Abortion
 Facts you should know before you consider Abortion


 Fetal Development

Fetal development is the term used to refer to human development before birth. Human development begins at conception or fertilization and continues throughout the individual’s lifetime. Conception or fertilization refers to “the process by which the male’s sperm unites with the female’s ovum. By this event, a new life is created and the sex and other biological traits are determined. These traits are determined by the combined genes and chromosomes that exist in the sperm and ovum.”

The new life that begins at conception/fertilization is referred to by different terms depending on the stage of its development. From conception until its implantation into the uterus, the new life is referred to as the zygote. Once implantation occurs between 7-10 days after conception, the growing life is known as the embryo. The embryonic stage of development continues until week eight, at which point all the organ systems are present, the heart is fully developed and the embryo looks like a tiny human being. From week eight until birth, the life in the womb is referred to as the fetus. During the fetal phase, the organ systems become more mature, and the fetus grows from approximately 3cm and 2.5g at 60 days to 50 cm and 3300g at term.

During the zygotic and embryonic stages, development occurs by cell division and specialization into various organ systems. The fetal phase is characterized by maturation of the existing organs and immense fetal growth.

Life Begins (Weeks 1 and 2)

The moment the ovum and sperm join at conception/fertilization, the life of a new, distinct, human individual begins. Fertilization of the ovum usually occurs as it travels from the female ovary through the uterine tube, and into the body of the uterus. When the sperm and ovum unite, the resulting zygote develops from one cell into about 32 cells by day four after fertilization. By this time, the cells start to specialize, either into embryonic cells, or cells that will form the placenta and the membranes that will surround the embryo. Within 72 hours of fertilization, the zygote reaches the uterus where it will implant 7-10 days after fertilization. By the end of the second week, implantation is complete.

As implantation occurs, the placenta starts to form. The placenta is an essential, though temporary organ, which serves as a vital pathway between the mother and fetus. It transfers oxygen from mother to fetus, and carbon dioxide from fetus to mother. It transports nutrients from mother to fetus, and wastes from fetus to mother. It transfers heat from mother to fetus, and helps to regulate the effect that maternal drugs and medications have on the fetus. It produces hormones essential for fetal growth and for the continuation of the pregnancy.

Week 3

During the third week, the embryo’s heart and circulatory system, kidneys, brain, spinal cord, gastrointestinal tract and diaphragm start to develop. Leg and arm buds begin to form and the embryo is approximately 2 mm long from crown to rump.

Week 4

By week four, the embryo’s leg and arm buds become more noticeable. The lungs begin formation; the liver and pancreas appear as buds and a “single-tubed heart begins to beat at 21 - 25 days from fertilization.” By twenty-eight days’ gestation, the heart is able to circulate its own blood.

Week 5

By the fifth week, the leg and arms buds are more fully developed. The eyes and ears begin to form and nerves become visible in the brain. It is during the fifth week that the brain, heart and circulatory system will “show the most advanced development.”

Week 6

The sixth week involves development of the external ears, primitive skeleton and central nervous system. Brain waves can be detected, and the liver begins to produce red blood cells. At this stage “the upper and lower jaws are recognizable … the upper lip has formed, and the palate is developing.”

Six weeks after conception (teardrop baby) in I LIKE MIKE by .

 

Week 7

During week seven, the arms and legs begin to move, elbows and toes are visible and the mouth and lips become visible. Teeth buds, hair follicles, the diaphragm and nipples begin to form. The eyelids and tongue are also starting to develop. Towards the end of the seventh week, cartilage will begin to develop, and this cartilage will soon start converting into bone.


Week 8

By week eight, the embryo’s heart is complete and facial features continue to develop. External genitals begin to form according to the gender determined at conception. During the eighth week, the larger muscles are able to contract and bones start to form. By the end of this week, all the major organ systems are present, the embryo “clearly resembles a human being” and is approximately 3 cm long from the crown of the head to the rump. This marks the end of the embryonic stage of development.

 

 


                       

11 week old fetus
The toes are almost completely formed

Week 9 – 12

The beginning of week nine signals the start of the fetal stage of development. Between the ninth and twelfth week of development the head will account for almost half the size of the fetus. The digestive system begins to function, urine is produced and excreted, blood starts to form in the bone marrow, vocal cords begin to form allowing the fetus to make sounds and the face, neck, fingers and toes are almost completely formed. By twelve weeks’ gestation the fetus can make a fist, weighs approximately 45 grams, is 5 cm long from crown to rump and has a heart beat that can be detected electronically. At this point in development the gender of the fetus can also be determined visually.


Week 13 – 16

During week thirteen to sixteen, fine hair develops on the head, bones become harder, the fetus starts to make sucking motions, the skin is transparent, and fingernails are detected. By week fifteen, the sensory system begins to function, allowing the fetus to sense pressure and touch, as well as feel pain. The fetus will also gain 4 times its weight during these four weeks. The mother may be able to feel fetal movement by the sixteenth week. By the end of the sixteenth week the fetus will have a functioning pancreas and liver and will also be able to swallow amniotic fluid.

           
                        Fourteen week old fetus.           

 


20 weeks old fetus

Week 17 – 20

By the seventeenth and eighteenth week of development, the heartbeat can be heard with a stethoscope. The eyebrows and head hair appear, the muscles are well developed and the fetus can produce antibodies. By the end of the twentieth week the fetus will have developed “definite sleeping and activity patterns … that will guide sleep/wake patterns throughout life.” By the twentieth week, the fetus weighs 435 – 465 grams and is approximately 19 cm long.


              21 week old fetus grabbing tightly onto the finger of the surgeon operating on it.                                    
        

Week 21 – 24
NL_Premature_Kelly - kelly premature

This is Kelly Thorman - 3 weeks after birth. Born 30/1/71. She surprised her mother by being born very prematurely - at 21 weeks gestation - just a little over 4 1/2 months of pregnancy.

Between weeks twenty-one and twenty-four, the eyelashes and eyebrows are almost fully formed, and the pupils react to light. The fetus responds to loud or sudden sounds with a startle reflex and can grasp with his/her hands. The formation of blood in the bone marrow increases as formation of blood decreases in the liver. At this stage in development the fetus has reached viability, which means that it has the chance of surviving outside the womb. At twenty-four weeks’ gestation the fetus weighs approximately 780 grams and measures 24 cm from crown to rump.

Week 25 – 28

During weeks twenty-five to twenty-eight, the formation of blood cells completely transfers to the bone marrow, the central nervous system controls some functioning, the eyelids can open and close and the fetus has its own distinct fingerprints. The fetus is now approx. 28 cm long, weighs about 1200-1250 grams and usually moves into a head-down position to prepare for birth.  

Week 29 – 32

Between the twenty-ninth and thirty-second week, the central nervous system takes more control of body functions and the rhythmic movement of breathing begins. The lungs are not yet fully mature at this stage. By the end of the thirty-second week, the fetus responds to sounds from the outside world. Body fat rapidly increases, and by the end of week thirty-two, the fetus weighs almost 2000 grams  and measures 30 cm.

Week 33 – Term

From week thirty-three until birth, body fat continues to increase, fine hair starts to disappear and breast buds form on males and females. The mother supplies the fetus with antibodies against disease and the fetus completely fills the uterus. The final weeks of development are committed to the maturation and growth of the fetus. During the final weeks, the fetus gains approximately 14 grams of fat a day. All body systems are functioning, and the fetus is ready to meet the world outside the mother’s womb. Given oxygen, nutrition, and a nurturing environment, the healthy fetus will continue to develop into an infant, toddler, adolescent, adult, and senior, until death.

From:  http://www.abortionincanada.ca/facts/fetal_development.html                                    Top of Page

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 Methods of Abortion

Induced abortion is the active removal of the human embryo* or fetus† from the uterus before the stage of viability, or 20 weeks’ gestation. ”

Although abortion is defined as termination up to 20 weeks’ gestation, a lack of restrictions on abortion in Canada has made it legal and accessible through all 40 weeks/nine months of pregnancy.

There are many methods of abortion used in Canada. The method used depends mainly on the stage of the pregnancy and the size of the developing fetus. Other factors considered include the status of the woman’s health, personal preference, and where the abortion will occur.

Included in the following section are the methods reportedly used in Canada in 2004, the latest year for which statistics have been released. Abortion methods used in Canada are incomplete in the statistical report. Clinic abortion methods are only included for the province of Alberta. Because recording and reporting of abortions in Canada is inconsistent and incomplete, it is unclear exactly how many abortions occur nationally by each method listed below.

*Embryo refers to the developing human from the second to eighth week of development. All major organ systems develop during this stage and are present in the embryo at eight weeks.

†Fetus refers to the developing human from approximately 60 days up to birth. During the fetal phase, the organ systems become more mature, and the fetus grows from approximately 3cm and 2.5g at 60 days to 50 cm and 3300g at term.

 Surgical Abortion Methods

 Medical Abortion Methods

  Surgical abortion

Surgical abortion refers to abortion done using surgical instruments. Procedures vary due to the stage of the pregnancy and size of the fetus at the time of the abortion.

 Suction Aspiration (surgical aspiration, vacuum abortion, suction dilation and curettage (D&C))

Suction aspiration was the method used for approximately 90% of all abortions reported in Canada in 2004, and is generally used between six and 14 weeks of pregnancy.

Suction curettage can be done under general anesthetic, but is usually done in a clinic with local anesthetic injected into the cervix to control pain. The cervix is forced open with a compressed seaweed preparation called laminaria that swells as moisture is absorbed, or a series of rigid rods. Sometimes the prostaglandin Misoprostol is used to soften the cervix and make it easier to dilate.

A hollow plastic tube is inserted into the uterus through the cervix and attached to a suction machine. The suction tears the fetus into small parts, which are sucked through the tube into a collection bottle. Often a sharp loop-shaped knife called a curette is then inserted into the uterus to loosen any remaining tissue so that it can be suctioned out. When the suctioning is finished, the abortionist must examine the fetal parts and tissue to see if the abortion is complete.
[Image of vacuum aspiration abortion performed at 10 weeks]


















 Menstrual Aspiration (menstrual extraction, manual aspiration)

In 2004, less than 1% of abortions reported in Canada used this method.

Before abortion was legalized, the term ‘menstrual extraction’ was used to disguise the performance of an early suction abortion up to seven weeks’ gestation, sometimes even before a pregnancy was confirmed. The term is misleading, since either the embryo (if the woman is pregnant), or the uterine lining (if she is not pregnant) is suctioned out. Currently, menstrual aspiration refers to an early abortion from three to 10 weeks’ gestation, using a syringe for suction. A thin hollow tube is inserted into the slightly dilated cervix. The tube is attached to a large syringe and the embryo is suctioned out.

 Dilation and Evacuation (D&E)

Statistics are not clear on how many D&E abortions occur in Canada each year. In 2004, the most recent year for which abortion statistics have been released, at least 11% of abortions in Canada occurred after 13 weeks’ gestation. In the US, the majority of abortions that occur after 13 weeks are performed using a variation of this method.

D&E abortion refers to an abortion done using forceps to dismember and extract the fetus instead of, or together with, suction. In reality, a combination of methods is generally used in abortion after 13 weeks. As the fetus grows larger and its bones become harder, the fetus becomes more difficult to extract. The cervix must be opened wider, and the head of the fetus is large and must be crushed before it can be removed. Bone fragments are sharp and must be carefully removed to avoid damage to the uterus and cervix. The fetal parts removed must be identified to make sure the abortion is complete and no parts are left in the uterus. Suction is used for a final clean out of any bits of fetal or placental tissue that may remain.

Sometimes medications such as digoxin or potassium chloride are injected into the fetus through the woman’s abdomen, to kill it before the D&E procedure. After 19 to 20 weeks, a solution of urea or saline is sometimes injected into the amniotic sac before the abortion. This kills the fetus and stimulates contractions. Urea also begins the breakdown of fetal bones and other tissue to make removal of the parts easier for the abortionist and less painful for the mother. Oxytocin may be used to stimulate contractions and bring about delivery of the fetus.

 Dilation and Extraction (D&X) (intact D&E, partial birth abortion)

There are no laws in Canada restricting abortion. Since abortion reporting and recording is inconsistent and incomplete across Canada, it is not known if, or how many, abortions occur by this method in Canada each year.

D&X abortion is a variation of the D&E method, and is used after the first 20 weeks of pregnancy. Laminaria treatment over several days causes wide cervical dilation. The abortionist, guided by ultrasound, uses forceps to grasp the fetus and position it face down and feet first. The fetus, intact and often still alive at this point, is delivered up to the head. The head is too big to pass through the cervix. After puncturing the base of the skull, the brain is suctioned out, the skull collapses, and the dead fetus is delivered. Digoxin, potassium chloride, saline or urea are sometimes used to kill the fetus before delivery.

 Surgical Dilatation and Curettage (D&C)

Approximately 6% of abortions reported in Canada in 2004 used this method.

Local or general anesthetic is given to the mother before her cervix is dilated. The cervix is dilated with laminaria or rigid dilators; sometimes, the prostaglandin Misoprostol is also given to soften and dilate the cervix.

A loop-shaped knife called a curette is inserted through the cervix. The curette cuts the fetus and its placenta from the uterine wall and breaks it up. Then the fetal parts and the placenta are scraped out of the uterus through the cervix and discarded.

 Hysterotomy and Hysterectomy

Hysterotomy refers to a caesarean delivery as an abortion method. The woman’s abdomen and uterus are opened surgically. The fetus is lifted out, the placenta is delivered and the umbilical cord is clamped. If no chemical has been injected to kill the fetus prior to this point, the fetus is often still alive. Hysterotomy is sometimes used in situations where there is a uterine abnormality, which would make the more common abortion methods difficult or impossible.

Hysterectomy is the removal of the uterus. When used as abortion methods, these procedures have a higher risk of major complications and death than any other method.

There were no reports of either method being used for abortion in 2004 in Canada.
                                                                                                                                             Surgical Abortions
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 Medical Abortion


In Canada in 2004, approximately 3% of reported abortions were done using pharmaceutical drugs. Medical abortion is considered successful if complete expulsion of the embryo and placenta occurs without the need for surgery to complete the abortion.

Medical abortion is not commonly recommended in pregnancies past the first 49-63 days because of the increase in incomplete abortion, heavy and prolonged uterine bleeding and ongoing pregnancy past this stage. When severe bleeding or pain is present, surgical techniques are used to complete the abortion.

Medical abortion takes longer than surgical abortion, is less effective, and requires more clinic visits. Medical abortion results in heavier, more prolonged bleeding, and more pain, nausea and vomiting than surgical abortion. Medical abortion has a 10 fold greater risk of serious infection and death than surgical (suction curettage) abortion.

Medical abortion is preferred over surgical abortion by some women because of its effectiveness in early pregnancy, or because it does not require anesthetics or use of surgical instruments. Other women prefer it because it is more private and possibly more accessible, and because it may more closely resemble natural miscarriage.

Most medical abortions involve the use of a combination of drugs that work together to bring about the abortion over a period of a number of days or weeks.

 Methotrexate and Vaginal or Oral Misoprostol

In Canada, methotrexate and misoprostol are used together for medical abortion up to 49 days of pregnancy.

Methotrexate breaks down the cell layer that attaches the embryo to the wall of the uterus, depriving the embryo of essential nutrients and resulting in its death.

Misoprostol is a synthetic prostaglandin that causes the cervix to soften and dilate, and the uterus to contract and expel the embryo or fetus.

Abortion with methotrexate and misoprostol requires several clinic visits. During the first visit, methotrexate is injected, followed at 2-7 days with misoprostol pills at home or at a clinic, either inserted into the vagina or taken by mouth. A follow-up visit is required after 1 to 3 weeks to determine if the abortion has occurred.

The methotrexate and misoprostol abortion regimen causes complete abortion in 70-97% of cases. While most of the abortions occur within the first hours or days after taking the misoprostol, 20 to 35% will take up to several weeks. A surgical abortion is scheduled to complete the abortion if it has not occurred by that point because the drugs used can cause birth defects.

Side effects of medical abortion using methotrexate and misoprostol include: significant cramping pain and heavy bleeding during the abortion, along with nausea, vomiting, diarrhea, headache, fever, and chills; prolonged bleeding for one to seven weeks afterwards, and infection; birth defects if the pregnancy is ongoing and the fetus survives.

 Misoprostol

Misoprostol is a synthetic prostaglandin that causes the cervix to soften and dilate, and the uterus to contract and expel the embryo or fetus.

Misoprostol is used vaginally in abortions up to 56 days since the first day of the last menstrual period.

When used alone, Misoprostol causes complete abortion in 22-94% of cases.

Early side effects are worse with this method than with other methods of medical abortion, and include pain, dizziness, nausea, vomiting, diarrhea, chills and rashes. Heavy and prolonged bleeding and infection are associated with medical abortion in general. Misoprostol is generally used with another drug because of the higher incidence of side effects and lower rate of effectiveness when it is used alone.

Misoprostol is commonly used in surgical abortions as well, to soften and dilate the cervix, and to reduce bleeding.

 Mifepristone and Misoprostol

Mifepristone, also known as RU-486 or the ‘abortion pill’, used together with misoprostol is the most commonly used medical abortion combination worldwide.

Mifepristone is not approved for abortion in Canada. In 2001, the only Canadian trial of Mifepristone was stopped after the death of a woman from toxic shock brought on by a bacterial infection related to her abortion; similar deaths were recorded elsewhere.

Mifepristone causes abortion by blocking the action of progesterone. Progesterone prepares the uterine lining for implantation and is essential for maintenance of the pregnancy. Progesterone also suppresses uterine contractions.

Mifepristone causes the uterine lining to break down, resulting in detachment of the embryo from its source of nutrition. It causes the cervix to soften and dilate. It also makes the body release prostaglandins and increases the effects of these prostaglandins in causing the uterus to contract.

Mifepristone/misoprostol abortions are quicker than methotrexate/misoprostol abortions. Both regimens have similar rates of complete abortion, side effects and complications. Serious infection and heavy, prolonged bleeding are the most notable side effects, along with nausea, vomiting, diarrhea and headache.

 Labor induction methods (instillation methods)

In Canada in 2004, less than 1% of reported abortions used labor induction methods, such as instillation of saline, urea or prostaglandin solutions into the amniotic sac.

 Saline abortion

Saline abortion refers to the injection of a concentrated salt solution into the amniotic sac through the mother’s abdomen. The solution burns and kills the fetus, stops placental functioning, and stimulates labor.

Saline abortions are rare in Canada, due to maternal deaths and a high level of side effects.

 Urea

No urea abortions were reported in Canada for 2004. Although urea instillation abortions are safer than saline abortions, the abortion takes a long time to occur. Urea is sometimes used in D&E abortions to kill the fetus and soften its bones to make it easier to remove.

 Prostaglandins

Less than 1% of reported abortions in Canada in 2004 were listed as prostaglandin abortions. Prostaglandins can be injected into the amniotic sac or taken by the mother to induce abortion. However, due to a high rate of side effects, as well as cases of temporary fetal survival, this is not a common abortion method. Sometimes saline or urea are injected into the amniotic sac to ensure the fetus will be dead when it is delivered, or the fetus is killed by an injection of potassium chloride or digoxin into the fetal heart or amniotic sac.

 Other reported methods

In addition to the methods listed above, there are other methods of abortion infrequently used in Canada.
Combinations of the above methods may also be listed under “Other” in statistical reports.

From:  http://www.abortionincanada.ca/methods/index.html                                       
                                                                                                                                             Medical Abortions
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 Health Effects

Physical Health Effects

Physical complications of abortion vary, depending on the age of the pregnancy and the type of abortion. In general, the risk of complications increases with gestational age past eight weeks. Some complications appear in the first hours following the abortion, while others may take days, weeks and even years to show up. Statistics on abortion complications are inconsistent and incomplete. Most studies focus on short-term complications, while later effects on both physical and psychological health are usually neglected.

 Short-term Health Risks

 Long-term Health Risks

 Risks in Future Pregnancies

Psychological Effects of Abortion


 Short-term Health Risks

 Acute Hematometra (post-abortal syndrome)

Acute hematometra occurs when the uterus fills with blood and blood clots, generally as a result of retained tissue. Symptoms usually occur within an hour of the abortion, and include increasing lower abdominal cramping and an enlarged, tender uterus. If fetal parts or placental tissue remains in the uterus, it will not contract effectively. Acute bleeding into the uterus results. The woman will have to undergo another procedure to clean out the uterus completely, and she will need drugs to help her uterus contract.

 Retained products of conception (retained fetal and placental tissue)

Retained tissue is the result of an incomplete abortion. This may cause excessive and prolonged hemorrhage. A life-threatening later complication is septic infection of the uterine lining.

 Endometritis (infection of the lining of the uterus)

Endometritis is an infection of the uterine lining. It is usually associated with retained tissue. Endometritis can lead to toxic shock syndrome, which can be fatal. Fatal toxic shock syndrome has been associated with the bacterium clostridium sordellii following medical abortion. A Canadian woman died of the same condition in 2001 during clinical trials involving medical abortion with the drugs mifepristone (RU 486) and misoprostol. The trials were halted, and mifepristone is not approved for medical abortion in Canada.

 Uterine perforation and lacerations

Uterine perforation is most common with surgical abortion. According to one abortionist, “Uterine perforation is an inevitable occurrence if one does enough abortions or dilatation and curettage procedures of any sort.” Perforation can occur with the use of rigid dilating rods, sharp curettes, suction catheters, forceps, or fetal bone fragments. When the uterine blood vessels are damaged, life-threatening hemorrhage occurs. If the abortion instruments enter the abdominal cavity, injury can result to many organs surrounding the uterus. Suction abortion can cause a section of the bowel to be sucked into the otherwise sterile uterus. Damage to the bowel or other pelvic organs can cause immediate life-threatening hemorrhage and septic infection. Hysterectomy, or removal of the uterus, may be necessary to save the woman’s life, leaving her permanently infertile. In some cases, surgery to repair the bowel or other organs may be necessary.

 Hemorrhage

Hemorrhage, or heavy bleeding, is one of the most common after-effects of abortion. Heavy, prolonged bleeding is associated with medical abortion and may be the result of incomplete abortion, or failure of the uterus to contract following the abortion.

Hemorrhage associated with surgical abortion is often caused by injury to the cervix or uterus, retained tissue, or failure of the uterus to contract.

In later abortions, and saline abortions, the risk of a life-threatening complication called disseminated intravascular coagulation (DIC), along with hemorrhage, is increased.

 Disseminated Intravascular Coagulation (DIC) 

DIC results in widespread blood clotting in the tiny peripheral blood vessels throughout the body, causing tissue starvation and eventual tissue death. As the clotting factors are depleted, massive hemorrhage occurs throughout the body.

 Cervical lacerations and injury

Cervical injury can occur as a result of vigorous and forceful opening of the cervix with rigid dilators and laminaria preparations. Clamps and the surgical instruments used in the abortion, as well as fetal bone fragments can also injure the cervix. Low cervical perforations may injure the uterine artery and cause severe hemorrhage and death. 

Cervical injury may also lead to incompetent cervix. An incompetent cervix is abnormally prone to dilating before term delivery, and is a risk factor for pre-term birth. The risk for pre-term birth in subsequent pregnancies increases with more abortions.

 Gastro-intestinal disturbances (nausea, vomiting, diarrhea)

Nausea, vomiting and diarrhea may follow abortion, especially with medical abortions involving prostaglandins or abortions involving the use of oxytocin to help the uterus to contract.

 Convulsion

Convulsion can be a true epileptic seizure, a reaction to anesthetics, or a hysterical manifestation.

Saline poisoning (salt poisoning, hypernatremia) 

Hypernatremia can occur in saline abortion, with the injection of the salt solution into the mother’s system instead of the fetus or amniotic sac. Hypernatremia develops quickly, and in high levels is toxic to the brain. In fact, saline abortion has fallen out of favour because of this risk.

 Uterine Rupture

Uterine rupture can occur with the use of oxytocin, or misoprostol when used to stimulate uterine contractions. Surgery, and sometimes removal of the uterus is needed to control bleeding.

 Embolism

An embolism is the sudden blocking of an artery by a clot of foreign material, such as a blood clot, fat globule, air bubble, or piece of tissue. Unless the blockage is quickly relieved, tissues past the blockage will die. Abortion can result in amniotic fluid and air embolism.

 Anesthetic reactions

Both local and general anesthesia in abortion have resulted in death. General anesthetic is used less often than local anesthetic, but both carry risks.

Pelvic Inflammatory Disease (PID) 

The development of pelvic infection following abortion is one of the most commonly-occurring side effects. PID carries long-term risks of chronic pelvic pain, dyspareunia (pain during sexual intercourse), reduced fertility and ectopic pregnancy.

 Mortality

A small but consistent number of maternal deaths result from abortion, although the numbers likely remain under-reported. Most of these deaths are caused by hemorrhage, infection, embolism, or cardiomyopathy. Complications stemming from general anesthesia are also a factor in maternal mortality following abortion.

The maternal death rate in the 12 months following an abortion is four times greater than the rate of death among women following completed pregnancies, according to a Finland study from 1997.     
                                                                                                                                   Short-term Health Risks
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 Long-term Health Risks

 Breast Cancer

Hormonal factors, including estrogen, are well known to be connected to an increase in breast cancer risk. Cancer advocacy groups such as the Canadian Cancer Society also acknowledge this by mentioning several risk factors associated with increased estrogen exposure. Among the "Causes of breast cancer" listed on their website (www.cancer.ca) are: no childbirth, or first childbirth after age 30, early onset of menstruation, late menopause, taking combined hormone replacement therapy, and taking oral contraceptives. These risk factors are all associated with increased estrogen exposure.

Induced abortions increase a woman's window of exposure to estrogen, in two basic ways. Abortions deny women the estrogen-balancing protective effects of a full term pregnancy as well as breast feeding. This is undisputed. A woman's estrogen exposure is even more significant if she has an abortion before ever having a full term pregnancy, because it exposes rapidly-dividing, immature breast cells to massive amounts of estrogen. Obviously, abortions are performed on women who are already pregnant. Soon after conception occurs, estrogen levels surge, causing breast cells to multiply profusely. When such massive cell multiplication occurs, more errors or mutations can also occur, resulting in abnormal cells. Under the influence of estrogen, the abnormal cells also multiply, which can lead to cancer formation. Estrogen can also directly attack the DNA, causing more abnormal cells to form and multiply. Late in pregnancy, other hormones not only cause most of the breast cells to mature into milk-producing cells that are resistant to the damaging effects of estrogen, they also help to repair damage that may have occurred under the influence of estrogen. When induced abortion halts the normal protective hormonal process of progressive cell maturation and cell repair, more immature, rapidly-dividing breast cells are exposed to the effects of estrogen. Note that spontaneous abortion (miscarriage) usually occurs with low levels of pregnancy hormones, including estrogen, thus not increasing breast cancer risk.

Biology shows that estrogen, without the balancing effects of the other pregnancy hormones, is a factor in increased breast cancer risk. Induced abortion increases a woman's total estrogen exposure, ultimately increasing her risk for breast cancer.

Beginning in 1957 and as current as the fall 2007 Journal of American Physicians and Surgeons, there have been more than 50 studies in peer-reviewed medical journals that have shown an increased risk of breast cancer among women who have had induced abortions.

In addition there have been three medical malpractice lawsuits since 2002 in which the failure to warn women about the abortion-breast cancer link has resulted in two out-of-court settlements and one adjudicated judgment, all in favour of the post-abortive women who brought the suits forward.

For more information on abortion and breast cancer, with references, go to www.abortionbreastcancer.ca .

 Infertility

Induced abortion may be a contributing factor to future infertility, with symptoms often appearing years after the abortion when the woman attempts to conceive a child. The complications negatively influencing future fertility include post-abortal Pelvic Inflammatory Disease (PID), uterine perforations causing scar tissue, uterine adhesions and retained fetal fragments, or endometrial ossification. Women whose first pregnancies end in abortion are at particular risk for future problems with fertility.                                                          
                                                                                                                                    Long-term Health Risks   
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 Risk in Future Pregnancies

Pre-term birth  (premature birth)

Induced abortion has been found to increase pre-term birth (before 33 weeks’ gestation) and early pre-term birth (20-30 weeks’ gestation) in following pregnancies. The risk increases with more abortions. Abortion can cause cervical injuries resulting in incompetent cervix, which is a risk factor for pre-term birth. Abortion is also associated with uterine scarring, adhesions and infection, which in turn increase the risk for pre-term birth. Pre-term birth is an important risk factor for cerebral palsy.

 Placenta Previa

Abortion is associated with placenta previa in future pregnancies. The placenta attaches very low in the uterus, partly covering the cervical opening. Placenta previa increases the risk for bleeding during pregnancy and labor, and can result in premature separation of the placenta, severe hemorrhage and fetal death.

 RH sensitization

When an RH negative mother carrying an RH positive fetus delivers her child, either through birth or abortion, the mother may become sensitized to RH antigens. The fetus’ RH antigens enter the mothers’ blood stream, stimulating her to develop anti-RH antigens. In future pregnancies with RH positive fetus’ these may cross back through the placenta and cause clumping of the fetus’s red blood cells, causing nerve and brain damage. Sensitization can also cause serious consequences with clumping of blood if the woman is ever transfused with RH positive blood.

RH sensitization is avoidable in childbirth and abortion with an immunization of the mother following delivery. 

 Ectopic Pregnancy

Abortion has been shown to be a risk factor for future ectopic pregnancy.

From: http://www.abortionincanada.ca/methods/index.html                                                         
                                                                                                                            Risks in Future Pregnancies
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 Psychological Effects of Abortion

Women who have undergone induced abortion are more likely to experience mental health problems. These problems can range from mild depression to severe anxiety disorders. In a 2006 study conducted in New Zealand it was found that “in all comparisons, those becoming pregnant and seeking abortions had significantly higher rates of disorder than the not pregnant group and, with the exception of anxiety disorder, significantly higher rates of disorder than the pregnant no abortion group.” Researchers concluded that “exposure to abortion is a traumatic life event which increases longer-term susceptibility to common mental disorders.”

When compared to women who have given birth, women who have had an abortion also have significantly higher rates of admission to hospital for psychiatric reasons. In a 2003 study sponsored by the Ontario College of Physicians and Surgeons it was found that women who had an induced abortion had a five times higher rate of admission to hospital for psychiatric reasons in the following three months than women who had not undergone induced abortion.

Women with a past history of abuse or mental problems as well as women with a lack of support, conflicting belief systems or those in their teen years are at an even higher risk for developing psychological problems following an abortion. Researchers have also found that women who are pressured or coerced into having an abortion are also “likely to experience more distress around the decision, as well as guilt, anxiety and depression.”

 Common psychological health problems linked to induced abortion

Women who have undergone abortion also tend to smoke more frequently, abuse alcohol, develop eating disorders, abuse or neglect subsequent children and experience relationship problems.

 Anxiety

Women who undergo abortion show higher levels of generalized anxiety when compared to women who carry to term.

 Depression

In a National Longitudinal Study of Youth conducted in the US it was found that “women who reported induced abortion were 65% more likely to score in the high-risk range for clinical depression than women whose pregnancies resulted in birth.” The Planned Parenthood Federation of America reports that approximately 20% of post-abortive women experience some form of mild depression, while 10% of post-abortive women will experience persistent depression. 

 Drug Abuse

Induced abortion has been linked to increased rates of substance abuse, especially among young woman. A 2006 study conducted in New Zealand by David Fergusson found that young women who aborted had a significantly high rate of drug dependence than young women who had never been pregnant and pregnant young women who carried to term. A 2004 study published in the American Journal of Drug and Alcohol Abuse found that women who had had an abortion reported using marijuana twice as frequently as women who carried a pregnancy to term.

 Post Traumatic Stress Disorder

According the Canadian Mental Health Association, approximately one out of every 10 people is affected by an anxiety disorder known as Post Traumatic Stress Disorder (PTSD). This type of disorder is typically caused by a “psychologically traumatic event” which can include “seeing another person harmed or killed.” Symptoms of this disorder can be classified in three different categories: “the first involves re-experiencing the event … avoidance and emotional numbing are the second … the third category of symptoms involves changes in sleeping patterns and increased alertness. Insomnia is common.”

One study found that at least 19% of women who had undergone abortions suffered from PTSD. A 2007 study on parental coping after the termination of pregnancy for fetal anomalies found that 44% of women suffered symptoms of PTSD and 13.8% of women experienced some kind of psychological distress.

 Sexual Dysfunction

According to the Elliot Institute women who have undergone abortion can experience “loss of pleasure from intercourse, increased pain, an aversion to sex and/or males in general, or the development of a promiscuous life-style” in approximately 30 – 50% of cases. A 2003 research study found that 10 – 20% of women reported that they experienced negative effects in their sexual/couple relationship and on sexual functioning after an induced abortion.

 Sleep Problems

Recent results from the National Longitudinal Study of Adolescent Health found that young women who had undergone abortion reported higher rates of sleep disturbance than women who had not had an abortion. According to the Elliot Institute, 36% of women who had undergone an abortion were experiencing sleep disturbances eight weeks after the abortion.

 Suicidal ideation

Induced abortion has been linked to suicidal thoughts and suicide attempts. In a 2006 New Zealand study it was found that teenagers aged 15-18 who underwent an abortion were twice as likely to experience suicidal ideation when compared to teens the same age who had never been pregnant or teens who had been pregnant but chose not to have an abortion. The rates of suicidal ideation were also higher for 18-25 year olds in the same study.

Suicide rates were also found to be higher among women who had an induced abortion, in a study conducted by Finnish researchers. This study used data collected using several administrative registers, including the death register which tracks all deaths among citizens of Finland. It was found that 60% of suicides occurred among women who aborted when compared to women who had either been pregnant and given birth or had been pregnant and miscarried. Suicide rates were twice as high for women who had aborted when compared to only those women who had been pregnant and miscarried.

From: http://www.abortionincanada.ca/methods/index.html            
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