Physical Consequences after abortion
copyright 2000 Elliot Institute
DEATH: According to the best record based study of deaths following pregnancy and abortion, a 1997 government funded study in Finland, women who abort are approximately four times more likely to die in the following year than women who carry their pregnancies to term. In addition, women who carry to term are only half as likely to die as women who were not pregnant.(16)
The Finland researchers found that compared to women who carried to term, women who aborted in the year prior to their deaths were 60 percent more likely to die of natural causes, seven times more likely to die of suicide, four times more likely to die of injuries related to accidents, and 14 times more likely to die from homicide. Researchers believe the higher rate of deaths related to accidents and homicide may be linked to higher rates of suicidal or risk-taking behavior.(16)
The leading causes of abortion related maternal deaths within a week of the surgery are hemorrhage, infection, embolism, anesthesia, and undiagnosed ectopic pregnancies. Legal abortion is reported as the fifth leading cause of maternal death in the United States, though in fact it is recognized that most abortion related deaths are not officially reported as such.(2)
There is strong evidence that abortion increases the risk of breast cancer. A study of more than 1,800 women appearing in the Journal of the National Cancer Institute in 1994 found that overall, women having abortions increased their risk of getting breast cancer before age 45 by 50%. For women under 18 with no previous pregnancies, having an abortion after the 8th week increased the risk of breast cancer 800%. Women with a family history of breast cancer fared even worse. All 12 women participating in the study who had abortions before 18 and had a family history of breast cancer themselves got cancer before age 45.
The risk of breast cancer almost doubles after one abortion, and rises even further with two or more abortions.(3)
CERVICAL, OVARIAN, AND LIVER CANCER:
Women with one abortion face a 2.3 relative risk of cervical cancer, compared to non-aborted women, and women with two or more abortions face a 4.92 relative risk. Similar elevated risks of ovarian and liver cancer have also been linked to single and multiple abortions. These increased cancer rates for post-aborted women are apparently linked to the unnatural disruption of the hormonal changes which accompany pregnancy and untreated cervical damage.(4)
Between 2 and 3% of all abortion patients may suffer perforation of their uterus, yet most of these injuries will remain undiagnosed and untreated unless laparoscopic visualization is performed.(5) Such an examination may be useful when beginning an abortion malpractice suit. The risk of uterine perforation is increased for women who have previously given birth and for those who receive general anesthesia at the time of the abortion.(6) Uterine damage may result in complications in later pregnancies and may eventually evolve into problems which require a hysterectomy, which itself may result in a number of additional complications and injuries including osteoporosis.
Significant cervical lacerations requiring sutures occur in at least one percent of first trimester abortions. Lesser lacerations, or micro fractures, which would normally not be treated may also result in long term reproductive damage. Latent post-abortion cervical damage may result in subsequent cervical incompetence, premature delivery, and complications of labor. The risk of cervical damage is greater for teenagers, for second trimester abortions, and when practitioners fail to use laminaria for dilation of the cervix.(7)
Abortion increases the risk of placenta previa in later pregnancies (a life threatening condition for both the mother and her wanted pregnancy) by seven to fifteen fold. Abnormal development of the placenta due to uterine damage increases the risk of fetal malformation, perinatal death, and excessive bleeding during labor.(8)
COMPLICATIONS OF LABOR: Women who had one, two, or more previous induced abortions are, respectively, 1.89, 2.66, or 2.03 times more likely to have a subsequent pre-term delivery, compared to women who carry to term. Prior induced abortion not only increased the risk of premature delivery, it also increased the risk of delayed delivery. Women who had one, two, or more induced abortions are, respectively, 1.89, 2.61, and 2.23 times more likely to have a post-term delivery (over 42 weeks).(17) Pre-term delivery increases the risk of neo-natal death and handicaps.
Pregnancy problems Cervical damage from previously induced abortions increase the risks of miscarriage, premature birth, and complications of labor during later pregnancies by 300 - 500 percent.1,2,4,7 The reproductive risks of abortion are especially acute for women who abort their first pregnancies. A major study of first pregnancy abortions found that 48% of women experienced abortion-related complications in later pregnancies. Women in this group experienced 2.3 miscarriages for every one live birth.4 Yet another researcher found that among teenagers who aborted their first pregnancies, 66% subsequently experienced miscarriages or premature birth of their second, "wanted" pregnancies.6
When the risks of increased pregnancy loss are projected on the population as a whole, it is estimated that aborted women lose 100,000 "wanted" pregnancies each year because of latent abortion morbidity.5 In addition, premature births, complications of labor, and abnormal development of the placenta, all of which can result from latent abortion morbidity, are leading causes of handicaps among newborns.3 Looking at premature deliveries alone, it is estimated that latent abortion morbidity results in 3000 cases of acquired cerebral palsy among newborns each year. 5,7 Finally, since these pregnancy problems pose a threat to the health of the mothers too, women who have had abortions face a 58 percent greater risk of dying during a later pregnancy.
HANDICAPPED NEWBORNS IN LATER PREGNANCIES:
Abortion is associated with cervical and uterine damage which may increase the risk of premature delivery, complications of labor and abnormal development of the placenta in later pregnancies. These reproductive complications are the leading causes of handicaps among newborns.(9)
Abortion is significantly related to an increased risk of subsequent ectopic pregnancies. Ectopic pregnancies, in turn, are life threatening and may result in reduced fertility.(10)
Ectopic pregnancies. If the scar tissue covers the openings from the fallopian tube to the uterus only partially, then the sperm will be able to reach the egg in the tube. Conceptions occurs, and fertilized egg (baby) begins to grow and move toward the uterus. The fertilized egg is too large to get from the fallopian tube to the uterus opening because of the scar tissue blocking part of the opening. The baby continues to grow inside the tube, eventually causing the tube to burst. If surgery is not done to remove the baby, then the mother will die. There has been a 300% increase in ectopic pregnancies since abortion was legalized. (US Dept. H.H.S., Morbidity and Mortality Weekly Report, no. 33, no. 15, April 20, 1984--quoted in Willke's book p. 108). Among women who aborted their first pregnancy there was a 500% increase in subsequent ectopic pregnancies. (Chung et al. "Effects of Induced Abortion Complications on Subsequent Reproductive Function" U. of Hawaii, Honolulu, 1981--Wilke p. 109) This is not to say that every woman who experiences tubal pregnancy has had an abortion.
PELVIC INFLAMMATORY DISEASE (PID):
PID is a potentially life threatening disease which can lead to an increased risk of ectopic pregnancy and reduced fertility. Of patients who have a Chlamydia infection at the time of the abortion, 23% will develop PID within 4 weeks. Studies have found that 20 to 27% of patients seeking abortion have a Chlamydia infection. Approximately 5% of patients who are not infected by Chlamydia develop PID within 4 weeks after a first trimester abortion. It is therefore reasonable to expect that abortion providers should screen for and treat such infections prior to an abortion.(11)
Endometritis is a post-abortion risk for all women, but especially for teenagers, who are 2.5 times more likely than women 20-29 to acquire endometritis following abortion.(12)
Endometritis is an inflamatory disease caused mainly by bacteria that can lead to infertility due to obstruction of the falopian tromps.
Approximately 10% of women undergoing elective abortion will suffer immediate complications, of which approximately one-fifth (2%) are considered life threatening. The nine most common major complications which can occur at the time of an abortion are:
- infection, Signs of infection are fever, abdominal pain, vaginal secretion. Best treatment is a repeated aspiration procedure or D&C to empty the uterus in case of retention and to remove the infected endometrium, combined with an antibiotic course. Salpingitis may lead to sterility.
The typical infection involving the woman's reproductive organs (uterus, fallopian tubes, and ovaries) is pelvic inflammatory disease or PID. PID is often difficult to manage and often leads to sterility, even with prompt treatment. Some women have serious chronic pain the rest of their lives because of PID. Some women even have pain every time they have sex because of PID. (M. Spence, "PID: Detection and Treatment," Sexually Transmitted Disease Bulletin, Johns Hopkins University, vol. 3, no 1, February 1983). (PID is not a sexually transmitted disease but is a common complication from infection from abortion and STD's such as gonorrhea and chlamydia.) Sterility. Because of such early complications as infections after an abortion, the uterus is often scarred. If the scar tissue covers the opening from the tube to the uterus, then the tiny sperm cannot reach the egg. Fertilization cannot occur
- excessive bleeding,
- embolism: An embolism is an obstruction of a blood vessel by a foreign substance such as air, fat, tissue, or blood clot. Childbirth is a normal process, and the body is well prepared for the birth of the child and the separation and expulsion of the placenta. Surgical abortion is an abnormal process and slices the unripe placenta from the wall of the uterus into which its roots have grown. This sometimes causes the fluid around the baby, or other pieces of tissue or blood clots, to be forced into the mother's circulation. These then travel to her lungs, causing damage and occasionally death. (W. Cates et al., American Journal OB/GYN, vol. 132, p. 16
Usually, such a blockage is minor and goes unnoticed and is eventually dissolved. But if the block occurs in the brain or heart, it may result in a stroke or heart attack. This condition may occur anywhere from 2-50 days after an abortion and is a relatively frequent major complication.
- ripping or perforation of the uterus,
- anesthesia complications,Due to the rich blood supply around the uterus during pregnancy, local and general anesthesia during abortions is risky. Convulsion, heart arrest and death are not an uncommon result because outpatient abortion clinics generally have little equipment and expertise to deal with it.
- hemorrhage, Bleeding from the injection sites after injecting the local anesthetic occurs frequently but invariably ceases within a few minutes. So we are only concerned with uterine bleeding of the uterus by classical D&C in an advanced pregnancy blood loss may be abundant, first from the partly removed placenta, later from the exposed implantation site of the uterine wall. The latter will finish if the uterus is empty, because then the uterus contracts and thereby closes its vessels. Termination with prostaglandins too is generally accompanied with much blood loss probably due to early separation of the placenta from the uterine wall.
- cervical injury,
- and endotoxic shock.
The most common "minor" complications include:
- second degree burns,
- chronic abdominal pain,
- gastro-intestinal disturbances, and
- Rh sensitization.(13)
INCREASED RISKS FOR WOMEN SEEKING MULTIPLE ABORTIONS:
In general, most of the studies cited above reflect risk factors for women who undergo a single abortion. These same studies show that women who have multiple abortions face a much greater risk of experiencing these complications. This point is especially noteworthy since approximately 45% of all abortions are for repeat aborters.
LOWER GENERAL HEALTH:
In a survey of 1428 women researchers found that pregnancy loss, and particularly losses due to induced abortion, was significantly associated with an overall lower health. Multiple abortions correlated to an even lower evaluation of "present health." While miscarriage was detrimental to health, abortion was found to have a greater correlation to poor health. These findings support previous research which reported that during the year following an abortion women visited their family doctors 80% more for all reasons and 180% more for psychosocial reasons. The authors also found that "if a partner is present and not supportive, the miscarriage rate is more than double and the abortion rate is four times greater than if he is present and supportive. If the partner is absent the abortion rate is six times greater." (15)
This finding is supported by a 1984 study that examined the amount of health care sought by women during a year before and a year after their induced abortions. The researchers found that on average, there was an 80 percent increase in the number of doctor visits and a 180 percent increase in doctor visits for psychosocial reasons after abortion.(18)
INCREASED RISK FOR CONTRIBUTING HEALTH RISK FACTORS:
Abortion is significantly linked to behavioral changes such as promiscuity, smoking, drug abuse, and eating disorders which all contribute to increased risks of health problems. For example, promiscuity and abortion are each linked to increased rates of PID and ectopic pregnancies. Which contributes most is unclear, but apportionment may be irrelevant if the promiscuity is itself a reaction to post- abortion trauma or loss of self esteem.
INCREASED RISKS FOR TEENAGERS:
Teenagers, who account for about 30 percent of all abortions, are also at much high risk of suffering many abortion related complications. This is true of both immediate complications, and of long-term reproductive damage.(14)
1. An excellent resource for any attorney involved in abortion malpractice is Thomas Strahan's Major Articles and Books Concerning the Detrimental Effects of Abortion (Rutherford Institute, PO Box 7482, Charlottesville, VA 22906-7482, (804) 978-388.) This resource includes brief summaries of major finding drawn from medical and psychology journal articles, books, and related materials, divided into major categories of relevant injuries.
2. Kaunitz, "Causes of Maternal Mortality in the United States," Obstetrics and Gynecology, 65(5) May 1985.
3. H.L. Howe, et al., "Early Abortion and Breast Cancer Risk Among Women Under Age 40," International Journal of Epidemiology 18(2):300-304 (1989); L.I. Remennick, "Induced Abortion as A Cancer Risk Factor: A Review of Epidemiological Evidence," Journal of Epidemiological Community Health, (1990); M.C. Pike, "Oral Contraceptive Use and Early Abortion as Risk Factors for Breast Cancer in Young Women," British Journal of Cancer 43:72 (1981).
4. M-G, Le, et al., "Oral Contraceptive Use and Breast or Cervical Cancer: Preliminary Results of a French Case- Control Study, Hormones and Sexual Factors in Human Cancer Etiology, ed. JP Wolff, et al., Excerpta Medica: New York (1984) pp.139-147; F. Parazzini, et al., "Reproductive Factors and the Risk of Invasive and Intraepithelial Cervical Neoplasia," British Journal of Cancer, 59:805-809 (1989); H.L. Stewart, et al., "Epidemiology of Cancers of the Uterine Cervix and Corpus, Breast and Ovary in Israel and New York City," Journal of the National Cancer Institute 37(1):1-96; I. Fujimoto, et al., "Epidemiologic Study of Carcinoma in Situ of the Cervix," Journal of Reproductive Medicine 30(7):535 (July 1985); N. Weiss, "Events of Reproductive Life and the Incidence of Epithelial Ovarian Cancer," Am. J. of Epidemiology, 117(2):128-139 (1983); V. Beral, et al., "Does Pregnancy Protect Against Ovarian Cancer," The Lancet, May 20, 1978, pp. 1083-1087; C. LaVecchia, et al., "Reproductive Factors and the Risk of Hepatocellular Carcinoma in Women," International Journal of Cancer, 52:351, 1992.
5. S. Kaali, et al., "The Frequency and Management of Uterine Perforations During First-Trimester Abortions," Am. J. Obstetrics and Gynecology 161:406-408, August 1989; M. White, "A Case-Control Study of Uterine Perforations documented at Laparoscopy," Am. J. Obstetrics and Gynecology 129:623 (1977).
6. D. Grimes, et al., "Prevention of uterine perforation During Curettage Abortion," JAMA, 251:2108-2111 (1984); D. Grimes, et al.,"Local versus General Anesthesia: Which is Safer For Performing Suction Abortions?" Am. J. of Obstetrics and Gynecology, 135:1030 (1979).
7. K. Schulz, et al., "Measures to Prevent Cervical Injuries During Suction Curettage Abortion," The Lancet, May 28, 1983, pp 1182-1184; W. Cates, "The Risks Associated with Teenage Abortion," New England Journal of Medicine, 309(11):612-624; R. Castadot, "Pregnancy Termination: Techniques, Risks, and Complications and Their Management," Fertility and Sterility, 45(1):5-16 (1986).
8. Barrett, et al., "Induced Abortion: A Risk Factor for Placenta Previa", American Journal of Ob&Gyn. 141:7 (1981).
9. Hogue, Cates and Tietze, "Impact of Vacuum Aspiration Abortion on Future Childbearing: A Review", Family Planning Perspectives (May-June 1983),vol.15, no.3.
10. Daling,et.al., "Ectopic Pregnancy in Relation to Previous Induced Abortion", JAMA, 253(7):1005-1008 (Feb. 15, 1985); Levin, et.al., "Ectopic Pregnancy and Prior Induced Abortion", American Journal of Public Health (1982), vol.72,p253; C.S. Chung, "Induced Abortion and Ectopic Pregnancy in Subsequent Pregnancies," American Journal of Epidemiology 115(6):879-887 (1982)
11. T. Radberg, et al., "Chlamydia Trachomatis in Relation to Infections Following First Trimester Abortions," Acta Obstricia Gynoecological (Supp. 93), 54:478 (1980); L. Westergaard, "Significance of Cervical Chlamydia Trachomatis Infection in Post-abortal Pelvic Inflammatory Disease," Obstetrics and Gynecology, 60(3):322-325, (1982); M. Chacko, et al., "Chlamydia Trachomatosis Infection in Sexually Active Adolescents: Prevalence and Risk Factors," Pediatrics, 73(6), (1984); M. Barbacci, et al., "Post- Abortal Endometritis and Isolation of Chlamydia Trachomatis," Obstetrics and Gynecology 68(5):668-690, (1986); S. Duthrie, et al., "Morbidity After Termination of Pregnancy in First-Trimester," Genitourinary Medicine 63(3):182-187, (1987).
12. Burkman, et al., "Morbidity Risk Among Young Adolescents Undergoing Elective Abortion" Contraception, 30:99-105 (1984); "Post-Abortal Endometritis and Isolation of Chlamydia Trachomatis," Obstetrics and Gynecology 68(5):668- 690, (1986)
13. Frank, et.al., "Induced Abortion Operations and Their Early Sequelae", Journal of the Royal College of General Practitioners (April 1985),35(73):175-180; Grimes and Cates, "Abortion: Methods and Complications", Human Reproduction, 2nd ed., 796-813; M.A. Freedman, "Comparison of complication rates in first trimester abortions performed by physician assistants and physicians," Am. J. Public Health, 76(5):550- 554 (1986).
14. Wadhera, "Legal Abortion Among Teens, 1974-1978", Canadian Medical Association Journal, 122:1386-1389,(June 1980).
15. Ney, et.al., "The Effects of Pregnancy Loss on Women's Health," Soc. Sci. Med. 48(9):1193-1200, 1994; Badgley, Caron, & Powell, Report of the Committee on the Abortion Law, Supply and Services, Ottawa, 1997: 319-321.
16. Gissler, M., et. al., "Pregnancy-associated deaths in Finland 1987-1994 -- definition problems and benefits of record linkage," Acta Obsetricia et Gynecolgica Scandinavica 76:651-657 (1997).
17. Zhou, Weijin, et. al., "Induced Abortion and Subsequent Pregnancy Duration," Obstetrics & Gynecology 94(6):948-953 (Dec. 1999).
18. D. Berkeley, P.L. Humphreys, and D. Davidson, "Demands Made on General Practice by Women Before and After an Abortion," J. R. Coll. Gen. Pract. 34:310-315, 1984.
Pregnancy Problems Notes
1. Harlap and Davies, "Late Sequelae of Induced Abortion: Complications and Outcome of Pregnancy and Labor", American Journal of Epidemiology (1975), vol.102,no.3.
2. Hogue,"Impact of Abortion on Subsequent Fecundity", Clinics in Obstetrics and Gynaecology (March 1986), vol.13,no.1.
3. Hogue, Cates and Tietze, "Impact of Vacuum Aspiration Abortion on Future Childbearing: A Review", Family Planning Perspectives (May-June 1983),vol.15, no.3.
4. Lembrych, "Fertility Problems Following Aborted First Pregnancy",eds.Hilgers, et.al., New Perspectives on Human Abortion (Frederick, Md.: University Publications of America, 1981).
5. Reardon, Aborted Women-Silent No More, (Chicago: Loyola University Press, 1987).
6. Russel, "Sexual Activity and Its Consequences in the Teenager", Clinics in Ob&Gyn, (Dec. 1974). vol.1,no.3,pp683-698.
7. Wynn and Wynn, "Some Consequences of Induced Abortion to Children Born Subsequently", British Medical Journal (March 3, 1973), and Foundation for Education and Research in Child Bearing (London, 1972).
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