Category: abortion

Lancet: Women should be offered post-abortion psychological care

The British medical journal, The Lancet, published an editorial in their August 23 issue regarding appropriate care for women after an abortion. Although the editorial could have taken a stronger stance on the APA report, I believe they have issued an important caution to those reviewing literature on mental health and abortion.

More than a third of American women will have an abortion by the age of 45 years, if current rates continue. A study published in The Lancet last year showed that 1·5 million abortions were done in the USA and Canada in 2003, compared with 42 million abortions worldwide.
Much attention has been given to the ethical considerations of terminating a pregnancy, but little effort has been directed at the long-term mental health effects of abortion on women. In 1989, the American Psychological Association (APA) undertook a systematic review of the literature and concluded that a single elective abortion did not result in long-term mental health problems. However, in 2006, a study published in the Journal of Youth & Adolescence concluded that abortion had a greater risk of adverse mental health outcomes compared with childbirth. This review was used in a South Dakota court to support a proposal to have abortion made illegal. The proposal failed, but doctors in the state must now inform women having a termination that they will be at risk of future mental health problems.
Recognising the need for a definitive decision on the issue, the APA commissioned the Mental Health and Abortion report, released on Aug 13. The authors systematically reviewed 50 studies, published in peer-reviewed journals since their last report in 1989, and concluded that, among adult women who have an unplanned pregnancy, the relative risk of mental health problems is no greater if they have an elective first-trimester abortion than if they deliver that pregnancy.
Although this report shows that there is no causal link between abortion and mental ill-health, the fact that some women do experience psychological problems after a termination should not be trivialised. The APA report concludes that such cases are often the result of confounding issues, such as a history of mental ill-health. Abortion is an important part of comprehensive reproductive health services. Women choosing to terminate must be offered an appropriate package of follow-up care, which includes psychological counselling when needed.

Factcheck.org on Obama's opposition to the Born Alive Infant Protection Act

Abortion may be the most troubling issue Barack Obama has faced in his bid to lure Evangelical voters to his campaign. Extremely controversial is Obama’s handling of questions surrounding the federal and IL state versions of the Born Alive Infant Protection Act (BAIPA).
This Newsweek article excerpts Factcheck.org’s examination of the controversy. Here is the thumbnail version:

We find that, as the NRLC said in a recent statement, Obama voted in committee against the 2003 state bill that was nearly identical to the federal act he says he would have supported. Both contained identical clauses saying that nothing in the bills could be construed to affect legal rights of an unborn fetus, according to an undisputed summary written immediately after the committee’s 2003 mark-up session.

It appears that Obama did not believe living, possibly pre-viable infants had legal status as persons. It is unclear to me what he believes now. His campaign’s most recent explanation involves an argument that suggests a vote against BAIPA at the state level was necessary to protect Roe v. Wade but a vote in favor at the federal level would have no bearing on RvW. I do not understand this reasoning.
I suppose another way to frame the issue is to ask when is an abortion complete? If the fetus is delivered and is alive but of questionable viability, how do we regard this life? The Obama doctrine appears to be that an infant born alive but of questionable viability is not a legal person – or at least this was his view while an IL Senator. Here is a speech on the 2001 Senate floor:

Obama, Senate floor, 2001: Number one, whenever we define a previable fetus as a person that is protected by the equal protection clause or the other elements in the Constitution, what we’re really saying is, in fact, that they are persons that are entitled to the kinds of protections that would be provided to a – a child, a nine-month-old – child that was delivered to term. That determination then, essentially, if it was accepted by a court, would forbid abortions to take place. I mean, it – it would essentially bar abortions, because the equal protection clause does not allow somebody to kill a child, and if this is a child, then this would be an antiabortion statute.

Rick Warren at the Saddleback Civil Forum asked Sen. Obama when a baby is entitled to human rights and Obama said such answers are above his pay grade. From a reading of this material, making these determinations was at his pay grade at one time not long ago. Simply saying he favors the federal bill now really does not address what protection he now believes should be afforded these infants.

Washington Times: Is abortion a mental health risk?

This morning, the Washington Times published my article on the American Psychological Association Mental Health and Abortion Task Force.
In it, I call for the APA to start over on this topic. One study formed the essential basis for the Task Force conclusions. I do not agree that the Gilchrist study is better than the 2005 Fergusson study which did demonstrate a reason to be cautious. However, even if one concludes Gilchrist is best, that does not mean it is sufficient or adequate to make a dogmatic conclusion. By calling one study, the 1995 Gilchrist study, “the best scientific evidence,” the task force has misled the public by portraying the best evidence as being good enough evidence.

Royal College of Psychiatrists statement on abortion and mental health

Regular readers will no doubt note the number of posts on abortion, mental health and related topics. I am doing some research and writing on this topic and want to get some of the information I am finding into view. Here is one interesting statement from another mental health association regarding abortion and mental health effects. This from the Royal College of Psychiatrists in Great Britain.

Position Statement on Women’s Mental Health in Relation to Induced Abortion
14th March, 2008
In the Government Response to the Report from the House of Commons Science and Technology Committee on the Scientific Developments Relating to the Abortion Act 1967, the following request was made:
“In view of the controversy on the risk to mental health of induced abortion we recommend that the Royal College of Psychiatrists update their 1994 report on this issue”
The College has undertaken a literature review to inform the following position statement, which includes the recommendation that a full systematic review around abortion and mental health is required.
The Royal College of Psychiatrists is concerned to ensure that women’s mental health is protected whether they seek abortion or continue with a pregnancy.
Mental disorders can occur for some woman during pregnancy and after birth.
The specific issue of whether or not induced abortion has harmful effects on women’s mental health remains to be fully resolved. The current research evidence base is inconclusive – some studies indicate no evidence of harm, whilst other studies identify a range of mental disorders following abortion.
Women with pre-existing psychiatric disorders who continue with their pregnancy, as well as those with psychiatric disorders who undergo abortion, will need appropriate support and care. Liaison between services, and, where relevant, with carers and advocates, is advisable.
Healthcare professionals who assess or refer women who are requesting an abortion should assess for mental disorder and for risk factors that may be associated with its subsequent development. If a mental disorder or risk factors are identified, there should be a clearly identified care pathway whereby the mental health needs of the woman and her significant others may be met.
The Royal College of Psychiatrists recognises that good practice in relation to abortion will include informed consent. Consent cannot be informed without the provision of adequate and appropriate information regarding the possible risks and benefits to physical and mental health. This may require the updating of patient information leaflets approved by the relevant Royal Colleges, and education and training to relevant health care professionals, in order to develop a good practice pathway.
These difficult and complex issues should be addressed through additional systematic reviews led by the Royal College of Psychiatrists into the relationship between abortion and mental health. These reviews should consider whether there is evidence for psychiatric indications for abortion.

In my opinion, this is where the APA Task Force on Mental Health and Abortion should have stopped.

Did Barack Obama vote to withhold treatment to infants surviving abortion?

This question continues to dog the Obama campaign and now the National Right to Life organization has amassed documentation regarding the claim and the Obama response.
Rather than reproduce it all here, I am going to post the link and comment more a bit later.
Click here to read the NRTL news release.
The Weekly Standard has some reporting on this issue as well.
Jill Stanek, the Illinois nurse who blew the whistle on infants left to die has ongoing coverage of this controversy.
The New York Sun has an article clarifying the issue even more. It seems Obama is now saying that the Illinois bill might have impacted Illinois law but that he would have voted for the federal version since there was no federal abortion law.

Indeed, Mr. Obama appeared to misstate his position in the CBN interview on Saturday when he said the federal version he supported “was not the bill that was presented at the state level.”
His campaign yesterday acknowledged that he had voted against an identical bill in the state Senate, and a spokesman, Hari Sevugan, said the senator and other lawmakers had concerns that even as worded, the legislation could have undermined existing Illinois abortion law. Those concerns did not exist for the federal bill, because there is no federal abortion law.

However, he is a prime supporter of the Freedom of Choice Act which would become federal law. Does that mean he would support the repeal of the federal Born Alive Act?