(A3a4a1b) Brent Rooney's folder

As of this date, 06-02-05, this folder contains 1 item. ******* item 1 ASSUMPTIONS CLOUD ABORTION QUESTION (VANCOUVER SUN ARTICLE) **************************************************************************************************************************************** ******* item 1 ASSUMPTIONS CLOUD ABORTION QUESTION (VANCOUVER SUN ARTICLE) ******* Date: Sat, 4 Feb 2006 From: "brent rooney" ******* I find the abortion debate absurd. Once one honestly recognizes IA as DANGEROUS Medical QUACKERY, what is there to debate? What % of Canadians would agree with "A woman's right to choose .... DANGEROUS Medical QUACKERY"? ******* In May 2002 I objectively demonstrated that IA (Induced Ab.)was quackery in the medical journal Ars Medica (see P.S.). ******* Cheers, Brent ******* P.S. Ars Medica article ******* http://escuela.med.puc.cl/publ/ArsMedica/ArsMedica6/Art09.html ******* July 2005, The most important risks of elective abortion (for Spanish readers) - Brent Rooney ******* In 2002 the Chilean medical journal Ars Medica published my five part article about abortion risks; the URL: ******* http://escuela.med.puc.cl/publ/ArsMedica/ArsMedica6/IndiceArMedica6.html ******* Here is the English source that was translated into that article: ******* Rooney B, Is elective induced abortion healthy for women and their future newborn? Ars Medica [Spanish language] 2002;4(6):95-111 ******* [URL: escuela.med.puc.cl/publ/ArsMedica/ArsMedica6/IndiceArMedica6.html] ******* Is elective induced abortion healthy for women and their future newborn? Brent Rooney ******* [URL: escuela.med.puc.cl/publ/ArsMedica/ArsMedica6/IndiceArMedica6.html] ******* Part I: Overview and short term all-cause mortality risks ******* This paper will address the question of which is the safer option for young pregnant women in 'developed' countries, elective induced abortion or delivery. First to be considered will be ALL-CAUSE mortality in the short term of twelve (12) months after the end of pregnancy. ******* After that is addressed, three other risks will be considered: ******* Breast Cancer Suicide Preterm delivery of a subsequent pregnancy ******* ALL-CAUSE mortality in the short term of 12 months after pregnancy end ******* It is commonly believed that in the 'short term' (i.e. one year or less) that the mortality risk for the mother is much lower if she selects induced abortion than if she selects to deliver a child.1 This misunderstanding results from many medical professionals believing that 'maternal mortality' and 'all-cause mortality' are the same. Maternal mortality, as currently defined, excludes the following causes of death (which are included in all-cause mortality): ******* 1. accidents ******* 2. suicides ******* 3. homicides ******* 4. cancer ******* In the United States automobile and truck accidents are the number one cause of youth death between the ages of 15 years and 24 years.4 ******* Suicide is also an important cause of youth death. Thus, maternal mortality is a very poor substitute for all-cause mortality and any researcher comparing the death rates of women who selected induced abortion versus women who selected term births should use all-cause mortality. An all-cause maternal mortality study was done in 1997 and published in the top Scandinavian medical journal in field of obstetrics and gynecology.3 ******* From the data in that study the relative mortality risks (in the 12 months after the end of pregnancy) for women who delivered versus those who had induced abortions are easily computed for these Finnish women from the data provided in the 1997 report (3): ******* Table 1. Relative Maternal Death Risks (3) ******* Women who delivered / Women with Induced Abortion ******* Total mortality 1.0 / 3.52 [+252%] ******* Natural deaths 1.0 / 1.63 [ +63%] ******* Accidents 1.0 / 4.24 [+324%] ******* Suicides 1.0 / 6.46 [+546%] ******* Homicides 1.0 /13.99 [+1299%] ******* All of the above results are statistically significant. Any researcher who has assumed that the mortality risk from accidents or suicides would not differ between women who delivered and those who 'terminated' should be sobered by these results. In 1985 Kaunitz (et al.) reported on the United States maternal mortality for the years 1974 through 1978. Did the authors consider that deaths from vehicular accidents, suicides, homicides or malignant neoplasms should be included within the category of maternal deaths? "Injuries from vehicular accidents (41), were the most frequent unrelated (nonmaternal) cause of death reported among pregnant women. In addition there were 25 deaths from nontrophoblastic malignant neoplasms, 15 from suicide, eight from homicide, and 41 from other unrelated causes."2 Clearly, accidents, suicides, homicides, and cancer were excluded as causes of maternal death!2 In the 1997 study of Finnish women, those with induced abortions had a 324% higher risk of dying in an accident and 546% higher risk of dying via suicide (versus women who delivered); the homicide risk was 1299% higher for women who 'terminated' their pregnancy.3 The all-cause mortality in the twelve (12) months after the end of pregnancy was 252% higher in women who chose induced abortion compared to those carrying to term.3 ******* Women who delivered had a lower all-cause mortality than women not pregnant in the prior twelve months. I.E. women carrying to term have the lowest all-cause mortality of all.3 Your author is not aware of any study that contradicts the 1997 'Gissler' study. ******* Is long term all-cause mortality lower for moms? ******* One might suppose that in the short term women who deliver have lower all-cause mortality but possibly higher all-cause mortality in the long term. A 1988 British study reported that married women without children had a 16% higher all-cause mortality than women with children.5 ******* Much of the difference was due to differences in cancer risks.5 That single women were excluded from this study can provide no 'comfort' since it is well known that married women have a lower mortality risk than single women. ******* Nulliparous women have about double the risk of ovarian cancer as parous women.6 ******* Conclusion to Part I ******* Only ALL-CAUSE mortality studies can identify whether the mortality risk of elective induced abortion is safer or more dangerous for the mother than delivering a newborn. A 1997 Finnish study clearly found that women who terminated' their pregnancies had a 252% higher all-cause mortality in the twelve (12) months after pregnancy end than women who carried to term. 'Maternal mortality' is not 'all-cause' mortality. ******* Part I: References ******* 1 Cates W, Smith JC, Rochat W, Grimes DA. Mortality from Abortion and Childbirth. JAMA 1982;248:192-196 ******* 2 Kaunitz AM, Hughes JM, Grimes DA. Smith JC, et al. Causes of Maternal Mortality in the United States. Obstetrics & Gynecology 1985;65:605-612 ******* 3 Gissler M, Kauppila R, Merilainen J, Toukomaa H, Elina Hemminki E. Pregnancy-associated deaths in Finland 1987-1994 - definition problems and benefits of record linkage. Acta Obstet Gyn Scand 1997;76:651-657 ******* 4 McGinnis JM, Foege WH. Actual Causes of Death in the United States. JAMA 1993;270:2207-2212 ******* 5 Green A, Beral V, Moser K. Mortality in women in relation to their childbearing history. BMJ 1988;297:391-395 ******* 6 Whittemore AS, Harris R, Itnyre J. Characteristics Relating to Ovarian Cancer Risk: Collaborative Analysis of 12 United States Case-Control Studies, America J Epidemiology 1992;136:1184-1203 ........................................................................ Part II: The Two (2) Breast Cancer Risks of elective induced abortion (Brent Rooney) Breast Cancer researcher Nancy Krieger wrote, "Conversely, early age at FFTP [first full-term pregnancy] consistently has emerged as the strongest protective [against breast cancer] factor".1 It has been strongly suspected since the 17th century that 'something' about birth reduces breast cancer risk for the mother, since it was noted that nuns had a relatively high breast cancer risk; strict nuns do not deliver newborn. Was it the number of children, the duration of breast feeding, the age at last delivery, age at first birth, or something else that conferred BC risk reduction? The answer was delivered dramatically by Dr. Brian MacMahon (Harvard) and colleagues in 1970: age at first first full-term birth was the dominant BC reduction factor; note that it was not just pregnancy, but full-term pregnancies that conferred risk reduction.2 MacMahon et al. reported that women with a FFTP before age 20 years had 1/2 the BC risk as women with a FFTP after age 35.2 ******* The younger the age at FFTP, the lower the breast cancer risk.2 It is not productive when medical science issues become highly politicized. For almost a decade there has been a U.S. public debate whether there is an 'ABC' (Abortion-Breast-Cancer) risk. ******* As the question is framed, it is assumed by many that one and only one independent ABC risk is being claimed. This assumption is false. The debate is whether there is a 'second' independent abortion breast cancer risk "interrupted pregnancy"). What is well accepted is that there is a 'first' abortion-breast-cancer risk: medically postponed first full-term birth. Consider the following statement published in the Journal of the National Cancer Institute: "Scientists agree that a full-term pregnancy at a young age protects against breast cancer." (Troy Parkins (NCI employee), JNCI 1993;85:1987). ******* Each one year delay in FFTP increases BC risk ******* In 1983 Dimitrios Trichopoulos, Brian MacMahon et al. (via re-analyzing their 1970 data) reported that each one year delay in FFTP increased relative breast cancer risk by 3.5 percent (compounded).3 ******* How much breast cancer protection does an early first full-term birth provide? Compare a woman with a first full-term birth at age 20, versus women with later first full-term births (using the 'MacMahon' 3.5% figure): ******* Table 2. Age at first full-term pregnancy and relative BC risk ******* Age at FFTP / Increase in relative breast cancer risk (vs. FFTP at age 20) ******* 20 / 0 ******* 25 / 18.7% ******* 30 / 41.0% ******* 35 / 67.3% ******* 40 / 98.8% ******* What is the connection between an early first birth and elective induced abortion? ******* Consider a childless 20 year-old 'Alice' who is pregnant and chooses to have an induced abortion (U.S. consent forms will not tell her that postponing her first birth increases her breast cancer risk). If 'Alice' waits until age 30 to have her first birth, her relative breast cancer risk is 41% higher than if she had a full-term birth at age 20.3 If the induced abortion had the side- effect of sterilizing her, 'Alice' will have no children and her relative breast cancer risk is about 90% higher compared to having a full-term birth at age 20.7 She also doubles her risk of ovarian cancer.9 ******* What is the 'ABC' debate about? ******* That there is one abortion breast cancer risk (postponed first full-term birth) is not debatable. If medical researchers are at least 95 percent confident of increased risk, they have obtained what is termed "statistical significance". This can be called the 'gold standard' of medical science. ******* For the second abortion breast cancer risk ("interrupted pregnancy"), there have been seventeen (17) studies that have achieved "statistical significance". Sixteen (i.e. over 94%) of the seventeen studies found that an induced abortion increases breast cancer risk. How much breast cancer risk increase would there be for a young (under age 25) childless woman who has an induced abortion? There is the postponed first full-term birth breast cancer risk mentioned above and the second risk ("interrupted pregnancy"). In 1996 a "meta-analysis" reported that this second independent risk yielded an increased relative risk of breast cancer of 50 per cent for an induced abortion before a first full-term pregnancy; this 50 per cent does not include the independent BC effect of postponing a first full-term birth and the authors so state this.4 The total relative breast cancer risk increase for a young childless pregnant woman of age 20 years who has an elective induced abortion: ******* Table 3. Total BC risk from nulliparous 20 year-olds having abortions ******* Age at first full-term pregnancy / Total increase in relative BC risk ******* 25 years / 68.7% (18.7% + 50%) ******* 30 years / 91.0% (41% + 50%) ******* 35 years / 117.3% (67.3% + 50%) ******* [postponement BC risks of 18.7%, 41%, and 67.3% are derived from a 1983 International Journal Cancer estimate of 3.5% increase (compounded) in BC risk for each one year delay in first full-term birth.3] ******* ABC risk for women carrying to full-term a first pregnancy ******* The 1996 'Brind' ABC meta-analysis analyzed twenty-three 'ABC' studies.4 The authors very clearly state that this meta-analysis excluded the independent effect of postponing a first full-term birth via induced abortion. The researchers reported an overall significantly increased relative risk of breast cancer of 30% from any induced abortions; it must be repeated that this 30% does not include the BC risk increase from a postponed of first full-term birth. 'Brind' estimated 4,700 U.S. women contracting breast cancer annually from induced abortion exposure. In 1973 a U.S. Supreme Court decision (Roe v Wade) had the defacto effect of allowing induced abortion for any woman who wanted one. However, as the 'Roe v Wade' generation of women enters menopause, the annual U.S. breast cancer toll may climb much higher. 4,700 utterly dwarfs the infamous Tuskegee study that involved 412 black men with prior syphilus. These 412 men were not told that they had syphilus, nor were they given therapies for their syphilus for many years. However, the doctors conducting the Tuskegee study did nothing to cause any cases of syphilis. For the ABC risk the number of patients is much greater and the doctors performing 'pregnancy terminations' caused an increase in the risk of breast cancer! As of September 2001, no U.S. abortion clinic informs women of either the accepted ABC risk or the second independent ABC risk ("interrupted pregnancy") validated by the 1996 'Brind' meta-analysis. This failure to disclose a "material risk" for an elective medical treatment violates a doctor's legal duty to inform a prospective patient of "material" risks. A doctor also has a legal duty (in the U.S. and Canada) not to perform any treatment that is not in a patient's best interests.10 Exposing a patient to an elective procedure with an increased breast cancer risk can not be considered to be in a patient's best interests.10 The Hippocratic dictum of "First, do no harm" is being violated. ******* The etiology of the Abortion-Breast-Cancer Risk ******* Dr. Charles E. Simone explained the etiology of Abortion-Breast- Cancer thus: "When conception occurs, hormonal changes influence the breast. The milk duct network grows quickly to form other networks that will ultimately produce milk. During this period of tremendous growth and development, breast cells are undergoing great change and are immature or 'undifferentiated'; hence, they are more susceptible to carcinogens. But when a first full-term pregnancy is completed, hormonal changes occur that permanently alter the breast network to greatly reduce the risk of outside carcinogen influence. When a termination occurs in the first trimester, there are no protective effects, and many of the rapidly dividing cells of the breast are left in transitional states...... It is in these transitional states of high proliferation and undifferentiation that these cells can undergo transformation to cancer cells."8 ******* Cells left in "transitional states" (i.e. undifferentiated) that Dr. Simone refers to, are vulnerable to becoming cancer cells. This is the second independent 'ABC' risk, "interrupted pregnancy", to which women, nulliparous or parous are vulnerable. To this independent 'ABC' risk Brind et al. compute a relative risk of 1.3 in their meta-analysis.4 Nulliparous women suffer an additional breast cancer relative risk increase of 3.5% for every one year postponement of their first full-term pregnancy.3 A ten year postponement of FFTP increases relative breast cancer risk by 41 per cent. ******* Summary ******* 1 Breast Cancer researcher Nancy Krieger wrote, "Conversely, early age at FFTP [first full-term pregnancy] consistently has emerged as the strongest protective [against breast cancer] factor".1 A postponed first full-term birth via an induced abortion is the 'first' independent ABC risk and is not debatable.1,2,3,6,7 ******* 2 There is very strong evidence for the 'second' independent ABC risk ("interrupted pregnancy").4,5 Sixteen of seventeen significant studies reported increased breast cancer risk from prior induced abortions. ******* 3 All U.S. and Canadian abortion clinic consent forms fail to inform women of either the accepted ABC risk (postponed first full-term pregnancy) or the second very probable ABC risk. A medical doctor is legally prohibited from performing a medical treatment that the doctor knows, or ought to know, is not in a patient's best interests. 10 ......................................................................... Part II: References ******* 1 Krieger N. Exposure, susceptibility, and breast cancer risk. Breast Cancer Research and Treatment 1989;13:205-223 ******* 2 MacMahon B, Cole P, Lin M, Mirra AP, et al. Age at First Birth and Breast Cancer Risk. Bull WHO 1970;43:209-221 ******* 3 Trichopolous D, Hsieh Cc, MacMahon B, Lin T, et al. Age at any Birth and Breast Cancer Risk. International J Cancer 1983;31:701-704 ******* 4 Brind J, Chicchilli VM, Severs WB, Summy-Long J. Induced abortion as an indepdendent risk factor for breast cancer: a comprehensive review and meta-analysis. J Epidemiology & Community Health 1996;50:481-496 ******* 5 Daling J, Malone KE, Voigt LF, White E, Weiss NS. Risk of Breast Cancer Among Young Women: Relationship of Induced Abortion. Journal of the National Cancer Institute 1994;86;1584-1592 ******* 6 Decarli A, La Veechia C, Negri E, Franceschi S. Age at any Birth and Breast Cancer in Italy. International J Cancer 1996;67:187-189 ******* 7 White E. Projected Changes in Breast Cancer Incidence due to the Trend toward Delayed Childbearing. Amer J Public Health 1987;77:495-497 ******* 8 [book] Simone C. Breast Health. Avery Pub. Group, Garden City Park, N.Y. 1995 (p. 147) ISBN 0895296608 ******* Ovarian Cancer ******* 9 Whittemore AS, Harris R, Itnyre J. Characteristics Relating to Ovarian Cancer Risk: Collaborative Analysis of 12 United States Case-Control Studies. American J Epidemiology 1992;136:1184-1203 ******* A Doctor's Legal Duty to Protect a Patient's Health ******* 10 [book] Picard E, Robertson G. Legal Liabilities of Doctors and Hospitals in Canada. 1996 (pp. 264-265). Carswell, Scarborough, Ontario, Canada. ISBN 0-459-25412-X (pbk.) ..................................................................... ******* Part III: Does Elective Induced Abortion boost Premature Birth Risk? (Brent Rooney) ******* A preterm birth is a birth before 37 full weeks' (i.e. 259 days) gestation. Preterm newborn are at increased risk of serious conditions such as asthma, blindness, deafness, low IQ, repiratory distress and cerebral palsy. The more preterm the birth, the higher the risk of serious maladies. Consider seventeen studies finding that previous induced abortions significantly boost the risk of a subsequent preterm birth.1-17 These studies were referenced in a recent letter to the European Journal of Obstetrics & Gynecology and Reproductive Biology to support a link between induced abortion and cerebral palsy.18 ******* Cerebral palsy is an extremely serious malady characterized by poor balance, posture, and movement. Extremely preterm infants (<28 weeks' gestation) are very likely to be very low birth weight (under 1500 grams); VLBW newborn are at a much elevated risk of cerebral palsy.19-21 ******* In a 1991 meta-analysis Escobar et al. estimated from world wide studies that VLBW newborn have thirty-eight times the risk of CP as newborn in the general population.21 However, the CP risk for U.S. VLBW newborn was 50 percent higher than that for non-U.S. contries.21 ******* Elective Surgery and Preterm Birth risk ******* Consider a 1999 study of over 61,000 Danish women.2 Relative risk of a very preterm birth (before 34 weeks' gestation) for Danish women with one previous induced abortion is 1.99. The relative risk of a preterm birth for women with two previous "evacuation" type abortions is 12.55.2 The preterm RR for one previous "evacuation" abortion is 2.27.2 All these results are significant; it is disturbing that a relative risk of 12.55 was not included in the article abstract or in the main text, being only found in a table.2 Some may claim that 'recall bias' (cases more accurate in recall of induced abortion history than are controls) may explain the apparent finding of an APB (Abortion-Preterm-Birth) risk when there actually may be little or no risk. This 1999 study of Danish women completely eliminated this possibility by using an abortion registry instead of interviews to ascertain a woman's induced abortion history. ******* Confirmation of the Danish study ******* A 1998 study of German women found the following significant increases in risk of very preterm (<32 weeks' gestation) newborn for women with prior induced abortions(17): ******* Table 4. Very preterm birth risk vs. number of prior abortions ******* number of prior induced abortions / increased relative risk of very preterm (<32 weeks') birth ******* 1 / 150% ******* 2 / 460% ******* 3 / 510% ******* Since preterm births are the leading cause of infant mortality, it is surprising that this 1998 study with its disturbing results was not widely publicized.17 The United State's preterm birth rate of about eleven percent should prompt public health officials to warn women of any elective medical procedure with a credible risk of future premature births. The 1998 German results should also prompt all other countries to enforce laws against elective medical procedures clearly not in a patient's best interests. ******* Contrary evidence ******* Are there any studies finding that prior induced abortions significantly reduce the risk of future preterm births? To my knowledge there are no such studies, but readers who believe that they know of such studies may email me their citation. My current total of significant studies finding that prior abortions boost prematurity or low birth weight (LBW: newborn weight under 2500 grams) risk is thirty-three and a current list is available from me via email. If one limits oneself to considering significant studies of APB, the evidence is totally one sided in favor of increased risk (thirty-three vs. ZERO). I believe it very likely that my list of significant APB studies will expand beyond thirty-three. ******* Biologically plausibility ******* Professor Barbara Luke (University of Michigan), has identified one mechanism that explains abortion causing prematurity risk. "The procedures for first-trimester abortion involve dilating the cervix slightly and suctioning the contents of the uterus (...).The procedures for second-trimester abortion are more involved, including dilating the cervix wider and for longer periods, and scraping the inside of the uterus. Women who had had several second-trimester abortions may have a higher incidence of incompetent cervix, a premature spontaneous dilation of the cervix, because the cervix has been artificially dilated several times before this pregnancy."22 Luke's 1995 comprehensive book of prematurity risk factors is a classic in the field, with a forward by a giant in the field of preterm birth, Dr. Emile Papiernik (France).22 Luke asserts that an 'incompetent' cervix multiplies the risk of a birth before 32 weeks' gestation by a factor of ten (10).22 ******* Are there other mechanisms that may explain the APB risk? ******* "Our findings indicate that an abortion in a woman's first pregnancy does not have the same protective effect of lowering the risk for intrapartum infection in the following pregnancy as does a live birth", according to researchers from the University of Washington writing in Epidemiology.23 Infection is a leading cause of death from induced abortion (if breast cancer and suicide risks are ignored). Infection is often mentioned as a risk factor for premature birth. In 1992 Dr. Janet Daling and Marijane Krohn reported that if the previous pregnancy ended in induced abortion, the risk of intraamniotic infection increased by 140%.24 Confirming the Daling study is a 1998 study that reported: "Women with spontaneous abortion (odds ratio =4.3; 95% confidence interval (2.9 to 6.4) or elective termination (odds ratio = 4.0; 95% confidence interval 2.7 to 5.8) had an increased risk of intraamniotic infection."25 "Among all births, the frequency of IAI [intraamniotic infection] is from 2% to 5%; however, the frequency is increased for women delivering preterm preterm (5% to 15%) compared with women delivery at term.... IAI has very serious consequences for neonates born after a labor for which it is a complication. After controlling for preterm delivery, infants have a twofold increased risk of death and a greater than twofold increased risk of sepsis."25 ******* In 1998 Judith Lumley wrote about abortion and infection, "One possible mechanism is that cervical instrumentation can facilitate the passage of organisms into the upper part of the uterus, increasing the probability of inapparent infection and subsequent preterm birth.".1 ******* Infection boosts cerebral palsy risk in very preterm newborn "Factors associated with an increased risk of cerebral palsy after adjustment for gestational age were chorioamnionitis [infection of the membranes] (odds ratio 4.2 [95% CI 1.4-12.0])....." wrote researchers Murphy et al. in 1995.26 ******* Professor Barbara Luke lists vaginal infection as a risk factor for preterm birth.22 It is hardly a secret that infection is a common risk of surgery and specifically induced abortion surgery. ******* Informed medical consent ******* Failure to inform prospective patients of a serious medical treatment risk is 'medical negligence'. Pediatrician Dr. Elliot Gersh informs readers that preterm birth is a risk factor for cerebral palsy and also informs readers that a CP risk factor is: "Incompetent cervix (premature dilation) leading to premature delivery"19 ******* It is well known that induced abortion surgery increases the risk that a woman will have an incompetent cervix.22 Thus, all surgical abortion consent forms must list the risk of 'incompetent cervix' and the associated risk of subsequent preterm birth. Some forms do list the equivalent of 'incompetent' cervix (e.g. 'laceration of the cervix') but no consent form lists the associated preterm birth risk. This fits the definition of failure to inform and thus, is medical negligence, in my opinion. ******* When was the preterm risk of induced abortion well recognized? ******* It would hardly be inaccurate to assert that Dr. Malcolm Potts is a defender of the overall safety and value 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."27 Those who favor fully informed medical consent for women patients at abortion facilities can use the words of Dr. Malcolm Potts. Doctors who wish to minimize their exposure to malpractice law suits may benefit from adhering to the words of the Father of Medicine, Hippocrates, "First, do no harm." Further, "Let us ensure that women of reproductive age are fully informed about health risks of medical treatments to them and their future children."28 ******* Part III: References ******* 1 Lumley J. The association between prior spontaneous abortion, prior induced abortion and preterm birth in first singleton births. Prenat Neonat Med 1998;3:21-24. ******* 2 Zhou W, Sorenson HT, Olsen H. Induced Abortion and Subsequent Pregnancy Duration. Obstetrics & Gynecology 1999;94:948-953 ******* 3 Pickering RM, Forbes J. Risk of preterm delivery and small-for-gestational age infants following abortion: a population study. British J Obstetrics and Gynecology 1985;92:1106-1112 ******* 4 Michielutte R, Ernest JM, Moore ML, Meis PJ, Sharp PC, Wells HB, Buescher PA. A Comparison of Risk Assessment Models for Term and Preterm Low Birthweight. Preventive Medicine 1992;21:98-109 ******* 5 Berkowitz GS. An Epidemiologic Study of Preterm Delivery. American J Epidemiology 1981;113:81-92 ******* 6 Lieberman E, Ryan KJ, Monson RR, Schoenbaum SC. Risk Factors Accounting For Racial Differences in the rate of premature birth. NEJM 1987;317: 743-748 ******* 7 Lang JM, Lieberman E, Cohen A. A Comparison of Risk Factors for Preterm Labor and Term Small-for-Gestational-Age Birth. Epidemiology 1996; 7:369-376 ******* 8 Mueller-Heubach E, Guzick DS. Evaluation of risk scoring in a preterm birth prevention study of indigent patients. Am J Obstetrics & Gyn 1989; 160:829-837 ******* 9 Shiono PH, Lebanoff MA. Ethnic Differences and Very Preterm Delivery. Am J Public Health 1986; 76:1317-1321 ******* 10 Pantelakis SN, Papadimitriou GC, Doxiadis SA. Influence of induced and spontaneous abortions on the outcome of subsequent pregnancies. Amer J Obstet Gynecol. 1973;116:799-805 ******* 11 Van Der Slikke JW, Treffers PE. Influence of induced abortion on gestational duration in subsequent pregnancies. BMJ 1978;1:270-272 ******* 12 Richardson JA, Dixon G. Effect of legal termination on subsequent pregnancy. British Med J 1976;1:1303-1304 ******* 13 Pickering RM, Deeks JJ. Risks of Delivery during 20th to the 36th Week of Gestation. Intl J Epidemiology 1991;20:456-466 ******* 14 Koller O, Eikhom SN. Late Sequelae of Induced Abortion in Primigravidae. Acta Obstet Gynecol Scand 1977;56:311-317 ******* 15 Papaevangelou G, Vrettos AS, Papadatos D, Alexiou C. The Effect of Spontaneous and Induced Abortion on Prematurity and Birthweight. The J Obstetrics and Gynaecology of the British Commonwealth. May 1973;80:418-422 ******* 16 Bognar Z, Czeizel A. Mortality and Morbidity Associated with Legal Abortions in Hungary, 1960-1973. AJPH 1976;66:568-575 ******* 17 Martius JA, Steck T, Oehler MK, Wulf K-H. Risk factors associated with preterm (<37+0 weeks) and early preterm (<32+0 weeks): univariate and multi-variate analysis of 106 345 singleton births from 1994 statewide perinatal survey of Bavaria. European J Obstetrics & Gynecology Reproductive Biology 1998;80:183-189 ******* 18 Rooney B. Elective Surgery boosts Cerebral Palsy risk European J Obstetrics & Gynecology and Reproductive Biology 2001;96:239-240 ******* 19 Gersh ES. Children with Cerebral Palsy: a parent's guide / edited by Elaine Geralis. 1998; chapter 1: page 14 Bethesda, Maryland: Woodbine House ISBN 0933149824 ******* 20 Ericson A, Kallen B. Very low birthweight boys at 19. Arch Dis Child Fetal Neonatal Ed 1998;78 :F171-F174 ******* 21 Escobar GJ, Littenberg B, Petitti DB. Outcome among surviving very low birthweight infants; a meta-analysis. Arch Dis Child 1991;66:204-211 ******* 22 Luke B, Every Pregnant Woman's Guide to Preventing Premature Birth. 1995 (Times Books, New York) ISBN 081292472X ******* 23 Muhlemann K, Germain M, Krohn M. Does an Abortion Increase the Risk of Intrapartum Infection in the Following Pregnancy? Epidemiology 1996;7:194-198 ******* 24 Daling JR, Krohn MA, Miscarriage or Termination in the Immediately Preceding Pregnancy Increases the Risk of Intraamniotic Infection in the Following Pregnancy. American J Epi 1992;136:1013 [SER Abstracts] ******* 25 Krohn MA, Germain M, Muhlemann K, Hickok D. Prior pregnancy outcome and the risk of intraamniotic infect in the following pregnancy. Am J Obstet Gynecol 1998;178:381-385 ******* 26 Murphy DJ, Sellers S, MacKenzie IZ, Yudkin P, Johnson AM. Case-Control study of antenatal and intrapartum risk factors for cerebral palsy in very preterm singleton babies. Lancet 1995;346:1449-1454 ******* 27 Potts M. Legal Abortion in Eastern Europe. Eugenics Review 1967;59:232-250 ******* 28 Rooney B. Having an induced abortion increases risk in future pregnancy. British Medical J 2001;322:430 ............................................................ Part IV: Lower Suicide risk via Birth or Elective Abortion? (Brent Rooney) ******* "A 1985 study by researchers at the University of Minnesota of 3636 Minnesota [USA] rural high school students (grades 9-12, avg. age 16.3) found that if a girl had undergone an abortion within the last 6 months she was 10 times more likely to have attempted suicide than if she had not had an abortion in that period (4% of attempters had abortion vs. 0.4% of non-attempters). If a girl had an abortion any time previously in her lifetime she was about 6 times more likely to have attempted suicide compared with girls who had not aborted."1 ******* "Despite the mood swings and stesses associated with pregnancy and impending childbirth, pregnant women have a significantly lower risk of suicide than women of childbearing age who are not pregnant," wrote Marzuk et al in the American Journal of Psychiatry in 1997.2 "the age-and-race-adjusted risk of suicide among pregnant women was .40 (95% confidence interal=0.15-0.87)."2 This study fulfilled the authors' hypothesis of lowered suicide risk from pregnancy and thus, "pregnancy could be a model for exploring protective factors against suicide in women in general."2 A British (Appleby) study reported that pregnant women are 1/20 as likely to commit suicide as nonpregnant women of childbearing age.3 ******* But what about suicide risk in the year after the end of pregnancy? ******* There are undoubtedly many stesses for new moms in the first 12 months of caring for a new infant. One might speculate that in this year the suicide rate would be high and that perhaps such women may regret not having terminated' their last pregnancy. In the 1997 the top Scandinavian medical journal in the field of obstetrics and gynecology published the results of a study of Finnish women followed for 12 months after the end of pregnancy.4 Finnish women who gave birth had 1/2 the risk of suicide as the general non-pregnant female population of reproductive age. Women who 'terminated' their pregnancies had over six times (6.46) the risk of committing suicide as women who carried to term. Those who believe that pregnancy 'termination' lowers stress and anxiety, would logically expect that those who choose induced abortion would have a much lower suicide risk than those women who delivered newborn. This belief is strongly opposed by results in the top Scandinavian obstetrics and gynecology medical journal and the British Medical Journal.4,5 The Appleby study also reported a standardized mortality ratio of postnatal suicide of 0.17 (i.e. 83% reduced suicide risk) in the twelve months after the end of pregnancy.3 ******* Confirmation of the study of Finnish women? ******* A 1985 United States study published the results of an analysis of about 16.1 million U.S. births in the period 1974-1978.6 Since the main concern was 'maternal mortality', the statistic of 15 suicides was termed "unrelated (nonmaternal)".6 The women in this U.S. study were followed for 12 months after the end of pregnancy.6 Even if one believes that suicides are much underreported and thus, 15 suicides should be doubled to represent a 'true' total of 30 suicides, this is still an extremely low total of suicides for approximately 16 million women over a 21 month period (9 months pregnancy plus 12 months after delivery). This 1985 study is strongly suggestive of a very low suicide risk in the 12 months after delivery. ******* Any studies finding that induced abortion significantly cuts risk? ******* I am not aware of even one statistically significant study reporting reduced suicide risk for women who underwent elective induced abortion. ******* Conclusion ******* There are not many studies that examine the suicide risk of induced abortion. However, those that do find a very high relative risk of attempts or actual suicides. Pregnancy confers a very low risk of suicide. ******* Part IV: References ******* 1 Strahan TW. Newsletter [Assoc. for Interdisciplinary Research in Values and Social Change]. 1990;Vol. 3 (No. 3):10 ******* 2 Marzuk PM, Tardiff K, Leon Ac. Hirsch CS, et al. Lower Risk of Suicide During Pregnancy. Am J Psychiatry 1997;154:122-123 ******* 3 Appleby L. Suicide during pregnancy and in the first postnatal year. BMJ 1991;302:137-140 ******* 4 Gissler M, Kauppila R, Merilainen J, Toukomaa H, Elina Hemminki E. Pregnancy-associated deaths in Finland 1987-1994 - definition problems and benefits of record linkage. Acta Obstet Gyn Scand 1997;76:651-657 ******* 5 Gissler M, Hemminki E, Lonnqvist J. Suicide after pregnancy in Finland, 1987-94: register linkage study. BMJ 1996;313:1431-1434 ******* 6 Kaunitz AM, Hughes JM, Grimes DA. Smith JC, et al. Causes of Maternal Mortality in the United States. Obstetrics & Gynecology 1985;65: 605-612 ....................................................................... Part V: Summary: Which is safer for women, delivery or elective abortion? (Brent Rooney) ******* A proper and legal medical procedure must never have serious harms that greatly outweigh potential benefits. Compared to delivery of a newborn, elective induced abortion surgery has the following relative risks: ******* Table 5: Four elective abortion risks (relative to delivery) ******* RR Ref. Suicide: 6.5 (1) ******* Breast Cancer: 1.3 (2) [>1.3 if woman is nulliparous] ******* Mortality (12 month): 3.5 (1) ******* Future Very Preterm birth: 2.5 (3) ******* In the United States and Canada, a medical doctor has a legal duty to protect a patient's best health interests. The breast cancer risk (a minimum of RR = 1.3) alone demands that induced abortion as an elective procedure never be performed. Can the patient accept such a serious risk as breast cancer by signing a consent form that lists that risk? "If a patient requests treatment which the doctor considers to be inappropriate and potentially harmful, the doctor's overriding duty to act in the patient's best interests dictates that the treatment be withheld."4 ******* What is quackery? ******* The dictionary defines a quack as one who pretends to skill or knowledge that he does not possess. If one pretended that an elective 'therapeutic' procedure that increases short term mortality risk actually dramatically reduces short term mortality risk, that qualifies as quackery of a dangerous kind. If, in addition, the elective procedure boosts risks of suicide, breast cancer, and future very preterm birth, the danger of the quackery deepens. It is time for medical doctors and researchers to summon the courage to denounce a popular but dangerous form of quackery endangering the health of millions of women yearly, elective induced abortion. ******* Informed medical consent ******* To date (September 2001) no abortion clinic consent form lists future increased risk of preterm birth. 'Incompetent' cervix is a well known and accepted risk of induced abortion surgery.5 'Incompetent' cervix is also an accepted risk factor for preterm birth.5 Barbara Luke asserts that an 'incompetent cervix' multiplies the risk of a preterm birth before 32 weeks' gestation by a factor of ten.5 Thus, future preterm birth risk must legally be included on all abortion clinic consent forms but is currently absent on all such forms. ******* Since proper informed medical consent is the right of all patients, increased risks of prematurity, breast cancer, suicide, and short term (12 months) mortality should be listed on all abortion clinic consent forms, but are not. There are other risks, beyond the scope of this article, such as infertility and sterility, that some consent forms omit. Ethical doctors and researchers aware of this 'medical negligence' (omitting serious adverse risks on consent forms) will demand that this breach of informed medical consent be repaired. Hippocrates "First, do no harm," admonished the 'Father of Medicine', Hippocrates. For the good health of all women, let us adhere to this medical ideal in the area of women's reproductive health. Brent Rooney (Independent Medical Researcher) Reduce Preterm Risk Coalition 3456 Dunbar St. (146) Vancouver, Canada V6S 2C2 [email protected] Part V: References 1 Gissler M, Kauppila R, Merilainen J, Toukomaa H, Elina Hemminki E. Pregnancy-associated deaths in Finland 1987-1994 - definition problems and benefits of record linkage. Acta Obstet Gyn Scand 1997;76:651-657 2 Brind J, Chicchilli VM, Severs WB, Summy-Long J. Induced abortion as an indepdendent risk factor for breast cancer: a comprehensive review and meta-analysis. J Epidemiology & Community Health 1996;50:481-496 3 Martius JA, Steck T, Oehler MK, Wulf K-H. Risk factors associated with preterm (<37+ 0 weeks) and early preterm birth (<32+ 0 weeks): univariate and multivariate study analysis of 106 345 births from 1994 statewide perinatal survey of Bavaria. Eur J Obstet & Gyn Reproductive Biology 1998;80:183-189 4 [book] Picard E, Robertson G. Legal Liabilities of Doctors and Hospitals in Canada. 1996 (pp. 264-265) ISBN 0-459-25412-X (pbk.) Carswell, Scarborough, Ontario, Canada 5 [book] Luke B, Every Pregnant Woman's Guide to Preventing Premature Birth. 1995 (Times Books, New York) ISBN 081292472X ...................................................................... On Fri, 3 Feb 2006, J.Hof wrote: > Print Story - canada.com network > > > Assumptions cloud abortion question > 'Pro-life' or 'pro-choice'? It's not that simple. There are four basic positions on abortion and the law that should govern it > > Margaret Somerville > Special to the Sun > > > Friday, February 03, 2006 > > > Once again in a federal election campaign the media thrust microphones in front of politicians and asked, "Are you pro-life or pro-choice?" > > Paul Martin responded that it's a simple question, "Are you pro-choice, yes or no?" Stephen Harper said, "it's a complex issue." > > The media's question assumes: > > (a) That everyone is either pro-life or pro-choice -- there are no other possibilities. > > (b) That accepting any restrictions on abortion is pro-life and all pro-lifers believe all abortion should be prohibited. > > (c) That being pro-life -- advocating any restriction on abortion -- is incompatible with respecting women and their rights. > > (d) That all pro-choicers agree there should no restrictions on abortion. > > (e) That all social conservatives believe all abortions should be prohibited by law and all social liberals believe there should be no restrictions. > > All of these assumptions are wrong. > > The four basic positions on abortion and the law that should govern it are: "No;" "Yes;" "No, unless I;" and "Yes, but I." The question "Are you pro-life?" or "Are you pro-choice?" assumes there are only "no" and "yes" positions. > > "No, abortion is always wrong and must be prohibited as murder" cannot be enacted as law because it would contravene a woman's Charter right to security of the person. > > That position has never been the law in countries like Canada because a defence of necessity has always applied when abortion was required to protect a woman's life or health. Abortion is always an ethical issue and women may always reject abortion for themselves, but that stance may not be imposed by law. > > "Yes, abortion should always be available with no strings attached" encapsulates the polar opposite view. > > Some feminists see unrestricted access to abortion as the litmus test of respect for women and their rights. They believe abortion is of no ethical or moral concern and certainly not beyond the personal, private sphere; it is simply not society's business, even if an abortion involves a viable fetus (one that might survive outside the womb.) > > Many Canadians are surprised and shocked to learn that a woman can legally have an abortion until just before she gives birth. When I say that, many think they have misunderstood. > > Statistics Canada deliberately does not request gestational age when collecting statistics on abortion, but about 50 per cent of reporting hospitals include it. These numbers show around 500 post-viability abortions were performed in 2002. > > According to newspaper reports, Quebec just sent a gynecologist to the United States to learn to perform post-viability abortion, which is usually by way of a lethal injection of potassium chloride into the fetus's heart. > > Recently, I was consulted on two cases in which healthy women (whose identities were not disclosed) were post-32-weeks pregnant with a viable fetus and wanted an abortion. > > One, a 28-year-old graduate student from the Middle East, had concealed her pregnancy and said her family would disown her if they found out. The other, a 33-year-old married woman, had been told the fetus had a cleft palate (a relatively minor, correctable, congenital abnormality) and she and her husband did not want "a defective child." > > Legally, both could have an abortion; however, the physicians who called me believed that was unethical, but were unsure how to handle the situation. > > Provided the fetus is born dead, abortion does not entail any legal liability in Canada. If the same fetus were born alive and then killed the charge would be murder. > > Princeton philosopher Peter Singer, a strong pro-choice advocate, has long argued this is an inconsistent position and that parents should have the right for a certain time after the birth of a child with disabilities to have it euthanized. > > I disagree with his stance about both abortion and infanticide, but he is correct about the inconsistency. His advocacy of this position was described by Newsweek as "the pro-choice advocates' worst nightmare come true." > > A question that is not addressed is whether a viable fetus should be delivered without first intentionally killing it. Is a woman's right to abortion at any time during pregnancy just a right to evacuate her uterus or also a right to demand that a viable fetus be killed when that is avoidable? > > Ironically, some pro-choice supporters are anti-elective (non-medically necessary) caesarian sections. Surely if at a given time a woman could choose to have an abortion, she has a right to choose a C-section. > > "No, abortion raises serious ethical issues and should not be undertaken unless it can be justified" was Canadian law's position before the Supreme Court of Canada's ruling in the Morgentaler case in 1988. > > The court struck down the Criminal Code's requirement that a "therapeutic abortion committee" certify abortion was needed to protect the life or health of the woman as infringing her Charter right to security of the person, because not all women who needed an abortion for health reasons might have access to such a committee. It made clear abortion could be legally regulated by an amended law, but Parliament was unsuccessful in passing one, leaving Canada, uniquely among comparable countries, with no abortion law. > > "Yes, abortion is available, but not if certain conditions are present," for example, the fetus is viable and there is no health reason for abortion, is the law in the United States as a result of the U.S. Supreme Court ruling in Roe v. Wade in 1973. A similar situation exists in France, where up to a certain early point in pregnancy abortion-on-demand is allowed in practice, but abortion is legally restricted beyond that point. > > The "No, unless" and "Yes, but" positions differ on where to draw the line restricting abortion and in their basic messages. The "No, unless" allows abortion as an exception to the norm and carries much stronger values messages that abortion is always a serious matter. But both are non-absolute positions in comparison with the "No" and "Yes" positions, which are both absolutes, but of opposite content. > > These non-absolute positions are on a spectrum between the "No" and "Yes" poles. A stance against abortion unless a woman's life or health is in danger is closer to the "No" pole, one that abortion should be freely available except, for example, for sex selection, is closer to the "Yes" pole. > > My anecdotal experience is that most Canadians fall somewhere in the middle of this spectrum and struggle to decide exactly where. > > As Stephen Harper rightly said, making that decision and implementing it through law is a complex matter, but it is one that we still need to address as a Canadian society and one that, sooner or later, Parliament is likely to face. > > Margaret Somerville is founding director of the McGill Centre for Medicine, Ethics and Law. > > © The Vancouver Sun 2006 > > > > > > > > > Copyright © 2006 CanWest Interactive, a division of CanWest MediaWorks Publications, Inc.. All rights reserved. ****************************************************************************************************************************************

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The following warning is a prophetic message given to me, Frank Wagner, in November of 1974. ******* LISTEN TO THE CRY OF THE ABORTED CHILDREN. THEIR CRY IS NO. THEIR CRY IS A CRY OF TERROR. HEED THEIR CRY. ******* This prophecy is now being fulfilled. ******* For details about the source, meaning and fulfillment of this prophetic message go to ******* http://ca.geocities.com/fwagner4/index.html ******* email me at *** [email protected] ***