Memorandum 21
Submission from Professor Byron C Calhoun,
Professor and Vice-Chair, Department of Obstetrics and Gynaecology,
West Virginia University
This paper will address the Select Committee's
inquiry number 3 "evidence of long-term or acute adverse
health outcomes from abortion..." Specifically, the increased
risk for preterm birth, significant mental health effects, increased
all cause mortality, increased substance abuse, and increased
domestic violence against children will be addressed in turn by
number.
1. Preterm Birth: There has been a documented
200% increase in preterm birth rate (< 32 weeks) with one abortion.
(Compilation of 49 studies)1. There are now over 60 studies which
demonstrate increased risk for preterm birth with an abortion
prior to first delivery. Further these studies demonstrate a "dose
effect" with more abortions leading to increased risk for
preterm birth. 2-7 Preterm birth leads to a 38 times increased
risk for cerebral palsy8 and this translates into increased costs.
A recent paper from Oxford that estimated the out of hospital
costs in the first five years of life found a cost £14,614
for a < 28 week delivery (very low birth weight) and £11,958
for a baby delivering at 28-32 weeks (low birth weight) for the
first five years of life.9 These costs were only for the first
five years of out of hospital life and did not the lifetime cost
for the morbidities due to preterm delivery.
2. Mental Health Effects: Studies note 63%
more mental health visits 90 days after pregnancy ending in abortion
patients compared to pregnancies ending in delivery. 10 There
are 21% more mental health visits over four years after abortion
compared to delivery. 10 Women with an abortion have a 154% increased
risk for suicide compared to delivery. 11 Aborting women were
65% more likely to have "high risk" for clinical depression
with an abortion compared to delivery. 12 Anxiety-with unintended
first pregnancy ending in abortion or live birth resulted in a
34% increase in Generalized Anxiety in aborting women, 86% higher
anxiety in Hispanics with abortions, 42% higher risk of anxiety
in unmarried women who had abortions, and a 46% higher risk of
anxiety with an abortion if under age 20 years at the time of
the abortion. 13 Sleep disorders were increased in patients whose
pregnancies ended in abortion compared to those giving birth (comparing
aborting women to women with sleep disorders at the end of pregnancy).
14 These findings included a persistence in sleep disorders to
include an 85% higher risk of sleep disorders at 6 months after
abortion compare to birth, 68% higher incidence of sleep disorders
in aborting women at one year, 40% higher incidence of sleep disorders
in aborting women at two years, 41% higher incidence of sleep
disorders in aborting women at three years, and a 29% higher incidence
in aborting women across ALL four years studied. 14
3. Increased all cause mortality: All causes
death rates were 370% higher within one year of an abortion compared
to delivering women. 15 Death rates were 50% higher in aborting
women when compared to non-pregnant women controlling for demographic
characteristics, socioeconomic status, health status, and medical
disorders. 16 Women with abortions have been found to have a 80%
higher risk of dying in an "accident" within the year
after an abortion. 17
4. Substance abuse: Women experience a 460%
increase in illicit drug and 122% increase in alcohol use in subsequent
pregnancies after an abortion in the prior pregnancy. 18 When
comparing a subsequent pregnancy after either a live birth or
an abortion, researchers found an increased risk for substance
abuse with a 929% more likely use of marijuana in patients who
aborted, 460% more likely use of illicit drugs (heroin, cocaine,
methamphetamines, etc) in patients who aborted, and a 122% more
likely use of alcohol in patients who aborted. 18 After comparing
an abortion to either a previous stillbirth or miscarriage there
was noted a 201% higher risk for marijuana use in those who aborted,
a 198% higher risk for crack cocaine for those who aborted, a
406% higher risk for other types of cocaine (other than crack
cocaine) for those who aborted, a 180% higher risk for illicit
drugs for those who aborted, and a 100% higher risk for tobacco
use for those who aborted. 19 Neither stillbirth or miscarriage
carried any increased risk for substance abuse over the normal
population.
5. Child abuse: Abortion carried a 144%
higher risk of child physical abuse compared a pregnancy that
ended without an abortion. Live birth was not associated with
an increase in child physical abuse. But more importantly, neither
was miscarriage or stillbirth associated with an increase in risk
of physical child abuse. 20
This is not an exhaustive list of all the scientific
information available regarding abortion complications. In light
of all these recent scientific findings supporting "long-term
or acute adverse health outcomes from abortion", coupled
with abortion's significant public health costs in both prematurity
and mental health care, a complete reappraisal of whether or not
elective abortion ought to be part of the public health policy
of Great Britain is in order.
Thank you for your kind attention in this matter.
If you have any further questions do not hesitate to contact me
at my office at 304-388-1599 or my email: byron.calhoun@camc.org.
REFERENCES
1. Rooney B, Calhoun BC. Induced abortion and
risk of later premature births. J of Am Physicians and Surgeons
2003;8(2):46-49. www.jpands.org/vol8no2/rooney.pdf
2. Lumley J. The association between prior spontaneous
abortion, prior induced abortion and preterm birth in first singleton
births. Prenat Neonat Med 1998;3:21-24.
3. Zhou W, Sorenson HT, Olsen J. Induced abortion
and low birth weight in the following pregnancy. Int J of Epi
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survey. Br J Obstet Gynaecol 2001;108: 1036-1042.
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Risk factors associated with preterm (<37+0 weeks) and early
preterm (<32+0 weeks): univariate and multivariate analysis
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8. Escobar GJ, Littenburg B, Petitti DB. Outcome
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Arch DI Child 1991; 66:204-211.
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P, Henderson J, Goldacre M. Pediatrics 2003;112(6):1290-1297.
10. Coleman PK, Reardon DC, Rue V, and Cougle
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mental health claims over four years. Am J of Orthopsychiatry
2002;72:141-152.
11. Reardon DC, Cougle J, Ney PG, Scheuren F,
Coleman, PK, Strahan T. Deaths associated with delivery and abortion
among California Medicaid patients: A record linkage study. Southern
Med J 2002; 95:834-841.
12. Cougle J, Reardon DC, Coleman PK. Depression
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of the NLSY cohort. Medical Science Monitor 2003:9: CR105-112.
13. Cougle J, Reardon DC, Coleman PK, Rue VM.
Generalized anxiety associated with unintended pregnancy: A cohort
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14. Reardon DC & Coleman PK. Relative treatment
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record-based study. Sleep 2006;29: 105-106.
15. Gissler M, Kauppila R, Merilainen J, Toukomaa
H, Elina Hemminki E. Pregnancy-associated deaths in Finland 1987-1994—definition
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1997;76:651-657 (All causes mortality)
16. Gissler, M, et al, Pregnancy-associated mortality
after birth, spontaneous abortion, or induced abortion in Finland,
l987-2000., American J. ObGyn (2004)190, 422-7.
17. Reardon, et.al., Deaths Associated With Pregnancy
Outcome. Southern Medical Journal, Vol 95, No 8, August 2002.
18. Coleman PK, Reardon DC, Rue V, and Cougle
J. History of induced abortion in relation to substance use during
subsequent pregnancies carried to term. Am J of Obstet Gynecol
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19. Coleman PK, Reardon DC, Cougle J. Substance
use among pregnant women in the context of previous reproductive
loss and desire for current pregnancy. Brit J Health Psychology
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20. Coleman P, Maxey CD, Rue V, Coyle CT. Associations
between voluntary and involuntary forms of perinatal loss and
child maltreatment among low-income mothers. Acta Paediatrica
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September 2007
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