Archive for December 2010
Bent Abortion Science: Using Inadequate Comparison Groups
One of the most common methodological flaws in abortion research involves the use of poor comparison groups. A good comparison group will match the abortion group as closely as possible, controlling for a number of other factors - age, income, education, and so on. One of the most important factors to control for is the wantedness of the pregnancy. When studying the psychological effects of aborting an unwanted pregnancy, the only adequate comparison groups will be composed of women who carried an unwanted pregnancy to term.

Skewing the results against abortion is as easy as choosing an inadequate comparison group. Examples of this include:
  • Women who have never been pregnant.
  • Women who carried a wanted pregnancy to term.
An example:

A 2006 study by Fergusson, Horwood, and Ridder concluded that women who aborted were at an increased risk of mental health problems. The "pregnant - no abortion" comparison group was not controlled for pregnancy wantedness or intendedness - there is no way to know how many of these women were actively trying to get pregnant and viewed the pregnancy positively. Furthermore, this study was conducted in New Zealand, where abortion access is extremely limited:

Firstly, women must approach their doctor and are then referred to specialist consultants. Two certifying consultants must then 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. (p. 17)

The "pregnant - abortion" group and the "pregnant - no abortion" group are composed of two very different sets of people. The first includes only women requiring abortion for medical/psychological reasons (some of whom may have been deeply emotionally invested in their pregnancies), rape/incest victims, very young girls, and mentally handicapped women. The latter includes women who wanted their pregnancies and women who were forced to carry their unwanted pregnancies to term due to legal restrictions on abortion. It's impossible to know how many of the participants fall into each of these categories within the two groups.

This obviously casts a great deal of doubt on the validity of the results. The failure to control for pregnancy wantedness and extremely traumatic events - such as rape or the termination of a wanted pregnancy due to severe medical complications - makes it seem absurd to draw conclusions about the abortion procedure as a primary cause of mental illness in the participants. In a section titled "the role of contextual factors," the authors weakly identify (and mostly skirt around) this serious problem with their research:

It is clear that the decision to seek (or not seek) an abortion following pregnancy is likely to follow 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. The data available in this study was not sufficient to explore these options.

I'll give you a moment to place your bets on how anti-abortion groups portrayed the results.

Done? Okay.

LifeNews reported that several medical journals rejected the study, but in nearly 500 words failed to find the space to even mention the methodological problems that might've led to the decision.

"We went to four journals, which is very unusual for us — we normally get accepted the first time," he said.

Fergusson told the Herald he knew of the "circus" that could result from the study but he said it would be "scientifically irresponsible" to not publish the results even though they are controversial.

Hear that? It's the world's smallest violin, and it's playing just for you.

In an article titled "How Abortion Harms Women's Health," the Family Research Council included this blurb:

A "pro-choice" research team in New Zealand, analyzing data from a 25-year period and controlling for multiple factors both pre- and post-abortion, found conclusively that abortion in young women is associated with increased risks of major depression, anxiety disorder, suicidal behaviors, and substance dependence. This is the most comprehensive, long-term study ever conducted on the issue.

Right. Well, except for the fact that the authors admitted that there were other plausible explanations for their findings, and that the editors of a number of peer-reviewed journals felt that the research was too weak to warrant publishing it. I really do hope that this isn't "the most comprehensive" study "ever conducted" on the topic.

Right to Life of Northeast Ohio, Voice for Life, and The National Right to Life Committee (NRLC) also commented on the study. None of them mentioned the flawed comparison groups. The NRLC claimed that the study "brought to light the professional bias" against results that "challenge the pro-abortion political agenda."

It seems that Fergusson had no trouble shoving the weaknesses in his work under the rug - and unfortunately, there are even more subtle ways of manipulating comparison groups to dramatically alter results. One popular method involves excluding participants with a history of multiple abortions from the delivery group but not the abortion group. The result? Women who have had no abortion are compared with women who've had any number of abortions. It might seem unlikely that this would significantly impact results, but (for reasons mentioned below) it can actually make a big difference.

In fact, a 2005 study by Schmiege and Russo found that attempting to mitigate this effect by excluding participants who'd had abortions subsequent to their first pregnancy from both the delivery group and the abortion group had a profound effect on the results. Women who delivered were significantly more likely to be depressed (determined by exceeding the cut-off score for Center for the Epidemiologic Studies Depression Scale, or CES-D) than women who had an abortion (APA Task Force on Mental Health and Abortion, p. 38-41). When women who'd had subsequent abortions were included in both groups, there was no significant difference in depression rates between the two.

Compare this to studies that do differentially exclude women with subsequent abortions from the delivery group (but not the abortion group!) and you'll find that almost all of them show higher levels of mental illness in the abortion group.

In other words, something as simple as removing women with subsequent abortions from the delivery group without doing the same for the abortion group can dramatically bias the direction and significance of the results. This is a very nuanced way to bend science, and if you don't know to look for it, it's easy to miss.

The likely explanation for this effect is actually quite simple: lower levels of education and higher rates of poverty correlate with repeated unwanted pregnancies (APA, p. 33). Additionally, pregnancy coercion and contraceptive sabotage correlate with a higher risk of both intimate partner violence and unwanted pregnancy (Miller, Decker, McCauley, Tancredi, Levenson, Waldman, Schoenwald, & Silverman, 2010). As the APA Task Force notes in its overview, "positive associations observed between multiple abortions and poorer mental health may be linked to co-occurring risks to both multiple unwanted pregnancies and mental health problems."

To summarize: comparison groups should always be as closely matched to abortion groups as possible. If researchers can't provide a very compelling reason for manipulating their comparison group(s) in ways that subvert their similarities with the abortion group, doing so presents a serious threat to the validity of their research.

If this post has piqued your interest in the methodological flaws that taint most abortion research, I can't encourage you enough to read the Report of the APA Task Force on Mental Health and Abortion in full.
By Triptrain with 0 comments
Bent Abortion Science: Using Biased Participant Groups
This is the first post in what will (hopefully) become a series on the tools used by anti-abortion activists to bend science. My hope is that this information will be used by pro-choice advocates to critically evaluate and counter the massive quantity of bad research produced by anti-abortion interests.

Today's post covers the use of biased participant groups.

Perhaps the most classic example of this trick is a 1994 study that found that 94% of the participants had, at some point, regretted the decision to abort. The big problem here is that all of the participants in this study were women who had made contact with Women Exploited By Abortion (WEBA), Victims of Choice, or Last Harvest Ministries. Furthermore, some of the participants had already been "counseled" by these groups. The only conclusion supported by this research is that 94% of women who contact anti-abortion groups for post-abortion counseling have at some point regretted the decision to abort. Not exactly a shocker.

(Note that support groups exist for mothers struggling with the decision to parent or give up a child for adoption, and one could easily follow a similar procedure to get equally distorted results with these groups.)

Even the author admits that his findings aren't applicable to post-abortive women in general:

Because this is a self-selected sample of the those who had a "bad experience" these findings should not be interpreted as representative of a random sample of all women who have had abortions.

However, when this study is cited by anti-abortion organizations, any mention of the biased sample completely vanishes. As you can see below, these groups are blatantly lying about the implications of the research.

Sozo Life Clinic (Family Life Ministries):

A Survey of Post-Abortive Women Found That:

28% attempted suicide
31% experienced suicidal feelings
60% commented that the decision to abort made their lives worse
94% regretted the decision to abort

Hope for Families:

...what your mother may not realize is that 94% of women who have had an abortion regret their decision.

Twin Falls Pregnancy Crisis Center:

Most women regret abortions. In fact, when Dr. David Reardon, Ph.D., surveyed 260 women who’d had abortions, he found that:

94 percent had regrets about their abortion
28 percent attempted suicide
58 percent lost pleasure from intercourse
63 percent had flashbacks of their abortion

As this example shows, it is extremely important to read about the participants when evaluating research. There are countless ways to manipulate the participant pool to get more favorable results. Off the top of my head, I can think of several:

  • Select women from a conservative church who attend multiple services.
  • Select women who are having to abort a wanted pregnancy.
  • Select impoverished or homeless women.
  • Select women who are currently being treated for depression or anxiety.

Note that there's nothing inherently dishonest about studying abortion outcomes in these groups - the problem lies in extrapolating conclusions about the general population of women from information about smaller, specialized samples. I think it would be very useful to know more about how abortion affects the homeless and conservative church-goers - but it doesn't say anything about women who don't fall into those specific categories.

Finally: when you're quoted statistics that seem wildly inaccurate, demand the source. If someone can't provide any credible information about their data, chances are that something is being skewed - either in the research itself, or in its interpretation. Beyond that, hold a high standard for the information you pass on. A lot of journal articles and research reports are just one Google search away!
By Triptrain with 0 comments
Missouri's Bait-and-Switch
The Pitch has a nice little post on Missouri's recently-enacted SB-793, which essentially requires doctors to lie to women seeking abortion about the kind of aid offered to them if they continue their pregnancies. The "Alternatives to Abortion Services Fact Sheet" - which abortion doctors must provide to their patients - suggests that medical/prenatal care, food, childcare, housing and utilities, transportation, clothing, pregnancy supplies, and job training/placement are all available to women in need. The only problem? It's not really true.

So the state of Missouri will help new mothers afford parenthood, huh? Not according to the stats from the Mid-America Research Council's Metropolitan Council on Early Learning. According to the "policy issues" page on its website, Missouri is ranked 49th in the nation in childcare assistance funding.

"Once a baby is born, women are pretty much on their own," says Ruth Ehresman, the director of health and budget policy for the Missouri Budget Project. Unemployed moms can be eligible for Temporary Assistance to Needy Families (aka "welfare"), which equals $292 a month for a family of three. If the mother or her spouse works, that amount is reduced. There's a five-year lifetime limit on this support, so it maxes out quickly. As Ehresman puts it, "It is negligible support."

If the state of Missouri won't provide the services it promises, how does it expect women to access them? The answer is disappointing, to say the least. Doctors must hand out lengthy lists of crisis pregnancy centers (CPCs) and other religious organizations, billing them as "Pregnancy Assistance Information Providers" and "Missouri Alternatives to Abortion Program Providers." These groups give aid at their own discretion; they're not required to provide any of the services promised by the state of Missouri, even to the women with the greatest need. The stated goal of many of these groups is to prevent women from aborting and "educate" them about Christianity, not to help them afford their babies.

But wait, there's more.

The law also requires that women seeking abortion be presented with color photographs of "the developing unborn child" at two-week gestational increments, all the way up to full term. Descriptions of the anatomy and heart/brain functions of the fetus must accompany the photos. And then there's this:

The printed materials shall prominently display the following statement: "The life of each human being begins at conception. Abortion will terminate the life of a separate, unique, living human being."

Never mind that this definition requires a very narrow reading of the terms "separate" and "unique," or that a person isn't generally considered alive by medical professionals unless he or she sustains a certain level of brain functioning, which certainly isn't present at conception. Missouri legislators had to get as close to "you're killing your baby" as they possibly could. And unfortunately, that's not even the worst of it.

Women seeking abortion after 22 weeks must be told that the fetus may feel pain. The doctor must describe the steps of the abortion procedure in detail, and make note of "which steps... could be painful to the unborn child." No one is exempt. Even women carrying wanted pregnancies with severe complications are required to sit through this - and there's no opportunity to opt out.

In case you're thinking "no way, I could never put someone through that if she asked me to stop," there's this: to violate any of the bill's provisions is a Class B Felony, carrying a prison sentence of 5-15 years. Doctors' hands are tied. Not only must they be complicit in the aid bait-and-switch, they must also make a difficult decision even more painful for their most vulnerable patients.

Fuck Missouri.
By Triptrain with 0 comments