"Medically, in the proper hands, it's a very safe procedure and doesn't have much impact on future pregnancies until you get to four or more," he told ABCNews.com. "But in the long run, most do fine."
In Vilar's case, her final two pregnancies were healthy ones, and her daughters are now thriving at 3 and 5.
Her story is a reminder that more needs to be done to educate women about the proper use of birth control and providing better access, according to Dr. Lauren Streicher, clinical assistant professor at the Northwestern University School of Medicine.
"This book really isn't about using abortion as birth control," she told ABCNews.com. "She is unconsciously sabotaging contraception for self-mutilation. It's a way of escaping feeling empty."
"It's an interesting book and she writes beautifully," said Streicher, who hosts the nationally syndicated radio show for medical professionals, Reach MD. "But by her very admission, she is a psychologically disturbed woman."
Ultimately, after some self-discovery and nursing her beloved dying dog, Vilar ends her dysfunctional marriage. She finds stability and love with a new husband, a writer and poet, and she builds a new family, reveling in the motherhood she once thought was impossible.
"Does that just end overnight? " asked Streicher. "The death of your dog, the birth of your child? You still fight your demons."
But Vilar blames much of her poor choices on a hypersexualized society that at once values the perfect mother, but also expects women to be sexually attractive to men and to achieve professionally.
"Women have a deep need for agency, for purpose and direction and society is not providing natural and healthy channels for creative action," she said.
"In school and on TV, every message I get is what I am doing as a mother or wife is wrong," said Vilar. "I should be thinking about a profession and not mothering. Everyone is having babies, and yet they don't want to care for them.
"Are many of the repeat abortions in part an embodiment of this mixed message? A lost, ambivalent attempt at an act of agency that cannot find its proper vessel? "
ABC writer Dominick Tao contributed to this report.