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Am J Obstet Gynecol 2002;187:1673-8

Previous research has revealed a general association between induced abortion and substance use. The purpose of this study was to examine the correlation when substance use is measured specifically during a subsequent pregnancy.

Women with a prior history of abortion are twice as likely (2.22) to use alcohol, five times more likely (5.60) to use illicit drugs, and ten times more likely (10.29) to use marijuana during the first pregnancy they carry to term compared to other women delivering their first pregnancies, according to a study published in the newest issue of the American Journal of Obstetrics and Gynecology.

The researchers conclude that higher rates of substance use during the subsequent pregnancies would place the newborn children of these women at higher risk of congenital defects, low birth weight, and death.              

The research is based on the National Pregnancy and Health Survey, using a nationally representative sample of 2,613 women who had recently given birth.

The survey was sponsored by the U.S. Department of Health and Human Services, the National Institutes of Health, and the Division of Epidemiological and Prevention Research at the National Institute on Drug Abuse for the purpose of providing the first national assessment of licit and illicit drug use and alcohol consumption among pregnant women. 

This is the seventeenth study linking abortion to elevated rates of substance abuse.

It is the first study, however, to specifically show that drug and alcohol abuse remain higher during subsequent pregnancies.

Reardon, who directs the Elliot Institute and is co-author of the new book, "Forbidden Grief: The Unspoken Pain of Abortion," says many women use drugs and alcohol to cope with unresolved emotional issues related to past abortions. Since unaddressed issues of loss, grief, and guilt may become more intense during a subsequent wanted pregnancy, women may have more difficulty abstaining from drugs and alcohol even though they know it puts their wanted pregnancies at risk, he said.

The researchers recommend that obstetricians should screen pregnant women for a prior history of abortion and substance abuse in order to make better recommendations for counseling. "Counseling that addresses only the surface problems of the woman's substance abuse may fail to give her the help she needs to truly overcome this problem." Reardon said.

This is the fifth study documenting emotional problems linked to abortion to be published this year. The other studies have linked abortion to higher rates of long term depression, increased need for mental health treatments, higher death rates (including death from suicide), and poor bonding with and parenting of later children.

Screening for abortion history may help to identify pregnant women who are at risk for substance use more effectively. (Am J Obstet Gynecol 2002;187:1673-8.)The American Journal of Obstetrics and Gynecology is one of the most respected and influential medical journals in the United States.


OBJECTIVE: Previous research has revealed a general association between induced abortion and substance use. The purpose of this study was to examine the correlation when substance use is measured
specifically during a subsequent pregnancy.

STUDY DESIGN: A nationally representative sample of women was surveyed about substance use during
pregnancy shortly after giving birth.Women with a previous induced abortion, whose second pregnancy was
delivered, were compared separately with women with one previous birth and with women with no previous

RESULTS: Compared with women who gave birth, women who had had an induced abortion were significantly
more likely to use marijuana (odds ratio, 10.29; 95% CI, 3.47-30.56), various illicit drugs (odds ratio,
5.60; 95% CI, 2.39-13.10), and alcohol (odds ratio, 2.22; 95% CI, 1.31-3.76) during their next pregnancy. The
results with only first-time mothers were very similar.

CONCLUSION: Psychosocial mechanisms that may explain the findings are discussed. Screening for abortion
history may help to identify pregnant women who are at risk for substance use more effectively.

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[Coleman PK, Reardon DC, Rue VM, Cougle JR. "History of induced abortion in relation to substance use during pregnancies carried to term." American Journal of Obstetrics and Gynecology. December 2002; 187(5):1673-8.; The Elliot Institute News, 2January03;]

From the Department of Psychology, University of the South,a the Elliot Institute,b the Institute for Pregnancy Loss,c and the Department of Psychology, University of Texas.
Received for publication January 24, 2002; revised May 14, 2002; accepted
June 14, 2002.