If you have already read this post, please accept my most humble apologies. This started as a reblog of a reblog of a reblog of a reblog of this original post, the content of which had long been lost and buried in debate.
Anyway, I feel that the information contained here needs to be reproduced with a title and accessible under the tags. Again, I’m sorry if you are somehow opposed to me plagiarizing myself.
1) What’s interesting is that the Chilean study shows that making abortion illegal does not cause the maternal death rate to rise, showing that the idea that we need to legalize abortion or else people will get hurt even more from illegal abortion isn’t based in truth.
2) Interestingly enough, I wonder if we can judge whether pro-abortion really is pro-choice. After all, 64% of women who got an abortion felt like they were pressured to do so, according to one national study.
(These snippets came from two entirely different responses, so don’t think that they are supposed to run together)
First off, some background for my readers: the “Chilean study” referenced above refers to Koch E et al., Women’s education level, maternal health facilities, abortion legislation and maternal deaths: a natural experiment in Chile from 1957 to 2007, PLoS ONE, 2012, 7(5):1–16, which asserted that because the maternal* mortality rate did not increase when Chile placed new restrictions on abortion in 1989, there is no correlation between maternal* mortality and criminalization of abortion.
The first thing that I as a scientist always recommend when looking at a journal article is to look at the authors’ names and affiliations. This is important in all branches of science, because you may have an article written by someone notorious for fudging data, or you may have an article published by faculty at a university with a conflict of interest in that particular field of research.
In this case, it should be noted that the primary author is affiliated with the “Center of Embryonic Medicine and Maternal Health” at a Catholic university. While this does not necessarily mean the study is flawed, it should be kept in mind, as this is a study about abortion. If the article comes to radically different conclusions than every other study in this area, it does become prudent to suspect bias.
The other problems with this article are purely methodological in nature. The primary problem stems from the fact that Chile did not change its abortion laws from anything resembling Europe or the United States’- its laws were already restrictive and only allowed abortion in cases to preserve the health or life of the mother*. This means that the data obtained offers no evidence for decreased maternal mortality with liberal abortion laws.
The Guttmacher Institute has already issued a review of the methodology of Koch, et al., with their conclusion below:
For the reasons outlined above, the study by Koch et al. does not alter the existing body of evidence on the impact of abortion restrictions on maternal mortality. In particular, since Chile’s abortion laws were already highly restrictive in the pre-1989 era, the study does not show that significantly restricting a country’s abortion laws has no negative impact on women’s health.
A body of research, largely published in peer-reviewed journals, makes clear that the decline in maternal morbidity and mortality from unsafe abortion in Chile in the past decades coincides with greater access to and use of contraceptives, as well as the use of less dangerous clandestine abortion methods. Misoprostol, a drug that can be used to induce nonsurgical abortions, is legally and widely available in Chile; women’s groups have helped make misoprostol available to women seeking abortions, and abortion providers and women themselves have been using the drug to terminate pregnancies since the 1990s.
The use of misoprostol as an abortifacient is associated with a lower risk of severe health consequences than the use of illegal surgical procedures, and is considered an important explanatory factor in the decline in abortion-related deaths in the past two decades.
By helping to reduce unintended pregnancy, family planning programs also help to reduce recourse to unsafe abortion. Contraceptive use has increased substantially in Chile
Considering the methodological flaws of the Koch study, the potential bias of the primary investigators, and theoverwhelming body of evidence that lower maternal* mortality rates are directly linked to liberal abortion laws, I must conclude that this study is not a sufficient argument against legalizing abortion.
The second article mentioned above is a far sneakier attempt to pass off a biased source as legitimate. At first glance, it does appear to be a solid paper from a reputable journal, but it too fails the author test.
The primary author is Dr. Vincent Rue, director of the “Institute for Pregnancy Loss” in Jacksonville, FL, the primary mission of which appears to be anti-abortion in nature. (That’s strike one against any claims of impartiality). While Dr. Rue does have a legitimate Ph.D. from an accredited university, his Ph.D. is in “Human Development and Family Studies.” This is, in fact, a perfectly legitimate field, but the vast majority of Dr. Rue’s publications seem to be centered around “post abortion stress syndrome,” a syndrome that has been proven fictional time and time again. Dr. Rue is not a psychologist, psychiatrist, neurologist, or otherwise trained in a mental health field, and yet he continues to publish papers that go against the prevailing evidence compiled and analyzed by the American Psychological Association and the Academy of Medical Royal Colleges. I frankly do not believe him.
The other issue I take with Dr. Rue is that I cannot find his name on any works that are not related to abortion, and I cannot find anyone publishing his name other than anti-abortion groups. The man appears to be obsessed with abortion and attempting to stir up anti-abortion sentiments. While this is a perfectly fine hobby (many of us are dedicated activists), it is not normal or acceptable for an academic scientist. If you casually search for any other scientist whose career has lasted as long as Dr. Rue’s (more than three decades) in academic literature, you should find their name cropping up everywhere, even as a tertiary, quaternary, or lower author on barely tangentially related papers. As a Family Studies expert, I would expect to see Dr. Rue appear as a co-author on at least a few non-abortion Family Studies papers, but I don’t. He has spent three decades taking on only those “research projects” which further his agenda. The only conclusion I can take from this is that Dr. Rue has spent his career deliberately pursuing an anti-abortion agenda, and that his papers must be examined through that lens.
If you think I am being too hard on poor Dr. Rue, just wait until you see what I have next.
The fourth author on this paper, a man allegedly responsible for Statistical Analysis, Data Interpretation, Manuscript Preparation, and the Literature Search (the meat of the paper, honestly), is none other than anti-abortion celebrity and faux academic David Reardon.
I have written about our beloved engineer-turned-unaccredited-medical-researcher before:
[The link in the original post] is to an article published in 2000 in the Post-Abortion Review “journal.” This journal is published by the Elliot Institute, an anti-choice organization with three whole employees and spearheaded by David Reardon. Reardon has impressive qualifications for someone claiming to be an expert in women’s health issues- he has an accredited degree in electrical engineering and a “Ph.D.” in biomedical ethics from Pacific Western University (an unaccredited, correspondence-only college) in lieu of an accredited M.D. or Ph.D. in the life/health sciences.
Given that Reardon both wrote the article in question and is the founder/owner/operator of both the journal in which it was published and its parent organization, most (qualified) members of the scientific community would say he has a conflict of interest. Also given that Reardon runs the Elliot Institute/The Post Abortion Review with only two other people and gives no reference to who allegedly reviewed this article, I find it unlikely that the article received any sort of review before publication. And if it did, there are few former-engineers with fake Ph.D.s writing papers about medicine, so it would be difficult to find a worthy peer for peer review.
The Elliot Institute claims to be an organization dedicated to research, but Reardon uses his fake degree and his Institute to lobby for anti-choice legislation. Scholarly research requires that proper protocols for remaining unbiased be followed, and any research undertaken with a fore-drawn conclusion is not scientifically sound.Reardon has come under fire repeatedly by actual experts in the fields of reproductive health and psychiatry for publishing his own methodologically flawed studies, and then citing himself in the attempt to look legitimate. His entire operation is a ruse, and he is fooling no one in the scientific community.
Now, Dr. Rue is an actual academic, if horrifically biased. He holds a degree from and a position at an accredited university. He knows protocol well enough to pass his papers through peer review. (Although the Medical Science Monitor does allow authors to pick their own reviewers, and it is unclear if Dr. Rue did that for this paper). Dr. Rue may have just picked David Reardon’s brain and used him for the busywork on this article. Maybe Dr. Rue didn’t know that Reardon is a renowned joke.
But he listed Reardon’s fake organization, The Eliot Institute, on the paper, and cited several of Reardon’s papers in this article.
In the scientific community, it is highly taboo to even give the time of day to someone who claims to be an expert but has not earned a degree to make them worthy of that title. By including Reardon in his research, giving credence to Reardon’s fake research organization, and then citing Reardon’s other “works,” Dr. Rue has destroyed the last few shreds of credibility he had.
Oh, and as for the actual content of the paper:
1) The study drew its conclusions from 217 American women.* That’s some pretty small number statistics when you think about how many women* have abortions.
2) The study participants were self-selecting, and no information is given on how they were offered participation. The researchers could have easily targeted or made their study sound appealing to women* who already felt vulnerable or pressured.
3) Women* who had experienced multiple abortions were told to disregard all but their “most stressful” abortion when answering questions.
4) According to this article, the questionnaire that the women* answered was written by the Institute for Pregnancy Loss (the anti-choice organization that Dr. Rue operates). Let’s see some evidence that that
questionnaire wasn’t biased, leading, or fishing for certain answers.
5) A casual glance at the literature cited section reveals numerous papers regarding mental health outcomes after abortion that have been found methodologically flawed by the APA.
6)Their data analysis was done by a man with a false degree in biomedical ethics.
So, I am also forced to conclude that this study also offers no valuable contribution to the abortion discussion. Maybe next time.
Picking apart studies is one of my very favorite things to do. tehsunshine has given a lot of helpful tips on what to look for. If you want to read more about analyzing studies for the next time an anti-choicer comes up with one (a rare occurrence, I know), I wrote a post on the subject, summarized some of the APA’s analysis of studies on the link between mental health and abortion (which was mentioned in #5), and have a list of resources I look to when finding studies.
Go forth and smack down.