October 20, 2012
Abortion: How Safe is Safe?
By Lyn Smith
Abortion advocates frequently use the criterion, when discussing abortion, that they be “safe and legal”. The question should be, “safe for whom”? For the 100,000 Canadian babies aborted annually in Canada, there wasn’t any safety factor, only certain death. So, the question now becomes does the word “safe” truly apply for the mothers whose pregnancies were ended by abortion?
Prior to 1969 abortions were not legal in Canada. With the liberalisation of the law in 1969, abortions were permitted “if the continuation of the pregnancy would likely endanger the life or health of the mother.” This, despite the numerous statements from physicians such as Dr. Roy Heffernan, then president of the American Medical Association and Dean of Tufts Medical School who stated in a 1951 presentation to the American College of Surgeons that ” anyone who performs a therapeutic abortion is either ignorant of modern methods of treating the complications of pregnancy or unwilling to take the time to use them.” Dr. Everett Koop, M.D., former Surgeon General of the U.S. said “In my thirty six years in pediatric surgery, I’ve never know of one instance where the child had to be aborted to save the mother’s life.”
Actually, the word “health” was never clarified and the definition formulated by the World Health Organization became a standard to justify abortion: “health is a state of emotional and social well being and not merely the absence of disease and infirmity.” Abortion proponent Dr. Alan Guttmacher said in 1967, “Today it is possible for almost any patient to be brought through any pregnancy alive, unless she suffers from a fatal illness such as cancer or leukemia, and if so, abortion would be unlikely to prolong, much less save, life.”
In 2017, the Dublin Declaration on Maternal Healthcare stated “As experienced practitioners and researchers in obstetrics and gynaecology, we affirm that direct abortion – the purposeful destruction of the unborn child – is not medically necessary to save the life of a woman.”
The Canadian Institute for Health Information (CIHI) reported 83,576 abortions for 2019. However, a freedom of information request revealed a discrepancy in the number of abortions for the province of Ontario. CIHI reported 27,911 abortions for Ontario but the Ministry of Ontario for Health and Long term Care disclosed 46,189 abortions for 2019. CIHI statistics are missing 18,278 abortions for Ontario. Hence, the total number of abortions for the country is most likely 101,854 abortions. The exact number of abortions is unknown since clinics report to CIHI on a voluntary basis.
In 2019 a total of 24,852 induced abortions were reported for Canadian hospitals (excluding Quebec hospitals), most of which were done on women on an out-patient basis. Similarly, 58,724 induced abortions were performed in clinics requiring about a two to four hour stay. In 2019, the majority of abortions were clinic abortions.
It should be noted that unless there are immediate complications at the time of the induced abortion, there is never any long term follow-up of a woman’s medical condition after her abortion. Nevertheless, the 2019 statistics indicate that in the case of hospital abortions (excluding Quebec), 400 women experienced complications. Complications were reported for 2.3% of hospital abortions. These hospital statistics are incomplete, as information is not available for 7,431 of the hospital abortions performed. The situation of non- information is even worse in the case of complications incurred during clinic abortions. No figures are provided, despite the fact that clinic abortions represent 70% of all abortions performed in Canada. CIHI states that “information on complications is not available from clinic data or Quebec data.”
Complications listed by CIHI for hospitals (excluding Quebec) within 28 days of initial induced abortion were: hemorrhage (0.9%), infection (0.3%), retained products of conception (0.4%), Combination (0.2%) and other (0.5%). CIHI notes that “complications that occur during the initial visit or hospitalization, as well as complications on subsequent visits, transfers or readmissions for cases where the health number was not recorded during the initial visit or hospitalization are not included: Complications may therefore be undercounted.”
According to international research examined by the deVeber Institute for Bioethics and Social Research, “immediate complications occur in 3.4 to eleven per cent of surgically-induced abortions, depending on the jurisdiction.” A 2011 study by the Project for an Ontario Women’s Health Evidenced-Based Report (POWER) found: “Overall in Ontario, emergency department/same-day surgery visits or hospitalizations within fourteen days and for any reason were observed after 4.5% of abortions, [while] 0.4% of abortions resulted in hospitalization.” The Institute notes that “while 4.5% was the average complication rate, the range of complication rates was 5.2% for women aged fifteen to nineteen years, and 3.5% for women aged 40 to 49 years. These rates do not include complications handled by attending physicians, community health clinics or nurse practitioners in a community practice.”
The deVeber Institute reports on the findings of other studies showing that:
- Women who undergo an induced abortion later suffer a higher rate of Pelvic Inflammatory disease (PID) than the general population.
- Evidence linking ectopic pregnancy to previous induced abortion is overwhelming.
- Women who have had one or more induced abortions have a significantly higher rate of prematurity or preterm birth, and lower birth weight in subsequent pregnancies.
- The rate of complications following medical (drug induced) abortion is up to four times higher than for surgically induced abortions.
- There are now 57 studies that show a positive association between abortion and breast cancer, of which 34 are statistically significant. (1)
It is a fact that physical complications have been associated with abortion including perforation of the uterus, infection, hemorrhaging, cervical laceration and an inability to carry a subsequent pregnancy to term. We also know from women who have gone public about the aftermath of abortion on their lives that there is long term psychological trauma: guilt, depression, anxiety, feelings of hopelessness, lowered self-esteem, hostility, insomnia, suicidal feelings, drug dependency and difficulties with family and sexual relationships. Such conditions cry out for the need to undertake in-depth and objective studies to determine the nature of any delayed reaction to abortion. We owe this much to Canadian women!
After the 1969 abortion law was struck down in 1988, the number of reported abortions rose from just over 70,000 in 1987 to 106,255 in 1994. There are at least 100,000 abortions annually in Canada. Today one pregnancy in five ends in abortion and the number of repeat abortions reported by hospitals in 2019 (excluding Quebec) was 25.6%. The number of previous induced abortions was unknown for 4,769 hospital abortions and for clinic data. Statistics Canada once estimated that if the 1993 rate for first time abortions continued, one woman in three would undergo an abortion in her lifetime (34%). Abortion is having a major impact on women’s lives and, it would seem, also on their health.
As far back as 1957 the scientific literature has reported a positive association between the termination of a first pregnancy by induced abortion and the increased risk of developing breast cancer. Researchers around the world have long acknowledged that women who carry their first baby to term reduce their risk for breast cancer by almost one-half. A women’s first full term pregnancy initiates hormonal changes which permanently alter the structure of the breasts. If, however, there is a premature interruption of this pregnancy by an induced abortion in the first trimester, the maturation process is not completed, leaving the less stable transitional cells with a greater potential of becoming cancerous. Most abortions are done in the first trimester and 34.8% of hospital abortions (excluding Quebec) are done on women with no prior delivery. Information on the number of previous deliveries is not available from clinic data and from Quebec data.
The scientific literature indicates that women who abort their first pregnancy increase their risk of breast cancer and repeat abortions, particularly without an intervening delivery, escalate the risk. Since one woman in nine will suffer from breast cancer during their life time, the necessity of compiling accurate medical records for any woman undergoing an abortion is obvious. The necessity of informing women of existing research which shows the positive association between induced abortion and an increased risk for developing breast cancer is imperative.
While acknowledging that many women will experience no adverse physical or psychological effects from induced abortion, the documented risks are real and women have a right to this information.
The word “safe,” when applied to abortion, seems to be a misnomer.
(1) The deVeber Institute for Bioethics and Social Research. Complications: Abortion’s impact on women. 2nd edition: revised and updated, 2018.
Updated: October 2021
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