One in 25 women hospitalized after abortion
Much lower StatsCan figure based on incomplete and misleading data, study shows
By Isabelle Being
A recent custom tabulation of Canada's hospitalization statistics shows that, out of 103,244 women who received legally induced abortions in 1992-1993, 3,931 women were hospitalized for an average of two days because of life-threatening complications. This yields a hospitalization rate of 3.8 per cent, or one out of 25 women - a rate three times higher than the 1.3 per cent figure given in Statistics Canada's 1995 Therapeutic Abortions publications.
The two percentages differ because they come from two distinct databases. In the Therapeutic Abortions publication, from which official abortion statistics are taken, the total complication rate is lower than the custom tabulation figure for the following reasons: (1) Complications from abortions performed in clinics are not covered, when one out of three abortions in Canada is performed in a clinic; (2) Only three-quarters of all hospitals surveyed report medical complications due to abortion; and (3) Those hospitals report only immediate complications. Complications requiring re-admission, therefore, are not linked to the original abortion record in any way.
The custom tabulation, however, comes from Statistics Canada's hospitalizations database, which covers all hospitalizations by diagnosis code given upon admision for in-patient care (the type of care involving at least one overnight stay). The code for complications from legally induced abortion is ICD 635.
The custom tabulation yielded the number of hospital records in which diagnosis code ICD 635, appears in any of the five diagnosis fields, with each record being counted only once, even if this same code appears twice on the same record. In the latest year for which these figures are available from Statistics Canada, namely 1992-1993, there were 3,931 such hospital records. Out of 103,244 abortions performed that year, this yields a hospitalization rate of 3.8 per cent, or one out of 25 women.
So why are abortions so dangerous that they land one in 25 women in the Hospital? The World Health Organization (WHO) in its 1994 publication, Clinical Management of Abortion Complications, warns doctors (but not their famale patients, sadly) that if induced abortions are incomplete, the women are in danger of haemorrhaging (bleeding heavily) or of septicaemia (blood poisoning), or both.
Haemorrhaging involves the loss of large quantities of blood due to the sudden exposure of major blood vessels when retained placenta or baby parts detach from the uterus. Septicaemia results from bacteria festering in retained cadaver parts and spilling into the mother's blood stream.
Delayed haemorrhage is a particularly dangerous occurrence. It can result from abdominal injuries, lacerations or perforations made during the procedure. Numerous studies have shown that doctors can inadvertently inflict this kind of damage using the dilator, the suction cannula, the forceps and the curette (a sharp instrument used to scrape the uterus after suction and dismemberment of the child). If a woman's haemorrhaging is delayed, she is at great risk, since by the time the bleeding begins, she may be on the road travelling home. As the WHO's 1994 publication repeatedly states, "Delays in stopping the bleeding and replacing fluid or blood volume can be fatal. If not treated promptly, haemorrhage can result in shock and death."
Canadian hospital records show how serious an emergency it is when women are haemorrhaging or have septicaemia. Dcotors must perform emergency blood transfusions, D & Cs and A & Cs, and remove retained placenta.
Will women ever know that they have a one in 25 chance of needing life-saving hospitalization after the procedure? There is no reason that they shouldn't, now that we have accurate statistical information.
Isabelle Begin is an Ottawa translator and researcher. She thanks Canadian Physicians for Life for their generous financial support in obtaining the custom tabulation of Statistics Canada information reported in this article.