Economic Costs of Induced Abortion

Martha Shuping
by Martha Shuping, M.D., Brent Rooney, M.Sc.,
Byron C. Calhoun, M.D., Elizabeth Shadigian, M.D.

United Nations, March 4, 2008
Updated September 7, 2008
Reproduced with Permission

Induced Abortion and Preterm Birth Connection

The EUROPOP data (2004) shows that "previous induced abortions were significantly associated with preterm delivery and the risk of preterm birth increased with the number of abortions."1 More than 50 published studies to date, from more than twenty countries, show that induced abortion is significantly associated with preterm birth.2,3 Many large studies involving hundreds of thousands of cases show the risk of preterm birth increased with increasing numbers of abortions.4,5

Short-Term Economic Costs of Preterm Births

"Induced Abortion contributes to significantly increased neonatal health costs by causing 31.5% of early preterm births."6 Early preterm birth refers to births at less than 32 weeks gestation. "The total initial financial consequence of induced abortion attributable to premature deliveries" of less than 32 weeks "is greater than $1.2 billion in the U.S. per year."7 This is only for initial newborn hospital care for the early preterm births attributable to induced abortion, not considering long term costs, and not considering costs associated with cerebral palsy.

Complications With Premature Births

"Low birth weight and premature birth are the most important risk factors for infant mortality or later disabilities."8 Premature infants are at increased risk for cerebral palsy, mental retardation, blindness, deafness, learning disabilities, and other neurodevelopmental disabilities.9

Long Term Costs of Preterm Births


A major 2003 review article, accredited for continuing education for physicians stated, "We concluded that informed consent before induced abortion should include information about the subsequent risk of preterm delivery."21 This is in keeping with the Beijing Platform for Action which states, "Take all appropriate measures to eliminate harmful, medically unnecessary…medical interventions…and ensure that all women are fully informed of their options, including…potential side effects."22

This report was prepared to accompany a workshop presented by Dr. Elizabeth Shadigian at the United Nations on March 4, 2008. A minor updating was provided by the authors on September 7, 2008.

Martha Shuping, MD, MA, is a psychiatrist practicing in Winston-Salem, NC. Email:

Brent Rooney is a medical researcher. He may be contacted at the Reduce Preterm Risk Coalition, 3456 Dunbar St. (146), Vancouver, Canada V6S2C2. E-mail address: or

Byron C. Calhoun, MD, FACOG, FACS, MBA, is Professor and Vice Chair, Department of Obstetrics & Gynecology, West Virginia University-Charleston, Charleston, WV.

Elizabeth Shadigian, MD, FACOG an obstetrician-gynecologist in private practice and Adjunct Clinical Associate Professor of Obstetrics and Gynecology at the University of Michigan Medical School.


1 Ancel P, Lelong N, Papiernik E, Saurel-Cubizolles M, Kaminski M. History of induced abortion as a risk factor for preterm birth in European countries: results of the EUROPOP survey. Human Reproduction 2004; 19:(3)734-760. This study used EUROPOP data from ten countries, and included 2938 preterm births with 4781 controls at term. [Back]

2 Rooney B and Calhoun B. Induced abortion and risk of later premature birth. Journal of American Physicians and Surgeons 2003; 8:(2)46-49 (Accessed February 23, 2008, ). At the time of this 2003 report, at least 49 studies showed these results. Since then, additional studies have been published such as the report by Ancel et al., above, bringing total to more than 50. The article by Rooney and Calhoun list the 49 available at that time. [Back]

3 Calhoun B, Shadigian E, Rooney, B. Cost Consequences of Induced Abortion as an Attributable Risk for Preterm Birth and Impact on Informed Consent. The Journal of Reproductive Medicine 2007; 52:929-937. [Back]

4 Ibid. [Back]

5 Rooney and Calhoun, op. cit. [Back]

6 Calhoun, Shadigian, Rooney, op. cit. [Back]

7 Ibid. [Back]

8 Rooney and Calhoun, op. cit., citing Escobar GJ, Littenberg B, Petitti DB. Outcome among surviving very low birthweight infants; a meta-analysis. Arch Dis Child 1991; 66:204-211. [Back]

9 Behrman RE, Butler AS [Book] Preterm Birth: Causes, Consequences, and Prevention 2007; Washington (DC): Institute of Medicine; 2007. Executive Summary Available at: (Accessed February 23, 2008). [Back]

10 Calhoun, Shadigian, Rooney, op. cit. [Back]

11 Ibid. [Back]

12 Behrman RE, Butler AS [Book] Preterm Birth: Causes, Consequences, and Prevention 2007; Washington (DC): Institute of Medicine; 2007. URL: (Accessed Feb. 24, 2008). [Back]

13 Himpens E, Van den Broeck C, Oostra A, Calders P, Vanhaesebrouck P. Prevalence, type, distribution, and severity of cerebral palsy in relation to gestational age: a meta-analytic review. Developmental Med Child Neur 2008; 50:334-340. [Back]

14 Calhoun, Shadigian, Rooney, op. cit. [Back]

15 Ibid. [Back]

16 Behrman RE, Butler AS [Book] Preterm Birth: Causes, Consequences, and Prevention 2007; Washington (DC): Institute of Medicine; 2007. Executive Summary Available at: (Accessed February 23, 2008). [Back]

17 Ibid. [Back]

18 Ibid. [Back]

19 Ibid. [Back]

20 Ibid [Back]

21 Thorp JM, Hartmann KE, Shadigian EM. Long-term physical and psychological health consequences of induced abortion: review of the evidence, Obstet Gynecol Survey 2003; 58 (1): 67-79, (Accessed March 4, 2007, at [Back]

22 Beijing Declaration and Platform for Action, United Nations, 1995. [Back]