March 28, 2001
volume 12, no. 81

Abortions and Subsequent Premature Births

    Doctors are constantly worried about malpractice suits filed against them. As a consequence they try their very best to avoid elective surgeries that may result in a law suit. One such elective surgery is abortion.

    Obstetricians are especially vulnerable because many babies these days are born premature. The low birth weight, resulting from the early departure from the womb gives rise to many complications for the baby -- both physical and mental, including cerebral palsy.

    The prematurity rates have risen substantially over the last 25 years. The reason being the damage done to the cervix by the instruments necessary for its dilatation prior to an abortion and the damage done to the lining of the uterus. Thus, both cervix and uterus being subject to trauma, which may include lacerations and scarring and in some cases an actual perforation of the uterus is not conducive to holding subsequent pregnancies to full term. Now, this should not be hard for anyone to understand.

    Also, because of the incompetent cervix, germs have easier access to the uterus and therefore infections are more likely. Germs can also be introduced by the abortionist, through non sterile instruments. Abortion mills are not regulated the same as hospitals.

    If more than one abortion was done, before a full term delivery, then the cervix is damaged even further, as is the uterine lining. The odds of an incompetent cervix and uterine infection rises with each abortion.

    For the purpose of this discussion, I will not include ALL the risks of abortions, except to name a few of the more serious ones: Increased risk of breast cancer, hemorrhage, punctured uterus, infection, ectopic pregnancies and sterility. Then, there are the related risks, but NOT less important -- increased drug and alcohol abuse and suicide.

    In Britain there was “a threefold rise in litigation for negligence leading to brain damage to infants between 1984 and 1989, and that the average award had increased almost threefold in a similar period." If the birth is so preterm that the birth weight falls below 1500 grams, the risk of cerebral palsy is approximately thirty-eight times that of a full-term normal weight newborn infant.

    If there was one statistically significant report in a peer reviewed medical journal finding that an elective medical treatment raised the risk of a subsequent preterm births, then women must be warned of this possible risk.

    Not only is there just one study statistically significant, but there are a minimum of TWENTY. However, since abortions are the number one culprit of subsequent premature deliveries, the public hears nary a word about it. You will not hear about it on the 6:00 PM, or 11:00 PM news, or read about it in the newspapers.

    The media's credo -- first do no harm to the abortion industry. The harm and suffering to babies and the anguish to parents is secondary. Yet the media will constantly bombard us with lesser life saving news, such as -- a new way to get rid of wrinkles, or how to rate your mate.

    These twenty reports certainly make the induced abortion/prematurity risk a more than merely credible one and one that legally must be included on consent forms. The rest of this article will present arguments that will convince 'objective obstetricians' that the purported risk has very high credibility.

    What if three world renowned preterm birth experts identified an elective medical procedure as boosting subsequent preterm birth risk? Would that make the risk very plausible? The only answer to that question can only be "YES". The three renowned experts:

  • 1- Barbara Luke (ScD, MPH; Dept. of Obstetrics and Gynecology, University of Michigan)
  • 2- Judith Lumley (PhD; Centre for the Study of Mother's and Children's Health, Victoria, Australia)
  • 3- Emile Papiernik (MD, Professor of Obstetrics and Gynecology, Maternite Port Royal)

    Professor Barbara Luke in her classic book wrote, "If you have had one or more induced abortions, your risk of prematurity with this pregnancy increases by about 30 percent." (Every Pregnant Woman's Guide to Preventing Premature Birth, 1995)

    Dr. Luke, has identified one mechanism that explains why abortion raises 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 abortions 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.”

    "Birth before 32 weeks [gestation] is ten times more likely with the diagnosis of incompetent cervix", wrote Professor Luke. Since black American women have about triple the rate of induced abortion as Caucasian women, this helps to explain their tripled risk of preterm birth relative to Caucasian women.

    The editor of the medical journal of Obstetrics & Gynecology, Roy M. Pitkin M.D, wrote about Prof. Luke’s book, “this complete and accurate book should have great appeal to the discriminating woman who is pregnant or planning a pregnancy, as a means of maximizing her chances for a successful pregnancy.”

    Australian researcher Judith Lumley in 1998 wrote, "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."

    Emile Papiernik MD, was director of a national program in France that lowered the prematurity rate by 31.5 percent in its first ten years!! Compare this magnificent accomplishment with the U.S. situation where the prematurity rate has risen steadily over the last 20 years. In 1999 Papiernik, et al., reported 1. 86% increased risk of very preterm birth (less than 33 weeks' gestation) for women with previous first trimester abortions 2. 267% increased risk of very preterm birth for women with previous second trimester abortions

    Preterm birth (less than 37 week's gestation) is universally recognized as the number one cause of infant death before age one. Those 'preemies' who do not die are at much higher risk for physical and mental handicaps. One such handicap is cerebral palsy.

    Researchers (1996) from the University of Washington in the respected medical journal ‘Epidemiology,’ wrote, “a second biological risk that helps to explain higher prematurity risk is infection. 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 livebirth."

    Infection is a leading cause of death from induced abortion if one ignores breast cancer and suicide from abortion.

    In 1992 Dr. Janet Daling and colleagues reported that if the previous pregnancy ended in induced abortion, the risk of intraamniotic infection [i.e. infection of the amniotic sac] increased by 140%.

    Most abortion clinic consent forms list infection as a risk and some list 'incompetent cervix' (e.g. "lacerated cervix") but NO form lists a very serious consequence of these risks -- elevated risk of a future preterm birth.

    In a nutshell what makes the abortion/preterm birth risk very credible is:

  • 1. Three world experts (Luke, Lumley, Papiernik) report that induced abortion boosts prematurity risk
  • 2. ONE HUNDRED percent of TWENTY statistically significant medical studies find increased prematurity risk
  • 3. Most of the studies that looked for it, found that the more the number of previous induced abortions, the higher the prematurity risk. Two evacuation abortions increases prematurity risk by 1155%
  • 4. Biological Plausibility - incompetent cervix and infection are risks of induced abortion and risks for preterm birth.
  • 5. Consent forms list infection and/or incompetent cervix as risk factors of induced abortion, but NOT premature deliveries on subsequent pregnancies.
  • 6. In 1967 in Eugenics Review, Dr. Malcolm Potts, who has always been a stout defender of induced abortions, conceded that induced abortion increased prematurity risk."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."

    Quite a concession from one who defends induced abortions, but why the term "therapeutic" abortion. 99% of all abortions are no more therapeutic than I am a master of this kEyboaRd. The last I heard, they ALL end in death to one of the two parties involved and the party not killed is left more often than not with lasting physical and/or emotional problems and even death, e.g., increased risk of breast cancer, hemorrhage, perforated uterus, infection, subsequent premature births, or ectopic pregnancies, cigarette, drug, and alcohol abuse and suicide.

    THERAPEUTIC ABORTION -- please, give me a break. Maybe in Planned Parenthood’s dreams. The more accurate term should be -- MALHEALTH ABORTIONS. (as in malpractice)


    A medical doctor has a legal duty to protect a woman patient's health. To severely threaten a woman's reproductive health is a direct and potentially expensive violation of this duty. Defenders of abortions will trot out the old 'Joe Camel' defense of 'not conclusively proven' and thus, no warning of risk should be given. Only one report in a peer reviewed medical journal finding increased prematurity risk from previous induced abortions need be provided for a warning of possible preterm birth to be issued.

    TWENTY reports is 1900 percent more than one report. To protect themselves from potentially huge legal liabilities, medical doctors should refrain from performing elective induced abortions.

    I want to thank Brent Rooney from for his research in making this report possible. For other references, see references.

Dr. Frank Joseph

For past columns by Dr. Frank, see PRO-LIFE PRESCRIPTIONS Archives

March 28, 2001
volume 12, no. 81
Dr. Frank Joseph's PRO LIFE PRESCRIPTIONS column
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