Select Committee on Science and Technology Written Evidence

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:


1.  Rooney B, Calhoun BC. Induced abortion and risk of later premature births. J of Am Physicians and Surgeons 2003;8(2):46-49.

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 2000;29:100-106.

4.  Henriet L, Kaminski M. Impact of induced abortions on subsequent pregnancy outcome: the 1995 French national perinatal survey. Br J Obstet Gynaecol 2001;108: 1036-1042.

5.  Martius JA, Steck T, Oehler MK, Wulf K-H. Risk factors associated with preterm (<37+0 weeks) and early preterm (<32+0 weeks): univariate and multivariate analysis of 106 345 singleton births from 1994 statewide perinatal survey of Bavaria. Eur J Obstet Gynecol Reprod Biol 1998;80:183-189.

6.  Moreau C, Kaminski M, Ancel PY, Bouyer J, Escande B, Thiriez G, Boulot P, Fresson J, Arnaud C, Subtil D, Marpeau L, Roze JC, Maillard F, Larroque B; EPIPAGE Group. Previous induced abortions and the risk of very preterm delivery: results of the EPIPAGE study. BJOG 2005;112(4):430-7.

7.  Ancel PV, Lelong N, Papiernik E, Saurel-Cubizolles MJ, Kaminski M. History of induced abortion as a risk factor for preterm birth in European countries: results of EUROPOP survey. Human Repro 2004; 19(3): 734-740.

8.  Escobar GJ, Littenburg B, Petitti DB. Outcome among surviving very low birthweight infants; a meta-analysis. Arch DI Child 1991; 66:204-211.

9.  Petrou S, Mehta Z, Hockley C, Cook-Mozaffari P, Henderson J, Goldacre M. Pediatrics 2003;112(6):1290-1297.

10.  Coleman PK, Reardon DC, Rue V, and Cougle J. State-funded abortion versus deliveries: A comparison of outpatient 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 associated with abortion and childbirth: A long-term analysis 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 study o f the 1995 National Survey of Family Growth. J of Anxiety Disorders 2005;19: 137-142.

14.  Reardon DC & Coleman PK. Relative treatment of sleep disorders following abortion and childbirth: A prospective 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 problems and benefits of record linkage. Acta Obstet Gyn Scand 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,, 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 2002;187: 1673-1678.

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 2005;10: 255-268.

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 2005;94: 1476-83.

September 2007

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