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Abortion Risks

Significant risk factors (like breast cancer) have been associated with abortion.

The foundational arguments against abortion are not rooted in its potential danger to women. Abortion is immoral and unjust because it kills a living human being. The safety of a particular activity does not make it right or wrong. The impact it has on other people does. With that said, there are two reasons why we survey the medical risks of abortion. First, some women (and men) are not particularly concerned about the violence abortion does to their offspring; far fewer are unconcerned about the violence abortion might do to themselves. A greater understanding of the medical risks may dissuade them from ending their child's life. Second, the abortion industry's consistent reluctance to provide women with information that portrays abortion in anything less than a positive light is strong indication that they may care more about money and politics than they do about a woman's health. If they didn't have a vested interest in her "choice," why do they lobby so hard against having to more thoroughly disclose to women what abortion is and does?

To get a better understanding of the severity of the abortion procedure, consider the following testimony from Abortion Practice, the most widely used abortion textbook in existence.

A high level of operator skill is at least as important in abortion as it is in any surgical endeavor. Abortion is a blind procedure that proceeds by touch, awareness of the nuances of sensations provided by instruments, honesty, and caution...abortion, almost more than any other operation, demands experience to develop skill...Well trained, highly experienced, and reputable gynecologists found, to their dismay, that when abortions became legal and they began performing them, the complication rates were frequently quite high.¹

The book's author, Dr. Warren Hern, told The New York Times, "As a society, I think we've been in denial about the risks of abortion both because of ideology, and because of economics. There are a lot of respectable doctors doing a lousy job."²

The duration of this page will examine some of the risk factors associated with abortion, including breast cancer, uterine damage, complications in future pregnancy and death.

Not surprisingly, the website for the largest abortion provider in America, Planned Parenthood, has this to say about the risks of abortion: "There are many myths about the risks of abortion. Here are the facts. Abortion does not cause breast cancer. Safe, uncomplicated abortion does not cause problems for future pregnancies such as birth defects, premature birth or low birth weight babies, ectopic pregnancy, miscarriage, or infant death."³

A closer look at the evidence paints a very different picture.

BREAST CANCER

The National Abortion Federation (NAF) has a page on their website titled "Abortion and Breast Cancer." The page states that of the "several dozen studies" investigating the connection between abortion and breast cancer," the results seem "contradictory."⁴ Nevertheless, they point to a 2003 National Cancer Institute workshop⁵ as definitive proof that abortion is not a risk factor for breast cancer. The National Cancer Institute (NCI), the American Cancer Society (ACS), and Susan G. Komen for the Cure all join NAF in stating that "research clearly shows no link between abortion and the risk of breast cancer."⁶ Like NAF, all three point to the findings of the 2003 workshop to justify their stance, though NCI notes that research "continues to be conducted to determine whether having an induced abortion… influences a woman’s chances of developing breast cancer later in life"⁷ (a strange concession if research has already demonstrated that no link exists).

What none of these organizations disclose is that in 2009, Dr. Louise A. Brinton, "the chief organizer of the 2003 NCI workshop"⁸ co-authored a research paper which included the following findings:

In analyses of all 897 breast cancer cases (subtypes combined), the multivariate-adjusted odds ratios for examined risk factors were consistent with the effects observed in previous studies on younger women (Table 1). Specifically, older age, family history of breast cancer, earlier menarche age, induced abortion, and oral contraceptive use were associated with an increased risk for breast cancer. (emphasis added)⁹

Doctor Brinton is listed in the NCI staff directory as a "Senior Investigator" in the "Chief Hormonal and Reproductive Epidemiology Branch."¹⁰ Interestingly, her study connecting abortion to breast cancer is not included in the selected publications they list for her. A 2010 article from Medical News Today, includes the following quote from Karen Malec, president of the Coalition on Abortion/Breast Cancer (ABC): "Although the study was published nine months ago, the NCI, the American Cancer Society, Susan G. Komen for the Cure and other cancer fundraising businesses have made no efforts to reduce breast cancer rates by issuing nationwide warnings to women."¹¹ They are not alone in their silence. One of the few media outlets to even report the story was Canada's The Globe and Mail. Gloria Galloway writes:

… a study released last fall by the respected Fred Hutchinson Cancer Research Institute in Seattle by a number of distinguished cancer experts including Louise Brinton, the chief of the Hormonal and Reproductive Epidemiology Branch of the National Cancer Institute lists induced abortion as being “associated with an increased risk for breast cancer.” Background documents further suggest that it increases the risk of the disease by 40 per cent.

An e-mail to Dr. Brinton on Friday was returned by an Institute spokesman named Michael Miller who said: “NCI has no comment on this study. Our statement and other information on this issue can be found at http://www.cancer.gov/cancertopics/ere.” That link turns up a 2003 document that says a workshop of more than 100 leading experts concluded that having an abortion or miscarriage does not increase a woman’s subsequent risk of developing breast cancer.

Requests for an explanation of the apparent discrepancy between that position and the information contained in the study released last spring went unanswered by NCI.

… trying to prevent abortions by scaring women with breast cancer would truly be wrong. But so too would be suppressing the risks of abortion or any medical procedure.¹²

Dr Joel Brind, the professor who first suggested the abortion/breast cancer connection (though he was excluded from participating in NCI's 2003 workshop)¹³ notes that if those numbers are correct, legal abortion has resulted in an additional 300,000 breast cancer deaths. His exact quote can be found in a January 2011 ABC press release:

If we take the overall risk of breast cancer among women to be about 10% (not counting abortion), and raise it by 30%, we get 13% lifetime risk. Using the 50 million abortions since Roe v. Wade figure, we get 1.5 million excess cases of breast cancer. At an average mortality of 20% since 1973, that would mean that legal abortion has resulted in some 300,000 additional deaths due to breast cancer since Roe v. Wade.¹⁴

Doctor Brind may not have accounted for the fact that an estimated 47% of all abortions are performed on women who have already had a previous abortion, but even if we assume those 50 million abortions were performed on "only" 25 million women, that would still place the abortion-related, breast cancer death toll well over 100,000. Seven years before the 2009 study, Dr. Angela E. Lanfranchi made the following comments in a statement to the press, prior to her testimony in a California lawsuit against Planned Parenthood:

Although I observed in my own practice in the early 1990s an inordinate number of 30 year olds with breast cancer who had no family history, but had abortions as teenagers, it wasn’t until 1999 that I informed my patients of this risk. That was when a Harvard professor in charge of risk assessment at a well known Boston clinic told me she knew abortion was a risk factor for breast cancer and considered it in the evaluation of her patients. Although she chose not to publicly speak about this issue, she encouraged me to do so.

I was reluctant at first to follow her suggestion. I depend upon referrals from obstetrician-gynecologists, some of whom do abortions, and I was worried they would stop sending me patients when they heard me give lectures on the abortion-breast cancer link. I lecture on the subject because it is unjust to withhold pertinent medical information from patients that is so well documented in the literature for over 20 years and that is in my textbooks.¹⁵

Doctor Lanfranchi's testimony before the California Supreme Court asserted that "she had private conversations with leading experts who agreed abortion raises breast cancer risk, but they refused to discuss it publicly, saying it was 'too political.'"¹⁶ Her 2009 publication, "Normal Breast Physiology: The Reasons Hormonal Contraceptives and Induced Abortion Increase Breast-Cancer Risk" explains the connection between abortion and breast cancer.¹⁷ Doctor Brind's memorandum to the UK Parliament provides a more succinct overview.¹⁸

On January 8, 2010, Pam Stephan, the breast cancer guide for About.com, posted an article titled, "Abortion, Birth Control Pills, Raises Breast Cancer Risk." She concludes the article as follows:

Before I was diagnosed with breast cancer in March 2002, I took birth control pills for about 5 years. They prevented conception, made me a little queasy, but seemed otherwise harmless. In those days, the hormones in The Pill were lower than contraceptives that were produced in the 1980's, so I thought they were safe. After all, a doctor prescribed them for me - so no health risk, right? Maybe they were wrong! As soon as my breast lump was detected on a mammogram, when I was 46 years old, I was told to stop taking The Pill. That was one year before NCI told us that The Pill would not raise my risk for breast cancer. Now, I wish I'd never taken it. Perhaps one's risk is not as simple as taking The Pill, or eating a healthy diet, or having a genetic mutation - but if my risk is lower now because of being off contraceptives and never having had an abortion, I'm glad there's something I can do. I just wish we could have as much information as possible, to reduce our risk of breast cancer.¹⁹

At the close of the National Abortion Federation page on abortion and breast cancer, you'll find the following statement:

Anti-choice activists are opposed to legal abortion under almost any circumstances, regardless of its safety. Their real goal in this controversy is preventing women from exercising their legal right to choose abortion, not protecting women's health.²⁰

Truth be told, this is a relatively accurate assessment. Though "anti-choice" is a silly and dishonest moniker to apply to those who oppose abortion, they've correctly identified our most fundamental goal. Abort73 exists to eliminate abortion through education, not to eliminate breast cancer. That doesn't mean we don't care about breast cancer. Of course, we care about breast cancer! Of course, we want to see it eliminated, but this is not a website about breast cancer. It's a website about abortion. Why do we bring up such a disputed issue at all? Becasue, as abortion advocates love to point out, abortion is a complicated decision that women don't make lightly. If someone is teetering on the edge of indecision, we want to offer her every possible reason to choose against abortion. Though a woman may have no moral objection to killing a tiny embryo or fetus, she may well have a practical objection to compromising her own health. We do not say that having an abortion causes breast cancer. We do say that there is broad evidence that abortion may be a significant risk factor.

Saying all that, we've laid our cards on the table. We've admitted our bias, which is something the National Abortion Federation seems entirely unwilling to do. They make no allowance for the mere possibility that abortion has a causal connection to breast cancer. Why? Perhaps they're doing exactly what they accuse "anti-choice activists" of. Namely, caring more about the abortion issue than they do about women's health? Is it possible they're more concerned about protecting the sacred rite of abortion than they are about honestly considering the evidence? If there is uncertainty, doesn't it make more sense to error on the side of avoiding a suspected risk factor? Doesn't it make more sense to let women know that abortion may increase their risk of breast cancer? Wouldn't that be a course of action more consistent with the promotion of women's health? We think so.

UTERINE DAMAGE

For decades now, Dr. Warren Hern has been "one of the few doctors in America to specialize in late abortion."²¹ He is arguably the most prominent abortionist in the country. These are some of the remarks he makes about the potential for uterine damage in his textbook, Abortion Practice:

One of my more experienced colleagues recently commented, “Abortion is a simple procedure except for the uterus’s total intolerance to poor technique.” The first half of this comment summarizes the popular notions about abortion within the medical community; the last half summarizes the wisdom of one who is experienced with the pitfalls of this “simple” procedure.  In medical practice, there are few surgical procedures given so little attention and so underrated in its potential hazard as abortion.²²

It may be argued that each abortion, no matter how carefully performed, results in a contaminated uterine cavity.²³

Even following abortions performed by highly experienced operators, tissue is retained frequently enough to require assiduous attention to this point.²⁴

The common factor in most operative complications is hemorrhage or conditions that predispose to hemorrhage.  Perforation of the uterus with bowel injury does not in itself cause death immediately.  Perforation of the uterus that lacerates a uterine artery can result in death in a short time, however.²⁵

Medical abortions, considered less invasive to the uterus than surgical abortions, can still require surgical intervention. The article, "Management of side effects and complications in medical abortion," published in the American Journal of Obstetrics & Gynecology reports that, "approximately 2% to 10% of (medical abortion) patients will require surgical intervention for control of bleeding, resolution of incomplete expulsion, or termination of a continuing pregnancy."²⁶

In 1989, another article in the American Journal of Obstetrics and Gynecology titled, "The frequency and management of uterine perforations during first-trimester abortions," indicates that approximately 2% of all first-trimester abortions result in a perforated uterus.²⁷ This is about seven times the rate that was generally reported before.²⁸ The three authors, who conducted 6,408 first-trimester abortions during a two-year stretch at their "free-standing surgical facility" report that eight uterine perforations were noted at the time of procedure, resulting in a perforation rate of 1.3/1000 procedures, which is similar to what is "reported in the literature."²⁹ During the same time period, the authors performed an additional 706 first-trimester abortions in conjunction with laparoscopic sterilizations. They were surprised to find that though only two perforations had been noted at the time of procedure, the laparoscope revealed twelve additional perforations, resulting in an actual perforation rate of 19.8/1000.³⁰ Because the camera was able to pick up what often goes unnoticed, the article concludes: "most uterine perforations go unrecognized and untreated."³¹ Perforations of the uterus are dangerous not only because they may provoke life-threatening internal bleeding, but because they are capable of leaving scar tissue in the womb that my "blow out" during a subsequent pregnancy.

COMPLICATIONS IN FUTURE PREGNANCY

The American Association of Pro-Life Obstetricians & Gynecologists (AAPLOG) has a slew of resources on its website demonstrating the connection between abortion and future preterm delivery.³² In a posted review of an American Journal of Obstetrics & Gynecology article by Jay D. Iams, MD, they quote Dr. Iams as follows:

Contrary to common belief, population-based studies, have found that elective pregnancy terminations in the first and second trimesters are associated with a very small but apparently real increase in the risk of subsequent spontaneous preterm birth (PTB).³³

This quote prompts two questions from AAPLOG. Number one, since there are 114 studies showing a significant association between abortion and subsequent preterm birth and "just about none to the contrary," why is the link between abortion and PTB "contrary to common belief"?³⁴ Number two, since the study Dr. Iams references indicates that a single, prior abortion increases a woman's likelihood of PTB by 36%, why does he call this "a very small" increase?³⁵ Doctor Iams notes that the PTB rate amongst African American women is twice that of other women,³⁶ but makes no explanation for the disparity–a disparity that easily fits with the much higher rate of abortion in the African American community. In Ireland, "an industrialized country where abortion is illegal, the preterm birth rate is about 6%—that is what it was in the USA before abortion on demand. It is now 12.7% in the USA."³⁷

AAPLOG calls the "relative indifference displayed by medical authorities and professional colleges" to the abortion/PTB connection as "a kind of informational malpractice."³⁸ They also point out that the ACOG Practice Bulletin released by the American Congress of Obstetricians and Gynecologists in 2001 positively denounced any connection between abortion and breast cancer or abortion and preterm birth. The bulletin that was released in 2006 to replace earlier versions, "did not repeat this egregious misinformation."³⁹ Instead it said nothing. For all these reasons, you can understand AAPLOG's pleasant surprise when Ob.Gyn. News finally published an article titled, "Induced Abortions Linked to Preterm Delivery."⁴⁰

Years before this more recent debate about abortion and preterm birth, the Centers for Disease Control (CDC) released a study on ectopic pregnancies, showing that from 1970-1980, there was a threefold increase in the rate of ectopic pregnancy in the U.S.⁴¹ They suggest a rise in pelvic inflammatory disease as the culprit. A few months later, the American Journal of Obstetrics & Gynecology would publish an article indicating that "pelvic infection is a common and serious complication of induced abortion and has been reported in up to 30% of all cases."⁴² It should be noted that the dramatic increase in ectopic pregnancy parallels the dramatic increase in abortions in the U.S. The number of ectopic pregnancies in the U.S. continued to increase until about 1989, when it began to level off and decline.⁴³ This is the same statistical trajectory that abortion has followed.

One final issue that bears mentioning is tied to an American Journal of Obstetrics & Gynecology article reporting that, "compared with women who gave birth, women who had had an induced abortion [are] significantly more likely to use marijuana, various illicit drugs, and alcohol during their next pregnancy."⁴⁴ Since any one of these behaviors can lead to serious pregnancy complications, the authors suggest that, "screening for abortion history may help to identify pregnant women who are at risk for substance use more effectively."

DEATH

Abortion advocates frequently argue that abortion is safer than giving birth. They say this because they deny that abortion is a risk factor for breast cancer, they deny the existence of anything like post-abortion stress syndrome, and they reference data indicating that a higher percentage of women die giving birth than die having an abortion.⁴⁵ While the physical act of giving birth does have a higher mortality rate for the mother than the physical act of having an abortion, a 14-year Finnish study reports that the "natural cause" mortality rate for women who give birth is much lower than for women who have an abortion.⁴⁶ Studying all causes of death for women aged 15-49 years, they report a mortality rate of 57.0 deaths per 100,000 person-years. For women who had an abortion within the last year, her mortality rate goes up to 83.1/100,000. On the other hand, women who miscarried during the last year had a mortality rate of only 51.9/100,000–slightly lower than the rate for women who had not been pregnant at all. Women who had given birth within the last year had a mortality rate of only 28.2/100,000. In other words, statistics show that women who give birth are significantly less likely to die of "all natural causes" than women who have an abortion. And these numbers do not include Dr. Joel Brind's opinion (referenced above) that hundreds of thousands of breast cancer deaths could fairly be classified as abortion-related.

The Centers for Disease Control (CDC) periodically reports on abortion-related deaths. Their most recent "Abortion Surveillance" report, dated February 25, 2011 but only providing data through the year 2007, indicates that six women died from abortion complications in 2007.⁴⁷ All six were the result of legal abortions. One was the result of a medical abortion. The other five were the result of surgical abortions. Three more deaths were reported to be potentially related to abortion, but the CDC concluded that these deaths were not a direct result of abortion. A comprehensive report on pregnancy mortality has not been released since February 21, 2003, covering the years 1991-1999. During that period 34% of abortion-related deaths were the result of infection, 22% were the result of hemorrhaging, and 16% were the result of "other medical conditions."⁴⁸ The CDC has not been able to issue national case-fatality rates for abortion since 1997 because some states, including California, no longer report abortion data to the federal government.⁴⁹ More abortions occur in California than in any other state. It's safe to assume that more abortion-related, maternal deaths happen in California than anywhere else as well. More recently, the practices of Philadelphia abortionist, Dr. Kermit Gosnell, have sparked outrage around the nation and world. He was charged with 8 counts of murder, all abortion-related.⁵⁰

In 1972, the year prior to the federal legalization of abortion, the CDC reports that there were 39 maternal deaths related to illegal abortion in the United States and 24 maternal deaths that came as a result of legal abortions.⁵¹ In 1973, there were 25 maternal deaths as a result of legal abortion and 19 maternal deaths as a result of illegal abortion.⁵² The numbers for 1974 and 1975 were 32 and 33 maternal deaths, respectively.⁵³ In 1980, maternal deaths dropped to 10, and the number was only 5 in 1990.⁵⁴ The CDC suggests that "the increasing use of D&E… for second-trimester abortions" from 1972 to 1992 is what accounts for the overall reduction in abortion-related, maternal deaths–not the act of legalizing abortion itself.⁵⁵

Footnotes

1. Warren M. Hern. Abortion Practice (Philadelphia: J.B. Lippincott Company, 1990), 103.
2. Tamar Lewin. “A New Weapon In an Old War—A special report.; Latest Tactic Against Abortion: Accusing Doctors of Malpractice,” The New York Times, April 9, 1995 http://www.nytimes.com/1995/04/09/us/new-weapon-old-war-special-report-latest-tactic-against-abortion-accusing.html?pagewanted=all
3. Planned Parenthood. “Thinking About Abortion > Are There Any Long-Term Risks of Abortion?” http://www.plannedparenthood.org/health-topics/pregnancy/abortion-21519.htm, accessed Apr 29, 2011.
4. National Abortion Federation. “Abortion and Breast Cancer: Scientific Research”: http://www.prochoice.org/about_abortion/facts/abortion_breast_cancer.html (accessed Apr 27, 2011)
5. National Cancer Institute. “Summary Report: Early Reproductive Events and Breast Cancer Workshop”: http://www.cancer.gov/cancertopics/causes/ere/workshop-report (Mar 4, 2003)
6. Susan G. Komen for the Cure. “Table 25: Abortion and breast cancer risk: Introduction”: http://ww5.komen.org/BreastCancer/Table25Abortionandbreastcancerrisk.html (accessed Apr 27, 2011)
7. National Cancer Institute. “Abortion, Miscarriage, and Breast Cancer Risk: Introduction”: http://www.cancer.gov/cancertopics/factsheet/Risk/abortion-miscarriage (accessed Apr 27, 2011)
8. Medical News Today. “Researcher Finally Admits Abortion Raises Breast Cancer Risk In Study That Fingers Oral Contraceptives As A Probable Cause Of Breast Cancer”: http://www.medicalnewstoday.com/articles/175394.php (Jan 7, 2010)
9. Cancer Epidemiology, Biomarkers & Prevention. “Risk Factors for Triple-Negative Breast Cancer in Women Under the Age of 45 Years”: http://cebp.aacrjournals.org/content/18/4/1157.full.pdf+html (Mar 31, 2009)
10. National Cancer Institute. “Louise A. Brinton, Ph.D., M.P.H.”: http://dceg.cancer.gov/about/staff-bios/brinton-louise (accessed Apr 27, 2011)
11. Medical News Today. “Researcher Finally Admits Abortion Raises Breast Cancer Risk In Study That Fingers Oral Contraceptives As A Probable Cause Of Breast Cancer”: http://www.medicalnewstoday.com/articles/175394.php (Jan 7, 2010)
12. Gloria Galloway. “Was Maurice Vellacott right about abortion?” The Globe and Mail: http://m.theglobeandmail.com/news/politics/ottawa-notebook/was-maurice-vellacott-right-about-abortion/article1424760/?service=mobile&aki=spid (Jan 11, 2010)
13. Jill Stanek. “Top scientist finally admits abortion-breast cancer link.” World Net Daily:  http://www.wnd.com/index.php?fa=PAGE.view&pageId=121749 (Jan 13, 2010)
14. Coalition on Abortion/Breast Cancer. “Press Release” http://www.abortionbreastcancer.com/press_releases/110117/index.htm (Jan 11, 2011)
15. Angela Lanfranchi, M.D., F.A.C.S., “Statement to the Press.” Population Research Institute Conference: http://www.abortionbreastcancer.com/angelalanfranchi.htm (April 5, 2002)
16. Coalition on Abortion/Breast Cancer. “Press Release”: http://www.abortionbreastcancer.com/press_releases/110117/index.htm (Jan 11, 2011)
17. Angela Lanfranchi, M.D., F.A.C.S. “Normal Breast Physiology: The Reasons Hormonal Contraceptives and Induced Abortion Increase Breast-Cancer Risk.” The Linacre Quarterly 76(3): http://www.abortionbreastcancer.com/download/LQ_76_3_2_Lanfranchi.pdf (Aug 2009)
18. Dr Joel Brind. “Memorandum 14 Select Committee on Science and Technology.” UK Parliament: http://www.publications.parliament.uk/pa/cm200607/cmselect/cmsctech/1045/1045we15.htm (Aug 2007)
19. Pam Stephan. “Abortion, Birth Control Pills, Raises Breast Cancer Risk.” About.com: http://breastcancer.about.com/b/2010/01/08/abortion-birth-control-pills.htm (Jan 8, 2010)
20. National Abortion Federation. “Abortion and Breast Cancer: Some Additional Facts”: http://www.prochoice.org/about_abortion/facts/abortion_breast_cancer.html (accessed Apr 27, 2011)
21. John H. Richardson. “The Last Abortion Doctor.” Esquire, Aug 5, 2009:  http://www.esquire.com/features/abortion-doctor-warren-hern-0909
22. Warren M. Hern. Abortion Practice (Philadelphia: J.B. Lippincott Company, 1990), 101.
23. Ibid, 104.
24. Ibid.
25. Ibid, 175.
26. Beth Kruse, et al. “Management of side effects and complications in medical abortion.” American Journal of Obstetrics & Gynecology, Aug 2000:  http://www.ajog.org/article/S0002-9378(00)70448-0/abstract
27. Steven G. Kaali, et al. “The frequency and management of uterine perforations during first-trimester abortions.” American Journal of Obstetrics & Gynecology, Aug 1989, 407.
28. Ibid.
29. Ibid.
30. Ibid.
31. Ibid, 408.
32. American Association of Pro-Life Obstetricians & Gynecologists. “Induced Abortion and Pre-Term Birth” http://www.aaplog.org/complications-of-induced-abortion/induced-abortion-and-pre-term-birth/
33. American Association of Pro-Life Obstetricians & Gynecologists. “New Year, New Article, but Old Mindset?” Jan 6, 2011 http://www.aaplog.org/get-involved/letters-to-members/new-your-new-article-old-mindest//
34. Ibid.
35. Ibid.
36. Jay D. Iams, et al. “Care for women with prior preterm birth”American Journal of Obstetrics & Gynecology, Aug 2010: http://www.ajog.org/article/S0002-9378(10)00209-7/abstract
37. American Association of Pro-Life Obstetricians & Gynecologists. “New Year, New Article, but Old Mindset?” Jan 6, 2011 http://www.aaplog.org/get-involved/letters-to-members/new-your-new-article-old-mindest//
38. Ibid.
39. Ibid.
40. Kate Johnson. “Induced Abortions Linked to Preterm Delivery.” Ob.Gyn. News, Dec 2010: http://www.obgynnews.com/article/S0029-7437(10)70420-1/fulltext
41. Centers for Disease Control and Prevention. “Ectopic Pregnancies – United States, 1979-1980.” Morbidity and Mortality Weekly Report, April 20, 1984.
42. Stellan Osser, M.D., et al. “Postabortal pelvic infection associated with Chlamydia trachomatis and the influence of humoral immunity.” American Journal of Obstetrics & Gynecology, Nov 15, 1984.
43. Centers for Disease Control and Prevention. “Current Trends Ectopic Pregnancy—United States, 1990-1992.” Morbidity and Mortality Weekly Report, Jan 27, 1995: http://www.cdc.gov/mmwr/preview/mmwrhtml/00035709.htm
44. Priscilla K. Coleman, et al. “A history of induced abortion in relation to substance use during subsequent pregnancies carried to term”American Journal of Obstetrics & Gynecology, Dec 2002: http://www.ajog.org/article/S0002-9378(02)00489-1/abstract
45. David A. Grimes. “Estimation of pregnancy-related mortality risk by pregnancy outcome, United States, 1991 to 1999”American Journal of Obstetrics & Gynecology, Jan 2006: http://www.ajog.org/article/S0002-9378(05)00973-7/abstract
46. Mika Gissler, et al. “Pregnancy-associated mortality after birth, spontaneous abortion, or induced abortion in Finland, 1987-2000”American Journal of Obstetrics & Gynecology, Feb 2004: http://www.ajog.org/article/S0002-9378(03)01136-0/abstract
47. Centers for Disease Control and Prevention. “Abortion Surveillance – United States, 2007.” Morbidity and Mortality Weekly Report, February 25, 2011: http://www.cdc.gov/mmwr/pdf/ss/ss6001.pdf, 8
48. Centers for Disease Control and Prevention. “Pregnancy-Related Mortality Surveillance—- United States, 1991—1999” Morbidity and Mortality Weekly Report, February 21, 2003: http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5202a1.htm
49. Centers for Disease Control and Prevention. “Abortion Surveillance – United States, 2007.” Morbidity and Mortality Weekly Report, February 25, 2011: http://www.cdc.gov/mmwr/pdf/ss/ss6001.pdf, 4
50. Maryclaire Dale. “Women: Pa. doc’s abortions left us sterile, near death.” MSNBC.com, Jan 22, 2011: http://www.msnbc.msn.com/id/41211777/ns/us_news-crime_and_courts/
51. Centers for Disease Control and Prevention. “Abortion Surveillance – United States, 1992.” Morbidity and Mortality Weekly Report, May 3, 1996: http://www.cdc.gov/mmwr/PDF/ss/ss4503.pdf, 33
52. Ibid.
53. Ibid.
54. Ibid.
55. Ibid, 34.

 

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