Monday 21 May 2007

Babies, Storks and the Academic Dishonesty of the Anti-Choice Lobby

A recent advertisement circulated in Irish print media by the anti-choice group, “Pro Life Campaign”, is a striking example of the manipulative and unethical tactics the anti-choice lobby are willing to embrace. The ad, spotted originally by Choice Ireland in the Dundalk Democrat, encourages citizens not to give their vote to parties that have given a commitment to introduce abortion legislation. It founds this request on the claim that, “Support for abortion ignores the dignity and humanity of the unborn child and the most recent findings showing the negative effects of abortion on women (Journal of Child Psychology and Psychiatry, January 2006).”

The above citation to the reputable Journal of Child Psychology and Psychiatry is an obvious attempt to create an impression of academic and scientific support for the oft-cited (but scientifically insupportable) anti-choice assertion that abortion “has negative effects on women”. In fact a basic examination of the article cited merely demonstrates the extent to which the anti-choice agenda are willing to misrepresent facts and embrace academic dishonesty in an effort to garner support for their agenda.

The first point to be made here is that the journal article is mis-referenced and misrepresented at the most basic level. The article in question makes no reference to the notion that “abortion ignores the dignity and humanity of the unborn child”. Neither does the article find “negative effects of abortion on women”.

What the journal article does say is, “The findings suggest that abortion in young women may be associated with increased risks of mental health problems" (Fergusson et al, 2006, 16). The important word here is "associated". This is not the same as "showing the negative effects of abortion on women". What it specifically means is that the authors found a statistically significant relationship (at the Alpha level of below .05) between having an abortion and the presence of the specific mental health indicators they looked for. That by no means indicates or provides evidence for cause. Only correlation. This is a subtle but vital difference.

In order to elucidate the vital distinction between correlation and causation, statisticians often cite the following example. If you examine the records of the city of Copenhagen for the decade following World War II, you will find a strong positive correlation between the annual number of storks nesting in the city, and the annual number of human babies born in the city. Jump too quickly to the assumption of a causal relationship, and you will find yourself saddled with the conclusion either that storks bring babies or that babies bring storks.

In fact what you have here is a situation where the two variables (or things) being examined are correlated (or associated), not because one is causing the other, but rather because both are influenced by a third variable, that is not being taken into account. During the decade following World War II, the populations of most western European cities steadily grew as a result of migrations from surrounding rural areas. Additionally this was the post-war baby boom era. Copenhagen is also home to annually fluctuating numbers of storks. As population increased, there were more people to have babies, and therefore more babies were born. Also as population increased, there was more building construction to accommodate it, which in turn provided more nesting places for storks; hence increasing numbers of storks.

The findings of this research cannot be used to assert causation, only correlation. Abortion does not cause mental problems, it is "associated" or "correlated" with it. The study itself goes into the limitation of this in the discussion section. What it means methodologically is that, while confounding factors were taken into account (third factors that might influence the results), there is the possibility that other confounding factors which were not controlled for have not been taken into account and the association is a result of a third factor. Pointedly, the research did not control for existing psychiatric illness. It is quite possible that this, or any other factor not controlled for is creating a “confounding” association similar to the one between babies and storks.

The research itself also suffers from a variety of methodological problems which impose very serious limitations on the already weak finding that, “abortion in young women may be associated with increased risks of mental health problems”. Indeed the word “may” in this sentence already indicates the extent to which this is an unfounded hypothetical possibility, rather than a definitive evidence based reality.

Perhaps the most striking limitation to this research is the fact that it was conduced in New Zealand. In New Zealand, the provision of abortion is determined by the Contraception, Sterilisation and Abortion Act, 1977.The Act requires that certain criteria are met before allowing a woman to undergo an abortion. In order to have an abortion in New Zealand, two certifying consultants must agree: 1) that the pregnancy would seriously harm the life, physical or mental health of the woman or baby; or 2) that the pregnancy is the result of incest; or 3) that the woman is severely mentally handicapped. An abortion will also be considered on the basis of age, or when the pregnancy is the result of rape. Given the implications of these criteria in terms of the mental health of women who are allowed to have an abortion in New Zealand, it is hardly surprising that the study should find some association between women with negative mental health indicators and abortion. Given the circumstances in which the pregnancy must take place, the presence of negative mental health indicators is almost required to have an abortion in New Zealand.

This is by no means the only methodological problem. Importantly, the sample of people that was used for the research may have been biased since it does not match the real population in New Zealand. Specifically the people that were sampled had a lower reported rate of abortion compared to the real population. We would always expect some difference in terms of populations, however as the study itself points out, this difference was statistically significant, (Fergusson et al, 2006, 17). This poses serious problems in terms of the validity of the research since certain types of people may be more likely to admit to having had an abortion. If this is so, the sample will be biased and the results may be invalid.

Another profoundly serious problem, which the article itself points out, is that the research took no account of the role of contextual factors. As the article itself makes patent, " It is clear that the decision to seek (or not seek) an abortion following pregnancy is likely to involve a complex process relating to: a) the extent to which the pregnancy is seen as wanted; b) the extent of family and partner support for seeking or not seeking an abortion; c) the woman's experiences in seeking and obtaining an abortion. It is possible, therefore, that the apparent associations between abortion and mental health found in this study may not reflect the traumatic effects of abortion per se but rather other factors which are associated with the process of seeking and obtaining an abortion. For example, it could be proposed that our results reflect the effects of unwanted pregnancy on mental health rather than the effects of abortion per se on mental health.” (Emphasis added, Fergusson et al, 2006, 22)

Owing to these limitations the real conclusions of the report are as follows:

"On the basis of the current study, it is our view that the issue of whether or not abortion has harmful effects on mental health remains to be fully resolved." (Fergusson et al, 2006, 23)

"Notwithstanding the reservations and limitations above, the present research raises the possibility that for some young women, exposure to abortion is a traumatic life event which increases longer-term susceptibility to common mental disorders.” (Emphasis added. Fergusson et al, 2006, 23)

"These findings are inconsistent with the current consensus on the psychological effects of abortion.”

The findings of this research are indeed out of step with the current consensus on the psychological effects of abortion. This is most likely due to the profound methodological limitations of the research as discussed above. In fact there has been much research on this issue and the consensus is that there is no link between abortion and psychological harm to women. The highly reputable and prestigious American Psychological Association outlined this in their 2005 statement on abortion. It concluded that “well designed studies of psychological responses following abortion have consistently shown that risk of psychological harm is low … the percentage of women who experience clinically relevant distress is small and appears to be no greater than in general samples of women of reproductive age” (American Psychological Association, 2005)."

This is not to deny that abortion is a difficult event for many women. Abortion is a hard choice for all women and one, which no woman chooses lightly. But for some women it is their choice. And with quality counselling to explore their decision prior to making it, it is a choice they rarely regret (IFPA, 2000).

What can be particularly traumatic for women in Ireland facing crisis pregnancy, is the fact that they are forced overseas to avail of an abortion. As women in crisis pregnancy in Ireland are exported abroad the reality of their situation and the decisions they must face are blatantly denied and their choice stigmatised in a way that can only compound the anxiety of a crisis pregnancy. Moreover women who choose an abortion are faced with the enormous financial burden incurred from travelling abroad. A statement by the Royal College of Obstetricians and Gynaecologist is particularly salient in this regard. “Only a small minority of women experience any long term psychological squeal after abortion. Early distress, although common, is usually a continuation of symptoms present before the abortion. Conversely, long lasting, negative effects on both mothers and their children are reported where abortion has been denied.” (Royal College Obstetricians and Gynaecologists, 2000).

If those who maintain the anti-choice agenda are truly concerned about the psychological welfare of women they might examine the academic consensus on the issue instead of misrepresenting it. Each year between 6000 and 7000 women from Ireland travel to Britain for an abortion. Abortion is a choice women will continue to make. It is also a right that they must be allowed to exercise over their own bodies. It is the absence of abortion rights in Ireland, which is damaging to the psychological well being of women.

The anti-choice lobby claims to be interested in the psychological well being of women and in reducing the numbers of abortions. This interest will not be served by misrepresenting academic research or by manipulating women. Neither will it be aided by denying women their right to an abortion in Ireland and compounding the crisis of their pregnancy. It will be served through legislation legalising free abortion; the introduction of adequate sex education programs; an end to the stigma surrounding sex and abortion; free and accessible contraception and the introduction of real supports for women who choose to go through with their pregnancies. If the anti-choice lobby are truly interested in the psychological well-being of women and reducing the numbers of abortions, the reality is that they would be better served turning their energies towards these issues.

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