There has been considerable media interest in the fact that two MPs (Nadine Dorries and Frank Field) have tabled abortion 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 information and 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 on the health consequences of abortion 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 (pictured) 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.
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 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 in January without a proper consultation period, has now withdrawn it in order to await a report from the Royal College of Psychiatrists. I have previously already written to David Cameron with my concerns about the lack of transparency, bias and undue haste surrounding their consultation.
The comments of Telegraph 'Strategic Events Editor' Tom Chivers (pictured) are also a revealing example of the way that scientific evidence is cherry-picked by pro-choice commentators 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’ Chivers 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 friends on 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.
Chivers 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 journal 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 in fact 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 at all (or the Royal College) but is actually one by the American Psychological Association which has been widely criticised as I have previously outlined on this blog.
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 30 year longitudinal study which had carefully corrected for confounding variables. What makes it doubly interesting is that Fergusson himself comes from a pro-choice perspective so arguably had a vested interest in his research not showing any link between abortion and mental health problems.
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.’
You don't get mental health issues when you get your appendix removed.
ReplyDeletePeter, you're a star.
ReplyDeleteChivers' sleight of hand is absolutely characteristic of the desperation of supporters of abortion to justify what is simply not able any more to be supported by the peer reviewed evidence.
ReplyDeleteThe RCPsych report is obviously crucial and we need to pray they will do a more comprehensive job than the RCOG.
Thank you for another brilliantly informative and useful article, Peter!
ReplyDeleteIain McLaughlan,
ReplyDeleteAre you really comparing the destruction and killing of a baby to the removal of an appendix, or have I misunderstood you? A baby is a living being worthy of respect. It is in no way comparable to an appendix which is merely an organ.
George,
Ms. Dorries is a remarkable woman and one who has tremendous strength of character and courage. I have relatives who live in her constituency who have nothing but praise for her. Her religious views have no bearing on the matter. I am neither christian nor a "fundamentalist", but a very liberal-minded hindu, and yet I feel the same way as her. What is pathetic are YOUR attempts to reduce her efforts to religious fundamentalism. Anyone with a spark of decency can see that abortion is morally and ethically wrong on so many levels. Even many atheists are repulsed by it.
The RCOG should be thoroughly ashamed of themselves for promoting the abortion agenda and concealing their own vested interests in the matter. It is indeed time to take the power for producing "abortion guidelines" away from them. Of course it is blatently obvious that they have crucial vested interests. I've heard it said that many RCOG bigwigs themselves are performing abortions! Should those who make money out of other people's misery be allowed to promote themselves and their sick agenda? Surely Ms. Dorries and Mr. Field are right to try and stop it. I say well done to them - they have my strong support and that of my family.
Raghuram
You rest a lot on your assertion that RCOG has been "widely criticised", but what you link to amounts to you, Dorries and a few unnamed sources she cited in the House (were these case studies from 'Forsaken in Taunton' like all the others?)
ReplyDeleteYou also do nothing to establish that Dorries is in any way right in her 30% assertion.
Tim,
ReplyDeleteThe 30% assertion is in the abstract of Fergusson's 2008 paper linked in the text above.
This paper (and the 2006 one that preceded it) were landmark publications in that they showed for the first time, in prospective trials that corected for confounding variables, that women with no previous history of mental health problems who had abortions were 30% more likely to experience them than otherwise matched women who hadn't had abortions.
It was these papers that led the RCPsych to change its view on the issue.
The blog I link to citing 'wide criticism' links to other articles - but the real indicator was the volume of submissions that went into the RCOG before the extended closing date. I did not personally submit.
The RCOG have withdrawn their guidance from their website now to revise it. The real test will be how much it has changed when it is finally republished.
To get a flavour of the specific criticisms that have been made see the CMF submission at http://admin.cmf.org.uk/pdf/publicpolicy/RCoGsubmission_2_2011.pdf.
Kind regards
Peter
"the real indicator was the volume of submissions that went into the RCOG before the extended closing date"
ReplyDeleteEven if you tack this on while skipping right over Dorries relying on unnamed sources in a campaign for transparency (did those case studies come from 'Forsaken'? Have you asked?), I fail to see how this automatically gets you to 'widely criticised'. The submissions may have come from a narrow band of the public (say, an interest group) and may have had low/no merit.
As for your assertion that a report's abstract supports what Dorries has claimed re: 30%, you have in your comment (as you have in your post) skipped right over the matter of correlation not equalling causation, and you have not shown how the report supports Dorries' 30% assertion beyond waving a hand in its general direction and assuring me that it does.
Tim,
ReplyDeleteYou can read the whole 2008 Fergusson paper with the 30% figure yourself at http://bjp.rcpsych.org/cgi/reprint/193/6/444
You will find much more detail on the background by following my links in the main blog post above.
Have a look at the RCPsych 2008 statement too.
'Forsaken' is not a book I have read but I gather it is just a collection of women's testimonies.
Fergusson's paper is a peer-reviewed journal article.
Have a look at the CMF submission I linked above to get a flavour of comments other individual groups, researchers and individuals have made. This contains a number of scientific references on a whole host of other issues misrepresented by the RCOG in addition to the abortion/mental health link.
If you would like more peer-reviewed papers on the abortion mental health link or any other related matters let me know and I will do my best to get them to you. eg. ABC link, premature birth, fetal sentience, informed consent etc.
The RCOG draft guidelines were a very shoddy piece of partisan cherry-picking and this is all very embarrassing for them.
Nadine Dorries may not be a medical researcher but she is on to something very big here. The rabbit hole goes very very deep. It is all really quite scandalous and there is a lot of public money involved. Not good!
All the best
Peter
"The rabbit hole goes very deep."
ReplyDeleteSo you say. But you'll need to do better than wave in the direction of what may or may not be a black circle painted on the wall.
Reading the summary of the report (that you have again addressed with a vague wave of your hand), I see that the evidence does not establish what Dorries asserts but instead summarises its position that the evidence is "consistent with the view that abortion MAY
be associated with a small increase in risk of mental
disorders"
BTW, aren't you the least bit curious to know where Dorries' case studies come from?
Tim,
ReplyDeleteFergusson is being typically modest and guarded as any researcher should. And like any good researcher he will say that more research is needed. His next paper is due any month now.
He summarises his results as follows:
'After adjustment for confounding, abortion was associated with a small increase in the risk of mental disorders; women who had had abortions had rates of mental disorder that were about 30% higher. There were no consistent associations between other pregnancy outcomes and mental health. Estimates of attributable risk indicated that exposure to abortion accounted for 1.5% to 5.5% of the overall rate of mental disorders.'
As I say, if you are genuinely interested in this area have a look at the CMF submission above.
For many other papers on the link between abortion and mental health see my Washington Post blog at http://pjsaunders.blogspot.com/2010/11/dont-believe-everything-you-read-in.html
Feel free to tell me where the Dorries studies come from. I thought they came from women's testimonies. There are lots of similar collections around.
All the best
Peter
Dorries has not said where her 'case studies *see; testimonies) come from, and the 'Right to Know' editors (whoever they may be) have deleted comments asking that she do so. I would hope you would be at least be a little bit curious about that, and not count on me to give you answers after my questions have been deleted.
ReplyDeleteAnd once again, you have ignored the matter of correlation not equalling causation; the finding that women who had had abortions had rates of mental disorder that were about 30% higher (after adjustments) could just as easily signify that a higher percentage of women with a mental disorder seek abortions. This finding does not support what Dorries asserts.
Tim,
ReplyDeleteRe 'Forsaken' pray tell. I am genuinely curious.
Re causation and correlation, studies of this kind cannot establish causation, only correlation. Causation is deduced from the fact that all possible confounding variables - including pre-existing mental disorder - have been corrected for.
The fact that this was done is what makes the Fergusson study unusually robust and is why it is taken so seriously by researchers on both sides of the abortion divide. Fergusson himself is pro-choice. You really should read it right through.
You are sounding a wee bit like a man who is approaching this matter with his mind already made up. What is so difficult about accepting that some women suffer mental health problems from abortion?
I hope you don't mind me saying but from your questions and comments you seem a touch out of your depth here. What is your own background?
All the best
Peter
Dear Mr. Ireland,
ReplyDeleteHaving now read your blog, it seems to me that your beef is primarily with Ms. Dorries and not abortion per se. In short, you appear to dislike the lady intensely, and are determined to malign her by hook or by crook. I suspect if she came out with a policy that you endorsed, you would STILL pooh-pooh her remarks even on that subject of which you approve, such is your obvious hatred of her. I have read your blog in some detail, and I agree with you that some of the things that Ms. Dorries says are too "fantastic" to be strictly accurate, and she may even sometimes be exaggerating in order to "sell" her ideas - however, one must remember that she is not a medical person (she used to be a nurse. They don't have any medical training. I do, and Dr. Saunders does). She is also a politician, and all politicians will lie to a greater or lesser extent. You will not find a single one that does not or has not lied in the past - it is the nature of their work. There is nothing special about Ms. Dorries - she is no worse than any of the Labour politicians, and probably much better. At least she cares for her constituents, which is more than can be said for many other MPs.
The evidence regarding mental health issues is well established and from a peer-reviewed journal. I myself, as a practising doctor, often see women who have had abortions and who consequently suffer depression, sometimes even many years later. The guilt that accompanies the taking of an innocent life is not something that will just go away. It is the kind of thing that stays with you for life. To dismiss this as being of no significance is nonsensical.
You may choose to disregard my experiences as anecdote, but a large number of such anecdotes are what collectively make up "evidence". You seem to have highlighted the word "may" (in the summary of the report) in an attempt to mislead - nobody has asserted that EVERY woman who has an abortion will have subsequent psychiatric morbidity. But some of them definitely will. Therefore one has to use the word "may" instead of "will", since it applies not to everybody but only to some people. Those "some people" still constitute a significant number, whether you wish to acknowledge this or not.
I find your views on the abortion debate as polarised as that of any of the pro-lifers including Ms. Dorries. As I said, the primary problem here seems to be that you have an unrelenting and overwhelming hatred for Ms. Dorries. She may be a liar but she is definitely not the only one. In my view, the pro-choice brigade have mouthed far more lies and half-truths in their attempts to "sell" the abortion agenda to the rest of us. I do not see you taking apart the arguments of those who would convince us that fetuses feel no pain and are not "sentient beings", but bits of tissue to be destroyed and disposed of when unwanted. Unless you criticise arguments on both sides of the debate, I will have to conclude that you are only motivated by hatred for anything that Ms. Dorries espouses. I myself admit willingly that the arguments used by Ms. Dorries and her friends are not always correct or scientific. Are you willing to make the same concessions about the pro-choice lobby?
Raghuram
Btw, Tim, it would be nice if you stop using the word "fundamentalist" regarding Ms. Dorries (both here and on your blogs). I respect her for trying to be a christian (even if she fails, that is of no account - we should always strive even if we cannot achieve). One does not need to be a christian oneself to respect her choice of religion. As far as I know, she does not discriminate against those of other religions/no religion, and she treats all of her constituents with the same respect and tolerance. That is good enough for me.
ReplyDeleteMy only quarrel with christians, as Dr. Saunders knows, is that some of them are so completely clueless about other cultures and religions inlcuding my own (Peter himself, sad to say, falls under this category), but I guess one cannot have everything!:)
Best wishes,
Raghuram
I urge you to exercise your curiosity; take it out for a proper walk. If Dorries denies the 'case studies' she has cited recently come from Forsaken and yet does not mention where they did come from, do not bring your curiosity straight home, it is not finished yet.
ReplyDeleteOn 30%, I not only have serious doubts about what Dorries claims... but why she claims it. (This should not reflect badly on the study, merely on Dorries.)
That I arrived with deep suspicions does not change that the report you have shown me has yet to support what Dorries has stated as if it were an established fact.
Dorries has arrived at this debate under false pretences, with a false premise.
And if you don't mind me saying so, a major aspect of this appears to play to your prejudices.
Raghuram:
ReplyDeleteMy view on the abortion debate is that it should be conducted far more honestly than By the low standards Dorries sets, and this MP features heavily on my blog purely because of her incredible dishonesty. You assume much when you assume I dismiss any suggestion of any negative emotional impact, for example.
(I also recognise that lying comes with the job when you're an MP, but make the distinction between Dorries and other MPs here.)
I also do not use the word 'fundamentalist' recklessly. I have detailed why I think Dorries' adherence to Psalm 139 approaches fundamentalism, I do not rush to brand her as a fundamentalist, not even exaggerating in order to "sell" my ideas, as some might. I am also correct in identifying secretive backers like Andrea Williams as fundamentalist when I do so, because she describes herself as one. At no stage am I doing what you imply; equating Christianity with fundamentalism.
Tim,
ReplyDeleteI'm sorry but I'm not really that interested in your apparent obsession with Nadine Dorries and Andrea Williams nor your various ad hominem arguments.
I see the issues here as follows.
1. Women with unplanned pregancies currently find it very difficult to access counseling or information independent of the abortion industry.
2. The RCOG guidance misrepresents some of the scientific evidence and the panel who put it together has little or no expertise in psychiatry
3. There is a body of credible scientific evidence linking abortion and mental health problems. Fergusson's paper is one such example. The RCPsych acknowledges this.
4. There are financial vested interests involved here. Both the abortion industry and members of the RCOG receive tax payers money for doing abortions.
5. The two amendments to the Health and Social Care Bill by Field/Dorries are trying to address some of these issues and are therefore important.
Peter
This comment has been removed by the author.
ReplyDelete(previous version of this comment deleted. typo corrected.)
ReplyDeleteI can prove that questions of character are entirely relevant in this instance. Dorries is a proven liar on this very topic, and this is not the first time she has used a false premise to pretend that hers isn't a religious agenda. As for Andrea Williams, I was castigated for using the term 'fundamentalist' and I explained the context in which I used it. (If you would like evidence that Williams describes herself as a fundamentalist, I am happy to include it.)
You, meanwhile, have offered nothing to support your own "various ad hominem arguments" against myself, the RCOG, and what you refer to as the 'abortion industry'. You imply that they are motivated by money, and that I am motivated by some kind of mental condition. Neither of these allegations are new, and neither have any merit, or basis in reality.
(I assume this this means you've lost interest in actually looking into where Dorries gets her case studies, and that you have no interest in dealing with the problem that Dorries has once again put forward as fact something that is not.)
Dear Tim,
ReplyDeleteI think you have to be very careful using the word 'liar'. There is a difference between not being entirely accurate through carelessness or lack of familiarity with the detail on one hand (or because you are busy journalist or politician) and deliberately intending to deceive on the other.
I think that both Tom Chivers (see Ministry of Truth blog on David Fergusson and my post above) and Nadine Dorries are guilty of the former (as are most of us to a lesser or greater extent) but I think you have to be very careful before accusing people of the latter.
I have pointed you on two occasions above to the CMF submission to the RCOG which outlines in great detail the inaccuracies in their draft guidance which we and others have identified. Please read that first and come back to me on the specifics which I do not intend to spell out in detail here. I see little point when it is all outlined in such detail there.
I did not say that the RCOG or abortion providers (what I have perhaps provocatively called 'the abortion industry') were motivated by money, only that they had financial vested interests and should not rightly therefore be offering both abortion (for which they receive payment of public money) and also information about the helath conseuqences of abortion (which I argue should be provided by a neutral body).
I did not say that you had a medical condition, just that you appeared to be obsessed with Nadine Dorries and Andrea Williams to the extent that you seem unwilling to debate the issues and want to talk only about the personalities. Any neutral person coming to this debate freshly I think might reasonably conclude that from what you have written on your blog and elsewhere.
I have already asked you for information about the source of the case studies and am still waiting for you to tell me as you obviously know the answer.
With respect to the word 'fundamentalist' I think you need to define it before you make judgements about people. It is a label with a long history. People appear to use it today without defining it as some kind of pious putdown, rather than talking about specific beliefs and convictions. I think it is an unhelpful label. Perhaps you could explain what you understand by the word yourself and we could then have a meaningful discussion about it?
Kind regards
Peter
Tim,
ReplyDelete>> My view on the abortion debate is that it should be conducted far more honestly than By the low standards Dorries sets
No, I'm afraid it is quite apparent that you dislike Ms. Dorries, and this is about her primarily rather than abortion. I suspect if she became pro-choice suddenly, you would still accuse her of dishonesty.
>> and this MP features heavily on my blog purely because of her incredible dishonesty.
Sorry, but this is nonsense. I assume you live in mid-Bedfordshire and this explains your obsession with Dorries and her "lies". But I suggest you take a look around at some of the other MPs who are far more dishonest. This woman is hated so much, simply because she espouses something that is very "unfashionable" i.e. bringing down the abortion age. The fact is that women in this country have started to regard abortion as their basic "right". They don't like being "judged" as baby-killers, which is what they really are, by the likes of Dorries and co. They see the fetus as an unwanted appendage to be destroyed at will - and they don't like any woman who opposes their stance. Any woman who does so will be subjected to the utmost hatred and vitriol. I have seen this happen very very often to female friends and medical colleagues once they reveal that they are opposed to abortion. It is the feminists who are at the bottom of this hatred. Dorries' so-called lies would not feature at all in ANY blog if she embraced "liberal" values like abortion, euthanasia, promiscuity, etc. Her lies are only lies because she has dared to stick her neck over the parapet and take on the pro-choicers who are baying for blood literally (her's as well as their own childen's, ironically enough).
>> You assume much when you assume I dismiss any suggestion of any negative emotional impact, for example.
I am relieved to hear you agree there is significant negative emotional impact following abortion. The same sort of impact there is when a woman loses a child by miscarriage. If it were only a "bunch of cells" that is miscarried/aborted, there would be no reason for anyone to be depressed or upset.
Raghuram
By the way, that last post was also by myself.
ReplyDeleteI forgot to sign it.
Raghuram.
That is weird - Peter, your blog has swallowed up my posts again! I will re-post my last post later on if possible.
ReplyDeleteRaghuram
It is not polite to challenge someone to respond and then delete their response without leaving any indication that you have done so, Peter.
ReplyDeleteWe are happy to allow the private healthcare industry offer consultations to patients, despite the far more significant vested interests involved. I guess this is because we consider them to be professionals, who can be trusted to act in a professional manner.
ReplyDeleteWhy are you not prepared to extend the same courtesy to organisations that provide termination services?
If you really want to combat the number of terminations in this country, you would do well to refocus your efforts on effective contraception, and dealing with the careless promiscuity shown by many people in our age.
Even then, the decision about whether to have a termination doesn't belong to you, or me... It belongs to the woman concerned. I've no doubt that a termination will have emotional consequences for her, and it is therefore for HER to decide.
Tim,
ReplyDeleteI haven't deleted any of your responses. The blogspot software does however automatically delete long responses and I suspect this is what may have happened. I suggest you try again.
Madaxemen,
The RCOG have betrayed the trust placed in them by misrepresentng the medical evidence about the health complications of abortion. This is why they are being criticised.
See my Friday blog on Welsh morning-after pill to re effectiveness of contraception campaigns in stopping unplanned pregnancy. I agree with you re promiscuity though of course.
The law doesn't agree with you about women having an absolute right to abortion. Neither would most people in this country. Regardless women deserve accurate health information and currently they are not getting it. Hence the Dorries/Field amendment.
Abortion is not just any other medical procedure because it ends a human life. That is why it is regulated by law.
Peter
I would add to what Tim says that abortion isn't in fact legal. It's only immunity from prosecution that is granted under the Abortion Act to do otherwise would allow serious assaults on pregnant women leading to the death of their children as not being at least manslaughter. Even the most hardened pro-choice campaigner can see the parallels between that and the situation with the slave trade where slaves were treated as cargo. As a society though we treat unborn child as "cargo".
ReplyDeleteOops, I meant I would add to what *Peter* says...
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