This month, a Senate committee held a hearing on whether to halt the growing number of state laws reducing access to abortion services in the name of protecting women's health. The "expert" testimony revealed just how much these laws rely on fringe science and discredited research.
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The Women's Health Protection Act (WHPA), introduced last year by Senator Richard Blumenthal (D-CT), would prohibit states from passing so-called Targeted Regulation of Abortion Providers (TRAP) laws, which rely on onerous and costly regulations as a tactic to shut down abortion providers. To date, 28 states have enacted more than 200 such laws, and clinics already have begun closing their doors in Texas, Alabama, Indiana, North Dakota and Mississippi. And, while the WHPA wouldn't overturn existing TRAP laws, it would facilitate court challenges against them.
An Alleged Public Health Crisis
At the hearing held by the Senate Committee on the Judiciary, witnesses opposing WHPA didn't hide their desire to see abortion banned entirely, but their testimony focused mostly on how abortion procedures allegedly are a threat to women's well being—and, in the process, creating a national public health crisis.
Representative Marsha Blackburn (R-TN), an abortion opponent who was invited by Senate Republicans to testify, set the tone for the hearing:
This legislation sets a dangerous precedent because it would place unconstitutional limits on a state's ability to assure the safety of medical facilities. Abortions, despite their grotesque nature, are medical procedures and should be regulated by the state as such.
I find it so curious that this legislation is termed "The Women's Health Protection Act." In my opinion it would more accurately be titled the "Removal of Existing Protections and Safety Measures for Women Undergoing Abortion Act."
And then, the statistics began pouring forth, as witnesses began reciting a litany of dubious "scientific findings." Representative Diane Black (R-TN) declared:
Women who have had abortions are…18% more likely to develop breast cancer as opposed to the average of just 12%. In the case of women with a family history of breast cancer, this figure jumps to 80%.
Abortions not only pose serious physical health risks, but endanger a woman's mental health as well. After having an abortion, a woman is 81% more likely to develop a mental health issue, is at a 37% increased risk of depression, a 110% increased risk of alcohol abuse, and sadly, a 155% increased risk of suicide.
And, according to Dr. Monique Chireau, an assistant professor in the Department of Obstetrics and Gynecology at Duke University Medical Center:
A number of studies have documented these risks in detail in the peer-reviewed scientific literature. For example, a study by Niinimaki et al of all women who underwent induced abortion (42,000 women) in the nation of Finland noted that 20% of patients undergoing medically induced abortion (i.e. with medications) and 5.6% of women undergoing surgical abortion experienced an adverse event (including bleeding, hemorrhage, injury)...These statistics represent a significant burden of disease; if applied to the United States, where 1.3 million abortions are performed annually, this translates to 260,000 adverse events per year.
Facts Are Inconvenient Things
These statistics would be very disturbing—if they were true. But they're built upon cherry-picked facts and, more egregiously, discredited scientific studies that belong in the same category as "vaccines cause autism" and "eating GMO food will make you sterile."
Let's start with Black's assertion that abortions cause breast cancer. Short answer: False. Long answer: Here's an overview from the American Cancer Society, mentioning just a couple of studies that have put this claim in the dustbin of medical history:
In 2003, the US National Cancer Institute (NCI) held a workshop of more than 100 of the world's leading experts who study pregnancy and breast cancer risk. The experts reviewed human and animal studies that looked at the link between pregnancy and breast cancer risk, including studies of induced and spontaneous abortions. Some of their findings were:
The level of scientific evidence for these findings was considered to be "well established" (the highest level).
- Breast cancer risk is increased for a short time after a full-term pregnancy (that is, a pregnancy that results in the birth of a living child).
- Induced abortion is not linked to an increase in breast cancer risk.
- Spontaneous abortion is not linked to an increase in breast cancer risk.
The American College of Obstetricians and Gynecologists (ACOG) Committee on Gynecologic Practice also reviewed the available evidence in 2003 and again in 2009. In 2009, the Committee said, "Early studies of the relationship between prior induced abortion and breast cancer risk were methodologically flawed. More rigorous recent studies demonstrate no causal relationship between induced abortion and a subsequent increase in breast cancer risk."
Next we have the claim that abortions endanger a woman's mental health. Short answer: Also, false. These oft-cited statistics stem from a 2009 analysis conducted by Bowling Green State University's Priscilla Coleman and published in the Journal of Psychiatric Research (JPR). As a recent academic article notes:
Coleman describes herself as the most-published author of peer-reviewed articles on abortion and mental health, and in all of them she concludes that abortion leads to serious psychological problems, including substance abuse. The problem, however, is that Coleman fails to distinguish between mental health conditions that existed before the abortions and those that occurred afterward. Eventually, after repeated criticism from other researchers, even the editor-in-chief of JPR and the principal investigator of the study that generated the national dataset Coleman used for her analysis published their own rebuke of Coleman's study in JPR. They noted that Coleman and her colleagues utilized a "flawed" methodology and that their "analysis does not support their assertions that abortions led to psychopathology" using the dataset relied upon.
More importantly, subsequent studies have contradicted Coleman's findings. Notably, as reported by io9, public health researchers with the UC San Francisco group Advancing New Standards in Reproductive Health (ANSIRH) used data from 956 women who sought abortions at 30 different abortion clinics around the U.S. 182 of them were turned away. The researchers, led by Diana Greene Foster, followed and did intensive interviews with these women, who ran the gamut of abortion experiences. Some obtained abortions easily, for some it was a struggle to get them, and some were denied abortions because their pregnancies had lasted a few days beyond the gestational limits of their local clinics.
The "Turnaway Study" found no indication that abortion could be linked with increased mental health disorders. There were no statistical differences between turnaways and women who had abortions when it came to developing clinical depression:
As the researchers said at the American Public Health Association Meeting, "One week after seeking abortion, 97% of women who obtained an abortion felt that abortion was the right decision; 65% of turnaways still wished they had been able to obtain an abortion." Also one week after being denied an abortion, turnaways told the researchers that they had more feelings of anxiety than the women who had abortions. Women who had abortions overwhelming reported feeling relieved (90%), though many also felt sad and guilty afterwards. All of these feelings faded naturally over time in both groups, however. A year later, there were no differences in anxiety or depression between the two groups.
But, what about Finland?
And then Monique Chireau, who, on the basis of a Finnish study, threw some calculations together to declare that there were 260,000 women per year suffering from medical complications caused by abortion—in her words, "a significant burden of disease" on our health system.
How do her back-of-the-envelope calculations stand up against numerous other studies on medical complications? (Studies that actually used U.S. data.) One typical analysis of medical abortions (which account for around 25% of non-hospital abortions in the U.S.), found that around two per 1,000 women experienced complications. For surgical abortions, the percentage was 1.1, or 13 out of 1,132 women. That's 100 times less than the figures cited by Chireau.
And, what about the risks associated with pregnancy and childbirth? Writing over at The Hill, Andrea Flynn reports:
How about a nod to the fact that sadly, pregnancy in the United States — particularly for young women, poor women and women of color — is risky business? Today, the U.S. maternal mortality rate (MMR) — 18.5 per 100,000 births — is higher than at any point in the last 25 years, ranking the U.S. 60th out of 180 countries. How about some indignation that the U.S. is one of only seven other countries to experience an increase in their MMRs over the last decade (other countries include Afghanistan and South Sudan)? Or that for women of color — who have MMRs three to four times higher than white women — pregnancy outcomes are particularly bleak? In Fulton County, Ga., which includes Atlanta, the MMR for black women is 94 per 100,000 births. In Chickasaw County, Miss., it is 595 per 100,000 — a rate higher than in many countries in sub-Saharan Africa. Where is the outrage and shame over that?
Where indeed? It certainly wasn't in the Senate.