Replacement Pregnancies/Rapid Repeat Pregnancies After Abortion
From Abortion Risks
Repeated requests for termination of pregnancy. Some socio-cultural and psychological aspects, B Mattauer et al, Contracept Fertil Sex (Paris) 12(4) 573-580,1984 (English Abstract)
- A French study found that women with defective parental images had three times the risk of repeat abortion. Previous difficulties of pregnancy or delivery were associated with a higher risk of repeat abortion. Religious practice was associated with a reduced risk of repeat abortion.
Repeat abortion: a qualitative study, M Tornbom, A Moller, J. Psychosom Obstet Gynaecol 20(1):21-30, 1999
- In-depth interviews of Swedish women seeking a repeat abortion found that most of the women seemed to have a psychological vulnerability with many current and previous problems, as well as problems regarding sexuality. The authors concluded that the main reason for an unplanned pregnancy is not a lack of information or even a lack of knowledge, but rather a failure to integrate the knowledge with situational, intrapsychic and social factors.
"Adolescent Mourning Reactions to Infant and Fetal Loss," NH Horowitz, Social Casework 59:551, 1978.
- Replacement pregnancies may follow adolescent abortion.
"Post-Abortion Perceptions: A Comparison of Self-Identified Distressed and Non- Distressed Populations," GK Congleton and GC Calhoun, The Int'l Journal of Social Psychiatry39(4): 255, 1993.
- Women experiencing postabortion stress were more likely to report a desire to replace the fetus, report depression around the anniversary date or due date, and immediately experience feelings of loss compared to women reporting relieving/neutral postabortion experiences.
"Post-Abortion Trauma; 9 Steps to Recovery," Jeanette Vought (Grand Rapids: Zondervan, 1991)
- 53% of women in a religiously-based postabortion recovery group stated they desired to get pregnant again to compensate for the loss.
"Physical and Psychological Injury in Women Following Abortion: Akron Pregnancy Services Survey," L Gsellman, Association for Interdisciplinary Research in Values and Social Change Newsletter 5(4): 108, Sept/Oct, 1993
- In a questionnaire survey of post-abortion women who were obtaining a variety of services at a pregnancy services center between 1988-93, 23% stated they desired to get pregnant again as a psychological reaction to abortion.
"Selection bias in a study on how women experienced induced abortion," H Soderberg et al, Eur J Obstet & Gynecol 77:67, 1998.
- Swedish researchers at Lund University calculated that of approximately 33,000 induced abortions in Sweden each year, that about 6000 of these women will become pregnant again within 12 months, with half of them carrying to term, and the other half undergoing another induced abortion. (Non-participants in the follow-up study seemed to have a sense of guilt that they did not wish to discuss. These non-participants were significantly more likely to conceive again within 12 months and carry to term compared to study participants.)
"Conception rates after abortion with methotrexate and misoprostol," MD Creinin, Int'l J Gynaecol Obstet 65: 183-188, 1999.
- 25% of women who had abortions using methotrexate and misoprostol became pregnant again within the next 12 months. The vast majority of these pregnancies resulted in another induced abortion.
"Contraception and Repeat Abortion: An Epidemiological Investigation," MJ Shephard and MB Bracken, J Biosocial Science 11:289, 1979.
- In a Connecticut study of abortion and contraceptive practice, it was found that 42% of women repeating abortion had had an abortion within the previous year.
"Repeat Pregnancies Among Metropolitan Area Teenagers, 1971-1979," MA Koenig and M Zelnik, Family Planning Perspectives 14(6):341, Nov/Dec 1982.
- Among metropolitan teenagers age 15-19 whose first premarital pregnancy ended in abortion, 27% had a second premarital pregnancy within 12 months, 49.8% within 18 months and 74.9% within 24 months postabortion.
"Rapid Repeat Pregnancy and Experiences of Interpersonal Violence Among Low- Income Adolescents," M Jacoby et al, Am J Prev Med 16(4):318-321, 1999.
- A Michigan study of low income women aged 13-21 found that within 12 months of a prior pregnancy outcome (delivery, spontaneous abortion, elective abortion), 43.6% of the women were again pregnant within 12 months, and by 18 months 63.2% had experienced at least one additional pregnancy. Women whose pregnancies ended in spontaneous or elective abortion were more likely to experience rapid repeat pregnancy than women who carried to term.
Characteristics of women undergoing repeat induced abortion.] Fisher WA, Singh SS, Shuper PA, Carey M, Otchet F, MacLean-Brine D, et al. CMAJ 2005;172(5):637-41
- Background: Although repeat induced abortion is common, data concerning characteristics of women undergoing this procedure are lacking. We conducted this study to identify the characteristics, including history of physical abuse by a male partner and history of sexual abuse, of women who present for repeat induced abortion.
- Methods: We surveyed a consecutive series of women presenting for initial or repeat pregnancy termination to a regional provider of abortion services for a wide geographic area in southwestern Ontario between August 1998 and May 1999. Self-reported demographic characteristics, attitudes and practices regarding contraception, history of relationship violence, history of sexual abuse or coercion, and related variables were assessed as potential correlates of repeat induced abortion. We used χ2 tests for linear trend to examine characteristics of women undergoing a first, second, or third or subsequent abortion. We analyzed significant correlates of repeat abortion using stepwise multivariate multinomial logistic regression to identify factors uniquely associated with repeat abortion.
- Results: Of the 1221 women approached, 1145 (93.8%) consented to participate. Data regarding first versus repeat abortion were available for 1127 women. A total of 68.2%, 23.1% and 8.7% of the women were seeking a first, second, or third or subsequent abortion respectively. Adjusted odds ratios for undergoing repeat versus a first abortion increased significantly with increased age (second abortion: 1.08, 95% confidence interval [CI] 1.04–1.09; third or subsequent abortion: 1.11, 95% CI 1.07–1.15), oral contraceptive use at the time of conception (second abortion: 2.17, 95% CI 1.52–3.09; third or subsequent abortion: 2.60, 95% CI 1.51–4.46), history of physical abuse by a male partner (second abortion: 2.04, 95% CI 1.39–3.01; third or subsequent abortion: 2.78, 95% CI 1.62–4.79), history of sexual abuse or violence (second abortion: 1.58, 95% CI 1.11–2.25; third or subsequent abortion: 2.53, 95% CI 1.50–4.28), history of sexually transmitted disease (second abortion: 1.50, 95% CI 0.98–2.29; third or subsequent abortion: 2.26, 95% CI 1.28–4.02) and being born outside Canada (second abortion: 1.83, 95% CI 1.19–2.79; third or subsequent abortion: 1.75, 95% CI 0.90–3.41).
- Interpretation: Among other factors, a history of physical or sexual abuse was associated with repeat induced abortion. Presentation for repeat abortion may be an important indication to screen for a current or past history of relationship violence and sexual abuse.