The Effects of Abortion on Health and Demography in North America

Philip G. Ney, MD, FRCP(C),

Introduction
Maternal Mortality
Maternal morbidity
Maternal Behaviour
Fertility rates
Demographic changes
Effect on men
Effect on siblings
Effect on the Elderly
Conclusions
References

A.     Introduction

1. Science or polemics, reason or rationalizations.

In North America it has been contended that abortion is “an extremely safe procedure.” This is not the case. There are many articles to the contrary. The studies showing there has been no harm are badly flawed.^{1 2 3} Although an early study ⁴ indicated that maternal mortality for an induced abortion up to sixteen weeks gestation was less than that of a continued pregnancy, that survey was skewed by its exclusive use of vital statistics. American vital statistics were reporting only 52% of the abortion fatalities.⁵ The available evidence since the seventies demonstrated maternal mortality as a result of medically induced abortion has higher rates than a completed pregnancy and delivery after 13 weeks. It has been difficult to obtain figures on abortion complications and mortality rates.⁶ The Department of Health and Social Security in England was reluctant to publish the facts concerning maternal mortality, making it necessary to table a parliamentary question to obtain differential mortality statistics. What seemed to escape everyone’s notice is that comparing abortion mortality rates to death during a full term pregnancy is invalid because of the time scale. On average, a delivered pregnancy is three times longer than an aborted one. All influences being equal, deaths during pregnancy should be three times more common. The fact they are nearly similar rates indicates abortions are three times more dangerous. Recent record linkage studies highlight this fact.⁷

Since it is not possible to randomly select pregnant women to have a baby or to have an abortion, it is not possible to do a controlled study on humans. However, it would be possible to do this with animals in order to obtain information regarding physical and mental benefits or hazards. An animal study has never been done regarding abortion. Abortion is probably the only exception to the usual procedures required before introducing any medical procedure. Abortion is now the most common surgery in the world but there are still no scientifically established benefits.

Standard psychiatric textbooks state there are no psychiatric indications for abortion. “Patients who were sicker before abortion had more serious post abortion problems.” “Patients who were psychiatrically ill before abortions did poorly.” “Psychiatric indications for therapeutic abortions did not stand the test of scrutiny.” “Women suffering from psychiatric illness before abortion showed no significant improvement after abortion and had more difficulty in coping with the stress of abortion than the psychologically healthier women.” ⁸ The so-called “social indication” of diminishing the rates of child abuse and neglect by making sure unwanted children were not born has never been proven. In fact, the opposite is true.⁹ Rates of abortion correlate closely with rates of child abuse for a number of important reasons.¹⁰ The Canadian Psychiatric Association, after reviewing the research on psychiatric indications for abortion, issued this statement: “The justification of a decision to terminate a pregnancy under pseudo-psychiatric rubrics is to be deplored.”¹¹ Abortion increases the rate of suicide by 600% ^{12 13} while pregnancy reduces the risk of suicide by a large factor.¹⁴

In a review of the MedLine literature, I found there were no articles able to demonstrate that abortion is beneficial for any psychiatric or social condition at any stage of pregnancy. Those who report benefit usually indicate there has been “relief” following the abortion. Major claims women have benefited from abortion and would do it again, but in her study there was only a 42% follow-up rate at two years.¹⁵ This was not a representative sample and no benefit can be concluded. Generally speaking the women who report back to the abortion clinic are more likely to feel their decision was justified while those who feel more hurt go elsewhere to have their wounds attended to.

Major contends that 70% of the 418 women in her study were satisfied with their decision and 72% reported more benefit than harm from their abortion. In fact, this is 72% of the 52% at follow-up, which was 85% of the people canvassed, i.e. only 30% of the original sample. The authors believe that their sample was representative, but they showed no evidence for this. In fact, it is likely that they were not representative since it was clear from the interviewers and the questions they asked that there was a biased attitude toward receiving affirmative responses rather than those that would tend to negate the position of the researchers. Another major fault in Major’s study and those similar to it is that their pre-abortion interview of the women took place in the clinic one or two hours before the procedure took place. A woman who is confronted with the results of one of the hardest decisions she has ever made (to have an abortion) and is probably still ambivalent about it is in no position to be evaluated. This is her usual pregnant psychological state.

Major admits that the women’s negative emotions increased and their satisfaction with the decision decreased over time. As women become more aware that their pre-abortion problems didn’t resolve, and realized their post-abortion grief and guilt didn’t evaporate, they become more acutely aware of what the abortion really accomplished. At two years, 19% of their subsample stated they would definitely not or probably not have a repeat abortion.

In spite of deficiencies in design and methodology that minimize the impact of abortion, Major reports that 17% indicated they experienced physical complications. The authors found that depression consistently predicted poor post abortion mental health and more negative post abortion related emotions and evaluations. “Pair wise comparisons indicated that depression levels decreased from T1 - T2 and increased from T2 - T3 and from T3 – T4.” This indicates that the greater the time interval following abortion, the more likely women were to be depressed. They report that, “Across time, relief and positive emotions declined and negative emotions increased.”.

Research has clearly shown there are no psychiatric indications for abortion. There are no studies showing psychiatric benefit. It is generally concluded that the more severely ill a person is psychiatrically, the more likely they are to have psychiatric complications following the abortion. No one has ever proven any kind of psychiatric, psychological or emotional improvement from late term abortion or partial birth abortion.¹⁶ Any one who claims there is significant mental health improvement has either not followed up their own patients, or has not read the psychiatric literature.

It is possible that there are individual physicians who do late term abortions and claim they are beneficial to people who have psychiatric or emotional illness, but they have never published their data. Before anyone can claim benefit from abortions, they either have to cite references or show improvement to women with diagnosed illnesses from follow-up results of their own practice. Until there is either considerable data to show benefit from abortions in general and late abortions in particular, or until a physician is able to demonstrate from his/her own practice there is long-term psychiatric and social improved health, no physician can do abortions for any medical, surgical, psychiatric or social reasons.

B.      Maternal Mortality

1. Increased rates:.

a)  Breast cancer
Twenty-seven out of thirty-three studies showed an average of 30% increased risk of breast cancer to women who have had an abortion compared to those who deliver their first pregnancy.¹⁷ The impact of Brind’s metanalysis was carefully reviewed by the Royal College of Obstetricians and Gynaecologists, who found “the Brind paper had no major methodological short comings.”

b)  Suicide
An analysis of death certificates and medical records by researchers in Finland revealed a suicide rate among aborting women approximately six times higher than women who delivered and three times higher than that of women in the general population.¹⁸ Researchers in Britain found that, prior to their pregnancy, aborting and delivering women had similar rates of suicide attempts. The rate of suicide attempts increased markedly after the abortion. These researchers concluded “the increased risk of suicide after an induced abortion may therefore be a consequence of the procedure itself.”¹⁹

c)  Homicide, AIDS, etc.
There is strong evidence of increased smoking and drinking following abortion.^{20 21} There are increased rates of death by; accidents, AIDS, cardio-vascular disease and cerebral-vascular disease in those who have abortions compared to those who delivered their babies.²² Domestic violence and marital break up are more common. Poor sleep, particularly as a result of nightmares, is frequently reported. Difficulties with diminished libido and disparunia are not uncommon.

2. Pathogenesis:

In addition to an added risk of suicide associated with abortion, the observed difference in suicide rates also reflect the protective effect of childbirth. Pregnancy and childbirth reduce the risk of suicide.²³ Furthermore, as shown in a 15 year study of nearly one million women, the number of children a woman has is strongly and inversely related to the relative risk of suicide.²⁴ A greater sense of family obligations and a fear of hurting ones children correlates with fewer suicide attempts and suicidal thoughts.²⁵ In one study of women with a prior history of psychiatric problems, none of those who carried to term subsequently committed suicide over an 8 to 13 year follow-up, while five percent of those who aborted did commit subsequent suicide.²⁶ These findings suggest that for women with prior psychological problems, childbirth is likely to reduce the risk of subsequent suicide attempts whereas abortion aggravates that risk. The greater risk of deaths resulting from accidents and homicides following an abortion may result from suicidal or risk-taking behaviour. Some deaths which were classified as accidental may have been suicides. Reports of post-abortive women deliberately crashing their automobiles, often in drunken states, in attempts to kill themselves have been reported by both post-abortion counsellors and in the published literature.²⁷ Many of these accidental deaths may result from heightened risk-taking behaviour among post-abortive women that is related to increased self-punishment or decreased concern for self-protection. Alternatively, some women may use the adrenalin rush that accompanies risk taking behaviour to escape a general state of depression.²⁸

1. Increased rates:.

a)  Psychiatric admissions
Using data extracted from the Denmark Centralised National Medical Services Registry, David, Rasmussen and Hoist (1981) found the rates for psychiatric admission for aborting women was 18.4 per 10,000 compared to 12.04 for women who delivered their babies.²⁹ Women who were divorced, separated or widowed at the time of the pregnancy event were found to have admission rates of 63.8 per 10,000 for aborting women and 16.9 for women who delivered their babies. Research exists demonstrating that repeat aborters are more likely than first time aborters to suffer from negative psychological reactions. Another Danish study, using data from the Danish Central Psychiatric Register found that the rate for psychiatric admissions; no abortions was 1.9 %; one abortion 3.4%; two abortions 4.0%; three abortions 6.0%. No such increase was observed in relation to the number of live births.³⁰ In the recently published study by Reardon et al ³¹ of California Medicaid recipients, we identified a population of 168,551 low income women whose data could be record linked during the first two years after the pregnancy event. Psychiatric inpatient claims rate was 287.4 per 100,000 for delivering women and 435.7 per 100,000 for women who aborted their pregnancy. Although this study measured only the rate of inpatient psychiatric care not the prevalence of psychiatric illness, it clearly indicates women are made psychiatrically worse rather than better by abortion.

b)  Clinic visits
We found ³² in a study of 1428 women representative of all Canadian women attending a family physician for a wide variety of reasons that 34% of them at that point in time felt they needed professional help to deal with their pregnancy loss. For any period of time since their abortion the rate of women needing treatment would be considerably higher. There was a deterioration in general health, probably due to pathological grief. Pathological grief frequently results in depression. In depression, the immune system does not function as well and people are more likely to have infections and cancers. It is generally understood that women are most ambivalent about their pregnancies in the early stages. They become increasingly interested in and attached to their unborn child as the pregnancy progresses. Therefore, those who have late abortions are more likely to experience guilt, grief and the whole range of conflicts and symptoms of the Post-abortion Syndrome. Berkeley and Humphreys ³³ found that in a family physician’s office there was an 80% increase in attendance for physical reasons and 180% increase in attendance for psycho-social reasons following abortion. A five year study in Canada showed that aborting women were over eight times as likely to visit a psychiatrist on an outpatient basis compared to women in the general population.³⁴

c)  Alcohol and drug use
Women who abort subsequently have higher rates of drug and alcohol abuse.^{35 36}

d)  Depression
All of these physical and psychological problems following abortion combine together to provide family doctors and specialists with difficult-to-treat problems. Some women have physical complications of the abortion, which compounds their psychological conflicts. Too frequently, physicians are likely to diagnose the woman’s problems as depression and prescribe anti-depressants. Anti- depressants interfere with the resolution of many conflicts and prevent natural grief.

2. Pathogenesis:.

If losses are not fully mourned, it becomes pathological grief leading to depression and consequently poor physical and mental health, is more likely to occur.^{37 38} There is evidence that depression interferes with the functioning of the immune system. Irwin et al ³⁹ found the severity of depressive symptoms in women was associated with an impairment of the natural killer cell activity, an absolute loss of suppressor/cytotoxic cells, and increase in the ratio of T-helper to T-suppressor/cytotoxic cells. Kiecolt-Glazer et al ⁴⁰ found poor marital quality to be associated with greater depression and a poorer response of immune function among separated or divorced women. More recent losses, and greater attachment to the ex-spouse, were associated with poorer immune function and greater depression.

Abortions usually result in intense psychological conflicts, partly because women have been pressured to terminate their pregnancy. Any decision to abandon the preborn baby counters a woman’s biological imperative and the inevitable growing biological attachment to her baby. Deep conflicts also occur as women realize that they have contributed to the loss. The greater ambivalence and many complicated factors regarding the choice, make counselling for these kinds of losses very difficult. With the pressure from partner, friends, family and the medical profession to abort early in a pregnancy, there is seldom time to deal with each of the many aspects which must be considered before a rational choice can be made. The lack of partner support appears to contribute to a greater tendency to both miscarry and choice to abort a pregnancy. The mother’s hurt and anger at being neglected and/or rejected by her partner may be displaced onto the fetus. There are also complex neurohormonal factors that may contribute to the rejection of the infant.

1. Increased rates:.

a)  Partner separation
Many cases of post-abortion women report feeling lack of trust in their partner because they were not supported. Women may have deep anger at being coerced by their partner or family. They may experience fear of their own aggression and project it into their partner, who they may blame for being angry. Women increasingly criticise of their partner because of their own diminished self respect. They may have diminished sex drive and diminished sex pleasure. They may have a tendency to socially withdraw. In our study of post abortion recovery contacts, we found 80% of relationships broke up following abortion.

b)  Mistreating children
In a series of separate studies, we found that abortion impaired a woman’s ability to bond to her subsequent children.8, 9 Thus, there was a significant positive correlation between previous induced abortion and rates of child abuse and neglect. In one country we found the breast feeding rate after the introduction of the one child policy when women were likely to have an abortion was 17.8% . Before the introduction of that policy when abortion was relatively rare, women breastfeeding was 83.2% of newborns. Since breast milk is the only feasible source of essential fatty acids (EFAs) and EFAs are necessary in the formation of brain cells and peripheral nerves, it means that this nation is inadvertently lowering the average intelligence of the children.

Child abuse is often the result of a poor bond between mother and infant.⁴¹ The bond may be disturbed by a variety of factors, including the mother’s perinatal depression. There is evidence that more women who had a previous abortion became depressed during pregnancy with a wanted child.⁴² Colman and Colman point out that a previous loss by stillbirth or abortion interferes with a woman’s preparation for a subsequent pregnancy. Thus, it appears that abortion interrupts bonding, and consequently, increases child abuse.^{8 9}

1. Conception rates

“Cervical Chlamydia trachomatis is a risk factor for postabortal PID, and prophylaxis with erythromycin significantly reduces the frequency of PID.”⁴³ “If women applying for termination of pregnancy with Chlamydia infection are not treated, 50-60% will develop pelvic infection.” “Salpingitis due to Chlamydia is regarded as one of the most important causes of tubal infertility and extrauterine pregnancy.” “The majority of women applying for termination of pregnancy with Chlamydia infection have no symptoms.”⁴⁴

2. Fertility

By and large, people who are abortion survivors do not want to have other children. There is a sense in which they could not bear to see happen to their child the kinds of experience that they have been through as abortion survivors. They feel guilty for existing and have little desire to promote their own or the species’ survival. Because of the persistent anxious attachment between any abortion survivor and their parents, they feel obligated to care for them but deeply resent having to do so. They sense they will have the same intense ambivalence to their children and want to avoid that turmoil by not having children.

3. Pre-term Birth

Pre-term birth is the number one cause of neonatal death and disease. Both pre-term births and low birth weight are significantly more common in women who have had abortions.⁴⁵ Women who have had two abortions had twice as many early premature births. We found the relative risk of a miscarriage following an abortion is 1.86.

The population is declining almost world-wide. For at least 20 years when the United Nations was trying to frighten people into complying with their agenda with threats of overpopulation and ecological disasters, serious demographers wrote that the threat was more likely to be underpopulation. The UN has recently had to admit there is an exponential population implosion.

Without purpose and hope, every nation declines. The presence of children makes us concerned about the quality of the future, the conservation of resources, the civility of our interactions, and the promotion of art and science for those who follow. When there are few children, there is less hope. Without hope people are not inclined to have children. A vicious cycle of declining hope and fewer children creates a national atmosphere of apathy and hedonism. There is increasing evidence that when basic family nurturing and bonding mechanisms are undermined, there is little desire to have and protect children. Soon after, the declining birth-rate cannot be reversed by incentives or coercion.

1. Economic implications

It is unlikely that any nation can sustain a free market economy with a declining population. What do graduating teachers do when there are fewer children? How do old people continue to be cared for in nice homes for the aged if there are too few individuals available to pay the taxes that make medical services available to all? There has been an unprecedented three year decline in the Dow Jones. Countries with restrictive immigration policies are now opening their doors. Many nations are beginning to question their permissive abortion policies and to institute measures to promote population growth. In spite of growing economic rescue attempts, the World Bank is warning of devaluation similar to the events before the Great Crash. No one should be surprised that houses and commodities are losing value because of declining population.

In almost every western country men have been deprived of a legal right to protect their unborn children. Men often suspect their partner might, at any time, terminate the life of their unborn child without their awareness or consent. Because they might lose their “baby”, they do not allow themselves to attach before he/she is born. Because the father does not attach to the baby, he does not support his partner. We have shown in an in-depth study that the partner is more likely to have an abortion or miscarriage when she is not supported.⁴⁶ Because she is not supported by her partner she is more likely to abort. Because she is more likely to abort, he is less likely to attach to the baby and support the mother. This vicious cycle that the courts inaugurated is a major cause of higher rates of abortion.

The father that is not well bonded to his unborn baby is more likely to abandon the family and is less likely to be protective after the baby is born. Because they have been deprived of deeply ingrained male prerogatives, they feel both impotence and rage that can express itself as family violence. The incidence of rape and marital and family violence is increasing as abortion increases.

It is not lost on young minds that if “the first right of every child is to be wanted”, then “if they are not wanted they have no right to be”. Children born because they are wanted, try to stay wantable. Eventually they resent being dangled by the tenuous thread of wantedness and violently rebel. Children who live in countries where many or most children are aborted, or have siblings who were aborted, or who are part of a minority who would have been aborted had they been detected, or who have survived an abortion attempt, are Abortion Survivors.^{47 48} Most, if not all, children know when a brother or sister is aborted.

The Abortion Survivors’ conflicts are;

a)  Survivor guilt. “I don’t deserve to be alive when my sibling, who was just as good as I am, was arbitrarily killed.”

b)  Existential anxiety. “I suspect some force over which I have no control, will kill me just like it killed my unborn brother.”

c)  Ontological guilt. “I didn’t plan for the future or take advantage of my opportunities, so now I feel guilty for not becoming the person I could have been.”

d)  Distrust of parents and parental authorities. “How can I trust my parents when they killed my unborn siblings. They said they did it in love for me. If that is what love and being a parent is all about, I don’t want either.”

e)  No inherent worth. “They tell me they had me because they wanted me. If I am alive only because I am wanted, I have no inherent worth, and neither does anybody else. Without inherent value, it is not hard for me to die and it isn’t hard to kill others.’

f)  Anxious attachment. “I couldn’t bond to my parents because they are killers and yet I needed their care. So I tried to be good.”

g)  Superficial relationships. “My parents weren’t really attached to me nor I to them, so how can I commit myself to others.”

h)  Pseudo-secrets. “I don’t really want to know my mother had an abortion, but I suspect she did. We will collude. I won’t ask if she won’t tell.”

i)  Rage. “Why didn’t the state or my father protect my aborted brother or sister? If they don’t protect people when they are most vulnerable, why should I care what happens to them?”

j)  Pessimistic. “The world is falling apart so I don’t want kids. Because I’ve got no kids I might as well help it fall apart.”

k)  Risk taking. “I survived the ultimate dangers of my mother’s womb, nothing can touch me now. Let her rip.”

l)  Fascination with the occult. “Nothing can be more evil than parents who kill their own kids. I would kinda like to know where that evil came from.”

m)  Confused identity. “I don’t know who I am. I feel obligated to live part of my life as a woman because my little sister didn’t have a chance.”

A combination of these conflicts results in angry, narcissistic, self-destructive young people. There are millions of abortion survivors who are all too ready to destroy or be destroyed. One country’s awesome army is 80 – 90% abortion survivors; all too ready to die for the institution that provided them an identity, a purpose and protection from their parents.

Having aborted some of their children or having urged their children to abort, older people have a deep fear of retaliation. Recognising they are losing their “wantedness”, they desperately cling to their children who, in irritation, avoid them or put in an old age home. They fear their growing frailty and dependency, and may try to assert their last vestige of control by insisting on physician assisted suicide.

J.     Conclusions

There is a better way than abortion. From my experience treating those who have been deeply damaged by abortion, I suggest the following:

1. Medical. Apply the existing controls on the practice of medicine, to abortion. In evidence based medicine, there must be proven: 1) necessity; 2) a scientifically established benefit to the patient for the surgery; and 3) a relative freedom from harmful side effects. Doctors who do unnecessary surgery are liable for damages and/or charged with assault.
   
2. Family. One of the most important reasons women choose abortion is lack of partner support. Give men a legal right in abortion decisions.
   
3. Options. Provide all the options for pregnant women, e.g. homemakers, whole family fostering, full spectrum of adoptions, shared care, etc.
   
4. Informed consent. Women and men must know all the options, the established hazards and the reported damages from abortion.
   
5. Safe houses. Women need a safe place where they can be nurtured, encouraged, informed and protected from coercion while dealing with the crisis of pregnancy.
   
6. Education, not experimentation. Young people don’t need sexual titillation but proper health education, with emphasis on the benefits of chastity, bonding and monogamy.
   
7. Healing. In-depth counselling should be available for all who are deeply damaged by mistreatment and abortion.
   
8. Welcome. To be alive because you were wanted results in deep psychological conflicts. It is better for all to be welcomed and to welcome every preborn child, whoever they are.
   
9. Funding. Stop all forms of government funding for abortion and sex education until those who support or perform them show beyond reasonable doubt they are: necessary, efficacious and safe.

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