We know that prematurity or preterm birth is a direct consequence of both cervical incompetence and infection. Prematurity is the leading cause of infant death within the first month of life. (28) In the Eugenics Review, (29) Malcolm Potts expressed "little doubt that there is a true relationship between the high incidence of therapeutic abortion and prematurity."
During an abortion procedure, the cervical muscle must be stretched open to allow the abortionist to gain entry to the uterus. If enough muscle fibres are torn, the cervix becomes weakened, causing so-called cervical incompetence. Normally, before birth a woman's body will release a cascade of hormones which cause the cervix to open naturally. After the baby is born and the uterus is empty, the cervix closes tightly again.
When a pregnant woman stands upright her child's head rests on the cervix. The muscle must be intact and strong in order to keep the cervix closed. If it is weak or incompetent (as it can be after an abortion) it will not be able to maintain the seal and opening may occur, resulting in premature birth and sometimes in miscarriage.
Dr Barbara Luke (30) who wrote the book Every Pregnant Woman's Guide to Preventing Premature Birth discusses this:
"The procedures for first trimester abortion involve dilating the cervix slightly, and suctioning the contents of the uterus. The procedures for a second trimester abortion are more involved, including dilating the cervix wider and for longer periods, and scraping the inside of the uterus. Women who had had several second trimester abortions may have a higher incidence of incompetent cervix, a premature spontaneous dilation of the cervix, because the cervix has been artificially dilated several times before this pregnancy."
So how well established is this risk? Twenty studies between 1973 and 1999 in seven different countries (Denmark, Great Britain, U.S.A, Hungary, Germany, Greece, and France) show a statistically significant, increased risk of pre-term births after abortion. (Please refer to the reference section to find details of the studies). (31)
Dr Luke continues in her book:
"If you have had one or more induced abortions, your risk of prematurity with this pregnancy increases by about 30%."
Premature birth or low birth weight are the most important risk factors for infant mortality or later disabilities, as well as for lower cognitive abilities and greater behavioural problems. A study of 26,000 consecutive deliveries at UCLA California, examined whether previous abortions and premature births had increased the number of stillborn babies and neonatal (after birth) deaths.
The findings of this study were that the incidence of death "increased more than threefold" for those cases in which a previous abortion was involved. (32)
In 2003, Texas became the first state in the U.S. to inform women considering abortion, that the procedure increases the risk of delivering a future baby with cerebral palsy. The Texas Department of Health produced a booklet entitled A Woman's Right to Know which contains this warning about cerebral palsy and other problems to which premature babies are at high risk. (www.tdh.state.tx.us/wrtk/default.htm)
The booklet reads "Some large studies have reported a doubling of the risk of premature birth in later pregnancies if a woman has had two induced abortions." It continues "Very premature babies have the highest risk for lasting disabilities such as; mental retardation, cerebral palsy, lung and gastrointestinal problems, even vision and hearing loss." (33)
A Canadian court case, Renaerts vs Vancouver General Hospital in July 1991, has drawn attention to the plight of a child who suffered cerebral palsy. The child was an abortion survivor. Born alive, the baby was left without oxygen or medical treatment for 40 minutes until a nurse took her to the neonatal intensive care unit. The hospital involved was found negligent, thus legally responsible for her disabilities and was ordered to pay the plaintiff $8,700,000. (The National Post, Ontario, 31st July 1999).
An ectopic pregnancy occurs when the embryo begins to develop in any part of the woman's reproductive system other than the wall of the uterus, the most common area being the fallopian tube. Ectopic pregnancy is a significant cause of pregnancy related morbidity and mortality.
Failure to diagnose it can result in the death of both mother and child. Approximately 1.5% of all pregnancies are ectopic, and this problem remains the leading cause of maternal death during the first trimester of pregnancy. (34)
If the abortionist's curette scrapes or cuts too deeply across the opening of the fallopian tubes, a scar may develop resulting in partial blockage of the fallopian tube.
Microscopic sperm can still pass through such blockage and fertilise an ovum as it breaks away from the ovary. After fertilisation, the human embryo is several hundred times larger than the sperm and may not be able to return through the narrowed scarred passage. The embryo then nests itself into the fallopian wall leading to a life-threatening situation of an ectopic pregnancy.
Chung and others (35) in the American Journal of Epidemiology, attempted to discover why previous induced abortions lead to ectopic pregnancy. Reasoning that the retention of foetal parts following abortion and subsequent infection "showed a highly significant association" they concluded that these two medical complications were associated with a fivefold increase in ectopic pregnancy after induced abortion.
H Barber, (36) author of Ectopic Pregnancy, A Diagnostic Challenge made an additional connection between abortion and ectopic pregnancy; "The increased risk of Pelvic Inflammatory Disease - especially chlamydia - and induced abortion appear to play leading roles in the dramatic rise in ectopic pregnancy."
Physicians usually consider the possibility of an ectopic pregnancy when a pregnant woman (who is not seeking an abortion) displays symptoms of acute pain and bleeding.
Women are nowadays alerted to the possibility of such a complication and regular examinations make the condition less life-threatening. But where there is an undiagnosed ectopic pregnancy, a client may leave an abortion clinic believing that the abortionist has successfully terminated her pregnancy and that she is no longer pregnant.
However, if the child is implanted in the fallopian tube, the procedure will not have terminated the pregnancy. Convinced she is no longer pregnant, the woman may neglect to seek proper medical care when she develops the symptoms of a ruptured ectopic pregnancy. There is a high mortality associated with this later event.
Because ectopic pregnancy is a significant contributor to maternal death, calls have been made in the U.S.A for the Center for Disease Control (CDC) to investigate all cases of death from ectopic pregnancy, to determine if they are linked to recent abortions. Any identified cases would move the victim from the maternal death to the abortion-related death category with a resulting increase in the latter.
There is a known relationship between induced abortion and subsequent ectopic pregnancy. In a 1992 edition of the International Journal of Obstetrics and Gynecology Michalas and colleagues (37 )noted "...a worldwide epidemic of ectopic pregnancy, particularly in women who have postponed bearing children until later in their reproductive lives, has been taking place." They also found that "Induced abortions were positively related to ectopic pregnancy... ."
The relative risk of ectopic pregnancy was doubled for women who had undergone induced abortions. They referred also to another study from Boston U.S.A which reported a similar finding; a 260% increase in ectopic pregnancy after two or more induced abortions.
In Italy, Parazzini and colleagues (38) found that women faced an increased risk of ectopic pregnancy after induced abortion and that this risk continued to escalate after each subsequent abortion.
They found that the ectopic pregnancy risk in women having multiple abortions was thirteen times greater than for women who gave birth.
28. Martius J A et al, "Risk Factors Associated with Pre-term and Early Pre-term birth, Univariate and Multivariate Analysis of 106,345 Singleton Births from the 1994 State wide Perinatal Survey of Bavaria," European Journal of Obstetrics Gynecology and Reproductive Biology 80 (2): 183-189, 1998
29. Potts M, "Legal abortion in Eastern Europe," Eugenics Review, 58-59:232-250, 1967
30. Luke B, "Every Pregnant Woman's Guide to Preventing Premature Birth," 1995, New York, Times Books, p 32
31. See pages 55 and 56 of "Women's Health After Abortion" by the De Veber Institute for Bioethics and Social Research, Toronto, Canada, 2002
32. Funderburk S et al, "Suboptimal Pregnancy Outcome with Prior Abortions and Premature Births," American Journal of Obstetrics and Gynecology, Sept 1976, p 55-60
34. Syverson et al, "Pregnancy related mortality in New York City 1980-1984: Causes of death and associated risk factors," American Journal of Obstetrics and Gynecology, February 1991, 164 (2): 603-8
35. Chung et al, "Induced abortion and ectopic pregnancy in subsequent pregnancies," American Journal of Epidemiology, 115 (6):879-87, p 884
36. Barber H, "Ectopic Pregnancy, A Diagnostic Challenge," The Female Patient, Vol 9, p 10-18
37. Michalas et al, "Pelvic surgery, reproductive factors and risk of ectopic pregnancy: A case controlled study," International Journal of Obstetrics and Gynecology,1992, 38(2):101-5, p 101
38. Parazzini et al, "Induced abortions and risk of ectopic pregnancy," American Journal of Epidemiology, 1995, 10(7):1841-4