Abortion

How Abortion Harms Women's Health
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.
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.

Consequences for women
There is extensive evidence of physical, mental and emotional consequences for women and their families when pregnant mothers use abortion to end an inconvenient pregnancy.
Major Articles and Books Concerning the Detrimental Effects of Abortion reports that in the short term (eight weeks after the abortion), there are numerous indicators of emotional distress: 44 per cent of women who have abortions complain of nervous disorders, 36 per cent have trouble sleeping, 31 per cent regret their decision to abort and 11 per cent have been prescribed psychotropic drugs. But it is the longer-term problems that bear more scrutiny.
Using the most conservative estimate of post-abortion syndrome, or PAS, Dr. Brenda Major in the Archives of General Psychiatry in 2000, found 1.6 per cent of women who have an abortion will suffer from PAS, a variant of post-traumatic stress disorder. In Canada, that would mean approximately 50,000 women are suffering emotionally due to their abortions. Dr. Hanna Söderberg’s studies suggest the number could be closer to 60 per cent. Either way, there are many women with PAS. In Canada, the 1977 Report of the Committee on the Operation of the Abortion Law cited a five-year study in two provinces that found women who had an abortion used medical and psychiatric services much more often than others; in fact, 25 per cent of women who aborted made at least one visit to a psychiatrist compared to just 3 per cent of other women.
Alcoholism and drug abuse are higher among women who have abortions than those who don’t. The American Journal of Obstetrics and Gynecology noted in December 2002 that later alcohol and drug use during subsequent pregnancies could place newborn children at higher risk of congenital defects, low birthweight and even death. In all, there are nearly two dozen studies that link abortion to alcohol and drug abuse. Extrapolating from research conducted by Dr. David Reardon of the Elliott Institute, as many as 5,000 Canadian women will “begin abusing drugs and/or alcohol as a means of dealing with post-abortion stress.”
In 1996, the British Medical Journal reported that the suicide rate for women “after an abortion was three times the general suicide rate and six times that associated with birth.” This confirmed earlier studies and has been replicated since. Reardon says “one reason for the strong abortion-suicide link exists in the fact that in many ways, abortion is like suicide. A person who threatens suicide is actually crying out for help. So are women who contemplate abortion. Both are in a state of despair. Both are lonely. Both feel faced by insurmountable odds.” So it is no wonder that abortion does not solve the perceived problem: that of the inconvenient pregnancy.
Post-abortive women are more prone to suicide, cigarette smoking, divorce, low self-esteem, sexual dysfunction, eating disorders and reduced maternal bonding with future children, resulting in child neglect or abuse. Women who have had abortions are more likely to be on public assistance, because their pathologies (promiscuity, inability to form healthy relationships, drug and alcohol abuse) are likely to make them single parents. In 2004, Thomas Strahan, a researcher with the Association of Interdisciplinary Research in the United States, found that abortion hurts women economically: “The repeated utilization of abortion appears to lead not to economic prosperity or social well-being, but to an increasing feminization of poverty.”
But post-abortion health problems are not merely emotional. The Elliott Institute has collated the best available data on the physical risk complications of abortion and it reports that “approximately 10 per cent of women undergoing elective abortion will suffer immediate complications, of which approximately one-fifth (2 per cent) are considered life threatening.”
The most common immediate major complications include infection, excessive bleeding, embolism, ripping or perforation of the uterus, anesthesia complications, convulsions, hemorrhage, cervical injury and endotoxic shock. Minor complications include infection, bleeding, fever, second-degree burns, chronic abdominal pain, vomiting, gastro-intestinal disturbances and Rh sensitization. In the Canadian context, that means 10,000 women a year suffer complications and 2,000 face potentially life-threatening major complications.
Other problems manifest themselves over time. There are more than 30 studies that show a correlation between abortion and breast cancer, with women who had abortions more likely to get breast cancer. Women also face increased risk of cervical, ovarian and liver cancer. The risk for these four cancers are linked to the unnatural disruption of hormonal changes accompanying pregnancy. Untreated cervical damage increases the chances of getting cervical cancer. Between 2 and 3 per cent of all abortion patients suffer perforation of the uterus; this often leads to complications in subsequent pregnancies, the need for a hysterectomy and other complications, including osteoporosis. Smaller cervical lacerations can also cause problems, including cervical incompetence and subsequent labour complications.
Abortion also increases the risk of placenta previa in later pregnancies, which is life-threatening to both mother (excessive bleeding) and unborn child (perinatal death), and increases the chance of fetal malformation. Women who have abortions are more than twice as likely to suffer subsequent labour complications, including premature delivery. Pre-term delivery increases the risk of neo-natal death and handicaps. Abortion increases the risk of ectopic pregnancies and pelvic inflammatory disease, both of which can reduce future fertility or threaten the life of the mother.
Recent nation-wide data is unavailable in Canada, but Alberta and Nova Scotia statistics indicate that repeat abortions account for about one-third of all procedures. Repeat aborters vastly increase their risk of complications and this has serious consequences for those who routinely utilize abortion as birth control; it also costs the health care system.
Perhaps most worrying is that women who have abortions are more likely to die prematurely. Reardon notes, “Women who abort are approximately four times more likely to die in the following year than women who carry their pregnancies to term” – and that ” women who carry to term are only half as likely to die (pre-maturely) as women who were not pregnant.” That includes accidental deaths, suicides and homicides, among other causes.
The evidence that abortion harms women – and their loved ones – is overwhelming. But the harm goes beyond individuals.
Societal costs
No one knows for sure how much abortion costs taxpayers through the country’s socialized health care system. With the exception of New Brunswick and Nova Scotia, which do not cover the entire cost of abortions committed in private facilities, the provinces pay for abortions in both hospitals and free-standing facilities. LifeCanada estimates that the cost just for the surgical abortion procedures is $80 million (an average of $800 multiplied by 100,000 abortions). Because of under-reporting of abortion, there is reason to believe the cost is actually greater. In 1995, the Library of Parliament Research Branch said determining the cost of abortion is a “complex and inexact process.”
But that is only the surgery. The number of follow-up visits for immediate complications is not made public (if tracked at all) and so those costs are unknowable. There is also the cost of long-term problems including fertility treatments, psychiatry and drug/alcohol treatment.
There are other costs, as well; that of missing students, consumers and taxpayers.
The loss of 100,000 children every year means smaller classrooms and closed schools.
In 2005, People for Education, an advocacy group, reported that the rate of school closures in Ontario has more than doubled in recent years. Between 1986 and 1995, an average of 24 Ontario schools were closed every year, but between 1999 and 2005, it was an average of 52 schools per year. Remarkably, that is despite attracting the bulk of the country’s immigrants. The fact is that Canada is an aging country in which many smaller communities and older neighbourhoods no longer have the children and teens to sustain elementary and high schools. According to the Canadian Council on Learning, “The steepest declines tend to occur in small, rural and remote school districts.” It cites as an example British Columbia, where 10 school districts have seen their enrolments fall by at least 15 per cent since 2001, seven of which are rural districts with smaller populations.
From 1997-2005, 11 of 13 provinces and territories experienced a drop in enrolment, with six of them seeing declines of at least 10 per cent. The problem is worst in Atlantic Canada. Dr. Gerald Galway of the Faculty of Education at Memorial University in St. John’s gave a presentation to the 2009 Atlantic School Boards Conference entitled, “Where have all the children gone?” In it, he noted that school enrolment in Atlantic Canada has fallen precipitously over the past several decades. While intra-provincial migration accounts for some decline in population, he mostly blames falling fertility rates. Notably, in Newfoundland, enrolment has declined every year since 1971, except in 1984 (with the introduction of Grade 12). In fact, the school-aged population has been cut in half since 1971, from 160,000 to 80,000.
Over the long term, more communities will lose their schools and policy makers will have to make difficult decisions on how to provide quality education in sparsely populated areas.
There are also ramifications for public finance. Pierre Fortin, a professor of economics at the Université du Québec à Montréal, says there will be “a marked deterioration of public finances” because of increased health care costs and pension liabilities as the number of seniors grows rapidly and income tax revenues decrease due to fewer workers. The result is fewer taxpayers supporting more retirees. By 2015, there will be more seniors over 65 than children under 15; it is estimated that by 2030, those over 65 will comprise 25 per cent of the population.
According to the 2008 documentary The Cost of Abortion, the cumulative financial loss of nearly 50 million abortions in the United States from 1973-2007 was $37 trillion in GDP over the course of 35 years. That’s lost production and lost consumption due to the 50 million missing children and (later) workers. Assuming that Canada would have suffered a proportionate loss, the Canadian GDP over the past four decades would be in the neighbourhood of $4 trillion – or $100 billion per year. That represents about 7 per cent of the current Canadian economy. In other words, the economic activity of a population not decimated by abortion would be equivalent to more than twice the stimulus package Ottawa announced in January. But after 3.2 million abortions over four decades, the missing children translate into missing economic activity.
The cheapening of human life
The greatest cost imposed on a society that permits abortion is the devaluing of human life and the diminishment of family life. Abortion does not stalk the nation alone; but rather, as part of the larger culture of death. Since the legalization of abortion, contraception, gay sex and divorce in the 1960s, there has been a decline in marital stability, with growth in sexual activity outside marriage and other sexually deviant behaviour and new assaults on human life. There are more ways to chemically eliminate newly conceived life with the abortifacient morning-after pill and abortion drugs like RU-486. With pregnancy made easily avoidable, is it surprising that courts (and later Parliament) ignored the reproductive role of marriage when they redefined the institution to include same-sex partners?
In 2003, the Liberal government passed legislation opening the door to destructive embryonic stem cell research, cloning and other scientific experimentation that treats human life as raw material to be harvested and exploited. If inconvenient human life can be eliminated by mothers and doctors, why not create convenient lives for scientists and other researchers?
And lastly – though not yet – is euthanasia. Once the principle is established that inconvenient human beings can be killed, the question becomes who’s next. The answer, if the Netherlands, Belgium, Switzerland and Oregon and Washington are harbingers, is the terminally ill, the disabled and the old. Of course, we’ve already had Tracey Latimer and Sue Rodriguez and dozens of others whose names weren’t quite national news. But these are renegades, operating outside the law. Perhaps, though, not for long. Twice in the past four years, Bloc Quebecois MP Francine Lalonde has introduced a private member’s bill to legalize euthanasia and physician-assisted suicide. Public opinion leans toward so-called “mercy killing.” The principle of eliminating inconvenient people is well established.
The great corrupter
Abortion corrupts every institution that promotes or even countenances it. Two examples are government (and politics) and the medical profession, although one could also look at the failure of religious leadership, the denigration of the law and so much more.
As Fr. Alphonse de Valk noted in his 1979 pamphlet The Worst Law Ever, the medical profession didn’t take long to become fanatical in its support for abortion. In fact, de Valk said “the one group which obviously has suffered most from the 1969 law is the medical profession.” In the 1960s, the Canadian Medical Association lobbied for widening the abortion law to permit abortions to save the life or protect the health of the mother (albeit with a broad understanding of mental and emotional health). By 1973, it endorsed abortion on demand. Two years later, it amended the Hippocratic Oath to remove the reference against abortifacients that had been in place for 2,500 years. In 1977, it attempted to make abortion referrals mandatory, even in cases in which doctors were morally opposed. That battle continues more than three decades later.
Over the past 40 years, medical professionals have been harassed over their opposition to abortion and most medical schools screen applicants to keep pro-lifers out. Nurses have been fired, removed from certain duties and refused work because of their pro-life views, as have pharmacists. In order to make “choice” available to those seeking abortions, the choice of health care professionals to act according to their consciences has been compromised and even excised.
Abortion has also corrupted the political process. Parliament fashioned a dishonest and untenable amendment in 1969 – the therapeutic abortion committees which sanctioned the killing of the unborn. The Supreme Court threw out the minimal restrictions in 1988 and ordered Parliament to write a new abortion law. The Mulroney government twice introduced legislation to address the abortion issue, but the limits were once again giant loopholes that would not have restricted abortion. Since then, abortion has been permitted within the vacuum created by the absence of a law.
Politicians are scared of the issue. Many provincial politicians refuse to answer questions about abortion, claiming it is a federal matter (which it is as a matter of criminal law, but not as health policy). Many federal politicians hide behind the false notion that the 1988 Morgentaler decision established a right to abortion. (It did not, with only one of seven justices suggesting such a right.) In the 2000 federal election, then-prime minister Jean Chretien declared that Canada had “social peace” on the issue of abortion; in reality, it was the silence of timorous politicians enforced by a rigid media censorship of any substantive debate on the topic.
That censorship is widespread. Since 1995, British Columbia has had a legislated bubble zone prohibiting any pro-life speech near abortion facilities. In 1994, the Ontario government asked for and received a “temporary” injunction prohibiting pro-life speech near five abortion mills; that injunction remains in place today. In Quebec, a limited bubble zone is in place in several municipalities. Such censorship has moved to university campuses, where pro-life groups are denied club status and pro-life speakers or demonstrators are prevented from making their presentations.
To protect abortion from any criticism or resistance, genuine human rights, such as freedom of speech, freedom of association and freedom of conscience, are curbed. Such illiberal and intolerant measures are deemed necessary to defend “choice.”
Conclusion
These are but a few of the consequences of a broad abortion licence, a quick overview of the toll of abortion. Sold to a willingly ignorant public as a matter of personal choice, abortion has had terrible consequences for society and, tragically, the women who choose abortion thinking it is a solution to their perceived problems. The enormity of the consequences, one would presume, would lead to a massive re-thinking of unrestricted legal abortion. But instead of either sober reflection or a vigorous debate on abortion’s societal and individual ramifications, there is silence. And more death. And more suffering. Forty more years and millions more deaths are too great a cost for a dearth of necessary leadership to oppose abortion. But someday, these costs and consequences will be too great to ignore. Until then, we will continue to pay in blood, treasure, women’s health and a myriad of other ways.

Is Abortion Safe?
Psychological Consequences

Clinical research provides a growing body of scientific evidence that having an abortion can cause psychological harm to some women. "Women who report negative after-effects from abortion know exactly what their problem is," observed psychologist Wanda Franz, Ph.D., in a March 1989 congressional hearing on the impact of abortion. "They report horrible nightmares of children calling them from trash cans, of body parts, and blood," Franz told the Congressional panel. "When they are reminded of the abortion," Franz testified, "the women re-experienced it with terrible psychological pain ... They feel worthless and victimized because they failed at the most natural of human activities -- the role of being a mother."[106]

The emergence of chemical abortion methods poses a new possibly more devastating psychological threat. Unlike surgical abortions, in which women rarely see the cut up body parts, women having chemical abortions often do see the complete tiny bodies of their unborn children and are even able to distinguish the child’s developing hands, eyes, etc. [107] So traumatic is this for some women that both patients and researchers involved in these studies have recommended that women unprepared for the experience of seeing their aborted children not take the drugs. [108] Long-term psychological implications of this experience have not been studied.

Researchers on the after-effects of abortion have identified a pattern of psychological problems known as Post-Abortion Syndrome (PAS). Women suffering PAS may experience drug and alcohol abuse, personal relationship disorders, sexual dysfunction, repeated abortions, communications difficulties, damaged self-esteem, and even attempt suicide. Post-Abortion Syndrome appears to be a type of pattern of denial which may last for five to ten years before emotional difficulties surface. [109]

Now that some clinicians have established that there is an identifiable patterns to PAS, they face a new challenge. What is still unknown is how widespread psychological problems are among women who have had abortions. A Los Angeles Times survey in 1989 found that 56% of women who had abortions felt guilty about it, and 26% "mostly regretted the abortion."[110] Clinicians’ current goal should be to conduct extensive national research studies to obtain data on the psychological after-effects of abortion.[111]

With the growing awareness of Post Abortion Syndrome in scholarly and clinical circles, women with PAS can expect to receive a more sensitive appreciation of the suffering that they endure. Fortunately, a growing network of peer support groups of women who have had abortions offers assistance to women who are experiencing emotional difficulties.

Many post-abortive women have also been speaking out publicly about their own abortion experiences and the healing process they went through.. Women or family members seeking information about this particular outreach can contact American Victims of Abortion, 419 7th Street, NW, Suite 500, Washington, D.C., 20004.
Physical Consequences after abortion

DEATH: According to the best record based study of deaths following pregnancy and abortion, a 1997 government funded study in Finland, women who abort are approximately four times more likely to die in the following year than women who carry their pregnancies to term. In addition, women who carry to term are only half as likely to die as women who were not pregnant.(16)

The Finland researchers found that compared to women who carried to term, women who aborted in the year prior to their deaths were 60 percent more likely to die of natural causes, seven times more likely to die of suicide, four times more likely to die of injuries related to accidents, and 14 times more likely to die from homicide. Researchers believe the higher rate of deaths related to accidents and homicide may be linked to higher rates of suicidal or risk-taking behavior.(16)

The leading causes of abortion related maternal deaths within a week of the surgery are hemorrhage, infection, embolism, anesthesia, and undiagnosed ectopic pregnancies. Legal abortion is reported as the fifth leading cause of maternal death in the United States, though in fact it is recognized that most abortion related deaths are not officially reported as such.(2)

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BREAST CANCER:
There is strong evidence that abortion increases the risk of breast cancer. A study of more than 1,800 women appearing in the Journal of the National Cancer Institute in 1994 found that overall, women having abortions increased their risk of getting breast cancer before age 45 by 50%. For women under 18 with no previous pregnancies, having an abortion after the 8th week increased the risk of breast cancer 800%. Women with a family history of breast cancer fared even worse. All 12 women participating in the study who had abortions before 18 and had a family history of breast cancer themselves got cancer before age 45.
The risk of breast cancer almost doubles after one abortion, and rises even further with two or more abortions.(3)

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CERVICAL, OVARIAN, AND LIVER CANCER:
Women with one abortion face a 2.3 relative risk of cervical cancer, compared to non-aborted women, and women with two or more abortions face a 4.92 relative risk. Similar elevated risks of ovarian and liver cancer have also been linked to single and multiple abortions. These increased cancer rates for post-aborted women are apparently linked to the unnatural disruption of the hormonal changes which accompany pregnancy and untreated cervical damage.(4)

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UTERINE PERFORATION:
Between 2 and 3% of all abortion patients may suffer perforation of their uterus, yet most of these injuries will remain undiagnosed and untreated unless laparoscopic visualization is performed.(5) Such an examination may be useful when beginning an abortion malpractice suit. The risk of uterine perforation is increased for women who have previously given birth and for those who receive general anesthesia at the time of the abortion.(6) Uterine damage may result in complications in later pregnancies and may eventually evolve into problems which require a hysterectomy, which itself may result in a number of additional complications and injuries including osteoporosis.

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CERVICAL LACERATIONS:
Significant cervical lacerations requiring sutures occur in at least one percent of first trimester abortions. Lesser lacerations, or micro fractures, which would normally not be treated may also result in long term reproductive damage. Latent post-abortion cervical damage may result in subsequent cervical incompetence, premature delivery, and complications of labor. The risk of cervical damage is greater for teenagers, for second trimester abortions, and when practitioners fail to use laminaria for dilation of the cervix.(7)

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PLACENTA PREVIA:
Abortion increases the risk of placenta previa in later pregnancies (a life threatening condition for both the mother and her wanted pregnancy) by seven to fifteen fold. Abnormal development of the placenta due to uterine damage increases the risk of fetal malformation, perinatal death, and excessive bleeding during labor.(8)

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COMPLICATIONS OF LABOR: Women who had one, two, or more previous induced abortions are, respectively, 1.89, 2.66, or 2.03 times more likely to have a subsequent pre-term delivery, compared to women who carry to term. Prior induced abortion not only increased the risk of premature delivery, it also increased the risk of delayed delivery. Women who had one, two, or more induced abortions are, respectively, 1.89, 2.61, and 2.23 times more likely to have a post-term delivery (over 42 weeks).(17) Pre-term delivery increases the risk of neo-natal death and handicaps.
Pregnancy problems Cervical damage from previously induced abortions increase the risks of miscarriage, premature birth, and complications of labor during later pregnancies by 300 - 500 percent.1,2,4,7 The reproductive risks of abortion are especially acute for women who abort their first pregnancies. A major study of first pregnancy abortions found that 48% of women experienced abortion-related complications in later pregnancies. Women in this group experienced 2.3 miscarriages for every one live birth.4 Yet another researcher found that among teenagers who aborted their first pregnancies, 66% subsequently experienced miscarriages or premature birth of their second, "wanted" pregnancies.6
When the risks of increased pregnancy loss are projected on the population as a whole, it is estimated that aborted women lose 100,000 "wanted" pregnancies each year because of latent abortion morbidity.5 In addition, premature births, complications of labor, and abnormal development of the placenta, all of which can result from latent abortion morbidity, are leading causes of handicaps among newborns.3 Looking at premature deliveries alone, it is estimated that latent abortion morbidity results in 3000 cases of acquired cerebral palsy among newborns each year. 5,7 Finally, since these pregnancy problems pose a threat to the health of the mothers too, women who have had abortions face a 58 percent greater risk of dying during a later pregnancy.5

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HANDICAPPED NEWBORNS IN LATER PREGNANCIES:
Abortion is associated with cervical and uterine damage which may increase the risk of premature delivery, complications of labor and abnormal development of the placenta in later pregnancies. These reproductive complications are the leading causes of handicaps among newborns.(9)

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ECTOPIC PREGNANCY:
Abortion is significantly related to an increased risk of subsequent ectopic pregnancies. Ectopic pregnancies, in turn, are life threatening and may result in reduced fertility.(10)
Ectopic pregnancies. If the scar tissue covers the openings from the fallopian tube to the uterus only partially, then the sperm will be able to reach the egg in the tube. Conceptions occurs, and fertilized egg (baby) begins to grow and move toward the uterus. The fertilized egg is too large to get from the fallopian tube to the uterus opening because of the scar tissue blocking part of the opening. The baby continues to grow inside the tube, eventually causing the tube to burst. If surgery is not done to remove the baby, then the mother will die. There has been a 300% increase in ectopic pregnancies since abortion was legalized. (US Dept. H.H.S., Morbidity and Mortality Weekly Report, no. 33, no. 15, April 20, 1984--quoted in Willke's book p. 108). Among women who aborted their first pregnancy there was a 500% increase in subsequent ectopic pregnancies. (Chung et al. "Effects of Induced Abortion Complications on Subsequent Reproductive Function" U. of Hawaii, Honolulu, 1981--Wilke p. 109) This is not to say that every woman who experiences tubal pregnancy has had an abortion.

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PELVIC INFLAMMATORY DISEASE (PID):
PID is a potentially life threatening disease which can lead to an increased risk of ectopic pregnancy and reduced fertility. Of patients who have a Chlamydia infection at the time of the abortion, 23% will develop PID within 4 weeks. Studies have found that 20 to 27% of patients seeking abortion have a Chlamydia infection. Approximately 5% of patients who are not infected by Chlamydia develop PID within 4 weeks after a first trimester abortion. It is therefore reasonable to expect that abortion providers should screen for and treat such infections prior to an abortion.(11)

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ENDOMETRITIS:
Endometritis is a post-abortion risk for all women, but especially for teenagers, who are 2.5 times more likely than women 20-29 to acquire endometritis following abortion.(12)
Endometritis is an inflamatory disease caused mainly by bacteria that can lead to infertility due to obstruction of the falopian tromps. top

IMMEDIATE COMPLICATIONS:
Approximately 10% of women undergoing elective abortion will suffer immediate complications, of which approximately one-fifth (2%) are considered life threatening. The nine most common major complications which can occur at the time of an abortion are:

infection, Signs of infection are fever, abdominal pain, vaginal secretion. Best treatment is a repeated aspiration procedure or D&C to empty the uterus in case of retention and to remove the infected endometrium, combined with an antibiotic course. Salpingitis may lead to sterility.
The typical infection involving the woman's reproductive organs (uterus, fallopian tubes, and ovaries) is pelvic inflammatory disease or PID. PID is often difficult to manage and often leads to sterility, even with prompt treatment. Some women have serious chronic pain the rest of their lives because of PID. Some women even have pain every time they have sex because of PID. (M. Spence, "PID: Detection and Treatment," Sexually Transmitted Disease Bulletin, Johns Hopkins University, vol. 3, no 1, February 1983). (PID is not a sexually transmitted disease but is a common complication from infection from abortion and STD's such as gonorrhea and chlamydia.) Sterility. Because of such early complications as infections after an abortion, the uterus is often scarred. If the scar tissue covers the opening from the tube to the uterus, then the tiny sperm cannot reach the egg. Fertilization cannot occur

excessive bleeding,

embolism: An embolism is an obstruction of a blood vessel by a foreign substance such as air, fat, tissue, or blood clot. Childbirth is a normal process, and the body is well prepared for the birth of the child and the separation and expulsion of the placenta. Surgical abortion is an abnormal process and slices the unripe placenta from the wall of the uterus into which its roots have grown. This sometimes causes the fluid around the baby, or other pieces of tissue or blood clots, to be forced into the mother's circulation. These then travel to her lungs, causing damage and occasionally death. (W. Cates et al., American Journal OB/GYN, vol. 132, p. 16
Usually, such a blockage is minor and goes unnoticed and is eventually dissolved. But if the block occurs in the brain or heart, it may result in a stroke or heart attack. This condition may occur anywhere from 2-50 days after an abortion and is a relatively frequent major complication.

ripping or perforation of the uterus,

anesthesia complications, Due to the rich blood supply around the uterus during pregnancy, local and general anesthesia during abortions is risky. Convulsion, heart arrest and death are not an uncommon result because outpatient abortion clinics generally have little equipment and expertise to deal with it.

convulsions,

hemorrhage, Bleeding from the injection sites after injecting the local anesthetic occurs frequently but invariably ceases within a few minutes. So we are only concerned with uterine bleeding of the uterus by classical D&C in an advanced pregnancy blood loss may be abundant, first from the partly removed placenta, later from the exposed implantation site of the uterine wall. The latter will finish if the uterus is empty, because then the uterus contracts and thereby closes its vessels. Termination with prostaglandins too is generally accompanied with much blood loss probably due to early separation of the placenta from the uterine wall.

cervical injury,

and endotoxic shock.

The most common "minor" complications include:

infection,

bleeding,

fever,

second degree burns,

chronic abdominal pain,

vomiting,

gastro-intestinal disturbances, and

Rh sensitization.(13)

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INCREASED RISKS FOR WOMEN SEEKING MULTIPLE ABORTIONS:
In general, most of the studies cited above reflect risk factors for women who undergo a single abortion. These same studies show that women who have multiple abortions face a much greater risk of experiencing these complications. This point is especially noteworthy since approximately 45% of all abortions are for repeat aborters.

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LOWER GENERAL HEALTH:
In a survey of 1428 women researchers found that pregnancy loss, and particularly losses due to induced abortion, was significantly associated with an overall lower health. Multiple abortions correlated to an even lower evaluation of "present health." While miscarriage was detrimental to health, abortion was found to have a greater correlation to poor health. These findings support previous research which reported that during the year following an abortion women visited their family doctors 80% more for all reasons and 180% more for psychosocial reasons. The authors also found that "if a partner is present and not supportive, the miscarriage rate is more than double and the abortion rate is four times greater than if he is present and supportive. If the partner is absent the abortion rate is six times greater." (15)
This finding is supported by a 1984 study that examined the amount of health care sought by women during a year before and a year after their induced abortions. The researchers found that on average, there was an 80 percent increase in the number of doctor visits and a 180 percent increase in doctor visits for psychosocial reasons after abortion.(18)

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INCREASED RISK FOR CONTRIBUTING HEALTH RISK FACTORS:
Abortion is significantly linked to behavioral changes such as promiscuity, smoking, drug abuse, and eating disorders which all contribute to increased risks of health problems. For example, promiscuity and abortion are each linked to increased rates of PID and ectopic pregnancies. Which contributes most is unclear, but apportionment may be irrelevant if the promiscuity is itself a reaction to post- abortion trauma or loss of self esteem.