The causes of an immediately or secondarily fatal result of labor at the full period are few; in abortion nearly every one of these is present, with the addition of others peculiar to the sudden and untimely interruption of a natural process, and the death of the product of conception. There is the same or greater physical shock, the same or greater liability to hemorrhage, the same and much greater liability to subsequent uterine or ovarian disease. To these elements we must add another, and by no means an unimportant one; a degree of mental disturbance, often profound, from disappointment or fear, that to the same extent may be said rarely to exist in labors at the full period.[12]
Viewing this subject in a medical light, we find that death, however frequent, is by no means the most common or the worst result of the attempts at criminal abortion. This statement applies not to the mother alone, but, in a degree, to the child.
We shall perceive that many of the measures resorted to are by no means certain of success, often indeed decidedly inefficacious in causing the immediate expulsion of the fœtus from the womb; though almost always producing more or less severe local or general injury to the mother, and often, directly or by sympathy, to the child.
The membranes or placenta may be but partially detached, and the ovum may be retained. This does not necessarily occasion degeneration, as into a mole, or hydatids, or entire arrest of development. The latter may be partial, as under many forms, from some cause or another, does constantly occur; if from an unsuccessful attempt at abortion, would this be confessed, or indeed always suggest itself to the mother's own mind? Fractures of the fœtal limbs, prior to birth, are often reported, unattributable in any way to the funis, which may amputate, indeed, but seldom break a limb. A fall or a blow is recollected; perhaps it was accidental, perhaps not, for resort to these for criminal purposes is very common. In precisely the same manner may injury be occasioned to the nervous system of the fœtus, as in a hydrocephalic case long under the writer's own observation, where the cause and effect were plainly evident. Intrauterine convulsions have been reported; as induced by external violence they are probably not uncommon, and the disease thus begun may eventuate in epilepsy, paralysis, or idiocy.
To the mother there may happen correspondingly frequent and serious results. Not alone death, immediate or subsequent, may occur from metritis, hemorrhage, peritonitic, or phlebitic inflammation, from almost every cause possibly attending not merely labor at the full period, comparatively safe, but miscarriage increased and multiplied by ignorance, by wounds, and violence; but if life still remain, it is too often rendered worse than death.