Pro-Choice Press

a publication of BC's Pro-Choice Action Network

Summer 1997 Issue

Table of Contents

• Election Blues (anti-choice politicians elected)
• Forcing Pregnant Women to Behave
• Depo-Provera Approved in Canada
• Methotrexate Abortions Funded
• Publicity for Morning After Pill
• A Grateful "Hypocrite" (anti-choice woman has abortion)
• News from SFU
• News from Around the Country - and the World
• Hollywood Look at Abortion
• Population Report From United Nations
• Legal Abortion Benefits Society
• Psychological After-Effects of Abortion - The Real Story

Election Blues

The Coalition's web site also states that Jay Hill "accepts abortion for rape, incest, and the life of the mother" and that Val Meredith and Ted White did not respond but support Reform policy. The Reform Party platform calls for referenda to be held on contentious moral issues, such as abortion.

The Coalition surveyed candidates from six parties. Most did not respond, although based on the survey and candidates' past comments, many other elected MPs are anti-choice, including almost 50 Liberal MPs, six Tories, and one Nova Scotia NDPer, Yves Godin.

John Hof, president of Campaign Life Coalition, has said that the narrow Liberal majority will now give "pro-life" MPs much more clout within the caucus. "What's to prevent these MPs from being the ones to instigate legislation to ban partial-birth abortions from occurring Canada, as we've now found it does occur?" Since there is no such thing as partial-birth abortions, Hof may be referring to intact D&E's (as opposed to D&X's), a small number of which may be performed in Canada for some second trimester abortions. (For more details, see the Spring 1997 issue of Pro-Choice Press.) According to Statistics Canada, only .1% of abortions occur after 20 weeks in Canada.

The Liberal party has said they will not introduce amendments to the Criminal Code regarding abortion. There is some hope also that the Liberals, along with the Bloc Québécois, the NDP, and some Conservatives, will support the introduction of RU-486. Needless to say, Campaign Life Coalition is lobbying to prevent the approval of RU-486. The coalition opposes all abortions, including those resulting from rape or incest. It urges MPs to work to ban fetal-tissue experiments, to exclude abortion as an insured health service, and to oppose any initiative in support of "doctor-assisted suicide."

Thanks to Charlie Smith, of the Georgia Strait.

Forcing Pregnant Women to Behave

by Helen Janssens

The Canadian Society of Obstetricians and Gynecologists has made a public policy statement that forcing pregnant women to receive medical treatment is ethically and medically wrong, and represents a violation of their autonomy. The Supreme Court is currently considering the question of where to draw the line when it comes to forcing a pregnant woman to look out for her unborn child. The landmark case involves a pregnant Winnipeg woman whom child welfare authorities tried last year to force into a treatment program for a solvent-sniffing addiction. Currently, New Brunswick and the Yukon are the only jurisdictions in Canada that allow court orders to force pregnant women into treatment. But the society said that forced treatment can endanger the mother and the fetus by discouraging pregnant women most at risk from seeking any pre-natal medical care at all.

Now, with a recent case in New Brunswick, we also have to deal with the prospect of children suing their mothers for negligence while they were in the womb. In this case, the woman drove recklessly, crashing her car into a pick-up, and allegedly caused the child's cerebral palsy. But what about cases where a child has, say, fetal alcohol syndrome? Allison Brewer of CARAL (Canadian Abortion Rights Action League) says she sees nothing but confusion ahead if mothers can be sued for the way their children turn out.

I can't help but feel that this challenging issue is about more than a woman's right to self-autonomy. Of course, we fully support a woman's right to choose NOT to have and raise a child, but when a woman makes the decision to carry a pregnancy to term, obviously, her future child deserves the best chance possible for a reasonably good life. It's just not moral for a willingly pregnant woman to give her child fetal alcohol syndrome, cause it to be born drug-addicted, or stunt its physical and intellectual growth because she chooses to smoke. Society pays a huge price for treating and dealing with the myriad resulting social problems, but of course, the children pay the greatest price of all. The question is, how best to safeguard the civil rights of pregnant women, while at the same time ensure that their unborn children, who we know are destined to become contributing members of our society, get a fair opportunity to live a rewarding life? In other words, how do we be both pro-choice and pro-child at the same time?

The solution is certainly not to lock up pregnant women, nor to create a police state aimed at monitoring and controlling the behaviour of pregnant women. Punitive measures fail to resolve the complex problems of addiction, and ultimately may undermine the health and well-being of both women and their children. The more obvious answer is empowerment for women, a war against poverty, and well-funded social and educational programs aimed at disadvantaged women and their families. Because in an ideal society, all women would have the resources, knowledge, support, and desire to give their future children the best chance possible. The question is, what do we do in our less than ideal world? Pro-Choice Press welcomes your thoughts on this controversial issue.

Depo-Provera Approved in Canada

Depo-Provera, a synthetic hormone that offers the effectiveness of sterilization, but without its permanency, has finally been approved for use in Canada. It has been used worldwide since 1967 despite early studies linking it to breast cancer. A large 1991 study by the World Health Organization put these fears to rest, concluding that there was no increased risk.

Some women's groups are still concerned about the safety of the drug, while others, along with the medical profession, hailed the drug. Doctors say that it will help reduce unwanted pregnancies and an abortion rate that's been climbing since 1990. Marion Powell, a doctor and professor at the University of Toronto, says, "It gives women another choice." Gynecologist Victoria Davis of Toronto East General Hospital says, "Many women have difficulty taking the pill. They forget ... or they can't tolerate the side effects."

Depo-Provera is given as an injection in the arms or buttocks four times a year. It stops ovulation, but doesn't contain estrogen so it doesn't have some side-effects associated with oral contraceptives, like blood clots and high blood pressure. Depo-Provera's side effects include irregular bleeding, weight gain or loss, headache, nervousness, dizziness, decreased libido, and abdominal discomfort.

Methotrexate Abortions Funded

Funding for medical abortions using methotrexate has now been approved. Methotrexate is similar to the drug RU-486, and is used in conjunction with misoprostol to terminate a pregnancy of less than seven weeks. Funding covers all office visits for women with medical insurance, but there is a $50 charge to cover the cost of medications. The cost for women without medical coverage is $275. Methotrexate abortions are currently available from Dr. Ellen Wiebe, at 874-9897.

Patients will probably need to make several office visits, the first of them to have an ultrasound. Those accepted for a methotrexate abortion will receive an injection at the doctor's office. They will also be given a single dose of misoprostol in the form of a vaginal suppository to be inserted four days later, at home. About 50% of women abort successfully within 24 hours of inserting the misoprostol. Others need one or two more doses of the drug to complete the procedure. Contractions of the uterus may cause some pain and discomfort, and there may be heavy bleeding, which can last for several days. Other side effects of the misoprostol, occurring in 15% of patients, include nausea, vomiting, diarrhea, and chills. There is a 2% failure rate, while another 6% of patients end up having surgery because of bleeding, or because they no longer want to wait for the methotrexate to take effect.

Publicity for Morning After Pill

The Planned Parenthood Association of BC is launching an awareness campaign on the Morning After Pill, which they call the Emergency Contraceptive Pill (ECP), aimed at reducing the rate of unplanned pregnancies. Posters have been distributed to clinics, doctors' offices, and other interested groups throughout BC. A toll-free number (1-800-739-7367, or 731-4253 in the Lower Mainland) is available for people to call for information on the ECP.

Planned Parenthood states that health care providers may fail to provide information about emergency contraception to women during routine visits, and as a result, few women know that it is safe, effective, and accessible. It is readily available from sympathetic doctors, Planned Parenthood clinics, hospital emergency departments, and medical clinics.

The ECP is a highly effective treatment that either prevents ovulation or implantation, depending on when in the cycle the pills are taken. Treatment must start within 72 hours of unprotected intercourse, or intercourse with contraceptive failure. The ECP has side effects similar to those of regular birth control pills, but are generally minor in nature.

The Society of Obstetricians and Gynecologists of Canada has released its National Clinic Practice Guideline on Emergency Post-coital Contraception. The guideline specifies that the use of the ECP should be considered not only to prevent unwanted pregnancy, but also as an opportunity for doctors to initiate contraceptive counselling. Planned Parenthood believes that if the opportunity for contraceptive counselling is used to its full advantage, BC will see a decrease in the number of unplanned pregnancies.

A Grateful "Hypocrite"

An anti-choice woman who had an abortion last autumn sent the following letter to the clinic who helped her, Hope Medical Centre, in Shreveport, Louisiana. The clinic administrator, Robin Rothrock, thought it would be a good idea to make this letter public, and stated: "We saw this woman for her abortion on Saturday—it was a therapeutic termination because the medication she is required to take was killing her eight-week fetus. We received this letter at the clinic today. Sometimes it ALL seems worthwhile!"

Dear Staff,

I wanted to take a minute to thank you for your kind, compassionate and understanding handling of my recent termination. Ironically, I have spent most of my life spouting my opinion against abortion and pontificating endlessly on the value of the unborn child. Although I never actually made it to a protest, nor condoned violence towards a facility, I felt moved to tears whenever I was made aware of a facility in my area. I guess you could officially brand me a hypocrite now.

I'm unsure whether I would be considered a hypocrite or an enlightened one. Until now, I have closed my ears to any "propaganda" from the Pro-Choice camp and would only openly ponder issues from the Pro-Lifers. Being born, raised, and currently heavily involved in the Catholic religion, you may understand my situation. I never dreamed, in my wildest nightmares, that there would ever be a situation where I, personally would choose such an act. Of course, we would each like to think that our reasons for a termination are the exception to the rule. But the bottom line is that you people spend your lives, reputations, careers, and energy fighting for, maintaining, and providing an option that I needed, while I spent my energy lambasting you. Yet you still allowed me to make use of your services even though I had been one of your enemies.

You were kind enough to let us hypocrites sneak in the back door and hide in a private room because we were so uncomfortable having to come face to face with the true benefits of your services. You treated us as kindly and warmly as you did all of your patients and never once pointed an "I told you so" finger in our direction. For this we are so very grateful. I got the impression that you cared equally about each woman in the facility and what each woman was going through, regardless of her reasons for choosing the procedure. I have never met a group of purely non-judgmental people like yourselves.

I feel as though I an supposed to put my experience to work in some way but am unsure how. I don't know if I could volunteer to counsel women because my strong feelings toward the unborn are very close to the surface. I am no longer embarrassed to say I had the procedure nor am I embarrassed to say where I had it done. I have no reservations about my name being associated with such a facility, for those who pass judgement have not walked in my shoes. If there is anything I can do to support your facility, whether it be through volunteer work, financial support, speaking on your behalf about my experience, etc., please feel free to call on me. My husband and I learned a difficult lesson in choices and in absolutes (there are none). We are grateful for the hardships you endured to be able to provide the facility to us.

Thanks again for all you did.

(Name withheld by the clinic)

News from SFU

by Amanda Camley

The last few semesters at Simon Fraser University have been a challenge. While students have faced increased education costs, burgeoning student debt loads, and various funding threats, we have also had to contend with the neo-liberal agenda, which has pushed through plans for privatization of services and limited academic freedom through the Academic Code of Conduct policy. Our women's centre and other Left organizations have had to defend their existence, while issues of Choice have been monopolized by a vocal anti-choice minority.

Several right-wing groups based in Christian reformist principles have found an uncomfortable home at Simon Fraser University. An anti-choice group on campus, which was particularly busy last semester, ran weekly poster campaigns and had a membership table during Clubs Days. Close to Remembrance Day, this anti-choice group set up a display of mini-white crosses at the base of SFU which featured anti-choice slogans. They also distributed literature across campus that argues that women should lose the right to choose, and which also targets the gay community on campus with hateful homophobic rhetoric.

Unfortunately, this group has not been operating in isolation. It is clearly part of a larger agenda that aims to transform university campuses into conservative monsters, whose main function is to serve corporate interests and uphold the status quo. A study undertaken by the Canadian Union of Public Employees, BC Division (April, 1997) aptly points out that corporate sponsorship does not see any economic benefit to studying lesbian or First Nations issues, and that with the corporate takeover of campuses, academic freedoms are being eroded.

Fighting Back

In the face of opposition, many people have come together to fight the anti-choice and the neo-liberal agenda. Initially, we held a day of action to raise campus awareness of the anti-choice's presence. Although we were eventually closed down by SFU security for what could be seen as political reasons, the event was a huge success, gathering support from the Simon Fraser Public Interest Research Group (SFPIRG), the Women's Centre, and the majority of students, staff, and faculty. This event spurred the beginnings of a social justice action group, which has undertaken the Choice issue exclusively. Members have run poster campaigns, written articles for The Peak, organized membership tables for Clubs Days, held a public meeting about the tactics of the anti-choice, and ran a controversial acoustic café program where feminist and pro-choice sentiments were delivered through the airwaves by CJSF, the SFU radio station.

Although the group has faced hostility and censorship, we have come back strong with support from the majority of the campus community and from our strong 'home' with SFPIRG. Perhaps the biggest success was the choice group's involvement in the Simon Fraser Student Society elections, where a coalition of groups shed light on the reformers, homophobes, and women-haters who were running under a slate called SLASH (Student League Against Socialist Hordes). In the end, SLASH was denied any presence within the executive positions of the Society.

Our choice group and many other progressive coalitions continue to fight the right-wing agendas on campus. As private corporate interests sneak into campus life under the guise of 'strategic relationships with business,' as APEC organizes for its fall conferences at UBC, and as the right-wing becomes more radical in its drive to hurt women and push its hateful politics on people, individuals on campus have come together in fierce opposition. Together, we have the power.

Around the Country - and the World

National

Canada is receiving international attention for its rising teen pregnancy rate. The pregnancy rate for Canadian women aged 15 to 19 has risen a full 20% since 1987. A growing number of young women are choosing to give birth and keep their babies rather than giving them up for adoption or seeking abortions. A recently released study indicates that adolescent pregnancy rates are down worldwide, and far fewer young women are becoming pregnant before the age of 20, especially in Asia, North Africa, the Middle East, and parts of Latin America.

Prince Edward Island

There are no abortion services at all on the Island. In the last 15 years, more than 2,000 women have left the Island seeking abortion services elsewhere. These are the ones who could afford it. In 1988, while the rest of Canada was celebrating the Morgentaler decision that struck down the abortion law, the PEI legislature held a unanimous vote favouring a resolution banning all abortions in PEI. Now, the newly-elected Conservative premier of PEI, Pat Binns, believes that abortion is "wrong under all circumstances."

Ontario

A study released in early April indicates that fewer than half of all hospitals in Ontario provide abortion services. The government asked for the study after a task force concluded that there were serious discrepancies in accessibility and availability of abortion services across the country. The study concluded that access is severely limited for women seeking abortion after the first 12 weeks of pregnancy, and for women living outside urban centres, particularly in northeast and eastern areas of the province. The study also noted that anti-choice harassment is quite widespread: 54% of hospitals that provide the service experience anti-choice picketing, and 8% of hospitals that do not provide the procedure have been picketed by anti-choice activists.

Alberta

Long waits for abortion services in Calgary are forcing women to travel to Edmonton for the procedure. The Calgary Regional Health Authority, claiming financial constraints, closed the abortion unit at Foothills Hospital, and restricted access at the Kensington Clinic to 1500 procedures a year. Although services have been expanded at the Peter Lougheed Centre, women are still waiting up to four weeks for an appointment, because the hospital cannot keep up with increased demands. Abortion services in the rest of the province remain poor to nonexistent.

United States

The Senate voted in May to ban "partial-birth abortions," but it is short three votes needed to override a probable veto by President Clinton. In the meantime, over 30 states have passed, tried to pass, or will try to pass legislation outlawing late-term abortion procedures. See our article in the Spring 1997 issue of Pro-Choice Press for more details.

European Union

Differing abortion laws in various European democracies are creating problems and inconsistencies in how women obtain abortions in Europe. As nations have relaxed their border controls so that people can travel freely within the Union, officials worry about the more than 15,000 women who annually cross borders to obtain abortions in countries with more liberal laws. For example, Irish women go to Britain, while French, German, and Italian women go to The Netherlands or Spain. France, normally thought of as a progressive country, has a restrictive 10-week limit for abortions! There are clinics, particularly in The Netherlands and in Spain, that specialize in abortions (mostly late ones) for foreign women. This situation creates a curious dilemma, with more freedom for women who could not otherwise obtain abortions in their own countries (and who can afford to travel), but less incentive for politicians to change laws, given that there is a safety valve just across the border for women who need it.

Poland

The new liberal abortion law in Poland was struck down in May. Poland's highest court, the Constitutional Tribunal, ruled that the law violated the Constitution because it did not protect the right to life. The law allows abortions until the 12th week of pregnancy for women deemed to face financial or emotional problems if they have a child. Parliament has six months to consider the ruling, but will be forced to change the law unless legislators override the verdict with a two-thirds majority vote.

South Africa

A new liberal abortion law in South Africa gives women the right to abortion on demand in the first 12 weeks of pregnancy. The Choice on Termination of Pregnancy Act, signed into law by President Nelson Mandela in December, replaces the restrictive 1975 law that allowed abortion only in cases of rape, incest, or endangerment of the woman's life. Recent statistics released by the Department of Health indicated that black South African women did not have the same access to safe abortions as white women under the old legislation. In fact, a 1994 Medical Research Council study on unsafe abortion in South Africa indicated that a full 99% of patients treated at state hospitals for incomplete abortions were black women.

Columbia

A challenge seeking to make abortion punishable as homicide was rejected by the Constitutional Court of Columbia in late January. The court, however, upheld Columbia's ban on all abortions. A tribunal ruled that life begins at conception, and held that a fetus has rights that preclude abortion. It is estimated that between 300,000 and 450,000 abortions take place in Columbia each year despite this ban.

Honduras

Complications arising from unsafe illegal abortions are the third leading cause of maternal death in Honduras, which has the fourth highest number of maternal deaths in Latin America. Statistics indicate that unsafe illegal abortions account for 221 out of 1000 maternal deaths. Women's groups and officials within the Ministry of Health have pushed for the legalization of abortion in certain cases, to reduce the risk to the lives of Honduran women, but they face strong opposition from the Catholic Church.

Thanks to Pro-Choice News, CARAL's newsletter, for some of this information.

Hollywood Looks at Abortion

A Film Review

by Helen Janssens

Two recent movies dramatize and satirize the struggle for abortion rights, If These Walls Could Talk, and Citizen Ruth.

If These Walls Could Talk is a trilogy of stories, each about a woman facing an unwanted pregnancy. Each woman lives in a different era of modern American history, but the thread that binds them together is that each lived in the same house at the time of their pregnancy; hence, the title of the movie.

The first story takes place during the 1940's and stars Demi Moore as a single woman desperately trying to find a way to abort her unwanted pregnancy. Through a nurse colleague, she finally connects with an illegal abortionist who makes "home visits". As if she has not been punished enough by the shame and secrecy society forces upon her, and the lack of compassion shown by those around her, the abortionist treats her with callous, businesslike disrespect, before leaving her to endure a solitary death by hemorrhage on her kitchen floor several hours later.

The scene then moves to the mid-1970's, shortly after Roe vs. Wade, to a family headed by traditionally-minded housewife Sissy Spacek. With her teenagers mostly raised, she makes plans for a more self-fulfilling life, until you-know-what happens. Her feminist teenage daughter encourages her mother—no—pressures her, to take control of her life, exercise her new lawful right, and have an abortion. But in the end, Spacek's character is unable to overcome her own guilt and uncertainties about her perceived "selfishness" and her "obligations" to her unborn child, so she decides to have the baby, much to her daughter's disgust.

The third story brings us to the 1990's, with Cher as a compassionate abortion doctor who wears bullet-proof vests to the clinic. A pregnant teenage girl and her girlfriend argue and agonize over the abortion dilemma—unfortunately, they are portrayed in the movie as anti-choice, which was one of the most unconvincing parts of the movie. They seemed far too socially-conscious and intelligent (not to mention irreligious) to be likely anti-choice adherents. When the young woman at last earns the emotional support of her friend for her abortion decision, she has a very rude experience at the clinic—only moments after her procedure is completed, a young, wild-eyed man bursts into the room and shoots Doctor Cher dead. (Clinic security was lax to say the least, and unfortunately for Cher, she took off her bullet-proof vest once she arrived at work.)

Taken together, the trilogies were a bit too gruesome and deadly serious for my taste. Also, I expected it to be a movie about how different women at different times dealt with the experience of an abortion, so it felt rather anti-climatic when Spacek's character decided against having one. All in all, however, the movie was solidly pro-choice.

Citizen Ruth is truly a comedic tour de force, lampooning the absurdities that can occur when a misguided, fanatical minority has the power to carry out political, legal, and media shenanigans at the expense of a woman's right to control her own body (in other words, the reality in the United States, today). Laura Dern is brilliant as Ruth Stoops, a self-absorbed, ignorant, solvent-sniffing basket case, who finds herself in jail and pregnant again, for the fifth time (her other kids are wards of the state). Ruth is bailed out and taken in by a zealously upbeat, but uncomprehending fundamentalist Christian family, who plan to persuade Ruth to have her baby, and then use her to mount a political and media campaign to promote the anti-choice cause. They take her to a "clinic" with antiseptic white walls, where she is presented with the traumatizing arsenal of anti-choice propaganda, tricked into naming her baby, and ignored when she demands an abortion. One of the funniest lines in the movie is when she worries out loud on her way out, "I've slept in dumpsters. Maybe I slept on some dead babies!"

The worst of director Alexander Payne's ridicule is reserved for the "pro-life forces", headed nationally by "Baby Savers" President Burt Reynolds, who comes complete with a very fake wig and a penchant for massages by an adolescent boy. But Payne pokes fun at both sides. Forced by the anti's to go to hilarious lengths to defend a woman's right to abortion, Swoosie Kurtz plays a lesbian who has just spent several months as an anti-choice spy, befriending the right-wing family who took in Ruth. When the family can't deal with Ruth's continued drug use, Swoozie the spy "kindly" offers to take Ruth in. Later, when she dramatically reveals her true self in front of Ruth (by pulling off her clever right-wing disguise), she declares with conspiratorial fervour, "I'm with the Pro-Choice!" Ruth just stares, dazed and confused (she's never heard of any of these people before). And as the pro-choice forces soon find out, Ruth is no poster girl for them—she's incapable of making an informed, moral choice about her situation. When, on live TV, the anti-choice offer Ruth $15,000 to have her baby, Swoosie and her band react with stunned dismay, while Ruth goes joyfully ballistic at the prospect of sudden wealth. She only returns to her original "decision" to have an abortion when one of the pro-choicers privately matches the pro-life offer.

Ruth's concerns about her privacy and her "right to pick" are given short shrift by both sides—by the anti-choicers, who want to use Ruth as a media pawn, and the pro-choicers, who want to use Ruth to send a message about the importance of a woman's right to abortion. The pro-choicers are not without concern for Ruth, unlikable as she is, but in the heated abortion war that ensues, they become so pre-occupied trying to protect Ruth from the anti-choice and helping her to exercise her legal right to abortion, that they forget to stop and listen to what she really has to say. Shortly before her scheduled abortion, Ruth miscarries in Swoosie's bathroom, but she can't get Swoosie to sit still long enough to hear the truth. That's because Swoosie is too busy arranging the logistics of getting Ruth to the abortion clinic safely, where there's a huge pro-life rally going on (on Ruth's behalf). In the end, Ruth avoids dealing with the issue entirely and makes a hilarious and daring "escape" from the abortion clinic's bathroom window. Calmly and with growing confidence, she walks away, past clinic security, past the police, and past the hundreds of anti-choice protesters on the streets. Nobody even gives her a second look.

Population Report From United Nations

The United Nations Population Fund released their state of the world population report in May. The report states that millions of women are dying and in danger as a result of violations of their reproductive rights. The report also notes that modern contraception has revolutionized family life, and nearly 50% of couples can choose when and whether to have children. Still, more than 585,000 women die annually from pregnancy-related causes, nearly all of them in developing countries. Gaps and failures in health care, as well as women's inequality and the pressures of society and family, keep people from exercising their sexual and reproductive rights, the report says.

Unfortunately, the report downplays the need to make abortion services legal, safe, and accessible around the world. The report recognizes the dangers of "unsafe abortion" but does not urge that laws be relaxed or that cultural attitudes towards abortion be changed. Instead, it stresses the need to reduce the need for abortion through better contraceptive services and improved family planning services. The report approvingly quotes the International Conference on Population and Development, whose position on abortion begins with the negative statement "In no case should abortion be promoted as a method of family planning." They go on to say, "Any measures or changes related to abortion within the health system can only be determined at the national or local level according to the national legislative process. In circumstances in which abortion is not against the law, such abortion should be safe."

The full report, titled The Right to Choose: Reproductive Rights and Reproductive Health, is available on the Internet, at http://www.unfpa.org/swp97

Legal Abortion Benefits Society

According to a Planned Parenthood fact sheet, American society has experienced many positive health benefits since abortion was legalized in 1973. For example:

Since 1973, women have been obtaining abortions earlier in pregnancy when health risks to them are lowest.

A large majority of legal abortions obtained in the US since 1973 replace abortions that had been performed illegally (and often unsafely) before that time. Estimates of illegal abortions in the '50s and '60s range from 200,000 to 1.3 million, and many resulted in infection and other complications.

Deaths from abortion have declined dramatically during the past two decades. In 1965, at least 193 women died from illegal abortions, which accounted for almost 17% of all deaths due to pregnancy and childbirth in that year. The risk of death from abortion has fallen steadily, and is now miniscule.

Medically safe, legal abortion has had a profound impact on American women and their families. For example, one-third of all abortions in the US are on women for whom the health and social consequences of unintended childbearing are the greatest—teenagers and women over 35. Also, abortion is now one of the most commonly performed clinical procedures, is eleven times safer that carrying a pregnancy to term, and nearly twice as safe as a penicillin injection.

For more information, see the Planned Parenthood web page.

Psychological After-Effects of Abortion

The Real Story

by Joyce Arthur

(first published in The Humanist, March/April 1997, Vol. 57, No. 2, pp. 7-9)

Over the last decade, a consensus has been reached in the medical and scientific communities that most women who have abortions experience little or no psychological harm. Yet, a woman's ability to cope psychologically after an abortion continues to be the subject of heated debates. Vocal anti-choice advocates claim that most women who have abortions will suffer to some degree from a variant of post-traumatic-stress disorder called "post-abortion syndrome," characterized by severe and long-lasting guilt, depression, rage, and social and sexual dysfunction. Why is there such a major discrepancy between the scientific consensus and anti-choice beliefs?

Conflicting studies done over the last 30 years have contributed to this atmosphere of confusion and misinformation. A 1989 review article that evaluated the methodology of 76 studies on the psychological after-effects of abortion noted that both opponents and advocates of abortion could easily prove their case by picking and choosing from a wide range of contradictory evidence. For example, many studies, especially those done between 1950 and 1975, purport to have found significant negative psychological responses to abortion. Such studies, though, often suffer from serious methodological flaws. Some were done when abortion was still illegal or highly restricted, thereby biasing the conclusions in favor of considerable (and understandable) psychological distress. In some cases, research was based on women who were forced to prove a psychiatric disorder in order to obtain the abortion. Further, a large number of studies, both early and recent, consist simply of anecdotal reports of a few women who sought psychiatric help after their abortion. In short, many studies that favor anti-choice beliefs are flawed because of very small samples, unrepresentative samples, poor data analysis, lack of control groups, and unreliable or invalid research questions.

Researcher bias on the part of scientists and physicians has also been a serious problem. In earlier times, society's views on how women "should" feel after an abortion were heavily skewed toward the traditional model of women as nurturing mothers. In one study done in 1973, post-doctoral psychology students taking psychoanalytic training predicted psychological effects far more severe than those predicted by women themselves before undergoing an abortion. This might be because traditional Freudian theory teaches that a desire to avoid childbearing represents a woman's denial of her basic feminine nature.

Some psychiatric studies, along with much of today's anti-choice literature, tend to cast women who have abortions into one of two roles: victim or deviant (although these terms are not necessarily used). Victims are coerced into abortion by others around them, in spite of their confusion and ambivalence, and against their basic maternal instincts. Deviants have little difficulty with the abortion decision, which is made casually for convenience sake. Such women have no maternal instinct and are often characterized in a derogatory or pitying fashion as selfish, callous, unfeminine, emotionally stunted, and/or neurotic.

Books written by anti-choice advocates that deal with post-abortion effects are, by and large, heavily infected with bias. Not only is contrary evidence unrefuted, it is rarely even mentioned. Incorrect and out-of-date "facts" abound. The authors' pop psychology often seems to be based on little more than their own wishful projections about the nature of women and how they should feel. Here are two typical examples from essays in the anti-choice book The Psychological Aspects of Abortion (1979):

"It is interesting that women who need self-punishment do not abort themselves more often. . . . Abortion is done 'to' the woman, with her as only a passive participant. This is further indication of masochism." (Howard W. Fisher, Abortion—Pain or Pleasure?)

". . . sooner or later [after the abortion], the truth will make itself known and felt, and the bitter realization that she was not even unselfish enough to share her life with another human being will take its toll. If she had ever entertained a doubt as to whether her parents and others really considered her unlovable and worthless, she will now be certain that she was indeed never any good in their eyes or her own. A deep depression will be inevitable and her preoccupation with thoughts of suicide that much greater." (Conrad W. Baars, Psychic Causes and Consequences of the Abortion Mentality)

With the advent of safe, legal, routinely performed abortion, a wealth of good evidence has come to light that is quite contrary to common anti-choice assertions. The typical abortion patient is a normal, mentally stable woman who makes a strongly resolved decision for abortion within a few days after discovery of the pregnancy, and comes through the procedure virtually unscathed. Several scientific review articles—published from 1990 to 1992 in highly respected journals such as Science and American Journal of Psychiatry—support this conclusion. The reviews evaluated hundreds of studies done over the last thirty years, noting the unusually high number of seriously flawed studies, and pointing out common methodological problems. Based on the more reliable studies, all the reviews concluded that although psychological disturbances do occur after abortion, they are uncommon and generally mild and short-lived. In many cases, these disturbances are simply a continuation of negative feelings caused by the unwanted pregnancy itself. Serious or persistent problems are rare and are frequently related to the circumstances surrounding the abortion rather than the abortion itself.

Further, many women who were denied abortion showed ongoing, long-term resentment, and their resulting unwanted children were more likely to have increased emotional, psychological, and social problems in comparison with control groups of wanted children. These differences between children widened throughout adolescence and early adulthood. Finally, many studies show that giving birth is much more likely than abortion to be associated with severe emotional after-effects, such as post-partum depression.

The review articles largely concluded that the most frequently reported emotions felt by women immediately following an abortion (experienced by about 75% of women) are relief or happiness. Feelings of regret, anxiety, guilt, depression, and other negative emotions are reported by about 5% to 30% of women. These feelings are usually mild and fade rapidly, within a few weeks. Months or years after an abortion, the majority of women do not regret their decision. In fact, for many women, abortion appears to be a positive experience that improves their self-esteem, provides inner strength, and motivates them to refocus their lives in a meaningful way.

Studies on abortion are done primarily through self-report measures, however, and it is possible that some women may be reluctant to admit negative feelings after their abortion. To help quantify this, consider these figures: every year since 1977, 1.3 million to 1.6 million abortions are performed in the United States; about 21% of all American women between the ages of 15 and 44 have had an abortion. These are very large numbers indeed. The American Psychological Association has pointed out that, even if only 10% of the millions of women who have had abortions experienced problems, there would be a significant mental health epidemic, clearly evident by large numbers of dysfunctional women requesting help. There is no evidence of any such epidemic, thereby supporting the general reliability of self-report measures.

Some women who are disturbed by or unhappy with their abortion decision belong to support groups like Women Exploited by Abortion, and Victims of Choice. Several anti-choice studies and books purporting to demonstrate the overall harmfulness of abortion limit their sample to the membership of such groups. Not only does this introduce an immediate and fatal flaw to their argument, it shows deliberate obfuscation on the part of the authors. This does not mean that post-abortion support groups are valueless to women. The very existence of such groups points to the strong need for health professionals to identify and provide extra help to women who are most at risk for developing psychological problems related to abortion. Many studies have shown that women at greater risk tend to include:

• emotionally immature teenagers
• women with previous psychiatric problems
• women aborting a wanted pregnancy for medical or genetic reasons
• women who encounter opposition from their partner or parents for their abortion decision
• women who have strong philosophical or religious objections to abortion
• women undergoing second-trimester abortions
• women who are highly ambivalent or confused about their abortion decision, and had great difficulty making the decision
• women who are coerced by others into having an abortion

In spite of psychological problems suffered by a few women after abortion, the existence of "post-abortion syndrome" is doubted by most experts. There is little need to posit a unique disorder in this case, since abortion is not significantly different from any other stressful life experience that might cause trauma in certain people. Former Surgeon General C. Everett Koop, himself anti-choice, noted this in 1988. Unfortunately, facts, evidence, and common sense rarely get in the way of anti-choice advocates who are determined to prove that women suffer terribly from "post-abortion syndrome." Certainly, if this were true, it would be a lethal weapon in the fight to reverse Roe vs. Wade. This was, in fact, the motivation behind a 1989 Surgeon General's report on the health effects of abortion on women, which was called for by former President Ronald Reagan on behalf of anti-choice leaders. Although the report was duly prepared, the Surgeon General chose not to release it, apparently because it did not support the anti-choice position. Meanwhile, anti-choice literature continues to churn out the myth that women are severely harmed by abortion.

Because abortion is such a volatile issue, it is probably unrealistic to expect this aspect of the controversy to die down soon, if at all. However, by recognizing that a small subset of women may require increased counseling and support during their abortion decision and afterwards, the women's community and health professionals can do much to minimize the damage wrought by the anti-choice movement's dangerous and irresponsible campaign of misinformation.