Does history of induced abortion increase risk of miscarriage?

Question

Last year I experienced a miscarriage at about 5 weeks into the pregnancy. Before this miscarriage, I had an induced abortion (approximately 3 years before). Presently, I am faced once again with a miscarriage, this time it was a missed abortion. My question is, is there any relation with having had an induced abortion and later on having miscarriages? I have never had my progesterone levels checked, is there any relation in low levels of progesterone and missed abortion?Thank you

Answer

Last Updated: July 24, 2013
I am sorry to hear about your situation. Yes, abortions can have an impact on future pregnancies. However, from the information I have, I don’t think that your two miscarriages were an effect of the abortion. Let me explain. It sounds like you had a “surgical abortion” which is associated with cervical damage, uterine perforations (puncture), infections, incomplete evacuation (parts of the child and placenta were left in the womb), and scarring to name a few. We don’t know the actual numbers of physical side effects because doctors who provide abortions are not required to be on staff at a hospital or have any of their procedures reviewed. The rest of the medical community has to have every aspect of their practice subject to review.

Your first miscarriage occurred quite early and I doubt this was a consequence of the previous abortion. The second miscarriage sounds as though it was “fetal demise” meaning the child had a genetic abnormality incompatible with life even in the womb. Other things could have occurred such as a poor placenta or cord, improper implantation, etc. The most likely cause is as you alluded to– poor progesterone levels.

The best way to investigate this is to be taught how to chart your menstrual cycles. The biological markers such as cervical mucus are highly accurate reflections of what is going on in your body. A trained doctor or provider can then order the appropriate tests (hormone levels, ultrasounds, etc) at the appropriate times of the cycle where the tests are meaningful. There is a wealth of information on menstrual charts which helps your doctor and you make diagnoses and treatment.

Keep in mind that while I don’t think your previous abortion were associated with your miscarriages, I would be concerned about other side effects of the abortion. Depression, drug use, and suicide increase by 3-4 fold in women who have under gone an abortion. Teresa Burke, PhD does an excellent job of describing this along with a great amount of research in her book “Forbidden Grief”. She cites the studies and organizations such as Rachel’s Vineyard which are available for people who need healing after an abortion (men included).

Also, the risks of breast cancer increase after an abortion especially in women who had an abortion prior to the first full-term pregnancy (Nat’l Institutes of Health). This is because during a pregnancy, the milk glands go from stage II to stage III. During the final weeks of a pregnancy, the glands go to the fully mature stage IV. If the pregnancy ends prior to the end of the pregnancy, the stage III glands are sort of left in limbo. They are much more prone to abnormal cell development. This occurs with women with repeated miscarriages and abortions. Women are not usually informed of this at the time of abortions.

I have given a lot of serious information but it is good that you are taking charge and looking into your health. CANFP and One More Soul have listings of doctors and providers who are trained in looking at menstrual charts. They also have lists of trained teachers. The American Academy of Fertility Care Providers has doctors who are trained in the very specifics of which I discussed above.

I sincerely hope that you will find the help and information that will help you and that this could help not only you but other people you may meet along the way.

Dr. Gretchen Marsh

Answered By:

Gretchen Marsh, D.O.
Dr. Marsh graduated from Western University of Health Sciences in 1987 in Pomona, CA and is board certified in Family Medicine by the American Osteopathic Board of Family Physicians. She has been certified as a NaProTechnology® Medical Consultant (NaPro) and Creighton model Fertility Care System (CrMS) teacher since 2001. She and her husband, Jon, have 5 sons and live in the Reno region, where she sees patients in person, in addition to her telehealth services offered via MyCatholicDoctor.com

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