David Fergusson reacts to the APA Mental Health and Abortion task force report

I asked New Zealand researcher, David Fergusson, about the APA Mental Health and Abortion task force report out today. He was one of 20 reviewers who commented extensively on the draft report. I specifically asked him what he thought of this statement from Task Force chair, Brenda Major in a Reuter’s report:

“The best scientific evidence published indicates that among adult women who have an unplanned pregnancy, the relative risk of mental health problems is no greater if they have a single elective first-trimester abortion or deliver that pregnancy,”

In addition, he commented on the report as a whole:

By the admission of the report, studies in this area (including my own) have significant flaws relating to sampling, measurement and confounding. What this means is that “the best scientific evidence” to which they refer, is really not all that good. Given that this is true then it would be inappropriate to draw strong conclusions on the basis of such limited evidence. The APA report, in fact, does draw a very strong and dogmatic conclusion that cannot be defended on the basis of evidence since this evidence is lacking by the admission of the report. As I stated to the APA committee in my review [of an earlier draft], the only scientfically defensible position to take is that the evidence in the area is inconsistent and contested. Under these conditions the only scientifically defensible conclusion is to recognise the uncertainty in the evidence and propose better research and greater investments in this area. What the Committee has, in effect, said is that until there is compelling evidence to the contrary, people should act as though abortion has no harmful effects. This is not a defensible position in a situation in which there is evidence pointing in the direction of harmful effects. In this respect, the response of the APA committee to this situation appears to follow the type of logic used by the Tobacco industry to defend cigarettes: since, in our opinion, there is no conclusive evidence of harm then the product may be treated as safe. A better logic is that used by the critics of the industry: since there is suggestive evidence of harmful effects it behooves us to err on the side of caution and commission more and better research before drawing strong conclusions. History showed which side had the better arguments.

What I also think the APA committee has failed to recognise is the size of the research investment needed to pin these issues down thoroughly. The tobacco example is a clear one: there have been literally tens of thousands of studies in this area (I have in fact published over 10 papers on tobacco related topics). This amount of research is needed in an area in which there are strongly divided opinions and deeply rooted agendas. The moral of all of this is very simple: In science drawing strong conclusions on the basis of weak evidence is bad practice. The APA report on abortion and mental health falls into this error.

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  • ken

    Can anyone tell me what the “very strong and dogmatic conclusion” the APA had reached in its report?

  • http://myspace.com/bruceclyne Bruce Clyne

    It is felt by some that there is not enough research on the subject to determin that there is little or no effect on women from a single abortion. To ignore the testimony of even a few women who have had an abortion and are suffering daily from the after effects of that abortion degrades those women and assigns them to a default catagory of women who had a problem prior to the abortion. Not having evidence to support this is irresponsible. These same women now need assistance and that abortion is part of their story and has to be considered in any treatment modality. Can we say then that all alcoholics had no previous problems prior to being introduced to alcohol? Then let us treat them and disallow any knoledge of treatment methods that are proven post behavior.

    Please, please let us not disreguard proven treatment modalities for other problems because the subject is “hot” at the time. Professionalism and not politically and personaly bias have no room here.

  • Pat Goltz

    It is self-evident to anybody with common sense that abortion would cause significant emotional harm in women. Women have already bonded subconsciously with their babies in several ways. They instinctively know that they are carrying their own child. Abortion is a deep and violent invasion of a woman’s body, and in the majority of cases, it’s coerced. It is also usually based on at least some fraud concerning warning a woman about the dangers.

    I personally suffered severe emotional consequences from ALMOST having an abortion. I can only imagine what happens to women who actually have one. I have talked to women who were suicidal after abortion. Sadly, I don’t think I was able to dissuade some of them. I never heard from them again.

    We shouldn’t be subjecting millions of women to the plight of being used as guinea pigs without their informed consent, simply because some politically powerful people have agendas that are not in the best interests of women. This is the sort of thing that should NOT be done without strong evidence it is BENEFICIAL. We women deserve better.

  • Ann

    Pat Goltz,

    Thank you – I appreciate everything you said in your comment.

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