Abortion, Mental Health and Science serving politics: addition

From the Ms. wire service:

A new review published in the journal Contraception by Johns Hopkins researchers found no link between abortion and psychological trauma or long-term effects on mental health. The review also found that “studies with the most flawed methodology consistently found negative mental health consequences of abortion [and that] scientists are still conducting research to answer politically motivated questions,” according to US News and World Report.

Scientists motivated by politics apparently strongly believe in “seek and ye shall find.”

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Here’s the abstract:

Abortion and long-term mental health outcomes: a systematic review of the evidence

Vignetta E. Charlesa , Chelsea B. Polisa, Srinivas K. Sridharab, Robert W. BlumaAbstract 

Claims that women who have elective abortions will experience psychological distress have fueled much of the recent debate on abortion. It has been argued that the emotional sequelae of abortionmay not occur until months or years after the event. Despite unclear evidence on such a phenomenon, adverse mental health outcomes of abortionhave been used as a rationale for policy-making. We systematically searched for articles focused on the potential association between abortion and long-term mental health outcomes published between January 1, 1989 and August 1, 2008 and reviewed 21 studies that met the inclusion criteria. We rated the study quality based on methodological factors necessary to appropriately explore the research question. Studies were rated as Excellent (no studies), Very Good (4 studies), Fair (8 studies), Poor (8 studies), or Very Poor (1 study). A clear trend emerges from this systematic review: the highest quality studies had findings that were mostly neutral, suggesting few, if any, differences between women who had abortions and their respective comparison groups in terms of mental health sequelae. Conversely, studies with the most flawed methodology found negative mental health sequelae of abortion.

14 thoughts on “Abortion, Mental Health and Science serving politics: addition

  1. That seems very strange. I would have guessed that guilt and remorse would be fairly common. Aren’t these sorts of emotions are are themselves traumatic by nature, and when compounded with the crisis of disrupting a natural flood of hormone instability? It would be very surprising if there were no difference when compared to the total population.

    How could you have PPD and not have some identified consequences for violent premature termination of a pregnancy? Doesn’t really make sense. I’m suspicious…

  2. thanks for the comment. What I noticed is that the studies that claim there is a link are methodologically suspect. That’s pretty serious for philosophers, among others. But the interpretation of the more positive result is a bit tricky.

    The article reviewed all studies published in the English language on the topic for the last 19 years and found those which were methodologically sound did not establish a link.

    We’re talking long term mental health, so temporary hormonal problems may not be relevant. Also, there’s a comparative element: women who had an abortion were no worse off than those who hadn’t. That allows that women who did not have an abortion still had factors in their lives which had negative effects. Perhaps having and rearing a child you really don’t want would have long term mental health effects – one would think it does. Perhaps being in a culture where you are not seen as capable of deciding about whether or not to continue a pregnancy has a long term effect – here again, one would think it does. There can be tons of downsides to giving birth.

    More generally, the results are consistent with the possibility that most women who get pregnant will suffer mental health consequences, and having an abortion just doesn’t make them worse.

  3. PS, brianbeattie, I hope other readers here will take a look at your blog! The ideas would delight a grandchild, I would guess.

  4. I have to disagree — at least with the implicit view that politically-motivated research is automatically `tainted’, or otherwise epistemically suspect based on that fact alone.

    First, on standpoint theory grounds. Whether you’re talking about Marxism, critical race theory, or post-Marxist feminist, standpoint theorists all claim that all knowledge is socially situated. On this view, all research is politically motivated, but not all research is epistemically suspect.

    Second, on pragmatist grounds. For a Deweyan pragmatist, scientific enquiry is motivated by the problems and projects we have in the realm of ordinary, everyday `common sense’. Since these include problems of injustice and our political and ethical projects, then scientific enquiry (and that’s all scientific enquiry) is politically motivated (although this motivation is less direct for the pragmatist than it is for the standpoint theorist).

    The problem, as Elizabeth Anderson (`Uses of value judgments in science’, Hypaia 2004) has pointed out, is not the involvement of ethical and political value judgements in scientific enquiry. The problem is dogmatism, holding our beliefs despite the evidence against them — or, in this case, sacrificing the methodological quality of one’s research in order to make it (appear to) support a foregone conclusion. And that’s orthogonal to one’s research being motivated by one’s political values, or even actively incorporating one’s political values into one’s research.

  5. Noumena, I think that from fact that research is and generally has to be responsive to political forces (otherwise no funding) it doesn’t really follow that the scientists were politically motivated in drawing the conclusions they draw, still less that the methodology was cooked to get to those conclusions. So I’m not sure we’re in disagreement really. Perhaps I was relying too much on the context to qualify what I was saying.

    I haven’t read the Anderson, but I’m not sure I agree. There’s also the responsiveness to political forces in a more general sense, which might include assumptions about which gender is more active, the passivity of nature, the view that mental illness is a disease, the solution to PTSD, the use of fMRI on small children, and so on. This sort of thing bothers me a lot, by the way, since I work with people whose research choices are often influenced by some of these more zeitgeiss things – e.g., very expensive technologies can have the burden of proof on their side, it can seem. (The latter issue is of current debate in my research group.) I don’t think that’s dogmatism.

  6. I agree that active male/passive female assumptions are problematic. But they’re problematic on the basis of ethical-political values. And my recommendation here is Helen Longino, `Gender, politics, and the theoretical virtues’, Synthese 104:3 (1995).

    Oh, and the Anderson paper I mentioned in my last comment was in Hypatia. Sorry for the typo.

  7. Were those studies including spontaneous abortions as well? I think this could make a difference either way, as they are obviously not chosen and are still pretty much taboo at least in my country. The secrecy and disappointment — including of relatives — can lead to misplaced blame and guilt, and that could be hard to control for in a study.

  8. There seem to be (at least) two different ways this kind of research can be politically motivated. One is in a “meta” sense — that the question asked in itself promotes a certain position, and that this is implicit not explicit in the research. The other is where the researcher’s question is simply a political question, but the asking of it does not necessarily incorporate the adoption of a certain worldview. The studying of alleged links between abortion and mental health problems seems to have meta problems in that it chooses a path that says “the rights and wrongs of abortion” are primarily psychiatric or scientific, rather than moral, ethical, legal. (From Margaret Oates, Ian Jones and Roch Cantwell commentary on Fergusson et al study, The British Journal of Psychiatry (2008) 193, 452–454.)
    A second point: as those same commenters point out,
    among the problems with studies of abortion and mental health is the impossibility of ethically being able to “conduct randomised controlled trials” that include women denied abortion, i.e. who are forced to bear and raise children they did not want. So if we can prove doing X causes harm to women, but know it is impossible to prove that being prevented from doing X causes even more (or less) harm, where does that leave the studies on links between doing X and harm?

  9. jj said: “the results are consistent with the possibility that most women who get pregnant will suffer mental health consequences, and having an abortion just doesn’t make them worse.”

    That is too fantastic to be believed, unless by “mental health consequences” you would include positive consequences such as learning, outwardly expanded caring, etc. Pregnancy and the birthing experinece are profound and affecting.

    Abortion is not a morally neutral act. If you consider the more than 90% of abortions in the Unites States that are 100% elective, for the mother’s (or father’s) convenience only, and compare that to group to the women who elect to carry their babies to term and do so successfully, there *must* be a difference between how that feels, and how the conclusion of the pregnancy will manifest in continuing mental state. How in the world could they even be comparable, let alone equal within tolerances? It makes no sense.

    If you add in the remarkably small percentage of woman whose abortion was preceded by abuse or crime, or whose real life was really actually in jeopardy, you would think that the mental anguish and wounding of those situations would throw the curve way over to the side of long-term mental health injury.

    I’m anything but a skilled philosopher, and will defer to your expertise – I’m just sayin’ the conclusion doesn’t pass the smell test for me.

    [Oh, and thanks so much for your kind words about my blog – I write fiction that amuses me, and grandchildren are most welcome provided their parents are on hand to explain it… ;-) ]

  10. Brianbeattie, we don’t really do deferring here, though it is refreshing to have someone being willing to do so.

    The questions you are raising are really very large and complex and this is not my day for big issues. One thing that does occur to me is the fact that recently a number of people have argued that human beings are far more resilient than we realize. Most of us can get over a very great deal. Some one who has argued this at length is Dan Gilbert, a noted psychologist at Harvard, who has a recent best seller on the topic. It is more a practical book than a technical one.

    Let me say that I think you write wonderfully well, and clearly you have a very developed, vivid imagination. I wonder if you’ve ever thought of writing books for children. It might be a lot of fun. I hear that finding agents to help sell one’s work is hard, but it might be worth the effort. If you know anyone who could do illustrating, you could put together something very appealing, I would think.

    If you are puzzled about how to begin, you might try writers groups in the community or on the web. If you are near a university, you might look at taking a creative writing course.

    Of course, it’s presumptuous of me to suppose you want or need the advice, so take it with a grain of salt!

  11. If we defer to anyone on the empirical question of what kind of mental health effects abortion and pregnancy have, shouldn’t we defer to the psychologists and sociologists who actually do that empirical research?

  12. Acai, in this blog we do ask that people present evidence for claim like that, particularly since the opposite appears to have a lot going for it.

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