2007). Again, the strength of the study is apparent in its ability to access complete medical information. The study also performed a population study which allowed them to survey all abortion treatments in the country, versus other studies that have suggested a risk between medical abortion and ectopic pregnancy using population-based case patients and controls (Virk et al. 2007).
The strengths of the Virk et al. study are evident in its access to medical records; however, its relatively small sample size contributes to its weaknesses. Among the 11,814 pregnancies in women who had undergone previous first-trimester abortion, 2,710 women had medical abortion and 9,104 women had surgical abortion. The study then compared the first-trimester results of the 11,814 subsequent pregnancies for birth weight, preterm birth, ectopic pregnancy, and spontaneous abortion (Virk et al. 2007). Only the results of 2,710 subsequent pregnancies were studied in women who had undergone previous medical abortion. This sample size is relatively small when considering the millions of subsequent pregnancies that have occurred in women with previous medical abortion history. The statistical information collected by Virk et al. was also adjusted for maternal age, parity, interpregnancy interval, cohabitation status, maternal residence, and gestational age at the time of the abortion, but was not adjusted for smoking, history of sexually transmitted diseases, or history of ectopic pregnancy (Virk et al. 2007). These are other variables which could affect subsequent pregnancies, yet were not examined in this study.
An additional study investigating the significance of abortion and its role on women's health examined the links between pregnancy and mental health outcomes. Over the course of the past two decades, research has been conducted to consider mental health outcomes, such as depression, substance use, anxiety, and suicidal behavior in association with induced abortion (Fergusson et al. 2008). The research performed by Fergusson et al. based their results from a longitudinal study of 534 women who had been participants in the Chirstchurch Health and Development Study (CHDS); CHDS studied individuals at birth, 4 months, 1 year, every following year to age 16, and at ages 18, 21, 25, and 30 (2008). Each woman had provided information over the 30-year period regarding pregnancies and mental health history. Based on this study group, 284 women reported a total of 686 pregnancies prior to age 30, and included a total of 153 abortions that occurred to 117 women (Fergusson et al. 2008). During every assessment from age 16 to 30 years, participants were questioned regarding mental health issues since the previous assessment using specific, structured questionnaires (Fergusson et al. 2008). After analyzing the correlations between abortion and mental health, Fergusson et al. found abortion may be associated with a small increase in risk of mental health disorders; women who had abortions showed rates of mental disorder that were approximately 30% higher than the other female participants (Fergusson et al. 2008).
The longitudinal research component of the Fergusson et al. study is its greatest strength (2008). Being evaluated since birth, the female participants each offered a comprehensive, detailed medical history. The comprehensive nature of their medical histories allow for significant insights into mental health and how life events affect the occurrences of mental disorders. This strengthened the research group's ability to evaluate correlations between the incidence of abortion and subsequent mental disorders. The study also considered such lifestyle dynamics as living arrangements, employment problems, illness or death in the family, and any partner relationship problems that could contribute to mental illness in order to identify direct relationships with abortion and mental health (Fergusson et al. 2008).
Weaknesses of the Fergusson et al. study include sample bias and the length of the study. There were an original 630 women in the CHDS study who entered the study at birth; only 534 women provided consent to be included in the Fergusson analysis. Based on information available from all 630 female CHDS participants, the 20% of women not represented in the study had a tendency to be from low socio-economic status which gives evidence of sample bias (Fergusson et al. 2008). The longitudinal nature of the study is a noted strength; however, the study only provided information on women to age 30. Women are still likely to become pregnant after age 30, and the