ENDEAVOUR FORUM ARTICLES - THE RISKS OF ABORTION AND THE VLRC REPORT

 

 

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The Risks of Abortion and the VLRC Report

An Endeavour Forum Analysis

                                  

On the 19th August 2008 the Hon. Peter Kavanagh MLC placed a Notice of Motion on the Victorian Legislative Council's Notice Paper attacking the VLRC Report.  Inter alia, the Notice of Motion said "that the Report either ignored or dismissed a large volume of cogent, valuable scientific evidence showing physical and mental health risks of abortion to women, and took no adequate or appropriate steps to provide the Government with that information."

The following analysis of the expert evidence on the physical and mental health risks of abortion to women (all of which evidence was provided to the VLRC) strongly supports the Motion. This analysis also draws attention to some of the grave harm which could be done to our women and our community if the present  Abortion Law Reform Bill 2008 is passed by the Victorian Parliament.

l. (a) Psychological damage, depression and suicide

 

   The VLRC had abundant evidence that abortions can cause psychological damage, depression and suicide.  Amongst other evidence the VLRC was referred to

 

(aa) The Rawlinson Report of the English  House of Lords on  Abortion in England (1996). This Report indicated that a high proportion of women who had abortions suffered some adverse psychological consequences, and a significant number suffered serious psychological problems requiring treatment.

 

(bb)  The submission   of Anne Lastman, a highly qualified psychologist who over the last twelve years has treated more than l,000 patients  for the mental problems following  abortion.  These problems include many patients with psychological damage and/or depression. The services Anne Lastman provides at her clinic are free so she derives no benefit whatever from the counselling work she does.  These post abortion problems are fully explained and detailed in her book "Redeeming Grief", a copy of which was provided to the VLRC.  This book incisively analyses from her own  extensive personal experience the mental health problems and the post abortion syndrome (PAS). 

 

   Although Anne may well be one of the best persons in Australia to advise the VLRC on post abortion problems, the VLRC made no attempt to contact her and without questioning her further were very dismissive of her views.  (see  Report p. 117, para 8.55)

 

 

(cc)   Successful legal actions  have been brought in Australia and the USA for women who had suffered psychological damage as a result of abortions. 

 

    In particular Mr. Charles Francis, AM, QC, a Melbourne barrister, made written submissions and personally consulted with Professor Rees, Chairman of the VLRC,  informing him of these legal actions.  The first such case in which he acted is known as "Ellen's"  case, full details of which were provided to Professor  Rees.  "Ellen" sued on the basis she was not warned the abortion could harm her mental health.  Following her abortion for some years she was crippled by a black depression which prevented her working. Her condition was so bad that her husband had to give up work to nurse her.  "Ellen's" case was brought in the Melbourne County court and was settled at mediation on 28 September 1998.

(see article "The Price of grief", Herald Sun, September 29, 1998) 

 

   The second case of which Charles Francis gave evidence is known as "Meg's" case, which was also brought in the Melbourne County Court.  "Meg" had an abortion in l997.  She was informed that after her abortion she might pass some of the products of conception and went home believing she might pass some placenta or other unidentifiable human tissue.  After she went home to her horror she passed what may have been the umbilical cord.  Later she passed an entire leg, to be followed by the other leg of her unborn child.  Thereafter she passed part of the spinal column, the rib cage and chest area with bones, muscles and flesh. finally came her baby's heart and then a small very clearly identifiable head with glassy eyes which appeared to be cold and staring.  "Meg" developed a gross post-traumatic stress disorder with severe depression.  

 

   "Meg" sued in the Melbourne County court on the basis she was not warned the abortion could cause her mental harm. (In her claim she also alleged failure to warn of the abortion breast cancer link).  When four years later on 2nd August 200l Meg's case was settled at mediation for a substantial sum, she was still in a dysfunctional state, depressed and unable to work. 

 

   Charles Francis orally advised Professor Rees of the factual details of these two cases and provided him with printed material setting out the above details.  At no time did Professor Rees question in any way the truth of what he was so informed nor did he question that both "Ellen" and "Meg" had suffered psychological damage.

 

 Professor Rees was also informed by Charles Francis of other successful legal actions for damage to  mental health in some of which he had also appeared as Counsel for the Plaintiff.  He had also assisted in a similar case in Pennsylvania which was settled for a substantial sum. 

 

(dd)  The written submission of a senior Melbourne barrister, Michael W. Houlihan.  His submission spoke of his personal involvement in many civil cases in which women who have had an abortion sued the doctor who conducted the operation and in several cases also the hospital where the procedure was carried out.  He said he had also "read the reports and interviewed numerous other women who for various reasons did not become involved in litigation.  Most  because they could not bear the trauma of reliving their experience, and some who were ......too damaged to be able to carry the burden of litigation".

 

   Michael Houlihan wrote:  "Each of these women had been profoundly and permanently damaged psychologically by their experience.  The damage in each case was sufficiently obvious and florid to induce the Defendants to offer substantial settlements rather than hazard a jury's verdict. 

 

   Other than acknowledge receiving his submission, at no time did the VLRC communicate with Michael Houlihan in any way, nor did it seek to query the accuracy of what he had said.

 

(ee)  The research of Canadian Professor Philip Ney, a psychiatrist who for more than twenty years has treated patients psychologically damaged by abortions and who has done extensive research on this problem and written articles and books on the subject.  The VLRC was told he was possibly the leading expert in the world on this subject and was referred specifically to his book "Deeply Damaged" (1997).

 

(ff) the research and statistics of the prestigious Elliott Institute, Springfield, Illinois, USA.  This Institute collates medical material and statistical surveys of matters concerning abortion all over the world.  The Commission was provided with a number of research articles from the Elliott Institute and the results of a number of American statistical surveys published by it.  Amongst the articles provided were "A List of Major Psychological Sequelae of Abortion" by Dr. David Reardon.  This article was very fully referenced and indicated that a major random study had found that a minimum of 19% of post abortion women suffer from diagnosable post traumatic stress disorder.  The Article was thus highly corroborative of the evidence of Anne Lastman of which the Report was dismissive (VLRC report page ll7, para 8.55).

 

   Further articles included "Women at Risk of Post-Abortion Trauma" which referred to British research in which 44% of women who had abortions complained of nervous disorders and ll% had prescribed psychotropic medicine treatment. The article also referred to Canadian research which found that 25% of aborted  women made visits to psychiatrists as compared to 3% of the control group. (See Badgley.et al :Report of the Committee on the Operation of the Abortion Law (Ottawa Supply and services 1977).

 

(gg)  the letter published in "The Times", England on 27 October 2006.  This letter was signed by 15 medical consultants including Professor of Psychiatry, Patricia Casey,  Andrew Sims, Past President of the English Royal College of Psychiatrists and Gordon Stirrat , an Emeritus Professor of Obstetrics & Gynaecology.

 

   Inter alia, the letter said "Research has shown that even women without past mental health problems are at risk of psychological ill effects after abortions.  Women who had abortions had twice the risk of major depressive illness as those who had given birth or never been pregnant.  Since women having abortions can no longer be said to have a low risk of suffering from psychiatric conditions such as depression, doctors have a duty to advise about long-term adverse psychological consequences of abortion."

 

(hh)  the recent study in New Zealand from Dr. David Fergusson  et al showing that women  who have abortions are more prone to psychological problems.  Dr. Fergusson is pro-choice but considers women should be warned of this risk.  (David M. Fergusson, L. John Horward and Elizabeth M Ridder, "Abortion in young women and subsequent mental health, Journal of Child Psychology and Psychiatry 47 (i) 15-24, 2006).

 

 (jj)  the work of "Silent No More" in Canada, an organisation which warns women of the physical and psychological harm done to to them by abortion.  Amongst other work, "Silent No More" does counselling similar to that of Anne Lastman.  The Commission was provided with its leaflet and a DVD about its work.

 

(kk) mandatory legislation in a number of states in the USA which require abortion providers to give women information about the risks of abortion, which include the risks of depression and post abortion stress syndrome.  The Commission was provided with the Disclosure and Consent form of a Texas abortion clinic, "Women’s Health Centre". San Antonio, Texas.  amongst the risks listed are:

 

  (i)  depression or "the blues"

  (ii) Post abortion stress syndrome

 

(ll) the Confirmation of Informed Consent Form of Planned Parenthood of Australia in which amongst the complications of abortion listed are included "Post abortion syndrome, Depression or mood disturbance and suicide". The Commission was provided with a copy of this form.

 

(mm)  A recent  British study investigating abortion and post traumatic stress disorder (PTSD) published in the B.M.C. Psychiatry Journal suggested that PTSD increased 61% after abortion  (http://www.lifesite.net.idn/2008/Feb/08021401.html).  The authors of this study called for more screening to be done on women prior to abortion in order to "help identify women at risk of PTSD and provide follow up care.

 

(nn)  A new statement by the British Royal College of Psychiatrists which warned that no woman should abort her child without counselling on possible effects such as depression and even suicide ("The Sunday times", England, 16 March 2008).

 

   (Note - a considerable body of other material was provided to the VLRC in relation to the risk of Psychological Damage and Depression.  the above thirteen matters constitute some of the more important material.

 

SUICIDE

 

   The VLRC had a body of evidence which demonstrated that one of the risks of abortion was the subsequent suicide of the aborted woman.   Amongst other evidence the VLRC was referred to

 

(oo)  the government funded study in 1997 of maternal deaths in Finland.  This study showed that in the first year following an abortion, aborting women were 252% more likely to die compared to women who delivered and many of the extra deaths were due to suicide.  Suicide rates within one year of pregnancy ending by induced  abortion were 34.7 per 100,000 as compared with 5.9 per l00,000 of suicide rates within one year of the delivery of a child.  This rate is less than the annual rate for all women which is ll.3 per l00,000.  (Gissler, Hemminke, & Longquist: "Suicde after pregnancy in Finland 1957-94 register linkage study" (British Journal of Medicine 313 1431- 4,  1996)

 

(pp)  The research in California in 2002.  This was a study of 173,000 low-income Californian women, which found that in the eight years following an abortion women who had been aborted had a 154% higher risk of death from suicide than other women.  (See Reardon D.C., Ney P.G. et al "Deaths associated with pregnancy outcome, a record linkage study of low-income women", Southern Medical Journal, August 2002  95(8)  834-841).

 

(qq)     the suicide of talented English artist Emma Beck.  Emma Beck had been pregnant with twins which were aborted.  On lst February 2008 Emma Beck hung herself.  Her death was the subject of news items. She left behind a suicide note which read "Living is hell for me.  I should never have had an abortion. I see now I would have been a good mum.  I told everyone I didn't want to do it, even at the hospital.  I was frightened, now it is too late.  I died when my babies died. I want to be with my babies - they need me, no one else does".

 

   All this information surrounding Emma Beck’s death and the material in her suicide note were provided to theVLRC.   (This one death alone indicates that there is some risk).

 

  Conclusion

 

   In the light of all the above information provided to the VLRC, how could it say, as it did, that there was a medical and scientific consensus that psychological damage, depression and suicide were not material risks?  (VLRC Report p. 117, para 8.55)

 

   The primary meaning of the word "consensus" is unanimity", although in certain contexts it may mean "a majority".

 

   If there be any such consensus it may well be worthless.  The determination of  such risks should not be made by some vote but by such matters as the facts of medical evidence and medical science, and from the results of properly conducted statistical surveys.  The VLRC had more than abundant evidence corroborating these risks but its reference to  that evidence was minimal.

 

 

1 (b) The Abortion Breast Cancer Link (The A.B.C. Link)

 

   The VLRC was provided with information and evidence that abortion increases the risk of breast cancer.  There has been a devastating increase in the incidence of breast cancer, especially among younger women.  In Australia the incidence has risen from one in eleven to one in eight women.  The single most avoidable risk factor for breast cancer is induced abortion.  The VLRC was informed inter alia that

 

(aa)  A full term pregnancy at an early age provides a woman with a protective effect against breast cancer.  Young childless pregnant women who have induced abortions of their first and second pregnancies will delay the age at which they have their first full-term delivery of a baby.  It is generally accepted by breast cancer epidemiologists that each one year increase in age at first full-term delivery elevates a woman’s life time risk of breast cancer.  According to top Harvard University epidemiologists, including the great Dr. Brian MacMahon, each one year delay in the first full-term pregnancy elevates relative breast cancer risk by 3.5% (compounded), that is, a five year delay in first birth boosts relative breast cancer risk by 19%, a 10 year delay by 41% and a 20 year delay by 99%.

(1. Trichopoulos D, Hsieh CC, MacMahon B, Lin TM et al. Age at any birth and breast cancer risk. Int J Cancer 1983;31:701-704.

2. Chris Robertson, Maja Primic-Zakelj, Peter Boyle, Chung-Cheng Hsieh et al. Effect of parity and age at delivery on breast cancer risk in Slovenian women aged 25-54. Int J Cancer 1997;73(1):1-9.)

 

(bb)  In addition to leaving a woman with a higher risk of breast cancer by abrogating the protective effect of full-term pregnancy, induced abortion is also an independent risk factor for breast cancer.  Twenty-nine out of 38 worldwide epidemiological studies show increased risk of breast cancer associated with induced abortion.  Of the 29, 17 found a statistically significant increase in risk.

 

(cc)  The  biological explanation for abortion as an independent risk factor for breast cancer relates to the maturation of cells which make up the milk glads (lobules) from type l lobules to type 4 lobules.  At birth there are primitive type l lobules which are very immature and which have many terminal ductal lobular units (TDLUs)  where cancers are known to arise.  These  type l breast lobules develop into  type 2 lobules at puberty, which are still primitive and susceptible to carcinogens. During the 3rd trimester of pregnancy (after 32 weeks), the breast lobules mature into type 3 lobules.  Type 4 are formed after childbirth and produce milk.  Both type 3 and type 4 lobules are resistant to carcinogens.  During the first two trimesters of pregnancy, under the influence of estrogen levels which rise 2000%,  the breast grows with an increase in the number of immature type l and 2 lobules. If a woman has an abortion, she is left with this increased number of  immature lobules which are susceptible to cancer.  This information was provided to the VLRC in the booklet “Breast Cancer  Risks and Prevention” by  breast surgeon,  Dr. Angela Lanfranchi, MD, FACS and Dr. Joel Brind. Professor of Endocrinology. There is no scientific study whatever which refutes this biological explanation of abortion as a cause of breast cancer.

 

 

(dd)  The results of a study in 1989 by Howe and others on women in New York State showed the risk.  The methodology of this study was impeccable.  The results revealed a statistically significant 90% higher incidence of cancer among women aged under 40 who had had an abortion as compared with the matched control group who had not had abortions. (Howe HL, Senie RT, Bzduch H et al. Early abortion and breast cancer risk among women under age 40. Int. J. Epidemiol. 1989;18:300-304.) 

 

(ee)  There was a study by Daling and others of 1994. Daling found that every woman in this study who had an abortion under age 18 and who also had a family history of breast cancer developed breast cancer by the age of 45.  Janet Daling is pro-choice but considered it very important that women should be made aware of this risk.  (Daling JR, Malone DE, Voigt LF, White E, Weiss NS. Risk of breast cancer among young women: Relationship to induced abortion. J. Natl. Cancer Inst. 1994;86:1584-92.)

 

(ff)  There was a French study by Andrieu and others of 1995.  This was a combined analysis of six case-control studies demonstrating a higher incidence of breast cancer amongst women who had had abortions.  It also revealed for the first time the study in Australia by TE Rohan 1988, which had shown abortion was the greatest risk factor for breast cancer – a relative risk of 2.6. (Andrieu N, Duffy SW, Rohan TE et al. Familial risk, abortion and their interactive effect on the risk of breast cancer: A combined analysis of six case-control studies. Br. J. Cancer 1995;72:744-51.)

 

(gg)  There was a study by Howe and others (2001) mainly covering the period 1987 to 1998.  This study showed that the entire increased incidence of cancer among women was due to breast cancer in women under age 65, i.e. the generation which had far more abortions in the wake of Roe v. Wade. (Howe HL, Wingo PA, Thun MJ et al. Annual report to the nation on the status of cancer, 1973 through 1998, featuring cancers with recent increasing trends. J. Natl. Cancer Inst. 2001;93:824-42. Figure 3.)

 

(hh)  A study by Patrick Carroll, a British actuary, was published in October 2007 in the Journal of American Physicians and Surgeons.  The VLRC was also provided with an associated Press Release.  The author, using national cancer registration data for breast cancer incidence in eight countries, that also have comprehensive data on abortion incidence, found that, of all the known risk factors for breast cancer, induced abortion is the best predictor of breast cancer.  In countries where there is a high incidence of abortion there is a high incidence of breast cancer.  Where there is a low incidence of abortion there is low incidence of breast cancer. (Carroll PS. The breast cancer epidemic: Modeling and forecasts based on abortion and other risk factors. Journal of American Physicians and Surgeons 2007;12(3):72-8.)

 

(jj)  The VLRC was also provided with the Endeavour Forum Inc. paper (enclosure C) “What every woman in the world has a right to know”  (which  is distributed at UN conferences and NGO meetings  and is available in several languages)  and which explains both the protective effect of a full-term pregnancy and the increased risk of breast cancer caused by abortion.

           

(kk)  The VLRC was also  provided with a leaflet  "Why Aren't Women being Told" produced by the Coalition on Abortion/Breast Cancer

           

(ll)   A DVD on the  "Abortion Breast Cancer Link"   (enclosure F) was provided to the VLRC  which included testimonies from women who had abortions and had developed breast cancer.

 

(mm)    A further submission to the VLRC   included an article by Dr. Angela Lanfranchi: “Abortion and Breast Cancer: The Link that Won’t Go Away”.  Dr. Lanfranchi who is Clinical assistant Professor of Surgery at the Robert Wood Johnson Medical School, New Jersey, has noted that the incidence of breast cancer  is increasing among young women and that  cancers associated with a history of induced abortion  appear to be  more aggressive.

 

(nn)  There have been three cases in Australia where women sued for both the failure to warn of the breast cancer link and also the failure to warn of the risk of psychological harm which have been settled at mediation and also a similar case in Pennsylvania in November 2003.

 

(oo)  There has been an even more significant case brought in Portland, Oregon.  A 15 year old girl was not informed of the abortion breast cancer risk.  When the case came on for hearing on 24 January 2005 the All Womens Health Services Clinic admitted there was a link and that they had failed to warn of it.  Judgement was entered against the Clinic and the amount of damages was subsequently agreed. (F.B v. All Womens Health Services. Multnomah County Circuit Court Case # 0307-07422.)

 

(pp)  A number of states in U.S.A. in their mandatory information legislation required a warning of the breast cancer risk.  The Disclosure and Consent form of Texas abortion clinic “Women’s Health Centre” San Antonio Texas lists as a risk “possible increased lifetime risk of breast cancer.”

 

   The VLRC in its “Law of Abortion: Final Report” was dismissive of this information and evidence on the abortion/breast cancer risk, (a very serious community health issue, and its impact on public revenue)  with the following, at paragraph 3.34 in Chapter 3 “Current Clinical Practice”:-

 

   “Some submissions pointed to particular risks associated with abortion, such as … an increase in breast cancer risk.  A recent UK parliamentary report on scientific developments relating to abortion … found no causal connection between abortion and the other risks raised.” (these included breast cancer).

 

   The VLRC did not reveal in its Report that it had received all this information on the ABC link, but merely made the above  brief comment.

 

l. (c) Infertility

Independent of the difficulties in bearing children caused by damage to the cervix and uterus which is discussed in l (d) below, the VLRC had evidence that abortion can cause infertility.  Amongst other evidence the VLRC was referred to

(aa)  The opinion of the Elliott Institute, Illinois, that one possible outcome of abortion related infections is infertility.  Researchers have reported that 3 to 5 percent of aborted women are left inadvertently sterile.  (Wynn and Wynn  "Some Consequences of Induced abortion to Children Born Subsequently":  British Medical Journal, March 3, 1973, and David Reardon "Aborted Women Silent No More", Chicago, Loyola University Press 1987.)

(bb)  The fact that women who acquire post-abortal infections are 5 to 8 times likely to experience ectopic pregnancies.  Between 1970 - 1983 the rate of ectopic pregnancies in the USA has risen 4-fold.  Other countries which have legalised abortion have seen the same dramatic increase in ectopic pregnancies.

(Hilgers: "The Medical Hazards of Legally Induced Abortion" in Hilgers and Horan eds Abortion and Social Justice, (New York: Steed and Ward 1972) and Wilke "Abortion Questions and Answers" (Cincinatti, Hayes publishing Co. 1985).

(cc)  Three further papers on induced abortion being a risk for female infertility, namely

(i)  Ring-Cassidy E, Gentles I. Women's Health after Abortion: The Medical and Psychological Evidence, 2nd edn. Toronto, Canada: The deVeber Institute for Bioethics and Social Research, Apr 2003. Available from URL: http://www.deveber.org/text/whaa-chapters.html [Accessed 26 September 2007].

(ii)  Heisterberg L, Kringelbach M.  "Early complications after induced first trimester abortion".  Acta Obstet. Gynecol. Scand. 1987;66(3):201-4, pp. 204.

(iii)   Frank P, McNamee R, Hannaford PC, Kay CR, Hirsch S. "The effect of induced abortion on subsequent fertility". BJOG 1993 Jun;100(6):575-80.

These articles assert that infertility research clearly shows that abortion  can lead to problems for women who wish to conceive.

(dd)  The fact that a number of states in the USA in their mandated  information legislation require warning of the risk of subsequent infertility.  The Disclosure and Consent Form of Texas Abortion Clinic "Women's Health Centre", San Antonio, Texas, supplied to the VLRC lists as a risk
"(e) sterility or being incapable of bearing children."

(ee)  In the Confirmation and Consent Form of Planned Parenthood of Australia provided to the VLRC the following complication is listed:

"Asherman's syndrome (cessation of periods and adhesions in uterus that may impair future fertility".

Without  citing any studies which refute all this evidence of the risks of future infertility, the  VLRC Report said at p. 117 para 8.55 that the current medical and scientific consensus was that this was not a material risk.


1 (d) Damage to Cervix and Uterus with Resulting Preterm Births in Subsequent Pregnancies with Concomitant Problems Including Cerebral Palsy

 

   The VLRC was provided with information and evidence that abortion increases the risk of premature birth in subsequent pregnancies.  Abortion can result in infections and damage to the cervix and uterus.  Evidence was included that premature birth increases the risk of a range of complications, including devastating cases of cerebral palsy.  The damage to the uterus can also cause problems during the full-term delivery of subsequent births which may result in the child being born with cerebral palsy.  Amongst other evidence, the VLRC was referred to

 

(aa)  The identification of the risk by Dr Greg R. Alexander in 2006 in the medical text of the very prestigious Institute of Medicine’s Preterm Birth: Causes, Consequences and Prevention of “Prior first trimester induced abortion” as an “Immutable Medical Risk Factor Associated with Preterm Birth”. (Behrman RE, Butler AS [eds]. Preterm Birth: Causes, Consequences and Prevention. Committee on Understanding Premature Birth and Assuring Healthy Outcomes, Board on Health Sciences Policy, Institute Of Medicine of the National Academies, The National Academies Press, Washington, D.C., U.S., 2007;625:Appendix B;Table B-5.)

 

   This is supported by overwhelming epidemiological evidence, including four studies to which the VLRC was referred, those by

 

(bb)  Lumley of 1998, which is a large study based on Victorian data. (Lumley J. The association between prior spontaneous abortion, prior induced abortion and preterm birth in first singleton births. Prenat. Neonat. Med. 1998;3:21-4.)

 

(cc)  Rooney and Calhoun of 2003. (Rooney B, Calhoun BC. Induced abortion and risk of later premature births. Journal of American Physicians and Surgeons 2003;8(2):46-9.)

 

(dd)  Ancel and others of 2004. (Ancel P-Y, Lelong N, Papiernik E et al. History of induced abortion as a risk factor for preterm birth in European countries: Results of the EUROPOP survey. Hum. Reprod. 2004;19(3):734-40.)

 

(ee)  Calhoun and others of 2007. (Calhoun BC, Shadigian E, Rooney B. Cost consequences of induced abortion as an attributable risk for preterm birth and impact on informed consent. J. Reprod. Med. 2007;52(10):929-37.)

 

   The study by Calhoun and others of 2007 lists 58 studies that found a statistically significant increase in risk of preterm birth from previous surgical induced abortions.

 

   The book Preterm Birth: Causes, Consequences and Prevention also reveals that preterm birth constitutes a risk factor for many conditions and complications, including respiratory distress syndrome, chronic lung disease, injury to the intestines, a compromised immune system, cardiovascular disorders, hearing and vision problems, neurodevelopmental disabilities and cerebral palsy.

 

   The 2003 Rooney and Calhoun study that confirms that induced abortion elevates the future risk of preterm delivery, which constitutes a risk factor for complications such as cerebral palsy, concludes with a discussion of liability and informed consent.  The VLRC was informed that this article was the key to the State of Texas in the U.S. requiring that abortion providers in that State warn women about the prematurity risk for subsequent pregnancies.  A key point in this study that convinced the Texan authorities was data from the 1998 Lumley study, which is based on the Victorian population and which reveals an 800% boost in relative risk of extremely preterm birth for women with more than three prior abortions.  The Texas warning mentions the 800% figure.  (See also (kk) below.)

 

   Neonatal care of premature babies is one of the most costly sectors of the health system.  The 2007 study by Calhoun and others found that induced abortion increased the early preterm birth delivery rate by 31.5%.

 

(ff)  The VLRC was provided with a copy of a Press Release which accompanied publication of this study, which revealed that the short term hospital costs in U.S. in 2002 for babies born under 32 weeks gestation, whose preterm delivery was attributable to their mothers’ prior induced abortions, was $U.S.1.2 Billion and there were 1,096 excess cases of babies born under 32 weeks gestation with cerebral palsy.  This cost does not include long-term medical, social and economic costs, including loss of earnings by those born with life-long handicaps resulting from induced abortion attributable to preterm birth.  The Press Release revealed that “the cerebral palsy damage just to U.S. newborns since 1980 is at least quadruple the birth defect damage caused to newborns by Thalidomide worldwide”.

 

(gg)  The VLRC was informed of  Bruce v. Kaye in the NSW Supreme Court and decided in April 2004.  (NSW Supreme Court Bruce v. Kaye 2004 NSWSC 277 (8 April 2004).)  In this case Dr Alan Kaye was found not responsible for causing cerebral palsy in Kristy Bruce who was born with this condition.  Kristy had sued her mother’s obstetrician, Dr Kaye, on the basis that he had allowed the pregnancy to go on beyond term.  Justice Grove found that it was unlikely that the cerebral palsy was caused by Dr Kaye’s obstetric care, but that the mother’s uterus had ruptured, depriving Kristy of oxygen, due to a previous induced abortion her mother had had, of which she had not told the obstetrician.  Justice Grove said that it was only the obstetrician’s skill that had saved both mother and baby.

 

(hh)  The VLRC was informed of law reform in other jurisdictions to lessen health effects of abortion.  In the early 1970s the Hungarian Government rewrote its abortion law, resulting in a reduction in abortions by 40% between 1973 and 1974.  This followed alarm at the striking increase in premature births to women with a record of induced abortion, and concern also at the striking increase in physically and mentally handicapped babies born to such women.  In 2003 the Russian Government introduced sweeping legislation to enforce stringent criteria before a woman can be approved for an induced abortion.  The health impact of abortion on women and their subsequent children was a major thrust behind this legislation. (Ring-Cassidy E, Gentles I. Women's Health after Abortion: The Medical and Psychological Evidence, 2nd edn. Toronto, Canada: The deVeber Institute for Bioethics and Social Research, Apr 2003.)

 

(ii)  In the Confirmation and Consent form of Planned Parenthood of Australia the following complications are listed

 

(i)              a tear in the cervix that may require stitching

(ii)            perforation of the wall of the uterus – that may require surgery

(iii)          incompetent cervix/stenosed cervix (too tight or too loose cervix which may impair future fertility)

(iv)          Asherman’s syndrome (cessation of periods and adhesions in uterus that may impair future fertility).

 

(jj)  A number of states in U.S.A. require warnings of these risks.  The Disclosure and Consent form for Texas abortion clinic “Women’s Health Centre” San Antonio Texas lists the following risks

 

(b)       perforation (holes in) uterus ….

(d)       infection of female organs: uterus, tubes, ovaries, and

(f)        incompetent cervix.

 

   The VLRC was asked to establish an impartial medical panel to conduct a full public inquiry to which it would be possible to bring expert witnesses.  Instead, presented with this evidence, the VLRC in its report dismissed these very serious community health issues and their impact on public revenue with the following, at paragraph 3.34 in Chapter 3 “Current Clinical Practice”:-

 

   “Some submissions pointed to particular risks associated with abortion, such as: increased risk of psychiatric illness, self-harm or suicide; greater likelihood of miscarriage of future pregnancies, or pre-term birth; and an increase in breast cancer risk.  A recent UK parliamentary report on scientific developments relating to abortion found there was conflicting literature on the increased risk of future miscarriage or pre-term birth.  A ‘large well-designed 2006 study’ showed no links, but other studies showed some links.  The inquiry recommended no change to the current Royal College of Obstetricians and Gynaecologists guidelines, which state that abortion may be associated with ‘a small increase’ in the risk of these outcomes.  The UK report found no causal connection between abortion and the other risks raised.”

 

   A large volume of evidence provided to the VLRC is that the increase in risk of preterm birth from induced abortion is statistically significant.

 

   The consequences are devastating.  Even one child’s life severely handicapped through complications from preterm birth is very serious – to the child themselves, to their family and to the community who, through payment of taxes, will be required to contribute to their medical and social care.  The VLRC relied on a U.K. inquiry’s findings, based on the Royal College of Obstetricians and Gynaecologists guidelines, of “a small increase” in risk of preterm birth.  This is a misleading understatement and an unreasoned dismissal of the evidence of the impact of the abortion/preterm birth risk.  Why, when Australia has some top level medical researchers, rely on U.K. reports?

 

(NOTE -

   An examination of the “recent U.K. parliamentary report” on which the VLRC  relied, the House of Commons Science and Technology Committee report Scientific Developments Relating to the Abortion Act 1967: Twelfth Report of Session 2006–07: Volume 1 (House of Commons, Science and Technology Committee, Scientific Developments Relating to the Abortion Act 1967: Twelfth Report of Session 2006–07: Volume 1, HC 1045–1 (2007) 44–49.), and the submissions to that Committee’s inquiry reveals that the “large well-designed 2006 study”, which is the only study to which the VLRC specifically referred in its dismissal of the scientific evidence for preterm birth risk, is a Finnish study by Raatikainen and others. (Raatikainen K, Heiskanen N, Heinonen S. Induced abortion: Not an independent risk factor for pregnancy outcome, but a challenge for health counseling. Annals of Epidemiology 2006;16:587-592.)

 

   Even if the Finnish study had been competently performed, it is absurd to imply that this Finnish study is more important than the scores of statistically significant studies, including the 58 listed in the study by Calhoun and others of 2007, finding higher risk of preterm birth and/or low birth weight risk.

 

   This Finnish study has been analysed by a co-author of several of the studies to which the VLRC was referred, Mr Brent Rooney MSc (Master of Science).  As a contribution to evidence on the abortion/preterm birth risk it has been found to be of negligible value.  The rate of very early preterm births, or births of infants with very low birth weight, is the major predictor for neonatal death rates and for severe complications in surviving children.  But the Finnish study provides no data for very early preterm birth or very low birth weight for women with prior induced abortions.  Thus, the Finnish study did not address the critical question of whether prior abortions increase the risk of very early preterm births.  Further, the Finnish study misreports a 2001 French study published in the British Journal of Obstetrics and Gynaecology as finding no abortion premature birth risk. (Henriet L, Kaminski M. Impact of induced abortions on subsequent pregnancy outcome: The 1995 French national perinatal survey. BJOG 2001;108(10):1036-42.)  It also misreports a 1999 study by Zhou and others of Danish women, claiming that it reported no abortion premature birth risk. (Zhou W, Sorensen HT, Olsen J. Induced abortion and subsequent pregnancy duration. Obstet. Gynecol. 1999;94:948–953.)

 

   The costs to the hospital and health systems, the Federal and Victorian Governments and, ultimately, the taxpayers of these health effects must be very great and would increase if abortion were legalised.)

 

 

ADDENDA

 

Although the British Journal of Obstetrics and Gynaecology is loath to publish any material suggesting abortion elevates the preterm labour risk, an e-mail by its Editor-in-Chief, Dr Philip Steer, to a colleague inadvertently reached the public domain.  In the e-mail he said “… the link between TOP (termination of pregnancy) and preterm labour … none of us dispute, the evidence is already overwhelming”.  Many British gynaecologists would have performed abortions or referred patients for abortions without any warning of this risk.  In these circumstances one can understand the reluctance of the College to publicly admit this risk.

 

 

 

 

 

 

 

Member Organisation, World Council for Life and Family

NGO in Special Consultative Status with ECOSOC of the UN