Nov 1, 2012 Dear ProLife Colleague, Thank you for voting your values this coming Tuesday!! Preterm birth, (and especially Very Preterm Birth, <32 wks) is a major medical problem in our country. Induced abortion is a major preventable event associated with subsequent preterm birth. Studies show about a 30% increase in PTB after one abortion, a 60 to 70% increase in PTB after 2 abortions. And the risk keeps going up with more abortions. Yet the ACOG, the “guardians of women’s healthcare,” consistently obfuscate this fact. If you are associated with a training program, we urge you make this a study project. What would be more appropriate! (see our website for reference material and summaries.) See letter below: James R. Scott, MD, FACOG, Editor Editorial Office, Obstetrics & Gynecology ACOG 409 12th Street, SW Washington, DC 20024-2188 Dear Dr Scott: I read with interest and then confusion ACOG Practice Bulletin #130, October 2012 “Predicton and Prevention of Preterm Birth” by Drs Iams, Dildy, Macones, and Silverman, MD. One of the strongest risk factors associated with preterm birth was completely ignored: abortion prior to first term pregnancy. There are 4 points in regard to this critical issue: 1. There are over 130 studies spanning almost 40 years demonstrating a statistically significantly associated increased risk for preterm birth with elective surgical abortion. (see attached complete list) 2. Three excellent studies have been done in the last 3 years: Two Systemic Reviews: Swingle HM, Colaizy TT, Zimmerman MB, Morris FH. Abortion and the risk of subsequent preterm birth: A systematic review with meta-analyses. J Rrepro Med 2009;54:95-108 and Shah PS, Zao J. Induced termination of pregnancy and low birth weight and preterm birth: a systematic review and meta-analysis. BJOG 2009;116:1425-1442; and a large record-linked study from Finland: Klemetti R, Gissler M, Niinimaki M, Hemminki E. Birth outcomes after induced abortion: a nationwide register-based study of first births in Finland. Human Reproduction 2012 August 29 [fusion_builder_container hundred_percent="yes" overflow="visible"][fusion_builder_row][fusion_builder_column type="1_1" background_position="left top" background_color="" border_size="" border_color="" border_style="solid" spacing="yes" background_image="" background_repeat="no-repeat" padding="" margin_top="0px" margin_bottom="0px" class="" id="" animation_type="" animation_speed="0.3" animation_direction="left" hide_on_mobile="no" center_content="no" min_height="none"][Epub ahead of print] http://www.ncbi.nlm.nih.gov/pubmed/22933527 3. ACOG has consistently refused to engage the elective abortion data or any of the literature in a meaningful way for the last 40 years in spite of the overwhelming scientific evidence. 4. Finally, using oblique and obtuse language in the Practice Bulletin (quoted below) a. “Additional proposed risk factors for preterm birth include aspects of obstetric and gynecologic history, demographic characteristics, current pregnancy complications, and behavioral factors. However, data are inconsistent about whether these factors are actually causative for preterm birth. Preconception care allows an opportunity to assess risk factors and provide counseling for women with risk factors that can be modified, such as smoking and optimal control of underlying chronic diseases.”(18) b. Uterine instrumentation (eg, dilation and curettage) also has been associated with an increased risk of preterm birth in some, but not all, studies; the mechanism is unclear, but intrauterine microbial colonization, injury to the endometrium, or both, together with host and environmental factors, has been suggested.(21) – will not release ACOG from liability by the use of disingenuous language with no specific reference to abortion. Instead–it becomes an “[aspect] of obstetric and gynecologic history” and “uterine instrumentation (e.g. dilation and curettage).” And then the modifiers: “However, data are inconsistent about whether these factors are actually causative for preterm birth” and “has been associated with an increased risk for preterm birth in some, but not all, studies.” ACOG seems to believe that if someone accuses them of ignoring the scientific literature or denying a link with abortion (including 134 statistically significant studies, 2 excellent systematic reviews, and, a recent 2012 data-linked study), and preterm birth, they can now point to this veiled language and say, “No we didn’t! It was included right here.” How sad. Women deserve better, ACOG members deserve better, and ACOG knows better. Thank you for your time and efforts, if you have questions do not hesitate to contact me at 304-388-1599 or my email at byron.Calhoun@camc.org. Respectfully, Enclosure: Preterm birth and abortion publication list (134 statistically significant papers) Byron C. Calhoun, MD, FACOG, FACS, MBA Professor & Vice-Chair, Department of Obstetrics and Gynecology West Virginia University-Charleston Charleston, WVNov 1, 2012 Dear ProLife Colleague, Thank you for voting your values this coming Tuesday!! Preterm birth, (and especially Very Preterm Birth, <32 wks) is a major medical problem in our country. Induced abortion is a major preventable event associated with subsequent preterm birth. Studies show about a 30% increase in PTB after one abortion, a 60 to 70% increase in PTB after 2 abortions. And the risk keeps going up with more abortions. Yet the ACOG, the “guardians of women’s healthcare,” consistently obfuscate this fact. If you are associated with a training program, we urge you make this a study project. What would be more appropriate! (see our website for reference material and summaries.) See letter below: James R. Scott, MD, FACOG, Editor Editorial Office, Obstetrics & Gynecology ACOG 409 12th Street, SW Washington, DC 20024-2188 Dear Dr Scott: I read with interest and then confusion ACOG Practice Bulletin #130, October 2012 “Predicton and Prevention of Preterm Birth” by Drs Iams, Dildy, Macones, and Silverman, MD. One of the strongest risk factors associated with preterm birth was completely ignored: abortion prior to first term pregnancy. There are 4 points in regard to this critical issue: 1. There are over 130 studies spanning almost 40 years demonstrating a statistically significantly associated increased risk for preterm birth with elective surgical abortion. (see attached complete list) 2. Three excellent studies have been done in the last 3 years: Two Systemic Reviews: Swingle HM, Colaizy TT, Zimmerman MB, Morris FH. Abortion and the risk of subsequent preterm birth: A systematic review with meta-analyses. J Rrepro Med 2009;54:95-108 and Shah PS, Zao J. Induced termination of pregnancy and low birth weight and preterm birth: a systematic review and meta-analysis. BJOG 2009;116:1425-1442; and a large record-linked study from Finland: Klemetti R, Gissler M, Niinimaki M, Hemminki E. Birth outcomes after induced abortion: a nationwide register-based study of first births in Finland. Human Reproduction 2012 August 29 [Epub ahead of print] http://www.ncbi.nlm.nih.gov/pubmed/22933527 3. ACOG has consistently refused to engage the elective abortion data or any of the literature in a meaningful way for the last 40 years in spite of the overwhelming scientific evidence. 4. Finally, using oblique and obtuse language in the Practice Bulletin (quoted below) a. “Additional proposed risk factors for preterm birth include aspects of obstetric and gynecologic history, demographic characteristics, current pregnancy complications, and behavioral factors. However, data are inconsistent about whether these factors are actually causative for preterm birth. Preconception care allows an opportunity to assess risk factors and provide counseling for women with risk factors that can be modified, such as smoking and optimal control of underlying chronic diseases.”(18) b. Uterine instrumentation (eg, dilation and curettage) also has been associated with an increased risk of preterm birth in some, but not all, studies; the mechanism is unclear, but intrauterine microbial colonization, injury to the endometrium, or both, together with host and environmental factors, has been suggested.(21) - will not release ACOG from liability by the use of disingenuous language with no specific reference to abortion. Instead--it becomes an "[aspect] of obstetric and gynecologic history" and "uterine instrumentation (e.g. dilation and curettage)." And then the modifiers: "However, data are inconsistent about whether these factors are actually causative for preterm birth" and "has been associated with an increased risk for preterm birth in some, but not all, studies." ACOG seems to believe that if someone accuses them of ignoring the scientific literature or denying a link with abortion (including 134 statistically significant studies, 2 excellent systematic reviews, and, a recent 2012 data-linked study), and preterm birth, they can now point to this veiled language and say, "No we didn't! It was included right here.” How sad. Women deserve better, ACOG members deserve better, and ACOG knows better. Thank you for your time and efforts, if you have questions do not hesitate to contact me at 304-388-1599 or my email at byron.Calhoun@camc.org. Respectfully, Enclosure: Preterm birth and abortion publication list (134 statistically significant papers) Byron C. Calhoun, MD, FACOG, FACS, MBA Professor & Vice-Chair, Department of Obstetrics and Gynecology West Virginia University-Charleston Charleston, WV [/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]
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