Abortion is common. Experts have warned that having just one abortion could raise a woman’s risk of courting life-threatening problems in future pregnancies, such as having premature babies to pre-eclampsia, reports Sade Oguntola.

Kemi Atanda (not real name) went through an unsafe abortion when she was about 20 years old. She was afraid to tell her mother that she was pregnant. Her close friend, who she confided in, told her about the option of abortion.

“I was very scared because I didn’t know anything about abortion, but he told me it was going to be okay and safe. He looked for the money, because I didn’t have any at that time, and paid a nurse who took me to a gynaecologist in the hinterland. I was four months pregnant,” she recounted

Although her life went back to normal, her low self-esteem made her to continue to look for love and acceptance made her to enter into another relationship and she got pregnant again because she was very naive and did not know much about safe sex protection.

The circumstances surrounding Mrs Helen Aduka (not real name), a school teacher, are different from that of Kemi. Her expectations of becoming a mother usually get dashed about the fifth month of her pregnancy, what her doctor termed miscarriage.

Regrettably, premature births and miscarriages are a common problem occurring in about 20 per cent of all pregnancies among couples.

Abortion is one of the main contributors to maternal death worldwide, and it is termed unsafe when the procedure is carried out outside hospitals, clinics and surgeries, or without qualified medical supervision.

Aside the fact that the women who seek unsafe abortion are more vulnerable to dangerous infections or bleeding in these environments, like women that find it difficult carrying a pregnancy to term, experts have observed that just one abortion could lead to such women giving birth prematurely later in life.

Arguably, the researchers stated that women who terminate their first pregnancy do not only risk their own health, but also their chances of becoming mothers in the future. They are at a higher risk of a many problems ranging from their next child being born prematurely to pre-eclampsia, a complication of pregnancy that can be fatal for mother and baby.

Pre-eclampsia causes high blood pressure, blood clots and kidney damage, and leads to the deaths of thousands of babies and mothers a year.

Many women start their reproductive life with an abortion in their first pregnancy. In medical abortions, pills are normally used early in pregnancy and account for almost half of terminations. Ironically, most people know somebody who has undergone abortion due to unemployment and other economic issues.

The researchers, who analysed the medical records of more than 600,000 Scottish women which spanned three decades, including many who had aborted their first baby, found that such women, who end their first pregnancy with abortion, are 37 per cent more likely to give birth prematurely in the future.

Importantly, women who had up to four abortions were no more at risk of premature births than those who had just one, the researchers stated in the British Medical Journal. Just one abortion appeared to be enough to do the damage, with subsequent terminations not being any more dangerous.

Of course, the researchers had ruled out other confounding factors such as smoking, history of miscarriage, socio-economic level and other factors that predispose to premature death and preterm birth of babies.

No doubt, the study could not establish a causal link between adverse outcomes and induced abortion. Nevertheless, the researchers suggested that “women should not be alarmed by our findings”, adding that surgical abortions, which are becoming increasingly common, could increase the risk of infection, which could affect future possibilities of pregnancies.

Repeated abortion, Dr Olusoji Adeyanju, a consultant obstetrician and gynaecologist, Adeoyo Maternity Hospital, Yemetu, Ibadan, Oyo State ,stated, has always been linked to premature births.

According to him, “the history of preterm delivery is high in cohorts that have repeated abortions, compared with those people who have never had abortion before.”

Premature deliveries, abortion and risk of low birth weight babies, are there links? The period of pregnancy is divided into three trimesters, lasting about three calendar months. “Causes of abortion in the first three months of pregnancy are different from those in the other trimesters. People that have more second trimester abortions tend to have more premature deliveries said Dr Adeyanju.

For instance, he explained, “during the process of maybe forcefully dilating the cervix, the mouth of the womb, when trying to achieve surgical abortion, could become damaged.”

Certainly, not all cases of premature deliveries can be linked to previous incidence of abortion, Dr Adeyanju cautioned. Nonetheless, he pointed out that women with structurally defective or incompetence cervix stand a higher risk of having premature delivery.

Incompetent cervix refers to the cervix beginning to open, painlessly, weeks or months before full-term. The bag of water can bulge through the cervix and preterm labour can begin.

“The weight of a baby at birth depends on its gestational age and so when a baby is born premature or before time, it may not be up to 2.5kilogrammes in weight. This explains why such women could have babies with low birth weight,” he argued.

Premature birth before 37 weeks is linked to several health conditions including lung disease, cerebral palsy, jaundice and mental health problems, in later life.
Given that the number of women having multiple abortions is increasing, the researchers stated that women seeking abortions should be made aware of the potential risks, including preterm birth and low birth weight in subsequent pregnancies.

Rather than having multiple unwanted or unplanned pregnancies aborted, accessing contraception is a better option in reducing the number of abortions.

Additionally, the steadily increasing survival of very pre-term infants should not be interpreted as a solution to the problem of pre-term birth. Increased survival of infants less than 28 weeks is at the cost of increased survival of infants with disability. So, preventing preterm birth is important not only for a current pregnancy but also for future pregnancies.

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