Time for a fresh look at the medical and psychological risks of abortion for women
By Ian Gentles

Earlier this summer much alarm and a great deal of media attention were generated by a single medical report highlighting some serious side-effects from the long-term use of hormone-replacement therapy (HRT) by women. One of the most avidly discussed findings was an increased risk of breast cancer of around twenty-five per cent. Yet curiously there has been almost no public discussion of the twenty-seven studies from ten different countries, which show an average increased risk of breast cancer of thirty per cent after induced abortion. Stranger still, the National Cancer Institute in the U.S. refuses to acknowledge these findings, even though a major study that it funded came up with a thirty-six per cent increased risk.

Breast cancer now afflicts more than one woman in ten during her lifetime. A teenage woman who bears a child and has no subsequent abortions will reduce that risk to seven per cent. By contrast a teenager who aborts her first pregnancy increases her risk to fifteen per cent. In other words, by choosing abortion over childbirth, she at least doubles her chances of contracting breast cancer.

So abortion carries a far higher risk of breast cancer than HRT. The public deserves to be at least as aware of the one danger as it is of the other. Yet so far it is the single study on HRT that has received virtually all of the media's attention.

The public also has the right to be informed about the many other health complications associated with induced abortion. The Royal College of Obstetricians and Gynaecologists in Britain has recently pegged the short-term complication rate at eleven per cent. Women themselves report a seventeen per cent rate. What are these immediate complications? They include perforation of the uterus, infection, uterine adhesions, bleeding and fever. Given the present annual abortion rate in Canada (120,000), anywhere from 13,000 to 18,000 women are affected in this country alone.

But it is the medium- and long-term complications of abortion that are most disturbing. A massive Scandinavian study has shown that women who undergo an abortion die at a rate four times greater within twelve months of the operation than women who give birth. The study also documents a remarkable suicide rate among women who abort their children, six times higher than women who give birth, and three times higher than the general population. These findings, published in the British Medical Journal, explode the oft-repeated claim that abortion is safer than childbirth. The Scandinavian findings are supported by British and American studies that have also uncovered sharply higher rates of suicide and maternal mortality among women who undergo abortions.

Among the long-term complications possibly the most disturbing is the increased risk of having a premature delivery in a subsequent pregnancy. The increase ranges from 86 to 267 per cent, depending on how early the abortion is performed. The chilling reality is that premature babies who weigh less than 1500 grams have a 3700 per cent higher incidence of cerebral palsy than those who go to full term. This translates into about a hundred new cases of the disease per year in Canada, directly attributable to abortion. It is high time that the dimensions of this medical calamity were publicly discussed.

Abortion is frequently touted as the cure for the emotional distress many women experience when they discover they are pregnant. But a woman who is already suffering from psychological or psychiatric disorders, or who is in her teenage years, will likely continue to experience these difficulties after an abortion, sometimes in greater measure. In the words of Mika Gissler, author of the Scandinavian study, "childbearing prevents suicide. Abortion, rather than being a relief, might be an additional proof of their worthlessness, and might contribute to suicidality". It also contributes to self-destructive behaviours such as the abuse of tobacco, alcohol and non-medical drugs.

In reality most women have mixed feelings about abortion. Ambivalence has been shown to result in more depression and guilt afterwards. Women often state that it was their male partner who decided on the abortion. Interestingly, when those who are ambivalent are offered supportive counselling, as they are in Sweden, they are more likely to opt for childbirth.

The accumulating evidence of these long-term emotional consequences raises the question, should not those who do abortion counselling consider -- in some cases at least -- steering depressed, guilty, angry, anxious, or adolescent women away from the procedure?

Now it is true that all the medical and psychological complications put together affect only a minority of the women who have abortions. Yet the complications are serious and extensive enough to justify a woman being told about them. If she is not told, how can she possibly give her informed consent to the operation?

Ian Gentles teaches the history of population at York University, and is research director of the deVeber Institute for Bioethics. Women's Health after Abortion: The Medical and Psychological Evidence, on which this article is based, has just been published.