Abortion increases the risk of premature birth - the weight of evidence increases

The best available evidence from around the world suggests that women who have had at least one abortion are considerably more likely to give birth prematurely in subsequent pregnancies. This inconvenient truth - acknowledged by most medical professionals but too little talked-about in the wider abortion debate - received new empirical support recently from a paper presented at a conference of the European Society of Human Reproduction and Embryology (LINK) in Stockholm.

The paper presented the findings of a large-scale study based on Scottish health data (it has yet to be published or peer-reviewed).

Dr Peter Saunders of the Christian Medical Fellowship reproduces the Times newspaper's report on his blog. The most pertinent findings are as follows:

• Women who have had one termination are 34 per cent more likely to have a premature birth than those pregnant for the first time.
• Women who have had one termination are 73 per cent more likely to have a premature birth than those in a second pregnancy

Now it is hard to discuss this issue completely until we see the final published paper. There are some questions that need to be clarified and points expanded. But it seems pretty clear that this study

As Dr Saunders says:

“The study examined the Scottish Morbidity Records for all women in the country aged 15 to 55 who had two pregnancies between 1981 and 2007. They identified 171,208 women who had a second pregnancy after an abortion, 6,098 who had a second pregnancy after miscarriage, 458,337 who had a second pregnancy after a live birth, and 458,339 women pregnant for the first time. 

There are actually at least 119 articles in the world literature already attesting to an association between abortion and premature birth, and very few indeed that contest the association (see below). So why is this new study a news story?

What makes it news is the fact that this is the first major British study on the subject - as it is virtually impossible to do research on the health consequences of abortion in this country because abortion authorisation forms do not carry NHS patient numbers (a story in itself!) 

We will of course have to wait to see the full study once it is formally published but this is a further huge reason why women seeking abortion must have access to fully informed consent from a neutral party which does not downplay the facts.“

It is worth reiterating a couple of points here. First, the fact that this study is, according to Dr Saunders, the first major British study on abortion and prematurity. If this is correct, then it would appear to be indicative of a rather complacent attitude by the British medical establishment. Abortion is one of the most common medical procedures in the UK, with 200,000 every year. A link between abortion and prematurity has long been suggested. Why then has there been no large-scale investigation of this possible link?

Second, it no longer seems tenable for the medical establishment to suggest that abortion carries only a small risk of subsequent prematurity.  The Royal College of Obstetricians and Gynaecologists, at present, recommends only that "women should be informed that induced abortion is associated with a small increase in risk of subsequent preterm birth, which increases with the number of abortions."

This wording needs to be reviewed, in the light of new evidence. The RCOG, like some other organisations, has sometimes seemed reluctant to be fully open about the possible consequences of abortion for women's health (a consultation earlier this year concerning new guidelines on the issue attracted considerable criticism). It is essential for women's health and wellbeing that information not be hushed up and that it is made freely and widely available for women seeking abortion. Otherwise full informed consent is not being given.