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Informed Choice
Are you thinking about having an abortion or do you know someone who is? Perhaps that's why you picked up this booklet or
maybe you're simply curious. Whatever the reason, you'll find the information that follows straightforward and factual regarding
the medical aspects of induced abortion.
When people talk about abortion, one is likely to hear a great deal about the social, moral, and even religious reasons for having
or not having an abortion, but little about the basic medical details. In fact, many women make the decision to have an abortion
without ever discussing either the medical procedures or the health considerations with anyone. Perhaps no other procedure is
performed with this degree of patient ignorance.
It doesn't have to be that way.
American citizens have a right to be informed about things that might affect their health. There is no reason why any woman
should go through surgery of any kind, especially induced abortion, or take powerful drugs that induce abortion, and not even be
informed about potentially serious side effects.
Inside this booklet, you'll find factual, yet easy to understand information about induced abortion taken from the latest medical
texts and journals. That should help you have a better idea of the risks involved. Before making a decision that could change
your life forever, it only makes sense to get all the information you can on the procedure and its potential effects on you and the
child you carry.
"As American citizens, we have a right to be informed about things that might affect our health..."
Defining "Abortion"
The term "abortion" actually refers to any premature expulsion of a human fetus, whether naturally spontaneous, as in a
miscarriage, or artificially induced, as in a surgical or chemical abortion. Today, the most common usage of the term "abortion"
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Those found to be still pregnant in later visits (at least 1 in 25) are given surgical abortions. [42]
Even doctors who support abortion are reluctant to prescribe methotrexate for abortion because of its high toxicity and
unpredictable side effects. [43] Those side effects commonly include nausea, pain, diarrhea, [44] as well as less visible but more
serious effects such as bone marrow depression, severe anemia, liver damage and methotrexate-induced lung disease. [45]
The manufacturer warns in the package insert that while methotrexate has shown itself useful in treating certain types of cancer
and severe cases of arthritis and psoriasis, "deaths have been reported with the use of methotrexate," and recommends that its
use be limited to "physicians whose knowledge and experience includes the use of antimetabolite therapy." [46] Though
researchers performing methotrexate abortions have dismissed such concerns because of the low dosage used, [47] other doctors
in the abortion trade have disagreed, [48] and the package insert clearly warns that "toxic effects may be related in frequency
and severity to dose or frequency of administration but have been seen at all doses" (emphasis added). [49]
Dilatation (Dilation) and Evacuation (D&E)
Used to abort unborn children as old as 24 weeks, this method is similar to the D&C. The difference is that forceps with sharp
metal jaws are used to grasp parts of the developing baby, which are then twisted and torn away. This continues until the child's
entire body is removed from the womb. Because the baby's skull has often hardened to bone by this time, the skull must
sometimes be compressed or crushed to facilitate removal. If not carefully removed, sharp edges of the bones may cause
cervical laceration. Bleeding from the procedure may be profuse. [50]
Dr. Warren Hern, a Boulder, Colorado abortionist who has performed a number of D&E abortions, says they can be particularly
troubling to a clinic staff and worries that this may have an effect on the quality of care a woman receives. Hern also finds them
traumatic for doctors too, saying "there is no possibility of denial of an act of destruction by the operator. It is before one's
eyes. The sensation of dismemberment flow through the forceps like an electric current." [51]
To see an illustration of this abortion method, produced a professional medical illustration firm, click HERE.
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This procedure is used to abort women who are 20 to 32 weeks pregnant -- or even later into pregnancy.* Guided by ultrasound,
the abortionist reaches into the uterus, grabs the unborn baby's leg with forceps, and pulls the baby into the birth canal, except
for the head, which is deliberately kept just inside the womb. (At this point in a partial-birth abortion, the baby is alive.) Then
the abortionist jams scissors into the back of the baby's skull and spreads the tips of the scissors apart to enlarge the wound.
After removing the scissors, a suction catheter is inserted into the skull and the baby's brains are sucked out. The collapsed head
is then removed from the uterus.[71]
(More information on Partial-Birth Abortion can be found here.)
Hysterotomy
Similar to the Caesarean Section, this method is generally used if chemical methods such as salt poisoning or prostaglandins fail
(see pp. 12-14). Incisions are made in the abdomen and uterus and the baby, placenta, and amniotic sac are removed. [72] Babies
are sometimes born alive during this procedure, raising questions as to how and when these infants are killed and by whom.
This method offers the highest risk to the health of the mother, because the potential for rupture during subsequent pregnancies
is appreciable. [73] In the first two years of legal abortion in New York State, the death rate from hysterotomy was 271.2 deaths
per 100,000 cases. [74]
Is Abortion Safe?
The argument used by many advocates of abortion -- that abortion is safer than childbirth -- is difficult to defend in light of
medical evidence to the contrary. The Abortion Surveillance Branch of the Centers for Disease Control (CDC) maintains that
induced abortion is safer than childbirth [75] and that the serious complication rate is less than one percent. [76] Yet there is no
agreement among investigators as to what constitutes a major complication and no real national system for the reporting these
kind of statistics, [77] making the accuracy of such assertions questionable. Furthermore, the experiences of private physicians
and gynecologists do not seem to support the validity of the CDC's claim. [78]
Daniel J. Martin, M.D., Ltd., clinical instructor at St. Louis University Medical School, St. Louis, Missouri, has said, "The impact of
abortion on the body of a woman who chooses abortion is great and always negative. I can think of no beneficial effect of a
social abortion on a body." [79]
Why is this so? Because induced abortion is the premature, willful, and violent penetration of a closed and safeguarded system -a system in which nearly every cell, tissue and organ of a woman's reproductive system has been specially transformed and
activated to carry out the function of sustaining and nourishing the developing child. Not surprisingly, any violation of the
integrity of that system can lead to serious complications. Physical problems range from hemorrhage and infection to sterility
and even death. Psychological effects range from depression and mental trauma to divorce and even suicide.
NancyJo Mann is one of many who has experienced both kinds of complications. Infection and bleeding followed her abortion
which eventually led to a hysterectomy. Recalling her experience, she said, "Beforehand, I liked myself. I had never entertained
the idea of abortion. But the minute that needle went through my abdomen, I hated it, because I knew it could not be reversed. I
wanted to scream, 'Don't do this to me!'" [80]
Physical Complications*
Despite the use of local anesthesia, a full 97% of women having abortions reported experiencing pain during the procedure, [81]
which more than a third described as "intense," [82] "severe" or "very severe." [83] Compared to other pains, researchers have
rated the pain from abortion as more painful than a bone fracture, about the same as cancer pain, though not as painful as an
amputation. [84]
Studies also reveal that younger women tend to find abortion more painful than do older adults, [85] and that patients typically
found abortion more painful than their doctors or counselors expected. [86] The use of more powerful general anesthetics can
reduce the pain, but significantly increases the risk of cervical injury or uterine perforation. [87]
Complications such as these are common, as are bleeding, hemorrhage,[88] laceration of the cervix, [89] menstrual disturbance,
[90] inflammation of the reproductive organs, [91] bladder or bowel perforation, [92] and serious infection. [93]
Even more harmful long term physical complications from abortion may surface later. For example, overzealous currettage can
damage the lining of the uterus and lead to permanent infertility. [94] Overall, women who have abortions face an increased risk
of ectopic (tubal) pregnancy [95] and a more than doubled risk of future sterility. [96] Perhaps most important of all, the risk of
these sorts of complications, along with risks of future miscarriage, increase with each subsequent abortion. [97]
The particular type and severity of complications depend a great deal on the experience of the abortionist and the particular
abortion method used. Given that most abortions are performed at abortion clinics rather than by a woman's regular ob-gyn, [98]
the doctor performing the abortion is likely to be a stranger of whose skill and experience a woman knows very little. [99] Such
things as an inadequate gynecologic examination prior to the operation, the carelessness of the abortionist, or the retention of
fetal and placental tissue can all bring on complications. These kinds of complications can usually be treated and generally
subside (though not always), [100] but few women ever return to the clinics for crucial post-operative examinations. [101]
There is strong evidence that abortion increases the risk of breast cancer. A study of more than 1,800 women appearing in the
Journal of the National Cancer Institute in 1994 found that overall, women having abortions increased their risk of getting breast
cancer before age 45 by 50%. For women under 18 with no previous pregnancies, having an abortion after the 8th week increased
the risk of breast cancer 800%. Women with a family history of breast cancer fared even worse. All 12 women participating in the
study who had abortions before 18 and had a family history of breast cancer themselves got cancer before age 45. [102]
Of course, death of the mother is the most serious of all complications. Over 200 women have died from legal abortions since
1973. [103] The risk of death increases according to the duration of pregnancy [104] and the complexity of the abortion technique
employed. [105]
* In most of the discussions above, the abortions referred to are surgical abortions. Chemical methods being relatively new and rare, most studies over the past
twenty or so years usually tracked only complications for surgical methods. Complication rates for chemical techniques may be somewhat different; for example,
while there is little risk of perforation and laceration with a chemical method, pain and bleeding will probably exceed that of surgical methods. Chemical methods
also bring unique risks of their own.
Psychological Consequences
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Clinical research provides a growing body of scientific evidence that having an abortion can cause psychological harm to some
women. "Women who report negative after-effects from abortion know exactly what their problem is," observed psychologist
Wanda Franz, Ph.D., in a March 1989 congressional hearing on the impact of abortion. "They report horrible nightmares of
children calling them from trash cans, of body parts, and blood," Franz told the Congressional panel. "When they are reminded of
the abortion," Franz testified, "the women re-experienced it with terrible psychological pain ... They feel worthless and
victimized because they failed at the most natural of human activities -- the role of being a mother."[106]
The emergence of chemical abortion methods poses a new possibly more devastating psychological threat. Unlike surgical
abortions, in which women rarely see the cut up body parts, women having chemical abortions often do see the complete tiny
bodies of their unborn children and are even able to distinguish the child's developing hands, eyes, etc. [107] So traumatic is this
for some women that both patients and researchers involved in these studies have recommended that women unprepared for the
experience of seeing their aborted children not take the drugs. [108] Long-term psychological implications of this experience
have not been studied.
Researchers on the after-effects of abortion have identified a pattern of psychological problems known as Post-Abortion
Syndrome (PAS). Women suffering PAS may experience drug and alcohol abuse, personal relationship disorders, sexual
dysfunction, repeated abortions, communications difficulties, damaged self-esteem, and even attempt suicide. Post-Abortion
Syndrome appears to be a type of pattern of denial which may last for five to ten years before emotional difficulties surface.
[109]
Now that some clinicians have established that there is an identifiable patterns to PAS, they face a new challenge. What is still
unknown is how widespread psychological problems are among women who have had abortions. A Los Angeles Times survey in
1989 found that 56% of women who had abortions felt guilty about it, and 26% "mostly regretted the abortion."[110] Clinicians'
current goal should be to conduct extensive national research studies to obtain data on the psychological after-effects of
abortion.[111]
With the growing awareness of Post Abortion Syndrome in scholarly and clinical circles, women with PAS can expect to receive a
more sensitive appreciation of the suffering that they endure. Fortunately, a growing network of peer support groups of women
who have had abortions offers assistance to women who are experiencing emotional difficulties.
Many post-abortive women have also been speaking out publicly about their own abortion experiences and the healing process
they went through.. Women or family members seeking information about this particular outreach can contact American Victims
of Abortion, 512 10th St. NW, Washington, D.C., 20004.
Alternatives to Abortion
Despite all their talk about "choice," those at abortion clinics who counsel women on their options often act as if abortion is a
woman's only realistic alternative. This simply isn't so.
Throughout the United States, there are nearly 3,000 Crisis Pregnancy Centers staffed by volunteers ready to provide real help to
women facing unplanned or untimely pregnancies. [112] In addition to providing pregnancy tests and counseling, these centers
often offer a full range of services, helping women obtain housing, maternity and baby clothes, baby equipment, pre- and
post-natal medical care, legal assistance and financial support, information about adoption, and even advice on how a woman in
school can continue her education. [113] Offering real and tangible assistance, these centers have helped thousands of women to
realize that they didn't have to choose between their own lives and the lives of their unborn babies.
Unlike their counterparts at the local abortion clinic, the volunteer counselors at your Crisis Pregnancy Center do not have a
vested financial interest in the ultimate decision you make. Their concern and commitment are genuine, so you can count on
them to stick by you through the tense and sometimes difficult months ahead.
If you picked up this pamphlet at your local Crisis Pregnancy Center, you already have some idea of the quality of people who
work there. But if not, you can look in the Yellow Pages under the heading "Abortion Alternatives," or call, toll-free, 1 (800)
848-LOVE, any time, day or night, to find the nearest Crisis Pregnancy Center in your area. You'll find someone who genuinely
cares about what happens to you and your unborn baby.
References
1. Roe v. Wade, 410 U.S.; 113, 163-164 (1973) and Doe v. Bolton, 410 U.S. 179, 191-192 (1973). While Roe declares that the state
may proscribe late term abortions in the interest of protecting fetal life after viability, it adds the caveat "except when it is
necessary to preserve the life or health of the mother," which Doe explains is to include not only physical health but mental
health, to be understood to include factors such as age, familial status, emotional state, etc.
2. Aida Torres and J.D. Forrest, "Why Do Women Have Abortions?" Family Planning Perspectives, Vol. 20, No.4 (July/August 1988).
P. 170.
3. Keith L. Moore, The Developing Human, 4th ed.. (Philadelphia,: W.B. Saunders Co., 1988), p. 3, 29. Moore's chart uses the
actual age of the child rather than the gestational age commonly used by most doctors. His numbers are translated here into
gestational age, measured from the woman's last menstrual period, or LMP.
4. According to the Morbidity and Mortality Weekly Report of the Centers for Disease Control (CDC), Vol. 43, No. 50 (December 23,
1994), p. 931, only about 13.8% of abortions are performed prior to 7 weeks of gestation.
5. Robert Rugh, Ph.D., and Landrum Shettles, M.D., Ph.D., From Conception to Birth (New York: Harper & Row, 1971), p. 46.
Rugh's and Shettles' dates are also translated to gestational age here, measured by LMP.
6. Hannibal Hamlin, M.D., "Life or Death by EEG," Journal of the American Medical Association (October 12, 1964), p. 113. See also
Sharon Begley, "Do you hear what I hear?" Newsweek (Special Issue, Summer 1991), p. 14.
7. The CDC says 15.2 % of abortions are performed during week 7, 20.9 % during week 8, and 24.6% in weeks 9 through 10. This
totals 60.7% of all abortions. See note 4.
8. Sharon Begley with John Carey, "How Human Life Begins," Newsweek, January 1, 1982, p. 46.
9. Phillip G. Stubblefield, "First and Second Trimester Abortion," in Gynecologic and Obstetric Surgery, ed. David H. Nichols
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(Baltimore: Mosby, 1993) p. 1016. Also, the U.S. Centers for Disease Control (CDC), "Abortion Surveillance: Preliminary Data -United States, 1991, " Morbidity and Mortality Weekly Report, Vol. 43, No. 3, 1994, p. 43, puts the percentage of suction curettage
abortions relative to other techniques at 98%, though the CDC admits that their numbers include a number of D & E abortions
which should be classified otherwise (personal communication with Lisa Koonin,Division of Reproductive Health, CDC, March 6,
1996).
10. U.S. Senate Report of the Committee on the Judiciary, Human Life Federalism Amendment, Senate Joint Resolution 3, 98th
Congress, 1st Session, legislative day June 6, 1983, p. 36. (Hereafter referred to as Human Life Federalism Amendment).
11. A. Jefferson Penfield, M.D., Gynecologic Surgery Under Local Anesthesia, (Baltimore: Urban & Schwarzenburg, 1986), p. 79.
12. Jane E. Hodgson, M.D.,"Abortion by vacuum aspiration," Abortion and Sterilization: Medical and social aspects, Jane E.
Hodgson, ed. (New York: Academic Press, Grune and Strathon, 1981), pp. 256-258.
13. Ibid, pp. 256, 260-261.
14. Human Life Federalism Amendment, cited in note 10, p. 36.
15. F. Gary Cunningham, M.D., et al, Williams Obstetrics, 19th ed. (Norwalk, CT: Appleton & Lang, 1993), p.683.
16. Penfield,cited in note 11, pp. 50-51.
17. According to Andrea Sachs, because of these generic names, the RU 486 technique is sometimes referred to as the "M & M "
method. "Abortion Pills on Trial," TIME, December 5, 1994, p. 45.
18. tienne-mile Baulieu, M.D., Ph. D., "1993: RU 486 -- A Decade on Today and Tomorrow," in Clinical Applications of
Mifepristone (RU 486) and Other Antiprogestins, Institute of Medicine, eds. Molla .S. Donaldson et al (Washington, D.C.: National
Academy Press, 1993), p. 92-96. Though Baulieu, creator of the abortion pill, recommends its use up to nine weeks, American
trials have found the method considerably less effective after the seventh week, according to Carol Jouzaiis, "Abortion Pill Clinic
Tests Drawing to a Close in U.S.," Chicago Tribune, Wednesday, August 30, 1995, p. 1.
19. The Population Council of New York, Release, October 27, 1994, p. 3. The Population Council is the entity conducting tests on
RU 486 in the United States. The regimen in France, where the drug was first developed and approved, involves a total of four
visits, adding an additional week for reflection prior to the ingestion of the pills (Diane Gianelli, "RU 486 effective, not problemfree," American Medical News, April 12, 1993, p. 25.
20. See Janice G. Raymond, Renate Klein, Lynette J. Dumble, RU 486: Misconceptions, Myths, and Morals (Cambridge, MA:
Institute on Women and Technology, 1991), pp. 17, 34, 35; and Beatrice Couzinet, M.D., et al, "Termination of Early Pregnancy by
the Progesterone Antagonist RU 486 (Mifepristone)," New England Journal of Medicine Vol. 315 (December 18, 1986), p. 1565;
Louise Silvestre, M.D., et al, "Voluntary Interruption of Pregnancy with Mifepristone (RU 486) and a Prostaglandin Analogue," New
England Journal of Medicine, Vol. 322 (March 8, 1990), p. 645.
21. Raymond, Klein, and Dumble, Misconceptions, cited in note 20, pp. 57-62.
22. Andr Ulmann, et al, "Medical Termination of Early Pregnancy With Mifepristone (RU 486) Followed By A Prostaglandin
Analogue," Acta Obst. Gyn. Scand., Vol. 71 (1992), pp. 280-281.
23. Population Council, Release, cited in note 19, p. 3
24. Gianelli, "RU 486 effective..." cited in note 19, p. 25.
25. lisabeth Aubeny and ..Baulieu, "Contragestion with Ru 486 and an orally active prostaglandin," C.R. Acad. Sci. Paris (III),
Vol. 312 (1991), pp. 539-545, obtained a 95% completion rate with women 49 days amenorrhea or less. Carolyn McKinley, et al,
"The effect of dose of mifepristone and gestation on the efficacy of medical abortion with mifepristone and misoprostol," Hum.
Reproduc., Vol. 8 (1993), pp. 1502-1503, obtained a completion rate of 89.1% for women 50-63 days amenorrhea.
26. Mary W. Rodger and David T. Baird, "Blood loss following a prostaglandin analogue (Gemeprost)" Contraception, Vol. 40
(1989), pp. 439-447.
27. UK Multicentre Trial, "The efficacy and tolerance of mifepristone and prostaglandin in first trimester termination of
pregnancy, B.J. Obst. & Gyn., Vol. 97 (1990), pp. 480-486.
28. Population Council, Release, cited in note 19, p. 3.
29. McKinley, et al, "The effect of dose of mifepristone...," cited in note 25, p. 1504.
30. Alan Riding, "Frenchwoman's Death is Linked To Abortion Pill and a Hormone," New York Times, April 10, 1991, p. A-10
31. Mark Louviere, M.D., "Group lied when it said 'abortion pill' test resulted in no complications,' Waterloo Courier, September
24, 1995, p. F3. See alsoTom Carney, "'Abortion pill' test goes awry for one patient," Des Moines Register, September 21, 1995, pp.
1M, 5M.
32. Raymond, Klein, and Dumble, Misconceptions, cited in note 20 , pp. 71-79.
33. Richard U. Hausknecht, M.D., "Methotrexate and Misoprostol to Terminate Early Pregnancy," New England Journal of
Medicine, Vol. 33, No. 9 (August 31, 1995), p.538, and Eric A Schaff, M.D., et al, "Combined Methtrexate and Misoprostol for Early
Induced Abortion," Archives of Family Medicine, Vol. 4. 1995, p. 2.
34. Mitchell D. Creinin, M.D., "Methotrexate for abortion at 42 days gestation," Contraception, Vol. 48, No. 6 (December, 1993),
p. 519.
35. Daniel R. Mishell, Jr., M.D., and Val Davajan, M.D., Infertility, Contraception, & Reproductive Endochrinology, 2nd Ed.
(Oradell, NJ: Medical Economics Books, 1986), pp. 120.
36. Keith Moore, Ph.D., Essentials of Human Embryology (Philadelphia: B.C. Decker, Inc., 1988), p. 10.
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68. Willard Cates, M.D. and H.V.F. Jordaan, "Sudden Collapse and Death of Women Obtaining Abortion Induced by Prostaglandin
F2 Alpha," American Journal of Obstetrics and Gynecology, Vol. 133 (February 15, 1979), pp. 398-400. See also David Grimes, M.D.,
et al, "Midtrimester abortion by intra-amniotic prostaglandin F2a: Safer than saline?" Obstet Gynecol, Vol. 49 (1977), p. 612 and
A.C. Wentz, et al, "Posterior cervical rupture following prostaglandin-induced midtrimester abortion," American Journal of
Obstetrics and Gynecology, Vol. 115 (1973), p. 1107.
69. Some have also used the highly descriptive term "brain suction abortion" to refer to the procedure.
70. See Maureen Hack, et.al, "Very Low Birth Weight Outcomes of the National Institute of Child Health and Human Development
Neonatal Network," Pediatrics, Vol. 87, No. 5 (May 1991), p58.
71 . Dr. Martin Haskell described the partial-birth abortion procedure, which he called "dilation and extraction,"at a Sept. 1992
meeting of the National Abortion Federation, a trade association of abortion providers. He said he had done 700 of these
"procedures." See Martin Haskell, M.D., "Dilation and Extraction for Late Second Trimester Abortion," in "Second Trimester
Abortion: From Every Angle," Fall Risk Management Seminar, September 13-14, 1992, Dallas, Texas, National Abortion
Federation. See also Diane Gianelli, "Shock-tactic ads target late-term abortion procedure," American Medical News (July 5,
1993), pp. 3, 15-16.
72. Human Life Federalism Amendment, cited in note 10, p. 37.
73. Cunningham, et al, cited in note 15, p. 683.
74 . P. Diggory, "Hysterotomy and hysterectomy as abortion techniques," in Abortion and Sterilization, ed. Hodgson, cited in note
12, p. 326.
75 . Willard Cates, Jr., et al, "Mortality from Abortion and Childbirth: Are the Statistics Biased?" Journal of the American Medical
Association, Vol. 28, No.2 (July 9, 1982), p. 196.
76 . J.W. Buehler, K.F. Schulz, David. A. Grimes, C.J.R. Hogue, "The risk of serious complications from induced abortion: Do
personal characteristics make a difference? American Journal of Obstetrics and Gynecology, Vol. 153 (1985), pp. 14-20.
77 . Christopher Tietze, "Demographic and Public Health Experience with Legal Abortion: 1973-1980," in J. Douglas Butler and
David F. Walbert, eds., Abortion, Medicine, and the Law 3rd Rev. ed. (New York: Facts on File, 1986), p. 303.
78 . Matthew Bulfin, M.D., "Complications of Legal Abortion: A Perspective from Private Practice," The Zero People, ed. Jeff Lane
Hensley (Ann Arbor, MI: Servant Books, 1983), pp. 97-105.
79 . Daniel J. Martin, M.D. , "The Impact of Legal Abotion on Women's Minds and Bodies," paper presented at the "Human Life and
Health Care Ethics" national conference, April, 1993.
80. Christine Russell, "Don't Do This," Washington Post, January 23, 1983, p. A13.
81. Phillip G. Stubblefield, M.D., et al, "Pain of first-trimester abortion: Its quantification and relations with other variables,"
American Journal of Obstetrics and Gynecology, Vol. 133, No. 5 (March 1, 1979), p. 489.
82. Nancy Wells, D.N.Sc., R.N., "Pain and Distress During Abortion," Health Care for Women International, Vol 12 (1991), pp.
296-297. Actually, all 35 women participating in Wells' study (100%) reported some degree of pain during the abortion, which
34.4% described as "intense."
83. Stubblefield, et al, cited in note 80, p. 493.
84. Eliane Blanger, Ronald Melzak, and Pierre Lauzon, "Pain of first-trimester abortion: a study of psychosocial and medical
predictors," Pain, Vol. 36 (1989), pp. 343, 345.
85 . Belanger, et al, cited above, p. 345, and Stubblefield, et al, cited in note 80, p. 495.
86 . See Tables VII, VIII, IX, X, and XIII, in Stubblefield, et al, cited in note 80, pp. 493-496.
87 . Kenneth F. Schulz, David A. Grimes, Willard Cates, Jr., "Measures to Prevent Cervical Injury During Suction Curettage
Abortion," The Lancet, May 28,1983, p. 1184. See also Steven G. Kaali, M.D., et al, "The frequency and management of uterine
perforations duing first-trimester abortions," American Journal of Obstetrics and Gynecology, August 1989, p. 408.
88 . Schulz, et al, cited in note 87, p. 1182.
89. Stubblefield, cited in note 9, pp. 1023-1024, and S. Kaali, cited in note 87 pp. 406-408.
90. Stubblefied, cited in note 9, p. 1023
91. L.H. Roht, et al, "Increased Reporting of Menstrual Symptoms Among Women Who Used Induced Abortion," American Journal
of Obstetrics and Gynecology, Vol. 127 (1977), p. 356.
92. Ibid.
93 . David N. Danforth, Ph.D., M.D., ed., et al, Obstetrics and Gynecology, 5th ed. (Philadelphia: J.B. Lipincott, 1986), pp. 217,
257, 382-383. See also Jack Pritchard, et al, Williams Obstetrics, 17th ed. (Norwalk, CT: Appleton-Century-Crofts, 1985), p. 484.
94. Danforth, cited above, p. 887, and David H. Nichols, M.D., Gynecologic and Obstetric Surgery (St. Louis: Mosby-Year Book Inc.,
1993), p. 260, and Leon Speroff, Robert H. Glass, Nathan G. Kase, Clinical Gynecological Endochrinology & Infertility (Baltimore:
Williams & Wilkins, 1983), pp. 156-157.
95. A. Levin, et al, "Ectopic Pregnancy and Prior Induced Abortion," American Journal of Public Health, Vol. 72, No. 3 (March
1982), pp. 253-256.
96. Anastasia Tzonou, et al, "Induced abortions, miscarriages, and tobacco smoking as risk factors for secondary infertility,"
Journal of Epidemiology and Community Health, Vol. 47 (1993), p. 36.
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97. A. Levin, et al, "Association of induced abortion with subsequent pregnancy loss," Journal of the American Medical
Association, Vol. 243, No. 24 (June 27, 1980), pp. 2495-2496, 2498-2499.
98. In 1992, out of 1,528,930 abortions, only 54,460, or 3.6% were performed in physician's offices. The vast majority were
performed in abortion clinics (1,057,500 or 69.2%) or at other clinics (307,020 or 20.1%). The rest were performed in hospitals
(109,950 or 7.2%). Figures from Stanley K. Henshaw and Jennifer Van Vort, "Abortion Services in the United States, 1991 and 1992,
Family Planning Perspectives, Vol. 26, No. 3 (May/June 1994), p. 101.
99. Pamela Zekman and Pamela Warrick, "Women take chances with 'tryout' doctors," Chicago Sun Times, November 14, 1978, p.
1.
100. Stanislaw Z. Lienbrych, M.D., "Fertility Problems Following Aborted First Pregnancy," New Perspectives on Human Abortion,
ed. Hilgers, Horan, and Mall, (Frederick, MD: University Publications of America, 1981), pp. 128, 132.
101. Diane Gianelli, "With RU-486, Will More Physicians Provide Abortions?" American Medical News, April 12, 1993, p. 3, 25, 27.
102. Janet Daling, et al, "Risk of Breast Cancer Among Young Women: Relationship to Induced Abortion," Journal of the National
Cancer Institute, Vol. 86, No. 21 (November 2, 1994), pp. 1584-1592.
103. Lawson , H. et al, "Abortion Mortality U.S., 1972-1987," American Journal of Obstetrics and Gynecology, Vol. 171, No. 5
(November 1994), pp. 1365-1352. See also, Morbidity and Mortality Weekly Report (CDC), "Abortion Surveillance - U.S., 1989, Vol.
141, No. 55-5, September 4, 1992.
104. Pritchard, cited in note 92, p. 483.
105. Hern, Abortion Practice, cited note 50, pp. 26-35. See also Centers for Disease Control, Abortion Surveillance, 1978,
(November 1980) and Christopher Tieze, et al, "Maternal mortality associated with legal abortion in New York State: July 1,
1970-June 30, 1972," Obstet Gynecol, Vol. 43 (1974), p. 315.
106. Wanda Franz, Ph.D., testimony, U.S. Congress, House, Human Resources and Intergovernmental Relations Subcommittee of
the Committee on Government Operations, Hearing on Medical and Psychological Impact of Abortion, 101st Congress, 1st Session,
March 16, 1989 (Hereafter referred to as Hearing on the Impact of Abortion, 1989). See also Vincent Rue, Ph.D., testimony, U.S.
Congress, Senate Committee on the Judiciary, Constitutional Amendments Relating to Abortion, R.J. Res. 18, S.J. Res. 19 and
S.J. Res. 110, 97th Congress, 1st Session, Vol. 1, pp. 3329-378; David C. Reardon, Aborted Women, Silent No More (Chicago: Loyola
University Press and Westchester, IL: Crossway Books, 1987); Anne Speckhard, Ph.D., The Psycho-Social Stress Following Abortion
(Kansas City, MO: Sheed and Ward, 1987); and David Mall and Walter F. Watts, M.D., eds., Psychological Aspects of Abortion
(Frederick, MD: University Publications of America, 1979).
107 . Debra Rosenberg, Michele Ingrassia, and Sharon Begley, "Blood and Tears," Newsweek, September 18, 1995, p. 68; Louise
Levanthes, "Listening to RU 486," Health, January/February 1995, p. 88. See also Mary Ann Castle, et al, "Listening and Learning
from Women About Mifepristone: Implications for Counseling and Health Education," Women's Health Issues, Vol. 5, No. 3 (Fall
1995), pp. 132-133.
108. Philip J. Hilts, "Clinic Trials of French Abortion Pill Begin in U.S., " New York Times, October 28, 1994, p. A28; also
Hausknecht, speaking on Donahue, cited in note 41, p. 6.
109. See note 106. See also Vincent M. Rue, Ph.D., Anne Speckhard, Ph.D., James Rogers, Ph.D., and Wanda Franz, Ph.D., "The
Psychological Aftermath of Abortion: A White Paper," presented to C. Everett Koop, M.D., Surgeon General of the U.S.,
September 15, 1987, enclosure to testimony of Wanda Franz, Ph.D., Hearing on Impact of Abortion, 1989, cited in note 106.
110. George Skelton, "Abortion often causes guilt, poll finds," The Sacramento Bee, March 19, 1989, p. A7.
111. Letter from C. Everett Koop, M.D., Sc.D., U.S. Surgeon General to President Ronald Reagan, January 9, 1989.
112. International Life Services, Inc., 1996-1997 Pro-Life Resource Directory (Los Angeles, CA: International Life Services, Inc.,
scheduled for publication, 1996). The 1994-1995 Pro-Life Resource Directory listing Crisis Pregnancy Services in the U.S. and
Canada is available from International Life Services, 2606 West 8th St., Los Angeles, California, 90057-3810.
113. See the 1994-1995 Pro-Life Resource Directory, cited above, and also Frederica Mathewes-Green, Real Choices (Sisters,
Oregon: Multnomah Books, 1994), pp. 234-235.
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