Wednesday, August 08, 2012

1975: Antiquated, Needlessly Risky Abortion Kills California Woman

On August 6, 1975, 29-year-old Cheryl Tubbs underwent a saline abortion at Pacific Glen Hospital in Los Angeles County. She experienced heavy vaginal bleeding after this safe, legal abortion, so she was transferred to White Hospital on the evening of August 7.

Cheryl continued to bleed profusely, and twice went into cardiac arrest. Staff performed a paracentesis on her to remove blood and fluids from her abdomen. About an hour after midnight, staff could no longer detect any blood pressure. For an hour they tried heart massage, to no avail. Cheryl was pronounced dead at 2:30AM on August 8.

An autopsy revealed that Cheryl's uterus had ruptured during the abortion, spilling blood and uterine material into her abdomen. She had bled to death.

Two years later, Jackie Bailey also bled to death from a ruptured uterus caused by a saline abortion at Pacific Glen.

Saline abortion was hardly a pleasant experience. The abortionist would remove as much amniotic fluid as he could using a needle and syringe. He would then replace the amniotic fluid with a concentrated saline (salt) solution that would poison and kill the fetus. The woman would then go into labor and expel the fetus.

Saline abortions became very popular in Japan following WWII. Within the Japanese medical community, however, word quickly spread: this method was unsatisfactory. Too many women were being injured and killed. Over 70 papers were published in the Japanese medical community reporting hazards of saline abortions, including at least 60 maternal deaths. The Japanese Obstetrical and Gynecological Society condemned the technique, and it was quickly abandoned. But the Japanese abortionists kept news of the trouble among themselves -- until Western nations discovered instillation abortions and embraced them with great enthusiasm.

Two Japanese doctors, Takashi Wagatsuma and Yukio Manabe, broke the silence. Wagatsuma wrote, "It is, I think, worthwhile to report its rather distasterous consequences which we experienced in Japan." Manabe wrote, "It is now known that any solution placed within the uterus can be absorbed rather rapidly into the general circulation through the vascular system of the uterus and placenta. Thus any solution used in the uterus for abortion must be absolutely safe even if given by direct intravenous injection. ... A solution deadly to the fetus may be equally toxic and dangerous to the mother. ... In spite of the accumulating undesirable reports, the use of hypertonic saline for abortion is still advocated and used ... in the United States and Great Britain. I would like to call attention to the danger of the method and would perdict the further occurrence of deaths until this method is entirely forgotten in these countries."

 As western abortionists gained experience with saline abortions, other grim reports arose. A British study published in 1966 found that the saline would enter the mother's bloodstream and cause brain damage. Swedish researchers noticed an unacceptably high rate of complications and deaths. Sweden and the Soviet Union abandoned saline abortion as too dangerous for women in the late 1960s.

For whatever reasons, American abortionists were deaf to these warnings. When New York had completely repealed its abortion law, doctors had tremendous leeway in abortion practice. In New York City in particular, it became popular to inject the woman with the saline in the office, then send her home with instructions to report to a hospital when she went into labor. This was, to say the least, a highly irresponsible way to use an abortion technique that was risky even when performed in a hospital under close medical supervision. Women started dying from these reckless saline abortions.

Women were also already dying in California as well, even though the law there still required abortions to be done in hospitals.

After Roe v Wade was handed down, saline and other instillation abortions spread to other areas of the country, despite the dismal goings-on in New York and California, and of course more women died.

US abortionists showed no alarm over these deaths. Even as late as the 1990's, the American College of Obstetricians and Gynecologists, and abortionists such as Don Sloan and Warren Hern, were describing saline and other instillation abortions in such terms as "a low-risk procedure."

Stastics show, however, that abortionists did gradually move away from saline instillation abortions, albeit more slowly in New York City than in the rest of the country.

Since the problem of maternal deaths from instillation abortions had been long documented, this factor probably only had a minor impact on the move away from saline and other instillation abortions. One important factor was financial: although suction and D&C were adequate procedures for first-trimester abortions, they were inadequate for killing and removing the larger second-trimester fetuses. But the uterus was not large enough to perform instillation abortions until 16 weeks. This left a 4-week "grey period" during which women could change their minds about aborting.

There was also the problem of starting a suction or D&C abortion only to discover that the pregnancy was already in the second trimester. Necessity is the mother of invention, and abortionists who found themselves dealing with second-trimester fetuses that had already been damaged had to come up with ways to remove these fetuses quickly and without alarming the patient. Thus evolved the Dilation and Evacuation (D&E) procedure that remained popular for mid-trimester abortions for over a decade.

D&E was cheaper than instillation abortions, which required at least an overnight hospital stay. It also had the advantage of producing fewer live births, the "dreaded complication" no abortionist wanted to face.

In spite of all the problems, abortionists still performed 366 instillation abortions in the US in 2010, the most recent year for which numbers are available

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