The most comprehensive review to date into the link between abortion and mental health problems has confirmed that women who have an unwanted pregnancy are at an increased risk of experiencing mental health problems after an abortion (See NZ Herald, Guardian and BBC).
More significantly it reveals that 98% of all abortions carried out in New Zealand are technically illegal.
This new Review by the Academy of Medical Royal Colleges (AMRC) shows that abortion does not improve mental health outcomes for women with unplanned pregnancies, despite approximately 98% of the abortions being carried out in this country each year on mental health grounds.
This means that doctors who authorise abortions in order to protect a woman’s mental health are doing it on the basis of a false belief not supported by the medical evidence. In other words the vast majority of abortions in this country are technically illegal.
Otherwise the report confirms earlier conclusions that negative attitudes towards abortion, pressure from a partner to have an abortion and negative reactions to the abortion including grief or doubt, may have a negative impact on mental health after abortion.
Controversially it also claims that the risk of mental health problems after abortion is not any greater than the risk after birth but that both life events are nevertheless associated with an increase in mental health problems.
However the strength of evidence for the claim that abortion poses no greater risk to mental health than childbirth is weak as the report itself admits:
‘The evidence for this section of the review was generally rated as poor or very poor…These factors limit the interpretation of the results.’
This main conclusion of the report is what most media coverage (including the NZ Herald) has picked up, even though it is based on only four studies (Cougle, Steinberg, Fergusson, Gilchrist), two of which were judged as ‘fair’ and the author of the only one judged ‘very good’ (New Zealander, Professor David Fergusson) has a new paper in press which he claims shows a link between abortion and mental health problems in unwanted pregnancies which is not there for unwanted pregnancies carried to term.
He summarises this as follows:
‘The implications of this analysis are inescapable: despite the claims made in previous reviews about the absence of association between abortion and mental health, when data are pooled across studies there is consistent evidence suggesting that women having abortions are at modestly increased risks of mental health problems when compared with women coming to term with unplanned/unwanted pregnancies… While it remains possible that these findings reflect methodological problems of sample selection, residual confounding and investigator bias these considerations do not justify the strong conclusion that there is no evidence to support the view that abortion has adverse mental health consequences. It is our view that the scientifically appropriate and cautious assessment is that: there is currently suggestive evidence indicating that abortion is associated with modest increases in risks of common mental disorders. However to confirm this conclusion requires further and better research which addresses issue of measurement, confounding and investigator bias. A detailed paper describing these findings is currently under review.’
There are some strong messages to take home for those offering counselling and support to women with unplanned pregnancies.
First, women with unplanned pregnancies need to know that abortion will not reduce their risks of mental health problems relative to giving birth.
Second, those who have a past history of mental health problems, who believe that abortion is wrong, who are being put under pressure by their partners or who are experiencing other stressful life events, are at risk of increased rates of post-abortion mental health problems.
The first response to an unplanned pregnancy should therefore not be abortion but, as the review rightly recommends, proper support and care for women.
The government should make the provision of fully independent counselling for all women with an unplanned pregnancy a key priority, in order that they can have access to support and counselling that is not linked to abortion provision.
Cross posted from the Culture Vulture:
Courtesy of Catherine Gilles I found myself reading this interesting article late yesterday…
Germany has an abortion rate of 8 abortions per 1,000 women aged 15-44 per year. By contrast Britain’s rate is more than double this at 17.
European countries with laws requiring the offer of counseling or a cooling off period before abortion have abortion rates on average that are a third lower than those, like the UK, which don’t.
In German counselling is designed specifically to protect the unborn life, so the counsellor is required to inform the woman that the unborn have a right to life, and to try and convince her to continue with the pregnancy. The counsellor cannot however force this choice on the woman.
Germany also has a three day cooling off period of reflection after a decision to have an abortion is made before it can be carried out. Furthermore the counseling must by done by someone other than the doctor (or agency) doing the abortion.
The provisions are laid out in Section 219 of the German Criminal Code in a section titled ‘Counseling of Pregnant Women in an Emergency or Conflict Situation’ as follows:
(1) The counseling serves to protect unborn life. It should be guided by efforts to encourage the woman to continue the pregnancy and to open her to the prospects of a life with the child; it should help her to make a responsible and conscientious decision. The woman must thereby be aware, that the unborn child has its own right to life with respect to her at every stage of the pregnancy and that a termination of pregnancy can therefore only be considered under the legal order in exceptional situations, when carrying the child to term would give rise to a burden for the woman which is so serious and extraordinary that it exceeds the reasonable limits of sacrifice. The counseling should, through advice and assistance, contribute to overcoming the conflict situation which exists in connection with the pregnancy and remedying an emergency situation. Further details shall be regulated by the Act on Pregnancies in Conflict Situations.
(2) The counseling must take place pursuant to the Act on Pregnancies in Conflict Situations through a recognized Pregnancy Conflict Counseling Agency. After the conclusion of the counseling on the subject, the counseling agency must issue the pregnant woman a certificate including the date of the last counseling session and the name of the pregnant woman in accordance with the Act on Pregnancies in Conflict Situations. The physician who performs the termination of pregnancy is excluded from being a counselor.
Cross posted from the Culture Vulture.
Earlier this week the UK Daily Mail ran an article by Jenny Stocks, a journalist who went undercover posing as a terrified pregnant women seeking counseling about her situation from three abortion providers and three pro-life pregnancy centres.
Her report exposes some serious issues in regards to the counseling being offered to women by abortion providers, where the counseling she experienced pushes women towards choosing abortion with statements that sow seeds of doubt and uncertainty, or which gloss over important information.
Just listen to what Stocks has to say about her experiences at one abortion provider…
“Nevertheless, the message seemed very much to be that abortion was the best option. ‘It goes against our very nature to have an abortion,’ she said. ‘But we do things every day that go against our very nature.’
This was followed by: ‘You want what you want . . . is it worth having a child because you don’t want to deal with a bit of guilt?’”
And at another abortion provider (a Marie Stopes centre)…
“On the phone, the operator repeatedly tried to book me in for a medical assessment, the first step to getting an abortion — despite me stressing that I hadn’t yet made up my mind.
I felt bulldozed into starting the termination process and had to insist on having counselling. In real life, a worried woman might have gone along with whatever she was told.”
These aren’t small and insignificant things, instead they place incredible pressure on vulnerable women in desperate situations and they have a profound impact on unduly influencing a person’s final decision in such matters.
The article also highlights the case of Catherine Stone, a 31 year old PR account manager in the UK.
Stone regrets her abortion, which she says happened because she received inferior counseling prior to making her decision to abort.
“I was in a stable relationship with my boyfriend, who’s still my partner, but we didn’t own our own house… I panicked about my career and the effect a baby would have on my life. It was, frankly, a knee-jerk reaction and one I bitterly regret” says Stone, who received counseling at Marie Stopes, but had such a bad experience there that she went on to have her abortion somewhere else.
She says that “the assumption by the counsellor was: “Of course you are having an abortion — this is your choice as a woman.” No one, at any point, said to me: ‘Are you sure about this?’ I wasn’t given the chance to think about what I was doing — it was quick, clinical, and I felt women were being herded towards the abortion table like cattle… I blanked out the possibility of keeping the baby — if I’d had the support of a counsellor I’m fairly sure that today I’d have a child.”
Tragically Catherine Stone was then left to deal with the experience of severe depression after having her abortion.
So, as far as abortion providers go, Jenny Stocks undercover investigations have revealed that the experience o Catherine Stone is not an isolated aberration, instead it clearly seems to a very worrying norm that is part and parcel of the type of pressure that women face in counseling sessions offered by abortion providers.
But what about the pro-life pregnancy centres, how did they measure up in this undercover investigation?
Well, it’s a mixed bag really, because on the one hand Jenny Stocks says that, out of all the counseling facilities she visited, the best counseling she received was from the Christian affiliated centre known as ‘Choices’.
Although, it’s a little hard to know what to make of this statement about the counseling she received from Choices: “Her only advice was that I made a decision soon, as I was already quite late on in the pregnancy.”
It’s hard to know whether the counselor did indeed phrase the statement in this way, because if she did then it would seem to be problematic, because the counselor would have been placing pressure on her to rush into a major life altering decision.
So on the one hand, Stocks says that her experience of the counseling offered at Choices was one which she considered to be balanced and which “had I really been pregnant, I would have considered keeping the baby, without feeling pressured to do so”, but unfortunately she says that her experiences at another two pro-life centres she visited were not as good.
At those other two visits Stocks says that she experienced the following…
a. arriving at one centre to discover it was a Christian organization, something which was not stated on its website anywhere
b. a counselor suggesting to her that having a baby would be a matter of keeping all that she’s already got while simply adding a ‘little one’ to all those other things in her life (which is obviously a very misleading oversimplification of what’s actually involved in having a child).
c. invasive counseling techniques which saw personal information gleamed about her family situation then used to try and emotively influence her decision making processes.
d. a counselor who didn’t seem to know important aspects of UK abortion law (either that or she mislead Stocks because she didn’t want to tell her what the gestational limit for abortion was).
e. being told that she needed to tell her boyfriend ‘tonight’ that she was pregnant
Now to be fair to these two pro-life pregnancy centres, I do think that Stocks has probably made more out of one or two things than is fair – for example, she lists ‘being warned about all the relationships that break up because of abortion’ as a negative act, but surely (as long as the presentation of this information is factually correct and not emotionally manipulative) such information isn’t out of place in a counseling session intended to explore all of the issues associated with abortion?
I also do think that Stocks is coming at this issue from the a priori assumption that the ethical nature of the act of abortion issue isn’t actually relevant here, but I’m not sure that this is a valid assumption (she certainly hasn’t shown in any logical way why the ethical issue is irrelevant, and only personal choice matters) – but that’s a cultural conditioning thing, and to respond to that requires a much bigger discussion than what we have space for here.
The one point that Stocks makes that I do think is fair is her point about one of these pro-life centres advertising itself as being ‘non-directive’, yet aspects of what she experienced there clearly weren’t non-directive at all.
The important challenge here for pro-life crisis pregnancy centres is to ensure that they are honest in their representations of themselves, and that in their haste to see an ethical outcome achieved, they don’t fall pray to the error of Consequentialism – the notion that the end justifies the means, in this case: ‘anything goes for the pro-life cause’.
Important virtues such as honesty and empathy mustn’t give way to manipulation and misrepresentation in order to secure a good outcome, for to do this is ultimately a failure to adhere to that which lies at the heart of our pro-life cause – love.
Ultimately we are not morally accountable for the free moral decisions of other people, only for the moral decisions that we make ourselves.
So if someone freely chooses abortion, that isn’t on us, and we must never fall prey to the trap of violating important moral principles, or to manipulating people into making their choices, because such acts are no longer acts of love, but of deception, and even if they do manage to secure a good outcome, the means we have used to get there in such an instance are not ethically good, and they are not acts of authentic love.
Ultimately, though, while Stocks’ investigation certainly raises some important challenges for pro-life pregnancy centres, there is little doubting that it has uncovered some very serious flaws in the currently accepted practice of having counseling carried out by abortion providers.
Pro-life pregnancy centers can fix the issues raised for them in this article by simple adjustments to their practice behaviors, however I’m not sure that this is good enough for abortion providers, because it would seem that the current practice lacks transparency, and leaves women vulnerable to pressures that are driven by the financial benefits gained by these abortion providers every time they convince a woman to choose abortion.
Cross posted from Shannon Buckley at Mercatornet.
The abortion rules in the United Kingdom are set to be tightened in what has been described as “the biggest shake-up in a generation”. The plan would introduce a mandatory obligation on abortion clinics to offer women access to independent counselling, which is run on separate premises by a group which does not itself carry out abortions.
This makes sense to me given that you must be a fairly pro-abortion individual to be working for an abortion clinic – out of doctors who agree with abortion being a choice, few are actually willing to do it and much less specialise in it. This must surely mean skewed advice?
Although difficult to quantify, pro-life campaigners suggest the change could result in up to 60,000 fewer abortions each year in Britain, meaning 60,000 more births. Last year, 202,400 abortions were carried out in the United Kingdom. Robert Mendick reports in The Telegraph:
The proposed change comes ahead of a Commons vote, due to take place next week, on amendments to a public health Bill put forward by Nadine Dorries, a backbench Conservative MP. The amendments would prevent private organisations which carry out terminations — such as Marie Stopes and the British Pregnancy Advisory Service (Bpas) — from offering pre-abortion counselling. Women would instead be offered free access to independent counsellors.
A spokesman for the Department of Health said: “We are currently developing proposals to introduce independent counselling for women seeking abortion. These proposals are focused on improving women’s health and wellbeing. Final decisions on who should provide this counselling have not yet been made.” Proposals under discussion would involve withdrawing payments made by the taxpayer to abortion clinics for counselling women.
What is particularly concerning about abortion clinics giving pre-abortion counselling is that they are essentially advertising their own “product” – an awful way to put it given that it’s a human life we’re talking about, but people do make money out of it:
Last year, Marie Stopes and Bpas carried out about 100,000 terminations and were paid about £60 million to do so, mostly through the NHS…In a report entitled The Case for Independent Abortion Counselling, published last month by the campaign group Right to Know to bolster the Dorries amendment, abortion providers are accused of a “financial motivation… to grow revenues and increase the numbers of abortions that they perform” and claims that “the independence of counselling is compromised by the drive to encourage a decision for abortion”.
The report suggested that the “abortion industry” was worth £60 million a year to Marie Stopes and BPAS. The fewer abortions they carry out, the less income the charities would receive. In 1991, the NHS funded 84,369 abortions, but by 2010 that figure had more than doubled to 181,304. The additional abortions, paid for by the taxpayer, were entirely carried out by private providers such as BPAS and Marie Stopes on behalf of the NHS.
Regardless of what happens in the House of Commons, the United Kingdom Department of Health, is promising to develop proposals to introduce independent counselling for women seeking abortion, seemingly accepting that the advice given by abortion providers is not independent. This seems a positive step forward for women in the United Kingdom to me – many of whom rush to an abortion clinic in a panic, to make what is a very significant decision.
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