AbortionsCan cause miscarriages in later life?
Medical opinion is divided. But TV presenter Nadia Sawalha and many others who’ve had terminations are haunted by the question...
out and, and as far as I know know, it was over in minutes.
‘When I came round, as soon as they’d checked me over to make sure I was physically OK, they showed me to the door and I had to stand outside in the pouring rain waiting for Mum, who was late because she’d got lost.
‘When she arrived she was quite cheerful, suggesting we go to a garden centre to buy a plant “to remember the baby”. But I couldn’t stop crying.’
The emotional repercussions of that day have stayed with Sian, but it’s the possible physical effects that concern her most.
‘It was only when I met Craig at 24 and we tried for over a year to get pregnant that I began to seriously worry my abortion had reduced my chances. Thankfully, we conceived Sophia. Although I had a horrendous pregnancy, pregnancy with pre- eclampsia and pelvic problems, the main thing was my baby girl was here and she was safe.’
Then, when Sophia was six months old, Sian and Craig started trying for another baby.
‘We’ve always wanted at least two children, so we started trying quite quickly but nothing happened. We weren’t too worried at first but after a year had passed and still nothing, we began to worry.
‘We knew the NHS wouldn’t help with fertility issues because we already had one child and I kept saying to Craig: “I must be being punished for the termination. Maybe one child is all we’ll have.”
‘He was reassuring and told me it would happen one day.’ In August 2016, Sian did get pregnant — only to lose the baby at 12 weeks. ‘I was distraught,’ she says. ‘I’d had some bleeding at eight weeks and had gone in for a scan. While they could see the baby, there was no heartbeat, but the midwife said the baby seemed to be growing normally.
‘But I had another scan a week later and there was no heartbeat, then another, and again no heartbeat, yet the foetus was still growing.
‘By 12 weeks we were told we’d lost it. We were beyond devastated. I couldn’t help but think back to what I’d done as a teenager and if it was to blame.’
Clearly women are making a link, even if medical opinion is inconclusive — and the guilt can be overwhelming.
‘Women who have had terminations and later miscarry often look back and think “is that why?” ’ says Ruth Bender-Atik, of the Miscarriage Association Association. ‘Like Nadia, they think it must be their fault, that it’s karma or perhaps some damage was caused during the abortion, which is actually very unlikely.
‘But women are rarely given an explanation for their miscarriage so they are left with no information, which often means they blame themselves.’ DR
GORGy, of the Fertility Academy, stresses there is very little evidence to suggest that women who have had an abortion have an increased risk of miscarriage.
There is a small risk of developing Asherman Syndrome, which is the formation of scar tissue with adhesions inside the cavity of the womb. Excessive curettage (the surgical scraping away of tissue) of the womb cavity or infection can result in different degrees of the syndrome, which may lead to infertility or miscarriage.
However, Dr Gorgy says women should not be alarmed unnecessarily. ‘Any surgical procedure can cause problems,’ he says.
‘Around one in ten surgical terminations (conducted between ten and 24 weeks by either vacuum or forceps) can result in some form of infection, but this is often caught early early, treate treated and leads to no further problems.
‘Damage to the neck of the womb is rare and might occur in one in 100 surgical abortions. In very rare cases — around one in 250 to one in 1,000 surgical terminations and less than one in 1,000 medical terminations (conducted up to the tenth week of pregnancy by using medication) — there may be damage to the womb itself which may result in miscarriage.
‘But most terminations these days are suction-based, which is a much gentler approach, and any resulting problems are uncommon. Studies have suggested links but the evidence is not strong and in the large majority of cases there is no link.’
yet for Nadia Sawalha, Sian Jones and women like them, the deep- seated guilt is very hard to overcome.
‘I look back to the abortion and think, was it the right thing to do? I do know my mum had my best interests at heart,’ says Sian. ‘I would have found life very tough for the past 13 years and might not have met Craig or had Sophia. So although I regret it, it was probably the right decision.
‘Even now, when my due date comes around, I have a moment of quiet reflection. I’m trying to make peace with it all but convincing myself emotionally that it wasn’t my fault is very, very hard.’
HER distress all too apparent, Loose Women star Nadia Sawalha looked haunted as she relived darkness from her past. Speaking candidly on an internet podcast with her husband last month, the 53-year-old presenter remembered the trauma of her four miscarriages and spoke of her overwhelming guilt that an abortion she’d had before her marriage may have been to blame.
‘I had a termination years before,’ she said, choking back tears. ‘And I think, you know, all that guilt came up. And I was thinking, is this a punishment? With each subsequent miscarriage I felt like that — I felt it was a punishment. I immediately felt panic- stricken. What if I’m barren now and I can’t have a baby?’
Nadia, who went on to have two daughters, now aged 15 and nine, with husband Mark, was widely praised for her honesty, with many women lauding her on social media.
One said: ‘So brave of you both to talk about it so openly. Can totally understand, same thing has happened to me’, while another said: ‘Thank you for sharing. Very brave to do. I admire you both.’
For while medical evidence of any link between abortion and subsequent miscarriage remains inconclusive, women like Nadia are coming to their own conclusions about the long-term repercussions, and can be crushed with guilt.
‘Up to 25 per cent of the women who come to see me with fertility problems or who have had miscarriages have had a previous termination,’ admits Dr Amin Gorgy of the Fertility Academy, in London.
‘They do feel guilty,’ he says. ‘We do our best to reassure them the abortion will have had nothing to do with their current problems, but women blame themselves and look back on their abortion as a “reason”.’
He is quick to stress that the few studies which have been carried out to date are incon- clusive. One 2003 Chinese study suggested there was some correlation between vacuum abortion and subsequent miscarriage in the first three months of pregnancy, while a Danish study in 1980 found that women who’d had two or more induced abortions had a twofold to threefold increase in the risk of a miscarriage.
But with the abortion rate in England and Wales at a five-year high, perhaps more questions need to be asked, particularly as official figures out this week reveal that of the 161,181 conceptions for women aged under 20 in 2016, nearly a third (31.6 per cent) ended in abortion.
Could some of these young women later be tortured by their decision?
Sian Jones certainly is. Now 31, she was 18 when she reluctantly underwent an abortion — and today she blames the procedure for her two subsequent miscarriages and struggle to conceive a second child.
‘I’m still beating myself up for something that happened 13 years ago,’ says Sian, a receptionist who lives with her husband Craig, also 31, and their daughter Sophia, five, in Nottingham.
‘It doesn’t help that my little girl is constantly asking me if she’s getting a baby brother or sister. I know Craig and I often have one of those “moments” in the park where we’re watching her play and both thinking: “She might be an only child.”
‘The guilt I feel is huge. I’ve said to Craig and to friends that I feel I’m being punished.’
Sian was nearing the end of her A- level year and on course to study English at university when she got pregnant accidentally.
‘It was someone I was dating casually. I was on the Pill but I’d had a course of antibiotics, which can reduce its efficacy,’ she says. ‘When the condom split, I even took the morning-after pill within 12 hours but that didn’t work either.
‘Six weeks later, I hadn’t had my period but I was convinced I couldn’t be pregnant. A friend marched me to the chemist to get a pregnancy test. When it was positive, I crumpled to the floor. Things had already fizzled out with the guy I’d been dating. All I could think about was how my parents would react. I knew my mum would be horrified.’
She was right. When her mother Jayne, who passed away in 2017, discovered her daughter was pregnant she made her feelings clear.
‘Mum and I were very close and she knew instinctively that something was wrong,’ says Sian. ‘I’d been gathering myself for a day to tell her, but she just came out with it: “You’re pregnant, aren’t you?” I couldn’t reply. She walked out of the room and went into the conservatory.
‘ I followed her and found her leafing through the Yellow Pages for abortion clinics. She was so o upset. I remember her saying to o me: “You’re such a disappointment. t. You’re going to university. You can’t t have a baby.” ‘I could barely speak. I know now w she was probably just in shock and didn’t want me to ruin my life, but at the time it was hurtful and scary.’ Sian assumed she would have an n abortion but, over the course of a few days, she had a change of heart. ‘I’ve always wanted to be a mother,’ she says. ‘Even when I was little and people would ask me: “What do you want to do?”, I’d reply: “I don’t mind as long as I have children.” ‘So I decided I wanted to keep it. I thought about deferring university and, in my naivety, thought it would be really easy to find accommodation and be supported. ‘But Mum and her partner (she’d split from my father) made it very clear I was living in a dream. Mum was cold with me. Every day, she would say: “Have you come to a decision?” When I replied I was keeping it, she’d look at me as if to say “wrong answer” and would ask again the next day. I hated the atmosphere. My studies were suffering. I was so scared about the future.’ It was when she was 15 weeks pregnant, feeling the first flutterings of the foetus, that she was given an ultimatum. ‘Mum said to me: “If you have this baby, I will not have anything more to do with you”,’ says Sian. ‘The thought of having a baby was scary enough but doing it without Mum’s support was terrifying. I knew I had to go through with the termination.’ SIAN
was referred by her GP to an abortion clinic when she was 15- and- a- half weeks pregnant. ‘It was the worst day of my life,’ she says. ‘Mum drove me there but was told to leave me on my own. I went to the waiting room shaking with fear.
‘I had to have a scan and the doctors made it difficult for me not to watch the screen. I could see my baby wriggling around and couldn’t believe what was about to happen.
‘I wanted to tell them I didn’t want this, that it was a mistake, but I was too scared. I was too young to stand up for myself. One of the doctors asked me quite sternly why I’d left it so long and all I could say was that I hadn’t made my decision until now. But I was heartbroken.
‘I could hear women crying as I was given the anaesthetic and the noise of the suction machines as they aborted other women’s babies. It was horrific, but I was soon knocked