Science vs. Ideology

A new political low was reached in Salt Lake City Wednesday evening during a political debate arguing HB 461 which requires a 72-hour waiting period before a woman may obtain an abortion: Representative Bradley Daw made his opening remarks by reading from a “well-known philosopher and poet.” This would not have been remarkable, and perhaps it would have even been touching, had the context not been the infringement of women’s reproductive rights. Representative Daw’s opening remarks were read directly from “Horton Hears a Who” by Dr. Seuss, closing his remarks with “After all, a person is a person, no matter how small.”

Needless to say, I was outraged from the start. Representative Daw’s point was, of course, that pregnancy at any gestational age is a “person.” He failed to mention that the woman carrying the pregnancy is also a person. He was, however, quick to point out the thousands of women he represents and on their behalf advocated for HB 461. Representative Daw also seemed very knowledgeable regarding availability of health care and contraception to those in the lower socioeconomic classes, stating “contraception is available in any drug store, gas station, clinic for only a few dollars.” As someone on the front line in the daily health care battle I opine that statements like these are grossly ignorant.

Like most politicians, and like almost all who restrict women’s access to comprehensive reproductive health care, Representative Daw is not a clinician. He has no clinical training or experience and has no credentials to speak to health care provision, practice, or availability. This does not prevent him or any others from making statements such as “access to contraception is widespread,” or “pregnancy from rape is a justifiable reason to have an abortion,” as if he has a list of “justifiable” and “unjustifiable” reasons. For the record, cases like Savita’s do happen here, fortunately not often.

I have a request of journalists who have the paramount opportunity to ask questions of our legislators writing and passing laws affecting women’s lives: ask the right questions.

  • Can you speak to the risks of carrying a pregnancy to term? Of giving birth? Of rearing a child?
  • Can you speak to the risks of having an abortion? Medical versus surgical? First versus second trimester?
  • Do you feel you are medically qualified to counsel a woman on her options regarding a newly diagnosed pregnancy?

A politician no more belongs in my clinic instructing me how to care for my patients than I do in their staffing office writing legal bills. Evidence-based medicine and science, not ideology, should guide policy-making in health care.

The greater the ignorance the greater the dogmatism.
— Sir William Osler

Dispelling the Myths: Abortion and Mental Health

She said, “I deserve this” as she moaned with pain while I dilated her cervix. I tried to numb her, keep her as comfortable as possible, so I asked for more numbing medicine to try to take the pain away. Something told me there was a bigger problem that lidocaine wouldn’t be able to fix.

Guilt, regret, post traumatic stress disorder (PTSD): these are some of the buzz words that anti-choice folks throw at women to deter them from taking control of their own lives. My patient, this woman who could have been a friend or cousin of mine, believed she deserved to be in pain for what she was doing. She believed she fully deserved the pain she was experiencing because she was doing what she needed to do to take care of herself. Why would she feel this way?

She feels guilty, clearly. Why would someone feel guilty about ensuring their own well-being and/or the well-being of their family? Isn’t that what good people do? Perhaps because all too often society, religious leaders, and politicians tell women, “You’re killing your unborn child,” when they really should be saying, “I’m proud of you for being responsible and doing the right thing for you and your family.” The impact on a woman’s mental health before and after her abortion has a great deal more to do with the social stigmatization of her decision and her support system than it has to do with the abortion itself. Deciding the best course of action for an unplanned pregnancy is a decision no woman makes lightly. Those who disagree with abortion may do so, but should do so with compassion and sympathy, not with anger and derision.

Poor-quality research on mental health and abortion has been published (and is often cited by inexperienced readers) stating that abortion increases a woman’s probability of experiencing depression, regret and PTSD. This is not true, however, and the majority of the medical research community has criticized these publications as being borderline criminal. High-quality research has shown the following:

Most women do not experience psychological problems or regret their abortion 2 years post-abortion, but some do. Those who do tend to be women with a prior history of depression.” “Most women were satisfied with their decision, believed they had benefited more than had been harmed by their abortion, and would have the abortion again. These findings refute claims that women typically regret an abortion.
— Major et al, Arch Gen Psychiatry, 2000

The vast majority of women expect to cope well after their abortion. A small number make the decision to terminate their pregnancies even though they anticipate difficulty coping after the procedure.
— Foster et al, Contraception, 2012

Protesters do upset some women seeking abortion services. However, exposure to protesters does not seem to have an effect on women’s emotions about the abortion 1 week later.
— Foster et al, Contraception, 2012

The name-calling, guilt-laying, and self-righteous proclamations of why she should do as you say (and you know who you are) must end. There is no malice in having an abortion. It is a decision that a woman makes for herself most importantly, and for her family as well. She does not make it for anyone else; it would be detrimental if she did. A woman having an abortion will most often have feelings of relief knowing that she was able to take care of herself safely and live the life she desires. Guilt and regret come from stigmatization, not from doing the right thing. The stigmatization of abortion must come to an end.

Libertyville abortion protesters