of how the physicians obtained and used the mercury powder to perform abortion.

The medical manuscripts Meteria Medica of Shen Nong, China's most famous emperor and physician, contain more details about the practice of abortion. He mentions Trichosanthes Kirilowii as an abortifacient. "The plant is native to southern China and was recorded in Shen Nong's Medical Catalog Meteria Medica in 500 BC," writes Andy Miles in "Tian Hua Fen, An Integrative View". 

According to Shen Nong, quoted by Miles, the plant can stimulate menstruation, expulsion of the placenta, and facilitate the practice of deliberate premature abortion. To practice abortion, people must first concoct the plant, then brew and drink it.

Meanwhile, in other parts of the world such as in Ancient Greece, abortion was practiced in a similar way but with different plants. Several Greek medical experts classified abortion-inducing plants such as pennyroyal, artemisia, rue, and silphium which only grow in Greece.

Hippocrates (460–380 BCE), a renowned Greek physician, in On the Nature of the Woman stated that the plants are effective as abortifacients, which can be used by drinking or inserting it into the female genitalia. However, Hippocrates didn't approve of the abortion method because it was dangerous. The toxic content of the potion could not only kill the fetus, but also the mother.

Bound by his oath, Hippocrates refused to do it. "I will not administer lethal drugs, even if asked, nor will I give such advice. In the same way, I would not give a woman drugs that could lead to abortion."

So he suggested another way. "In addition, one author (Hippocrates) describes openly the treatment which he once administered to a prostitute owned by one of his relatives. The girl was worried that she was pregnant. The doctor (Hippocrates) told her to jump up and down, touching her bottom with her heels at every leap. She followed his instructions, and at the seventh leap the 'seed' fell out onto the ground," Sue Blundell wrote in Woman in Ancient Greece.

The efficacy of these methods depended on the age of the pregnancy. If the pregnancy was under four months, there was a greater chance of successful termination. According to John Riddle in Eve's Herb, there are times when herb methods make babies deformed for reasons such as being more than five months pregnant and measuring the ingredients incorrectly.

Inside the Womb

Abortion was a common practice in Greece as Greeks didn't view abortion as murder or a heinous act, regardless of the method. "There was no law against abortion and the State only intervened when it was a question of protecting the rights of the woman's master, whether she was free or slave," Nikolaos A. Vrissimtzis wrote in Love, Sex and Marriage in Ancient Greece.

Some philosophers tended to be tolerant of the practice of abortion. Plato (427-347 BCE) argued that a fetus cannot yet be considered a human being, so aborting a fetus cannot be considered a criminal act.

He also advised women who became pregnant through incest to abort because the state only accepted babies who were legitimate according to the law. "The child of incest isn't good for the state, so it must be aborted," wrote C.B. Kusmaryanto in Kontroversi Aborsi, quoting Plato.

Although only few in number, there was a circle of opponents to the practice of abortion in Greece consisting of the followers of philosopher Phytagoras (582–496 BCE). "According to the Pythagoreans, the embryo was an animate being from the moment of conception. Consequently, for the Pythagoreans abortion whenever practiced, meant destruction of a living being," wrote Kourkouta Lambrini in "Views of Ancient People on Abortion", published in Health Science Journal, Vol. 7, 2013.

Another philosopher, Aristotle (384-322 BCE), rejected this view. He assumed life doesn't begin when fertilization occurs. He named the result of fertilization as zygote, and this stage is called the vegetative stage. The zygote then divides and develops to animalia or animal stage. The zygote then turns into an embryo, followed by the last stage: the entry of the soul into the embryo. The embryo, now called a fetus, begins to move. "Formation of males, marked by the first movement, was said to be completed by around forty days, and that of females by around ninety days," Zubin Mistry wrote, quoting Aristotle, in Alienated From the Womb.

Based on this assumption, Aristotle stated that abortion must be practiced before the fetus develops sensation and life. He considered such abortions as birth control, which comes in line with his concept of an ideal city. "If conception occurs in excess of the limit so fixed, . . . have abortion induced before sense and life have begun in the embryo," John Riddle wrote in Contraception and Abortion from the Ancient World to the Renaissance quoting the philosopher. 

Aristotle's theory about the stages of fetal development persisted for hundreds of years. The theories were followed by many medical experts and used as an ethical-philosophical basis for abortion practice in many places. During that time, people practiced abortion in many ways. Some methods are passed down from the ancient Greeks, while some others are developed by physicians.

Theodorus Priscianus, a physician at Constantinople during the fourth century, noted that abortion could be performed with a bath. "A warm bath mixed with a sponge appears to be a practice to smooth the uterus and relax the woman. As a result, the fetus is easily expelled," wrote M.J. Elsakkers in Reading Between the Lines. The practice is somewhat similar to the process of facilitating birth, but if a woman does this before the fetus can live outside the womb or after five months, the practice can be called abortion.

In Rome, physicians introduced a painful way of abortion: embryotomy or abdominal surgery. This method originated from the surgical techniques of Claudius Galen, a Greek medical expert. "By mechanical abortive agents it is meant sharp-edged instruments and shafts introduced into the pregnant uterus," Plinio Prioreschi wrote in “Contraception and Abortion in the Greco-Roman World” published in Vesalius Vol. I No. 2 of 1995. After the stomach is split, the fetus can be removed. This practice was common during the Middle Ages (5th-15th century).

Embryotomy marked male intervention in the practice of abortion. Previously, women had complete control over the practice of abortion, while men only had the role of advising. "Abortion is about women; it's done by women for women. And medieval writers were very conscious of this," Elsakker wrote. 

In Asia, people weren't yet familiar with body surgery techniques, at least until the massive European arrival in the region in the 14th century. To terminate a pregnancy, women could ask a traditional birth attendant to massage their abdomen. 

This practice is depicted in reliefs at Cambodia's temple complex Angkor Wat, which was built in the 12th century. "The carvings of massage abortion appear in the thirty-second hell. Women are piled up like cord wood, naked with bound hands, and each is about 20 weeks pregnant. The male figures in the reliefs are pounding the abdomen of a pregnant woman with a pestle," Malcolm Potts et al. wrote in “Thousand-year-old Depictions of Massage Abortion”, published in The Journal of Family Planning and Reproductive Health Care.

Apart from Cambodia, people in the Malay Archipelago and the Philippines were also familiar with massage for abortion, even when the Europeans began to set foot in these regions. Women usually combined massage with plant-based concoctions. "Ethnographers in many parts of the region have established that contraceptive herbs and massage to induce abortion were part of female lore," Anthony Reid wrote in Southeast Asia in the Age of Commerce 1450-1680.

As for the practice of abortion, the locals considered it a common occurrence. "In the Malay epic Sejarah Melayu (1612: 166) abortion is described as a normal occurrence," Anthony Reid wrote. 

Modern Abortion

As the Europeans gained more power in Southeast Asia regions in the 19th century, a change in the way embryos were viewed took place in Europe. Aristotle's theory about the fetus was criticized. Ferdinand Kember, a physician, doubted that the fetal stage of life began on the 40th day after conception.

Kember argued that quickening isn't the starting point of the baby's development. Through modern research on fetuses, Kember concluded that the important process begins at conception. "This discovery implied that ensoulment takes place at conception," wrote Jeffrey H. Reiman in Abortion and the Ways We Value Human Life. Thus, the practice of abortion can be considered the killing of a human being. This discovery made opponents of abortion have the wind at their backs. In several countries, they demanded that the government prohibit the practice of abortion by law.

Some countries started to formulate regulations regarding abortion, while bans were imposed in several federal states in the United States. Newspapers could no longer advertise the practice of abortion freely. On the other hand, some allowed it under specific conditions, for example therapeutic abortions that can save the mother's life, as long as it was done medically.

At that time, medical technology was developing rapidly, enabling the practice of abortion to be safer and faster, such as by consuming abortion pills that can be obtained freely at pharmacies.

However, in the 20th century, the pro-abortion movement gained strength again mainly because of the rise of feminism in several Western countries. These activists argued that abortion isn't about when life begins, but about a woman's right to make choices.

In Indonesia, abortion laws have existed since 1918. "This law made abortion for the sole purpose of terminating a pregnancy a crime," wrote Gayung Kasuma in “Perilaku Aborsi di Jawa Masa Kolonial”, published in Kota-Kota di Jawa. The colonial government passed this law because it saw abortion practices that endangered women's lives, such as traditional massage.

This law lasted until independence. The government banned all abortion practices. Even so, traditional birth attendants and doctors opened the practice behind closed doors. Once exposed, there would be a big uproar over it, such as the case of doctor C.L. Blume in Jakarta in the 1960s. He was charged with practicing abortion for seven years. Blume’s abortion technique followed that of Western countries: injecting the patient with pantopan containing morphine. "The goal is to make the womb suffocate," Kompas wrote on August 16, 1969. The whole abortion process only took around 20 minutes.

Debates regarding abortion are still going on in many countries even until today. Abortion techniques have been developed expeditiously, although the way women view their pregnancies is never the same. Some enjoy it, while others don't want it at all.

‍

For more information about Abortion and Postabortion Care in Java,

Indonesia:https://www.guttmacher.org/fact-sheet/induced-abortion-indonesia