Might the large disparity in premature birth rates between black and white women be partly explained by abortion?

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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 FinnishDanish 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.

Posted by Dr Peter Saunders
CMF Chief Executive
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