Pro-choice critics of the Dorries/Field amendments on abortion counselling are misrepresenting the medical facts

Article by Dr Peter Saunders

There has been considerable media interest in the fact that two MPs (Nadine Dorries and Frank Field) have tabled amendments to the Health and Social Care Bill (See Sunday Express, Daily Mail and Daily Telegraph). 

These two MPs are attempting to ensure two things. 

First they want women with unplanned pregnancies to have access to counselling that is not provided by the abortion industry. At present most women contemplating abortion go directly via abortion providers like Marie Stopes International (MSI) and BPAS. The MPs argue that these groups have a financial vested interest in providing abortion for which they receive over 60 million pounds of taxpayers’ money annually. This does not give women a fair deal. 

Second they want the responsibility for producing abortion guidelines to be taken away from the Royal College of Obstetricians and Gynaecologists (RCOG) and given to the National Institute for Health and Clinical Excellence (NICE). They claim that the RCOG guidelines misrepresent the scientific evidence and that some RCOG members have financial and ideological vested interests in abortion provision. 

Not surprisingly this move has generated a strong reaction from abortion providers and pro-choice commentators. 

BPAS Ann Furedi, chief executive of BPAS, has said: 
‘This amendment is a misguided attempt to solve a problem that does not exist. If abortion providers have a vested interest, it is to be as sure as possible that women are making the choice that is right for them. The RCOG is clearly the body best suited to produce guidance on what information is appropriate. We find it bizarre that anyone should think that this expert, clinical role should be removed from them.’ 

Ann Furedi does not give any reasons to support her claim that the RCOG is the best body to provide guidance and fails to mention that this body’s abortion guidance has been widely criticised for misrepresenting research data about the health consequences of abortion. 

This is precisely the problem that Dorries and Field are attempting to address. She also does not tell us that 11 of the 18 people on the RCOG panel producing the guidance benefit financially from abortion provision nor that both BPAS and MSI themselves are represented on the panel. Nor does she mention that there are no psychiatrists on the panel despite the fact that it purports to speak authoritatively on the link between abortion and mental health. 

The RCOG, which published the latest draft of its guidance without a proper consultation period, has now withdrawn it in order to await a report from the Royal College of Psychiatrists. I have already written to David Cameron with my concerns about the lack of transparency, bias and undue haste surrounding the RCOG consultation. 

I found the comments of Telegraph Strategic Events Editor Tom Chivers a revealing example of the way that scientific evidence is cherry-picked by pro-choice commentators in this area in order to justify their view that abortion has few if any consequences for women’s health. 

In a blog titled ‘Abortion and the 'Right to Know' – or, why we should link to our sources’ he criticizes Dorries and Field for not quoting primary sources to support their claim that women having abortions are 30% more likely to experience mental health problems. 

He correctly identifies the primary source (after help via Twitter) as an article by Fergusson et al originally published in the British Journal of Psychiatry in 2008 but then goes on, ironically, to make misleading statements about the scientific evidence in this field. 

He claims that the Fergusson study is ‘now rather out of date’ and that ‘The BJPsych itself has revisited the topic, with a 2009 systematic review’. Both these statements are simply untrue.

If you follow the link in Chivers’ blog you will see that it does not refer to a BJPsych review at all, but rather to a letter written to the BJPsych by two non-psychiatrists with close links to the pro-choice movement, Sam Rowlands and Kate Guthrie. 

The Royal College of Psychiatrists has itself acknowledged in a 2008 statement that there are studies which show a link between abortion and mental health problems and is currently carrying out a review of the literature that has not yet been published. 

The review that Rowlands and Guthrie refer to is not from the editors of the BJPsych (or the Royal College) but actually one by the American Psychological Association which has been widely criticised as I have outlined on this blog before. 

Why is all this so important? For two reasons. 

First most abortions in Britain (about 98%) are carried out on mental health grounds when in fact there is no clear evidence in the literature to show that being denied abortion has mental health consequences. The jury is still out on this question as the RCPsych acknowledges. This makes the vast majority of abortions in Britain technically illegal. 

Second, there is growing evidence that abortion actually poses a risk to mental health. The significance of Fergusson’s research is that it was a particularly robust randomized, prospective study which had carefully corrected for confounding variables. What makes it doubly interesting is that Fergusson himself comes from a pro-choice perspective.

Fergusson and his co-authors are simply asking that people be honest about the scientific facts. I will leave the final comments to them. 

‘It is our collective view that the most important implications of our findings relate to the current legal justification for abortion in the UK, New Zealand and a number of other jurisdictions in which abortion is authorised principally on medical grounds. In all of these jurisdictions, the great majority of abortions are authorised on mental health grounds. Our findings strongly challenge the use of mental health criteria as a routine justification for abortion. Our results suggest that the mental health risks of having an abortion may be greater and are certainly no less than the risks of coming to term with an unwanted pregnancy. Further, as far as we can tell, there is no evidence that suggests that the mental health risks of abortion are less than those of continuing with an unwanted pregnancy. To establish this would require a series of replicated studies showing that the mental health outcomes of those having an abortion are better than those of an equivalent series of women coming to term with an unwanted pregnancy. No such evidence exists…What emerges most clearly from the accumulated body of evidence on abortion and mental health is: (a) the primary reasons that most women seek abortion are personal, social and economic rather than relating to mental health concerns; and (b) there is no body of evidence that would lead a reasonable person to conclude that the provision of abortion mitigates the mental health risks of abortion.’

Source

Dr Peter Saunders: Christian Medical Comment

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