Letter to the editor of the British Medical Journal 

[BMJ letter to the editor; 2001;322:430]

Having an induced abortion increases risk in future pregnancy

Editor-The latest of three Danish reports about reproductive
history informs readers that "fetal loss is high in women in
their late 30s or older, irrespective of reproductive history
. This should be taken into consideration in pregnancy planning
and counseling."1
   Consider a woman whose first pregnancy occurs at age 30.
According to Melbye et al and Zhou et al, if she is pressured
to have an induced abortion she should be warned that is she
does so she will increase her risk of never having a birth.2,3
Will the abortion clinic tell her that her best chance for a
full term birth is to carry her current pregnancy to term? No,
it will not; no abortion clinic's consent form mentions such
a risk. Even if the woman does have a future birth, a previous
abortion roughly doubles the risk that it well be very preterm
(less that 34 weeks' gestation), according to another study
of Danish women (relative risk 1.99 (95% confidence interval
1.64 to 2.43)).3  If the woman has two evacuation type
abortions she increases her risk of preterm birth by 1155%
(5.14 to 30.64).3  There are at least nine other reports that
found an increased risk of prematurity from previous induced
abortions 4,5 (readers can visit www.vcn.bc.ca/~whatsup for
references to the 10 studies know to me).
   By not informing prospective patients of health risks
associated with induced abortion, abortion doctors are
violating their legal duty to protect health and not 
needlessly endanger it. Is there any serious health risk
for a mother who has a preterm birth? In their study of
Danish women Melbye et al inform us that if the gestation
of a newborn infant is under 32 weeks the mother has 
doubled her risk of breast cancer compared with having a
full-term birth (relative risk 2.08 (1.20 to 3.60) for
gestation of 29-31 weeks).2
   Let us ensure that women of reproductive age are fully
informed about health risks of medical treatments to them
and their future children.

Brent Rooney  independent medical researcher
Reduce Preterm Risk Coalition, 3456 Dunbar St. 
(146), Vancouver, Canada   V6S 2C2
[email protected]

1 Nybo Andersen A-M, Wohlfahrt J, Christens P, Olsen J,
  Melbye M. Maternal age and fetal loss: population
  based register linkage study. BMJ 2000;320:1708-12
  (24 June)
2 Melbye M, Wohlfahrt J, Andersen A-MN, Westergaard T,
  Andersen PK. Preterm delivery and risk of breast
  cancer.  Br J Cancer 1999;80:609-13.
3 Zhou W, Sorenson HT, Olsen H. Induced abortion and
  subsequent pregnancy duration. Obstet Gynecol 1999;
4 Lieberman E, Ryan KJ, Monson RR, Schoenbaum SC. Risk
  factors accounting for racial differences in the
  rate of premature birth. N Engl J Med 1987;317:743-8
5 Berkowitz GS. An epidemiologic study of preterm
  delivery. Am J Epidemiol 1981;113:81-92

For a list of at least THIRTY-FOUR (34) studies that
have  reported that prior elective induced abortions
significantly boost the  risk of  future  preterm or
low-birth-weight births, click on the following:
 Significant Preterm/LBW studies