Of the 281 deaths, 127 (45 percent) were attributed to natural causes. As seen in Figure 5, the age adjusted odds ratio of dying from natural causes within a year following any outcome of pregnancy is less than the odds ratio of dying for non-pregnant women.

The obvious implication of this finding is that women

who are capable of becoming pregnant are simply healthier and less likely to die of natural causes than women who cannot or do not become pregnant. In other words, women who are most likely to die from a natural physical ailment are less likely to have been pregnant in the last year of their lives.

Comparing abortion to birth, however, we once again see that the risk of death from natural causes was significantly higher (60 percent higher in this sample) for women who had an induced abortion in the prior year compared to those who carried to term or had a natural pregnancy loss.

While the researchers found that miscarriage was also associated with a lower health score, induced abortion was more strongly associated with a lower health assessment and more frequently identified by women as the cause of their reduced level of health. More than 20 percent of the women participating in the study expressed a moderate to strong need for professional help to resolve their loss.

From this data, Dr. Philip Ney, who led the research team, concluded that acute or pathological grief after the loss of an unborn child, whether by miscarriage or abortion, has a detrimental effect on the psychological and physical health of some women.

Ney proposed several possible reasons for this: (1) depression has been linked to suppressed immune responses, (2) psychological conflict consumes energy that would otherwise be spent in more healthy ways, and (3) prolonged or unresolved mourning may distract the woman from taking care of other health needs or confuse her interpretation of situations and events. In addition to these factors, abortion has been linked to sleeping disorders, eating disorders, and substance abuse, all of which can have a direct negative impact on a woman's health.

The STAKES study of pregnancy-associated deaths is beyond reproach. It is a record-based study in a country with centralized medical records. While a small number of women who died during the period investigated may have had births or abortions outside of Finland which would not have been identified in the records, there is no reason to believe these few cases would have altered these dramatic findings.

Clearly, the odds of a woman dying within a year of having an abortion are significantly higher than for women who carry to term or have a natural miscarriage. This holds true both for deaths from natural causes and deaths from suicide, accidents, or homicide. In addition, the study underscores the difficulty in reliably defining and identifying maternal deaths. Only 22 percent of the death certificates examined had any mention of the woman's recent pregnancy.

By stepping back from a predefined notion of what constitutes a pregnancy-related death, the STAKES team has shown that deaths among women following a pregnancy cannot easily be tracked when a study is based purely on short-term post-operative recovery. This is particularly true following an abortion. Maternal deaths after an abortion are seldom identified as such unless the death occurs on the operating table, if even then (see accompanying article on page 5). By examining all death certificates and all pregnancy events in the prior year, the STAKES team avoided the basic problem of pre-defining what deaths will be included or excluded in maternal mortality reports.

Even this study, however, has shortcomings. The most obvious limitation is that the researchers examined only a single year of the reproductive history of women who had died during the study period. Since suicide attempts are often associated with the anniversary date of the abortion, some portion of deaths from suicide or accidents that occurred slightly over one year after a prior abortion were probably missed.

As seen in Figure 6, the distribution of suicides by month following the pregnancy event indicate an increased level of suicides at seven to ten months following an abortion. This may correspond to a negative anniversary reaction related to the expected due date of the aborted child. A similar spike is seen among women who had miscarriages, though it peaks a couple of months earlier, perhaps because the miscarriages generally occurred further along in gestation than the abortions.

Another disadvantage of the one-year limit on the STAKES data set is that it does not reveal how long the protective effect of birth extends, or conversely, how long the odds ratio of death for those who abort remains elevated. A study spanning a longer period of time would be needed to identify these longer term effects.

Finally, the STAKES study does not shed any light on whether or not women who died from suicide or risk-taking behavior after an abortion were already self-destructive before their abortions. It is probable that many were. Women with a propensity for risk-taking would be more likely to become pregnant and perhaps more likely to choose abortion. In such cases, while abortion may not be the underlying cause of their problems, it probably contributed to their psychological deterioration and was a contributing cause of their death.

On the other hand, it is also clear from other studies that many women who were not previously self-destructive become so as a direct result of their traumatic abortion experience. Whether this latter group represents a major or minor portion of those who died in the STAKES sample is unknown.

Additional insights could be gained by looking back over several more years of the women's medical records. It is likely that prior suicide attempts, a high incidence of treatment for accidents, prior psychological treatments, and other prior pregnancy losses would all be associated with an increased risk of subsequent death by suicide, homicide, or accident.

Abortion advocates will naturally argue that abortion did not "cause" any of these deaths, but rather that these women were simply self-destructive or ill beforehand and would have died anyway. This is a flimsy argument, since clearly this same data shows that giving birth has a protective effect. Even women who committed suicide after giving birth waited until after their children were born to take their own lives.

It is quite probable that the best way to help a self-destructive woman to change her life, and value her own life, is to encourage her to cherish the life of her unborn child. Conversely, it is clear that aiding and encouraging a self-destructive woman to undergo an abortion is likely to aggravate her self-destructive tendencies.

These findings underscore the importance of holding abortion clinics liable for screening women who are seeking an abortion for a history of suicide, self-destructive behavior, and psychological instability. The failure to screen for these risk factors is clearly gross negligence. In addition, when abortion clinic counselors falsely reassure women that abortion is safer than childbirth, they should be held accountable for false and deceptive business practices.

Originally printed in The Post-Abortion Review, 8(2), April-June 2000. Copyright 2000, Elliot Institute.
See also:

21. Gissler, et.al. (1997) 652.

copyright 2000 Elliot Institute
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