Adapted from the book,
Pro-Choice Pro-Adoption. It’s Time for a Loving, Positive Response to Unplanned Pregnancy  
by Terri Marcroft

 INTRO 

Each year, almost three million American women face an unplanned pregnancy. When a pregnancy is unwanted and those involved are not ready, willing or able to parent, that is a dilemma for which there is no ideal solution.

The obvious options for one facing an unplanned pregnancy are abortion, parenting and adoption, but few among us know much about the pro’s and con’s of those three options. Let’s explore.

 

HOW ABORTION HURTS WOMEN 

Abortion is presented as a safe, quick, painless answer. And we dupe women into believing that by withholding the rest of the story. During the last fifty years of unfettered abortion access in this country, we’ve learned what abortion does to the female body. We’ve been able to observe and study the side effects over time among large groups. Those findings reveal significant risks to women’s health.  

Yet we don’t hear about the side effects of abortion from those who are selling them. Society tells us that there’s no downside to abortion. That is simply not true.  

Elective abortions can exact an immense physical and emotional toll on women. Most women who undergo abortion procedures are not made aware of the long-term effects, but numerous studies have documented them in three categories—compromised mental health, preterm births, and increased risk of breast cancer. 

Compromised Mental Health
Hundreds of US studies have examined the association between abortion and mental health. The most comprehensive source is the research done by Dr. David C Reardon, Dr. Priscilla Coleman, and the American Association of Pro-Life Obstetricians and Gynecologists, known as AAPLOG.[1]  

Both pro-life and pro-choice researchers agree that "the abortion experience directly contributes to mental health problems."[2] Large studies done with nationally representative samples and a variety of controls for personal and situational factors indicate abortion significantly increases risk for the following mental health problems: [3]

·        Depression

·        Anxiety

·        Substance abuse

·        Suicide ideation and behavior[4]

Suicide, specifically, is a serious risk, based on the much-studied correlation. Young women, under 18 years old, account for 15–30% of abortions and have a significantly higher suicide rate than their peers: compared with women who delivered, women were 6.5 times more likely to die by suicide during the year after an induced abortion.[5] AAPLOG says that another large study found a 155% increase in suicidal behavior post-abortion.[6]  

“Literally every large scale study of the abortion and mental health link has revealed higher rates of mental illness among women.”[7]
For many women who’ve chosen abortion, reconciling with the decision is a life-long endeavor. Dr. Coleman notes in a 2015 interview that about 50% of women who have abortions do believe that they are “terminating the life of a human being,” and that belief tends to make the aftermath more traumatic. As ultrasound technology improves, we’re able to clearly see the human formation even earlier.  

About 80% of Americans view biologists as the group most qualified to determine when a human’s life begins. A recent survey of 5577 biologists from 1,058 academic institutions around the world showed a consensus: 96% of those experts in biology agree that human life begins at fertilization.[8] That makes it increasingly difficult for a pregnant women to deny that she is carrying a human life, a dissonance which can lead to compromised mental health issues and even PTSD-like trauma. 

The trauma is undeniable.

I saw this firsthand at a Rachel’s Vineyard retreat:  it was attended by 19 women, ranging in age from their 20s to their 80s. It made a lasting impression on me that women in their 70s and 80s sobbed as they shared their stories. They were still grieving their abortions, many decades later. These care programs and support groups give women a place to talk with others and share their experience, process their grief and forgive themselves. With this assistance, post-abortive women can finally get closure, heal and move on with their lives.[9] 

 Preterm Births

Abortion increases the risk of very preterm births—that is babies born between 22 and 26 weeks, at the edge of life—for any future pregnancy.

 As of November 2021, 168 studies have been published on the association between abortion and preterm birth (PTB).[10] These tiny babies require neonatal intensive care support to survive, and many of the 22–24 week-old babies don’t survive. Very premature births of post-abortive women result in over three million infant deaths worldwide each year.

AAPLOG writes on their findings[11]:

-         First trimester induced abortion is one of the top three risk factors for preterm births.

-         Surgical abortions are associated with a “dose effect,” meaning an increased number of abortions confer increasing risk of PTB (because the cervix is weakened with each subsequent procedure).

-         Two or more abortions increase a woman’s risk of future preterm birth by up to 93%, and her risk of VERY preterm birth by more than 200%. 

-         Preterm births can have health risks for a baby. Vital organs have not had enough time to fully develop. Also, preterm birth leads to an increased risk for short and long term complications such as cerebral palsy, impaired vision and/or hearing and impaired cognitive development.

The Royal College of Obstetrics and Gynecology (RCOG) acknowledges the association of surgical abortion and PTB, as does the AAPLOG. Despite the evidence presented in these 168 peer-reviewed science-based studies, the largest providers of abortions in the US do not inform patients of the association between surgical abortion and later preterm births. AAPLOG recommends that information about the increased risk of preterm births after surgical abortion should be included in informed consent practices prior to surgical abortion.

 Increased Risk of Breast Cancer

In their Committee Opinion 8: Abortion and Breast Cancer, AAPLOG states:

“The protective effect of a full-term pregnancy on breast cancer risk has been known since the Middle Ages when it was noted that nuns had a higher risk of breast cancer than women with children. Medical authorities agree that a full-term pregnancy lowers a woman’s risk of breast cancer. . . . These facts are not controversial and are acknowledged by all medical organizations.”[12] 

An abortion-breast cancer link passes every one of the standard criteria[13] which determine if causation can be deduced. These same criteria were used in 1964 by the U.S. Surgeon General to determine causality of cigarettes in lung cancer promotion. Today they prove causation of the link between abortion and breast cancer.[14]

America was not content to blindly follow when the tobacco industry denied a link between tobacco and lung cancer, based on its own studies. AAPLOG suggests applying the same wisdom here.

There is a scientific, biologically plausible mechanism for breast cancer promotion caused by electively terminating a normal pregnancy. Here’s that explanation in a nutshell:

Over the course of a woman's life, her breast tissue will develop into four different types of lobules. All women are born with Type 1 lobules, which mature into Type 2 lobules at puberty. The lobules type is important to note because 99% of all breast cancers arise in Types 1 & 2 lobules. Types 3 & 4 lobules are resistant to breast cancer.

During the first half of pregnancy, she will see a sharp increase in Type 2 lobules. Beginning at 20 weeks, her Type 2 lobules will begin to mature into Type 4 lobules. As pregnancy continues beyond 32 weeks, 70-90% of her breast tissue has matured into Type 4 lobules by week 40, and the risk of future breast cancer is reduced. There is a 90% risk reduction when she carries a pregnancy to term compared to if she remained childless.[15]

After lactation ceases, the breast forms Type 3 lobules. After menopause, these Type 3 lobules regress to Type 1 lobules, but the protection gained from earlier term pregnancies is permanent and provides lifelong protection to these Type 1 lobules.

What's the Risk?
Ending a pregnancy before 32 weeks stops the Type 2 lobules from developing into Type 4 lobules. That is, ending a pregnancy early stops breast development at a time when there is an increased amount of cancer-vulnerable Type 2 lobules. The longer a woman maintains Types 1 and/or 2 lobules, the higher her risk of breast cancer.

Ethical medical practice obligates a physician to counsel a woman considering abortion that this decision may increase the risk of breast cancer later in life.[16]

Chemical abortions

In 2000 the FDA approved the two-drug “abortion pill,” and women have been able to perform their own early abortions—up to 10 weeks of gestation—without leaving their homes.

 First, the woman takes the mifepristone pill, or RU-486. Then, 24 to 48 hours later, the woman takes misoprostol or Cytotec. Together, these drugs induce delivery.[17]

In 2021, the FDA made it easier to get a chemical abortions by phone: the “in-person dispensing requirement” -- stating that mifepristone be given only in health-care settings such as clinics, medical offices, and hospitals --  was removed.

Verifying that a pharmacy is certified does not replace in-person medical care. If the procedure is done at home, without a medical exam and without an ultrasound, then: 

• The viability of her pregnancy cannot be confirmed. If the pregnancy is ectopic (in the fallopian tube), she’ll need specialized medical care.

• The stage of her pregnancy is not confirmed. In practice, women are often unsure how far along they are. If she’s past that ten-week maximum, attempting a chemical abortion at home can be dangerous.

·        Taking these pills alone at home, she may be far from emergency medical care when it’s needed, which is often.

Intense pain, bleeding, and contractions may last for days and necessitate intervention: “Seventeen states maintain records of state Medicaid reimbursements for abortions and subsequent emergency room (“ER”) treatment within 30 days of the abortion. Based on this data, in 2015, the rate of ER visits per 1,000 women who underwent a chemical abortion in the past 30 days was an astonishing 354.8.”[18] Thirty-five percent go to the ER after attempting an abortion at home. Women taking these drugs at home alone, without medical supervision or access to a doctor, may be risking their health. And at-home, chemical abortions are growing quickly as requests for mail-order abortion pills surged after the Roe reversal. They now account for over half of the abortions in the US.

 

Summary: Let’s Be Honest about Abortion

The short-term and long-term effects on women from induced abortion—compromised mental health, increased risk of preterm births, and increased risk of breast cancer—are not well known. The dangers of at-home chemical abortions are also not well known. But they should be. Medical professionals are obligated to provide relevant information about the effects of abortion on women prior to any procedure as a matter of “informed consent.” In the area of abortion, they simply don’t.

We don’t do women any favors by suggesting that abortion is a quick, easy solution without negative, lasting effects on the women we love. 

 

[1] AAPLOG, the American Association of Pro-Life Obstetricians and Gynecologists. (www.aaplog.org/) AAPLOG ‘s mission is to encourage and equip its members and other concerned medical practitioners to defend the lives of both the pregnant mother and her pre-born child.

[2] National Library of Medicine, National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6207970/
Article: The abortion and mental health controversy: A comprehensive literature review of common ground agreements, disagreements, actionable recommendations, and research opportunities by David C Reardon

[3] AAPLOG Practice Bulletin No. 7, Abortion and Mental Health, December 30, 2019. FINAL-Abortion-Mental-Health-PB7.pdf (aaplog.org)
https://aaplog.org/wp-content/uploads/2019/12/FINAL-Abortion-Mental-Health-PB7.pdf

[4] IBID.

[5] Reardon, David C., et al. "Deaths associated with pregnancy outcome: a record linkage study of low income women." Southern Medical Journal, vol. 95, no. 8, Aug. 2002, pp. 834+. Gale Academic OneFile. Accessed 26 Oct. 2022.

[6] https://aaplog.org/resources/patient-brochures/

[7] Reardon DC, Craver C. Effects of Pregnancy Loss on Subsequent Postpartum Mental Health: A Prospective Longitudinal Cohort Study. International Journal of Environmental Research and Public Health. 2021; 18(4):2179. https://doi.org/10.3390/ijerph18042179  

[8] Jacobs, Steven and Jacobs, Steven, The Scientific Consensus on When a Human’s Life Begins (November 29, 2021). Jacobs, S.A., The Scientific Consensus on When a Human’s Life Begins, Issues in Law & Medicine, Volume 36, Number 2, 2021., Available at SSRN: https://ssrn.com/abstract=3973608

[9] (https://www.rachelsvineyard.org/)

[10] PB-5-Overview-of-Abortion-and-PTB.pdf (aaplog.org) https://aaplog.org/wp-content/uploads/2021/11/PB-5-Overview-of-Abortion-and-PTB.pdf

[11] Ibid.

[12] https://aaplog.org/wp-content/uploads/2020/01/FINAL-CO-8-Abortion-Breast-Cancer-1.9.20.pdf 

[13] The Bradford-Hill Criteria for causation are strength, consistency, specificity, temporality, biological gradient, plausibility, coherence. experiment and analogy.

[14] https://aaplog.org/wp-content/uploads/2020/01/FINAL-CO-8-Abortion-Breast-Cancer-1.9.20.pdf 

[15] Note: But if she never got pregnant, she would not have experienced that initial increase in the development of Type 2 lobules during the first 24 weeks of pregnancy.

[16] For more information, please see the January 2020 publication, “Abortion and Breast Cancer” https://aaplog.org/wp-content/uploads/2020/01/FINAL-CO-8-Abortion-Breast-Cancer-1.9.20.pdf 

[17] https://www.youtube.com/watch?v=j0tQZhEisaE&ab_channel=fsbcjc Noted board-certified OB/GYN Dr. Anthony Levatino testified before the US House of Representatives Committee on the Judiciary in 2015 and lead Congress through the steps.

[18] https://journals.sagepub.com/doi/pdf/10.1177/23333928211053965 A Longitudinal Cohort Study of Emergency Room Utilization Following Mifepristone Chemical and Surgical Abortions, 1999–2015