Abortion and maternal health



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The researchers found that more women who gave birth after wanting an abortion but did not report having a fair or poor health 5 years later, compared to women who have had an abortion.

A higher proportion of women who gave birth reported having "fair or poor health" (27%, 95% CI 21% -34%) compared to women who received a first trimester (20%, 95% CI 16%). 24%) or second trimester abortion (21%, 95% CI 18% -25%), said Lauren J. Ralph, PhD, of the University of California at San Francisco, and her colleagues .

In addition, women who gave birth reported more chronic health problems, such as headaches, migraines and joint pain, than those who had an abortion, wrote Ralph and his colleagues in the US. Annals of Internal Medicine.

The authors noted that, despite extensive research on the effects of birth on the physical health of women, few studies have addressed the health consequences of pregnancy compared to that resulting from a pregnancy. unwanted pregnancy compared to abortion.

"Given that more than one in 20 women report that abortion poses problems for their own health, additional research comparing the consequences of abortion on maternal health with birth is needed" , wrote Ralph's group.

In an accompanying editorial, Lisa H. Harris, MD, and Vanessa Dalton, MD, both of the University of Michigan at Ann Arbor, said this type of data is important for medical doctors because it illustrates the links between reproductive health and overall health. .

"Reports like this suggest that tackling the rising rates of maternal morbidity and mortality in the United States is work that affects all physicians, not just those who provide pregnancy care," wrote the authors. columnists. "These are important findings, as some anti-abortion activists and legislators justify abortion restrictions by claiming that they protect the health and well-being of women."

Ralph and his colleagues reviewed data from Turnaway Study, a prospective five-year study of women who had requested but did not necessarily undergo an abortion from January 2008 to December 2010. The authors explained that this study complements her earlier work. . Women who gave birth after being denied an abortion "reported several life-threatening pregnancy complications," and one woman who was denied an abortion died.

In this study, women were asked about their current general health status with the help of a 5-point Likert scale, which was compared to their self-reported basic health status "just before to become pregnant ".

Of the approximately 3,000 first participants in the study, 558 women responded to the five-year interview. Participants were on average 25 years old, about one third were white, one-third were African-Americans and 22% were Hispanics. Most were single and more than one-third were below the federal poverty line, the authors said. In addition, one quarter reported having a history of depression or anxiety and about 20% reported that their pre-pregnancy health status was fair or poor.

A higher proportion of women who gave birth reported chronic headaches or migraines at age 5 compared to those who had abortions in the first or second trimester, and more women reported chronic joint pain at birth compared to who had also aborted, wrote the authors.

Approximately 10% of women who gave birth experienced pregnancy-related hypertension, compared to 1.9% and 4.2% of women who had first-trimester and second-trimester abortions, respectively.

In particular, eight out of 1,132 women died during the follow-up – four died among women who were denied abortion and four among those who had an abortion in the second trimester.

Harris and Dalton argued that, according to this study, "reproductive life events and overall health are closely linked long after childbirth and may be worse for women who can not have abortions." when they wish, "whether or not these adverse effects are attributable to a" term pregnancy, "the birth process itself, or parenthood".

They also looked at recent abortions, except in cases where the life or health of a woman is in danger.

"[These data] stress that birth always carries more risks of morbidity and mortality than abortion. As part of this study, health exceptions to abortion bans would apply … well, always, "editorialists wrote.

The limitations of the study included the fact that there was no way to determine whether the deterioration in the health of the women who had given birth was attributable to the delivery itself or the "cumulative effects of parenting and childbirth. the education of a child ". They also noted the significant loss of follow-up from the initial study, as well as its self-reported nature.

The study was funded by the Wallace Alexander Gerbode Foundation, the David and Lucile Packard Foundation, the William and Flora Hewlett Foundation, and an anonymous foundation.

Ralph revealed the support of the National Institute of Child Health and Human Development Eunice Kennedy Shriver.

Harris has announced support for the Society of Family Planning, Fellowship in Family Planning, Michigan Maternity Planning, the Bissell Family Foundation, the Anonymous Foundation, the American Society for Bioethics and Humanities, the American Association for History of Medicine, at Physicians for Reproductive Health. , the American College of Obstetricians and Gynecologists, the American Society for Reproductive Medicine and the Greenwall Foundation.

Dalton has announced the support of AHRQ, Bayer, the National Institute of Reproductive Health, the Blue Cross Blue Shield Foundation and the NCI.

2019-06-10T17: 15: 00-0400

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