Abortion and Women’s Health
By Shauna Burkholder (nee Hollingshead), MD

In 1988 the Supreme Court struck down Canada’s abortion law and effectively removed all barriers to abortion on demand. In the ensuing 15 years, over 1.5 million babies have been extinguished by abortion in Canada. Our society has been led to believe that abortion has made a positive contribution to women’s health. As a female medical student, and member of Canadian Physicians for Life, I would like to offer some thoughts on why abortion is actually detrimental to women's health, both physically and psychologically.
           
Psychologically, pro-abortion vocabulary uses phrases like "my body, my choice". This sounds empowering, however it is rarely the woman’s choice alone. These phrases speak to the subconscious of women in the voices of their employers, partners, teachers, and parents: "Yes it is your body, and you had better choose what we are expecting of you, so as to make our lives easier. This burden is yours alone, and we support only one choice, that which will save us hassle and worry." In essence, the woman often feels abandoned rather than empowered and supported. Pro-abortion vocabulary also tells us that "men have no right to say what you should do with your body", and yet women often hear "men have no obligation to help you through this". Once again, she hears that she is alone. Relationships often suffer consequences secondary to abortion. Many women blame their partner for the pain they go through following an abortion, and the relationship then suffers the same fate as the pregnancy. Women are expected to have abortions in certain circumstances such as unplanned pregnancy, if she is single or if her partner isn't interested in parenting, and during school and university years. Women are pressured to have an abortion on many socioeconomic fronts. Abortion has allowed employers and universities to treat pregnancy as an easily avoidable condition. When support and approval are only there for one course of action, so much for choice.
           
As a medical student, I have encountered yet another example of the false vocabulary that permeates the abortion debate. In my Obstetrics and Gynecology rotation, we had the option of attending many subspecialty clinics, such as perinatology and infertility. Another clinic on the list is entitled the "Reproductive Health Clinic", a name which certainly does not explain its purpose of terminating unwanted pregnancies, and which does not have much to do with either reproduction or health. Abortion must make use of such pseudonyms to avoid the reality of what abortion actually is.
           
There are many sorrowful psychological consequences to abortion. As a medical student in my Obstetrics and Gynecology rotation, when asking a woman about her obstetrical history, I have yet to meet a woman who seemed content and liberated by her choice to terminate a pregnancy. No, on the other hand, when asked about past terminations, the usual reaction is not one of pride, empowerment or even the expression of satisfaction of making a good or "right" choice. Rather the woman drops her head, her gaze moves downward, and she seems bound by sadness and regret. Many situations can reawaken those negative feelings, such as the birth of a woman's first "wanted" child, seeing a girlfriend’s ultrasound picture of her unborn child, or the anniversary of the termination. Post Abortion Syndrome is very real. But too often, a woman is unable to speak of the grief she experiences. She may feel that because it was her choice, she now can't expect others to sympathise with her private sorrow. She may feel that admitting her grief would give support to the "pro-life" message, and she has been taught that "pro-lifers" are her enemy. Through organizations like Project Rachel, a post-abortion healing outreach within the Catholic Church, women have a forum in which they are comfortable to express their grief.
           
In addition to emotional health, abortion has physical health consequences for women. The links between abortion and the increased incidence of breast cancer, premature delivery in subsequent pregnancy, depression and suicide are being demonstrated by new studies. Women who have abortions are at significantly higher risk of death secondary to various causes than women who give birth, according to a study published August 2002 in Southern Medical Journal(1) . "Deaths Associated With Pregnancy Outcome: A Record Linkage Study of Low Income Women" reports on research which linked California Medicaid records for 173,279 women who had an induced abortion or a delivery in 1989 to death certificates for 1989 to 1997. Compared with women who delivered, those who aborted had a significantly higher age-adjusted risk of death from all causes (1.62), from suicide (2.54), and from accidents (1.82), as well as a higher relative risk of death from natural causes (1.44). The study concludes that higher death rates associated with abortion persist over time and across socioeconomic boundaries. This may be explained by self-destructive tendencies, depression, and other unhealthy behaviour aggravated by the abortion experience.
           
The California data was also used in a study published in the July issue of The American Journal of Orthopsychiatry (2), which reveals that aborting women seek more subsequent mental health care. By examining 173,279 Medi-Cal records, the research team compared the rate of psychiatric outpatient treatments for women who had abortions versus those who carried to term. To control for differences in prior psychological health, they excluded all women who had any psychiatric care for one year prior to their pregnancy outcome. Women were 63 percent more likely to receive mental care within 90 days of an abortion compared to delivery. In addition, significantly higher rates of subsequent mental health treatment persisted over the entire four years of data examined. Abortion was most strongly associated with subsequent treatments for neurotic depression, bipolar disorder, adjustment reactions, and schizophrenic disorders. A third study published last January in the British Medical Journal reveals that subsequent long-term clinical depression is more common among women who have had abortions (3).
           
As well, there is an important link between abortion and breast cancer: In 1996, Dr. Joel Brind published the pooled data from 28 abortion/breast cancer studies and found a connection that could not be ignored (4). Overall, a minimum 30% increase in breast cancer risk can be expected as one of the consequences of a typical abortion. In one particular group (teenagers with a family history of breast cancer) it appeared that the termination of a first pregnancy almost guarantees eventual breast cancer (5).
           
Abortion has been credibly blamed for another expensive and tragic consequence, the loss or impairment of children through premature delivery in subsequent pregnancies. Though not as immediately alarming to the public imagination as breast cancer, prematurity is a leading cause of cerebral palsy and various learning problems. Abortion probably leads to future premature birth by damaging the cervix and introducing risks for infection. Data show that one abortion raises the risk of a later premature delivery by 30% and two abortions by a distressing 90%(6).
           
Abortion has taught our children that a baby deserves life only if her parents want her. Our living children know that our culture allows abortion. How do they feel when they realize that a future brother or sister could be easily removed from the family unit? Why did they escape that fate? The knowledge that children live in a place where life is not necessarily respected has a detrimental effect on their psychological development. Abortion upholds the selfishness of those in power over the lives of the powerless. It treats children as disposable objects before birth, and therefore may be contributing to the increasing incidence of child abuse when this attitude persists after birth. The idea that some babies deserve life and others do not goes against a principle of feminism, as feminists have been fighting for the intrinsic value of women. Should a child not deserve the same? A woman’s value is not dependent on acceptance by a man, and similarly a child’s intrinsic value is not dependent on a woman’s desire for the child. We want the right to control our bodies, and yet we do not give our unborn daughters and sons the same privilege.
           
As a medical student, informed consent is very important to my interactions with patients. No matter what the procedure being proposed, more information allows patients to make better choices about their health care. This principle of health care does not seem to be as imperative when abortion is the proposed procedure. In an age where embryology and ultrasound technology has taught us so much about the anatomy and development of the embryo, I am appalled when I hear from women who have been told that the abortionist will simply scrape out the "tiny blob of tissue".

Today physicians perform incredible prenatal medicine, including in utero surgery and administration of drugs and blood transfusions. Thanks to recent technology, we cannot keep pretending that abortion does not end a life. However, "pro-choice" advocates are desperately trying to keep ultrasound machines out of the realm of the abortion decision, as they believe that offering such information is "intimidating". I fail to see why allowing women all available information so they can make informed decisions is equal to "intimidation". A National Institute of Family & Life Advocates study reports that 90% of women requesting abortion change their minds after seeing an ultrasound image, no doubt because they realize that this "blob of tissue" has a beating heart, fingers, toes, and male or female sex organs. Choice should be informed by all available knowledge. To withhold some information from women is to be condescending and paternalistic. It is a form of coercion.
           
Although some abortion supporters attempt to make us believe that they hold the majority position and those who do not agree with their opinions are simply fanatics, the data shows a different story. Only 23% of Canadians want all abortions to be publicly funded, and only 30% would deny legal protection to unborn children, according to a Léger poll in October 2002. In addition, 51% of 1500 Canadians polled said that abortion should only be tax-funded in medical emergencies such as a threat to the mother's life, or in the case of rape or incest. Another 15% said that paying for abortion should be a private responsibility. In order for a medical procedure to be publicly funded under the Canada Health Act it must be medically necessary and therapeutic. In the majority of cases, abortion is neither of these things, and yet taxpayers in most provinces are paying for abortions every day.
           
We know that abortion is a tragedy, but we also know that it is an avoidable tragedy. Canadian society needs to take another look at our collective thoughts on abortion. The solution is complex, but it involves education, prevention of unwanted pregnancy, support for young mothers and single mothers, acceptance of adoption as a very real alternative, and the recovery of a culture that embraces all human life from conception to natural death.

Shauna Hollingshead wrote this article in 2003 when she was a University of Alberta Medical Student.  Today, Dr. Shauna Burkholder is a resident physician specializing in Pediatrics at the Alberta Children’s Hospital in Calgary, Alberta.  She is a member of the Canadian Physicians for Life editorial Board. 

References:

1. Reardon, DC, Ney, PG, Scheuren, F, Cougle, JR, Coleman, PK, Strahan, TS. Deaths Associated With Pregnancy Outcome: A Record Linkage Study of Low Income Women. Southern Medical Journal, Vol 95. No 8. August 2002, 834.
2. Coleman PK, Reardon DC, Rue VM, Cougle JR. State-funded abortions vs. deliveries: A comparison of outpatient mental health claims over five years. American Journal of Orthopsychiatry, 2002, Vol. 72, No. 1, 141-152.
3. Reardon, DC, Cougle JR. Depression and unintended pregnancy in the national longitudinal survey of youth: a cohort study. BMJ 2002; 324: 151-152
4. Brind et al., "Induced abortion as an independent risk factor for breast cancer: a comprehensive review and meta-analysis," J of Epidemiology & Community Health, 1996;50:481-496
5. Daling, Janet R. et al., Risk of Breast Cancer Among Young Women: Relationship to Induced Abortion 86 Journal of the National Cancer Institute; (1994);1584
6. Henriet L, Kaminski M. Impact of induced abortions on subsequent pregnancy outcome: the 1995 French national perinatal survey. British J Obstetrics Gynaecology 2001;108:1036-1042.