Life Issues Connector
April 2006

Abortion VS Childbirth
Which is Safer?

By J.C. Willke, MD

Throughout the years of the controversy over abortion, those who favor it have relentlessly sounded one continuous note, i.e. “Abortion is safer than childbirth.” This was a central reason given in Roe vs Wade for the legalization of abortion. It continues to be one of their central arguments as they continuously repeat that “abortion is seven times safer than childbirth.”

To say that this is a difficult question to answer accurately, is a gross understatement. Let’s first list reasons why it is difficult to nail this down. They include:

Looking at the above, one is tempted to comment that the comparison of abortion deaths to childbirth deaths is not only comparing apples with oranges, but has so many qualifying factors and unknowns that any type of reasonably accurate comparison is all but impossible. Because of the above factors we can start by dismissing out of hand the abortion industry’s often repeated claim that “abortion is seven times safer than childbirth.” This is pure nonsense and has no basis in fact. To find our way through this, let’s explore the above areas one at a time and see if we can come to an accurate answer.

Let’s start with maternal mortality. A United Nations agency has recently inaccurately reported that in the US there are 17 maternal deaths for every 100,000 live births. The US Center for Disease Control (CDC) has been reporting a very slow decrease, now down to approximately 6 deaths. However, the Council on Scientific Affairs of the American Medical Association a few years ago noted that if deaths, other than those associated with delivery, were eliminated, the figure would be closer to 4.5. What are these “others?” Maternal mortality reported in the US includes deaths from induced abortion, tubal pregnancy and molar pregnancy. It also includes deaths from heart disease and high blood pressure, which may only be peripherally related to delivery. In some states it includes any death that occurs within a certain time frame after she delivers her child. These can conceivably even include deaths from trauma. So, when we speak of maternal mortality we cannot accept the typically reported figures. If we compare it only to childbirth, then the reported figure should be lower, perhaps closer to four.

If we would ask what the death rate was from prostate surgery, we would look into the medical literature, examine various reports of series of cases, and find that there is a fairly narrow range in death rates reported in the literature. We accept this on every surgical procedure done except abortion. Abortion is different. With few exceptions, studies about surgical death rates from induced abortion come from university medical centers. In these hospitals we have skillful surgeons, top notch surgical procedures and follow-up and accurate reporting. These accurately reflect the maternal mortality rate from abortions done in university medical centers. But these constitute less than 5 percent of the induced abortions done in America. Over 90 percent are done in freestanding abortion centers. With almost no exceptions, these abortion mills have no supervision, are not state inspected and are not required to have emergency resuscitation equipment. They have inadequate ambulance facilities, often have no RN’s on duty and, most importantly, no qualified surgeon to do the work. The only requirement to do abortions in almost every state is an MD or a DO degree. You can be a dermatologist and open an abortion facility. You can be a hack, denied surgical or even admitting privileges in any hospital, and still do abortions. In fact, many abortionists are these kinds of incompetent doctors. The point to be made here is that the standard of care in the typical freestanding abortion facility doesn’t remotely compare to the standard of care at a university hospital. Therefore the complication and death rate reported at the university center is not remotely comparable to what it is in that freestanding abortion mill.

The other factor, that is totally obvious, is these freestanding facilities don’t report any complications. There are no accurate scientific studies of the safety of abortions in these abortion mills. When there is a complication, e.g., severe bleeding, she is rushed to the local legitimate hospital where she is taken care of by legitimate physicians. Commonly, her discharge diagnosis often doesn’t even mention abortion as the cause for her hemorrhage. One reason for this is that she commonly denies she had the abortion and if the attending physician is not absolutely sure, he may hesitate to mark down abortion as a cause of the problem.

But there are other dynamics in play. I recall once when a pro-life surgeon friend of mine had treated a girl who had been badly butchered by an abortionist and had died in spite of my friend’s efforts. He did not put abortion down on the death certificate. I asked him why. He said: “That family has suffered enough and I’m not going to add to their woes by revealing that she had an abortion.”

Another reason for mal-reporting is the occasional abortionist who does have hospital privileges. He injures a girl, then treats her himself in the hospital. Whether she lives or dies, it is certainly not in his interest to mark down abortion, for he would hurt his own reputation. Therefore he’ll put down a different diagnosis.

And what about reporting from individual states? Reporting about childbirth and delivery is accurate enough at the state level, but reporting about abortions and their complications is an entirely different matter. The number of abortions done is supposed to be reported to the Center for Disease Control, but there are a number of states that don’t comply. This, incidentally, includes California. The state that doesn’t even report abortions, certainly is not going to be reporting any sort of statistically relevant information about complications. So a high percentage of abortion complications are never reported.

But that isn’t the only problem. There is also the Center for Disease Control itself. Originally, its abortion-reporting area was supervised by doctors Cates and Grimes. Both were doing mid-trimester abortions, moonlighting at a local Atlanta hospital. Cates wrote an article for a medical journal proposing how to set the fee for an abortion. He suggested measuring the length of the fetal foot and charging accordingly. Grimes has gone to California but has remained one of the chief apologists for abortion-on-demand in the US. The exposé of the CDC occurred in the book, Lime 5, by Mark Crutcher (1996 p. 135). His devastating critique of the accuracy of CDC’s reporting is best detailed in his own words: “Here at Life Dynamics we knew abortion complications were grotesquely underreported, but attributed it to garden variety, bureaucratic incompetence. As our research continued, however, we became suspicious that the flawed abortion data being released by the CDC was the product of dishonesty and manipulation. By the time we discovered that a large percentage of CDC employers had direct ties to the abortion industry, we were no longer suspicious; we were convinced. CDC actually stands for Center for Damage Control. It doesn’t oversee abortion, it justifies it. CDC’s role is to eliminate medical opposition to abortion.” Not long after enough light was shown on this unsavory operation, the CDC discontinued reporting statistics on anything relating to abortion complications and confined itself to simply reporting the number of abortions that it received from the states that did report.

Direct Surgical Complications
Let’s look at hepatitis as a good example of a surgical complication of abortion. Here is a woman who had an induced abortion. As a result, she had gross hemorrhage and needed blood transfusions. She recovered, but later developed hepatitis from the blood transfusion. In her case, she ultimately died of hepatitis. This was a direct result of the induced abortion; however, abortion was not reported as the cause of death.

Another woman had an induced abortion at which time the abortionist, using his loop-shaped steel knife, a curette, cut so deeply while scraping the inside of the womb, that part of the lining of the womb was replaced by scar tissue. In a subsequent pregnancy, the placenta (the afterbirth) would not separate because of this scarring. This can be a cause of major hemorrhage and death. More common would be the inability to remove that placenta, necessitating the removal of the uterus. This would certainly be a direct complication of the abortion, but would not be reported as such.

One obvious complication most of our readers are familiar with is the damage to the cervix from an induced abortion. This donut-like muscle closes the door on the uterus and then prevents the developing baby from falling out. Normal labor slowly opens the cervix, allowing delivery of the child. But if the cervix is damaged by the dilatation required for an induced abortion, it can and does open prematurely, allowing the too-soon birth of the developing baby. Premature babies die more often than full-term babies and have more medical complications. Premature birth is sometimes a direct result of induced abortion. This is certainly a complication that would not be listed as such.

What about chemical abortions? RU-486 is relatively new on the scene. There has been substantial, recent publicity about the 10 maternal deaths from this drug. What has received less publicity has been details obtained from the Food and Drug Administration. It reported over 600 adverse effects by women taking this drug. These included 220 cases of hemorrhages, 71 of which were life threatening and required blood transfusions. Also, 392 women needed surgery to repair damage from the abortion, many under emergency conditions. Note that this was the FDA reporting, not the CDC.

Other Complications and Sequelae
To think only of the possible problems directly associated with abortion and delivery in their immediate aftermath is to take an extremely narrow view and to miss most of the problems. Investigations in past years did take that narrow view, and since there are no studies of what actually happens in the 90 percent of abortions done in freestanding abortion facilities, these studies are uninformative. More recently, we have had a large series of studies taken from official government records that have followed women for a number of years after the procedure. When confounding factors are eliminated, a picture has emerged of a broad spectrum of problems resulting from abortion. Let us list some:

Maternal Deaths: Compared to childbirth, women who have abortions have an elevated risk of death later from all causes. This persists for at least 8 years. A higher risk of death from suicide and accidents are most prominent. Projected on the national population, this effect may contribute to 2000-5000 additional deaths among women each year. ¹

Psychiatric Hospitalization: A review of the medical records of 56,741 Medicaid patients revealed that the women who had had abortions were 160 percent more likely to be hospitalized for psychiatric treatment in the first 90 days following abortions, as compared to those who delivered. Rates of such treatment remain significantly higher for at least 4 years.

Clinical Depression: Compared to women who carry their first unintended pregnancy to term, women who abort their first pregnancy are at a significantly higher risk of clinical depression, as measured in an average of 8 years after their first pregnancy.³

Substance Abuse: Compared to women who carry to term, women who abort are 5 times more likely to subsequently abuse drugs or alcohol.⁴

Outpatient Psychiatric Care: Analysts of California Medicaid records show that women who have abortions will subsequently require significantly more treatment for psychiatric illness through outpatient care.⁵

Effect on Children: The children of women who have abortions, have less supportive home environments and more behavioral problems than the children of women without a history of abortion. This finding supports the view that abortion may negatively effect bonding with subsequent children and disturb mothering skills. It may not only have such negative effects upon the children, but in very significant ways impact women’s psychological stability.⁶

Substance Abuse During Subsequent Pregnancies: Compared to women delivering their first pregnancy, women with a history of abortion are five times more likely to use illicit drugs and two times more likely to use alcohol during their next pregnancies. Besides the negative effects on the women, these substances place their unborn children at risk of birth defects, low birth weight and death.⁷

Long Term Clinical Depression: Analysis of a federally funded longitude study of American women revealed that women who aborted were 65 percent more likely to be at risk of long-term clinical depression, after controlling for age, race, education, marital status, history of divorce, income and prior psychiatric state.⁸

Placenta Previa: After abortion there’s a 7 to 15-fold increase in placenta previa in subsequent pregnancies. This abnormal development of the placenta is due to damage to the lining of the womb from the abortion. It can be fatal for the women. It also increases the risk of birth defects, stillbirth and excessive bleeding during labor.

Premature Birth: Premature birth is a well-documented after-effect of induced abortion. This is due to damage to the cervix, which results in an increased incident of premature births. Preemies die more often than full term babies and have more frequent disabilities resulting from the premature birth. Such problems obviously have continuing negative emotional impact on the women.

Ectopic Pregnancy: Women have an increased risk of subsequent tubal (ectopic) pregnancies. These can be life threatening; they also reduce future fertility.

Other Post-Abortion Problems: Thirty to fifty percent of such women report experiencing sexual dysfunction such as promiscuity, loss of pleasure from intercourse, increased pain and aversion to sex and men. Women with a history of abortion are significantly more likely to subsequently have shorter relationships and divorce more often. Women with a prior abortion are four times more likely to have a repeat abortion in the future than those who have no abortion history. Note: 45 to 47 percent of all abortions are now repeat abortions.

The significant increase in breast cancer among women who have had abortions is well known. With a higher rate of Human Papilloma Virus (HPV) infections, they also have a higher risk of cervical cancer. Since smoking is sharply increased among post-abortion women, one could anticipate a possible greater incident of lung cancer.

And finally, one cannot overlook the fact that 10 percent of women suffer immediate complications. These include infection, hemorrhage, cervical injury, blood clots, anesthesia complications, chronic abdominal pain, Rh sensitization, gastro-intestinal disturbances, vomiting, fever and occasionally, endotoxic shock.

Note that while many of the above complications fall under the sequelae included under “Post-Abortion Syndrome,” there is much, much more guilt, distress and heartbreak not directly reflected in the above.

Conclusion
We now have enough definitive studies about women who’ve had abortions to totally refute any attempt by pro-abortion zealots to claim that abortion is safer than childbirth. The above complications are an incomplete list, but space prevents further elaboration.

Our thanks go to Dr. David Reardon, Director of the Elliot Institute, who is the author of most of the studies quoted above. To contact the Elliot Institute for more documentation, visit www.afterabortion.org.

¹ Southern Medical Journal 2002
² Pregnancy Associated Deaths in Finland 1987 - 1994, M. Gissler At All Acta Obstet. Gynecal. Scandi 76, 1997, p. 651-657, graphs from Elliot Institute.
³ British Medical Journal 2002
⁴ American Journal of Drug and Alcohol Abuse 2000
⁵ American Journal of Ortho Psychiatry 2002
⁶ Journal of Child Psychology and Psychiatry 2002
⁷ American Journal of Ob-Gyn 2002
⁸ Medical Science Monitor 2003