Research published this week in the Canadian Medical Association Journal suggests that Canadians from Indian, Chinese, Vietnamese, Filipino and Korean backgrounds are deliberately aborting their daughters due to a preference for male children. 

Skewed sex ratios have also been found amongst Indian communities in the UK, as highlighted in a 2007 study by  S Dubuc and D Coleman.

The ProLife Alliance is shocked that women living in Canada and the UK, and no doubt other countries are still at the mercy of ancient customs which run completely counter to equality of opportunity, to the point where they are even expected to kill their own children. 

The Guttmacher Institute and the World Health Organisation (WHO) have published a study in the Lancet linking increasing global numbers of unsafe abortions to countries where abortion is illegal. As the Guttmacher Institute states that one of its five aims is to allow people to “exercise the right to choose safe, legal abortion”, these conclusions come as no surprise.
 
It should be observed that legalising abortion does not lead to safe outcomes for women.  There is no shortage of documented evidence to this effect.  In fact the opposite is true.  Countries such as Chile, Poland and Ireland have extremely low maternal mortality rates.  In Poland most abortions were banned in 1993.  Subsequently, both Poland’s abortion rate and the maternal mortality rate declined, and declined rapidly.  Ireland, according to the World Health Organisation 2005 maternal mortality report, has the lowest maternal mortality rate in the world.

In fact the Lancet report notes that India, where an estimated 6.5 million or 15% of global abortions occur, has liberal abortion laws, and yet an estimated two thirds of abortions there are deemed unsafe by WHO.  In Cambodia abortion is legal upon request in the first trimester, and yet over 50% of abortions are believed to be ‘unsafe’.

According to the report, the regions with the highest rate of abortion are Eastern Europe and Russia, where Communist regimes introduced liberal abortion laws decades ago.  South East Asia is the region with the second highest rate of abortion, and most of this is accounted for by Vietnam, which has very liberal abortion laws, and where there are financial penalties for parents having more than two children.  It should be noted that Marie Stopes International, a UK based organisation, is involved in abortions in Vietnam, Cambodia and India. 

Acknowledging the incidence of unsafe abortions in countries with legal abortion, the report states:
“A liberal abortion law alone does not ensure the safety of abortions”, and claims that other “necessary” steps include the dissemination of knowledge about the law to women and those who might abort them, the willingness of health professionals to carry out abortions, and other factors, including “government commitment to provide the resources needed to ensure access to abortion services, including in remote areas.”
 
The Guttmacher report correctly links poor maternal outcomes with poverty.  We would suggest that the money that they request for abortions would be better spent on initiatives which help women and their families out of poverty, and on providing better maternity care for women, of a kind known to make childbirth safer.
 
It should be added that many of the statistics that the report uses are estimates, as countries where abortion is illegal do not keep records unless complications cause admission to hospital.  Additionally, only 57 of the 84 countries which they deem to have “liberal abortion laws” collect statistics about the procedures done.  Consequently, the statistics given are affected by the assumptions of the researchers about how many women have abortions.  The reasons for having unintended pregnancies are therefore also likely to be guesswork.

Whatever the true number, the ProLife Alliance believes that every one of the abortions mentioned in this report is a tragedy. Women need real, effective aid which respects both their own lives and the lives of their babies. 

The ProLife Alliance is very concerned that easier, safer screening tests will make it all the more socially acceptable to abort disabled babies. It is also likely that healthy babies will be aborted, purely because of a perceived risk that they are affected by, or carriers of,  some sex-linked condition.  The ProLife Alliance believes that all people have a right to live, whether male or female, disabled or otherwise. 

It is also likely that unscrupulous doctors will use this test for social reasons, particularly in countries such as Korea where boys are the preferred sex.

We call for a more positive attitude towards people with disabilities, rather than the usual unrelenting ‘search and destroy’ approach to those still in the womb.

Women are not informed of the risks to their mental and physical health except in the blandest terms.  They are not made aware of the considerable body of research which demonstrates these risks.  They are not made aware of the development of their own baby.  They are not given details of support available to them should they choose to have their baby.

As the ProLife Alliance has repeatedly said, women need to know the reality of abortion BEFORE the event, rather than discovering to their horror what really happened afterwards when there is no chance of turning back the clock. 

In Texas pro-lifers have carried out a successful campaign to ensure that women have the right to know.  One aspect of their campaign is a demand that women should be given the chance to see what their baby looks like – which may include an ultrasound scan prior to the abortion.  A scan provides real, live and incontrovertible evidence and gives the ‘products of conception’ a chance to be seen for what it really is, a small and very vulnerable child.  Surely women have a right to this knowledge rather than making a decision blindly?  This particular ‘woman’s right’ has met with extreme resistance from the pro-choice lobby who have appealed repeatedly against it.  For details see link. 

In their decision the appeals court observed that it is ‘obvious’ that the ‘disclosures of a sonogram, the fetal heartbeat, and their medical descriptions are the epitome of truthful, non-misleading information.’ They added that denying the woman up-to-date information ‘is more of an abuse to her ability to decide than providing the information.’

The ProLife Alliance would strongly urge that women wanting abortions should not be deprived of information on risks, on their baby’s development and on help available to have the child.  This should not be made in any way a ‘box to tick’ – just another part of the abortion paperwork.  Instead, the ProLife Alliance wants to see this information given to any woman wanting an abortion by any doctor she consults, pro-life or otherwise, as a matter of good medical practice and basic humanity.  Women need at least a chance to change their minds before going through with a ‘procedure’ which ends a human life, and which many women bitterly regret. 

Rebecca Gomperts, founder of rogue abortion provider Women on Waves, is once again in the news for an initiative that puts women’s lives at risk. Her organisation is most notorious for providing abortions to women from countries where abortion is illegal in international waters, providing no aftercare. Following a court case in her native Netherlands, Women on Waves were legally obliged to cease this work in 2009. Ms Gomperts continues to provide abortions without follow-up care. She offers a web-based service for women from countries where abortion is not permitted, posting abortifacient drugs to them in blank envelopes.  

The latest incident saw her posting information on Facebook on how women can induce self-abortions at up to 9 weeks pregnancy using a pill, Cytotec, designed to treat stomach ulcers. Initially Facebook removed this information for being in violation of the site’s Statement of Rights and Responsibilities, however, following protests from pro-choice activists the information has been re-posted.

Gomperts’ recommendation puts women at grave risk. The active chemical in Cytotec is misoprostol, which is also administered by clinics to induce abortions. No large studies have established a protocol for the use of misoprostol alone for inducing abortions. Side effects can include profound diarrhoea leading to severe dehydration, sedation and tremors. Further, the efficacy when used for abortions can be as low as only working two thirds of the time, meaning that any surviving unborn children could face disability. Several reports in the literature associate the use of misoprostol during the first trimester of pregnancy with skull defects, cranial nerve palsies, facial malformations, and limb defects.

Facebook were right to initially remove this information. It is a great shame that Facebook has backtracked under pressure from pro-choice activists and is now sharing information that endangers women and makes Facebook complicit in the death and disabling of unborn children. 

Professor Coleman herself has issued a public response to the UK Report and we are happy to publish this in its entirety.

A Critique of the Systematic Review Of Induced Abortion and Mental Health Released by the Royal College of Psychiatrists

Priscilla K. Coleman, Ph.D.

December 13, 2011

The Royal College of Psychiatrist’s recently conducted review of scientific literature published from 1990 to the present on abortion and mental health is hauntingly similar to the American Psychological Association Task Force Report released in 2008. The report by the RCP is, however, far more complex and on the surface it may appear to be more rigorous than the APA report.  An enormous amount of time, energy, and expense has been funneled into a work product that was not undertaken in a scientifically responsible manner. In this critique, I provide evidence that should incite scientists and clinicians to reject the conclusions of the report and work together to provide an accurate and truly exhaustive review of the peer-reviewed research.

Unjustified Dismissal of Studies

The RCP review incorporates four types of studies: 1) reviews of the literature; 2) empirical studies addressing the prevalence of post-abortion mental health problems; 3) empirical studies identifying risk factors for post-abortion mental health problems; and 4) empirical studies comparing mental health outcomes between women who choose abortion and delivery. In each category, there are studies that are ignored and large numbers of studies that are entirely dismissed for vague and/or inappropriate reasons. With regard to the first type of study, only 3 reports are considered (APA Task Force Report, 2008; Charles et al., 2008; Coleman, 2011). The authors of the RCP report “missed” 19 reviews of the literature (listed at the end of this document), published between 1990 and 2011. Moreover, no criteria were identified for selection of particular reviews to discuss and to provide context for the current report. In relation to the third type of study, only 27 studies are included in the RCP report. At the end of this document, citations to 20 relevant and unmentioned articles published in highly respected peer-reviewed journals are provided. They are not listed in Appendix 7 of the RCP report, which contains all included and excluded studies.

Among the scores of studies identified and excluded across study types 2 through 4 above, the most common reasons are the nebulously defined “no usable data” and “less than 90 days follow-up.” The latter resulted in elimination of 35 peer-reviewed studies in each of the prevalence, risk factor, and comparison study types. The RCP authors state that “Because the review aimed to assess mental health problems and substance use and not transient reactions to a stressful event, negative reactions and assessments of mental state confined to less than 90 days following the abortion were excluded from the review.” This is highly problematic for various reasons. First, elimination of studies that only measured women’s mental health up to 90 days, does not effectively remove cases of transient reactions. Just because the authors of these dozens of studies did not follow the women long-term, it does not mean that the women were not still suffering quite significantly beyond the early assessment. Moreover, when investigating the mental health implications of an event, it is logical to measure outcomes soon after the event has occurred as opposed to waiting months or years to gather data. As more time elapses between the stressor and the outcome(s), healing may naturally occur, there may be events that moderate the effects, and more confounding variables may be introduced. Finally, focusing only on mental health events that occur later in time effectively misses the serious and more acute episodes that are effectively treated soon after exposure.

Ironically, many of the studies removed from the analyses due to the abbreviated length of follow-up, had incorporated controls for prior psychological history and other study strengths. As a result, the samples of studies included in each section of the RCP review were not representative of the best available evidence and many of the eliminated effects coincidentally revealed adverse post-abortion consequences. In the category wherein the authors sought to derive prevalence estimates, only 34 studies were retained, including 27 without controls for previous mental health. In contrast, in the Coleman review, 14 out of the 22 studies had controls for psychological history.

Factual Errors

Perhaps even more disturbing than the elimination of large segments of the literature, are the factual inaccuracies that are present in the RCP report. As the author of the Coleman (2011) review cited in the report, I was alarmed to see the content in “Section 1.4.4:  Summary of Key Findings from the APA, Charles, and Coleman Reviews.” The first 6 points are not reflective of the conclusions derived from the meta-analysis and the 7^th and final point in this section wrongly states, with reference to the meta-analysis that “previous mental health problems were not controlled for within the review.” In fact, as noted above, the meta-analysis incorporated more studies into the final analyses with controls for prior psychological problems than the current review. Moreover, the conclusions derived from the meta-analysis were based on more studies with controls for prior psychological history than the Charles and the APA reviews as well.

I do not have the time or interest in identifying all errors present, but a few others jumped out at me. First, several studies are eliminated from the RCP report, because the outcome(s) assessed are lifetime estimates of mental health problems, deemed inappropriate by the RCP team. Nevertheless, the Coleman et al. (2009) and the Mota et al. (2010) articles, which relied upon lifetime estimates, are included in the prevalence section of the report. Inclusion reflects an inaccurate read of the two studies. I also noticed my affiliation is stated as the Department of Psychiatry at Bowling Green State University. I wish we had a medical school, it would make retrieval of articles much less expensive, but unfortunately we do not.

Problematic “Quality Assessments”

This review is being pitched as methodologically superior to all previously conducted reviews, largely because of the criteria employed to critique individual studies and to rate the overall quality of evidence. However, the quality scales employed to rate each individual study are not well-validated and require a significant level of subjective interpretation, opening the results to considerable bias.  The main problems with the quality scale employed to rate the individual studies are as follows: 1) the categories used are missing key methodological features including initial consent to participate rates and retention of participants across the study period; 2) the relative importance assigned to  the included criteria is arbitrary, as opposed to being based on consensus in the scientific community; 3) the specific requirements for assigning a “+” or “-” within the various categories are not provided; 4) the authors fail to explain (as their predecessors, Charles et al. 2008 did) how combinations of pluses and minuses in the distinct categories add up to an overall rating ranging from “Very Poor” to “Very Good.” Incredulously, the Gilchrist et al. (1995) study received a rating of “Good”, when very few controls for confounding 3rd variables were employed, meaning the comparison groups may very well have differed systematically with regard to income, relationship quality including exposure to domestic violence, social support, and other potentially critical factors. Further Gilchrist et al. reported retaining only 34.4% of the termination group and only 43.4% of the group that did not request a termination at the end of the study. No standardized measures for mental health diagnoses were employed and evaluation of the psychological state of patients was reported by general practitioners, not psychiatrists. The GPs were volunteers and no attempt was made to control for selection bias. Despite these facts, the study received a mark of “+ thorough” for confounder control, a “+” for representativeness, and a “+” for validated tools. I can provide a similar rebuttal to many more of the individual study ratings provided by the RCP; and the reader should not trust these “quality” assessments.

Similarly, when it came to evaluating the quality of evidence associated with specific outcomes, such as anxiety, depression, suicide ideation, drug or alcohol abuse, psychiatric treatment, etc. with regard to the comparative studies, “Grade Working Group grades of evidence” were employed by the RCP. The anchors on this scale are vague and oftentimes only one reason is identified as the basis for a “Very Low” rating.  For example, in the category of “Any Psychiatric Treatment,” which actually only included the Munk-Olsen et al. study (p.104), the basis for the “Very Low” (very uncertain about the estimate) rating was not controlling for pregnancy intention. As if this isn’t problematic enough, when the study is again evaluated (see pages 198 and 199), it is rated as “Good” in the comparison category. There are loose, poorly conceived rationales and inconsistencies like this throughout the report and the problem lies in the application of an inadequate quality assessment protocol for individual studies and for the body of evidence.   

Faulty Conclusions

Each section in the RCP report includes conclusions that are based on a very small number of studies that are not properly rated for quality. The results should, therefore, not be trusted as a basis for professional training protocols or health care policy initiatives. To illustrate how incomplete and misleading the conclusions provided by the RCP are, I will use one example. I recently identified 119 studies published between 1972 and 2011 using the MEDLINE, PubMed, and PsycINFO data bases specifically related to risk-factors associated with post-abortion psychological health. Below is a list of the most common risk factors derived from the 119 peer-reviewed journal articles identified.

0.Timing during adolescence or younger age (18 studies confirm: 2 studies do not)

0.Religious, frequent church attendance, personal values conflict with abortion (18 studies confirm; 1 study does not)

0.Decision ambivalence or difficulty, doubt once decision was made, or high degree of decisional distress (29 studies confirm; 3  studies do not)

0.Desire for the pregnancy, psychological investment in the pregnancy, belief in the humanity of the fetus and/or attachment to fetus (21 studies confirm; 1 does not)

0.Negative feelings and attitudes related to the abortion (16 confirm; 1 does not)

0.Pressure or coercion to abort (10 studies confirm; 1 does not)

0.Conflicted, unsupportive relationship with father of child (24 confirm; 6 do not)

0.Conflicted, unsupportive relationships with others (28 confirm; 7 do not)

0.Character traits indicative of emotional immaturity, emotional instability, or difficulties coping including low self-esteem, low self-efficacy, problems describing feelings, being withdrawn, avoidant coping, blaming oneself for difficulties etc. (42 studies confirm; 1 study does not)

0.Pre-abortion mental health/psychiatric problems (35 studies confirm; 3 studies do not)

0.Indicators of poor quality abortion care (feeling misinformed/inadequate counseling, negative perceptions of staff, etc.) (10 studies confirm)

The RCP conclusions relative to studies addressing risk factors for post-abortion mental health problems make no mention of most of the variables described above. They simply state (based on 27 studies) that “The most reliable predictor of post-abortion mental health problems is having a history of mental health problems prior to abortion” and “A range of other factors produced more mixed results, although there is some suggestion that life events, pressure from a partner to have an abortion, and negative attitudes towards abortion in general and towards a woman’s personal experience of the abortion, may have a negative impact on mental health.” I am one academic, without a lab full of graduate students and with a heavy teaching load (not a Department of Psychiatry), yet I was able to find all these studies. Why wasn’t this high powered research team able to do a better job? Simply glancing at titles and abstracts to determine which studies merit further attention will not yield the information needed and resulted in a short-sighted view of the available evidence.  

Before I leave this section on poorly developed conclusions, I should note how curious it    was to read one of the conclusions under the risk factor section: “Women who show a negative emotional reaction immediately following an abortion are likely to have a poorer mental health outcome.” How can this “conclusion” be derived if studies that only examined women in the first 3 months following abortion were eliminated? Moreover, if this is true, why would these studies have been eliminated in the first place? Shouldn’t the researchers be most concerned with those most likely to be adversely impacted?

Appropriateness of Meta-Analysis

Counter to the claims of the authors of this report, a quantitative review or meta-analysis can be performed when there is heterogeneity present in the effects one wishes to summarize. The random effects model is specifically designed to address heterogeneity. In addition, separate meta-analyses, based on distinct comparison groups and outcomes can be performed. There is no excuse not to perform extensive meta-analyses from the vast literature that has accumulated.  Such an approach is much more reliable and the results derived yield more valid conclusions than a narrative review; data that can be translated more readily into practice.

A Call for Change

The bottom-line conclusion of the RCP review, based on only 4 studies, is that abortion is no riskier to women’s mental health than unintended pregnancy delivered. When this report was released a few days ago, several of my colleagues emailed “Here we go again…” Many of us are left wondering, how many of these purposefully driven “systematic reviews” have to be published with results splashed all over the world, before women’s psychological health will finally take precedence over political, economic, and ideological agendas?  This report constitutes no less than a crafty abuse of science and if the merits of this report are not seriously challenged, we will shamefully grow more distant from our ability to meet the needs of countless women. Until there is acknowledgement than scores of women suffer from their decision to undergo an abortion, we will remain in the dark ages relative to the development of treatment protocols, training of professionals, and our ability to compassionately assist women to achieve the understanding and closure they need to resume healthy lives. 

Narrative Reviews Not Addressed

0.Adler NE, David HP, Major BN, Roth SH, Russo NF, Wyatt GE. Science 1990 6; 248(4951):41-4. Psychological responses after abortion.

0.Adler NE, David HP, Major BN, Roth SH, Russo NF, Wyatt GE. Psychological factors in abortion. A review. Am Psychol. 1992;47(10):1194-204.

0.Adler NE, Ozer EJ, Tschann J. Abortion among adolescents. Am Psychol. 2003; 58(3):211-7.

0.Allanson S, Astbury JJ. Psychosom Obstet Gynaecol. 1995;16(3):123-36.The abortion decision: reasons and ambivalence.

0.Bhatia MS, Bohra N. The other side of abortion. Nurs J India. 1990; 81(2):66, 70.

0.Cameron S. Induced abortion and psychological sequelae. Best Practice & Research. Clinical Obstetrics & Gynaecology 2010; Vol. 24 (5), pp. 657-65.

0.Coleman PK, Reardon DC,  Strahan T, Cougle R. The psychology of abortion: A review and suggestions for future research. Psychology & Health 2005; 20(2), p237-271.

0.Dagg PK. The psychological sequelae of therapeutic abortion–denied and completed. Am J Psychiatry. 1991;148(5):578-85.

0.Harris AA. Supportive counseling before and after elective pregnancy termination.  Midwifery Women’s Health. 2004; 49(2):105-12.

0.Lie ML, Robson SC, May CR. Experiences of abortion: a narrative review of qualitative studies. BMC Health Serv Res. 2008; 8:150.

0.Lipp A. Termination of pregnancy: a review of psychological effects on women. Nursing Times 2009; 105 (1), pp. 26-9.

0.Major B, Appelbaum M, Beckman L, Dutton MA, Russo NF, West C. Abortion and mental health: Evaluating the evidence. Am Psychol. 2009; 64(9):863-90.

0.Major B, Cozzarelli C.  Psychosocial Predictors of Adjustment to Abortion. Journal of Social Issues 1992; 48 (3), p121-142.

0.Robinson GE, Stotland NL, Russo NF, Lang JA, Occhiogrosso M. Is there an "abortion trauma syndrome"? Critiquing the evidence. Harvard Review of Psychiatry 2009; 17 (4), pp. 268-90.

0.Rosenfeld JA. Emotional responses to therapeutic abortion. Am Fam Physician. 1992; 45(1):137-40.

0.Speckland A., Rue V. Complicated Mourning: Dynamics of Impacted Pre and Post-Abortion Grief," Pre and Perinatal Psychology Journal 1993; 8 (1):5-32.

0.Stotland NL.Clin Obstet Gynecol. Psychosocial aspects of induced abortion.1997 Sep;40(3):673-86.

0.Turell SC, Armsworth MW, Gaa JP. Emotional response to abortion: a critical review of the literature. Women Ther. 1990;9(4):49-68.

0.Zolese G, Blacker CV. The psychological complications of therapeutic abortion.

            Br J Psychiatry. 1992; 160:742-9.

Studies of Statistically Validated Risk Factors Not Addressed

0.Allanson S. Abortion decision and ambivalence: Insights via an abortion decision balance sheet. Clinical Psychologist 2007; 11 (2), p50-60.

0.Brown D, Elkins TE, Larson DB. Prolonged grieving after abortion: a descriptive study. J Clin Ethics 1993; 4(2):118-23.

0.Fielding SL, Schaff EA. Social context and the experience of a sample of U.S. women taking RU-486 (mifepristone) for early abortion. Qualitative Health Research 2004; 14 (5), pp. 612-27.

0.Hill RP, Patterson MJ, Maloy K. Women and abortion: a phenomenological analysis. Adv Consum Res. 1994; 21:13-4.

0.Kero A, Lalos A. Ambivalence–a logical response to legal abortion: a prospective study among women and men. J Psychosom Obstet Gynaecol. 2000; 21(2):81-91.

0.Linares LO, Leadbeater BJ, Jaffe L, Kato PM, Diaz A. Predictors of repeat pregnancy outcome among black and Puerto Rican adolescent mothers. J Dev Behav Pediatr. 1992;13(2):89-94.

0.Mufel N,  Speckhard AC, Sivuha S. Predictors of posttraumatic stress disorder following abortion in a former Soviet Union country. Journal of Prenatal & Perinatal Psychology & Health 2002; 17(1), pp. 41-61.

0.Osler M, David HP, Morgall JM. Multiple induced abortions: Danish experience. Patient Educ Couns. 1997; 31(1):83-9.

0.Østbye T, Wenghofer EF, Woodward CA, Gold G, Craighead J. Health services utilization after induced abortions in Ontario: a comparison between community clinics and hospitals. American Journal of Medical Quality 2001; 16 (3), pp. 99-106.

0.Prommanart N, Phatharayuttawat S, Boriboonhirunsarn D, Sunsaneevithayakul P. J Maternal grief after abortion and related factors. Med Assoc Thai. 2004;87(11):1275-80.

0.Remennick L, Segal R. Socio-cultural context and women's experiences of abortion: Israeli women and Russian immigrants compared. Culture, Health & Sexuality 2001; 3(1), p49-66.

0.Slade P, Heke S, Fletcher J, Stewart P. Termination of pregnancy: patients' perceptions of care. J Fam Plann Reprod Health Care. 2001;27(2):72-7.

0.Tamburrino MB, Franco KN, Campbell NB, Pentz JE, Evans CL, Jurs SG. Postabortion dysphoria and religion. South Med J. 1990;83(7):736-8.

0.Thomas T, Tori CD. Sequelae of abortion and relinquishment of child custody among women with major psychiatric disorders. Psychol Rep. 1999; 84(3 Pt 1):773-90.

0.Törnbom M, Ingelhammar E, Lilja H, Möller A, Svanberg Repeat abortion: a comparative study. B.J Psychosom Obstet Gynaecol. 1996; 17(4):208-14.

0.van Emmerik AA, Kamphuis JH, Emmelkamp PM. Clin Psychol Psychother. 2008; 15(6):378-85.

0.Vukelić J, Kapamadzija A, Kondić B. Investigation of risk factors for acute stress reaction following induced abortion. ed Pregl. 2010; 63(5-6):399-403.

0.Wiebe ER; Adams LC. Women's experience of viewing the products of conception after an abortion. Contraception 2009; 80 (6), pp. 575-7.

0.Wiebe ER, Trouton KJ, Fielding SL, Grant H, Henderson A. Anxieties and attitudes towards abortion in women presenting for medical and surgical abortions. J Obstet Gynaecol Can. 2004;26(10):881-5.

0.Wells N. Pain and distress during abortion Health Care Women Int. 1991; 12(3):293-302.

A spokesperson for the ProLife Alliance comments:

Once again the politics of abortion blinds those who should be rigorously objective in assessing epidemiological evidence.  This is a pick and mix report trying to minimize the psychological effects of termination of pregnancy in a way which does our so-called medical experts little credit.  

Robust evidence, such as that of Professor Priscilla Coleman, which conflicts with pro-abortion political ideology, is dismissed.  They conclude that there are no significant different mental health outcomes in the continuation of an unplanned pregnancy or termination.  They do, however, at least accept that women with prior mental health problems are at greater risk of problems after abortion, so the idea that abortion solves those initial psychiatric problems is not tenable.  

UK Abortion Statistics in recent years indicate that the vast majority (roughly 95%) are performed for the mental health of the mothers involved.  Given that there are nearly 200,000 terminations a year this represents a massive number of women undergoing abortion for mental health reasons.  How many of these patients – if any – had their mental health assessed properly?  

Psychiatric assessment is not even required under abortion law, just the consent of two medical doctors.  How could any report on induced abortion and mental health have any real value, certainly in the United Kingdom, when we have no idea what specific mental health problems the women were suffering from?

Margaret was employed by the NHS as a Mental Health worker. She had a private conversation with an NHS  colleague who worked as a receptionist organising Abortion appointments and gave her colleague a booklet called  "Forsaken". This contains testimonies from  5 women who have had Abortions about their experience of Abortion and how it affected them. She was later suspended and disciplined for “Gross Misconduct” for distributing “material which individuals may find offensive”.

Losing one’s job over a private, friendly exchange of ideas with a colleague is outrageous.  We encourage you to support Margaret Forrester and to attend the tribunal if you can. The address is Victory House, 3-34 Kingsway WC2 6EX. Click here for a map. 

This was revealed as Dr Trengia was discovered to have falsified paperwork and stated that she had had a miscarriage at 22 weeks. In fact, the woman had flown home from London, her baby having been killed by injection, to give birth back in Italy. Dr Trengia has now been sacked.

Lead obstetricians, including Peter Bowen-Simkins, have decried the incident as irresponsible and dangerous. A woman getting onto an aeroplane whilst still carrying her dead child risks spontaneous birth and haemorrhage, putting her life at risk. Bowen-Simkins commented to the Times:

 “It is extraordinary to kill the baby and then leave it to someone else in a different country to deliver the dead foetus. At best, it’s a bit of a gamble letting her get on a plane after foeticide.”

Department of Health figures show that there are 25 abortions a year after 24 weeks that are recorded as foeticide without surgical or medical removal of the dead foetus. These women could also be travelling home to deliver their aborted babies.

The ProLife Alliance comments:

"Only the super-efficient BPAS would consider it appropriate to send an sms to remind somebody about their abortion appointment. For them it is just another slot in the busy lives of their clients.  

"It is surely highly unlikely – no matter how offhand some women might be about terminating their pregnancies – that any woman could actually forget when she had an abortion scheduled.  This is no trip to the beauty parlour or even an appointment with the dentist.  Even for the most casual it is a very unpleasant experience.

"It is already common practice among abortion providers, however, to remind women when they book a termination that while they can always cancel, they need to give plenty of warning, otherwise they may use up an abortion slot that could have been available for somebody else.  The sms reminder may actually make women feel guilty if they have decided not to turn up, and in some circumstances sway them to go ahead when they already were having second thoughts."