essay about the unborn child

Stress and Pregnancy: How It Affects an Unborn Child's Brain

Avoiding the harmful effects of stress will make a big difference..

Posted April 28, 2022 | Reviewed by Vanessa Lancaster

• What Is Stress?
• Find a therapist to overcome stress
• Psychological stress during pregnancy produces lasting undesirable changes in both mothers and their children.
• High cortisol concentrations will lead to cell migrations to wrong destinations for the developing baby, resulting in abnormal neural circuits.
• Consequently, as the child grows older, they may suffer a decreased capacity to learn and remember.

All parents want to have healthy and happy children. When pregnant, they will make every effort to eat well, take the proper supplements, and avoid recreational drugs, alcohol , and cigarettes.

Few of them are unaware of the destructive power on their unborn children of parental stress.

While most people understand what the word stress means, the concept is quite difficult to define.

For our purposes, stress denotes both the internal and external demands that we face to accommodate change. Stress becomes negative when adaptation or coping mechanisms fail. However, stress is very subjective. For me, what may be horrifying to even contemplate may be savored by another, like bungee jumping.

Stress Hormones One group of stress hormones is called catecholamines, and they consist of adrenaline and nor-adrenaline. These are manufactured in the adrenal gland's inner core (the medulla), a small gland that sits on top of the kidneys. So, when a person feels stressed , the fight or flight response is initiated, and the adrenal gland injects adrenaline and noradrenaline into the circulation.

This system is part of the autonomic nervous system (the other part is the parasympathetic system) and is referred to as the sympathetic nervous system. It increases heart rate, blood pressure, and blood sugar production. Also, because the body is being readied for fight or flight, blood is diverted from the internal organs such as the stomach and the intestines to the large muscles of the legs (so you can run better) and the arms (obvious).

Stress During Pregnancy As an internal organ, the uterus suffers the same fate as the gastrointestinal tract, having its normal blood supply diminished. What that means for a pregnant woman is that her baby will receive less blood and, therefore, less oxygen and nutrients at times of stress. If this state persists, the consequences can be dire.

It should be added that stimulation of the sympathetic system is accompanied by inhibition of the parasympathetic system. The latter promotes rest, sleep, and digestion. Its inhibition leads to wakefulness and malabsorption of food. As you can see, the fight or flight response is well suited for a person being chased by a lion but not so great for a pregnant mother’s unborn child. There is another aspect to the body’s reaction to a perceived threat. And that occurs by way of what is called the HPA Axis.

This system works beautifully under normal conditions. It is designed , for lack of a better term, to preserve homeostasis (equilibrium) or restore homeostasis as quickly as possible at times of stress. It is a feedback loop apparatus similar to the heating systems of most apartments or houses where a thermostat is set at a certain temperature.

When the temperature in the room falls below the set temperature, the thermostat will signal to the furnace, and the furnace will heat up. After a while, the house heats up sufficiently for the thermostat to tell the furnace to shut down. Everything stops until the room cools, and then the whole process starts again.

Similarly, with the body. If a pregnant woman runs to catch a streetcar, she will experience stress, but her system will quickly return to normal after she reaches the streetcar and sits down. No harm was done.

On the other hand, if this pregnant woman experiences acute stress such as the death of a loved one or loss of a job, or is a single mother worried about how she will support the child she is carrying, her amygdala, in response to these ruminations will override signals from the hippocampus (“Hey! Stop that! There is enough cortisone in the blood already!”), and stoke the fires in the adrenals, so they keep making more cortisone, adrenaline, and noradrenaline. In either case, her body is flooded with stress hormones.

Thus, we have two possibilities: Short-lived major flooding of the mother’s and consequently her baby’s body with stress hormones or a higher-than-normal concentration of stress hormones over a protracted period. In either case, high levels of stress hormones are detrimental to the health of the mother and her unborn child.

Stress and the Developing Brain Research has shown that abnormally high and prolonged cortisone concentrations have many harmful effects on the developing baby. In this discussion, we explore how they affect the construction of their brain.

The brain develops from the early embryo's outward-most layer, the ectoderm. The neural cells travel from the neural tube to form the six layers of the cerebral cortex. Each layer has its distinct pattern of organization and connections.

Each cell is genetically programmed to journey to a particular location in the brain. This means that under normal conditions, a neuron which, for illustration purposes, we shall call A ends up at point X and there connects with neuron B.

Great. But what if there are large concentrations of cortisone, nicotine, or other neurotoxic substance in the brain?

High cortisol concentrations in the brain will lead to cell migrations to the wrong destinations, resulting in abnormal neural circuits. If this state is prolonged (chronic stress), a large concentration of stress hormones will create massive destruction of neurons, synapses, and dendrites (each neuron receives messages from other neurons by way of up to 15,000 fine hair-like branches called dendrites).

When this process occurs in the hypothalamic and reticular activating systems, it will interfere with the child’s internal states, such as sleep and digestion. When widespread cell destruction happens in the amygdala and hippocampus, it will interfere with information entering the brain freely.

Excessive and sustained stress also leads to a marked decrease of neurons in the prefrontal cortex resulting in an increased dominance of lower brain centers over higher centers. Stress also decreases the production of oxytocin , the so-called love hormone, and increases the production of vasopressin, a hormone that supports aggressive behaviour.

The sustained secretion and circulation of glucocorticoids such as cortisol eventually leads to a depletion of dopamine , which decreases activity in the brain's pleasure pathways; reduction of norepinephrine, resulting in a lack of motivation and alertness; and a lowering of serotonin, reducing feelings of happiness and well-being.

Due to a confluence of all these factors, this child will have a very strong propensity to develop a personality disorder .

Summary Unfortunately, stress during pregnancy may handicap a child from before they are even born. For this reason, assuring a stress-free pregnancy for all women should be a priority of all government public health programs.

Azmitia, E. C. (2007). Serotonin and brain: Evolution, neuroplasticity, and homeostasis. International Review of Neurobiology, 77, 31-56.

Dadds, Mark R.; Moul, Caroline; Dobson-Stone, Carol et al. (2014). Polymorphisms in the oxytocin receptor gene are associated with the development of psychopathy. Development and Psychopathy, Volume 26, Issue 1, pp. 21-31

DeMause, Lloyd (1982). Foundations of Psychohistory. Creative Roots Pub. New York, NY.

Marsh, Abigail A.; Blair R. J.R et al. (2008). Reduced Amygdala Response to Fearful Expressions in Children and Adolescents with Callous-Unemotional Traits and Disruptive Behavior Disorders. Am J Psychiatry, 165:712-720.

Maya Opendak, Elizabeth Gould. Adult neurogenesis: a substrate for experience-dependent change. Trends in Cognitive Sciences, 2015; DOI: 10.1016/j.tics.2015.01.001

McEwen, Bruce (2000). Allostasis and allostatic load: Implications for neuro-psychopharmacology. Neuropsychopharmacology, 22, 108-124

Thomas R. Verny, M.D. , the author of eight books, including The Embodied Mind , has taught at Harvard University, University of Toronto, York University, and St. Mary’s University of Minnesota. His podcast, Pushing Boundaries , may be viewed on Youtube or listened to on Spotify and many other platforms.

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Respect for Unborn Human Life: The Church's Constant Teaching

Fact sheet by the usccb committee on pro-life activities.

The Catechism of the Catholic Church states: "Since the first century the Church has affirmed the moral evil of every procured abortion. This teaching has not changed and remains unchangeable. Direct abortion, that is to say, abortion willed either as an end or a means, is gravely contrary to the moral law" (No. 2271). 

In response to those who say this teaching   has   changed or is of recent origin, here are the facts:

From earliest times, Christians sharply distinguished themselves from surrounding pagan cultures by rejecting abortion and infanticide.  The earliest widely used documents of Christian teaching and practice after the New Testament in the 1st and 2nd centuries, the   Didache   (Teaching of the Twelve Apostles) and   Letter of Barnabas , condemned both practices, as did early regional and particular Church councils.   

To be sure, knowledge of human embryology was very limited until recent times.  Many Christian thinkers accepted the biological theories of their time, based on the writings of Aristotle (4th century BC) and other philosophers.  Aristotle assumed a process was needed over time to turn the matter from a woman's womb into a being that could receive a specifically human form or soul.  The active formative power for this process was thought to come entirely from the man – the existence of the human ovum (egg), like so much of basic biology, was unknown.   

However, such mistaken biological theories never changed the Church's common conviction that abortion is gravely wrong at every stage.  At the very least, early abortion was seen as attacking a being with a human destiny, being prepared by God to receive an immortal soul (cf. Jeremiah 1:5: "Before I formed you in the womb, I knew you").

In the 5th century AD this rejection of abortion at every stage was affirmed by the great bishop-theologian St. Augustine.  He knew of theories about the human soul not being present until some weeks into pregnancy.  Because he used the Greek Septuagint translation of the Old Testament, he also thought the ancient Israelites had imposed a more severe penalty for accidentally causing a miscarriage if the fetus was "fully formed" (Exodus 21: 22-23), language not found in any known Hebrew version of this passage.  But he also held that human knowledge of biology was very limited, and he wisely warned against misusing such theories to risk committing homicide.  He added that God has the power to make up all human deficiencies or lack of development in the Resurrection, so we cannot assume that the earliest aborted children will be excluded from enjoying eternal life with God.  

In the 13th century, St. Thomas Aquinas made extensive use of Aristotle's thought, including his theory that the rational human soul is not present in the first few weeks of pregnancy.  But he also rejected abortion as gravely wrong at every stage, observing that it is a sin "against nature" to reject God's gift of a new life.

During these centuries, theories derived from Aristotle and others influenced the grading of penalties for abortion in Church   law .  Some canonical penalties were more severe for a direct abortion after the stage when the human soul was thought to be present.  However, abortion at all stages continued to be seen as a grave moral evil.   

From the 13th to 19th centuries, some theologians speculated about rare and difficult cases where they thought an abortion before "formation" or "ensoulment" might be morally justified.  But these theories were discussed and then always rejected, as the Church refined and reaffirmed its understanding of abortion as an intrinsically evil act that can never be morally right.

In 1827, with the discovery of the human ovum, the mistaken biology of Aristotle was discredited. Scientists increasingly understood that the union of sperm and egg at conception produces a new living being that is distinct from both mother and father.  Modern genetics demonstrated that this individual is, at the outset, distinctively human, with the inherent and active potential to mature into a human fetus, infant, child and adult.  From 1869 onward the obsolete distinction between the "ensouled" and "unensouled" fetus was permanently removed from canon law on abortion.

Secular laws against abortion were being reformed at the same time and in the same way, based on secular medical experts' realization that "no other doctrine appears to be consonant with reason or physiology but that which admits the embryo to possess vitality from the very moment of conception" (American Medical Association,   Report on Criminal Abortion , 1871).

Thus modern science has not changed the Church's constant teaching against abortion, but has underscored how important and reasonable it is, by confirming that the life of each individual of the human species begins with the earliest embryo.

Given the   scientific   fact that a human life begins at conception, the only moral norm needed to understand the Church's opposition to abortion is the principle that   each and every human life has inherent dignity, and thus must be treated with the respect due to a human person .  This is the foundation for the Church's social doctrine, including its teachings on war, the use of capital punishment, euthanasia, health care, poverty and immigration.  Conversely, to claim that some live human beings do   not   deserve respect or should   not   be treated as "persons" (based on changeable factors such as age, condition, location, or lack of mental or physical abilities) is to deny the very idea of   inherent   human rights.  Such a claim undermines respect for the lives of many vulnerable people before and after birth.

F or more information :  Congregation for the Doctrine of the Faith,   Declaration on Procured Abortion   (1974), nos. 6-7; John R. Connery, S.J.,   Abortion: The Development of the Roman Catholic Perspective   (1977); Germain Grisez,   Abortion: The Myths, the Realities, and the Arguments   (1970), Chapter IV; U.S. Conference of Catholic Bishops,   On Embryonic Stem Cell Research   (2008); Pope John Paul II,   Evangelium Vitae   (1995), nos. 61-2.

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Letter to an Unborn Child: How Could I Bring You Into a Collapsing World?

Daniel sherrell navigates love and desperation in the time of climate change.

On April 14, 2018, a civil rights lawyer named David Buckel burned himself alive in Prospect Park. He did it alone, just before sunrise, a brief illumination on a peripheral lawn. A cyclist found his body in a circle of char, though she had to pass by several times to be sure of what she’d seen. Later, she told reporters: it was hard to make myself believe it.

The suicide was well planned, even courteous. Buckel had cleared a ring of dirt around himself to keep the flames from spreading. “I apologize to you for the mess” read a note found by the police in a shopping cart next to the scene. A longer letter had already been emailed out to the press. This was an “early death by fossil fuel,” it read. “It reflects what we are doing to ourselves.”

I spent most of that day across town in Central Park. I remember it was gorgeous outside and the lakes were all crowded with row-boats, little schools of them flitting back and forth behind the curtain of the willows. I found a perch on top of a small hill and watched the loop road swell with people. Somewhere out of sight, a stoplight was releasing them in pulses: the tourists in their carriages, the cyclists, the loping Rollerbladers. They passed quickly and suddenly, then a beat of empty road, and then the unseen light changed once more, presumably, and the next wave came streaming past. The scene reminded me of a Bruegel painting I’d first come across in a history textbook: a landscape of a village in winter, painted from atop a nearby hill. In it, you can see hunters and woodcutters going about their business, ice-skaters crisscrossing a pond, chimneys smoking in snow. According to the textbook, this painting was meant somehow to delineate the beginning of the Renaissance. As if all it took was a small vantage, the right flow of people, to funnel the whole historical watershed.

After a while, I fell asleep in the grass, and when I woke up the temperature had dropped and the picnics dissipated. The few people still out seemed in a hurry to get home. I walked back through the park toward the East Side, past the closing museums, past the expensive boutiques that mimicked the museums, single handbags underlit in glass display cases. Then down the stairs to the train, which I took back to the Bronx. It was only once I stepped into my darkened apartment that I saw the news from Prospect Park, glancing past it on my phone and then scrolling slowly back up, registering what I’d read.

What struck me even more than the tragedy—and it did strike me, a slow onset, so that I failed to make dinner that night, and eventually, at a loss for what to do once I finally tore myself from the screen, went to bed without ever having turned on the lights—was how quickly the event, this flicker of violence, was subsumed once more into the general mill of the park. Was forgotten, essentially. Beyond the cordon of police tape, the newspapers reported, the barbecues continued as normal, the corporate kickball games resumed. Participants in a charity walk strode industriously by in matching purple T-shirts, which predicted, in cursive quotes, that an end to pancreatic cancer was at hand. Wage Hope, the shirts read. The moment had rolled on, in other words. And I’m only being partially rhetorical when I ask you: What else could it have possibly done?

Afterward, I felt irrationally like I should have been able to detect some ripple when it happened, a subtle shock wave passing from his park to mine, like a bell tolled to part one hour from the next. Undoubtedly the news alerts had been piling up in my pocket, but I’d set my phone on silent and so hadn’t felt even those regular vibrations I’d grown accustomed to associating with tragedy. While the man burned—the flames carbonizing his skin, then evaporating his blood—I hadn’t felt a thing. It had been a beautiful day, and as I said, I’d spent much of it asleep.

Several days after the immolation, I took an afternoon walk with my mother. We were strolling in circles around a smaller park near my apartment, a third park, St. Mary’s, this one less manicured than the other two. The cracked paths bristled with weeds that had sprouted eagerly at that first whisper of spring and then died once again in the ensuing cold snap. They looked brittle now, almost burnt. Apropos of very little, I had told her about the suicide and how sad I was about it. Which was not, in that moment, entirely true. In fact, I was often pathologically adaptive to news about the Problem, and that morning had woken up feeling completely fine, no longer able to access the pain I’d felt just days ago, like I’d stepped out of a room and had it lock behind me. My hope was that invoking the word “sadness” would somehow resurrect the emotion for us both. That I could cast the word like a spell and have it conjure between us an instant commiseration, obviating language altogether, which often struck me as plainly inadequate to any real consideration of the Problem.

Though when this didn’t work—and it never did—I’d fall back on the usual bromides, letting them drop lamely into conversation. “I feel overwhelmed” is what I said on this particular occasion. “It’s such a tragedy, and everyone’s already forgotten.” It was true, the news cycle had moved inexorably onward, though I still had a few emails at the bottom of my inbox with subject lines like “Rest in Peace,” or, in some cases, “Fwd: Re: Rest in Peace.” My mother buried her chin into her scarf, listening. “He must have been kind of crazy,” she said, sounding apprehensive, like she wanted to hear me agree. We walked in silence for a moment, past an empty playground, a row of old oaks. In the distance some men were playing soccer, and we watched the ball arc high above their heads.

I didn’t think he was crazy, I told her finally, looking down at my feet. From what I knew his life had been normal, even honorable. He’d spent decades winning legal battles for LGBTQ rights before retiring and turning his attention to the Problem. In his last years he’d founded a large-scale composting program, sequestering more and more carbon even as he watched global emissions tick upward. Reading about his death, a part of me had understood exactly where he was coming from. I’d often thought about it myself, I admitted—staging the perfect self-sacrifice, something to drive a lightning rod through the public discourse, a suicide that would finally make the Problem personal. Of course it sounded embarrassing when I said it, messianic and delusional. And I chose not to even mention the specific and melodramatic scenarios that I had at one point or another entertained in the back of my head. Climbing to the top of a smokestack and plunging in, for instance. Or monitoring the weather for the next freak hurricane and then waiting on the beach as the rain picked up and the last bungalow renters pulled out of their driveways until finally the flood would come and wash me far inland and then back out to sea. I’d even run through some of the logistics, like how I’d need to bring bolt cutters in case the smokestack had some sort of grate on top. Or how it would help to rig a GoPro setup before the storm hit, in case the TV cameras weren’t there to capture the moment I went under.

“I can’t believe you’re telling me this,” my mother said, lifting her head from her scarf so that we both had to stand there and look at each other. The sun was beginning to set, and we could hear shouts from the field behind us. Someone had scored a goal.

“I’m not depressed,” I told her, which was true. For a 20-something who spent an above-average portion of his time thinking or trying not to think about the end of the world, I was, to my surprise and almost frustration, basically happy. “It’s just occurred to me as a strategy,” I added, as if this clarification might offer some comfort.

“Don’t you ever, ever do anything like that,” she said. “It wouldn’t do a thing except destroy the people you love.”

In the unseasonable cold, burrowed down into her coat, she looked genuinely worried, and I suddenly regretted saying anything. Because of course I knew I agreed with her. It wouldn’t do a thing; it was bad strategy. The fire in the park had proven exactly this point: even if you bowed definitively and dramatically out, the Problem would simply go on without you. I promised her I wouldn’t, and it was an easy promise, but afterward I felt a new and this time unprompted sadness. Without the possibility of appeal to that ultimate recourse, there was little left to buffer this feeling that I’d been trying to outpace for months: that maybe it didn’t matter what you did, maybe there were just no strategies left to us at all.

It was around this time that I began writing to you about the Problem. At first it was only semiconscious, a straw I would grasp at to fend off hopelessness. I’d tap my anxieties into a note in my phone, then click it shut once the thought had petered out. It always felt absurd, trying to confide in you, something I would’ve been embarrassed to admit to anyone. But it also brought a strange kind of solace: As if I were fortifying the possibility that you might one day exist. As if, in addressing you, I could make you more and more real.

This was after college, in the years I first lived in New York. During that period, I would sometimes accompany my grandmother to her synagogue in Far Rockaway. It was an Orthodox shul, though members referred to it simply as “black-hat,” a term I preferred for its note of witchy intrigue.

We would sit apart from each other, my grandmother in the women’s section, which was separated from the men’s by a one-way screened partition. Through it she could watch me pretend to pray, flipping through the pages in my siddur, my train of thought curling into a little ouroboros of distraction. Around me the other men wore dark suits and tzitzis, occasionally a streimel lined with fur. They prayed in silence, shuckling and mouthing the words until the cantor broke abruptly into song. The singing was always disorganized, entirely absent the harmony of a choir, and those men who finished first would meander through the pews, pulling each other aside for hushed and familiar conversations. I knew that—invisible behind the screen—my grandmother was praying for you, praying that I’d get married and bring you into the world, and that after services let out she would take me by the arm and point out any number of devout and eligible young women with whom this goal might be accomplished. So I paid particular attention to the rabbi’s sermons, hoping to arm myself with another topic of conversation that might steer us away from you, from all the uncomfortable questions you raised.

The rabbi’s sermons often concerned the mashiach—when he would come and what we could do to hasten his arrival. The mashiach was meant to usher in olam ha-ba, the coming world, though there was much debate about what this world would consist of. “There is there neither eating, nor drinking, nor any begetting of children, no bargaining or jealousy or hatred or strife,” said the Babylonian Talmudist Abba Arika. “All that the righteous do is to sit with their crowns on their heads and enjoy the effulgence of the Divine Presence.” The second-century sage Rabbi Yose HaGelili pictured something darker and stranger. “The souls of the wicked,” he said, “will be slung away in the hollow of the sling.” The Sanhedrin claimed simply that all those who have died will be resurrected. And the book of Isaiah skirted the question entirely. As for the world to come, so it is written, “eye hath not seen.”

I agree there may be no use here in my speculating on the nature of the world to come. I mention all of this just to say that on some level I was already familiar with the eschatology of the Problem. I knew what it meant for fate to be dangled just beyond reach, like a carrot on a string. How it might feel to wait a lifetime for something immense and uncertain to finally run its course.

Over time, as the news got worse, the notes on my phone began cohering into this letter. This hadn’t been my intention. I’d stumbled into writing them, a private and haphazard stab at processing. But the more I addressed you on the page, the more I came to feel responsible for your existence beyond it. I realized that if I was ever going to actually start a family—if I was going to move you from the flourishing world in my palm into the collapsing world at hand—then I’d owe you an honest account of why. Not just the decision, but its context, the whole story: what I thought about and what I read, how I felt and how I was numb, where I found faith and where I harbored doubt. And how difficult it was to hold out hope, to keep you viable against the rising mercury. Not because I didn’t love you but precisely because I did, because I do. This is the point of my letter—maybe of any letter from parent to child. To show you that love. To show you where it is you’ve come from.

__________________________________

From Warmth by Daniel   Sherrell , published by Penguin Books, an imprint of Penguin Publishing Group, a division of Penguin Random House, LLC. Copyright © 2021 by  Danielle   Sherrell . An earlier version of the chapter “Correspondence” was published as “Hunters in the Snow” in Passages North, No. 41, in 2019.

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LIFE BEFORE BIRTH

The life of a human being begins at fertilization (or conception), when a sperm cell fuses with an oocyte (egg) to produce a new human organism. This individual is called a zygote at the one-cell stage of development, an embryo through the first eight weeks, and a fetus from eight weeks until birth. Each of us was once a zygote, embryo, and fetus, just as we were once infants, toddlers, and adolescents. All of these terms refer to stages in the life of a member of the species Homo sapiens .

Here are some of the milestones of human prenatal development. These dates are measured from the time of fertilization rather than from the last menstrual period (the dating method typically used during pregnancy), which occurs about two weeks earlier.

Conception: A new member of the human species begins . The zygote has a complete and unique set of 46 chromosomes (23 from each parent), the entire genetic blueprint. He or she needs only a suitable environment and nutrition in order to develop himself or herself through the different stages of human life.

6 days: The developing embryo, called a blastocyst at this stage, begins attaching to the wall of the mother’s uterus.

17 days: Blood cells have developed.

19 days: The eyes start to develop.

20 days: The foundation of the nervous system has been laid.

18-21 days: The heart begins to beat.

28 days: 40 pairs of muscles have developed along the trunk of the new individual; arms and legs are forming.

30 days: Regular blood flow exists within the vascular system; the ears and nasal passages have begun to develop.

6 weeks: The skeleton is complete and reflexes are present. The child has measurable brain waves.

7 weeks: The baby has the appearance of a tiny infant, with fingers, toes, and ears.

8 weeks: All organs are functioning—stomach, liver, kidney, brain—and all systems are intact.

9-10 weeks: The baby squints, swallows, and retracts his or her tongue.

11-12 weeks: The baby sucks his or her thumb and inhales/exhales amniotic fluid.

16 weeks: The mother may begin to feel her child’s movements. The baby grasps with hands, swims, kicks, and turns somersaults

18 weeks: The vocal cords are working.

20 weeks: A wealth of evidence indicates that, at least by 20 weeks, unborn children can experience pain. In the fifth and sixth months, the child responds to outside stimuli, including music and voices.

22 weeks: Babies today are usually capable of surviving outside the womb (with assistance) at 22 weeks post-conception (24 weeks from the last menstrual period). They can often survive even earlier. This is called viability .

38 weeks: The unborn child dramatically increases in size and weight during the second half of pregnancy until birth at about 38 weeks (40 weeks from the last menstrual period).

Birth, of course, is not the end of human development. The baby continues to grow and develop in the months, years, and decades to follow. The life of every human being is a continuum beginning at conception and proceeding (if all goes well) through the embryonic, fetal, infant, child, adolescent, and adult stages.

More detailed information about human prenatal development, including photographs and videos, is available from the Endowment for Human Development .

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• v.61(1); Jan-Mar 2020

A research on abortion: ethics, legislation and socio-medical outcomes. Case study: Romania

Andreea mihaela niţă.

1 Faculty of Social Sciences, University of Craiova, Romania

Cristina Ilie Goga

This article presents a research study on abortion from a theoretical and empirical point of view. The theoretical part is based on the method of social documents analysis, and presents a complex perspective on abortion, highlighting items of medical, ethical, moral, religious, social, economic and legal elements. The empirical part presents the results of a sociological survey, based on the opinion survey method through the application of the enquiry technique, conducted in Romania, on a sample of 1260 women. The purpose of the survey is to identify Romanians perception on the decision to voluntary interrupt pregnancy, and to determine the core reasons in carrying out an abortion.

The analysis of abortion by means of medical and social documents

Abortion means a pregnancy interruption “before the fetus is viable” [ 1 ] or “before the fetus is able to live independently in the extrauterine environment, usually before the 20 th week of pregnancy” [ 2 ]. “Clinical miscarriage is both a common and distressing complication of early pregnancy with many etiological factors like genetic factors, immune factors, infection factors but also psychological factors” [ 3 ]. Induced abortion is a practice found in all countries, but the decision to interrupt the pregnancy involves a multitude of aspects of medical, ethical, moral, religious, social, economic, and legal order.

In a more simplistic manner, Winston Nagan has classified opinions which have as central element “abortion”, in two major categories: the opinion that the priority element is represented by fetus and his entitlement to life and the second opinion, which focuses around women’s rights [ 4 ].

From the medical point of view, since ancient times there have been four moments, generally accepted, which determine the embryo’s life: ( i ) conception; ( ii ) period of formation; ( iii ) detection moment of fetal movement; ( iv ) time of birth [ 5 ]. Contemporary medicine found the following moments in the evolution of intrauterine fetal: “ 1 . At 18 days of pregnancy, the fetal heartbeat can be perceived and it starts running the circulatory system; 2 . At 5 weeks, they become more clear: the nose, cheeks and fingers of the fetus; 3 . At 6 weeks, they start to function: the nervous system, stomach, kidneys and liver of the fetus, and its skeleton is clearly distinguished; 4 . At 7 weeks (50 days), brain waves are felt. The fetus has all the internal and external organs definitively outlined. 5 . At 10 weeks (70 days), the unborn child has all the features clearly defined as a child after birth (9 months); 6 . At 12 weeks (92 days, 3 months), the fetus has all organs definitely shaped, managing to move, lacking only the breath” [ 6 ]. Even if most of the laws that allow abortion consider the period up to 12 weeks acceptable for such an intervention, according to the above-mentioned steps, there can be defined different moments, which can represent the beginning of life. Nowadays, “abortion is one of the most common gynecological experiences and perhaps the majority of women will undergo an abortion in their lifetimes” [ 7 ]. “Safe abortions carry few health risks, but « every year, close to 20 million women risk their lives and health by undergoing unsafe abortions » and 25% will face a complication with permanent consequences” [ 8 , 9 ].

From the ethical point of view, most of the times, the interruption of pregnancy is on the border between woman’s right over her own body and the child’s (fetus) entitlement to life. Judith Jarvis Thomson supported the supremacy of woman’s right over her own body as a premise of freedom, arguing that we cannot force a person to bear in her womb and give birth to an unwanted child, if for different circumstances, she does not want to do this [ 10 ]. To support his position, the author uses an imaginary experiment, that of a violinist to which we are connected for nine months, in order to save his life. However, Thomson debates the problem of the differentiation between the fetus and the human being, by carrying out a debate on the timing which makes this difference (period of conception, 10 weeks of pregnancy, etc.) and highlighting that for people who support abortion, the fetus is not an alive human being [ 10 ].

Carol Gilligan noted that women undergo a true “moral dilemma”, a “moral conflict” with regards to voluntary interruption of pregnancy, such a decision often takes into account the human relationships, the possibility of not hurting the others, the responsibility towards others [ 11 ]. Gilligan applied qualitative interviews to a number of 29 women from different social classes, which were put in a position to decide whether or not to commit abortion. The interview focused on the woman’s choice, on alternative options, on individuals and existing conflicts. The conclusion was that the central moral issue was the conflict between the self (the pregnant woman) and others who may be hurt as a result of the potential pregnancy [ 12 ].

From the religious point of view, abortion is unacceptable for all religions and a small number of abortions can be seen in deeply religious societies and families. Christianity considers the beginning of human life from conception, and abortion is considered to be a form of homicide [ 13 ]. For Christians, “at the same time, abortion is giving up their faith”, riot and murder, which means that by an abortion we attack Jesus Christ himself and God [ 14 ]. Islam does not approve abortion, relying on the sacral life belief as specified in Chapter 6, Verse 151 of the Koran: “Do not kill a soul which Allah has made sacred (inviolable)” [ 15 ]. Buddhism considers abortion as a negative act, but nevertheless supports for medical reasons [ 16 ]. Judaism disapproves abortion, Tanah considering it to be a mortal sin. Hinduism considers abortion as a crime and also the greatest sin [ 17 ].

From the socio-economic point of view, the decision to carry out an abortion is many times determined by the relations within the social, family or financial frame. Moreover, studies have been conducted, which have linked the legalization of abortions and the decrease of the crime rate: “legalized abortion may lead to reduced crime either through reductions in cohort sizes or through lower per capita offending rates for affected cohorts” [ 18 ].

Legal regulation on abortion establishes conditions of the abortion in every state. In Europe and America, only in the XVIIth century abortion was incriminated and was considered an insignificant misdemeanor or a felony, depending on when was happening. Due to the large number of illegal abortions and deaths, two centuries later, many states have changed legislation within the meaning of legalizing voluntary interruption of pregnancy [ 6 ]. In contemporary society, international organizations like the United Nations or the European Union consider sexual and reproductive rights as fundamental rights [ 19 , 20 ], and promotes the acceptance of abortion as part of those rights. However, not all states have developed permissive legislation in the field of voluntary interruption of pregnancy.

Currently, at national level were established four categories of legislation on pregnancy interruption area:

( i )  Prohibitive legislations , ones that do not allow abortion, most often outlining exceptions in abortion in cases where the pregnant woman’s life is endangered. In some countries, there is a prohibition of abortion in all circumstances, however, resorting to an abortion in the case of an imminent threat to the mother’s life. Same regulation is also found in some countries where abortion is allowed in cases like rape, incest, fetal problems, etc. In this category are 66 states, with 25.5% of world population [ 21 ].

( ii )  Restrictive legislation that allow abortion in cases of health preservation . Loosely, the term “health” should be interpreted according to the World Health Organization (WHO) definition as: “health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity” [ 22 ]. This type of legislation is adopted in 59 states populated by 13.8% of the world population [ 21 ].

( iii )  Legislation allowing abortion on a socio-economic motivation . This category includes items such as the woman’s age or ability to care for a child, fetal problems, cases of rape or incest, etc. In this category are 13 countries, where we have 21.3% of the world population [ 21 ].

( iv )  Legislation which do not impose restrictions on abortion . In the case of this legislation, abortion is permitted for any reason up to 12 weeks of pregnancy, with some exceptions (Romania – 14 weeks, Slovenia – 10 weeks, Sweden – 18 weeks), the interruption of pregnancy after this period has some restrictions. This type of legislation is adopted in 61 countries with 39.5% of the world population [21].

The Centre for Reproductive Rights has carried out from 1998 a map of the world’s states, based on the legislation typology of each country (Figure ​ (Figure1 1 ).

The analysis of states according to the legislation regarding abortion. Source: Centre for Reproductive Rights. The World’s Abortion Laws, 2018 [ 23 ]

An unplanned pregnancy, socio-economic context or various medical problems [ 24 ], lead many times to the decision of interrupting pregnancy, regardless the legislative restrictions. In the study “Unsafe abortion: global and regional estimates of the incidence of unsafe abortion and associated mortality in 2008” issued in 2011 by the WHO , it was determined that within the states with restrictive legislation on abortion, we may also encounter a large number of illegal abortions. The illegal abortions may also be resulting in an increased risk of woman’s health and life considering that most of the times inappropriate techniques are being used, the hygienic conditions are precarious and the medical treatments are incorrectly administered [ 25 ]. Although abortions done according to medical guidelines carry very low risk of complications, 1–3 unsafe abortions contribute substantially to maternal morbidity and death worldwide [ 26 ].

WHO has estimated for the year 2008, the fact that worldwide women between the ages of 15 and 44 years carried out 21.6 million “unsafe” abortions, which involved a high degree of risk and were distributed as follows: 0.4 million in the developed regions and a number of 21.2 million in the states in course of development [ 25 ].

Case study: Romania

Legal perspective on abortion

In Romania, abortion was brought under regulation by the first Criminal Code of the United Principalities, from 1864.

The Criminal Code from 1864, provided the abortion infringement in Article 246, on which was regulated as follows: “Any person, who, using means such as food, drinks, pills or any other means, which will consciously help a pregnant woman to commit abortion, will be punished to a minimum reclusion (three years).

The woman who by herself shall use the means of abortion, or would accept to use means of abortion which were shown or given to her for this purpose, will be punished with imprisonment from six months to two years, if the result would be an abortion. In a situation where abortion was carried out on an illegitimate baby by his mother, the punishment will be imprisonment from six months to one year.

Doctors, surgeons, health officers, pharmacists (apothecary) and midwives who will indicate, will give or will facilitate these means, shall be punished with reclusion of at least four years, if the abortion took place. If abortion will cause the death of the mother, the punishment will be much austere of four years” (Art. 246) [ 27 ].

The Criminal Code from 1864, reissued in 1912, amended in part the Article 246 for the purposes of eliminating the abortion of an illegitimate baby case. Furthermore, it was no longer specified the minimum of four years of reclusion, in case of abortion carried out with the help of the medical staff, leaving the punishment to the discretion of the Court (Art. 246) [ 28 ].

The Criminal Code from 1936 regulated abortion in the Articles 482–485. Abortion was defined as an interruption of the normal course of pregnancy, being punished as follows:

“ 1 . When the crime is committed without the consent of the pregnant woman, the punishment was reformatory imprisonment from 2 to 5 years. If it caused the pregnant woman any health injury or a serious infirmity, the punishment was reformatory imprisonment from 3 to 6 years, and if it has caused her death, reformatory imprisonment from 7 to 10 years;

2 . When the crime was committed by the unmarried pregnant woman by herself, or when she agreed that someone else should provoke the abortion, the punishment is reformatory imprisonment from 3 to 6 months, and if the woman is married, the punishment is reformatory imprisonment from 6 months to one year. Same penalty applies also to the person who commits the crime with the woman’s consent. If abortion was committed for the purpose of obtaining a benefit, the punishment increases with another 2 years of reformatory imprisonment.

If it caused the pregnant woman any health injuries or a severe disablement, the punishment will be reformatory imprisonment from one to 3 years, and if it has caused her death, the punishment is reformatory imprisonment from 3 to 5 years” (Art. 482) [ 29 ].

The criminal legislation from 1936 specifies that it is not considered as an abortion the interruption from the normal course of pregnancy, if it was carried out by a doctor “when woman’s life was in imminent danger or when the pregnancy aggravates a woman’s disease, putting her life in danger, which could not be removed by other means and it is obvious that the intervention wasn’t performed with another purpose than that of saving the woman’s life” and “when one of the parents has reached a permanent alienation and it is certain that the child will bear serious mental flaws” (Art. 484, Par. 1 and Par. 2) [ 29 ].

In the event of an imminent danger, the doctor was obliged to notify prosecutor’s office in writing, within 48 hours after the intervention, on the performance of the abortion. “In the other cases, the doctor was able to intervene only with the authorization of the prosecutor’s office, given on the basis of a medical certificate from hospital or a notice given as a result of a consultation between the doctor who will intervene and at least a professor doctor in the disease which caused the intervention. General’s Office Prosecutor, in all cases provided by this Article, shall be obliged to maintain the confidentiality of all communications or authorizations, up to the intercession of any possible complaints” (Art. 484) [ 29 ].

The legislation of 1936 provided a reformatory injunction from one to three years for the abortions committed by doctors, sanitary agents, pharmacists, apothecary or midwives (Art. 485) [ 29 ].

Abortion on demand has been legalized for the first time in Romania in the year 1957 by the Decree No. 463, under the condition that it had to be carried out in a hospital and to be carried out in the first quarter of the pregnancy [ 30 ]. In the year 1966, demographic policy of Romania has dramatically changed by introducing the Decree No. 770 from September 29 th , which prohibited abortion. Thus, the voluntary interruption of pregnancy became a crime, with certain exceptions, namely: endangering the mother’s life, physical or mental serious disability; serious or heritable illness, mother’s age over 45 years, if the pregnancy was a result of rape or incest or if the woman gave birth to at least four children who were still in her care (Art. 2) [ 31 ].

In the Criminal Code from 1968, the abortion crime was governed by Articles 185–188.

The Article 185, “the illegal induced abortion”, stipulated that “the interruption of pregnancy by any means, outside the conditions permitted by law, with the consent of the pregnant woman will be punished with imprisonment from one to 3 years”. The act referred to above, without the prior consent from the pregnant woman, was punished with prison from two to five years. If the abortion carried out with the consent of the pregnant woman caused any serious body injury, the punishment was imprisonment from two to five years, and when it caused the death of the woman, the prison sentence was from five to 10 years. When abortion was carried out without the prior consent of the woman, if it caused her a serious physical injury, the punishment was imprisonment from three to six years, and if it caused the woman’s death, the punishment was imprisonment from seven to 12 years (Art. 185) [ 32 ].

“When abortion was carried out in order to obtain a material benefit, the maximum punishment was increased by two years, and if the abortion was made by a doctor, in addition to the prison punishment could also be applied the prohibition to no longer practice the profession of doctor”.

Article 186, “abortion caused by the woman”, stipulated that “the interruption of the pregnancy course, committed by the pregnant woman, was punished with imprisonment from 6 months to 2 years”, quoting the fact that by the same punishment was also sanctioned “the pregnant woman’s act to consent in interrupting the pregnancy course made out by another person” (Art. 186) [ 26 ].

The Regulations of the Criminal Code in 1968, also provided the crime of “ownership of tools or materials that can cause abortion”, the conditions of this holding being met when these types of instruments were held outside the hospital’s specialized institutions, the infringement shall be punished with imprisonment from three months to one year (Art. 187) [ 32 ].

Furthermore, the doctors who performed an abortion in the event of extreme urgency, without prior legal authorization and if they did not announce the competent authority within the legal deadline, they were punished by imprisonment from one month to three months (Art. 188) [ 32 ].

In the year 1985, it has been issued the Decree No. 411 of December 26 th , by which the conditions imposed by the Decree No. 770 of 1966 have been hardened, meaning that it has increased the number of children, that a woman could have in order to request an abortion, from four to five children [ 33 ].

The Articles 185–188 of the Criminal Code and the Decree No. 770/1966 on the interruption of the pregnancy course have been abrogated by Decree-Law No. 1 from December 26 th , 1989, which was published in the Official Gazette No. 4 of December 27 th , 1989 (Par. 8 and Par. 12) [ 34 ].

The Criminal Code from 1968, reissued in 1997, maintained Article 185 about “the illegal induced abortion”, but drastically modified. Thus, in this case of the Criminal Code, we identify abortion as “the interruption of pregnancy course, by any means, committed in any of the following circumstances: ( a ) outside medical institutions or authorized medical practices for this purpose; ( b ) by a person who does not have the capacity of specialized doctor; ( c ) if age pregnancy has exceeded 14 weeks”, the punishment laid down was the imprisonment from 6 months to 3 years” (Art. 185, Par. 1) [ 35 ]. For the abortion committed without the prior consent of the pregnant woman, the punishment consisted in strict prison conditions from two to seven years and with the prohibition of certain rights (Art. 185, Par. 2) [ 35 ].

For the situation of causing serious physical injury to the pregnant woman, the punishment was strict prison from three to 10 years and the removal of certain rights, and if it had as a result the death of the pregnant woman, the punishment was strict prison from five to 15 years and the prohibition of certain rights (Art. 185, Par. 3) [ 35 ].

The attempt was punished for the crimes specified in the various cases of abortion.

Consideration should also be given in the Criminal Code reissued in 1997 for not punishing the interruption of the pregnancy course carried out by the doctor, if this interruption “was necessary to save the life, health or the physical integrity of the pregnant woman from a grave and imminent danger and that it could not be removed otherwise; in the case of a over fourteen weeks pregnancy, when the interruption of the pregnancy course should take place from therapeutic reasons” and even in a situation of a woman’s lack of consent, when it has not been given the opportunity to express her will, and abortion “was imposed by therapeutic reasons” (Art. 185, Par. 4) [ 35 ].

Criminal Code from 2004 covers abortion in Article 190, defined in the same way as in the prior Criminal Code, with the difference that it affects the limits of the punishment. So, in the event of pregnancy interruption, in accordance with the conditions specified in Paragraph 1, “the penalty provided was prison time from 6 months to one year or days-fine” (Art. 190, Par. 1) [ 36 ].

Nowadays, in Romania, abortion is governed by the criminal law of 2009, which entered into force in 2014, by the section called “aggression against an unborn child”. It should be specified that current criminal law does not punish the woman responsible for carrying out abortion, but only the person who is involved in carrying out the abortion. There is no punishment for the pregnant woman who injures her fetus during pregnancy.

In Article 201, we can find the details on the pregnancy interruption infringement. Thus, the pregnancy interruption can be performed in one of the following circumstances: “outside of medical institutions or medical practices authorized for this purpose; by a person who does not have the capacity of specialist doctor in Obstetrics and Gynecology and the right of free medical practice in this specialty; if gestational age has exceeded 14 weeks”, the punishment is the imprisonment for six months to three years, or fine and the prohibition to exercise certain rights (Art. 201, Par. 1) [ 37 ].

Article 201, Paragraph 2 specifies that “the interruption of the pregnancy committed under any circumstances, without the prior consent of the pregnant woman, can be punished with imprisonment from 2 to 7 years and with the prohibition to exercise some rights” (Art. 201, Par. 1) [ 37 ].

If by facts referred to above (Art. 201, Par. 1 and Par. 2) [ 37 ] “it has caused the pregnant woman’s physical injury, the punishment is the imprisonment from 3 to 10 years and the prohibition to exercise some rights, and if it has had as a result the pregnant woman’s death, the punishment is the imprisonment from 6 to 12 years and the prohibition to exercise some rights” (Art. 201, Par. 3) [ 37 ]. When the facts have been committed by a doctor, “in addition to the imprisonment punishment, it will also be applied the prohibition to exercise the profession of doctor (Art. 201, Par. 4) [ 37 ].

Criminal legislation specifies that “the interruption of pregnancy does not constitute an infringement with the purpose of a treatment carried out by a specialist doctor in Obstetrics and Gynecology, until the pregnancy age of twenty-four weeks is reached, or the subsequent pregnancy interruption, for the purpose of treatment, is in the interests of the mother or the fetus” (Art. 201, Par. 6) [ 37 ]. However, it can all be found in the phrases “therapeutic purposes” and “the interest of the mother and of the unborn child”, which predisposes the text of law to an interpretation, finally the doctors are the only ones in the position to decide what should be done in such cases, assuming direct responsibility [ 38 ].

Article 202 of the Criminal Code defines the crime of harming an unborn child, pointing out the punishments for the various types of injuries that can occur during pregnancy or in the childbirth period and which can be caused by the mother or by the persons who assist the birth, with the specification that the mother who harms her fetus during pregnancy is not punished and does not constitute an infringement if the injury has been committed during pregnancy or during childbirth period if the facts have been “committed by a doctor or by an authorized person to assist the birth or to follow the pregnancy, if they have been committed in the course of the medical act, complying with the specific provisions of his profession and have been made in the interest of the pregnant woman or fetus, as a result of the exercise of an inherent risk in the medical act” (Art. 202, Par. 6) [ 37 ].

The fact situation in Romania

During the period 1948–1955, called “the small baby boom” [ 39 ], Romania registered an average fertility rate of 3.23 children for a woman. Between 1955 and 1962, the fertility rate has been less than three children for a woman, and in 1962, fertility has reached an average of two children for a woman. This phenomenon occurred because of the Decree No. 463/1957 on liberalization of abortion. After the liberalization from 1957, the abortion rate has increased from 220 abortions per 100 born-alive children in the year 1960, to 400 abortions per 100 born-alive children, in the year 1965 [ 40 ].

The application of provisions of Decrees No. 770 of 1966 and No. 411 of 1985 has led to an increase of the birth rate in the first three years (an average of 3.7 children in 1967, and 3.6 children in 1968), followed by a regression until 1989, when it was recorded an average of 2.2 children, but also a maternal death rate caused by illegal abortions, raising up to 85 deaths of 100 000 births in the year of 1965, and 170 deaths in 1983. It was estimated that more than 80% of maternal deaths between 1980–1989 was caused by legal constraints [ 30 ].

After the Romanian Revolution in December 1989 and after the communism fall, with the abrogation of Articles 185–188 of the Criminal Code and of the Decree No. 770/1966, by the Decree of Law No. 1 of December 26 th , 1989, abortion has become legal in Romania and so, in the following years, it has reached the highest rate of abortion in Europe. Subsequently, the number of abortion has dropped gradually, with increasing use of birth control [ 41 ].

Statistical data issued by the Ministry of Health and by the National Institute of Statistics (INS) in Romania show corresponding figures to a legally carried out abortion. The abortion number is much higher, if it would take into account the number of illegal abortion, especially those carried out before 1989, and those carried out in private clinics, after the year 1990. Summing the declared abortions in the period 1958–2014, it is to be noted the number of them, 22 037 747 exceeds the current Romanian population. A detailed statistical research of abortion rate, in terms of years we have exposed in Table ​ Table1 1 .

The number of abortions declared in Romania in the period 1958–2016

Source: Pro Vita Association (Bucharest, Romania), National Institute of Statistics (INS – Romania), EUROSTAT [ 42 , 43 , 44 ]

Data issued by the United Nations International Children’s Emergency Fund (UNICEF) in June 2016, for the period 1989–2014, in matters of reproductive behavior, indicates a fertility rate for Romania with a continuous decrease, in proportion to the decrease of the number of births, but also a lower number of abortion rate reported to 100 deliveries (Table ​ (Table2 2 ).

Reproductive behavior in Romania in 1989–2014

Source: United Nations International Children’s Emergency Fund (UNICEF), Transformative Monitoring for Enhanced Equity (TransMonEE) Data. Country profiles: Romania, 1989–2015 [ 45 ].

By analyzing data issued for the period 1990–2015 by the International Organization of Health , UNICEF , United Nations Fund for Population Activity (UNFPA), The World Bank and the United Nations Population Division, it is noticed that maternal mortality rate has currently dropped as compared with 1990 (Table ​ (Table3 3 ).

Maternal mortality estimation in Romania in 1990–2015

Source: World Health Organization (WHO), Global Health Observatory Data. Maternal mortality country profiles: Romania, 2015 [ 46 ].

Opinion survey: women’s opinion on abortion

Argument for choosing the research theme

Although the problematic on abortion in Romania has been extensively investigated and debated, it has not been carried out in an ample sociological study, covering Romanian women’s perception on abortion. We have assumed making a study at national level, in order to identify the opinion on abortion, on the motivation to carry out an abortion, and to identify the correlation between religious convictions and the attitude toward abortion.

Examining the literature field of study

In the conceptual register of the research, we have highlighted items, such as the specialized literature, legislation, statistical documents.

Formulation of hypotheses and objectives

The first hypothesis was that Romanian women accept abortion, having an open attitude towards this act. Thus, the first objective of the research was to identify Romanian women’s attitude towards abortion.

The second hypothesis, from which we started, was that high religious beliefs generate a lower tolerance towards abortion. Thus, the second objective of our research has been to identify the correlation between the religious beliefs and the attitude towards abortion.

The third hypothesis of the survey was that, the main motivation in carrying out an abortion is the fact that a woman does not want a baby, and the main motivation for keeping the pregnancy is that the person wants a baby. In this context, the third objective of the research was to identify main motivation in carrying out an abortion and in maintaining a pregnancy.

Another hypothesis was that modern Romanian legislation on the abortion is considered fair. Based on this hypothesis, we have assumed the fourth objective, which is to identify the degree of satisfaction towards the current regulatory provisions governing the abortion.

Research methodology

The research method is that of a sociological survey by the application of the questionnaire technique. We used the sampling by age and residence looking at representative numbers of population from more developed as well as underdeveloped areas.

Determination of the sample to be studied

Because abortion is a typical women’s experience, we have chosen to make the quantitative research only among women. We have constructed the sample by selecting a number of 1260 women between the ages of 15 and 44 years (the most frequently encountered age among women who give birth to a child). We also used the quota sampling techniques, taking into account the following variables: age group and the residence (urban/rural), so that the persons included in the sample could retain characteristic of the general population.

By the sample of 1260 women, we have made a percentage of investigation of 0.03% of the total population.

The Questionnaires number applied was distributed as follows (Table ​ (Table4 4 ).

The sampling rates based on the age, and the region of residence

Source: Sample built, based on the population data issued by the National Institute of Statistics (INS – Romania) based on population census conducted in 2011 [ 47 ].

Data collection

Data collection was carried out by questionnaires administered by 32 field operators between May 1 st –May 31 st , 2018.

The analysis of the research results

In the next section, we will present the main results of the quantitative research carried out at national level.

Almost three-quarters of women included in the sample agree with carrying out an abortion in certain circumstances (70%) and only 24% have chosen to support the answer “ No, never ”. In modern contemporary society, abortion is the first solution of women for which a pregnancy is not desired. Even if advanced medical techniques are a lot safer, an abortion still carries a health risk. However, 6% of respondents agree with carrying out abortion regardless of circumstances (Table ​ (Table5 5 ).

Opinion on the possibility of carrying out an abortion

Although abortions carried out after 14 weeks are illegal, except for medical reasons, more than half of the surveyed women stated they would agree with abortion in certain circumstances. At the opposite pole, 31% have mentioned they would never agree on abortions after 14 weeks. Five percent were totally accepting the idea of abortion made to a pregnancy that has exceeded 14 weeks (Table ​ (Table6 6 ).

Opinion on the possibility of carrying out an abortion after the period of 14 weeks of pregnancy

For 53% of respondents, abortion is considered a crime as well as the right of a women. On the other hand, 28% of the women considered abortion as a crime and 16% associate abortion with a woman’s right (Table ​ (Table7 7 ).

Opinion on abortion: at the border between crime and a woman’s right

Opinions on what women abort at the time of the voluntary pregnancy interruption are split in two: 59% consider that it depends on the time of the abortion, and more specifically on the pregnancy development stage, 24% consider that regardless of the period in which it is carried out, women abort a child, and 14% have opted a fetus (Table ​ (Table8 8 ).

Abortion of a child vs. abortion of a fetus

Among respondents who consider that women abort a child or a fetus related to the time of abortion, 37.5% have considered that the difference between a baby and a fetus appears after 14 weeks of pregnancy (the period legally accepted for abortion). Thirty-three percent of them have mentioned that the distinction should be performed at the first few heartbeats; 18.1% think it is about when the child has all the features definitively outlined and can move by himself; 2.8% consider that the difference appears when the first encephalopathy traces are being felt and the child has formed all internal and external organs. A percentage of 1.7% of respondents consider that this difference occurs at the beginning of the central nervous system, and 1.4% when the unborn child has all the features that we can clearly see to a newborn child (Table ​ (Table9 9 ).

The opinion on the moment that makes the difference between a fetus and a child

We noticed that highly religious people make a clear association between abortion and crime. They also consider that at the time of pregnancy interruption it is aborted a child and not a fetus. However, unexpectedly, we noticed that 27% of the women, who declare themselves to be very religious, have also stated that they see abortion as a crime but also as a woman’s right. Thirty-one percent of the women, who also claimed profound religious beliefs, consider that abortion may be associated with the abortion of a child but also of a fetus, this depending on the time of abortion (Tables ​ (Tables10 10 and ​ and11 11 ).

The correlation between the level of religious beliefs and the perspective on abortion seen as a crime or a right

The correlation between the level of religious beliefs and the perspective on abortion procedure conducted on a fetus or a child

More than half of the respondents have opted for the main reason for abortion the appearance of medical problems to the child. Baby’s health represents the main concern of future mothers, and of each parent, and the birth of a child with serious health issues, is a factor which frightens any future parent, being many times, at least theoretically, one good reason for opting for abortion. At the opposite side, 12% of respondents would not choose abortion under any circumstances. Other reasons for which women would opt for an abortion are: if the woman would have a medical problem (22%) or would not want the child (10%) (Table ​ (Table12 12 ).

Potential reasons for carrying out an abortion

Most of the women want to give birth to a child, 56% of the respondents, representing also the reason that would determine them to keep the child. Morality (26%), faith (10%) or legal restrictions (4%), are the three other reasons for which women would not interrupt a pregnancy. Only 2% of the respondents have mentioned other reasons such as health or age.

A percentage of 23% of the surveyed people said that they have done an abortion so far, and 77% did not opted for a surgical intervention either because there was no need, or because they have kept the pregnancy (Table ​ (Table13 13 ).

Rate of abortion among women in the sample

Most respondents, 87% specified that they have carried out an abortion during the first 14 weeks – legally accepted limit for abortion: 43.6% have made abortion in the first four weeks, 39.1% between weeks 4–8, and 4.3% between weeks 8–14. It should be noted that 8.7% could not appreciate the pregnancy period in which they carried out abortion, by opting to answer with the option “ I don’t know ”, and a percentage of 4.3% refused to answer to this question.

Performing an abortion is based on many reasons, but the fact that the women have not wanted a child is the main reason mentioned by 47.8% of people surveyed, who have done minimum an abortion so far. Among the reasons for the interruption of pregnancy, it is also included: women with medical problems (13.3%), not the right time to be a mother (10.7%), age motivation (8.7%), due to medical problems of the child (4.3%), the lack of money (4.3%), family pressure (4.3%), partner/spouse did not wanted. A percentage of 3.3% of women had different reasons for abortion, as follows: age difference too large between children, career, marital status, etc. Asked later whether they regretted the abortion, a rate of 69.6% of women who said they had at least one abortion regret it (34.8% opted for “ Yes ”, and 34.8% said “ Yes, partially ”). 26.1% of surveyed women do not regret the choice to interrupted the pregnancy, and 4.3% chose to not answer this question. We noted that, for women who have already experienced abortion, the causes were more diverse than the grounds on which the previous question was asked: “What are the reasons that determined you to have an abortion?” (Table ​ (Table14 14 ).

The reasons that led the women in the sample to have an abortion

The majority of the respondents (37.5%) considered that “nervous depression” is the main consequence of abortion, followed by “insomnia and nightmares” (24.6%), “disorders in alimentation” and “affective disorders” (each for 7.7% of respondents), “deterioration of interpersonal relationships” and “the feeling of guilt”(for 6.3% of the respondents), “sexual disorders” and “panic attacks” (for 6.3% of the respondents) (Table ​ (Table15 15 ).

Opinion on the consequences of abortion

Over half of the respondents believe that abortion should be legal in certain circumstances, as currently provided by law, 39% say it should be always legal, and only 6% opted for the illegal option (Table ​ (Table16 16 ).

Opinion on the legal regulation of abortion

Although the current legislation does not punish pregnant women who interrupt pregnancy or intentionally injured their fetus, survey results indicate that 61% of women surveyed believe that the national law should punish the woman and only 28% agree with the current legislation (Table ​ (Table17 17 ).

Opinion on the possibility of punishing the woman who interrupts the course of pregnancy or injures the fetus

For the majority of the respondents (40.6%), the penalty provided by the current legislation, the imprisonment between six months and three years or a fine and deprivation of certain rights for the illegal abortion is considered fair, for a percentage of 39.6% the punishment is too small for 9.5% of the respondents is too high. Imprisonment between two and seven years and deprivation of certain rights for an abortion performed without the consent of the pregnant woman is considered too small for 65% of interviewees. Fourteen percent of them think it is fair and only 19% of respondents consider that Romanian legislation is too severe with people who commit such an act considering the punishment as too much. The imprisonment from three to 10 years and deprivation of certain rights for the facts described above, if an injury was caused to the woman, is considered to be too small for more than half of those included in the survey, 64% and almost 22% for nearly a quarter of them. Only 9% of the respondents mentioned that this legislative measure is too severe for such actions (Table ​ (Table18 18 ).

Opinion on the regulation of abortion of the Romanian Criminal Code (Art. 201)

Conclusions

After analyzing the results of the sociological research regarding abortion undertaken at national level, we see that 76% of the Romanian women accept abortion, indicating that the majority accepts only certain circumstances (a certain period after conception, for medical reasons, etc.). A percentage of 64% of the respondents indicated that they accept the idea of abortion after 14 weeks of pregnancy (for solid reasons or regardless the reason). This study shows that over 50% of Romanian women see abortion as a right of women but also a woman’s crime and believe that in the moment of interruption of a pregnancy, a fetus is aborted. Mostly, the association of abortion with crime and with the idea that a child is aborted is frequently found within very religious people. The main motivation for Romanian women in taking the decision not to perform an abortion is that they would want the child, and the main reason to perform an abortion is the child’s medical problems. However, it is noted that, in real situations, in which women have already done at least one abortion, most women resort to abortion because they did not want the child towards the hypothetical situation in which women felt that the main reason of abortion is a medical problem. Regarding the satisfaction with the current national legislation of the abortion, the situation is rather surprising. A significant percentage (61%) of respondents felt as necessary to punish the woman who performs an illegal abortion, although the legislation does not provide a punishment. On the other hand, satisfaction level to the penalties provided by law for various violations of the legal conditions for conducting abortion is low, on average only 25.5% of respondents are being satisfied with these, the majority (average 56.2%) considering the penalties as unsatisfactory. Understood as a social phenomenon, intensified by human vulnerabilities, of which the most obvious is accepting the comfort [ 48 ], abortion today is no longer, in Romanian society, from a legal or religious perspective, a problem. Perceptions on the legislative sanction, moral and religious will perpetual vary depending on beliefs, environment, education, etc. The only and the biggest social problem of Romania is truly represented by the steadily falling birth rate.

Conflict of interests

The authors declare that they have no conflict of interests.

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Essay: Life and the unborn child

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The word children is applied to infants from their birth but the time when they cease ordinarily to be so called is not defined by custom. A foetus not bigger than a man’s finger but having the shape of a child has been held to be a child. Blacks’ Law Dictionary defines an unborn child as a child not yet born especially at the happening of some event. The dictionary meaning of the word ‘person’ is ‘the living body of a human being’, including a man, woman or child. It follows, prima facie, that an embryo in the mother’s womb, which has not yet been born as a human being, is not a person so as to be entitled to any fundamental right. The question whether an unborn child has a right to life comes within the meaning of the word ‘life’ is not fully settled. Article 2 of the European Convention on Human rights says that ‘everyone’s right to life shall be protected by law’. It is contended that ‘everyone’ connotes a person who comes within the exception laid out in Article 2, and thus assumes that such a person is already born. Cases relating to ‘life’ in this topic are involved in the case of abortion. In such cases ‘domestic law’ is given prominence. In Paton v. UK the commission examined the law and constitution of various states including the American constitution on Human Rights 1969 where it was stated that under Article 4(1) that ‘life’ begins from the moment of conception. In Germany, when considering Article 2 above, it was stated life begins from 14th day after conception. Right to life is the most fundamental of all human rights, and any decision affecting human life, or which may put an individual’s life at risk, must call for the most apprehensive scrutiny. The sanctity of human life is probably the most fundamental of human social values. It is recognized in all civilized societies and their legal system and by the internationally recognized statements of human rights. Article 21 is a declaration of deep faith and belief in human rights. In this ‘pattern of guarantee woven in Chapter III of the constitution, personal liberty of man is at root of Article 21 and each expression used in this article enhances human dignity and values. It lays foundation for a society where rule of law has primary and not arbitrary or capricious exercise of power. Right to Life does not include the Right to take another person’s life and it is a punishable offence. An unborn child can be regarded as a living entity of its own. Article 21 of the Indian Constitution may be interpreted to mean that the word ‘person’ applies to all human beings including the unborn offspring’s at every stage of gestation. The state cannot discriminate against persons who are foetuses by offering them less or no protection than other persons. Therefore, the state is under obligation under Article 21 not only to protect the life of the unborn child from arbitrary and unjust destruction but also not to deny it equal protection under Article 14 of the Constitution of India. In Vinod Soni and Anr. v Union Of India it was observed by the Bombay High Court that ‘A child conceived is therefore entitled to under Article 21, as held by the Supreme Court, to full development whatever be the sex of that child. The determination whether at pre conception stage or otherwise is the denial of a child, the right to expansion, or if it can be so expanded right to come into existence.’ A clear definition of the word person has not been provided under the constitution. Under Article 367(1) unless the context otherwise requires, the General Clauses Act, 1897, shall, subject to any adaptations and modifications that may be made therein under Article 372, apply for the interpretation of the Constitution as it applies for the interpretation of an Act of the legislature of the domain of India. In Jabbar and Ors v State Justice M.H. Beg stated that ‘the term ‘person’ has not been defined in a technical or narrow sense in the section 11 of Indian Penal Code, 1860 (IPC). Section 11 defines it in the same way as the term ‘person’ has been defined in Section 3(42) of the Central General Clauses Act, 1897.This is hardly a definition. It seems to be only an indication of the intention of the legislature to use the word ‘person’ in a fairly wide sense so as to include even artificial persons. The word person is said to be derived from ‘persona’ which stood for the mask worn by an actor on the stage amongst the ancient Greeks and Romans. In law it implies the juristic personification of an entity which may or may not be an animate being.’ Justice M.H. Beg further added ‘An unborn child can be regarded as a living entity with a life of its own. The word ‘person’ is defined in the Shorter Oxford English Dictionary in two ways: firstly, it is defined as ‘an individual human being’ or ‘a man, woman, or child’; and, secondly, as “the living body of a human being”. I do not think that it can be denied that an unborn child in advanced stages of pregnancy has a being or life of its own and that it has a body. It may he that its life and body are not independent of the mother’s existence so that the unborn child cannot be said to have a separate exist-once. The word ‘person’ has not been defined in such a way as to involve a separate existence or the living creature spoken of as ‘a person’. As there is no such technical definition, I prefer to adopt the ordinary meaning of the term “person” as including a ‘child’ whether born or unborn. Even if the child is unborn and within the womb of the mother, it is capable of being spoken of as a ‘person’ if its body is developed sufficiently to make it possible to call it a ‘child”. The word ‘person’ has not been defined by the Indian Penal Code in such a way as to involve a separate existence of the living creature spoken of as ‘a person’. As there is no such technical definition, the court prefers to adopt the ordinary meaning of the term ‘persons as including a ‘child’ whether born or unborn. In Elliot v. Lord Joicey and Ors it was held that “From the earliest times the posthumous child has caused a certain embarrassment to the logic of the law, which is naturally disposed to insist that at any given moment of time a child must either be born or not born, living or not living. This literal realism was felt to bear hardly on the interests of posthumous children and was surmounted in the Civil Law by the invention of the fiction that in all matters affecting its interests the unborn child in utero should be deemed to be already born. Qui in utero est, perinde ac si in rebus humanis esset, custoditur, quoties de commodis ipsius partus quaeritur: quanquam alii, antequam nascatur, nequaquam prosit” Child in Womb is Equal to a Person in Existence In an English case R v. Tait the Court of Appeal quashed the conviction of a burglar on the ground that ‘threat to kill a foetus’ is not an offence directed against the ‘another person’. The foetus in uterus was not in the ordinary sense another person distinct from its mother. In another case R v. Sullivan midwives who attended the delivery of a foetus that failed to survive birth were charged with the offence of criminal negligence of causing death to another person (foetus). The conviction by the trail court was set aside, by the British Columbia Court of Appeal on the ground that a foetus that was not living on complete removal from its mother’s body was not a ‘person’ but the court substituted a verdict of guilty of criminal negligence causing bodily harm to another person, namely the pregnant woman. The foetus in the birth canal was found to be a part of the mother, so that injury to the foetus constitutes injury to her. This view was rejected in alter case, Bonbrest v. Kotz and the unborn child was recognized as a human being. The unborn child need not reach the stage of viability of maintain an action for recovery of damages under the law of torts . Thus the unborn child to whom live birth never comes is held to be a person who can be the subject of an action for damages for his death. The Law of Succession also for many purposes treated a child in the womb equal to a person in existence. In Oriental Insurance Co. Ltd. v. Santhilal Patal an accident resulted in the death of a women and ten month old foetus. The Andhra Pradesh High Court held that an unborn child aged five months onwards in the mother’s womb till its birth can be treated as a child in existence. The unborn child to whom the live birth never comes can be held to be a person who can be the subject of an action for damages for his death. The foetus is another life in woman and loss of foetus is actually a loss of child in the offing. In Manikuttan v. M.N. Baby where an accident resulted in the death of a pregnant woman carrying a four month old foetus. The Kerala High Court held that foetus is another life in the woman and it comes as a baby in the course of time. Loss of foetus upon death of a pregnant woman is actually loss of a child in the offing for the husband of the woman. The Court held that compensation to be granted for the death of pregnant women is for loss of two lives. RIGHT TO LIFE OF AN UNBORN CHILD IN INDIA Regarding the law in India, Acharya Dr D.D. Basu in his book on ‘Human Rights in Constitutional law’ concluded that:- Regard for sanctity of the embryo from the moment of conception is enjoined by the Hindu Scriptures. Thus, the destruction of a foetus is condemned as a heinous offence equal to Brahmahatya. In this condemnation, no distinction appears to have been made between different stages of gestation. The Garbhoponishad, which gives a meticulous account of the development of the foetus from the moment of conception of the mother, it states that from the second day after the entry of the male semen into the female uterus, the semen gets thickened and from the 8th day it takes the shape of a ball which is transformed into a lump after 15 days, leading to the creation of the head and the legs after two months. It follows that it would be an offence if the embryo is destroyed even at the nascent stage. In Davis v. Davis where a divorced wife and husband disputed on claiming of right on frozen Preembryos for implantation to have a child, the judge concluded that as a matter of law, human life begins at conception and the legal provision governing a human being existing embryo in vitro to be those of child custody law, dominated by the obligation to seek, protect and advance the best interest of the child. Since the time immemorial Indian law too treated the termination of pregnancy as an offence. Section 315 of The Indian Penal Code, 1860 recognizes that an embryo is entitled to legal protection of the unborn child’s right to life. Section 312 to 316 of Indian Penal Code provides for punishment for abortion or for destruction of the unborn child. Section 312 provides for imprisonment of either description for a term which may extend to seven years, and shall also be liable to fine to the woman causing miscarriage to a child. By treating the act of procuring an abortion as an offence, an inherent protection has been provided to the foetal right. The Madras High Court in a decision as early as in 1886 in Queen Express v. Ademma analyzed the distinction made in the Indian Penal Code between a woman with child, and a woman quick with child, and between the unborn child and quick born child , which goes to show that a woman is with child during the entire period of her pregnancy, and lexically as well as logically, a child is a person having life. This was pointed out by the English expression ‘pregnant’ means to be with child and the Indian equivalent ‘antaswatta’ unmistakably mean to have life within. Section 3 to 5 of The Medical Termination of Pregnancy Act, 1971 is by way of a pro tanto exception to the IPC, the law has become complicated and can be understood only if it is discussed under the following heads :- I. The Stage from conception to the end of three months of pregnancy- Causing abortion at this stage is punishable under Section 312 of IPC (unless it is caused in good faith for the purpose of saving the life of the woman), if it is caused by the woman herself or anybody other than a registered medical practitioner. When the abortion is caused at this stage by a registered medical practitioner, it will be no offence provided any of the following conditions are present, which take out the case from the pale of the IPC :- The Medical Practitioner must have formed an opinion in good faith – a) That the continuance of pregnancy would involve a risk to life of the pregnant woman or of grave injury to her physical or mental health . b) Or, that there is a substantial risk that if the child were born, it would suffer from such physical or mental abnormalities as to be seriously handicapped. II. The stage from the fourth month of pregnancy up to the end of the seventh month (i.e. before the foetus is 210 days old.) In this case, punishment under Section 312 of IPC shall be heavier. In this case, medical termination will take out the case from the IPC only if two registered medical practitioner form the opinion as stated above. III. After the foetus has lived for 210 days in the mother’s womb. At this stage, no offence is committed if the child is born alive (though premature) a no injury is caused to the mother or the child. The essential elements regarding the consent of Husband and wife under the Medical Termination of Pregnancy Act, 1971 is dealt below under the title Right to Abortion. Pre- Conception and Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994 prohibits the pre-natal tests of sex determination of the foetus, through which unborn female child could be protected. After expiry of three months, the foetus then presumable has the ‘capability of meaningful life outside the mother’s womb’ and this stage is known as ‘quickening’ i.e., when the foetus first starts recognizable movement in the Uterus. At this, state acquires compelling interest to protect potential. These provisions also show that India recognizes right to life of the unborn child. The right of a child is ‘en ventre sa mere’ in the family property and inheritance are very well recognized. ‘A child in the womb’ of the mother is for most purposes regarded in English law as being already born, but in Hindu law a child in his mother’s womb is equal in many respects to a child actually in existence . Section 20 of the Hindu Succession Act, 1956 has conferred a right to an unborn child, who was in the mother’s womb when the father died intestate to succeed the father’s estate. The section deals with the right of a child born after the death of the intestate. It imports a fiction saying that the child in the womb shall be deemed to have acquired the right to inherit to the intestate as if he or she had been born before the death of the intestate. The concept behind is this is that, at the time of the death of the intestate, the child is alive, and the child acquires equal rights along with other heirs. Section l3 of the Transfer of Property Act, 1882 deals with the transfer of property for the benefit of unborn persons. According to this Section where, on a transfer of property, an interest therein is created for the benefit of a person not in existence at the date of the transfer, subject to a prior interest created by the same transfer. Thus the Transfer of Property Act also recognizes the interest of unborn child as a person though not in existence. According to Salmond’s:- Though the dead possess no legal personality, it is otherwise with the unborn. There is nothing in law to prevent a man from owning property before he is born. His ownership is necessarily contingent, indeed, for he may never be born at all; but it is none the less a real and present ownership. A child in its mother’s womb is for many purposes regarded by a legal fiction as already born, in accordance with the maxim, Nasciturus pro jam nato habetur. Section 6 of the Limitation Act, 1963 provides that where a person entitled to institute a suit or make an application for execution of the decree is, at the time from which the prescribed period is to be reckoned, a minor, he may institute the suit or make the application within the same period after the disability has ceased. The explanation to Section 6 states that for the purposes of this section, ‘minor’ includes a child in the womb. The Matrimonial laws also recognized the right of unborn child to birth. In Sushil Kumar v. Usha the court held that aborting the foetus in the very first pregnancy by a deliberate act without the consent of the husband would amount to cruelty. Here the intention of the Legislature may be understood to bring the unborn child safely to the world. Neither wife nor the husband individually takes a decision to abort the child. However, such collective decision is also subject to the provisions Indian Penal Code and the Medical Termination of Pregnancy Act. When there is no possibility begetting a living child with all human potential it is better to prevent such child to be born and thereby save it from earthly miseries. However, the right to abortion and the right to birth must be decided on the merits of each independent case. Any rigid principles in this concern would to unnecessary ailment to the mother and to the child in the womb. The Madras High Court considered some important views on the subject quoting an article ‘Legal Protection for the unborn Child’ in the following words ‘The fact the unborn child is physically dependent on its mother prior to birth need not lead to the assumption that it has no relevant separate existence or to the assumption that it has no moral or legal significance.’ In Prakash and Ors v. Arun Kumar Saini and Anr the court was of the view that the rights of an unborn child are recognized in various different legal contexts; e.g. in criminal law causing death of foetus has been held to be an offence under Sections 312 to 316 of the Indian Penal Code, and the law of property considers the unborn child being for all purposes which are to its benefit, such as taking by will or descent. In Jan Hitai v State of Uttar Pradesh and other the Allahabad High Court has also considered the damages which can be caused by environmental pollution to the unborn child. The court observed that ‘The study shows that unborn babies are at risk too. The unborn child develops the organ of hearing in the fifth month of pregnancy and exposure to high levels of noise can affect the immature cochlea, the spiral cavity of the ear. The babies born may be hard of hearing because they are exposed to the loud clacking of looms long before they enter the world.’ The right of the fetus not to be wrongfully injured before birth has been recognized in tort law also. The leading case of Bonbrest v. Kotz wherein Prosser and Keeton describe the present legal situation as : ‘The child, if he is born alive, is now permitted in every jurisdiction to maintain an action for the consequences of prenatal injury, and if he dies of such injuries after birth an action will lie for his wrongful death.’ Rt. Hon’ble Lord Denning in his book ‘The Closing Chapter’ says:-‘The unborn child…..it is not only the Christian doctrine but it is the doctrine of our law and our common law that the unborn child has a life of its own and a right of its own which is recognized by the law at least from the time of quickening, and the common law has always recognized that.’ Sir William Blackstone, put it in this way: Life is the immediate gift of God, a right inherent by nature in every individual, and it begins in contemplation, at law as soon as the infant is able to stir in its mother’s womb. Such a child was protected by the law almost to the same extent as a new-born baby. If anyone terminated the pregnancy and thus destroyed the life of the child he or she was guilty of a felony punishable by life imprisonment. Any person who, with intent to destroy the life of a child capable of being born alive, by any willful act causes a child to die before it has an existence independent of its mother is guilty of the offence of child destruction, if it is proved that the act was not done in good faith for the purpose only of preserving the life of the mother. The punishment for this offence is imprisonment for life or for any shorter term.

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Minnesota Man Accused of Killing, Dismembering Pregnant Sister Because She Was 'No Longer Innocent'

A Minnesota man has been charged with the murder of his pregnant sister and her unborn child after being caught allegedly dumping her dismembered body parts on a neighbor's property, authorities said.

Jack Joseph Ball , 23, of Farmington, was recently charged with two counts of second-degree murder in the deaths of his sister, Bethany Israel , 30, and her unborn child, who was at approximately 17–18 weeks gestation, according to a statement from the Dakota County Attorney's Office.

According to the criminal complaint, Israel's family became concerned when she didn't return home after having dinner with Ball in Lakeville on May 23. Israel's mother went to the residence looking for her and saw Ball leaving the scene. When the she entered the home, she saw "a significant amount of blood" and called the police.

The Lakeville Police Department responded to the home at around 11 p.m., and officers arrived to find "a bloody saw, hatchet, and large, bloody knives" along with "several dismembered body parts" they believed belonged to Israel.

While police were searching for Ball, a 911 caller reported seeing a man on their home security camera "place what appeared to be a body part on their front step," in Rosemount.

Officers responded to that location, and found Ball in a neighboring backyard. He was allegedly "covered in blood on his head, shirt, arms, legs and pants" and had what appeared to be "a self-inflicted knife wound across his throat."

During their investigation, officers discovered several journals and other papers belonging to Ball, which detailed his anger that Israel was pregnant and "no longer innocent."

“The allegations in this case are deeply disturbing and horrific — words can’t describe what our law enforcement partners encountered during the investigation,” Dakota County Attorney Kathy Keena said in a statement. “My office will work hard to ensure the victims receive justice and will provide the necessary support for the victims’ family.”

According to the medical examiner, Israel died as a result of "complex homicidal violence."

Ball's bail was set at $2 million without conditions or $1 million with conditions. Once he is medically cleared, he will be transferred to the Dakota County Jail to await his next scheduled hearing on June 10.

TMX contributed to this report.

I was diagnosed with a severe fear of giving birth while I was pregnant. I'm not having any more kids.

• Jemma Smith suffered anxiety attacks throughout her pregnancy, obsessing about the risks of labor.
• Her fear of death became so intense she wrote goodbye letters to her partner and unborn child.
• Mental health experts stepped in after her diagnosis of tokophobia — a pathological fear of birth.

This as-told-to essay is based on a conversation with Jemma Smith. It has been edited for length and clarity.

In January, when I was around four months pregnant with my first child, I tearfully wrote two letters — one to my partner and the other to our unborn baby.

My letter to his father said, "By the time you read this, I won't be here anymore." I put the envelopes inside some newborn clothes we'd already bought for our son.

I imagined my partner opening the letter on the day that I died during childbirth. At the time, I was 100% convinced that something would go wrong and, though the baby would survive, I'd lose my life.

We decided to start a family shortly before I turned 32. I run a tuition franchise for children and loved the idea of finally having my own kids.

Luckily, I got pregnant within a matter of months . We were delighted, but almost as soon as I found out, I started worrying about the physical process of giving birth.

At first, I thought it was natural and everyone has the same fear. But it went far beyond that for me.

I'd wake up at 3 a.m., crying. My breathing would get faster. I'd feel it in my chest. It was the same type of feeling you get from extreme stage fright.

Then, unable to get back to sleep, I'd open my laptop and Google the likelihood of dying during childbirth . The statistics were relatively low in my native UK, but, in my mind, at least, the worst would happen to me.

I confided in a friend who suggested professional help

It never got to the point that I considered a termination. I wanted to have a baby so much. But the dread was affecting my mental health and the pregnancy as a whole.

I confided in a friend who was trained in cognitive behavioral therapy. They suggested that I needed professional help because I kept playing out nightmare scenarios like massive hemorrhaging.

Related stories

So, at around five months pregnant, I was assessed by a perinatal mental health team from the National Health Service (NHS.) They diagnosed me with tokophobia — a pathological fear of giving birth.

I'd never heard of it before, but knowing it was a recognized condition was a relief. Recent research has shown it can affect as many as 14 % of women, so I wasn't alone.

Fortunately, it can be treated with therapy. I began a six-week course of one-hour sessions before my due date at the end of April.

I told the mental health counselor that I saw childbirth as a giant mountain. It was such a big obstacle I couldn't see past it. I couldn't imagine coming out the other side with a newborn.

We discussed how my mom had experienced a traumatic labor with me. The details had stuck with me since I was a little girl. She'd needed an emergency C-section and blood transfusions.

However, the biggest part was the lack of control. I was terrified of not being in charge of events. I was fixated by the thought that I'd need a C-section, like Mom.

I verbalized my concerns and tried meditation, relaxation and visualization techniques. The counselor encouraged me not to fall into the habit of black-and-white, catastrophic thinking .

Next, they helped me set small, achievable goals. We made a flow chart listing the possible sequence of events and how best I wanted to deal with them.

I cried when I finally held my healthy son in my arms

In the end, I decided to have an elective C-section . I researched the risks. There's a definite split between emergency C-sections and those that are planned. It made me feel a lot more confident as I talked through the decision with my consultant.

A few days before the planned delivery in late April, I had a pre-op appointment, during which I met every member of the medical team. They explained the procedure, and they were an incredibly supportive group of professionals.

Still, I was incredibly nervous when I lay on the operating table. But I had a spinal block and used the relaxation techniques I'd been practicing. My partner was there to support me.

I felt no pain, just a bit of pressure. My son was born safe and sound . He weighed a healthy eight pounds and seven ounces. I cried with joy and relief when I held him for the first time.

That said, I won't be going through the process again. Raising our boy as an only child is fine by us.

Do you have a powerful story about a health condition that you'd like to share with Business Insider? Please send details to [email protected] .

Watch: How anti-abortion crisis pregnancy centers target women looking for abortions

• Main content

Minnesota man dismembered pregnant sister, placed body parts on porch, court papers show

A Minnesota man has been arrested after police say he killed and dismembered his pregnant sister last week and placed her body parts on a stranger's front porch.

Jack Joseph Ball, 23, of Lakeville, is charged with second-degree murder with intent and second-degree murder of an unborn child in connection to the death of his 30-year-old sister, Bethany Ann Israel, court records filed Tuesday in Dakota County District Court show.

The killing reportedly took place May 23 at Ball's home in Lakeville, about 20 miles south of Minneapolis, according to the Lakeview Police Department.

$15 Big Macs: As inflation drives up fast food prices, map shows how they differ nationwide

Mom discovers 'a substantial amount of blood,' court papers say

According to a five-page criminal complaint, police responded to Ball's home about 11 p.m. after the siblings' mother called 911 and reported she thought her daughter had been killed inside the residence.

The mother told arriving officers her daughter visited her son's home to have dinner earlier in the evening and when she did not hear from her, she went to the home to check on her.

She told police when she arrived, her son "tore out of the house" and when she went inside, court papers show, she saw "a substantial amount of blood" and called for help.

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Brother's journal reveals anger about sister's pregnancy

Officers entered the home and found a large amounts of blood in the kitchen and discovered a "bloody saw, hatchet, and large, bloody, knives," the complaint reads. They also reportedly found "several dismembered body parts" in the home and another bloody knife on the living room floor. 

In the home, the complaint continues, police found journals and handwritten notes from Ball expressing his anger Israel was pregnant and "no longer innocent."

A body part on the front porch

While searching for the suspect, police received a 911 call from a resident in Rosemount, a community about 11 miles northeast, reporting they watched a man through their Ring security system place a body part on their front porch.

Arriving officers located a dismembered body part believed to belong to Israel and during a search of the area around the home, found Ball near a shed in a neighboring backyard. He was covered in blood and had a "self-inflicted knife wound across his throat."

A further search of the area, the affidavit continues, found additional body parts belonging to the victim.

An autopsy revealed Israel died as a result of "complex homicidal violence" and was about 18 weeks pregnant when she was killed.

Ball was arrested and remained jailed without bond on Thursday, records show.

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GoFundMe describes woman as 'a cherished wife, daughter, sister'

According to an online fundraiser created by Kylie Contreras , Israel was "a cherished wife, daughter, sister, and an expectant mother but also a beloved figure in the volleyball community."

"Bethany’s radiant spirit and unwavering kindness touched the lives of all who had the privilege of knowing her," the fundraiser created to help raise money for funeral arrangements and her husband, Josh Israel, through financial hardship, reads.

As of Thursday it had raised more than $34,000 since it was created Tuesday.

USA TODAY has reached out to Contreras.

Natalie Neysa Alund is a senior reporter for USA TODAY. Reach her at [email protected] and follow her on X @nataliealund.

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Suspect killed his pregnant sister and dismembered her body because she was ‘no longer innocent’

Jack joseph ball was charged with two counts of second-degree murder on thursday for the killings of 30-year-old bethany ann israel and her unborn child, article bookmarked.

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A 23-year-old man from Minnesota has been accused of killing his pregnant sister and dismembering her body because she was “no longer innocent.”

Jack Joseph Ball was charged Thursday with two counts of second-degree murder for the killings of 30-year-old Bethany Ann Israel of Bloomington and her unborn child, who was four months along, according to Lakeville police .

Ball was arrested late Thursday in Rosemount, about five miles northeast of the homicide scene, and had a self-inflicted knife wound across his throat. He has been in hospital since, and was only charged on Tuesday. He was arraigned and bail was set at $2 million.

According to a criminal complaint, Ball was arrested after police arrived at a house near 172nd Street and Encina Path at around 11 pm where they found a large pool of blood on the kitchen floor under the sink and sink cabinet.

Officers said they found a bloody saw, hatchet and large bloody knives in the home. As they moved through the house, officers said they saw a knife on the living room floor near the staircase. As they searched, police found several dismembered body parts they believed were Israel’s.

Officers later found Ball covered in blood with a slash wound to his throat in the backyard of a neighboring home, where his car was also parked. He was found by officers after they recieved a 911 call from a Rosemount resident reporting they saw a man through their security camera who appeared to place a body part on their front step.

The complaint noted that, despite his injury, “(Ball) was able to communicate with officers and accurately told them the date, time and name of the current president.”

Police then searched the area and found several dismembered body parts believed to be those of Israel.

After finding Ball and taking him into custody, officers later found journals and other papers belonging to him where he wrote that he was angry Israel was pregnant and “no longer innocent,” according to court documents.

The Hennepin County Medical Examiner’s Office ruled Israel’s cause of death as complex homicidal violence. She was between 17 and 18 weeks pregnant, officials said.

“The allegations in this case are deeply disturbing and horrific — words can’t describe what our law enforcement partners encountered during the investigation,” said Dakota County Attorney Kathy Keena. “My office will work hard to ensure the victims receive justice and will provide the necessary support for the victims’ family.”

Assistant Dakota County Attorney Stacy St. George added that journal entries indicate the killing “may have been premediated.”

“This is a disturbing murder of the defendant’s sister and her unborn child,” he told the court on Tuesday while asking for the high bail amount. “Journal entries indicate that this may have been premediated. As the complaint describes, the defendant murdered, then dismembered the body and placed various body parts in different locations in Dakota County.”

Ball does not have a criminal history, court records show, and the complaint did not note any mental illness issues in his past. However, Rosemount Police Chief Mikael Dahlstrom said Ball used to live in Rosemount, and his department has had previous interactions with him.

Most recently, Rosemount Police responded to a mental health call for Ball in 2022, local outlet TwinCities reported, citing comments made by Dahlstrom.

Following her death, Israel was remembered as a “cherished wife, daughter, sister, and an expectant mother” who was also a “beloved figure” in the volleyball community. “Her love for life, her family, and the friendships she nurtured are the legacies she leaves behind,” a GoFundMe page reads. “As a beacon of warmth and generosity, Bethany’s absence leaves a void that cannot be filled.”

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NYU Nurse Is Fired After Calling the Gaza War a ‘Genocide’ in Speech

NYU Langone Health gave the nurse, Hesen Jabr, an award for her work. She said hospital officials then fired her because she made pro-Palestinian remarks in an acceptance speech.

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By Joseph Goldstein

Earlier this month, NYU Langone Health bestowed an award on a labor and delivery nurse for providing compassionate care to mothers who had lost babies. But shortly after, the nurse said, the hospital fired her over the speech she gave when she accepted the award.

In it, she spoke of the suffering of Palestinian women amid the Israel-Hamas war, which she called a “genocide.” The nurse, Hesen Jabr, is not the first medical worker to be fired at NYU Langone, a major New York hospital system, over commentary about the Israeli-Palestinian conflict. The hospital is currently embroiled in a lawsuit by a prominent cancer researcher, who was fired from his job as the director of its cancer center after he posted a variety of anti-Hamas political cartoons. Some included offensive caricatures of Arab people.

A young doctor-trainee was also “removed from service” at an NYU Langone hospital on Long Island, according to the hospital, after being accused of posting a message on Instagram defending the Oct. 7 Hamas attack on Israel — though he was later quietly reinstated.

In her speech, according to a video she posted on social media , Ms. Jabr drew a connection between her work with grieving mothers in New York and the war in Gaza.

“It pains me to see the women from my country going through unimaginable losses themselves during the current genocide in Gaza,” said Ms. Jabr, who is Palestinian-American. “This award is deeply personal to me for those reasons.”

She added , “Even though I can’t hold their hands and comfort them as they grieve their unborn children and the children they have lost during this genocide, I hope to keep making them proud as I keep representing them here at NYU.”

Ms. Jabr said that these remarks led to her firing on May 22 after she returned to work following the ceremony. “As soon as I walked into the unit, I was dragged into an impromptu meeting with the President and Vice President of Nursing at NYU Langone to discuss how I ‘put others at risk’ and ‘ruined the ceremony’ and ‘offended people’ because a small part of my speech was a tribute towards the grieving mothers in my country,” she wrote in a post on Instagram. She said that she then worked most of her shift before being summoned to an office where she was fired and escorted off the premises.

Israel has categorically denied the accusation that it is carrying out a genocide in Gaza .

A spokesman for NYU Langone, Steve Ritea, confirmed that Ms. Jabr was fired following her speech, saying that there had been “a previous incident as well.”

“Hesen Jabr was warned in December, following a previous incident, not to bring her views on this divisive and charged issue into the workplace,” Mr. Ritea said in a statement. “She instead chose not to heed that at a recent employee recognition event that was widely attended by her colleagues, some of whom were upset after her comments."

“As a result, Jabr is no longer an NYU Langone employee,” he added.

Mr. Ritea did not say what the “previous incident” was. On Facebook, Ms. Jabr suggested there had long been workplace tensions. Her postings described heated political arguments on the labor and delivery floor. “The pure psychological warfare NYU has waged on me as a nurse, Muslim, Palestinian, and woman, has only left me resolute,” read one message she posted on Facebook.

Ms. Jabr’s activism dates back to her childhood: When she was in fifth grade in Louisiana, the American Civil Liberties Union filed a lawsuit on her behalf after she was forced to accept a Bible from her school principal. “This is not my first rodeo,” she said in an interview Tuesday evening.

Ms. Jabr, who had worked at NYU Langone since 2015, said that in recent months she had been questioned repeatedly by hospital administrators about her social media postings about Israel and the war in Gaza. She described her speech at the awards ceremony as “the straw that broke the camel’s back.”

Other employees around the country have been fired , suspended or investigated for their comments about the Israel-Hamas war. While some states, such as Connecticut, have restricted the ability of employers to fire workers for their opinions or speech, New York’s protections for workers are more limited .

In Ms. Jabr’s case, she had been invited to the lectern and delivered a brief speech at the awards ceremony, where, according to the hospital , she had received an award given to “a nurse who exemplifies what it means to provide compassionate care to patients and their families during perinatal bereavement.”

Before turning to the war in Gaza, Ms. Jabr expressed gratitude to her co-workers, saying the award belonged to them: “Truthfully, it does belong to all the nurses on labor who have held the hands of a grieving mother.”

In the interview, Ms. Jabr defended her speech and said talking about the war “was so relevant” given the nature of the award she had won.

“It was an award for bereavement; it was for grieving mothers,” she noted.

Joseph Goldstein covers health care in New York for The Times, following years of criminal justice and police reporting. More about Joseph Goldstein

Our Coverage of the Israel-Hamas War

News and Analysis

Declaring Hamas no longer capable of carrying out a major terrorist attack on Israel, President Biden said that it was time for a permanent cease-fire in Gaza  and endorsed a new plan .

Prime Minister Benjamin Netanyahu of Israel has been put on the spot by Biden’s announcement outlining a proposal for a truce. Now he faces a stark choice .

The Israeli military said that its forces had advanced into central Rafah , pushing even more deeply into the southern Gaza city despite an international backlash.

In the West Bank: Since the war in Gaza began, armed Jewish settlers in the Israeli-occupied territory, often accompanied by the army, have stepped up seizures of land long used by Palestinians .

A Fateful Encounter: In an Israeli prison infirmary, a Jewish dentist came to the aid of a desperately ill Hamas inmate. Years later, the prisoner became a mastermind of the Oct. 7 attack .

Getting Relatives Out: For Americans racing to evacuate their family members from Gaza, the closure of the Rafah border crossing into Egypt — the only way out for civilians — has thrown an already complicated system into disarray .