Initiated Measure 11 Based on Bad Science

Bob Schwartz types faster than I this morning! Good work, Bob!

Initiated Measure 11, the retread abortion ban, seeks to write the following two assertions into South Dakota law:

(3) That submitting to an abortion subjects the pregnant woman to significant psychological and physical health risks, and that in the majority of cases there is neither the typical physician-patient relationship nor sufficient counseling between a pregnant woman contemplating submitting to an abortion and the physician who performs the abortion;...

(5) The state has a right and duty to protect the life of the unborn child, and to protect the life, health, and well-being of any pregnant woman within its jurisdiction, and it is therefore necessary to reasonably balance these interests to allow abortions only in certain circumstances which are set forth within this Act;

A new American Psychological Association review of research on the mental health effects of abortion knocks (highlighted this a.m. by Politics & Hypocrisy) another leg out from under these bogus assertions.

Short form: there is no evidence that aborting an unplanned pregnancy poses any greater mental health risk than carrying that pregnancy to term.

Read the full (PDF) draft report here.

Long form: The APA's Task Force on Mental Health and Abortion reviewed all published, peer-reviewed empirical studies since 1989 on mental health and abortion. 50 of the studies compared the mental health of women who had abortions with the mental health of other groups of women. 23 of the studies looked at mental health predictors among women who elected to have abortions. The TFMHA focused on studies since 1989 based on Surgeon General C. Everett Koop's conclusion in 1989 that, based on scientific evidence available at that time, "the psychological risks following abortion were 'minuscule' from a public health perspective" (p. 7).

The task force found "the majority of studies suffered from methodological problems, often severe in nature" (p. 5). The main findings:

The best scientific evidence published indicates that among adult women who have an unplanned pregnancy the relative risk of mental health problems is no greater if they have a single elective first-trimester abortion than if they deliver that pregnancy. The evidence regarding the relative mental health risks associated with multiple abortions is more equivocal. Positive associations observed between multiple abortions and poorer mental health may be linked to co-occurring risks that predispose a woman to both multiple unwanted pregnancies and mental health problems (pp. 5–6).

One abortion ("an abortion," as stated in IM11) does not subject a woman to any greater risk of psychological harm than going through a complete pregnancy and delivery. Multiple abortions may pose some risk of psychological harm, but the science is clear enough to determine whether that risk comes from the abortions themselves or other risk factors that that are associated with unplanned pregnancies and mental health problems in the first place.

Even when a woman terminates a wanted pregnancy late in the term due to fetal abnormality, the risk of psychological harm is less than if the woman delivers a child with life-threatening abnormalities (p. 6). Remember, IM11 makes no exception for such fetal abnormalities. The backers of IM11 would thus rather subject a woman to greater risk of psychological harm by forcing her to carry to term a non-viable fetus.

In reviewing the literature, the TFMHA finds that IM11 and its supporter may be doing actual psychological harm to women right now, whether or not the initiative wins a majority at the polls in November:

Hence, the sociocultural context can shape a woman’s appraisal of abortion not only at the time that she undergoes the procedure, but also long after the abortion. Social messages that encourage women to think about (reappraise) a prior abortion in more negative ways (as a sin, as killing a child) may increase women’s feelings of guilt, internalized stigma, and emotional distress about an abortion they had long ago. In contrast, social messages and support groups that encourage women to cognitively reappraise an abortion in a more positive or benign way may lead to improved emotional responses (Trybulski, 2006) [TFMHA, pp. 19–20].

In other words, squawking every election cycle that abortion is a sin worthy of state intervention only makes women feel worse. Leslee Unruh can stick with the "Live baby good dead baby bad" line, but she is disingenuous to claim that women's mental health is her first priority when her own tactics harm that mental health.

The TFMHA's report discusses another way that the fallacious reasoning behind IM11 may lead to more harm than good for women if IM11 passes. They address the "interventionist fallacy," the idea that an association between X and Y logically dictates that an intervention to reduce X will automatically reduce Y:

As applied to the case of abortion, one example of the interventionist fallacy would be the belief that if abortion and depression are related, then reducing access to abortion would reduce the prevalence of depression. A change in the availability of elective abortion, however, would have many consequences. It would mean that women who want to terminate an unwanted pregnancy would now be forced to deliver. As a consequence, the characteristics of the population of women who delivered children would change. Characteristics previously prevalent among women who had an abortion (e.g., greater poverty, exposure to violence) would now be prevalent among the delivery group. The portrait of the mental health of mothers might reasonably be expected to be worse. This potential change in the profile of women giving birth does not include any new mental health problems that might develop from stresses associated with raising a child a woman feels unable to care for, or may not want, or from relinquishing a child for adoption. Thus, reducing access to abortion would be likely to result in poorer mental health among women who deliver. Hence, rather than reducing the prevalence of depression among women, this intervention could potentially increase it [TFMHA, p. 32].

The draft report is a really good review of all the factors that we must consider when looking at the science on abortion and mental health. Read the full study, and don't be fooled: IM11's backers can't claim science or women's mental health as the basis for their position.