Dr. Priscilla Coleman

There are major problems with study showing no link between abortion, mental health problems

Dr. Priscilla Coleman
By Dr. Priscilla Coleman
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January 27, 2010 (LifeSiteNews.com) - Danish researchers Munk-Olsen, Laursen,  Pedersen, and colleagues published a study this week in the New England Journal of Medicine, addressing the risk of mental health disorders in women who have a first trimester abortion and those who experience a first childbirth.

The researchers focus on the fact that there is not a statistically significant difference in first-time inpatient admissions and outpatient psychiatric visits before and after an abortion, concluding that it is unlikely that the abortion procedure causes mental health problems. However there are some major problems with this conclusion.

First, the measure of pre-abortion mental health problems is likely high (more than 3 times greater than prior to birth, 14.6% vs. 3.9%), because many of the women were probably in the midst of abortion decision-making when they experienced their first psychiatric visit. This high rate of pre-abortion mental health problems is construed to indicate that women who choose abortion will often experience mental health problems based on factors other than the procedure.

In fact, the women in the sample are quite unlikely to fall into this “vulnerable” category since none of the women included in the study had any history of psychological diagnoses prior to 9 months before the abortion.  These researchers used a window of 0-9 months to measure pre-abortion mental health; however, the assessment should instead have been before the pregnancies were detected. The data do indicate that rates of mental health problems are significantly higher after abortion compared to after childbirth (15.2% vs. 6.7%) and compared to not having been pregnant (8.2%).

The bottom line is the fact that they found comparable rates before and after abortion does not negate a possible causal link between abortion and mental health. This is true because many women were likely disturbed to the point of seeking help, because they were pregnant and contemplating an abortion or had already chosen one and were awaiting the procedure. There are numerous published studies indicating high levels of stress among women facing an unplanned pregnancy and considering an abortion.

Second, the authors note in the beginning of their article that previous studies lack controls for third variables, but the only third variables they consider are age and parity. There are no controls for pregnancy wantedness, coercion by others to abort, marital status, income, education, exposure to violence and other traumas, etc.  Many studies have been deemed inadequate based on only one of these variables not being accounted for (see APA Task Force Report, 2008), yet the study design was considered adequate to merit publication in the NEJM.

Third, all women who had psychiatric histories more than 9 months prior to the abortion were not included in the study and there are many studies showing that these women are at heightened risk for post-abortion mental health problems. In this study, the researchers have narrowed the participant pool to only the healthiest of women and there are high rates before and after abortion…imagine if all women had been included! Women who experience repeat abortions are likewise not considered at all and they are more likely to be at risk for mental health problems post-dating the procedure.

Fourth, the results follow women for only one year post-abortion or childbirth and there is plenty of evidence suggesting that the negative effects of abortion may not surface for several years. There is also data indicating that women are most likely to experience postpartum psychological problems soon after birth with the benefits of motherhood often manifesting later than the first year wherein many life-style adjustments are necessary.

A more appropriate analytic strategy would have been to include all women experiencing an abortion, a birth, or no pregnancy and then compare pre and post-pregnancy mental health visits with statistical controls for all psychiatric visits pre-dating conception and all other relevant third variables described above. I am confident that the data would then be quite consistent with the dozens of studies published in recent years in high impact journals indicating that abortion increases risk for a variety of mental health problems.

Even without appropriate improvements to the design, the data reported does indicate increased rates of particular diagnoses at specific points in the first year. Relative risk for psychiatrics visits involving neurotic, stress-related, or somatoform disorders was 47% and 37% higher post-abortion compared to pre-abortion at 2 and 3 months respectively. In addition, psychiatric contact for personality or behavioral disorders was 56%, 45%, 31%, and 55% higher at 3, 4-6, 7-9, and 10-12 months respectively.

Note: Dr. Priscilla Coleman is a Professor of Human Development and Family Studies at Bowling Green State University.


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Jonathon van Maren Jonathon van Maren Follow Jonathon

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Arguments don’t have genitals

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By Jonathon van Maren

“As soon as he grows his own uterus, he can have an opinion.”

That was a comment left on The Abortion Rights Coalition of Canada’s Facebook page by a woman who presumably opposes men speaking out against misogyny, domestic abuse, rape culture, and female genital mutilation as well. Apparently, you see, male genitals disqualify people from speaking out on various human rights issues deemed by women who define themselves by their uteruses while protesting angrily against being defined by their uteruses as “women’s issues.”

Which abortion isn’t, by the way. It’s a human rights issue.

To break it down really simply for our confused “feminist” friends: Human beings have human rights. Human rights begin when the human being begins, or we are simply choosing some random and arbitrary point at which human beings get their human rights. If we do not grant human rights to all human beings, inevitably some sub-set of human beings gets denied protection by another group with conflicting interests. In this case, of course, it is the abortion crowd, who want to be able to kill pre-born children in the womb whenever they want, for any reason they want.

Science tells us when human life begins. Pro-abortion dogma is at worst a cynical manoeuvre to sacrifice the lives of pre-born human beings for self-interest, and at best an outdated view that collapsed feebly under the weight of new discoveries in science and embryology. But the abortion cabal wants to preserve their bloody status quo at all costs, and so they make ludicrous claims about needing a uterus to qualify for a discussion on science and human rights.

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In fact, feminists love it when men speak up on abortion, as long as we’re reading from their script, which is why the carnivorous feminists have such a support system among the Deadbeat Dads for Dead Babies set and the No Strings Attached Club.

Male abortion activists have even begun to complain about “forced fatherhood,” a new cultural injustice in which they are expected to bear some responsibility for fathering children with women they didn’t love enough to want to father children with, but did appreciate enough to use for sex. Casual fluid swaps, they whine, should not result in custody hearings.

This is not to mention a genuine social tragedy that has men forcing or pressuring women to have abortions or abandoning them when they discover that the woman is, indeed, pregnant.

Or the fact that abortion has assisted pimps, rapists, and misogynists in continuing the crimes of sex trafficking, sexual abuse, and sex-selection abortion.

And coming against these disgusting trends are thousands of men in the pro-life movement who believe that shared humanity means shared responsibility, and that when the weak and vulnerable are robbed of their rights, we have to stand up and speak out.

We are not at all convinced by the feminist argument that people should think with their reproductive organs or genitals. We think that the number of people currently doing that has perhaps contributed to the problems we face. And we refuse to be told that protecting the human rights of all human beings is “none of our business” and “outside of our interests.”

Arguments don’t have genitals, feminists. It’s a stupid argument trying to protect a bloody ideology.

Reprinted with permission from CCBR.


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Rachel Daly

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Gvmt strikes UK Catholic school admission policy that prefers Mass attendees

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By Rachel Daly

St. Joseph's Catholic Primary School in Epsom, England, was ordered to change its admissions policy after it was ruled discriminatory by the nation's Office of Schools Adjudicator, according to Your Local Guardian. St. Joseph's reportedly had been granting preferred acceptance to students whose families attended Mass at the affiliated church.

St. Joseph’s School is for students from age 4 to 11 and describes itself as “enjoy[ing] a high level of academic success.” The school furthermore places high priority on its Catholic identity, affirming on its homepage that “We place prayer and worship at the center of everything we do.”

The school states in its current admissions policy that it was "set up primarily to serve the Catholic community in St Joseph’s Parish" and that when the applicant pool exceeds 60 students, its criteria for prioritizing students includes "the strength of evidence of practice of the faith as demonstrated by the level of the family's Mass attendance on Sundays." 

Opponents of this policy reportedly argue that since donations are asked for at Mass, it could allow donation amounts to influence acceptance, and that forcing non-accepted local students to seek education elsewhere imposes a financial burden upon their families. 

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As Your Local Guardian reports, the adjudicators dismissed claims that donation amounts were affecting school acceptance, given that it is impossible to track donations. Nonetheless, the adjudicators maintained that "discrimination ... potentially arises from requiring attendance at the church rather than residency in the parish."

The Office of Schools Adjudicators, according to its website, is appointed by the United Kingdom’s Secretary of State of Education, to perform such functions as mediating disputes over school acceptances. The Office's ruling on St. Joseph's will require the school to release a revised admissions policy, which is expected in the next few days.

Reprinted with permission from the Cardinal Newman Society.


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Carolyn Moynihan

African women at risk of HIV, hostages to birth control

Carolyn Moynihan
By Carolyn Moynihan

Which should be the priority for a health organisation: preventing an incurable disease, or preventing a natural function that might have adverse physical consequences?

Preventing the disease, you would think. But the World Health Organisation would rather expose African women to HIV-AIDS than withdraw its support from a suspect method of birth control, arguing that childbirth is also risky in Africa. Riskier, apparently, than the said contraceptive. And at least one of WHO’s major partners agrees.

This is one of the stories you will not have read in coverage of the International AIDS Conference held in Melbourne last week, despite the fact that WHO made an announcement about it during the conference and the findings of a highly relevant study were presented there.

The story is this: there is increasing evidence that the method of contraception preferred by family planning organisations working in Africa (and elsewhere) facilitates the transmission of HIV. The method is the progesterone injection in the form of either DMPA (Depo Provera, the most common) or NET-En (Noristerat).

Millions of women in sub-Saharan Africa receive the injection every three months. The method overcomes problems of access. It can be given by nurses or health workers. A wife need not bother her husband for any special consideration; the teenage girl need not remember to take a pill.

But for 30 years evidence has been accumulating that, for all its “effectiveness” in controlling the number of births, the jab may also be very effective in increasing the number of people with HIV.

Three years ago at another AIDS conference in Rome, researchers who had analysed data from a number of previous studies delivered the disturbing news that injectables at least doubled the risk of infection with HIV for women and their male partners.

That study had its weaknesses but one of the experts present in Rome, Charles Morrison of FHI 360 (formerly Family Health International, a family planning organisation that also works in AIDS prevention), considered it a “good study” and subsequently led another meta-analysis that addressed some of the issues with previous research.

Last week at the Melbourne conference he presented the results. His team had re-analysed raw data on the contraceptive use of more than 37,000 women in 18 prospective observational studies. Of these women, 28 percent reported using DMPA, 8 percent NET-En, 19 percent a combined oral contraceptive pill, and 43 percent no form of hormonal contraception. A total of 1830 women had acquired HIV while in a study.

The analysis showed that both injectables raised the risk of infection by 50 percent:

Compared to non-users [of any hormonal contraceptive], women using DMPA had an elevated risk of infection (hazard ratio 1.56, 95% CI 1.31-1.86), as did women using NET-En (1.51, 95% CI 1.21-1.90). There was no increased risk for women using oral contraceptives.

Similarly, comparing women using injections with those using oral contraceptives, there was an elevated risk associated with DMPA (1.43, 95% CI 1.23-1.67) and NET-En (1.30, 95% CI 0.99-1.71).

Morrison also noted:

The results were consistent in several subgroup and sensitivity analyses. However, when only studies which were judged to be methodologically more reliable were included, the increased risk appeared smaller.

Morrison acknowledged that observational studies such as the FHI analysis depended on have their limitations. He is looking for funding to conduct a randomised controlled study – something that, after 30 years of suspicions and evidence, still has not been done.

So what is his advice to the birth control industry? Stop using this stuff in regions with a high prevalence of HIV until we are sure that we are not feeding an epidemic?

No.

One reason is that FHI is at least as interested in contraception as it is in HIV prevention. Though its website reflects a broad range of development activities, its core business is integrating birth control programmes with HIV prevention. The WHO – one of its partners -- describes the US based, 83 percent US government funded non-profit as “a global health and development organization working on family planning, reproductive health and HIV/AIDS.”

Another reason is that FHI 360 has a vital stake in precisely the kind of contraceptives that are under suspicion. Its annual report refers to:

Our trailblazing work in contraceptive research and development continues, as we develop and introduce high-quality and affordable long-acting contraceptives for women in low-income countries. Research is under way to develop a new biodegradable contraceptive implant that would eliminate the need for removal services. We are also working with partners to develop an injectable contraceptive that would last for up to six months. Currently available injectables require reinjections monthly or quarterly, which can be challenging where health services are limited.

That project is funded by the Bill and Melinda Gates Foundation and USAID.

So Morrison did not argue in Melbourne for restrictions on the use of injectables, and neither did the WHO, whose representative at the conference outlined the UN body’s new guidelines on contraception and HIV. Mary Lyn Gaffield said a review of studies up to – but not including Morrison’s – did not warrant a change to WHO’s policy that DMPA and NET-En should be available, without restriction, in areas of high HIV prevalence.

The most WHO will advise is that women should be informed of the risk:

“Women at high risk of HIV infection should be informed that progestogen-only injectables may or may not increase their risk of HIV acquisition. Women and couples at high risk of HIV acquisition considering progestogen-only injectables should also be informed about and have access to HIV preventive measures, including male and female condoms.”

Condoms? How do they defend such cynicism? By equating the risk of HIV with the risks of motherhood – complications of pregnancy or childbirth, maternal death and the effect on infants... And yet motherhood remains risky precisely because 90 percent of the world’s effort is going into contraception!

Seven years ago a meeting of technical experts convened by WHO to study the injectables-HIV link showed the reproductive health establishment worried about that issue, to be sure, but also concerned that funding was flowing disproportionately to HIV-AIDS programmes, setting back the cause of birth control. The integration of family planning and HIV prevention spearheaded by FHI 360 looks like they have found an answer to that problem.

Whether African women are any better off is very doubtful. They remain pawns in a game that is, above all, about controlling their fertility. They and their partners are encouraged to take risks with their health, if not their lives, while researchers scout for funds to do the definitive study.

FHI had an income of $674 million last year, most of it from the US government. Couldn’t it give Charles Morrison the money to do his research today?

Reprinted with permission from Mercatornet.com.


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