Considering Abortion

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Abortion Risks

It may seem like abortion will wipe away this situation and you can just move on.  It’s not that simple.  Abortion is not just a simple medical procedure. For many women, it is a life changing event with significant physical, emotional, and spiritual consequences. Most women who struggle with past abortions say that they wish they had been told all of the facts about abortion and its risks.

Abortion carries the risk of significant complications such as bleeding, infection, and damage to organs. Serious medical complications occur infrequently in early abortions, but increase with later abortions 1, 2. Getting complete information on the risks associated with abortion is limited due to incomplete reporting and the lack of record-keeping linking abortions to complications. The information that is available reports the following risks.

Immediate Risks

BLEEDING Some bleeding after abortion is normal. However, if the cervix is torn or the uterus is punctured, there is a risk of severe bleeding known as hemorrhaging.3, 4, 5 When this happens, a blood transfusion may be required. Severe bleeding is also a risk with the use of the abortion pill: one in 100 women require surgery to stop the bleeding.6 INFECTION Infection can develop from the insertion of medical instruments into the uterus, or from fetal body parts that are mistakenly left inside (known as an incomplete abortion). This may cause bleeding and a pelvic infection requiring antibiotics and a repeat abortion to fully empty the uterus.7, 8 Infection may cause scarring of the pelvic organs.9, 10 Use of the abortion pill has resulted in the death of a number of women due to sepsis (total body infection).11, 12 DAMAGE TO ORGANS The cervix and/or uterus may be cut, torn, or damaged by abortion instruments. This may cause excessive bleeding requiring surgical repair.13 Curettes and other abortion instruments may cause permanent scarring of the uterine lining.14 The risk of these types of complications increases with the length of the pregnancy. If complications occur, major surgery may be required, including removal of the uterus (known as a hysterectomy).15 If the uterus is punctured or torn, there is also a risk that damage may occur to nearby organs such as the bowel and bladder.16 DEATH In extreme cases, complications from abortion (excessive bleeding, infection, organ damage from a perforated uterus, and adverse reactions to anesthesia) may lead to death.17, 18 This complication is rare.

Long Term Risks

Finding out the real risks of abortion can be difficult. Women should be given comprehensive information before going through a procedure or taking a medicine that could have lifelong effects on health. Doctors should obtain informed consent before doing a medical procedure. Consider the following as you make your decision: ABORTION AND PRETERM BIRTH Women who undergo one or more induced abortions carry a significantly increased risk of delivering prematurely in the future. Premature delivery is associated with higher rates of cerebral palsy, as well as other complications of prematurity (brain, respiratory, bowel, and eye problems).19, 20, 21, 22 ABORTION AND BREAST CANCER Medical experts continue to debate the association between abortion and breast cancer. Did you know that carrying a pregnancy to full term gives a measure of protection against breast cancer? Terminating a pregnancy results in loss of that protection.23, 24 Despite the controversy around this issue, it is important for women to know what some experts say: a number of reliable studies have demonstrated connection between abortion and later development of breast cancer.25, 26, 27, 28, 29, 30 For more information regarding this potential risk, contact 0800 U Choose.
Following abortion, many women experience initial relief. The perceived crisis is over and life returns to normal. For many women, however, the crisis isn’t over. Months and even years later, significant problems develop. There is evidence that abortion is associated with a decrease in both emotional and physical health, long term.31 Many studies have shown abortion to be connected to: Clinical Depression 32, 33, 34 Drug and Alcohol Abuse 35, 36 Post-traumatic Stress Disorder 37, 38 Suicide 39, 40, 41, 42, 43 Women who have experienced abortion may develop the following symptoms: Guilt, Grief, Anger, Anxiety, Depression, Suicidal Thoughts Difficulty Bonding with Partner or Children Eating Disorders If you or someone you know is experiencing these symptoms, we can put you in touch with confidential, compassionate support groups designed to help women work through these feelings. You are not alone.

Spiritual Consequences

People have different understandings of God. Whatever your present beliefs may be, there is a spiritual side to abortion that deserves to be considered. 0800 U Choose are here to talk with you about any concerns you may have.

The information presented on this website is intended for general education purposes only and should not be relied upon as a substitute for professional and/or medical advice.
REFERENCES

1. Medical Management of Abortion. ACOG Practice Bulletin No. 67

2. Katz Comprehensive Gynecology, 5th Edition, 2007 Mosby-Elsevier

3. Katz Comprehensive Gynecology, 5th Edition, 2007 Mosby-Elsevier

4. Rock, J and Thompson J; TeLinde’s Operative Gynecology, 1997; 8th edition Lippincott-Raven

5. Stenchever, et al. Comprehensive Gynecology. 2001, 4th edition, Mosby, Inc

6. Mifeprex Package Insert FDA-approved label, July 2005.

7. Katz Comprehensive Gynecology, 5th Edition, 2007 Mosby-Elsevier

8. Stenchever, et al. Comprehensive Gynecology. 2001, 4th edition, Mosby, Inc

9. ACOG Practice Bulletin, Antibiotic Prohyllaxis for Gynecologic Procedures”; No. 74, July 2006

10. Dilatation and Curettage. ACOG Patient Education Pamphlet. American College of Obstetricians and Gynecologists December 2005

11. ACOG Practice Bulletin, Medical Management of Abortion; No. 67, October 2005

12. Meich R. Pathophysiology of mifepristone-induced septic shock due to Clostridium sordellii. Ann Pharmacother 2005;39:xxxx. Published online, 26 Jul 2005, www.theannals.com

13. Rock, J and Thompson J; TeLinde’s Operative Gynecology, 1997; 8th edition Lippincott-Raven.

14. ACOG Patient Education Bulletin, Dilatation and Curettage; December 2005

15. Rock, J and Thompson J; TeLinde’s Operative Gynecology, 1997; 8th edition Lippincott-Raven.

16. Ibid.

17. Ibid.

18. Katz Comprehensive Gynecology, 5th Edition, 2007 Mosby-Elsevier

19. Rooney B, Calhoun B. Induced abortion and risk of later premature births. Journal of American Physicians and Surgeons 2003; 8(2):46-49.

20. Ancel P, et al. History of induced abortion as a risk factor for preterm birth in European countries: results of the EUROPOP survey. Human Reproduction 2004; 19 (3)734-760.

21. Behrman, R and Stith Butler A. Preterm Birth: Causes, Consequences, and Prevention 2006.Institute of Medicine of the National Academy of Science.

22. Swingle HM, et al. Abortion and the risk of subsequent preterm birth, a systematic review with meta-analyses. J of Repro Med 2009 Feb; 54(2):95-108.

23. MacMahon, et al. Age at first birth and breast cancer risk. Bulletin of the World Health Organization 1970. 43:209-221.

24. Trichopoulos, D, et al. Age at any birth and breast cancer risk. Int J of Cancer 1983; 31:701-704.

25. Carroll, P. The breast cancer epidemic: modeling and forecasts based on abortion and other risk factors. J of Am Physicians and Surgeons. 2007; Vol 12(3).

26. Daling, J, et al. Risk of breast cancer among young women: relationship to induced abortion. J of the Natl Cancer Institute, November 1994; Vol 86(21).

27. Dolle J; Daling J; White E; Brinton L, et al. Risk factors for triple-negative breast cancer in women under the age of 45 years. Cancer Epidemiol Biomarkers Prev 2009 Apr; 18(4):1157-66.

28. Hsieh C-c, et al. Delivery of premature newborns and maternal breast-cancer risk. Lancet. 1999; 353-1239.

29. Melbye M., et al. Preterm delivery and risk of breast cancer. Bristish J of Cancer. 1999; 80:609-613.

30. Brind, J. Induced abortion as an independent risk factor for breast cancer: a comprehensive review and meta-analysis. J of Epidemiology and Community Health. 1996; 50:481-496.

31. Thorp JM, Shadigian E, et al. Long term physical and psychological health consequences of induced abortion: review of the evidence. Obstetrical & Gynecological Survey; 2003; 58(1):67-79.

32. Templeton S-K, “Royal College Warns Abortion Can Lead to Mental Illness,” The Sunday Times, March 16, 2008, http://www.timesonline.co.uk/tol/life_and_style/health/article3559486.ece (Accessed June 16, 2008); “Position Statement on Women’s Mental Health in Relation to Induced Abortion,” March 14, 2008, Royal College of Psychiatrists, http://www.rcpsych.ac.uk/members/currentissues/mentalhealthandabortion.aspx (Accessed June 16, 2008).

33. Cougle JR, et al. Depression associated with abortion and childbirth: a long-term analysis of the NLSY cohort. Med Science Monitor 2003; 9(4):105-112.d

34. Fergusson DM, et al. Abortion in young women and subsequent mental health. J of Child Psychology and Psychiatry 2006; 47(1):16-24.

35. Coleman P, Reardon D, Rue V. Prior history of induced abortion in relation to substance use during subsequent pregnancies carried to term. Am J of Obstetrics and Gynecology. 2002; 187:1673-78.

36. Coleman PK, et al. Predictors and correlates of abortion in the fragile families and well-being study: paternal behavior, substance use, and partner violence. Int J Ment Health Addiction 2008.

37. Thorp JM, Shadigian E, et al. Long term physical and psychological health consequences of induced abortion: review of the evidence.

38. Rue VM, et al. Induced abortion and traumatic stress: a preliminary comparison of American and Russian women. Medical Science Monitor 2004; 10:5-16.

39. DM, et al. Reactions to abortion and subsequent mental health. Brit J Psych 2009;

40. Yang C-Y. Association between parity and risk of suicide among parous women. Can Med Assoc J Apr 2010; 182; 569-572.

41. Reardon DC, Shuping MW, et al. Deaths associated with abortion compared to childbirth: a review of old and new data and the medical and legal implications. J of Contemporary Health Law and Policy; 2004; 20(2):279-327

42. Gissler M, et al. Suicides after pregnancy in Finland: 1987-1994: register linkage study. British Medical Journal 1996; 313:1431-4.d

43. Shadigian EM et al. Pregnancy-associated death: a qualitative systematic review of homicide and suicide. Obstetrical and Gynecological Survey 2005; 60(3):183