The Incidence and Effects of Alcohol and Drug Abuse in Women Following Induced Abortion

Association for Interdisciplinary Research in Values and Social Change
by Thomas W. Strahan, JD
Vol 3, No 2, Summer 1990
Reproduced with Permission

Despite the report of the World Health Organization that women who have undergone a previous induced abortion tend to consume alcohol more than women in the general population., there has been no systematic study of the problem. However, based on various studies and anecdotal reports, it appears that the elevated use of alcohol as well as other drugs is attributable, in large part, to effects of the abortion experience itself. Various studies have reported that alcoholic women are much more likely than alcoholic men to date the onset of alcohol abuse to a particularly stressful event. One study concluded, "in women the problem is more highly individual, the excessive drinking being more intimately associated with a definite life situation. Both sexes have in common a narcissistic type of personality with increasing inability to adjust to reality and adult responsibility."1

Women reported their first heavy drug and alcohol use to have occurred in conjunctions with the stress related to the abortion.

Two recent studies have reported substantial numbers of women who have related their drug and alcohol abuse to their abortion experience. In a study by David Reardon of 252 women members of a group called Women Exploited by Abortion, approximately 8-12 years following their abortion, nearly one third stated they drank more heavily after their abortions and 15% described themselves as becoming alcoholics. 40% said that after their abortions they began to use or increased their use of drugs and 11% described themselves as having become drug addicts.2

Alcohol and drug abuse which often follows induced abortion is a risk factor for AIDS in women.

In another study of 30 women via in depth interviews who had experienced induced abortions several years earlier and reported stress from the experience, 60% reported increased alcohol use following their abortion. The majority of the women reported their first heavy drug and alcohol use to have occurred in conjunction with the stress related to the abortion. Only 3 women (16%) stated they had already developed an unhealthy reliance on drugs and alcohol as a coping mechanism prior to the abortion. 65% of the women had self-destructive thoughts as a reaction to their abortion experience and 30 % of the women made suicide attempts. The suicide attempts in most cases were drug and/or alcohol overdoses that resulted in the women being hospitalized.3

Nearly one-third stated they drank more heavily after their abortions and 40% said they began to use or increase their use of drugs (WEBA Study)

The tendency to abuse drugs following abortion may be greater among those who had abortions as teenagers. In the Reardon Study 50% of the women studied had their abortions as teenagers. This is a disproportionately high figure since only 25 - 30% of the abortions in the U.S. occur in this age group. Researchers at the Medical College of Ohio also found a greater tendency for drug abuse among women who had abortions as teenagers. In a study of 70 women those who had abortions as teenagers showed significantly higher scores on the following scales of the Millon Clinical Multiaxial Inventory (MCMI): anti-social traits (p=.01), paranoia (p=.01), drug abuse (p=.01) and psychotic delusions (p=.007). The mean score for the teenage abortions on the drug abuse scale was 63.3 compared with 53.3 for those who had abortions at age 20 or more.4

Anecdotal reports

Anecdotal reports from women shed light on some of the reasons for drug or alcohol abuse following abortion. One woman interviewed by Reardon stated, "I began having nightmares about my aborted baby. I began drinking more and more until I was up to five bottles of alcohol per week." This report is not an isolated instance. Of the 252 women interviewed over 40% experienced nightmares related to the abortion and about the same number said they suffered from insomnia.2

I began having nightmares about my aborted baby. I began drinking more and more until I was up to five bottles of alcohol per week.

Post abortion dreams can be very traumatic. One woman who had been coerced into an abortion by her mother dreamed, "my mother and four men chased me into a white garage. The men held me and my mother made a cut in my vagina while I screamed." Her associations suggest she is re-living her abortion experience.5 A therapist who treated women for post abortion problems reported the following dream of a patient two months after her abortion. "I was passing shops with an urgency to get somewhere. I walked down steps into a grocery. I came to a shelf of small jars of baby food. I put loads in the basket. Someone said ‘you can't have those.’ I left them and had a feeling of panic and ran out of the store." The same woman dreamt one year after her abortion, "I dreamt of being pregnant. I was feeling great and going into the hospital to deliver and to see the baby born. It was natural child-birth and it was a red haired girl. I remember desperately wanting to take it home with me and being told that I couldn't. I had the feeling of overwhelming sadness and woke up crying."6 Studies of alcoholic women have reported that about 3/4 stated they do not dream when they are drinking and still others may have pleasant dreams when drinking.7 Substance abuse to overcome nightmares or insomnia related to the abortion experience appears to be one of the reasons for drug or alcohol abuse following induced abortion.

Substance abuse occurred in women following induced abortion to overcome nightmares or insomnia, as an attempt to reduce grief reactions and to repress the abortion experience itself.

Drug or alcohol use following abortion may be used to reduce grief reactions following abortion. A woman who aborted to please her fiance reported, "During the 8 months after the abortion I began drinking heavily and doing drugs mostly amphetamines . I hated myself and Jim (the aborted baby's father) so much that I could no longer keep it inside. I was very pathetic, instigating fights between us, saying things like he loved his ex-wife and children more than me and our aborted baby. Our secular therapist said I was experiencing a mourning period and overwhelming grief."8 Some grief experts have contended that drugs or alcohol could reduce anxiety and the intensity of grief. However, the use of drugs or alcohol following bereavement could postpone or inhibit grief work rather than minimize the pain.

Drug or alcohol use may also result from attempts to repress the abortion experience itself. A woman who aborted for medical reasons said, "when I left that hospital, I put up a big wall within myself with a big sign on it that said, 'don't ever think about this experience again...don't think about it, don't dwell on it...', after life went to alcohol and hard drugs, all the time."9

Random Study

In 1981 researchers at the University of North Dakota conducted a random survey of 917 women throughout the United States to determine their drinking practices and sexual experiences. Drinking behavior was categorized by taking into account frequency of alcohol consumption, heavy episodic drinking and total consumption. Heavy drinkers were defined as averaging at least one once of absolute alcohol per day. Moderate drinkers consumed from .22 to .99 ounces per day, light drinkers consumed under .22 ounces per day and abstainers had not consumed alcohol at all or not within the last 12 months. (an ounce of absolute alcohol is approximately equal to two cocktails, two 12-ounce beers or two 4-ounce glasses of wine). The survey found that heavy drinking was most likely to occur among women aged 21-34 and more likely to occur among women who were unmarried (9%), divorced or separated (8%) or cohabiting (20%) and also among women whose spouses or companions were frequent drinkers. Only 4% of the women who abstained from alcohol reported prior induced abortion, but 13% of those who were classified as moderate drinkers and 13% of those who were classified as heavy drinkers reported prior induced abortion - a more than threefold difference. The 1981 survey also found that 6% of the U.S. women were heavy drinkers. Thus, women who reported induced abortion had twice the rate of heavy drinkers, compared with U.S. women in general.10

Table 1. 1981 Random Survey of 917 U.S. Women
Did you ever have an induced abortion?
Abstainers 4% said yes
Light Drinkers 5%
Moderate Drinkers 13%
Heavy Drinkers 13%
Source: Sexual Experience and Drinking Among Women in a U.S. National Survey, Klassen and Wilsnack, Archives of Sexual Behavior 15(5):363 (1986)

Heavy drinkers in the survey were much more likely to have a variety of social problems. Heavy drinkers more often had memory lapses while drinking (36% vs 10% of all women drinkers) and more often suffered mental depression (19% vs 3% for abstainers). Driving while intoxicated was a problem for 45% of the heavy drinkers; 27 % of the moderate drinkers but only 17% of all women drinkers said they had driven while feeling drunk or high at least once in the preceding year. Heavy drinkers were likely to report belligerence after drinking. In the preceding year 34% had started fights with their husbands or partners while drinking and 11% had started fights with people outside the family.

Women who reported induced abortion had more that twice the rate of heavy drinkers compared with U.S. women in general.

Sexual relations outside of marriage were more prevalent among heavy drinkers. Heavy drinkers were more likely to have had sexual relations before marriage (53%) than women who completely abstained from alcohol (27%). Heavy drinkers were also much more likely to think that sexual relations between an unmarried man and woman who loved each other was not wrong than women who abstained from alcohol (74% vs 18%). Heavy drinking, especially episodic drinking, was also more likely to be found among women with a history of gynecological problems such as miscarriage, birth defects in offspring and infertility. The survey confirmed previous studies that had indicated that both problem drinking women and alcoholic women report high levels of sexual dysfunction. The survey suggests that a history of induced abortion may also tend to increase sexual dysfunction in women.

According to the 1980 U.S. census there were about 80 million women in the U.S. who were 21 years of age or older. About 4.8 million of these women were considered heavy drinkers in 1981 (80 x 6%). According to abortion figures of the Alan Guttmacher Institute about 6.8 million women in the U.S. would have undergone induced abortion from and including 1973 until the time of the 1981 survey. About 880,000 (6.8 x 13%) were likely to be heavy drinkers at the time of the 1981 survey. Therefore, considering only abortions since 1973 about 18% of the heavy drinkers could be linked to a history of induced abortion. If abortions occurring from 1967 thru 1972 (estimated to be about 1.3 million women) are included, 1,053,000 (8.1 x 13%) or about 22% of the heavy drinkers could be linked to a history of induced abortion. The impact of induced abortion on heavy drinking is therefore substantial, even according to these conservative calculations which do not take into account possible under-reporting of induced abortions or abortions that may have occurred prior to 1967, or the substantial number of moderate drinkers, many of which had social problems which may be possibly linked to induced abortion.

Gynecological Events and Alcohol Abuse

In 1976, researchers Morrissey and Schuckit studied 262 women seen at a detoxification center in King County, Washington. 89% of the women had experienced a gynecological event such as a first childbirth, first miscarriage, first abortion, hysterectomy, or menopause. 72% had borne children, 39% had at least one miscarriage, 18% had abortions, 23% reported hysterectomies and 24% had gone through menopause. It was found that primary alcoholics had the greatest likelihood of experiencing an alcohol-related problem in the same year as a gynecological event such as miscarriage or hysterectomy. Problem drinkers or secondary alcoholics, on the other hand, were more likely to have experienced abortions in the same year as an alcohol-related problem.

Problem drinkers and secondary alcoholics were abusing alcohol but were not alcoholics. They were frequently diagnosed as having an antisocial personality and affective disorder. 22% of the secondary alcoholics and 6% of the problem drinkers were also abusing drugs. Two thirds of the women in both groups reported drinking alone and drinking in bars at least once a week. Secondary alcoholics were prone to binge drinking (81%), physical fights (64%), blackouts (88%), hospitalization (55%), divorce or separation (41%), charge of driving while intoxicated (33%), auto accidents (33%) and job loss (41%). Problem drinkers also had binges (40%), blackouts (54%), physical fights (32%), a charge of driving while intoxicated (19%), hospitalization (9%), lost a job (9%) or were divorced or separated (3%).11 Thus, induced abortion, when followed by alcohol abuse, is a risk factor for a wide variety of personal and social problems, even though the women may not necessarily become alcoholiCS.

Substance Abuse and Violence

If women poorly assimilate their abortion experience and abuse alcohol or drugs as a result, there appears to be a substantial likelihood of increased violent behavior.

If women poorly assimilate their abortion experience and abuse alcohol or drugs as a result, there appears to be a substantial likelihood of increased violent behavior. In the King County, Washington study from 1/3 to 2/3 of those abusing alcohol engaged in physical fights.11 In the random study of U.S. women who were heavy drinkers 34% had started fights with their husbands or spouses in the past year.10 Anne Speckhard, in her study of women stressed by the abortion experience, found that feelings of anger, rage and hostility toward oneself, one’s partner or medical professionals occurred in virtually all of the women.3 Franco who studied women in a post-abortion support group stated, "anger toward boyfriends and physicians was vividly described. Many felt coerced by boyfriends, parents or physicians and did not believe they had a choice."16 Reardon reported, "anger, resentment and even hatred was directed at the husbands or boyfriends who had been involved in the abortion.”2 In each of these studies alcohol and/or drug abuse was reported. Because of the anger, rage or resentment the use of alcohol or drugs may reduce inhibitions or self-control in the women and increase the tendency toward violence and other antisocial behavior. Induced abortion may be implicated in the steady increase of the female prison population in the U.S. which had doubled in the last 5 years to a level of 40,000 in 1989. The main reason for this trend is reportedly drugs.

Post Abortion vs Post Partum Reactions

Increased use of alcohol, tobacco or drugs following induced abortion was also observed in a study of 157 women who presented for abortion at a psychiatric department in a Capetown, South Africa, hospital in 1974--75. 88 had their pregnancies terminated by induced abortion and 69 were refused abortion and carried their pregnancies to term. Both groups alleged psychiatric problems as the basis for the abortion. Mental health outcomes were observed 12-18 months following initial presentation. Post-abortion reactions were consistently more severe than the post-partum reactions. Those whose pregnancies were aborted admitted to an increased use of alcohol, tobacco or drugs (11.3% vs 7.1%), increased use of tranquilizers (14.8% vs 11%), adverse personality change (15% vs 10%), greater social isolation (6.8% vs 1.4%) and psychiatric treatment (13.6% vs 8.7%) compared with those who did not abort. There were no suicides among either group during the 12-18 month follow-up period; however, 4.3% of those refused abortion attempted suicide. The study may be somewhat flawed because the women approved for abortion were more likely to be black which suggests the possibility of racism.12 The South Africa study tends to refute the conclusions of some advocates of induced abortion who claim that induced abortion has fewer emotional sequelae than childbirth. In fact, this study shows that there are significantly more emotional and social problems following induced abortion in the population studied.

Alcohol Use During Pregnancy

Scottish Study

Elevated levels of alcohol consumption in women who are pregnant and intend to carry their pregnancies to term have been noted where there is a prior history of induced abortion. In a 1981 Scottish study of 1008 pregnant women, those with a history of induced abortion consistently had higher and more severe levels of alcohol consumption compared with those with a history of stillbirth, spontaneous abortion or those previously having a physically handicapped child. A history of induced abortion (labeled termination in the study) positively correlated with weekly consumption, maximum day's consumption in a previous week and maximum day's consumption in the first trimester. 71% percent reduced alcohol consumption during pregnancy and 28% were unchanged. A significant number of women (17%) reported increased emotional stress since conception, which was attributed to domestic problems or apprehension about the birth.13 Apprehension about a pending birth would be expected with each of the groups studied yet the induced abortion group had the highest level of alcohol consumption during pregnancy.

Maternal alcohol use is significantly elevated in women with a history of induced abortion compared with other pregnancy outcomes.

Kumar and Robson studied previous induced abortion (legal or illegal) and subsequent depression during subsequent pregnancies and found that depression and anxiety was higher in women having prior abortions than other women, including those with previous miscarriages. They have observed that "nearly all women will admit to anxieties about foetal abnormalities but we have observed an intensification of such fears in women who have had previous abortions." They attributed this to unresolved fears of grief, guilt and loss which may remain dormant until apparently re-awakened by another pregnancy with such fears spontaneously interpreted in terms of retribution.14 The Scottish study appears to confirm their observations as measured by alcohol use during subsequent pregnancies.

California Study

In a California study of smoking and drinking practices of over 12,000 pregnant women following the legalization of abortion during 1975-1977 it was found that among women reporting a history of two or more abortions, nearly all (98.5%) reported consuming alcohol during the entire 9 months of a subsequent pregnancy intended to be carried to term. This was at a much higher level than the total sample (51 % reported drinking) or for women who reported their health as good or excellent (19.7%).15 The significantly higher alcohol consumption by women having two or more abortions is very significant because nearly 50% of the women who have undergone abortions in the U.S. represent repeat abortions according to recent surveys. Higher levels of anxiety, mood disorders and depression have been noted in women repeating abortion, compared with those who have had only one abortion.16 Thus, substance abuse may be even more likely during subsequent pregnancies among women with a history of two or more abortions.

The Surgeon General of the United States has recommended that women do not consume alcohol at all during pregnancy and yet women with a history of induced abortion do so in significantly greater numbers than women with other pregnancy outcomes. Alcohol consumption has an adverse effect on maternal health and the well-being of future offspring. Decreased birth weights have been noted in some women who average only one ounce of absolute alcohol per day during pregnancy. Significant increases of spontaneous abortions have also been observed at a reported alcohol consumption as low as one ounce of absolute alcohol twice per week. If a woman consumes alcohol at amounts consistent with a diagnosis of alcoholism there is a risk of bearing a child with fetal alcohol syndrome.17 Physicians specializing in providing medical care to women with 'at risk' pregnancies have observed that alcohol use by pregnant women blunts the biological urge to do what's best for their babies.18 Thus, women who consume alcohol during pregnancy may not seek adequate pre-natal care or may take risks that will jeopardize their current pregnancy.

Alcohol use by women may also adversely affect the health and well-being of women themselves. Alcohol tends to inhibit the immune system and a number of studies have demonstrated that alcoholics are more susceptible to infection than non-drinkers with respect to such illnesses as cholera, tuberculosis and other lung problems.19 The pharmacological effect of alcohol can reduce self-control and it has been demonstrated that individuals are less likely to use contraceptives when intoxicated.20 Adolescents are also less likely to use contraceptives if they have consumed alcohol prior to sexual intercourse.21 Also, being sexually active is significantly related to alcohol use and having had a sexually transmitted disease is also significantly related to recent drug and alcohol use among runaway adolescents.22 Thus, alcohol and drug use is a particular risk of women for HIV or AIDS since unprotected intercourse, sexual promiscuity, and sexually transmitted diseases are known risk factors for AIDS.

Cocaine, Methamphetamine and Heroin Use During Pregnancy

Women who use cocaine during pregnancy have been found to have a higher incidence of prior induced abortions (particularly repeat abortions) compared to those women who do not use cocaine in pregnancy. In a study of 697 inner-city women who were enrolled for pre-natal care at Boston City Hospital during 1984, 49% of those using cocaine reported one more prior abortion compared with 33% of those not using cocaine. Women who reported 2 abortions were more than twice as likely to be using cocaine (19% vs 9%) and women reporting three or more abortions were three times more likely to be using cocaine (9% vs 3%). Cocaine users were also likely to use alcohol or other drugs during pregnancy. In the Boston City Hospital study 88% smoked, 80% consumed, 72% smoked marijuana, 14% used opiates and 9% used other illicit drugs. Three fourths of the women were single and only 8% were married, 17% were living with the father of the baby.23 (see table 2)

Table 2. Cocaine Use Among 679 Inner-City Women enrolled for Pre-Natal Care at Boston City Hospital During 1984
Ethnic Group
White 14 8
American Black 62 47
Other Black 4 19
Hispanic 11 21
Other 9 5
Marital Status
Single 75 59
Living with father of baby 17 16
Married 8 25
[Substance Use]
Cigarette Use 88 35
Alcohol Use 80 55
Marijuana Use 72 19
Opiate Use 14 2
Other Illicit Drug 9 1
History of STD before Pregnancy 44 14
More or More Spontaneous Abortions 30 21
Elective Abortions
One 21 21
Two 19 9
Three or more 9 3
Total 49 33

In a study published in 1987 on maternal drug abuse evidenced in 110 neonates at UCSD Medical Center in San Diego it was found that women who were using drugs were more likely than non-drug using controls to have a history of one or more induced abortions. The hospital served an economically and ethnically diverse population. Women who used cocaine and/or methamphetamine averaged 1.7 abortions compared with 1.2 abortions for non-drug using controls. Women who used heroin or methadone were even more likely than non-drug using controls to have had one or more abortions (2.4 vs 1.2.). Nine infants exposed to both heroin and either cocaine or methamphetamine were found to have mothers with a significantly higher number of pregnancies (5 avg.) and abortions (2.7 avg.) than the control mothers. These nine infants had the highest perinatal morbidities compared with the other groups. They had the highest incidence of no pre-natal care (44%) and cesarean sections (56%), the highest rate of prematurity (44%), significantly poorer growth, small birth weight and fetal distress (67%). The study found that cocaine was used primarily by urban blacks (77%) while methamphetamine use was widespread throughout San Diego County including suburban and semi-rural areas and was used by 58% of the whites.24

Women who were using drugs were more likely than non-drug using controls to have a history of two or more induced abortions.

The increase in drug abuse in women as the number of abortions increase is consistent with the findings of researchers in other areas. Increasing moral and social deterioration as well as increasing emotional or psychological conflict have been observed among women who repeat abortion. Those repeating abortion tend to have relationships of shorter duration than unmarried women having first abortion, be less concerned over moral and ethical issues of abortion, are more isolated, have higher distress scores in dimensions relating to personal relationships, less likely to have a religious affiliation, more often have been admitted to a psychiatric institution or had psychiatric consultations post abortion. The abuse of drugs may indicate masochism or self--punishment as this has been identified as a factor in motivation for repeat abortion. The abuse of drugs by those women repeating abortion is of considerable consequence as nearly 50% of the induced abortions occurring in the United States are now repeat abortions.25

The tendency to use cocaine among women who repeat abortion has potentially serious health consequences for the health of the woman. Cocaine causes heart attacks, seizures, convulsions, assaultive behavior, paranoid ideation, delirium, nausea, vomiting, respiratory paralysis, and death. It may bring about obstetrical complications such as abruptio placentae, spontaneous abortion, possible increased risk of congenital malformation and perinatal mortality.26

Drug abuse is a significant co-factor as a cause of death from AIDS or AIDS virus in women. In a recent study by the Centers for Disease Control drug abuse was an associated cause of death in 26.5 % of the HIV/AIDS deaths of black women aged 15 to 44 in New York and New Jersey during 1987. This was the leading cause of death for this population.27 The spread of AIDS is reportedly soaring among teenagers, women, "crack" smokers and heavy drinkers. "The emergence of crack cocaine use as a risk factor for the transmission of HIV is a new and disturbing development in the epidemiology of AIDS " according to Dr. Don Des Jarlis of the Mt. Sinai School of Medicine in New York City, in a statement made at the 6th International Conference on AIDS held in San Francisco in June 1990.28


The increased tendency of women to abuse the use of alcohol and other drugs such as cocaine or methamphetamine following induced abortion has a potentially increased risk for women in a variety of health and social aspects. Alcohol impairs the immune system and places the women at risk for a variety of diseases including AIDS. Social deterioration may occur due to sexual dysfunction, increased tendency to provoke fights, mental depression, memory loss, hospitalization, job loss, increased isolation and self-destructive behavior. Maternal health and well-being of future offspring may be impaired due to alcohol or drug abuse especially if used during subsequent pregnancies intended to be carried to term. It is clear that the abuse of alcohol and drugs following induced abortion is a potentially serious health and social problem and requires more attention than it is currently receiving.

The author, Thomas W. Strahan, is editor of this Newsletter, an attorney and consultant who specializes in researching legal-medical issues. He has authored an Annotated Bibliography entitled Major Books and Articles Concerning the Detrimental Effects of Abortion published by The Rutherford Institute; Manassas, VA (1988, 1989) which includes a review of the literature on the relationship between alcohol and drug abuse and induced abortion on which this article is based.


1 A Study of Alcoholism in Women, James H. Wall, Am. J. Psychiatry 93:943 (1937); Alcoholism in Women, G. Lolli, Connecticut Rev. Alcoholism 5:9-11 (Nov., 1953) [Back]

2 Aborted Women Silent No More, David Reardon (1987) [Back]

3 Psycho-Social Stress Following Abortion, Anne Speckhard, PhD Thesis, University of Minnesota (1985) [Back]

4 Abortion in Adolescence, Campbell et al, Adolescence, Vol.XXIII, No. 92, Winter 1988) p. 813-823 [Back]

5 Therapeutic Abortion During Adolescence Psychiatric Observations, Barglow and Weinstein, J. Youth and Adolescence 294:331-332 (1973) [Back]

6 Psychological Aspects of Pregnancy, Birthing, and Bonding, Barbara L. Blum, Ed.,Chapter on Psychological Aspects of Abortion, Edna Ortof, Human Sciences Press N.Y. pp.56-65 (1980) [Back]

7 Personality Studies in Alcoholic Women, Frank J. Curran, J.Nervous and Mental Disease 86(6):645 (dec.,1957) [Back]

8 Aborted Women Silent No More, David Reardon (1987) Testimony of Carol St. Armour p.80 [Back]

9 Aborted Women Silent No More, Testimony of Deborah Hulebak p.84-85 [Back]

10 Sexual Experience and Drinking Among Women in a U.S. National Survey, A. Klassen and S. Wilsnack, Archives of Sexual Behavior 15(5):363-392 (1986); Women's Drinking and Drinking Patterns from a 1981 National Survey, R. Wilsnack, S. Wilsnack and A. Klassen, Am. J. Public Health 74(11):1231 (Nov., 1984) [Back]

11 Stressful Life Events and Alcohol Problems Among Women Seen at a Detoxification Center, E.R. Morrissey and M.A.Schuckit, J. Studies on Alcohol 39(9):1559 (1978) [Back]

12 Therapeutic on Psychiatric Grounds, Nash and Drower, South Africa Medical Journal 54(2):604-608 (Oct.7, 1978) [Back]

13 Women, Drinking and Pregnancy, Moria Plant, London Tavistock Pub. (1985) [Back]

14 Previous Induced Abortion and Anti-Natal Depression in Primiparie, R. Kumar and Kay Robson, Psychological Medicine 8:711-715 (1978) [Back]

15 Patterns of Alcohol and Cigarette Use in Pregnancy, Kuzma and Kissinger, Neurobehavioral Toxicology and Terotology 3:211 -221 (1981); Cigarette use is also higher during pregnancy where there is a history of induced abortion. See for example Pregnancy Complications Following Legally Induced Abortion. An Analysis of the Population with Special Reference to Prematurity, Obel, Danish Medical Bulletin 26:192-199 (1979) [Back]

16 Psychological Profile of Dysphoric Women Post-Abortion, K.Franco et al, J. American Medical Women's Association 44(4)113 (July/Aug. 1989) [Back]

17 Surgeon General's Advisory on Alcohol and Pregnancy, FDABulletin Vol. 11, No. 2 (1981) [Back]

18 Substance Abuse and Pregnancy. A Perinatologists Perspective, Virginia Lupo, M.D., Bio-Medical Ethics Lecture, Univ. of Minnesota Medical School, Minneapolis, Minn., (Jan. 11, 1990) [Back]

19 Alcohol and Immune Defense, MacGregor, J. American Medical Association 256:1474-1479 (1986) Infections in The Alcoholic, Adams, Med. Clin. North America68:179-200 (1984); Alcoholism, Infection and Altered Host Defenses, J. Chronic Diseases 29:35-49 (1976) [Back]

20 Comfort With Own Sexual Activity, Substance Use and Contraceptive Use in Young Women. A Correlational Study, A. Torre- Bueno, Paper Presented to the School of Social Work, San Diego State Univ. (1986); Assessing Alcoholism as a Risk Factor for AIDS, C.A. Molgaard et al, Soc. Sci. Med. 27(11):1147-1152 (1988) [Back]

21 Alcohol and Condom Use Among Adolescents, Hingson et al, Paper presented at 6th International Conf. on AIDS: San Francisco, June, 1990 [Back]

22 HIV/AIDS prevention and multiple risk behaviors of gay male and runaway adolescents, Haignere, C. et al, Paper presented to 6th Int'l Conf. on AIDS: San Francisco, June, 1990 [Back]

23 Cocaine Use During Pregnancy. Prevalence and Correlates, D.A.. Frank et al, Pediatrics 82:(6):888, (Dec., 1988). [Back]

24 Perinatal Cocaine and Methamphetamine Exposure. Maternal and Neo-Natal Correlates, A.S. Oro and S.D. Dixon, J. Pediatrics 111:571-578 (1987) [Back]

25 For a summary of the literature on repeat abortion see Special Issue on Repeat Abortion, Association for Interdisciplinary Research Newsletter, Vol. 2 (3), (Summer 1989) [Back]

26 Special Report - Medical Complications of Cocaine Abuse, The New England Journal of Medicine 315, No. 23, p. 315, No. 23, p. 1495-1500, (Dec. 4, 1986) [Back]

27 Impact of the HIV Epidemic on Mortality in Women of Reproductive Age, U.S., Chu, et al, JAMA 264 (2): 225 (July 11, 1990) [Back]

28  Use of 'crack' called 'risk factor for AIDS', Minneapolis Star, Tribune newspaper, June 21, 1990. [Back]