Intended for healthcare professionals

Rapid response to:

News Roundup [abridged Versions Appear In The Paper Journal]

Depression and obesity are major causes of maternal death in Britain

BMJ 2004; 329 doi: (Published 18 November 2004) Cite this as: BMJ 2004;329:1205

Rapid Response:

Maternal Mortality Link to Abortion: Ignored or Suppressed?

Dear Editor:

While I have not yet read the it seems evident that either the RCOG
or the BMJ have failed to report on the association between abortion and
elevated mortality rates.

Four large, record-based studies have found a significant and strong
association between abortion and elevated mortality rates compared to
women who carry to term. Three examined the population of Finland (1-3),
one of which was published in the BMJ (2). The fourth examined low income
women in California and found that the elevated risk of death associated
with abortion persisted over several years and may effect maternal
mortality rates of subsequent pregnancies.(4) A fifth study published in
BMJ’s letters (5) found that the elevated risk of attempted suicide
following abortion is can not be explained by prior suicide attempts, for
the rate of prior suicide attempts is not higher among women who have

There have yet to be any studies that contradict these findings.
Given this literature, it seems unlikely that the RCOG researchers failed
to look at the association between abortion and maternal mortality in this
British population. This leads me to fear that the findings in this
regard may have been obscured or suppressed either in the RCOG report or
in the BMJ’s summary of it’s findings.

As previously suggested, much additional research needs to be done to
explore the association between abortion and elevated mortality rates,
including the finding of higher deaths associated with heart disease (6),
which may be related to higher rates of anxiety (7) and depression (8).
This requires a closer examination including complete reproductive
histories. It appears that RCOG has access to data that may help to shed
light on these associations. I hope there will be an additional report


David C. Reardon, Ph.D.

(1) Gissler M, Berg C, BouvierColle MH, Buekens P.
Pregnancyassociated mortality after birth, spontaneous abortion or induced
abortion in Finland, 19872000. Am J Ob Gyn 2004; 190:422427.

(2) Gissler M, Hemminki H, Lonnqvist J. Suicides after pregnancy in
Finland: 198794: register linkage study. BMJ 1996; 313:14314.

(3) Gissler M, Kauppila R, Merilainen J, Toukomaa H, Hemminki E.
Pregnancy-associated deaths in Finland 1987-1994 — definition problems and
benefits of record linkage. Acta Obsetricia et Gynecolgica Scandinavica
1997; 76:651-657.

(4) Reardon DC, Ney PG, Scheuren F, Cougle JR, Coleman, PK, Strahan
TW. Deaths associated with pregnancy outcome—a record linkage study of
low income women. Southern Medical Journal 2002; 95(8):834841.

(5) Morgan CM, Evans M, Peter JR, Currie C: Mental health may
deteriorate as a direct effect of induced abortion. Br Med J, 1997; 314:
902. (Letters)

(6) Reardon DC, Coleman PK. Pregnancyassociated mortality after
birth. American Journal of Obstetrics and Gynecology, 2004

(7) Cougle JR, Reardon DC, Coleman PK. Generalized anxiety following
unintended pregnancies resolved through childbirth and abortion: a cohort
study of the 1995 national survey of family growth. Journal of Anxiety
Disorders, 2005 19(1):137142.

(8) Reardon DC, Cougle JR. Depression and unintended pregnancy in the
National Longitudinal Survey of Youth: a cohort study. BMJ. 2002;

Competing interests:
None declared

Competing interests: No competing interests

20 November 2004
David C Reardon
Elliot Institute