Prematurity is associated with a wide variety of health
risks. In the UK, 7.8% of babies
are born prematurely (60,000 per year) and this number is on the rise.
The total cost of preterm birth to NHS is £2.9
billion a year, equivalent to that of smoking, alcohol and obesity.
Reducing the rate of preterm birth even by a small amount will therefore have a
significant impact on reducing this cost.
It is a well-established fact that, both in the US and the
UK, black women have
preterm birth rates of 15–18%, more than double than that of the white
population. But although we know a lot about the causes of prematurity this specific
disparity is as yet unexplained.
If you search on pub
med you will find a whole host of articles looking at possible
explanations. But research attributing the link to factors as diverse as infection, inter-pregnancy interval,
nutrient deficiency
and inequality
remains inconclusive.
Might abortion perhaps play a role?
According the 2013
abortion statistics for England and Wales, published just last week, ‘Black
or black British people’ only make up 3.3 per cent of the population but
accounted for 9 per cent of abortions.
Furthermore, the percentage of women having an abortion in
2013 who had one or more previous abortions also varied by ethnic group. 49% of
Black women having abortions in 2013 had previously had an abortion compared
with 36% of White women.
The link between abortion and premature birth is well
established but largely underplayed or denied by British authorities including
the Royal College of Obstetricians and Gynaecologists (RCOG).
Most doctors and women are therefore not aware of it.
I have previously
summarised the medical evidence for the link on this blog and have also highlighted major Finnish, Danish and Scottish studies
confirming it.
Last year I drew
attention to a paper from
North Carolina which has reviewed all the available data on the association
between abortion and preterm birth.
In fact there are now over 130 scientific articles reporting
on the link between abortion and preterm birth in the subsequent pregnancy and
two well-designed meta-analyses now demonstrate that just one prior abortion
increases by 36% the risk for a future ‘preterm’ birth and by 64% for a ‘very
preterm’ birth. Two or more abortions increase the risk for a future ‘preterm’
birth by 93%.
So might the large disparity in preterm birth rates between
black and white women be partly explained by the fact that black women have
more abortions?
One would have thought it was an obvious avenue of research.
So why isn’t anyone looking into it?
Now there’s a question.
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