Melanie McDonagh
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It's probably true to say that there is no such thing as entirely objective, unloaded research on abortion. Each successive academic study (and there have been quite a few) about whether abortion carries risks to the women who have them is instantly seized on by people seeking to tighten the law or trying to liberalise it. Value-free abortion research may be a nice idea, but there's no such thing as value-free researchers, however good their methodology.
There are certainly no value-free interpreters of the research. We can probably take it as read, then, that the conclusions of the latest body to consider the effect of abortion on mental health, the American Psychological Association (APA), will be meat and drink to the pro-choice lobby here.
The APA examined research published over the past 17 years on possible links between the two and concluded that most abortions of unplanned pregnancies in the first three months do not cause psychiatric problems, although it has an open mind about the effect of multiple abortions.
So, come October - when Parliament debates a contentious amendment to the Human Fertilisation and Embryology Bill that would require women considering an abortion to undergo compulsory counselling about the possible psychiatric risks - the pro-choice lobby will make much of this bit of research. Before then, we can expect those pundits who like to brag about their abortion experiences in print - snuff journalism - to proclaim that their own abortions did their mental health nothing but good; far more good than giving birth would have done.
My chief objection to abortion isn't the damage that it might cause the woman concerned; I mind that it kills the foetus. But if we are to take seriously the question of whether abortion may have problematic consequences, then we have to acknowledge that most of the research on mental health has not been conclusive.
You can pick holes in almost all of the studies to date - for a good example of how this hole-picking is done, look at the report of the Commons Science and Technology Committee last year, which considered various research papers about the effect of abortion on mental health. Basically, there are so many variables in each case, so many practical difficulties about comparing like with like, so few studies that follow their subjects over years and decades that it's difficult to declare yep, this one has cracked it.
One often-quoted study from 2007, by a research group led by Dr M. Fergusson which suggested that people who had abortions have an increased risk of depression, suicide and substance abuse, was criticised inter alia, for not including enough about the background of the pregnancies in question.
The APA report has itself been criticised by pro-life academics for bias, for selective standards in evaluating different research findings, for ignoring studies that might point to a different conclusion, for basing much of its conclusions on one problematic study in 1995 (Gilchrist et al). One US researcher from the other side of the argument, Dr Priscilla K. Coleman, has declared that “there is consensus among most social and medical science scholars that a minimum of 10 to 30 per cent of women who abort suffer from serious negative psychological consequences”. If true, that sounds like quite a lot to me, although it still means that about eight or nine out of ten women who abort aren't affected too badly.
Nor should we forget how susceptible MPs are to authoritative-sounding research with issues such as abortion. Before the recent Commons vote on whether to restrict the time limit on abortion, research was published that suggested the life chances of premature babies had not increased beyond 24 weeks, despite medical advances. This was extensively quoted in favour of keeping the limit at 24 weeks, even though babies born prematurely self-evidently have problems, or their mothers do. The study had no bearing on ordinary, healthy foetuses, yet was used to see off the attempt to change the time limit on abortion.
As regards abortion and mental health, if we are to accept that - to put it conservatively - there that remains, notwithstanding this latest research, at least a risk that having an abortion may cause depression, isn't there a case for warning women of this? There's no saying that compulsory counselling, or indeed a cooling-off period before an abortion, will make women change their minds, but at least they should consider the possibilities. (Certainly they should be warned about the real, not illusory, association between abortion and premature delivery in subsequent pregnancies.)
And the one in ten women who undergoes a later abortion - after three months - should definitely be counselled about the potential effects on mental health. Come to think of it, has anyone done any research on the effects on men when their wife or girlfriend has an abortion?
Of course, there is nothing magic about counselling. It depends how it's done. The best and most brutal example of pre-abortion counselling that I can think of is in the film Alfie (the original version, with Michael Caine) when the unfortunate illegal abortionist rattles through all the downsides of the procedure before pocketing his £25, mentioning, if memory serves me correctly, “the injustice to the unborn child”.
I wonder how they'd put that now? They have compulsory counselling in Germany before abortion and women there still have them. Granted, you wouldn't want me doing it. I wouldn't be able to stop myself saying: “Don't you realise the foetus is human too?” And then I'd be sacked. But with all the caveats, at least informed counselling could allow women to consider the risks as well as the immediate gains of abortion. And where the potential cost is so great, that has to be worth doing.
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