Abortion limit?
October 9, 2005 2:10 PM   Subscribe

Is there a limit to the number of abortions a woman may have?

I'm really not interested in your views on abortion, only medical possibilities. During a polotical discussion, I mentioned I have heard of women getting 20 or more abortions. my girlfriend thinks this just isn't possible.

She is basing her opinion on the belief that part of the uterus is cut back or scraped during a standard precedure, and subsequent abortions are risky. From a quick reading on Wikipedia, I believe this is the older D & C procedure that is not used as much anymore.

References to excessive abortions would also be helpful.
posted by Yorrick to Health & Fitness (17 answers total)
 
Best answer: I know someone who works at a family planning clinic who met a woman who was pregnant 20 times, had 11 abortions, and then I'm not sure how many kids and how many miscarriages. The thought makes me shudder.
posted by croutonsupafreak at 2:16 PM on October 9, 2005 [1 favorite]


I know two women who each had three abortions.

In seeking credible stats, you will run into the problem of defining abortion. Are you only interested in surgical abortion?

I had some luck in searching for "repeat abortions".
In the US, 78% of women who have an abortion have never before had one (52%) or have had one (26%). (http://www.prochoice.org/about_abortion/facts/women_who.html)

In Canada, fewer than 2% of women who have abortions have had three or more past abortions.(http://www.findarticles.com/p/articles/mi_qa3634/is_199701/ai_n8748633)

A Maryland study found 8.6% of women who had repeat abortions had had 4 or more. (http://www.mdrtl.org/abortionmd/stats4.html)

So, since there are lots of women who have had more than a couple of abortions, it appears that it's possible to have several.

A UK study found very few health risks to women who have repeat abortions. (http://www.spiked-online.com/Printable/0000000054E4.htm)

I was able to find several websites that said repeat abortions pose health risks or are complicated, but they all appeared to be from anti-choice groups. It did occur to me that women who have several abortions may also have some sort of health condition that influences such statistics, if they exist. But that's just a guess.
posted by acoutu at 2:32 PM on October 9, 2005


As I understand it, abortions early on in the pregnancy can be done by taking 2 pills which cause the uterus to reject the egg (or something), and therefore doesn't cause any physical damage to the uterus. If that's correct, then I imagine a woman could have infinite numbers of abortions, though I imagine questions would be asked at some point. (Like... "Have you heard of condoms?")
posted by Lotto at 2:34 PM on October 9, 2005


abortion does not "cut back" part of the uterus. it is one of the safest procedures in modern medicine.
posted by crabintheocean at 3:32 PM on October 9, 2005


It is estimated today that more pregnancies are lost [abort] spontaneously than are actually carried to term.

The rest of the linked web page has lots and lots of stats on likely this is to happen repeatedly to the same woman.
posted by alms at 4:24 PM on October 9, 2005


Best answer: "While a minority of respondents (3) had an abortion (conducted by physicians in the maternity hospital), the average frequency was rather high (15), with the maximum of 40 abortions for 37 year-old woman."

http://www.policy.hu/ghazaryan/Research%20Paper%20final%202004.doc
or (html version)

posted by trevyn at 4:29 PM on October 9, 2005


Risks of repeated abortion. Not a peer-reviewed article, but it's by a doctor.

20 abortions sounds extreme, but even D&Cs are (or once were) done therapeutically for various problems, so I doubt that a single D&C causes significant damage. I know that my mother had several D&Cs (after miscarriages, to remove leftover tissue) before she had me.
posted by needs more cowbell at 4:38 PM on October 9, 2005


HEARSAY ALERT: My Russian teacher once said that due to the very bad sex-ed policies of Russia and other former Soviet countries, abortion was the primary form of birth control over there. She said many women have had at least three or four.
posted by Anonymous at 6:38 PM on October 9, 2005


References to excessive abortions would also be helpful.

I'd have to say that this part of the question requires a personal interpretation. "Excessive" is clearly normative -- "that woman has had just too many abortions!" Since you're not interested in my views on abortion, though, I'm not allowed to tell you that, barring obvious medical risks, I don't think there's some categorical limit.
posted by electric_counterpoint at 6:57 PM on October 9, 2005


Schroedinger, my college friend who spent a semester in the Soviet Union explained as a manifestation of the Soviet system's tendency to favor services over consumer goods (birth control products being consumer goods, and abortions being services).
posted by alms at 7:26 PM on October 9, 2005


Response by poster: I apologize to electric_counterpoint and others for the poor phrasing of my last comment. Thanks to all for your comments.
posted by Yorrick at 8:02 PM on October 9, 2005


Svetlana, now elderly, had three abortions; her friend had 17.

Russia's abortion rate -- one of the highest in the world -- is widely assumed there to be a key factor in their population loss (some 700,000 annually).

Another factor is probably poor manufacturing quality for birth control, and lack of privacy in typical Soviet-era apartments. More More

Social science has shown that before contraception was widely available, women would often become pregnant continuously between marriage and menopause, with hormonally-controlled pauses only after each birth. (Ironically, this means that in countries without the pill, women undergo fewer menstruations in a lifetime than women on the pill -- which is considered as a cause of certain health problems.)

I would assume that the same rough calculation can hold true -- that a woman can get pregnant at least a couple of dozen times in a lifetime, and each of those could result in an abortion. Even a sanitary, modern abortion is not without risk, of course, but she could remain lucky. Abortions would hasten the return of menses, and thus increase the number of possible pregnancies leading to abortion. Theoretically I would not be surprised if the upper limit is close to 40, but that's assuming either a long period of fertility with continuous access to a partner, or more than one a year on average, which seems unlikely to be healthy.
posted by dhartung at 9:28 PM on October 9, 2005


One of the problems with this question is that some of the respondents are conflating two different kinds of abortions. In medicine, we speak of SABs and TABs; "spontaneous" and "therapeutic" abortions. Never mind the specific connotations for a moment; the former are ones that happen by themselves and the latter are those which are brought about by the intentional actions of a practitioner.

I'm pretty sure that the questioner is asking about therapeutic abortions of otherwise viable pregnancies, which changes the question a little bit. In medical school, we were taught that each one of these reduces a woman's chance of successfully conceiving at a later time, because of endometrial scarring. It never occurred to me that this might be propaganda; I think it's simply true.

That said, if the median woman becomes infertile after 3 D&C's, which sounds like a statistic I might have heard somewhere, there will always be a lady out there somewhere who will become pregnant after undergoing 20 D&C's. That's just the nature of statistics and the remarkable human organism.
posted by ikkyu2 at 12:13 AM on October 10, 2005


Except that now there are medical abortions (as opposed to surgical abortions) which are not invasive; pills or an injection cause the pregnancy to end. D&Cs aren't the only method anymore.

I'm sure there may be other risks associated with multiple medical abortions, but I assume that would at least circumvent the scarring problem?

In other words, it's not just spontaneous and therapeutic. There are different types of therapeutic abortions to take into account with this question.
posted by occhiblu at 8:20 AM on October 11, 2005


One should also try to be figuring in the timing of these multiple abortions, since the earlier in the pregnancy the abortion is provided, the safer and less complicated it is, generally. And it sounds like we're talking about the risks associated with complications here.
posted by occhiblu at 8:46 AM on October 11, 2005


Searching PubMed, i'm surprised to find how little literature there is on this topic. What there is seems to suggest that uncomplicated induced abortion doesn't, statistically, affect future fertility.

It almost looks like there haven't been any good epidemiologic studies funded to study this topic in the last 6 years or so.
posted by ikkyu2 at 10:30 PM on October 13, 2005


Funny how that works...
posted by occhiblu at 8:06 AM on October 14, 2005


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