Abyzou unmasked

In the abortion debate, a key question is not when the developing human gains biological human status, but rather moral human status (for example, a placenta, genetically distinct from the parents, has the former but not the latter). Assertions generally range from fertilisation to birth. Internal consistency requires that proponents of the former position (“fertilisationists”) give due (for those of moral human status) consideration to all post-fertilisation losses.

A recent study [1] found 1.06 million induced abortions performed in the US for 2011. US census data [2] reveals 3.95 million births over this period. These figures do not include spontaneous abortions (miscarriage). While spontaneous abortion occurs in approximately 10% of recognised pregnancies, the majority of spontaneous abortions occur prior to the first missed menstrual period. A study of 618 pregnancies biochemically detected via hCG [3] found that 7.9% ended in clinical spontaneous abortion while a further 24.6% ended prior to clinically recognised pregnancy. Therefore, it can be extrapolated that 5.01 million births plus induced abortions comprise 67.5% of 7.42 million hCG-detectable pregnancies.

These figures still underestimate the true incidence of subclinical spontaneous abortion because most losses occur prior to implantation and detectable hCG rise. A study of 107 hysterectomy specimens performed in women with optimal probability of having recently conceived [4] found only 34 ova, of which 13 were abnormal potential abortuses. Of 8 pre-implanted ova, 4 (50%) were abnormal. The failure to identify ova in other specimens was attributed to failure of fertilisation or disintegration of a fertilised ovum. The greatest losses occurred at the pre-implantation stage or soon after. The rough estimation that 50% of fertilised ova survive beyond pre-implantation resulting in 3.95 million births comprising 26.6% of 14.84 million fertilised ova, is serendipitously consistent with most studies demonstrating the maximum chance of achieving clinically recognised pregnancy in one cycle at ~30% [5].

Estimated post-fertilisation outcomes are as follows:

- 7.42 million (50%) unrecognised spontaneous abortions, pre-implantation

- 3.95 million (27%) births

- 1.83 million (12%) unrecognised spontaneous abortions, post-implantation

- 1.06 million (7%) induced abortions

- 0.58 million (4%) recognised spontaneous abortions

Fertilisationists and non-fertilisationists agree on the moral imperative to reduce recognised spontaneous abortions and significant medical efforts are directed towards this. While fertilisationists also direct significant attention against induced abortions, it is arguably unrecognised spontaneous abortions, outnumbering induced abortions almost ninefold, that merit most fertilisationist attention.

Several counter-arguments are untenable:

- “Unrecognised spontaneous abortions are natural.” Disease is natural. The moral imperative is to intervene.

- “Unrecognised spontaneous abortions occur unknowingly.” The death of one moral human status entity is not mitigated by the ignorance of another. The moral imperative is to increase awareness.

- “Unrecognised spontaneous abortions have no available intervention.” Effort has not been directed towards finding interventions. The moral imperative is for effort.

Failure to accept or otherwise resolve the unrecognised spontaneous abortion imperative creates a reductio ad absurdum against the fertilisationist position. Note that abortion at other stages of human development is separate from the question of fertilisationism.

References

1. Jones, Rachel K., and Jenna Jerman. "Abortion incidence and service availability in the United States, 2011." Perspectives on Sexual and Reproductive Health 46.1 (2014): 3-14.

2. Martin, Joyce A., et al. "Births: final data for 2010." National vital statistics reports 61.1 (2012): 1-72.

3. Wang, Xiaobin, et al. "Conception, early pregnancy loss, and time to clinical pregnancy: a population-based prospective study." Fertility and sterility 79.3 (2003): 577-584.

4. Hertig, A. T., and J. Rock. "Searching for early fertilized human ova." Gynecologic and Obstetric Investigation 4.3-4 (1973): 121-139.

5. Macklon, Nick S., Joep PM Geraedts, and Ban CJM Fauser. "Conception to ongoing pregnancy: the ‘black box’ of early pregnancy loss." Human Reproduction Update 8.4 (2002): 333-343.