Elective abortion: medical risks incurred by women


During the European seminar held in Brussels at the COMECE[1] last 22nd June on “Preventing abortion in Europe”, Cherline Louissaint, lawyer, backed by a number of studies on the subject, went over the medical risks incurred by women who abort.

Abortion does not come without medical risks, whatever the woman’s physical or mental health may be, and its consequences don’t concern women alone but also have an impact on the baby born afterwards or even on their current and/or future partner.

 

A) Physical health risks

 

1) Short-term risks

 

Planned Parenthood, the world’s biggest abortion centre itself, actually provides a list of the short-term risks after an abortion: infections, cervical lesions, blood clots in the uterus, incomplete abortion, etc[2].

Looking at the various studies, it would appear that the most frequent short-term risks are infections, and that they occur in 1 to 5% of cases[3]. Underage girls are, however, far more subject to short-term physical risks because they do not benefit from the protective power of the cervical mucus older women produce. Thus, one can note that the risk of them suffering from cervical tear is twice as high[4].

 

2) Long-term risks

 

 - Risks for future babies

Though the risks that can be observed occur straight after abortion, some risks occur much later, such as during ulterior births. The health of future babies is at risk. Indeed, for women having already had an abortion, the chances of giving birth to a premature baby is increased by 37%. More so, the risk of giving birth to an extremely preterm baby is far greater as the risk of giving birth before 32 weeks is increased by 64%[6].

The risk is all the greater for women who have had repeated abortions              as, for them, the risk of giving birth to a preterm baby is increased by 93%[7], and the risk of giving birth to an extremely preterm baby by 178%[8].

For women who abort, the risk of giving birth to a child weighing less than 1.5 kg is increased by 15%[9].

 

- Risks for women

Beyond the risks for future babies, the mother’s health can also be directly affected. Indeed, although opinions are not unanimous on the fact that abortion potentially has a direct impact on breast cancer, most studies on the subject show a direct link between abortion and breast cancer. Thus, for example, the National Cancer Institute of Canada brings out the fact that on a population of women who have been pregnant at least once, women who have had an abortion have 50% more chance of getting breast cancer compared with women who brought all their pregnancies to term[10].

 

B) Risks on mental health

 

1)  Mental diseases

 

Women who have aborted have a far greater risk of going into depression than women who have given birth (53% higher)[11], and the risk of self-mutilation is 7% higher[12] for women having had an abortion; this, on a population of women having no psychiatric history. The risk of depression is higher for underage girls, for whom suicide and suicidal ideation rates are 50% higher[13].

 

The risks of drug or alcohol consumption are also increased by 142% and 287% compared with women who gave birth[14].

Men are not spared by this reality and are also psychologically affected by their partner’s abortion. A comparative study between men and women shows that in cases in which 56.9% of women experience psychological distress before abortion, 40.7% of men go through a similar experience. Men, also, remain affected by abortion, as 30.9% declare they experience a strong feeling of distress[15].

 

2) Risk of suicide

 

The risk of committing suicide is aggravated by abortion, contrary to giving birth which reduces it.

The WHO declared that in 2000 the suicide rate was almost as high as the combined death rates of homicides and wars, i.e., 815 000 suicides. The suicide rate is higher for women[16]. China is a striking example; 56% of suicides are committed by women[17].

 After comparing suicides among women having given birth and after an abortion in various countries, it was made clear that abortion is an aggravating factor of the risk of committing suicide. Though it is true some women commit suicide after giving birth, giving birth usually has a rather positive effect on women. However, it is clear that the number of suicide attempts increases after an abortion (5 out of 1000 women against 8.1 out of 1000 women after an abortion)[18], while they decrease after having given birth[19]. Independently from the moment in time, the number of suicide attempts concerning births is only 4.8 for 1000 women, while it is 13.1 for 1000 abortions[20].

 

C) Risk on the couple relationship

 

The impact on the couple is also visible; many sexual dysfunctions occurs after an abortion. Up to 31% of women having aborted experiment various sexual dysfunctions which can last as long as one year after the abortion; they are often related to the anxiety and depression that comes after an abortion[21].  In the weeks following an abortion, dysfunctions were also observed in 18% of the women’s partners[22].

Likewise, the couple suffers. Both men and women who have aborted find it difficult to get back into a stable relationship, and have impersonal sexual relationships. Besides, certain arguments and separations are directly connected to abortion. A study revealed that around 50% of women said that abortion had been a cause for major crises in their couple and 50% say that the relationship with their partner had been significantly altered after an abortion[23]. 22% of relationships end after an abortion[24].

 

D) Risk of death

 

Having recourse to abortion can go as far as causing the woman’s death, as reported by the laboratory which produces abortive pills and which counted down 2207 incidents[25], of which 14 deaths, since women have started using them [26].

 

1) Maternal mortality

 

First of all, mother mortality is an important cause for death. Mother mortality is defined as a death that occurs for any reason other than accidental or fortuitous during the pregnancy or for as long as 42 days after it was terminated.

 

It is generally believed that maternal mortality is higher in countries which have a more restrictive legislation concerning abortion, because one of the consequences would be the practice of abortions in dangerous conditions due to its unlawfulness. However, in countries likewise developed, it has been shown that maternal mortality remains lower in countries with a strong restriction concerning abortion.

 

Thus, one can quote Malta and Italy as examples for Europe. In these countries, the maternal mortality rate is respectively 3 and 4 for 100 000. In France and Belgium, the rates are 9 and 6 for 100 000[29].

 

The example of Chili[30] is particularly telling. Its law on the subject, voted in 1989[31], is a restrictive one. However, from that very date, not only did the rate not increase but it halved. It went from 41.3 to 22 deaths for 100 000 in 2013. Inversely, the rate in the US is of 44 deaths for 100 000 births in 2013[32].

 

2)   Other causes for death

 

If the simple fact of being pregnant supposes an increase of the risk of death, during the first year, these risks are increased by 80% for women having chosen to terminate their pregnancy compared with women who brought their pregnancy to its term[33]. This risk is all the greater as the abortion is done later. Thus, as shown in a study, the risk of dying for women who abort during the first 20 weeks is 35 times greater. This risk is 91 times greater for women who abort after 21 weeks[34].

 

After identification of the various causes of death, the same conclusion can be made every time: there is a greater risk of death for women who abort. It is so for deaths of natural causes (Risk 60% greater)[35], caused by AIDS (twice as contaminated) [36], and caused by cardiovascular and mental diseases (risks 3 times greater) [37]. It should be added that depression, which occurs more often after an abortion than after a birth, is a factor for death because of the heart diseases and various types of cancers it causes.

 

Besides, it has been observed that women who have aborted are more likely to die from a lethal accident or from physical violence. A woman with a new-born baby is far more prudent. She avoids risks, which appear to be 4 times greater for women who have aborted compared with women who have given birth [38]. Likewise, women having aborted have a tendency to become self-destructive after an abortion and are less careful at avoiding confrontations. The risk of them dying from a homicide is 4 times higher than for the rest of the population[39].

 

[1the Commission of the Episcopates of the European Community.

[2] Planned Parenthood, In-Clinic Abortion procedures. Available at the following address: http://www.plannedparenthood.org/learn/abortion/in-clinic-abortion-proce...

[3] J.M. Thorp, “Public Health Impact of Legal Termination of Pregnancy in the US: 40 Years Later”, Scientifica, 2012.

[4] K.F. Schultz et al., “Measures to prevent cervical injury during suction curettage abortion”, Lancet 1, Vol.321, n°8335, 1993, p.1182 ; R.T. Burkman et al., “Morbidity risk among young adolescents undergoing elective abortion”, Contraception, Vol.30, n°2, 1984, p.99. Quoted in the report: Women’s protection project, American United for Life, Washington D.C., 2013.

[5] P.Shah et al., Induced termination of pregnancy and low birth weight and preterm birth: a systematic review and meta-analysis”, An International Journal of Obstetrics and Gynaecology, Vol.116, n°11, 2009, p.1425-1442.Another study concluded that there is a 20% risk after a first abortion and 90% after at least two abortions. (R.H.F. van Oppenraaij et al., “Predicting adverse obstetric outcome after early pregnancy events and complications: a review”, Human Reproduction Update, Vol. 15, n°4, March 7, 2009, p.409-421).

[6] H.M. Swingle et al., “Abortion and the Risk of Subsequent Birth: A Systematic Review and Meta-Analysis”, The Journal of Reproductive Medecine, Vol. 54, n°2, 2009, p.95-102; Another study shows that for a women who has had an abortion the risk of giving birth before 33 weeks is increased by 50% and by 70% of giving birth before 28 weeks (J.M. Thorp et al., op. cit. supra).

[7] P.Shah et al., op. cit. supra).

[8] R. Klemetti et al., “Birth outcomes after induced abortion: A nationwide register-based study of first births in Finland”, Human Reproduction, 2012. The risk of giving birth before 37 weeks increases by 35% when a woman has had more than 3 abortions. Besides, another study shows that the risk for a woman to give birth prematurely is doubled after two abortions; the risk is increased by 800% after a woman has had at least 4 abortions (B. Rooney & B.C. Calhoun, “Induced Abortion and Risk of Later Premature Births”, Journal of American Physicians and Surgeon, Vol. 8, n°2, 2003, p.46.

[9] Ibid.

[10] JR. Daling et al., “Risk of Breast Cancer Among Young Women: Relationship to Induced Abortion”, J. Natl Cancer Inst., Vol.86, n°21, 1994, 1584-92.

[11] PK. Coleman, “Abortion and Mental health: quantitative synthesis and analysis of research published 1995-2009”, The British Journal of Psychiatry, Vol.199, n°3, 2011, p.180-186.

[12] A.C. Gilchrist, P.C Hannaford, P. Frank, C.R Kay, “Termination of pregnancy and psychiatric morbidity”, Brit. J. Psychiatry, Vol. 47, n°1, 2006, p.16-24.

[13] DM. Fergusson, J. Horwood, EM Ridder, “Abortion in young women and subsequent mental health”, J.Child Psychol. Psychiatry, Vol.47, n°1, 2006, p.16-24

[14] PK. Coleman, art. cit. supra; NP. Mota, M. Burnett and J. Sareen, “Associations between abortion, mental disorders, and suicidal behaviour in a nationally representative sample” The Canadian Journal of Psychiatry, Vol.55, n°4, 2010, p.239-47: risk increased by 110% concerning alcohol abuse.

[15] P. Lauzon, D. Roger-Achim, A. Achim, R. Boyer, “Emotional distress among couples involved in first trimester abortions”, Can. Fam. Physician, Vol. 46, 2000, p. 2033-2040

[16] World Health Organisation, World report on violence and health, Geneva, 2002, chart 1.2, p. 10.

[17] DC. Reardon, “Suicide rates in China”, The Lancet, Vol. 359, 2002, p.2274.

[18] C. Morgan, M. Evans, JR. Peter, “Mental health may deteriorate as a direct effect of induced abortion”, British Medical Journal, Vol. 314, 1997, p. 902.

[19] Ibid

[20] Ibid

[21] F. Bianchi-Demicelli, E. Perrin, F. Ludick, PG. Bianchi, D. Chatton, A. Campana, “Termination of pregnancy and women’s sexuality”, Gynecol. Obstet. Invest., Vol. 53, 2002, p.48-53; in a study led on a group of Russian and American women, respectively 6.2% and 24% of these women report having had sexual dysfunctions directly related to a former abortion (VM. Rue et al., “Induced abortion and traumatic stress […] “)

[22] P.K. Coleman, V.M. Rue and C.T. Coyle, “Induced abortion and intimate relationship quality in the Chicago”, Health and Social Life Survey, 2009, p.1-8.

[23] DH. Sherman, N. Mandelman, TD. Kerenyi, J. Scher, “The abortion experience in private practice” in Women and loss: psychobiological perspectives, ed William F. Finn, et al., The Foundation of Thanatology Series, Vol. 3, New York, Praeger Publications, 1985, p. 98-107.

[24] W. Barnett, N. Freudenberg and R. Wille, “Partnership after induced abortion: a prospective controlled study”, Arch. Sex. Behav., Vol. 21, n°5, 1992, p. 443-455.

[25] Mifeprex Final Printed Labeling (FPL), 2005, available at the following address: www.accessdata.fda.gov/drugsatfda_docs/label/2005/020687s013lbl.pdf

[26] Mifepristone

[27] World Health Organisation, World health statistics 2015, p.66 available at the following address: http://www.who.int/gho/publications/world_health_statistics/2015/en/

[28] Ibid, p.62

[29] Ibid, p. 58 et 62.

[30] Ibid

[31] Ibid, p.58.

[32] L.A. Bartlett et al., Risk Factors for Legal Induced Abortion – Related Mortality in the United States”, Obstetrics & Gynecology, 1, Vol. 103, n°4, 2004, p.729, 731.

[33] D.C. Reardon and P.K. Coleman, “Short and long-term mortality rates associated with first pregnancy outcome: Population register based study for Denmark 1980-2004”, Med Sci Monit, Vol. 18, n°9, 2012.

[34] L.A. Bartlett et al., “Risk Factors for Legal Induced Abortion – Related Mortality in the United States”, Obstetrics & Gynecology, 1, Vol. 103, n°4, 2004, p. 729, 731.

[35] M. Gissler et al., “Pregnancy-Associated Deaths in Finland 1987-1994 – Definition Problems and Benefits of Record Linkage”, Acta Obstetricia et Gynecologica scandinavica, Vol. 76, n°7, 1997 quoted in art. Cit. supra: Reardon et al., “Deaths associated with abortion[…]”.

[36] DC. Reardon, PG. Ney, F. Scheuren, J. Cougle, P.K. Coleman and T.W. Strahan, “Deaths Associated with Pregnancy Outcome: A Record Linkage Study of Low Income Women”, Southern Medical Journal, Vol. 95, n°8, 2002, p. 834-841.

[37] Ibid

[38] DC. Reardon, T.W. Strahan, J.M. Thorp, M.W. Shuping, “Deaths associated with abortion compared to childbirth – a review of new and old data and the medical and legal implications”, The Journal of Contemporary Health Law and Policy, Vol. 20, n°2, 2004, p. 279-327.

[39] Ibid