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Abortion and medical problems

Do abortions cause miscarriages later in life?

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What causes miscarriages?

Anthony R. Scialli of the Department of Obstetrics and Gynecology at Georgetown University Medical Center states that "Most doctors consider a miscarriage as a protective mechanism that prevents the continued pregnancy of a nonviable or abnormal embryo or fetus." 1 The apparent incidence of miscarriage has increased over the past 2 decades with the development of more sensitive pregnancy tests. In the past, women may not have noticed many miscarriages. Currently, with home tests capable of detecting pregnancy as soon as 2 days before a missed period, more women have become aware of being pregnant and subsequently having a miscarriage. Dr. Scialli quotes recent studies which indicate that about 31% of pregnancies end in miscarriage. This rises to over 50% for women over 40 years of age.

Causes of miscarriage include:

bulletGenetic defects: Most embryos or fetuses that miscarry have been conceived with an abnormal number of chromosomes. Others have the correct number of chromosomes but involve an abnormal gene.

bulletImmune system: Since the embryo contains foreign genetic material, it can trigger the woman's immune system, which treats it a foreign substance. A blocking mechanism normally acts to inhibit the immune system during pregnancy. However, it can fail. In some cases, a woman's immune system will attack the placenta, even though it is made up of the woman's cells.

bulletHormones: Too low a level of the hormone progesterone can cause a miscarriage.

bulletState of the uterus: A miscarriage may be caused by the uterus having an abnormal shape, or adhesions due to previous surgeries.

bulletInfections: Some bacteria (listeria, chlamydia) and some viruses (herpes simplex, cytomegalovirus) can cause a miscarriage.

bulletRadiation exposure: High levels of radiation (as used in treating uterine cancer) usually induces a miscarriage in early pregnancies. According to a number of Internet sources, lower levels, as in diagnostic x-rays do, "...not increase the risk of miscarriage."

bullet Lifestyle factors: The consumption of alcohol and smoking have been associated with higher chances of miscarriage. In 1980, the U.S. Food and Drug Administration issued a warning against the use of caffeine by pregnant women. Animal studies had "linked caffeine to increased rates of birth defects, low birth weight, stillbirths and miscarriage" in animals. A more recent study found that even decaffeinated coffee influenced the miscarriage rate. It "found that women who drank three or more cups of decaffeinated coffee a day in the first trimester had 2.4 times the risk of miscarriage as those who did not drink decaf." 2

bulletMedication: Specific drugs have been linked to increased chance of miscarriage.

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Can abortions cause miscarriages?

It would seem that having a surgical abortion could scar a small section of the wall of the uterus and thus increase the chance of a subsequent miscarriage. The remaining potential causes of miscarriages listed above appear to be unrelated to any prior abortion.

Eventually, almost all surgical abortions will probably be phased out, and replaced with:

bulletEmergency contraception (a.k.a. the morning-after pill) taken shortly after unprotected sex, or
bulletNon-surgical, medically induced abortions, or
bulletManual vacuum aspiration, or the
bulletRU-486 abortion pill.

These do not cause significant uterine wall damage. The chance of any increased miscarriage rates should be eliminated.

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How great is the increased risk of miscarriage after an abortion?

A series of 5 studies have been quoted by pro-life groups and published in numerous web sites, scattered throughout the Internet. 3,4

bulletLevine et al.: This study was confined to "aggressively done abortions," and is thus not representative of typical surgical abortions. They found no increase in late abortions as a result of a single abortion. However, they found a 2 to 3 times increase risk of first trimester miscarriages after two or more abortions. 5

bulletHilgers et al.: This describes a long term study on 52 women who had had an abortion. Their their subsequent pregnancies were followed. Unfortunately, the study is of little value because they did not include a control group of women who had not had abortion. They did report a 27% miscarriage rate which is lower than average. 6

bullet Kodasek: This is a 1971 Czechoslovakian study. It refers to "cervical incompetence" causing the incidence of miscarriages to reach 30 to 40%. This would represent an increase of miscarriage rate by about 4 percentage points. This study was collected on women who had had late term abortions in which a material called laminaria is used to dilate the cervix. Such abortions are rare in North America; 90% of abortions are done during the first trimester and do not involve laminaria. These data is not particularly useful. 7

bulletRichardson & Dickson: This is a British study published in 1976 which showed that the miscarriage rate after an abortion was 17.5% when compared to 7.5% for women who have not had an abortion. Unfortunately, these numbers appear quite inaccurate. They do not agree with the average miscarriage rate, reported by other researchers, of about 31%. Also, the study was made only a few years after abortion was legalized in Britain. The increase in miscarriage rates may well have been due to back alley abortions. The results do not appear to have been replicated by other studies. 8

bulletKoller & Eiklam: They reported that women who had had an abortion on their first pregnancy had the "the highest frequency of late spontaneous abortion and premature delivery." Unfortunately, the study is over 20 years old. Results do not seem to have been replicated elsewhere.

Planned Parenthood answers the question "Does an early abortion make miscarriage more likely in future pregnancies?" with a simple "No." 10

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Conclusions:

There do not appear to be any convincing studies that would indicate that surgical abortions have any significant link to increased miscarriage rate -- at least for the first abortion.

One study may point to an increased rate after multiple abortions.

There seems to be no evidence at all that emergency contraception or non-surgical abortions increase the chances of later miscarriages.

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References:

  1. Anthony R. Scialli, "Miscarriage: Executive Summary," at: http://c3.org/ The summary is based upon a report "Miscarriage" by the same author. Article copies can be obtained from: Chlorine Chemistry Council, 1300 Wilson Boulevard, Arlington, VA 22209. (703) 741-5829
  2. Andy Evangelista, "Study of Caffeine and Miscarriage Yields Surprise Finding About Decaf," 1997-AUG-25, at: http://www.ucsf.edu/
  3. "Abortion: Questions & Answers," Ohio Right to Life, at: http://www.ohiolife.org/
  4. "Maternal Complications," Catholic Information Center on Internet ™, at: http://www.catholic.net/
  5. Levin et al., "Association of Induced Abortion with Subsequent Pregnancy Loss," JAMA, vol. 243, no. 24, June 27, 1980, pp. 2495-2499
  6. Hilgers et al., "Fertility Problems Following an Aborted First Pregnancy." In New Perspectives on Human Abortion, edited by S. Lembrych. University Publications of America, 1981, pp. 128-134
  7. A. Kodasek, "Artificial Termination of Pregnancy in Czechoslovakia," Internat'l Jour. of GYN & OB, vol. 9, no. 3, 1971
  8. Richardson & Dickson, "Effects of Legal Termination on Subsequent Pregnancy," British Med. Jour., vol. 1, 1976, pp. 1303-4
  9. Koller & Eikham, "Late Sequelae of Induced Abortion in Primagravida" Acta OB-GYN Scand, 56 (1977) p. 311.
  10. "Abortion: Commonly asked questions," Planned Parenthood, at: http://www.plannedparenthood.org/

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Copyright 1998 to 2010,  by Ontario Consultants on Religious Tolerance
Latest update: 2010-JUN-23
Author: B.A. Robinson

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