Reardon DC, Coleman PK. Short and long term mortality rates associated with first pregnancy outcome: Population register based study for Denmark 1980-2004. Med Sci Monit 2012;18(9):PH 71 – 76. Dr. Coleman’s summary The objectives of the study were to examine mortality rates associated with first pregnancy outcome and to explore differences in mortality rates associated with early abortion and late abortions (after 12 weeks). The population was comprised of a total of 463,473 Danish women who had their first pregnancy between 1980 and 2004 (2,238 died across the 10 year study period). Compared to women who carried their first pregnancy to term, after adjusting for age and birth year, the cumulative risk of death for women who had a 1st trimester abortion was significantly higher in all periods examined from 180 days (84%) through 10 years (39%). The risk of death was likewise significantly higher for women who had abortions after 12 weeks from one year (331%) through 10 years (141%) when compared to women who delivered a first pregnancy. Finally, for women who miscarried, the risk was significantly higher for cumulative deaths through 4 years (75%) and at 10 years (48%). Why is this study important? 1) Record-based studies provide complete reproductive history data for all residents. There are very few record-based studies of mortality risks associated with reproductive loss available in the published literature. Without data-linkage to complete reproductive histories (as in this study), results are highly unreliable as prior research suggests as many as 73% of all pregnancy associated deaths are not apparent from death certificates. 2) This study eliminates the potential confounding effect of unknown prior pregnancy history by examining mortality rates associated with first pregnancy outcome alone. 3) No previous record-based studies have compared early induced abortions to later abortions. There is consensus that late-term abortions are associated with more physiological risks and higher rates of maternal mortality in the short term compared to early abortions. However, longer term mortality risks have not been previously examined with record-based data. See more of Dr. Coleman’s comments at: Dr. Reardon’s summary Higher Death Rates After Abortion Found in U.S., Finland and Denmark Large Record Linkage Studies Show Women More Likely to Die After Abortion, Not Childbirth Springfield, IL (September 5, 2012) — A new study of the medical records for nearly half a million women in Denmark reveals significantly higher maternal death rates following abortion compared to delivery. This finding has confirmed similar large-scale population studies conducted in Finland and the United States, but contradicts the widely held belief that abortion is safer than childbirth. By linking records from Denmark’s fertility and abortion registries to death registry records, the researchers examined death rates following the first pregnancy outcome for all women of reproductive age in Denmark over a thirty year period, charting death rates at 180 days, 1 year, and in each of 10 subsequent years following each woman’s first pregnancy outcome. Significantly higher rates of death were observed among women who aborted in every time period examined. (click on table at right). Published in the Medical Science Monitor, this is the first record linkage study of maternal death rates associated with abortion to be published using Denmark’s centralized health data. Record linkage studies of the population of Finland and of low income women in California have also found higher death rates associated with abortion. Record Linkage Studies Eliminate Reporting Errors The findings of these record linkage studies from three different populations contradict the conclusion that abortion is safer than childbirth. That view has traditionally been based on death certificates alone or on voluntary reporting to government agencies. For example, a study published in February in the journal Obstetrics & Gynecology using that method concluded that the death rate associated with childbirth is 14 times higher than the death rate associated with abortion. According to Dr. David Reardon, an author of the new Danish record linkage study, the study published in February was an “apples versus oranges” comparison of two very incomplete and incomparable sets of data. “Doctors and other officials completing death certificates almost never know if the deceased had a history of abortion,” said Reardon, who directs the Elliot Institute. “Record linkage, such as we have done, is the only way to objectively identify and compare death rates associated with pregnancy outcome using the same yardstick.” The inaccuracy of traditional tallies of pregnancy-associated death was underscored by a 2004 study using Finland’s national health care data. The researchers found that only 27 percent of pregnancy-associated deaths could have been identified by looking at death certificates alone. Deaths associated with abortion were the most likely to be missed. Abortion Safety Bias Confounds Public Discussion Reardon said the February study was “worse than a junk in, junk out analysis” because its authors excluded record linkage studies, all of which contradicted their claim that childbirth is 14 times more dangerous than abortion, from their literature review. He believes that evidence of abortion-associated risks is being suppressed for ideological and political reasons. “Population control activists in the United States and Europe, governments, NGO’s, and academic circles are pressuring developing countries to legalize abortion,” he said. “Their long-standing documented objective is to reduce birth rates among the poor. But that objective is being disguised by the more politically correct sales pitch which asserts that abortion is safer than childbirth and represents a positive benefit to women’s health. Any evidence which undermines that sales pitch is therefore doggedly ignored or suppressed.” Reardon believes the higher rates of maternal mortality associated with abortion may be largely due to elevated rates of psychological stress associated with abortion. For example, the mortality studies in Finland found a three-fold increased risk of suicide in the first year following an abortion compared to the general population and a six-fold higher risk compared to women who gave birth. The highest suicide rate was within two months of the abortion. In the California studies, women with a history of abortion had higher rates of psychiatric treatment over a four-year study period and were 187 percent more likely to die of heart diseases, which can also be affected by stress. “Numerous studies have linked abortion to higher rates of substance abuse, self-destructive behavior, psychiatric hospitalization, sleep disorders, eating disorders and a general increase in treatments sought for medical care,” said Reardon. “More research is needed to explore how these or other pathways may help to explain the higher mortality rates observed in record linkage studies.” # # # The Elliot Institute is dedicated to conducting original research on the impact of abortion on women and to promoting efforts to create a safe, healing environment for those struggling with a past abortion. Studies Mentioned Reardon DC, Coleman PK. Short and long term mortality rates associated with first pregnancy outcome: Population register based study for Denmark 1980-2004. Med Sci Monit 2012;18(9):PH 71 – 76. Gissler M, Berg C, Bouvier-Colle MH, Buekens P. Pregnancy-associated mortality after birth, spontaneous abortion or induced abortion in Finland, 1987-2000. Am J Ob Gyn 2004;190:422-427. Reardon DC, Ney PG, Scheuren F, Cougle J, Coleman PK, Strahan TW. Deaths associated with pregnancy outcome: a record linkage study of low income women. South Med J 2002 Aug;95(8):834-41. Gissler M, Berg C, Bouvier-Colle MH, Buekens P. Methods for identifying pregnancy-associated deaths: population-based data from Finland 1987-2000. Paediatr Perinat Epidemiol 2004 Nov;18(6):448-55. Deneux-Tharaux C, Berg C, Bouvier-Colle MH,Gissler M, Harper M, Nannini A, Alexander S, Wildman K, Breart G, Buekens P. Underreporting of pregnancy-related mortality in the United States and Europe. Obstet Gynecol 2005 Oct;106(4):684-92. Erratum in: Obstet Gynecol 2006 Jan;107(1):209. Raymond EG, Grimes DA. The Comparative Safety of Legal Induced Abortion and Childbirth in the United States. Obstetrics & Gynecology 2012 Feb;119(2, Part 1):215-219. Gissler M, Hemminki E, Lönnqvist J. Suicides after pregnancy in Finland, 1987-94: register linkage study. BMJ 1996 Dec 7;313(7070):1431-4. Elliot Institute, PO Box 7348, Springfield, IL 62791, United States