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supplement to det

$Q$QQRWDWHG%LEOLRJUDSK\ZLWK&RPPHQWDU\ Supplement to Detrimental Effects of Abortion: An Annotated Bibliography With Commentary DISCLAIMER: This book is intended as an aid for the study and research of abortionrelated complications. The accuracy of citations and the accuracy of the annotationsdescribing research findings is not guaranteed. As with any secondary citation,researchers are advised to examine the original sources.
All rights reserved. No part of this book may be reproduced or transmitted in any form orby any means, electronic or mechanical, including photocopying, recording or by anyinformation storage and retrieval system without prior written permission from thepublisher, except for the inclusion of brief quotations in a review.
This title is also available in searchable electronic form.
SPECIAL NOTE: All the publisher’s profits from your purchase of this material are used to further post-
abortion research, education, and outreach. This is the product of enormous effort on the part ofthe editor and publisher. Please do not copy or distribute substantial portions of this work withoutpermission. Instead, please encourage other interested parties to purchase a copy for themselvesand thereby contribute to this ongoing effort.
Introductory Material
Note On Corrections and Recommendations
This is an ongoing project. The editor welcomes any corrections or suggestions you may make.
Recommendations regarding new or old studies that are not included in this bibliography, but should be,are also welcome. Corrections and recommendations should be sent to: Information Regarding This Supplement
and the Complete Bibliography
In order to keep the information in Detrimental Effects of Abortion as current as possible, the publisher is making this supplement available in .PDF format on our web site at www.afterabortion.org\Resources\detrimentaleffects.htm You are encouraged to use this supplement in conjunction with the published third edition of Detrimental Effects of Abortion which contains over 1200 entries in 140 categories. Please ask your localpublic, college, and medical libraries to order the bound copy of this work for their collections. Permissionis granted to print out this supplement as an addendum to printed copies of this work.
This supplement uses the same numbering format as the complete bibliography so the new
entries can be easily referenced to similar entries in the original third edition.
You will receive notice regarding publication and availability of additional supplements in the future if you sign up for the Elliot Institute email news list at www.afterabortion.org.
Original Table of Contents
(From the full text  not this supplement) Note On Corrections and Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . x Supplements and Updates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . x Editor’s Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi Editor’s Discussion of Key Research Findings and Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . xii Abortion Procedures - Standards and Guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Informed Consent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 General Background Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Crisis Theory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Pregnancy as a Crisis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Pregnancy Reactions/Unwanted Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Characteristics of Women Having Induced Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Abortion Decision Making - Role of Males . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Adoption as An Option . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Validity of Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Risk Factors for Adverse Emotional Consequences of Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Post-Abortion Stress/Trauma/Post-Abortion Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Grief and Loss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 General Background Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 Grief and Loss Following Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Guilt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Guilt General Background Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Abortion-Related Guilt/Regret/Violation of Conscience or Belief . . . . . . . . . . . . . . . . . . . . . . . 38 Ambivalence or Inner Conflict . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 Anxiety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Intrusion/Avoidance/Dreams/Nightmares . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 Denial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 Dissociation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Narcissism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 Self-Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 Self-Punishment (Masochism) or Punishment of Others (Sadism) . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Depression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 General Background Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Abortion-Related Depression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 Depression Shortly Prior to Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 Depression During Subsequent Pregnancies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 Anniversary Depressive Reactions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 Depressive Reactions from Genetic Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Short Term Depressive Reactions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 Long Term Depressive Reactions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 Psychiatric or Psychological Hospitalization or Consultation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 Self-Destructive Behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66 Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66 Accidents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 Repeat Abortions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 Eating Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 Substance Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 General Background Studies (Substance Abuse) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 Substance Abuse and Induced Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 Smoking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88 Long-Terms Effects of Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 Replacement Pregnancies/Rapid Repeat Pregnancies After Abortion . . . . . . . . . . . . . . . . . . . . . . . . 98 Sterilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99 Impact of Abortion On Others . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 Men And Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100 Abortion’s Impact on Siblings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 Impact of Abortion on Marriage and Family . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110 Violence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121 Wantedness as a Factor in Child Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121 Child Abuse and Its Relationship to Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122 Child Neglect or Failure to Bond . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124 Family Violence and Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126 Abortion as a Risk Factor for Violence During Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127 Homicide of Women During and Following Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129 Sexual Assault Pregnancy and Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130 Rape . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130 Incest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133 Second and Third Trimester Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135 6RFLDO(IIHFWVDQG,PSOLFDWLRQVRI$ERUWLRQ Outcome - Refused Abortions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 Sex Selection Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139 Genetic Engineering . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141 Deterioration of Economic and Social Conditions Following Abortion . . . . . . . . . . . . . . . . . . . . . 142 Abortion and Race or Poverty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143 Abortion and Religion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151 Decline of Religious Involvement After Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154 Abortion Technique and Its Relationship to Adverse Physical Effects . . . . . . . . . . . . . . . . . . . . . . 155 Short Term Complications and Other Aspects of Morbidity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156 Immediate Physical Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159 Cervical Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160 Perforated Uterus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161 Pain in Women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163 Acute Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163 Chronic Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164 Organ or System Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165 Cerebrovascular Diseases (Stroke) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165 Circulatory Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165 Disseminated Intravascular Coagulation (DIC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166 Amniotic Fluid Embolism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166 Pulmonary Embolism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167 Adult Respiratory Distress Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167 Infection Associated With Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168 Septic Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168 Acute Renal Failure from Septic Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168 Autoimmune Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168 Endometritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169 Genital Tract Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170 Pelvic Inflammatory Disease (PID) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172 General Background Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172 Abortion-Related Pelvic Inflammatory Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174 Bacterial Vaginosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177 Chlamydia Trachomatis Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179 Gonnorhea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181 HIV/AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182 Hepatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185 Use of Antibiotics in Connection With Induced Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185 Impact on Later Pregnancies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188 Secondary Infertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188 Uterine Fibroids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189 Gestational Trophoblastic Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189 Hypertension (High-Blood Pressure) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190 Ectopic Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192 Placenta Previa/Aburuptio Placentae/Retained Placenta . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196 Subsequent Miscarriage, Premature Birth or Low Birth Weight . . . . . . . . . . . . . . . . . . . . . . . 198 Neonatal Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204 Intraamniotic Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204 Subsequent Fetal Malformation/Birth Defects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204 Cancer Risk Associated With Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 206 General Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 206 Breast Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 206 Protective Effect of Early Childbirth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207 Induced Abortion as an Independent Risk Factor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209 Cervical Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214 Ovarian Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219 Endometrial Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 222 Lung Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 224 Colon and Rectal Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 226 Other Cancers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227 Maternal Death from Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227 Pregnancy-Associated Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233 Adolescent Developmental Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235 Abortion Decision-Making Among Adolescents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243 Pregnant Teenagers’ Reliance on Others to Make Pregnancy Resolution Decisions . . . . . . . . 246 Adolescent Abortion and Parental Involvement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247 Parental Notice or Consent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247 Effect of Parental Involvement Laws . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 248 Necessity of Parental Involvement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249 Family Estrangement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249 Parental Reaction to Pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251 Profile of Adolescents Not Disclosing Pregnancy or Abortion to Parents . . . . . . . . . . . . 252 Availability of Financial Resources as a Factor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 252 Adolescent Violation of Conscience or Belief . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255 Adolescent Long Term Psychological Sequelae . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256 Adolescent Demographic Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256 Differential Physical Complications of Adolescent Abortion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257 Adolescent Risk of Breast Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 258 'HILQLWLRQRI7HUPV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 260 1.1 Abortion Procedures - Standards and Guidelines National Abortion Federation, 1998 Clinical Policy Guidelines in A Clinician’s Guide toMedical and Surgical Abortion, Ed. Maureen Paul et al (New York: Churchill Livingston, 1999)255-269 Supercedes 1.1.9 Standards for Abortion Care, National Abortion Federation (1986) Demoralization; its impact on informed consent and medical care, DW Kissane, Med J Australia 175(10:537, Nov 19, 2001 Demoralization, a mental state characterized by hopelessness and meaninglessness, can interferewith a person’s capacity to give informed consent.
2.4 Pregnancy Reactions/Unwanted Pregnancy Cultural practices and social support of pregnant women in a northern New Mexico community,EW Domian, J Nursing Scholarship 33(4):331-336, 2001 Among Hispanic mothers in this community, pregnancy outcomes were positive because of asocialization process that helped mothers and family members to adapt to support the pregnancy.
This mutual sharing helped reinforce the family structure, integrate cultural beliefs, define rolesfor mother and family members, and define the nature of mother-child and family-childrelationships.
Women’s Health after Abortion: The Medical and Psychological Evidence, E Ring-Cassidy, IGentiles (Toronto: The deVeber Institute for Bioethics and Social Research, 2002) 255Research on the effects of abortion on women’s health, especially in North America, is highlyprone to the problem of selective citation. Some researchers refer only to previous studies withwhich they agree and do not consult, or mention, those studies whose conclusions differ fromtheir own. Voluntary interruption of pregnancy: comparative study between 1982 and 1996 in the maincenter of Cote d’Or. Study of women having repeat voluntary interruption of pregnancy, SDouvier et al, Gycecol Obstet Fertil 29(3): 200, Mar 2001 A French study of women who had repeated abortion in 1996 found that this group had beencharacterized by unstable couples and ambivalence with a wish of pregnancy but no wish ofchildren.
3.10.12 Memories Unleashed in Forbidden Grief. The Unspoken Pain of Abortion, Theresa Burke and David Reardon (Springfield, Il: Acorn Books, 2002) 121- 132 Describes flashbacks, dreams and nightmares, hallucinations, trauma and memory of post-abortion women.
Forbidden Grief: The Unspoken Pain of Abortion, Theresa Burke and David Reardon (SpringfieldIl: Acorn Books, 2002) 130-131 People use terms like spacing out and not being with it to describe the detached sensations thattherapists call dissociation. . . . It is very common for women to undergo abortions in adissociated state. Their bodies are there, but their emotional self is not. 3.15Self-Punishment (Masochism) or Punishment of Others (Sadism) Forbidden Grief. The Unspoken Pain of Abortion, Theresa Burke and David Reardon (SpringfieldIl: Acorn Books, 2002) 153 If a woman has masochistic tendencies, abortion may be experienced as a form of self-punishment. When the woman destroys her pregnancy and developing child, she is in some waydestroying an extension of herself. The loss and grief she experiences are things she feels shedeserves as a punishment for being bad. Conversely, by depriving herself of the potential pride,joy, and sense of accomplishment that come with the birth of a child, she is punishing herself byforbidding the enjoyments of motherhood that she does not deserve. . . . Such masochistictendencies can be an important factor in many repeat abortions.
3.19Depression During Subsequent Pregnancies Predictors of Repeat Pregnancy Outcome Among Black and Puerto Rican Adolescent Mothers,LO Linares et al, Developmental and Behavioral Pediatrics 13(2):89, 1992 A study of black and Puerto Rican adolescent mothers of low socioeconomic status 12 monthsafter delivery of a first child found higher depressive symptoms among women with priortherapeutic abortion compared to women with full term deliveries or women with no repeatpregnancy.
3.21Depressive Reactions from Genetic Abortions Abortion After Genetic Testing in Women’s Health After Abortion. The Medical andPsychological Evidence, E Ring-Cassidy, I Gentles (Toronto: The deVeber Institute for Bioethicsand Social Research, 2002) 155-167 Prenatal testing is expanding rapidly as ever more genetic markers are discovered and women areurged to undergo these tests. Couples are not prepared for the depression and guilt that frequentlyensue if abortion occurs when an anomaly is found. Nor are they usually informed about the helpthat is available for raising children with special needs.
3.24Psychiatric or Psychological Hospitalization or Consultation State-funded abortions vs. deliveries: A comparison of subsequent mental health claims over fiveyears, PK Coleman et al, American Journal Orthopsychiatry, 72(1):141, 2002 An examination of records for 173,000 low income California women found that women were 63percent more likely to receive mental health care within 90 days of an abortion compared towomen who delivered. In addition, significantly higher rates of subsequent mental healthtreatment persisted over the entire period in which data was examined.
3.25.14 Deaths Associated with Pregnancy Outcome. A Record Linkage Study of Low Income Women, DC Reardon et al, Southern Medical Journal 95(8):834, August 2002 A study of 173,279 low income California women who delivered and those who aborted in 1989were linked to death certificates over an 8 year period following the pregnancy event. Comparedto women who delivered, those who had an abortion had a significantly higher age-adjusted riskof death from suicide (2.54) and an increased risk of death from all causes (1.62).
3.27.44 Voluntary interruption of pregnancy: comparative study between 1982 and 1996 in the main center of Cote d’ Or. Study of women having repeat voluntary interruption of pregnancy, SDouvier et al, Gynecol Obstet Fertil 29(3):200, 2001 A 1996 French study found an increase in the number of repeat abortions from 15.8 percent in1982 to 21.6 percent in 1996. Women with repeat abortion were characterized by great socio-economic problems, unstable couples, and ambivalence with a wish to be pregnant but no wish ofchildren. The authors concluded that a real psycho-social precariousness existed and that thispopulation was well aware of contraceptive methods.
3.27.45 Impact of induced abortions on subsequent pregnancy outcome: the 1995 French national perinatal survey, L Henriet and M Kaminski, Br J. Obstet Gynaecol 108:1036-1042, Oct 2001 In a national sample of 12,432 French women who had a single birth in a public or privatematernity hospital during one week in 1995, women with two or more induced abortions weremore likely to be unmarried, less likely to be employed during pregnancy, had a lower educationallevel, a higher incidence of inadequate antenatal care, were more likely to be smoking duringpregnancy, and had a higher incidence of preterm birth compared to women with one inducedabortion or no history of prior induced abortion.
3.27.46 Profile of women presenting for abortions in Singapore at the National University Hospital, K Singh et al, Contraception 66(1):41, 2002 A study at the National University Hospital in Singapore found that the proportion of womenseeking a repeat abortion increased from 13.8 percent in 1996 to 33.2 percent in 2000. Ed Note: This is an example of several recent international reports of increased incidence ofrepeat abortion. This may be the reason for David Grimes and Kenneth Schulz of Family HealthInternational recently advocating insertion of intrauterine devices immediately after abortiondespite contrary warnings from IUD manufacturers. See Immediate postabortal insertion ofintrauterine devices (Cochrane Review), Cochrane Database System Rev 2002; (3):CD001777 3.28.13 What’s Eating You? Abortion and Eating Disorders, in Forbidden Grief: The Unspoken Pain of Abortion, Theresa Burke and David Reardon (Springfield, Il: Acorn Books, 2002) 187-200 The author first learned how abortion is a forbidden grief in leading a support group for womenwith eating disorders. 3.29Substance Abuse - General Background Studies 3.29.18 Case-Control Study of Attention-Deficit Hyperactivity Disorder and Maternal Smoking, Alcohol Use, and Drug Use During Pregnancy, E Mick et al, J Am Acad Adolesc Psychiatry 41(4):378,April 2002 Alcohol use during pregnancy was found to be a statistically significant increased risk forattention-deficit hyperactivity disorder in children. 3.31.31 Annual Smoking-Attributable Mortality, Years of Potential Life Lost, and Economic Costs  United States, 1995-1999. Centers for Disease Control, MMWR 51(14):300-303, April 12, 2002 During 1995-1999, smoking caused an annual average of 178,311 deaths of women in the U.S.
Most smoking deaths were attributed to lung cancer, ischemic heart disease, and chronic airwaysobstruction. Each year, smoking-attributable mortality was responsible for an estimated 2,284,113years of potential life lost for women. Adult females lost an average of 14.5 years of life becausethey smoked.
3.31.32 Impact of induced abortions on subsequent pregnancy outcome: the 1995 French national perinatal pregnancy survey, L Henriet, M Kaminski, Br J Obstet Gynaecol 108:1036-1042, 2001 A 1995 French national survey of women who delivered a singleton birth found that 23.6 percent of the women smoked during the third trimester of pregnancy where there was no inducedabortion history compared to 34.5 percent for women with a history of one induced abortion, and42 percent of women with a history of two or more induced abortions. Women with abortionhistory were also more likely to be heavier smokers compared to women with no abortion history.
3.31.33 Case-Control Study of Attention-Deficit Hyperactivity Disorder and Maternal Smoking, Alcohol Use and Drug Use During Pregnancy, E Mick et al, J Am Acad Child Adolesc. Psychiatry41(4):378, April, 2002 Smoking during pregnancy was found to be a statistically significant increased risk factor forattention-deficit hyperactivity disorder in children.
3.36Abortion’s Impact on Siblings or Subsequently Born Children 3.36.16 The quality of the caregiving environment and child development outcomes associated with maternal history of abortion using the NLSY data, PK Coleman et al, J. Child Psychology andPsychiatry 43(6):743, 2002 Data derived from the National Longitudinal Survey of Youth compared the quality of thechildcare environment and child development among children of mothers with a history ofabortion compared to children of women with no abortion history. After adjusting for potentiallyconfounding variables, the level of emotional support in the home was significantly lower amongfirst born children age 1-4 years where mothers had a history of abortion compared to non-aborting mothers. Among children age 5-9, more behavior problems were found where mothershad a history of abortion compared to non-aborting mothers.
A comparison of the prevalence of domestic violence between patients seeking termination ofpregnancy and other general gynecology patients, TW Leung et al, Int’l J Gynaecol Obstet77(1):47, April 2002 Researchers at the University of Hong Kong compared the prevalence of domestic violenceamong women seeking abortion with other general gynecology patients. The lifetime prevalenceof abuse in the group seeking abortion (27.3 percent) was significantly higher than generalgynecology patients (8.2 percent).
3.41.10 Violence in the Lives of Women Having Abortions: Implications for Practice and Public Policy, NF Russo and JE Denious, Professional Psychology: Research and Practice 32:142, 2001 A random household survey of more than 2,500 U.S. women sponsored by the CommonwealthFund found that 27.7 percent of women who reported abortion stated that they had beenphysically abused as children compared to 10.7 percent of women who reported no abortion history; 23.6 percent of women who reported abortion stated they had been sexually abused aschildren compared to 7.8 percent of women who reported no abortion history; 23.3 percent ofwomen who reported abortion stated they had a violent partner compared with 11.8 percent ofwomen who reported no abortion history.
3.43Homicide of Women During and Following Pregnancy Abuse during pregnancy and femicide: urgent implications for women’s health, J McFarlane etal, Obstet Gynecol 100(1):27-36, July 2002 A 10 city case-control study compared pregnant women who were victims of attempted orcompleted homicide with randomly identified abused pregnant women in the same city basedupon police and medical examiner records. Abuse during pregnancy was reported by 7.8 percentof the abused controls, 25.8 percent of attempted homicide cases, and 22.7 percent of thecompleted homicide cases.
3.44.15 Enforcing statutory rape, MW Lynch, Public Interest 132:3-16, 1998 It is prudent, moral, and just to build barriers to adult sex with minor girls.
3.44.16 DNA Analysis of Abortion Material Assisted by Histology Screening, B Karger et al, Am J Forensic Medicine and Pathology 22(4):397-399, 2001 DNA was successfully used to identify a suspected sexual abuser of a 13-year-old girl by DNAanalysis of aborted fetal remains by histology screening which concluded that the possibility ofpaternity was 99.9997 percent.
3.44.17 Sexual Abuse as a Factor in Adolescent Pregnancy and Child Maltreatment, D Boyer, D Fine, Family Planning Perspectives 24:4, Jan/Feb 1992 A Washington state study of young women who became pregnant as adolescents found that two-thirds had been sexually abused and 44 percent had been raped.
3.44.18 A Statewide Survey of Age at First Intercourse for Adolescent Females and Age of their Male Partners: Relation to Other Risk Behaviors and Statutory Rape Implications, H Leitenberg and HSaltzman, Archives of Sexual Behavior 29(3):203, 2000 A Vermont study found that younger adolescents were more vulnerable and were more likely tobe exploited by older males.
3.44.19 Experience of Violence Among Teenage Mothers in Alaska, BD Gessner and KA Perham- Hester, J. Adolescent Health 22:383, 1998 Teenage mothers were found to be more likely to experience violence during and after theirpregnancy compared to older women. For all women, the risk of violence increases afterpregnancy. Nearly one-half of the births to the youngest teenagers resulted from second degreestatutory rape.
3.44.20 Legal issues associated with sexual activity between adults and minors in Texas:a review, PB Smith et al, Texas Medicine 95(7):65, July 1999 A survey of Texas primary care physicians found that there was little, if any, understanding of keylegal facts associated with adolescent sexuality and pregnancy, especially when adult partnerswere involved.
Deterioration of Economic and Social Conditions Following Abortion Voluntary interruption of pregnancy :comparative study between 1982 and 1996 in the maincenter of Cote d’Or. Study of women having repeat voluntary interruption of pregnancy, SDouvier et al, Gynecol Obstet Fertil 29(3):200, Mar 2001 A 1996 French study compared women with a single abortion with women who had two or moreabortions. The authors concluded that women with repeat abortions were characterized by greatsocio-economic problems, unstable couples, and ambivalence. There was a wish of pregnancy butno wish of children. A real psycho-social precariousness existed and this population was wellaware of contraceptive methods.
Impact of induced abortions on subsequent pregnancy outcome: the 1995 French nationalperinatal survey, L Henriet and M Kaminski, Br J Obstet Gynaecol 108:1036, Oct 2001 In a national sample of 12,432 French women who had a single birth in a public or privatematernity hospital during one week in 1995, women with a single abortion or two or more priorinduced abortions were more likely to be unmarried, less likely to be employed during pregnancy,had a lower educational level, a higher incidence of inadequate antenatal care, were more likely tosmoke during pregnancy and had a higher risk of preterm birth compared to women with nohistory of prior induced abortion.
Teenagers Pregnancy Intentions and Decisions. A Study of Young Women Choosing to GiveBirth. The Alan Guttmacher Institute: Occasional Report, 1997 A study of unmarried pregnant women 15-18 years of age in four California counties in 1996 whohad decided to give birth found that 65 percent were opposed to or feared abortion and 4 out of 5thought it to be a difficult personal decision. Only 15 percent said that a major obstacle to abortion was lack of ready availability. A strong association was found between intendedpregnancy and foreign-born Hispanic women. These women were less likely to have been incontrolling or abusive relationships and were more likely to have strong support for the pregnancyfrom the baby’s father.
Reproductive health differences among Latin American-and U.S. born young women, AMMinnis and NS Padian, J Urban Health 78(4):627, Dec 2001 A survey of females aged 15-24 at reproductive health clinics in the San Francisco Bay areabetween 1995 and 1998 compared foreign born Latinas, U.S. born Latinas, and U.S. born non-Latinas. It was found that U.S. born Latinas were significantly more likely to have had anabortion and have a chlamydial infection compared to the other groups.
Pain control in medical abortion, E Wiebe, Int’l J Gynecology & Obstetrics 74:275-280, 2001 A Canadian study of abortion procedures using methotrexate and misoprostol reported that themean pain score was 6.2 on a scale from 1-10. Severe pain (scores of 9 or 10) was reported by23.4 percent of the women. Women experiencing severe pain were more likely to have a lowermaternal age, lower parity, higher anxiety and depression, and less satisfaction with theprocedure. The authors reported that pain medication given before the onset of the procedure didnot reduce the amount of severe pain.
5.24.16 Factors associated with HIV infection are not the same for all women, EV Boisson and LC Rodrigues, J Epidemiol Community Health 56(2):103, Feb 2002 A British study found that termination of pregnancy history significantly increased the risk ofHIV infection (OR= 6.7, 95%CI = 3.4 to 13.1) among women who shared needles and who hadfewer than 10 sexual partners in their lifetime. 5.33Subsequent Miscarriage, Premature Birth or Low Birth Weight 5.33.26 Infection and preterm birth, WW Andrews et al, Am J Perinatol 17(7):357, 2000 Preterm birth complicates 11 percent of all pregnancies in the U.S. and remains a leading cause ofinfant mortality and long-term neurological handicap. Despite widespread use of preventivestrategies, the rate of preterm birth is increasing and the prevalence of long-term handicap topreterm birth is also increasing. Considerable data implicate a clinically silent upper genital tractinfection as a key component of the pathophysiology of a majority of early spontaneous preterm births, but a minority of preterm births that occur near term.
5.33.27 The role of infection in the etiology of preterm birth, M Toth et al, Obstet Gynecol 71(5):723, A study at New York Hospital-Cornell University Medical College concluded that collectiveevidence implicates preexisting infection of the uterine cavity as a predisposing factor inpremature rupture of the membranes, preterm delivery, and amnionitis. . . . A strong correlationwas found between preterm birth and a history of pelvic inflammatory disease. . . . Amnionitiswas also associated with a history of pelvic inflammatory disease. 5.33.28 The Epidemiology of Preterm Labor, JN Robinson et al, Seminars in Perinatology Factors associated with preterm labor and delivery include maternal conditions such as inducedabortion. Maternal behaviors such as smoking and substance abuse can be risk factors for a shortgestation.
5.33.29 Impact of induced abortions on subsequent pregnancy outcome. The 1995 French national perinatal pregnancy survey, L Henriet and M Kaminski, Br J Obstet Gynaecol 108 :1036-1042,2001 In a national sample of 12,432 French women who had a singleton live birth during one week in1995, there was a statistically significant increased risk of preterm birth of 30 percent for womenwith one prior abortion, and a 90 percent increased risk of preterm birth for women with two ormore induced abortions compared to women with no induced abortion history.
5.34Neonatal Infection/Sub-Clinical Infection Risk factors associated with early-onset sepsis in premature infants, JA Martius et al, Eur JObstet Gynecol Reprod Biol 85(2):151, Aug 1999 A German study found that premature rupture of the membranes, and histologicalchorioamnionitis and/or funisitis were statistically significant risk factors for probable neonatalsepsis. The authors also reported a strong association between probable sepsis and intracranialhemorrhage of the infant.
The relationship between infections and adverse pregnancy outcomes: an overview, RS Gibbs,Ann Peridontol 6(1):153, Dec 2001 A large body of clinical and laboratory information suggests that subclinical infection is a majorcause of preterm birth, especially those occurring before 30 weeks. . . . Additional information hassuggested that subclinical infection is also responsible for many serious neonatal sequelaeincluding periventricular leukomalacia, cerebral palsy, respiratory distress, and evenbronchopulmonary dysplasia and necrotizing entercolitis. 5.35Intraamniotic Infection/Intrapartum Infection/Premature Rupture of Does an Abortion Increase the Risk of Intrapartum Infection in the Following Pregnancy?, KMuhlemann et al, Epidemiology 7:194-198, 1996 A case-control study using data from the Washington state birth registry for 1989-91 found thatthe relative risk for intrapartum infection among women with prior induced abortion or priorspontaneous abortion compared to women with a prior live birth was 4.3 (95% CI=3.5-5.4).
Maternal Infection and Cerebral Palsy in Infants of Normal Birth Weight, JK Grether and KBNelson, JAMA 278(3) 207, July 16, 1997 In a population-based case-control study at all hospitals in four northern California countiesduring 1983-85, intrauterine exposure to maternal infection was associated with a marked increaseof cerebral palsy in infants of normal birth weight. One or more indicators of maternal infectionwere present in 2.9 percent of control children, 22 percent of children with cerebral palsy, and 37percent of children with the spastic quadriplegic type of cerebral palsy.
Characteristics of women with clinical intra-amniotic infection who deliver preterm compared toterm, MA Krohn and J Hitti, Am J Epidemiol 147(2):111, Jan 1998 Researchers in King County, Washington found that women with preterm births with intra-amniotic infection were significantly more likely than women carrying to term with intra-amnioticinfection to have membrane rupture before contractions as well as prolonged membrane rupture.
Risk factors for intra-amniotic infection: a prospective epidemiologic study, DE Soper and HPDalton, Am J Obstet Gynecol 161(3):562, Sept 1989 A study at the Medical College of Virginia found that patients with intra-amniotic infection hadlonger durations of labor and ruptured membranes compared to patients without infections.
The relationship between induced abortion and outcome of subsequent pregnancies, S Linn etal, Am J Obstet Gynecol 146(2):136, May 15, 1983 An evaluation of 9,823 deliveries using logistic regression analysis to control for multipleconfounding factors found that a history of two or more induced abortions was statisticallyassociated with first trimester bleeding, abnormal presentations, and premature rupture of themembranes.
Risk factors for the development of preterm premature rupture of the membranes after arrest ofpreterm labor, DA Guinn et al, Am J Obstet Gynecol 173(4):1310, Oct 1995 Researchers at the University of Alabama at Birmingham found that women who had preterm premature rupture of the membranes were significantly more likely to have a history ofabortion(s) (p=0.001) compared to women who did not have preterm premature rupture of themembranes.
Public health issues related to infection in pregnancy and cerebral palsy, DE Schendel et al,Ment Retard Dev Disabil Res Rev 8(1):39-45, 2002 Researchers at the National Center on Birth Defects and Developmental Disabilities of theCenters for Disease Control reported that cerebral palsy is the most common neuromotordevelopmental disability of childhood, affecting as many as 8,000-12,000 born in the U.S. eachyear which corresponds to 2-3 per 1000 children. Greater numbers of preterm and very low birthweight infants are surviving with cerebral palsy and other developmental problems. Infection inpregnancy may be an important cause of the disorder. Chorioamnionitis might account for 12percent of spastic cerebral palsy in term infants, and 28 percent of cerebral palsy in preterminfants. Studies of biochemical markers of fetal inflammation associated with infection alsosuggest that inflammatory response may be an important independent etiological factor. 5.38Protective Effect of Early Childbirth/ Breastfeeding 5.38.11 Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50,302 women with breast cancer and 96,973women without the disease, V Beral et al, The Lancet 360:187, July 20, 2002 This large international study by a collaborative group studying hormonal factors in breast cancerfound that the relative risk of breast cancer decreased by 4.3 percent for every 12 months of breastfeeding in addition to a decrease of 7.0 percent for each birth. It was estimated by the authors thatthe cumulative incidence of breast cancer would be reduced by more than half from 6.3 to 2.7 per100 women by age 70, if women had the average number of births and lifetime duration ofbreastfeeding that had been prevalent in developing countries until recently. Breastfeeding couldaccount for almost two-thirds of this estimated reduction in breast cancer incidence.
5.38.12 Low Birth Weight in Relation to Multiple Induced Abortions, MT Mandelson et al, Am J Public A Washington state study of 6,541 white women who had a first birth between 1984 and 1987reported that 19.4 percent of women with no prior induced abortions were age 30 or more at firstbirth compared to 23.4 percent (one prior abortion), 27.4 percent (two prior abortions), 32.9 percent (three prior abortions), and 35.3 percent (four or more prior abortions). Ed. Note: Asubstantial number of postabortion women in this sample had an increased risk of breast cancerdue to delayed childbirth.
5.40.23 Determinants of cervical human papillomavirus infection: differences between high-and low- oncogenic risk types, PK Chan et al, J Infect Dis 185(1):28, Jan 2002 A Hong Kong study of women who participated in cervical cancer screening found that theprevalence of HPV infection was 7.3 percent overall (4.2 percent for high-risk, 1.9 percent forlow-risk and 2.1 percent for unknown-risk women). A history of induced abortion significantlyincreased the risk of HPV for women at high risk for HPV (OR 1.87, 95%CI 1.20-2.90),significantly increased the risk for women with any HPV, low risk, high risk or unknown risk,(OR 1.51, 95%CI 1.08-2.12 ),and significantly increased the risk for women with an unknownrisk for HPV (OR 1.97, 95% CI 1.05-3.69). Other factors with significantly increased the risk ofHPV included cigarette smoking, non-use of barrier contraception, young age at first intercourse,and four or more lifetime sexual partners.
Birth characteristics, maternal reproductive history, hormone use during pregnancy, and risk ofchildhood acute lymphocytic leukemia by immunophenotype (United States), Xo Ou Shu et alCancer Causes and Control 13:15-25, 2002 A U.S. study among participating hospitals in the Children’s Cancer Group investigated birthcharacteristics and reproductive factors with the increased risk of childhood acute lymphoblasticleukemia (ALL). T-cell childhood ALL was associated with a history of induced abortion (OR2.4, 95% CI 1.3-4.5). The risk of childhood ALL from all subgroups where there had been aninduced abortion prior to the index pregnancy was 1.2 (OR 1.2, 95% CI 1.0-1.4). Ed. Note:Reaearcher C Infante-Rivard and colleagues at McGill University have identified maternal use ofalcohol during pregnancy and mother’s use of antibiotics during pregnancy as other risk factorsfor ALL.) Deaths Associated With Pregnancy Outcome. A Record Linkage Study of Low Income Women,DC Reardon et al, Southern Medical Journal 95(8):834, August 2002 A record linkage study of low income women eligible for state-funded medical insurance inCalifornia identified all paid claims for abortion or delivery in 1989. These were linked to thestate death registry over an 8 year period. Compared to women who delivered, those who abortedhad a significantly higher age adjusted risk of dying from all causes (1.62); from suicide (2.54);accidents (1.82); from non-violent causes (1.44), including AIDS (2.18), circulatory diseases(2.87) and cerebrolvascular disease (5.46). The Effect of Religious Membership on Teen Abortion Rates, A Tomal, J. Youth andAdolescence 30(1):103-116, 2001 In a study of data from 1,024 counties in 18 states that report the incidence of teen abortion,abortion rates in counties with no parental involvement laws were about twice as high as thosecounties with parental involvement laws, irrespective of high or low religiosity.
7.10Differential Psychosocial Impact on Adolescents 7.10.16 Predictors of Repeat Pregnancy Outcome among Black and Puerto Rican Adolescent Mothers LO Linares et al, Developmental and Behavioral Pediatrics 13(2):89, 1992 A study of black and Puerto Rican adolescent mothers of low socioeconomic status 12 monthsafter delivery of a first child found higher depressive symptoms, more delayed grade placement,and poorer school attendance among women with prior therapeutic abortions compared to womenwith no repeat pregnancy.
7.10.17 Women Who Obtain Repeat Abortions: A Study Based on Record Linkage, PG Steinhoff et al, Family Planning Perspectives 11(1):30, Jan/Feb 1979 Women under age 18 who had abortions were more likely than women in general to have a repeatpregnancy within two years (29.2 percent v. 21.4 percent) 7.10.18 When Adolescents Choose Abortion: Effects on Education, Psychological Status and Subsequent Pregnancy, LS Zabin et al, Family Planning Perspectives 21(6):248, 1989 A study of young black women in Baltimore during 1985-86 found that those with a repeatpregnancy within two years following their abortion (37 percent of the sample) were significantlyless likely to remain in school or to graduate (78 percent vs. 97.4 percent), more likely to bebehind grade for age by 2 years (58.5 percent vs. 30.7 percent), and experience a negativeeducational change (34.1 percent vs. 8 percent) compared to those with a prior induced abortionand no repeat pregnancy within two years. 7.10.19 The Elliot Institute Survey. Psychological Reactions Reported After Abortion in Forbidden Grief. The Unspoken Pain of Abortion, Theresa Burke and David Reardon (Springfield, Il: AcornBooks, 2002) 287-300 A survey questionnaire completed by 260 postabortion women involved in Women Exploited byAbortion, Victims of Choice, and Last Harvest Ministries found that women who had at least oneabortion as a teenager were significantly more likely than older women to report nightmares;flashbacks to the abortion; hysterical outbreaks; feelings of guilt; fear of punishment from God;fear of harm coming upon their other children; a worsening of negative feelings on theanniversary date of the abortion, during a later pregnancy or when exposed to pro-choicepropaganda; experiencing false pregnancies, a dramatic personality change for the worse, and having talked to the aborted child prior to the abortion. . . . Women who had aborted as teenagerswere significantly less likely than older women to report a history of professional counseling priorto their abortion, that the memory of the abortion had faded with time, or being in touch with theirfeelings after the abortion.

Source: http://www.afterabortion.info/vault/DEA_Supplement_1.pdf

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PSYCHIATRIC MEDICATION FOR CHILDREN AND ADOLESCENTS: PART II - TYPES OF MEDICATIONS Psychiatric medications can be an effective part of the treatment for psychiatric disorders of childhood and adolescence. In recent years there have been an increasing number of new and different psychiatric medications used with children and adolescents. Research studies are underway to establish more c

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SUMMARY OF PRODUCT CHARACTERISTICS NAME OF THE MEDICINAL PRODUCT Leflunomide medac 10 mg film-coated tablets 2. QUALITATIVE AND QUANTITATIVE COMPOSITION Each film-coated tablet contains 10 mg of leflunomide. Excipients with known effect: Each film-coated tablet contains 76 mg of lactose (as monohydrate) and 0.06 mg of soya lecithin. For the full list of excipients, see sect

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