Chapter B. Evidence that induced abortion boosts prematurity risk
Quick summary of the evidence:
1. Over fifty 'gold standard' studies report increased APB risk
2. Top experts Barbara Luke, Judith Lumley, Emile Papiernik support
the APB risk
3. Dose/response: more abortions results in higher PB risk
4. Consent forms admit to higher risks of infection & incompetent cervix
5. 'Pro-choice' Dr. Malcolm Potts conceded the APB risk in 1967 in the
medical journal Eugenics Review (quote on page 235).33
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The APB Evidence
What if three world renowned preterm birth experts identified an
elective medical procedure as boosting subsequent preterm birth risk?
Would that make the risk very plausible? The only answer to that
question can only be "YES". The three renowned PB experts are Prof.
Barbara Luke (ScD, MPH; University of Michigan), Judith Lumley (
Director: Centre for the Study of Mothers' and Children's Health,
Australia), and Emile Papiernik (MD, Professor of Obstetrics and
Gynecology, Maternite Port Royal).
Barbara Luke in her classic book wrote, "If you have had one or
induced abortions, your risk of prematurity with this pregnancy
increases about 30 percent." (Every Pregnant Woman's Guide to Pre-
venting Premature Birth) Luke identifies both previous spontaneous
and induced abortions as risk factors for preterm birth. Judith
Lumley in 1998 reported both as risk factors and the amount of
relative risk was roughly the same.10
Who is Emile Papiernik? Dr. Papiernik was director of a French
national program that lowered the prematurity rate by 32 percent in
the first ten years! Compare this magnificent accomplishment with the
U.S. situation where the prematurity rate has RISEN (not dropped)
steadily over the last 20 years and is now approximately eleven (11)
percent. In 1999 Papiernik, et al. reported (19):
1. 86% increased risk of VPB (<33 weeks' gestation) for women with
a previous first trimester abortion
2. 267% increased risk of VPB for women with a previous second tri-
mester abortion
'GOLD STANDARD' APB studies
When a medical study is at least 95% confident of increased risk
(or 95% confident of decreased risk), such a report has achieved the
'gold standard' of medical science; (it is no reflection on research-
ers who do not achieve 95% confidence in a study, since a factor may
not change risk or there were not enough subjects in the study
because of under funding). In the area of APB how many 'gold stand-
ard' studies are there? As of July 2005 your author is aware of 59
APB 'gold standard studies'; the list of such studies is on webpage:
www.vcn.bc.ca/~whatsup/APB-Major.html .
'gold standard studies'
ZERO studies found decreased PB or Low Birth Weight risk from prior
abortions. Thus, all significant studies found increased risk. The
ratio of fifty+ to 0 is incalculably large. People questioning the
APB risk will identify studies that reported no APB risk. What does
is mean when researchers say that they found 'no risk increase' (or
decrease) from a specific factor (e.g. higher cancer risk from a
high fat diet)? The researchers found a risk increase (or decrease)
but they were not 95% confident of risk increase (or decrease). I.E.
the study failed the 'gold standard'. What should the researchers
say when they find an increased risk, but are not at least 95% confi-
dent of increased risk? Answer (via example): "We found a 36%
increased risk of preterm birth from previous induced abortions but
failure to be at least 95% confident of increased risk may be due to
too few subjects in our study or there actually may be no increased
risk." Researchers may assert 'no increase in risk' instead of an
honest statement such as that above. There is not one 'gold standard
' study, to your author's knowledge, that reported that previous
abortions reduce prematurity risk (for women who had induced abor-
tions versus mothers with no induced abortion history). When the
Yankees have over 50 runs and the Boston Red Sox have zero runs,
which team is ahead? It is possible that one or two 'gold standard'
studies will be found reporting decreased risk, but that would still
leave the ratio of 'significant' studies lopsided in favor of higher
PB risk from induced abortion.
Dose/Response
In medical science, proof of risk is considered stronger, if the
greater the quantity of a risk factor, the greater the amount of
risk (e.g. more fat in the diet results in higher risk of cancer).
Is there 'dose/response' for the APB risk? Yes. A clear majority
of 'gold standard' studies that actually examined possible dose/
response for APB, found that it existed. Consider the 1999 'Zhou'
study and a particular type of induced abortion ('evacuations')(1):
One (1) evacuation abortion increased PB risk by 127%
Two (2) evacuation abortions increased PB risk by 1155%
Consider a 1998 German study and the risk of very preterm (under 32
weeks' gestation) birth (17):
# induced abortions VPB risk (95% confidence interval)
increase
ONE 150% (1.95-3.24)
TWO 460% (3.53-8.96)
THREE 510% (2.85-13.3)
(All three results achieve the 'gold standard' of statistical signif-
icance, since the lower limits (1.95, 3.52, 2.85) all exceeded 1.0)
The following 'gold standard' studies found 'dose/response' risk: 1,2
3,7,8,10,15,16,17,18,19,20 [see References (Chapter G)]
...............
Consent forms admit to infection and incompetent cervix risks
Consider another purported risk of induced abortion: boosted risk
of breast cancer. Now imagine that there were abortion clinic consent
forms that listed a side-effect of abortion as higher levels of
undifferentiated (i.e. immature) cells in the breast (a known breast
cancer risk) but the form did not list increased risk of BC; this is
a purely imaginary example. Such a form would be clearly an example
of misinformed consent. What is the situation with abortion clinics
and preterm birth risk in relation to informed consent? Some forms
list risk of 'lacerated cervix' (i.e. incompetent cervix) but all
such forms FAIL to list a major consequence of this: higher risk of
a subsequent preterm birth! Many if not most abortion consent forms
admit to raised risk of infection, another risk for a later preterm
birth; again, the forms fail to list a major consequence of this risk
, higher odds of a future preterm birth. Incompetent cervix is such
a well accepted risk factor for preterm birth that no more in this
section need to said about it other than to mention that Barbara
Luke asserts that incompetent cervix increases the odds of preterm
birth before 32 week's gestation by a factor of TEN!!(26, page 40).
Within the last eleven years, infection has come to be recognized as
a very credible risk factor for preterm birth.10,26-31
When was the APB risk first recognized?
Dr. Malcolm Potts has always been a stout defender of induced
abortion. In 1967, Dr. Potts wrote about "Legal Abortion in Eastern
Europe" in the Eugenics Review, "there seems little doubt that there
is a true relationship between the high incidence of therapeutic
abortion and prematurity. The interruption of pregnancy in the young
(under seventeen) is more dangerous than in other cases."33 Thus,
APB has been a credible risk for over thirty-seven (37) years. Some
may ask why Dr. Potts would write in a journal dedicated to spreading
eugenics principles. Eugenics was the policy of Nazi Germany.
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copyright Brent Rooney ( [email protected] )