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WHY CAN'T WE LOVE THEM BOTH
by Dr. and Mrs. J.C. Willke
CHAPTER 22
NEONATAL AND CHILDHOOD SEQUELAE
— RELATED TO ABORTION
—
What is the main problem?
Premature birth and earlier losses. The main reason for this is
cervical incompetence. This can result from the too-early, forceful dilatation (stretching
open) of the cervix (mouth of the womb). During an abortion procedure, the cervical muscle
must be stretched open to allow the surgeon to enter the uterus. There is no harm to the
muscle in a D&C performed because of a spontaneous miscarriage, as the cervix is
usually soft and often open. Also, there is rarely any damage caused by a D&C done on
a woman for excessive menstruation, etc. When, however, a normal, well-rooted placenta and
growing baby are scraped out of a firmly closed uterus, protected by a long,
"green" (unripe) cervix, this "donut" muscle can be and often is torn.
If enough muscle fibers are torn, the cervix is permanently weakened, the most damage
being done if this is her first pregnancy.
Why is this a problem?
Let’s look at a woman’s first labor and delivery. Her
labor is often 12 to 20 hours. The nurse, as she checks the mother’s progress, uses
the terms "two fingers" (or cm) — "four fingers" — then
"complete." These terms refer to measuring the slow dilatation of the cervix.
Only when it is wide open ("complete") can the baby begin the journey through
the birth canal.
Before birth, nature opens this "door" very slowly. In a
miscarriage, all those cramps do the same thing. After emptying the uterus, this strong
donut-like muscle closes tight again.
The lowest part of a woman’s uterus is the cervix, and, when a
woman is pregnant and stands upright, the baby’s head rests on it — in effect,
bouncing up and down on the "door" throughout the pregnancy. The muscle must be
intact and strong in order to keep the cervix closed. If it is weak, or
"incompetent," it may not stay closed and may result in premature opening and
miscarriage, or premature birth.
"The main risk of induced abortion is . . . permanent cervical
incompetence." L. Iffy, "Second-Trimester
Abortions," JAMA, vol. 249, no. 5, Feb. 4, 1983, p. 588
Second trimester miscarriage
and premature birth frequently follow induced abortions. A. Arvay et al., "Relation of Abortion to Premature Birth," Review
French GYN-OB, vol. 62, no. 81, 1967 Levin et al., JAMA, vol. 243, 1982, p.
2495 A. Jakobovits & L. Iffy, "Perinatal Implications of Therapeutic
Abortion." Principals and Practice of OB & Perinatalogy, New York, J.
Wiley & Sons, 1981, p. 603 C. Madore et
al., "Effects of Induce Abortion on Subsequent Pregnancy Outcome," Amer.
Jour. OB/GYN, vol. 139, 1981, pp. 516-521 161
"In a series of 520
patients who had previously been aborted, 8.6% had premature labor compared to 4.4% of
[non-aborted] controls." G. Ratten et al.,
"Effect of Abortion on Maturity of Subsequent Pregnancy," Med. Jour. of
Australia, June 1979, pp. 479-480 "The induced abortion
group had the highest incidence of late spontaneous abortion and premature delivery."
O. Kaller et al., "Late Sequelae of Induced Abortion in
Primigravidae," Acta OB GYN Scandinavia, vol. 56, 1977, pp. 311-317
Can this damage be
prevented?
Using laminaria is an attempt to lessen such damage.
This is a small bit of dehydrated material which is inserted into the cervix one day
before the abortion. It absorbs water and swells to many times its size and, in the
process dilates the cervix. Laminaria, incidentally, are seldom used in most freestanding
abortion chambers because it means two visits, smaller volume, and smaller cash flow. The
use of laminaria reduces, but does not eliminate, cervical incompetence. S. Harlap et al., "Spontaneous Fetal Losses After Induced
Abortions," New England Jour. Med., vol. 8, Sept. 1971, p. 691
Have premature births
increased?
In the early years of legalized wide-open abortion, there was ample
evidence of the fact that induced abortion caused a sharp increase of premature births and
their unfortunate aftermaths. Some of the major original studies included:
- After one legal
abortion, premature births increase by 14%; after two abortions, it is 18%, after three,
it increases to 24%. Klinger, "Demographic
Consequences of the Legalization of 162 Abortion in Eastern Europe," Internat’l
Jour. GYN & OB, vol. 8, Sept. 1971, p. 691
- Non-aborted women have a
premature birth rate of 5%, aborted women have a rate of 14%. R. Slumsky, "Course of Delivery of Women Following Interruption of
Pregnancy," Czechoslovakia Gyn., vol. 29, no. 97, 1964
- Women who have had
abortions have twice the chance of delivering a premature baby later. G. Papaevangelou, U. Hospital, Athens, Greece, Jour. OB-GYN
British Commonwealth, vol. 80, 1973, pp. 418-422
- In Czechoslovakia, premature births resulting from abortions are
so frequent that a woman who has had several abortions and who becomes pregnant is
examined, and: "If the physicians can see scar tissue, they will sew the cervix
closed in the 12th or 13th week of pregnancy. The patient stays in the hospital as long as
necessary, which, in some cases, means many months." "Czechs Tighten Reins on Abortion," Medical World News, 106J, 1973
Among others, Dr. Zedowsky reported a higher
percent of brain in juries at birth. His report cited "a growing number of children
requiring special education because of mental deficits related to prematurity. " ibid.
A very large study, by the
World Health Organization, of 7,228 women in eight European countries, showed that
previously- aborted women had significantly higher midtrimester pregnancy loss, premature
delivery and low birth weight babies. Collaborative
Study, Lancet 1979 20 Jan; 1 (8108): 142-5 163
Are
there any comprehensive studies on premature births?
In New York State, a major prospective study was done between 1975
and 1979 which compared over 40,000 women; half of whom had an abortion and half of whom
had a live birth. An analysis of the subsequent reproductive history of these women found
a definite pattern of increased complications for those who had abortions (see chart
below).
| |
Study Group
(had an abortion) |
Control Group
(had a live birth) |
Difference |
Spontaneous fetal deaths
All subsequent pregnancies |
8.7% |
5.3% |
1.65 times more |
Spontaneous fetal deaths
First subsequent pregnancies |
8.7% |
4.7% |
1.85 times more |
Low Birthweight
(less than 2500 gms)
white |
7.0% |
4.7% |
1.5 times more |
Low Birthweight
(less than 2500 gms)
non-white |
13.4% |
8.4% |
1.5 times more |
| Premature Birth (less than 33 weeks)
|
2.3% |
1.3% |
1.8 times more |
| Labor Complications |
13.0% |
4.3% |
3.0 times more |
| Congenital Malformations |
same |
same |
same |
| Newborn Death |
36% |
0.98% |
1.4 times more |
V. Logrillo et al.,
"Effect of Induced Abortion on Subsequent Reproductive Function," N.Y. State
Dept. of Health, Contract #1-HD-6-2802, 1975-78 |
More preemies die?
Yes. A study of 26,000 consecutive deliveries at UCLA was done to determine if previous abortions (and premature
births) had increased the number of stillborn babies and neonatal (after birth) deaths.
The findings were that the death rate "increased more than threefold." 164 S. Funderburk et al., "Suboptimal Pregnancy Outcome with
Prior Abortions and Premature Births," Amer. Jour. OB/GYN, Sept. 1, 1976, pp.
55-60
Why does the U.S. rate about 20th in the world in its infant
mortality rate?
There are five major reasons:
(1) Because in some cases we’re comparing apples with oranges.
Rated #1 is Japan. But they do not count deaths until 72 hours after birth. If the U.S.
did this, it would be almost first too.
(2) Some nations, like Sweden, do not have large numbers of low
socioeconomic people. Therefore, you could more realistically compare Sweden to Minnesota
than to the entire U.S.
(3) When asked, many blame it on "poor" prenatal care,
particularly in the groups with the highest rates, i.e., teens and low socioeconomic
groups. But, good prenatal care is almost universally obtainable. The problem is that
mothers in these groups often don’t avail themselves of it.
(4) The big one is the trio — alcohol, smoking and drugs —
often associated with illegitimacy. Bluntly speaking, many newborns die because of their
parents’ unhealthy behavior. Even good prenatal care cannot compensate for the
mother’s smoking, drinking and drug use.
Nicholas Eberstadt of the American Enterprise
Institute has studied illegitimacy. He points to an eight-state study that found a higher
infant mortality among unmarried college graduates than among married grade school
dropouts. M. Charen, Inst. Mort., "Deeper Than
Health Care," Feb. 2, 1992
(5) Prematurity as a result of earlier induced
abortion.
More preemies die than full term babies.
With increasing technology, more ought to survive.
As detailed in the viability chapter, this is true, but technology
has also brought a new way for them to die. Through In-Vitro fertilization, multiple
pregnancies are common. The technique of
"pregnancy reduction" (see chapter on Abortions) sometimes results in the loss
of all the fetal babies. L. Wilcox et al.,
"Assisted Repro. Tech . . . & Multiple Births..," Fert. & Ster., vol.
65 #2, Feb. ’96, p. 361
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