Saline Abortion

Saline Abortionsaline, abortionSaline Abortions: Past, Present, Future
In 1934, Rumanian abortionist Eugen Abruel first got the idea of taking out amniotic fluid and replacing it with something to kill the fetus and/or induce premature labor. Although different substances were tried, with varying success and varying complications, hypertonic saline (a strong salt solution) became the most popular. Abortions that involve taking out amniotic fluid and replacing it with something else are called “instillation abortions” or “amniotic fluid replacement abortions,” or are named after the substance injected. I use the terms “saline abortion” and “saline instillation” interchangeably.
The saline causes abortion by two mechanisms:

  • Killing the fetus
  • Irritating the uterus

Saline abortion is 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.

**The Saline Abortion Experience**
First-person accounts.
Carhart in Review
An overview of the history of late abortion techniques.
**Abortion Techniques**
Other ways abortions are done.
**Abortion History**
More on the history of abortion practice.

Instillation abortions spread into nations where abortion was legal, and saline quickly became the favored abortifacient, although other substances, including glucose, were tried. Glucose was quickly abandoned because it fed infection rather than killing 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.
Mark Crutcher, Lime 5, p. 126
Manabe, “Artificial Abortion at Midpregnancy by Mechanical Stimulation of the Uterus,” Am. Journ. Ob Gyn 9/1/68
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.”

Wagatsuma, “Intraamniotic Injection of Saline for Therapeutic Abortion,” Am. Journ. Ob Gyn 11/1/65

Manabe, “Danger of Hypertonic Saline Induced Abortion,” JAMA 12/15/69
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.

Mark Crutcher, Lime 5, p. 127

Cameron, “Association of Brain Damage with Therapeutic Abortion Induced by Amniotic Fluid Replacement: Report of Two Cases,” British Medical Journal, 4/23/66

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 saline abortions.
New York Saline Abortion Deaths, 1970-1972external image from_about.gif
Women were also already dying in California as well, even though the law there still required abortions to be done in hospitals:
California Saline Abortion Deaths, 1972external image from_about.gif
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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:
Instillation Abortion Deaths After Roeexternal image from_about.gif
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:

Year

Saline Abortions

Reporting States

NY City

#

%
#

%
1974
42,669
7.7%
14,221
11.8%
1976
39,093
5.1%
8,339
8.2%
1978
21,805
2.8%
8,440
8.0%
1980
22,682
2.2%
7,579
7.4%
1982
20,732
2.0%
7,358
7.0%
1984
11,860
1.5%
3,681
3.8%
1986
8,938
1.1%
2,470
2.5%
1988
6,318
0.7%
1,345
1.5%
1990
2,825
0.3%
1,058
1.0%
1992
2,513
0.3%
917
0.8%
1994
2,161
0.3%
760
0.7%
1996
1,164
0.2%
617
0.6%

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 pregancy 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:
Dreaded Complications
While instillation abortions were still the most common method of mid-trimester abortion, roughly 500 live births were reported to the Centers for Disease Control every year by abortionists. The CDC’s Willard Cates thought that this number probably came nowhere near the true number of live births, because there is no penalty for failing to report these births to the CDC. “It’s like turning yourself in to the IRS for an audit,” Cates said.
So, addressing the multiple problems of live births, lost sales during the “grey zone,” and miscalculating gestational age, the abortion industry gradually phased out saline and other instillation abortions, replacing them with D&E dismemberment abortion.
The few persisting saline abortions raise interesting questions. Why are these physicians, who are conscientious enough to report the abortions they do, still using an outdated and highly risky technique? Are there still a large number of saline abortions being performed by fringe abortionists who aren’t reporting to the CDC? And will the “greying” of the abortionist pool eliminate saline abortions entirely over the next decade?
For the sake of the women, one would certainly hope so.


Instillation Abortion Deaths

This list of women known to have died from instillation abortions is by no means a complete accounting of instillation abortion deaths in the United States. I included only those deaths in which I could verify the abortion technique.

Jacqueline Bailey Jackie hemorrhaged after an incomplete saline abortion in Los Angeles County.

September 21, 1995: Linda Boom Linda died of salt poisoning after an abortion in Wisconsin.

Marla Cardamone Marla didn’t want an abortion, but relented under pressure from a social worker.

Twila Coulter On November 13, 1972, 21-year-old Twila traveled from her home in Colorado to California for a saline abortion. She developed clotting problems and died of cerebral hemorrhage.

Angel Dardie Angel’s mother sued after her daughter died of a saline abortion. The court settlement gave her less than $5000 to raise Angel’s two children.

Cristella Forte Cristella, age 16, screamed, convulsed, and went into cardiac arrest 27 hours after instillation of saline for an abortion. at New Centre Hospital on January 14, 1986.

Lynn McNair Lynn was 23 weeks pregnant when she was injected with saline by Dr. Edward Rubin at Jewish Memorial Hospital.

Natalie Meyers Sixteen-year-old Natalie was brought to San Vicente Hospital in Los Angeles by her mother on October 21, 1972.

Shelby Moran Shelby, a 39-year-old mother of five, was given Prostaglandin F2 Alpha for an abortion at Illinois Masonic Medical Center in January of 1978.

Katherine Morse After California legalized abortion-on-demand in 1970, a Texas company began selling referrals and air fare. One customer was 20-year-old Katherine Morse.

“Alice” Roe Alice was 31 years old when she underwent a 14-week saline abortion in New York City in 1970.

“Eleanor” Roe Eleanor was 20 years old and 19 weeks pregnant when she underwent her fatal abortion in 1973.

“Erica” Roe Erica was 20 years old and 22 weeks pregnant when she sought an abortion in 1974.

“Malorie” Roe This 35-year-old woman was 20 weeks pregnant when she underwent a saline abortion in 1974.

“Melissa” Roe Melissa was 27 years old and five months pregnant when she checked into Lutheran Medical Center of Brooklin on May 1, 1992.

“Nancy” Roe Nancy was 16 years old, and 16 weeks pregnant, when she underwent the saline abortion that ended her life.

“Sherri” Roe Sherri was 20 years old and late in the second trimester of her pregnancy when she underwent an abortion in 1975.

“Wendy” Roe Wendy was 23 years old and 16 weeks pregnant when she sought an abortion in 1972.

Elizabeth Tsuji According to an LA County Death Certificate, Elizabeth died after a saline abortion performed by a Dr. Jurewitz.

Cheryl Tubbs Cheryl died after a saline abortion in Los Angeles County.

“Patient 1” This 31-year-old woman had pancreatitis and pontine myelinolysis and underwent an abortion by prostaglandin instillation. Due to her poor health, she might have died even had she not undergone the abortion.”Abortion Deaths Associated with the use of Prostaglandin,” Am Journ Obstet Gynecol 2/1/77

“Patient 2” This 19-year-old woman had heart problems, and her doctor chose prostaglandin rather than saline because he thought it would cause less strain to her heart. She died of an apparent amniotic fluid embolism.”Abortion Deaths Associated with the use of Prostaglandin,” Am Journ Obstet Gynecol 2/1/77

“Patient 3” This 38-year-old woman was referred for a prostglandin instillation abortion at 24 weeks due to hypertension and pre-eclampsia. She died of intracranial hemorrhage.”Abortion Deaths Associated with the use of Prostaglandin,” Am Journ Obstet Gynecol 2/1/77

“Patient 4” This healthy 16-year-old girl underwent a prostaglandin instillation abortion at 18 weeks. She was given narcotics for the pain, and her death seemed to be due to a reaction to the anesthetic.”Abortion Deaths Associated with the use of Prostaglandin,” Am Journ Obstet Gynecol 2/1/77

“Patient 5” This healthy 33-year-old underwent an oxytocin abortion, augmented with saline and prostaglandin, at 24 weeks gestation. She developed overwhelming infection and coagulation defects as well as damage to her kidenys.”Abortion Deaths Associated with the use of Prostaglandin,” Am Journ Obstet Gynecol 2/1/77

“Case 1” A 35-year-old mother of six had prostaglandin instillation in a doctor’s office, which was this doctor’s routine practice. About five minutes later, she collapsed and lapsed into a coma from which she never recovered. She died five months later.”Sudden Collapse and Death of Women Obtaining Abortions Induced with Prostaglandin,” Am Journ Obstet Gynecol 2/15/79

“Case 2” A 26-year old woman had an instillation of prostaglandin at a teaching hospital. She seemed to tolerate the prostaglandin well, and was given a second instillation five minutes later. Shortly thereafter she developed chest and head pain and difficulty breathing. Five minutes later she had a siezure and her heart stopped. She was resuscitated and transferred to an ICU, where she eventually passed the fetus but remained in poor condition. She died a month after the abortion was initiated.”Sudden Collapse and Death of Women Obtaining Abortions Induced with Prostaglandin,” Am Journ Obstet Gynecol 2/15/79