If the Russian gov't had an ounce of sense (which is doubtful), it would outlaw abortion outright for the good of the country! Of course, we'd then hear an outcry from the UN population-control/"wimmin's rights" crowd.
Rosemarie | 02.24.03 - 12:07 pm | #

So, is the infertility caused by the type of abortion procedure, the quality of medical care in general, the quality of post-abortion medical care provided, etc, or what? You certainly wouldn't be meaning to mislead anyone by suggesting it's all the fault of the nebulous term "abortion" would you?
andy | Homepage | 02.24.03 - 1:24 pm | #

Andy,

The term is not nebulous to those of us who have been close to it. The procedures are unnatural, and only used in other circumstances when there is a serious uterine problem (I'm thinking especially of the D&C, which basically scrapes the uterine lining off). There is no abortion procedure that doesn't at least contribute to the chance that a woman will be infertile.

I wonder what will happen when many of these same women have breast cancer. Pravda did talk about the link a few years back.

Catherine
Catherine | 02.24.03 - 2:15 pm | #

Catherine -

From what I've read, D&C has the greatest chance of causing complications while newer procedures have little chance. Additionally, proper medical care and follow-up, as with ANY invasive procedure, should be used to check for complications before they can do much damage. I am willing to bet that the bulk of this problem in Russia is outdated medical techniques, lack of proper medical standards, and lack of follow-up.

The breast cancer links are tenuous, with the largest study to date finding no link when controlling for lifestyle and other factors.
andy | Homepage | 02.24.03 - 2:23 pm | #

Andy,

You write, "From what I've read, D&C has the greatest chance of causing complications while newer procedures have little chance."

Could you point out any of this research to me? I couldn't find any online.

When you mention newer procedures, could you be more specific?

For virtually every other medical procedure, we are advised of risks even if they have "little chance" of impacting us.

Also, it is perhaps true that a 1st trimester abortion performed under ideal circumstances would (say) raise your odds of becoming infertile by only 0.00001%. (I have no idea if that's the case, but let's stipulate that it is.)

Even so, in a medical facility (of whatever kind) that generally runs up to the highest standard, not all procedures performed there will meet ideal standards. That's one reason why patients are normally advised of potential side-effects.

If a federal study indicated a 3% increased risk of infertility, would you advocate that we require abortionists to notify patients of this?

Do you think it is reasonable for the federal government to conduct such a study?

Emily


Emily | Homepage | 02.24.03 - 2:54 pm | #

Actually, Andy, the studies I have seen are numerous, direct, and often administered by pro-choice scientists who were hoping to disprove the link.

As for "better techniques," the D&C is the most common one I've heard of. No matter how "modern" the technique, however, I can't see that something that inflicts an unnatural occurence on a body can have a good effect. The consequences of plastic surgery would be another good example.

I'm sure proper medical care would help, but I'm not sure I would trust a physician who would do an abortion at all to know what "proper medical care" is. I've had friends who had abortions, and I wouldn't call what they went through, from the original "counseling" through the "after effects" proper.

Catherine
Catherine | 02.24.03 - 2:57 pm | #

Here is a link that describes some studies and provides references for others regarding the breast cancer/abortion link:

http://www.prolifeinfo.org/upl2.html

Catherine
Catherine | 02.24.03 - 3:03 pm | #

Emily - I was reading information at WebMD, if you're interested.

If sound, initial research indicated an increased chance of infertility (or cancer) due to abortion, I would happily recommend that more be spent to look at the link. I'm all about providing people with scientifically sound information to make their decisions.

Catherine - it is my understanding that the largest, most comprehensive study of 1.5 million women (Danish, I believe?) found no link when adjusting for lifestyle and other factors. A larger sample is preferred to any smaller samples.
andy | Homepage | 02.24.03 - 3:20 pm | #

Andy,

So the 14 studies on the link that I posted do not have the weight of one? I hope you're not a doctor.

It is a grave disservice to the women served in clinics worldwide that this link, even if one concedes that it is a chance of a link, is not mentioned to a woman having an abortion, and denied by people in the medical profession. When I had my wisdom teeth out, I was warned about a .01% chance of death from anesthesia. Yet women who go to clinics for, as you described it, Andy, an invasive procedure, are not warned of this and other complications. And we live in a *free* society!

Catherine
Catherine | 02.24.03 - 3:36 pm | #

Dr. Joel Brind, author of a comprehensive meta-analysis of ABC studies which was published in the Journal of Epidemiology and Community Health, has a nice summation of ABC research on Abortion-Breast Cancer Link.
He also has a nice critique of the Danish study to which Andy refers. And Andy, in scientific research, a larger sample is not always to be preferred to a smaller one. It all depends on how the sample was chosen. Dr. Brind addresses the trouble with the Danish sample. I urge you to read up on Dr. Brind's insights before you cite that Danish research again.
prolife guy | Homepage | 02.24.03 - 3:52 pm | #

Andy,

Going back to your first comment: why wouldn't all of the procedures and care that are followed pursuant to an abortive choice fall under the "nebulous term 'abortion'"? Obviously, no abortion, no need for post-abortion medical care. No push to present abortion as nothing more than a medical choice (akin to removing a mole), no side-effects that must be swept under the rug as not the fault of the abortion per se.

Even permitting you to parse related complications from the abstract good of the ideal abortion (N.B., that's sarcasm, there), the bottom line is that couples are infertile likely because of previous abortions, a procedure that we're told repeatedly must be kept legal to avoid the less-than-ideal back-alley procedures. And this in a country that is bribing couples to procreate to head off depopulation.
Justin Katz | Homepage | 02.24.03 - 3:54 pm | #

Andy,

In response to my question above about where you did your research (see comment #4 in this strand),
you now write:

"I was reading information at WebMD, if you're interested."

WebMD is not an indepth purveyor of serious medical research. The link to the article you probably read at WebMD is here:

WebMD


Emily | Homepage | 02.24.03 - 5:04 pm | #

Following up on the above comment, if anyone clicks through on that WebMD link, they will find no citations to any scientific research.

What they will find is this:

"A therapeutic abortion is highly unlikely to affect your fertility...
A therapeutic abortion usually does not increase the risk of future problems with...fertility."

What this suggests is that there is some small risk to one's fertility. How small? We don't know, because they provide no citations.

I'm confident that women who are contemplating abortion would value being informed of the range of risk to their fertility.

With other medical procedures, we are routinely informed ad nauseum about potential side effects, even those with a very tiny chance of occurring.

Emily | Homepage | 02.24.03 - 5:13 pm | #

Indeed - what Russia needs is a pro-life and pro-family values government.

http://www.cyberussr.com/rus/uk1...k136- e.html#140

Lorne Dieterling | 02.24.03 - 5:55 pm | #

For many years, abortion was the contraceptive in Soviet Russia. It was cheap and readily available. Women had them repeatedly, to an extent that will seem improbable to people unfamiliar with the Soviet Union. Since the end of communism, the abortion rate has fallen significantly (I believe the WaPo article mentioned a 50% decrease), but abortion is still quite a bit more prevalent than in the U.S., with an average of 1 or 2 per woman according to the CCD's 1996 report on "Russian Women's Reproductive Health."

Even under the "best" surgical conditions here in the U.S., no doctor would encourage a woman to have multiple abortions. And multiple abortions in a country with crumbling medical infrastructure is bound to have horrible medical consequences for the woman involved.


Amy Pruss | 02.25.03 - 1:10 pm | #

This question is an example of how scientific research, unless demonstrating a very large correlation, benefit, harm etc., doesn't help much in answering social or policy questions. On the ABC issue,I think an objective analysis of the evidence suggests a link exists, but it is very small. The debate evolves then into critiques or defenses of the studies involved. A controlled prospective study could answer the question as much as possible, but is unlikely to receive funding. As far as post abortion infertility, lots of evidence exists for D&C infertility related to uterine wall changes; vacuum aspiration of small fetuses would do less damage (to the uterus). Intuition suggests,however, that it is not totally benign in every case, and depending on the amount of suction and collateral damage, some small chance of permanent uterine damage would follow.
MC | 02.25.03 - 1:12 pm | #

If it were any other medical procedure, plaintiff lawyers would have run it into bankruptcy long ago. Where are those plaintiff lawyers when you really need them?
C. Matt | 02.25.03 - 3:32 pm | #