January 2, 2008
Discussing recent study regarding miscarriage, abortion, premature births, and low birth weights with your patients
The Association of Reproductive Health Professionals (ARHP) encourages advocates, the media, and providers to critically analyze the science and methodology contained in a recent report in the Journal of Epidemiology and Community Health (JECH) linking spontaneous miscarriage and abortion to premature births and low birth weights.”
ARHP’s priority is to ensure that reproductive health care providers and their patients have the most accurate, evidence-based information available in order to inform medical decision making.
The following are factors ARHP considers crucial in weighing the results of this study:
- Scientifically-sound research is critical in determining causality and assessing risk. It’s challenging to know how to interpret this recent study given there is no distinction between spontaneous miscarriage and induced abortion.The World Health Organization (WHO) offers some data that may help put the study in perspective. According to WHO, of the 240 million conceptions world wide, 105 million do not result in a live birth. Of these, nearly 60 million result in miscarriage. Around 40 million result in abortion. This means that spontaneous miscarriages are exceptionally common, accounting for nearly 25% of all conceptions.
- As spontaneous miscarriage is far more prevalent than induced abortion, it’s critical for studies to make this distinction. This distinction is important because spontaneous miscarriage and induced abortion are medically distinct events. In the absence of this distinction it’s impossible to accurately determine the future risk of any health outcome.
- The data used in the study is from the 1960s; a time when induced abortion was illegal in the United States and unlikely to be self-reported. It is important to consider how likely a woman was to self-report undergoing an illegal abortion given the legal implications and stigma at the time and what impact this would have on the results of the study.
- The data used in the study is from the 1960s; a time when abortion was illegal in the United States and often unsafe. We know women who underwent abortions at that time assumed several potential risks to their health. The data may include a large number of women who experienced several adverse health outcomes, including premature birth and low birth weights in future pregnancies, because of adverse outcomes associated with unsafe abortion.