by Øjvind Lidegaard, Hjarn V Zernichow Borberg, Steen C Rasmussen, Anders P Mikkelsen
Journal of Obstetrics & Gynaecology Canada, https://doi.org/10.1016/j.jogc.2024.102612
Open access
Abstract
Objective: Little is known about whether induced abortions are associated with the final lifetime number of live births (life births). The objective of this study was to examine the association of number of life births with number of abortions a female has had in her lifetime.
Methods: In a national cohort design, we followed all Danish females from ages 15 to 44 years through the period 1977–2017 for induced abortions and live births. For each lifetime number of induced abortions, the average number of life births were assessed, and rates with 95% confidence limits calculated.
Results: The study included 409 497 females who completed 222 482 induced abortions and 831 742 live births. In 265 573 (64.9%) females who did not have any induced abortion, the average number of life births was 2.09 (95% CI 2.08–2.10). For females with 1 (23.4%), 2 (7.4%), 3 (2.6%), 4 (1.0%), and ≥5 (0.7%) induced abortions during their reproductive lifespan, the average number of life births was 1.88 (1.87–1.89), 1.99 (1.98–2.00), 2.09 (2.06–2.11), 2.13 (2.09–2.15), and 2.25 (2.21–2.29), respectively. The increase in number of life births in females with 1 to females with 5+ induced abortions was 4.7% for each additional induced abortion.
Introduction: While the legislation about induced abortion has undergone substantial changes in many countries over the last decades, the abortion law in Denmark has remained unchanged since all females in 1973 got the right to induced abortion until 12 weeks of gestation, and on specific indications and after regional board approval also from 12 until 22 gestational weeks.
While this health care service has been free of charge throughout this 50-year period, rate of first trimester induced abortions has since the mid 1970’s gradually decreased from 2.4% per year in females 15-49 years to now 1.0 % per year. At the same time first trimester abortions take place still earlier in pregnancy, with now 79% made before eight weeks of gestation, and 86% today made medically.
Figure 2. Age distribution of 222,482 induced abortions during the study period 1977-2017 among 409,467 females followed from 15 through 44 years of age
Discussion: …The association of a higher number of abortions with a higher number of live births in the individual female emphasizes the need for comprehensive health care, including access to effective contraception and abortion care.
Conclusion: We found the number of induced abortions during a woman’s reproductive lifespan to be positively correlated with the number of live births. This association is likely explained by a high fecundity in females with multiple pregnancies, including induced abortions, and suggests that even several induced abortions do not compromise a woman’s general reproductive end points.