By Randall K. O'Bannon, NRL-ETF Director of Research
Sharp increases could be the result of lesions
and inflammation
associated with abortion
An article published in the March issue of a leading
American medical journal reports that a large study has found a 50% increased
risk of ectopic (or tubal) pregnancy among women who have undergone abortion,
with an even greater risk among women who have had more than one previous
abortion. Publishing in the American Journal of Public Health, a
team of French doctors and researchers reported the results of a multicenter
study involving 1,955 women conducted in two regions of France between 1988
and 1991.
An ectopic, or tubal, pregnancy results when the embryo implants in the
fallopian tube or elsewhere rather than the uterine wall.1 Undetected, the
tube may rupture as the child grows (the fallopian tube lacks the expandability
of the mother's uterus), resulting in the child's demise and presenting
a serious threat to the mother's life. Currently, approximately 1.5% of
pregnancies are ectopic pregnancies. The authors indicate that despite progress
in diagnosis and treatment, ectopic pregnancy is still the leading cause
of maternal death during the first trimester of pregnancy.
All women younger than 45 admitted into maternity centers for ectopic pregnancy
in the Paris area in 1988 and in 15 maternity centers in the Rhône-Alps
area between 1989-1991 were paired with the next two patients admitted to
those same centers for regular deliveries. According to the report, the
authors found that among women each of whom had no previous ectopic pregnancy,
women who had previously had at least one induced (surgical) abortion were
50% more likely to develop an ectopic pregnancy than women who had not had
a previous induced abortion. Among women who had had two or more previous
induced abortions and no previous ectopic pregnancy, the risk was nearly
twice as high (90% increased risk).
The authors of the study say there has been a three- to fourfold rise in
the incidence of ectopic pregnancy in developed countries in the last 20
years. Several risk factors for ectopic pregnancy have been identified,
among them smoking at the time of conception, pelvic surgery, use of an
IUD, pelvic inflammatory disease, and induced ovulation.
Yet these factors, according to an earlier French study by many of the same
researchers, accounted for only about 65% of all ectopic pregnancies. The
present study was initiated to determine if other factors, such as previous
reproductive history, might explain some of the remaining one-third of ectopic
pregnancies among women without any of these known risk factors.
Even the most basic analysis offers solid grounds for making the association.
Twenty-two and half percent of the case patients (those presenting to the
maternity centers with an ectopic pregnancy) had had abortions, while only
16.2% of the controls (those women reporting for a delivery to those same
centers immediately after a woman with an ectopic pregnancy had been admitted)
reported having an abortion. Even with other risk factors and the possibility
of the controversial idea of recall bias (women not wanting to admit having
had an abortion) factored out, the discrepancy remained. Women who had previously
aborted had a 50% higher risk.
The authors speculate that the higher risk could be "the consequence
of uterine injuries consecutive to this procedure, either inflammatory lesions
or asymptomatic ascending infections," in other words, due to injuries,
inflammations, and infections resulting from the scraping and suctioning
of a woman's uterus in a surgical abortion. These inflammations or lesions
may damage the fallopian tube, inhibiting the transport of the embryo. Instead
of implanting in the uterine wall, the embryo implants in the fallopian
tube.
With approximately six million pregnancies in the United States each year
(6.4 million in 1992, according to the 1996 Statistical Abstract),
1.5% represents some 90,000 ectopic pregnancies, or more, per year. If one
assumes that women having abortions have the same rate of pregnancy as those
who do not, and that something in the neighborhood of one-third of all women
have had abortions, figures such as those generated by the French study
would lead one to estimate as many as 12,000 or more ectopic pregnancies
every year in America being attributable to abortion.
Despite the prevalence of abortion in the United States, there have been
few studies on American populations. Some have shown a similar risk, but
most, the authors say, "have not revealed any significant association."
The French researchers dismiss such studies, saying they "generally
have not included enough subjects to allow satisfactory statistical power."
Because of the size and design of the French study, there is little doubt
that an association exists between abortion and ectopic pregnancy. This
leads to an important series of questions. Why have there been so few American
studies? Why have scientifically and statistically weak studies been put
forward as proof of abortion's safety? Why should Americans have to look
to France to get a thorough and unbiased appraisal of abortion's health
risks?
One cannot help but see a parallel between this case and the situation with
the abortion-breast cancer link. When a cause, like abortion, is "politically
correct," much of the medical establishment often ignores or covers
up research, or simply fails to conduct research, that would challenge the
view of abortion's relative safety, even if, biologically, there is reason
to suspect a danger. And American women, as well as their unborn children,
suffer the consequences.
At a minimum, this study presents a strong case for informed consent or
"women's right to know" legislation. If this latest study is correct,
a woman who aborts her baby may not only lose that baby but the next one
as well and maybe the next one after that. How many women are told that
death, once chosen, is a companion not easily abandoned?