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How Abortion Harms Women's Health

Moira Gaul, M.P.H.

Advocates of legalized abortion downplay or deny the health risks associated with abortion. However, the research indicates that abortion isolates women and can often cause physical and psychological suffering.

Physical complications

Abortion can cause both short-term and long-term physical complications, and can significantly affect a woman's ability to have healthy future pregnancies.

Though there are no requirements for states to report abortion data to any federal agency, the Centers for Disease Control and Prevention (CDC) have received reports of the deaths of 386 women from legal abortion between 1973, when abortion was legalized nationwide, and 2004. [1] Reporting procedures and coding on U.S. death certificates for pregnancy-related deaths, as well as the lack of surveillance methods, have made it very difficult to accurately assess overall deaths associated with abortion procedures.[2]

Physical complications include cervical lacerations and injury, uterine perforations, bleeding, hemorrhage, serious infection, pain, and incomplete abortion.[3] Risks of complications increase with gestational age and are dependent upon the abortion procedure.[4]

Long-term physical consequences of abortion include future preterm birth and placenta previa (improper implantation of the placenta) in future pregnancies.[5] Premature delivery is associated with higher rates of cerebral palsy, as well as respiratory, brain, and bowel abnormalities. One recent large-scale evaluation published in Pediatrics, has concluded that preterm birth is the most frequent cause of infant death in the U.S.[6] Pregnancies complicated by placenta previa result in high rates of preterm birth, low birth weight, perinatal death, and maternal morbidity.[7]

While the question of whether abortion can increase the risk of breast cancer is hotly debated, a number of scientific studies have indicated that induced abortion can adversely affect a woman's future risk of breast cancer. Further, it has been clearly shown that induced abortion in young women causes the loss of a protective effect from a first, full-term pregnancy which when followed by a delay in child bearing, has the net effect of an increased risk for breast cancer.[8]

Physical complications from chemical abortion with the drug RU-486 include hemorrhage, infection, and missed ectopic pregnancy (a potentially fatal complication). Since 2000, at least 8 women have died from RU-486 due to hemorrhage and infection.[9]

Psychological complications

A "pro-choice" research team in New Zealand, analyzing data from a 25-year period and controlling for multiple factors both pre- and post-abortion, found conclusively that abortion in young women is associated with increased risks of major depression, anxiety disorder, suicidal behaviors, and substance dependence.[10] This is the most comprehensive, long-term study ever conducted on the issue.

Other studies also conclude that there is substantial evidence of a causal association between induced abortion and both substance abuse and suicide.[11]

A review of over 100 long-term international studies concluded that induced abortion increases risks for mood disorders enough to provoke attempts at self harm.[12] Researchers have also identified a pattern of psychological problems, known collectively as Post- Abortion Syndrome, in which women may experience depression, anxiety, anger, flashbacks, guilt, grief, denial, and relationship problems. Post-Abortion Syndrome has been identified in research as a subset of Post Traumatic Stress Disorder.[13]

Further, studies analyzing the effects of induced abortion in adolescents have shown that those who abort reported more frequent problems sleeping, more frequent marijuana use, and an increased need for psychological counseling, when compared to adolescents who give birth.[14]

Moira Gaul is director of women's and reproductive health at the Family Research Council. She has a Master of Public Health degree with an emphasis in maternal and child health.

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[1] See http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5609a1.htm#tab19

[2] D.C. Reardon, T.W. Strahan, J.M. Thorp, et al., "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 & Policy 20 (2004):279-327.

[3] K. F. Schultz, D. A. Grimes, and W. Cates, "Measures to Prevent Cervical Injury during Suction Curettage Abortion," Lancet (May 1983): 1182-1184; M. A. Freedman, D. A. Jillson, R. R. Coffin, et al., "Comparison of Complication Rates in First-Trimester Abortions Performed by Physician Assistants and Physicians," American Journal of Public Health 76 (May 1986): 550-4; D. A. Grimes, K. F. Schultz, and W. J. Cates, "Prevention of Uterine Perforation during Curettage," Journal of the American Medical Association (April 1984); S. G. Kaali, I. A. Szigetvari, and G. S. Bartfai, "The Frequency and Management of Uterine Perforations during First-Trimester Abortions," American Journal of Obstetricians and Gynecologists 161 (Aug. 1989): 406-8; National Abortion Federation. Clinical Policy Guidelines. Washington, D.C.: National Abortion Federation (2007); I. K. Warriner, O. Merick, C. Morroni, et al., "Rates of Complication in First-Trimester Manual Vacuum Aspiration Abortion Done by Doctors and Mid-level Providers in South Africa and Vietnam: A Randomized Controlled Equivalence Trial," Lancet Online www.thelancet.com (November 29, 2006).

[4] S. Lalitkumar, M. Bydeman, and K. Gemzell-Danielsson, "Mid-trimester Induced Abortion: A Review," Human Reproduction 13 (2007): 37-52; National Abortion Federation Clinical Policy Guidelines. Washington DC: National Abortion Federation, 2007.

[5] J. A. Martius, T. Steck, M. K. Oehler, et al., "Risk Factors Associated with Preterm (<37 + 0 Weeks) and Early Preterm Birth (<32 + 0 Weeks): A Univariate and Multivariate Analysis of 106,345 Singleton Births from the 1994 Statewide Perinatal Survey of Bavaria," European Journal of Obstetrics and Gynecology and Reproductive Biology" 80 (1998): 183-89; B. Rooney and B. Calhoun, "Induced Abortion and Risk of Later Premature Births," Journal of American Physicians and Surgeons 8 (Summer 2003): 46-49; C. Moreau, M. Kaminski, P. Y. Ancel, et al., "Previous Induced Abortions and the Risk of Very Preterm Delivery: Results of the EPIPHAGE Study," BJOG: An International Journal of Obstetrics and Gynaecology 112 (April 2005): 430-7; J. M. Thorp, K. E. Hartmann, and E. Shadigian, "Long-term Physical and Psychological Health Consequences of Induced Abortion: Review of the Evidence," Obstetrical and Gynecological Survey 58 (2002): 67-79; C. V. Ananth, J. C. Smulian, and A. M. Vintzileos, "The Association of Placenta Previa with History of Cesarean Delivery and Abortion: A Metaanalysis," American Journal of Obstetrics and Gynecology (November 1997): 1071-1078

[6] W. M. Callaghan, M. F. MacDorman, S. A Rasmussen, et al., "The Contribution of Preterm Birth to Infant Mortality Rates in the United States," Pediatrics 118 (October 2006): 1566-73.

[7] C. V. Ananth, J. C. Smulian, and A. M. Vintzileos, "The Association of Placenta Previa with History of Cesarean Delivery and Abortion: A Metaanalysis," American Journal of Obstetrics and Gynecology (November 1997): 1071-1078.

[8] Brind, J., "Induced Abortion as an Independent Risk Factor for Breast Cancer: A Critical Review of Recent Studies Based on Prospective Data," Journal of American Physicians and Surgeons 10 (Winter 2005): 105-110; Janet Daling, et al., "Risk of Breast Cancer among Young Women: Relationship to Induced Abortion," Journal of National Cancer Institute 86 (November 2, 1994): 1584-1592. J. M. Thorp, K. E. Hartmann, and E. Shadigian, "Long-term Physical and Psychological Health Consequences of Induced Abortion: Review of the Evidence," Obstetrical and Gynecological Survey 58 (2002): 67-79.

[9] M. M. Gary and D. J. Harrison, "Analysis of Severe Adverse Events Related to Use of Mifepristone as an Abortifacient," The Annals of Pharmacotherapy 40 (February 2006).

[10] D. M. Fergusson, I. J. Horwood, and E. M. Ridder, "Abortion in Young Women and Subsequent Mental Health," Journal of Child Psychology and Psychiatry 47 (2006): 16-24.

[11] P. K. Coleman, "Induced Abortion and Increased Risk of Substance Abuse: A Review of the Evidence," Current Women's Health Review 1 (2005): 21-34; D. M. Fergusson, L. J. Horwood, and E. M. Ridder, "Abortion in Young Women and Subsequent Mental Health," Journal of Child Psychology and Psychiatry 47 (2006): 16-24; M. Gissler, E. Hemminki, and J. Lonnqvist, "Suicides after Pregnancy in Finland, 1987-94: Register Linkage Study," British Medical Journal 313 (December 1996): 1431-1434; M. Gissler, C. Berg, M. Bouvier-Colle, et al., "Injury Deaths, Suicides, and Homicides Associated with Pregnancy, Finland 1987-2000," The European Journal of Public Health (July 2005): 1-5.

[12] J. M. Thorp, K. E. Hartmann, and E. Shadigian, "Long-term Physical and Psychological Health Consequences of Induced Abortion: Review of the Evidence," Obstetrical and Gynecological Survey 58 (2002): 67-79.

[13] A. C. Speckhard and V. M. Rue, "Postabortion Syndrome: An Emerging Public Health Concern," Journal of Social Issues 48 (1992):95-119; A. Speckhard and V.M. Rue, "Complicated Mourning: Dynamics of Impacted Post Abortion Grief," Journal of Prenatal & Perinatal Psychology & Health 8 (1993): 5-32; V. M. Rue, P. K. Coleman, J. J. Rue, et al., "Induced Abortion and Traumatic Stress: A Preliminary Comparison of American and Russian Women," Medical Science Monitor 10 (2004): SR 5-16.

[14] P. K. Coleman, "Resolution of Unwanted Pregnancy during Adolescence through Abortion Versus Childbirth: Individual and Family Predictors and Psychological Consequences," Journal of Youth and Adolescence 35 (2005): 903-911.

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