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Today, hospital abortions are usually quite safe, especially during the first trimester of pregnancy. Until the twelfth week, the standard technique is dilation and curettage ("D and C"); a surgeon merely stretches the cervix with dilators, then removes the conceptus with a tiny, scoop-shaped instrument called a curette. After three months, one method is to inject a salt solution into the amniotic sac, thus starting labor contractions that expel the fetus. In Communist countries, where the right to abortion is given or withheld at the whim of the state, a small vibrodilator is inserted in the uterus for 45 seconds; a tiny vacuum then empties the contents. Widely used until the twelfth week, the method minimizes injury, takes only three minutes. In 1964, Czechoslovakia reported no deaths in 140,000 legal abortions, Hungary only two in 358,000.
Despite the safeness, abortion is an emotion-charged equa tion: a maternal life saved equals a fetal life destroyed. Out of deep concern for the fetus—as well as tribal survival—men disapproved of abortion even before the Hippocratic oath. The very first Christians called it infanticide; in A.D. 314, the church prescribed ten years' penance for it. Thereafter, theologians debated the point at which the fetus is "animated" with a rational soul and hence murderable. By the 12th century, abortion was generally not punished by excommunication when performed within 40 days of conception for a male fetus and 80 days for a female, though it was impossible then (as it is difficult now) to fix the time of conception, and no one ever explained how fetal sex could be predetermined. Pope Sixtus V (1585-90) made abortion an excommunicatory sin at any stage of development, but this order was reversed in the year after his death by Gregory XIV, who approved excommunication only after a fetus was 40 days old. In 1869, Pius IX reverted the Roman Catholic Church to the Sixtus position, which holds that ensoulment begins at conception.
Modern Catholic clerics increasingly rely on embryology rather than ensoulment to urge that a newly fertilized ovum is virtually a person because it contains all the cell-creating chromosomes that a human ever has. As they see it, the conceptus is a living continuum from the start, a life that dies only by outside interference. In 1930, Pius XI made it clear that abortion is forbidden, even to save a woman's life, because the fetus is "equally sacred." The church's stand is widely ignored in Catholic countries, which ban birth control and have high rates of abortion as a result. In France, illegal abortions roughly equal—and may well exceed—live births. In South America, induced abortion is the No. 1 cause of death for women of childbearing age. Similar patterns exist in no-abortion Moslem countries; an estimated one-third of Iran's pregnancies are aborted.