Some good news: a study by U.S. and Danish researchers show that abortions using mifespristone (RU-486) pose no greater risk of future tubal pregnancy or miscarriage than surgical abortions. The study was conducted using 12,000 Danish women. Between eight and ten percent of abortions in the U.S. are performed using mifespristone, which allows women with early pregnancies to abort at home rather than in a doctor’s office.
While previous research has shown surgical abortions don’t increase the risk of problems in later pregnancies, little research had been done into the impact of medical abortions.
Generally, surgical abortions completely remove an embryo or fetus and surrounding uterine tissue but abortions done with pills may leave bits of placenta or other embryonic material. Some doctors have wondered whether that might interfere with subsequent pregnancies, said Dr. Matthew Reeves, a reproductive medicine expert at the University of Pittsburgh School of Medicine.
”This kind of squashes any concerns,” said Reeves, who was not involved in the study.
Three cheers for even more information proving that abortion is safe!
Although, I have to say that this information towards the end of the article really creeped me out:
In the new study, researchers used a national abortion registry to identify all women in Denmark who had abortions between 1999 and 2004, and then got information on later pregnancies from national patient and birth registries.
Denmark is the only country with an abortion registry, said study co-author Dr. Jun ”Jim” Zhang of the National Institutes of Health.
Um. Abortion registry? Is it just me, or does something seem a little rotten in the state of Denmark?
Can we maybe do another study? While I’m sure that the results of this one are completely valid, I’d really love the opportunity to quote a study that doesn’t involve such scary Big Brother overtones, and women who actually know that they’re being tracked.
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Cara, I don’t get your BB concerns. I’m Danish myself and ALL patients in Denmark, regardless of why they are being admitted to a hospital, are being tracked in a number of registers.
Apart from the Register of Legal Induced Abortion I could mention The National Patient Registry, The National Cancer registry, The National Diabetes Registry, The national Birth Registry, The National In Vitro Fertilization Register and The National Cause of Death register.
To be it clear: You WILL be be included in the appropriate register if you are being admitted to a hospital (or die!) – you have no choice. The registers are part of the national statistics on disease etc. and helps the department of health track development in disease patterns etc. It’s not creepy, it’s extremely useful as everybody is included and you avoid sampling bias.
I actually found a link in English explaining all this:
http://www.sst.dk/Informatik_og_sundhedsdata/Registre_og_sundhedsstatistik.aspx?lang=en
-then click on ‘The Registries of the National Board of Health’ in the left-hand sidebar to read more about the individual registers we have in Denmark. Note that not all of them have an English description (but most of the ones I mentioned in my previous post have).
Hey Ole,
I’m glad and a bit relieved that the register is not JUST for abortion, but I’m still really uncomfortable with the idea. I’d be fine with tracking of all procedures, but the fact that names and personal information are attached makes me REALLY uncomfortable. I think that it’s definitely creepy that the government has access to your personal medical information. I don’t know what the full rules are for this, of course, but since researchers were allowed to use the information, it can’t be under that high of security. Maybe mistrust of the government is an American thing (and past/current invasions of privacy, I think, give us a good reason to be wary), but I don’t want the government knowing about having my gall stones removed, let alone an abortion. I’m happy to be a number on the chart, but not a name in a list.
Hi Cara,
The information contained in all government registers in Denmark about all people in Denmark (yeah, we are registered in A LOT of registers) are controlled under some rather strict pieces of legislation, detailing who can have access and to what. It’s complicated to explain in detail…
Anyway, I’d say that the vast majority of Danes do not have a problem with this since it actually makes everyday life and dealing with various government departments a lot easier than it otherwise would be.
Also, while usually your name will be in the register together with birth date etc., this information can not be accessed by, for example, researchers. They would typically only be allowed to get information of direct relevance to their project in question. They would *not* be allowed to get the names, for example. I’d have to say that I definitely don’t share your mistrust about the government. Or rather, I do mistrust the US government, but not the Danish government…
I’m a Canadian researcher who actually used this type of government-collected administrative health data in my masters research on lung disease, and have used it since in many other projects. The Canadian system (of collecting information on all procedures) is similar to how it works in Denmark (and some other European countries as well). Basically a record is generated for every encounter with the health system (i.e. every prescription filled, every procedure, every physician visit). I can tell you from personal experience that accessing this data is not at all easy – there is a rather long, paperwork-laden, cumbersome process in acquiring it, and patient’s names are certainly not available; not ever. You also have to have an approved, university-backed, and very well-defined study to even begin the application process. We often lament that something similar doesn’t exist in the US actually – and many US researchers are troubled by it too. It is such a unique and rich resource for literally thousands of applications in improving the health and health services of healthcare users, and when proper controls of confidentiality are employed (which they are), it can provide vital information about population health.
Also, we should keep in mind that the reason other countries have databases like this are that they have universal healthcare systems – making this brand of work impossible in the US. There is research exactly like this, occurring right now among HMO groups in the US – it is just limited by the question of bias introduced by only including those with insurance in a given area.
Well I’m curious then, Cherlyp– why did the article say that Denmark is the only country with an abortion registry? Does Canada track all procedures EXCEPT abortion? Something doesn’t add up, so I’m really curious, now.
I’m also curious as to how the data would look. This study was based on watching the same patients to see if they had complications with tubal pregnancy or miscarriage. Would they assign numbers or codes to the patients to keep them confidential?
Again, I’m all for collecting data for statistical and research purposes (and all for universal health care), but calling it a Registry conjures up some scary images. Maybe it’s just a language/cultural barrier (different countries using the same word to imply different things– happens all the time), or it could just be the fact that governments are usually the best when it comes to naming their organizations.
Good question. Abortion is definitely captured in the Canadian databases (or at least in the British Columbia one I’m familiar with), but perhaps the distinction is given to Denmark because they have a separate database for it? Or perhaps getting access to those particular coded records in Canada takes another step that I’m unfamiliar with – I know the most about codes for asthma and the like. I checked the website for my data stewards and abortion codes are certainly on their list of available ones to request though, so it is tracked.
And yes, each person has their own PHN (personal health number) that never changes throughout their life. So you can track people over time (which I actually do in the case of bronchitis and asthma), but you wouldn’t actually know who they are, per se.
And yeah, I hear ya on the use of “register”. I think that may just be a language thing – you’re probably right about that.
Re the register scare: I agree with cherylp that it is a cultural/language thing.
Medical data in Denmark are tracked in much the same way as in Canada – we are issued a so-called civil registration number (CPR-number in Danish) when we are born. It never changes and all information that various government-related institutions hold about you is tied to your CPR-number (e.g. taxes, social security, health care, school/university attendance, pensions, address) .
But the information about you does not exist in just one big database; there’s literally hundreds of them and it’s illegal without prior permission to carry out cross-referencing between the databases, in order to protect your privacy. And applying for that is a cumbersome and tedious process, as indicated by cherylp.
Well, that pretty much clears everything up for me, then.
Thanks to both of you for setting me straight . . . and for being so patient about it. It’s good to have learned something new!
Thanks to you too! It’s good to hear perspectives from different countries with different systems on this kind of thing.
I’ll second that. And I like your blog a lot!
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