The Gross Inaccuracies of Focus on the Family’s Abortion Complications Page, Part II: Psychological Abortion Complications

How data is being misrepresented to mislead and manipulate pro-life voters

As I outlined in Part I of this post:

Focus on the Family has so manipulated the study results they report to uphold their biased views on abortion that they have entirely overstepped ethical and moral boundaries, which is completely antithetical to both their stated mission — “To be led by the Holy Spirit in sharing the Gospel of Jesus Christ with as many people as possible by nurturing and affirming the God-ordained institution of the family and proclaiming biblical truths worldwide” — and to the Christian faith as a whole.

If the truth does, indeed, support their views, why are they manipulating and lying to people in order to sway their opinion and garner their donations?

I’ve decided to provide a point by point rebuttal of the the gross inaccuracies presented on their abortion complications page because I believe in academic honesty and that people should form their opinions based on truthful and factually accurate information.

If you consider yourself pro-life because of your personal beliefs, fine. If you’re anti-abortion because you’ve been manipulated by biased and unreliable information, I think you should consider the points I’m outlining here. If, after that, you still maintain your previously held views, that is your prerogative — but either way, your personal religious views should not dictate public policy.

How to read this analysis: the bold titles correspond to paragraph titles on the Focus on the Family site. The italicized passages to the right of the vertical bar are direct quotes. I have linked the same studies they’ve cited, along with point by point explanations of the actual study contents and commentary on Focus on the Family’s use of the data. Because of the comprehensive nature of this analysis and the sheer amount of information it requires, I will split this into two parts — Part I covers the physical complications cited by Focus on the Family, while Part II covers the psychological ones.

Psychological Abortion Complications

A 2011 Finland study reveals the negative psychological effects of abortion show “considerable neglect,” revealing at least one-third of respondents experience symptoms such as depression, fear of infertility, abnormal eating behaviors, decreased self-esteem, nightmares, guilt and regret.

Study Cited: Psychological Consequences of Abortion among the Post Abortion Care Seeking Women in Tehran

• This study has no relevance to a “2011 Finland study”.
• Many studies and meta-analyses available on the psychological effects of abortion do not show similar results.
• An American Psychological Association Task Force on Mental Health and Abortion found the following:
  
  — The best scientific evidence indicates that the relative risk of mental health problems among adult women who have an unplanned pregnancy is no greater if they have an elective first-trimester abortion than if they deliver that pregnancy (Gilchrist et al., 1995).
  
  — The evidence regarding the relative mental health risks associated with multiple abortions is more equivocal. One source of inconsistencies in the literature may be methodological, such as differences in sample size or age ranges among samples. Positive associations observed between multiple abortions and poorer mental health (e.g., Harlow et al., 2004) also may be due to co-occurring risks that predispose a woman to both unwanted pregnancies and mental health problems.
  
  — Terminating a wanted pregnancy late in pregnancy due to fetal abnormality appears to be associated with negative psychological experiences equivalent to those experienced by women who miscarry a wanted pregnancy or experience a stillbirth or the death of a newborn.
  
  — The prevalence of mental health problems observed among women in the United States who had a single, legal, first- trimester abortion for nontherapeutic reasons appeared to be consistent with normative rates of comparable mental health problems in the general population of women in the United States.
• “Adolescents who have an abortion do not appear to be at elevated risk for depression or low self-esteem in the short term or up to five years after the abortion.” [Citation]

In regards to the cited study:

• Tehran, of course, is the capital of Iran. Despite Iran’s status as a theocracy based on sharia law, abortion is allowed in limited circumstances prior to 16 weeks. While abortion technically remains illegal (haram) in Iran, a legal opinion (fatwa) was issued in 2005 allowing for exceptions in cases where the mother’s life is at risk and when the fetus has an abnormality that is not compatible with life or that will cause difficulties for the mother to care for it after birth.
• Interestingly, one study on abortion in Iran found that “The negative effect of modern contraceptive use on the abortion rate is 31 percent greater than the negative effect of religiosity, and we highlight the implications of these findings for policies on reproductive health and family planning.”
• The study cited by Focus on the Family, though, had a sample size of 278, which is relatively small.
• You also have to consider that the social climate of Iran is incredibly different than that in the U.S. In this study, for instance:
  
  — A gap of age was observed between the respondents and their husbands
  
  — The majority of the respondents were married and living with their husbands (98.1%)
  
  — More than 70% of the respondents were housewives
  
  — 50% of the abortions belonged to those respondents who married at their 20s’ or those under 20 years of age
  
  — Close to one-forth of the study population (24.5%) aborted their children at home, which “could be an alarming indication of unsafe abortion with frequent undesirable consequences”
  
  — 45.2% said their reason for the abortion was “spontaneous”, 22.2% were due to fetal health, 16.4% for mother’s health, and 7.3% for sex preference
• The study authors said that “The distribution of consultants for abortion and post abortion care indicate that abortion seems to be still a hidden phenomenon practiced out of family and the family of origin supervision.”

Analysis:
This is another instance of a study taking place in a culture with very different societal views on abortion and women’s roles. The incredibly restrictive nature of sharia law and the resulting pressures on women who find themselves seeking abortions would reasonably lead to psychological issues in that population. However, studies in the U.S. and European countries do not find similarly high levels of psychological consequences for abortion.

In one of the longest-running post-abortive studies, researchers found that negative emotions increased and decision satisfaction declined over the course of 5 years.

Study Cited: Psychological Responses of Women After First-Trimester Abortion

• I actually cited this study as evidence against the type of information contained in the Focus on the Family site ironically enough, so I was already familiar with its contents and results.
• It is a longitudinal study of 882 women who sought first trimester abortions that participated in 4 assessments — 1 hour before the abortion, and 1 hour, 1 month, and 2 years after the abortion. At the two-year mark, 442 study subjects remained.
• The results were as follows: “Two years post-abortion, 301 (72%) of 418 women were satisfied with their decision; 306 (69%) of 441 said they would have the abortion again; 315 (72%) of 440 reported more benefit than harm from their abortion; and 308 (80%) of 386 were not depressed. Six (1%) of 442 reported posttraumatic stress disorder. Depression decreased and self-esteem increased from pre-abortion to post-abortion, but negative emotions increased and decision satisfaction decreased over time.”
• The study concluded that “Most women do not experience psychological problems or regret their abortion 2 years post-abortion, but some do. Those who do tend to be women with a prior history of depression.”

Analysis:
This study period ended at the two-year post-abortion mark, and therefore did not continue for five years as Focus on the Family suggests. While their assertion that “negative emotions increased and decision satisfaction declined” over time, it is clear that the majority of women do not regret their decision to have an abortion even years later.

Evidence also presents doubled risk for suicide and significantly higher HADS anxiety scores compared to those who had a miscarriage.

Studies Cited:
Decreased suicide rate after induced abortion, after the Current Care Guidelines in Finland 1987–2012

The course of mental health after miscarriage and induced abortion: a longitudinal, five-year follow-up study

• The Finland study does show a two-fold increased risk for suicide following an abortion.
• However, the full text of the study cannot be accessed to verify the confounding factors that may have influenced the results and to determine the statistical significance of this increase.
• Another study, which was done over a five year period in the U.S. to look at the risk of suicidal ideation of women who have abortions versus those who are denied abortion services, found that “levels of suicidal ideation were similarly low between women who had abortions and women who were denied abortions. Policies requiring that women be warned that they are at increased risk of becoming suicidal if they choose abortion are not evidence based.”
• The study authors also cite the Finland study in their review, saying that “these studies suffer from some serious methodological shortcomings that limit the validity of their results.”
• They go on to say, “The Finnish study did not control for the factors that are known to lead to the need for abortion, such as history of mental health conditions, violence, and abuse, and to increase a person’s risk of experiencing suicidal ideation or behaviors. When studies fail to account for these preexisting risk factors, they may misattribute any adverse mental health outcomes to the abortion rather than to those factors. An additional methodological problem is that many studies use inappropriate comparison groups by comparing women who have abortions to women who have never had an abortion or who choose to give birth.”
• “These comparisons,” they say, “are problematic because differences in financial or socioemotional resources may explain the decision to carry to term and therefore confound the effect of abortion on mental health. Studies that control for these confounding factors have found that abortion is not associated with an increased risk of suicidal ideation or behaviors.”
• A U.K. study examined deliberate self-harm by comparing women who gave birth with women who received abortions and women who were denied abortions. While women seeking abortion were at higher risk of deliberate self-harm than those who did not seek abortion, rates were highest among women denied an abortion (70% higher than those who had an abortion), although the researchers did not test whether the differences between women who had and women who were denied an abortion were statistically significant.
• They also found that “women with no history of psychosis faced a lower risk of psychosis after abortion than women with an unplanned pregnancy but who did not seek abortion” (the risk of the latter was 2.4 times higher than the former).

The purpose of the second study Focus on the Family cites was “to determine whether there are differences in the patterns of normalization of mental health scores after these two pregnancy termination events.” This study was done in Norway and had a total sample size of 120 women (40 who had miscarriages and 80 who had abortions).

• Their results were as follows:
  
  — Women who had experienced a miscarriage had more mental distress at 10 days and six months after the pregnancy termination than women who had undergone an abortion.
  
  — However, women who had had a miscarriage exhibited significantly quicker improvement on IES (Impact of Event Scale) scores for avoidance, grief, loss, guilt and anger throughout the observation period.
  
  — Women who experienced induced abortion had significantly greater IES scores for avoidance and for the feelings of guilt, shame and relief than the miscarriage group at two and five years after the pregnancy termination.
  
  — Compared with the general population, women who had undergone induced abortion had significantly higher HADS (Hospital Anxiety and
  Depression Scale) anxiety scores at all four interviews, while women who had had a miscarriage had significantly higher anxiety scores only at 10 days afterwards.
• In their abstract, the authors conclude, “Women who had undergone an abortion exhibited higher scores during the follow-up period for some outcomes. The difference in the courses of responses may partly result from the different characteristics of the two pregnancy termination events.”
• In the results of their study, they say, “There were statistically significant differences between the two pregnancy termination groups regarding their marital status, number of children and vocational activity. Therefore, these variables are possible confounders. As the outcomes of the study were related to mental outcomes, we also considered former psychiatric health (which was close to being significantly different between the two groups) to be a possible confounder.”
• They also acknowledge that “When scores for the mental health outcomes of the two groups were compared with those of controls for possible confounders (marital status, number of children, vocational activity and former psychiatric health), differences in IES avoidance at 10 days and six months were no longer statistically significant.”
• Their conclusion was as follows: “The responses of women in the miscarriage group were similar to those expected after a traumatic and sad life event. However, the women in the induced abortion group had more atypical responses. This may be because the mental health of the aborting women was somewhat poorer than that of the miscarrying women before the pregnancy termination event. The more complex nature of the induced abortion event may also account for differences in the course of psychological responses between the two groups.”

Substance abuse is a common factor as well; women who end their pregnancy are 5 times more likely to experience substance abuse relative to those carrying to term. In addition, when comparing women who lost a baby through miscarriage, ectopic pregnancy or stillbirth, post-abortive women are 4 times more likely to report substance abuse.

Study Cited: Abortion and subsequent substance abuse

• Both of the authors of this study are documented anti-abortion activists, meaning that they have significant conflicts of interest that are antithetical to academic honesty. In the interest of providing a full analysis of this particular piece of pseudoscientific “literature”, I feel like it’s pertinent to expound upon the backgrounds of its authors.

They have published an array of similar studies with other anti-abortion activists and have been met with criticisms from their professional colleagues, which include the American Psychological Association, American Medical Association, Royal College of Psychiatrists, and the Royal College of Obstetricians and Gynaecologists.

David Reardon

In his own words, David Reardon is “a frequent guest on Christian radio and Christian television talk shows and has been a frequently invited speaker state and national conventions for crisis pregnancy centers and pro-life organizations.”

He addressed the National Pro-Life Religious Council in 1998, where he discussed emotional reactions to abortion in the context of the disputed entity of “post-abortion syndrome”.

Reardon has a background in electrical engineering. He went on to receive a “Ph.D in biomedical ethics from Pacific Western University, which was an unaccredited correspondence school with no in-person learning requirements that was closed in 2006 following a lawsuit filed by the State of Hawaii.

Author Chris Mooney wrote an interesting and relevant piece in Washington Monthly in 2004 on the emergence of pseudoscience as “evidence” to support positions (often with political motivations) that legitimate science did not confirm.

• He points to the example of Joel Brind, who was unsatisfied with a massive study of 1.5 million women in Denmark that found no evidence to corroborate the so-called ‘ABC link’ — the notion that abortion raises the risk of breast cancer, which previous studies had found varying results on and the ones that confirmed the link were rife with methodological flaws.
• Brind continued to insist that the link existed —
  “Though he does not appear to have published any original research on the question, Brind–who did not return calls for this article–became a prolific writer of letters to academic journals and of articles in pro-life newsletters. In 1999, he even co-founded a think tank, the innocuously named Breast Cancer Prevention Institute, to promote his theory.
  
  “Even as mainstream scientists were discarding the earlier pro-ABC studies, Brind’s PR initiative started to drive policy. Pushed by pro-lifers, several states–including Texas, Kansas, and Minnesota–now require health-care providers to inform women about breast cancer risks before performing an abortion. In Washington, conservative politicians also embraced Brind’s ‘science.’
  
  “His biggest coup came in 2002 when, following a letter from Rep. Chris Smith (R-N.J.) and other pro-life members of Congress, the National Cancer Institute altered an online fact sheet that had discounted abortion breast cancer risks, updating it to suggest that studies were inconclusive.”
• “Brind’s story,” Mooney says, “provides a case study in how religious conservatives have shifted gears in their battles over science and policy. Instead of simply lecturing about the moral evils of abortion, they’ve increasingly depicted the procedure as damaging to women’s health.
  And on a range of other issues, Christian conservatives have similarly adopted the veneer of scientific and technical expertise instead of merely asserting their heartfelt beliefs.
  
  “Their claims–that abortion causes mental problems in women, that condoms aren’t very effective in preventing HIV and other sexually transmitted diseases, that adult stem cells have more research promise than embryonic ones, and so on–now frequently comprise the right’s chief arguments on these issues.”

David Reardon, Mooney explains, utilized the same strategy in his effort to “prove that abortion causes mental illness, chemical dependency, and a range of other poor health outcomes in women,” despite the fact that those claims have been “rejected by, among others, a group of experts convened by the American Psychological Association and Ronald Reagan’s surgeon general, C. Everett Koop.”

• He founded the Elliot Institute for Social Sciences Research, a quasi-academic think tank, in 1988.
• Over the years, Reardon has managed to publish a number of abortion-related papers in scientific journals. But at best, he has been able to show correlations between abortion and, say, depression or alcoholism–not causation.
• While he has acknowledged that “proving causation is always very difficult,” he has also patently ignored “well-designed studies that control for variables Reardon fails to take into account” that show “legal abortion is not found to be associated with degradation in mental health.” As Mooney puts it, “Reardon doesn’t just read the data differently; he appears to see what he wants to see.”
• When the obvious shortcomings and errors in his “studies” are called into question, Reardon has resorted to arguing that theological opinions are equally as valid as scientific data in showing that abortion harms women.
• In his published argument to that effect, Reardon makes his intentions and motivations known:
  “For the purpose of passing restrictive laws to protect women from unwanted and/or dangerous abortions, it does not matter if people have a pro-life view. The ambivalent majority of people who are willing to tolerate abortion in ‘some cases’ are very likely to support informed consent legislation and abortion clinic regulations, for example, because these proposals are consistent with their desire to protect women.
  
  “In some cases, it is not even necessary to convince people of abortion’s dangers. It is sufficient to simply raise enough doubts about abortion that they will refuse to actively oppose the proposed anti-abortion initiative. In other words, if we can convince many of those who do not see abortion to be a ‘serious moral evil’ that they should support anti-abortion policies that protect women and reduce abortion rates, that is a sufficiently good end to justify NRS efforts.
  
  “Converting these people to a pro-life view, where they respect life rather than simply fear abortion, is a second step. The latter is another good goal, but it is not necessary to the accomplishment of other good goals, such as the passage of laws that protect women from dangerous abortions and thereby dramatically reduce abortion rates.”
• In a 2007 New York Times article, Slate editor Emily Bazelon discussed these pseudoscientists’ strategy of stressing the “harmful psychological effects” found in their own studies (and almost solely there) as a way of driving support for outlawing abortion.
  
  Reardon, she says, knows “the anti-abortion movement will never win over a majority by asserting the sanctity of fetal life”, and therefore should “focus on disseminating information that abortion is psychologically harmful to women as a more effective strategy.”
  
  She continues: “For anti-abortion activists, this strategy offers distinct advantages. It challenges the connection between access to abortion and women’s rights — if women are suffering because of their abortions, then how could making the procedure readily available leave women better off?
  
  “It replaces mute pictures of dead fetuses with the voices of women who narrate their stories in raw detail and who claim they can move legislators to tears. And it trades condemnation for pity and forgiveness.
  
  “Pro-lifers who say, ‘I don’t understand how anyone could have an abortion,’ are blind to how hurtful this statement can be,” Reardon writes on his Web site. “A more humble pro-life attitude would be to say, ‘Who am I to throw stones at others?’
  
  “When researchers attack his findings, Reardon writes to the journals’ letters pages. “Even if pro-abortionists got five paragraphs explaining that abortion is safe and we got only one line saying it’s dangerous, the seed of doubt is planted,” he wrote in his book.”

Phillip Ney

Phillip Ney, who has run for office several times in Canada, was charged with animal cruelty in 2017 and has been interviewed by Priests for Life, which the Catholic Church has distinguished itself from and which Charity Navigator has awarded one star out of four for financial accountability and transparency after several instances of financial impropriety.

• Their director, Frank Pavone, has repeatedly embroiled himself in controversy (like deluging Amarillo, Texas, with graphic photos of aborted fetuses on the sides of trucks and sky letter banners) that has resulted in official corrective measures and was suspended for a time by the Bishop whose authority he was under.
• He also made a highly controversial move just prior to the 2016 elections, when he “ placed what he claimed was an aborted fetus on a Catholic church altar, in an effort by the outspoken pro-life priest to illustrate the stark contrasts he saw among the two main presidential candidates when it comes to the issue of abortion.”
• Notably, he serves as a member of Dr. James Dobson’s Focus on the Family Institute.

This background is relevant because it illustrates the types of organizations and people who are citing Ney’s work as truth.

In his interview with Priests for Life, Ney makes a variety of wild claims:

• That abortions lead to mothers having difficulties bonding with future children, who he says are more likely to be abused and neglected.
• That these children “know” that one of their siblings was aborted, and therefore suffer from “post-abortion survivor syndrome.”
• And the following bizarre statement:
  “They have in common many of the conflicts that were found in those people who survived the Holocaust. For instance they have survivor guilt. They feel it is not right for them to be alive. And they wonder why they should be selected when their little siblings were selected to die … which is precisely what happened to the people from the Holocaust.
  
  “Why were they selected to live and some of their friends, relatives, and family were selected to die? And it leaves this deep sense of guilt. And that is a difficult, difficult thing to treat, because it is so deeply embedded. And of course with that is how can you trust your parents? Are they capable of killing you too? They killed one of your little siblings. And then it comes down to one of the deepest fears of all children, which is my parents might kill and eat me.
  
  “And of course you see that in children’s stories like Hansel and Gretel, the wicked witch is going to put them in the oven. In various cultures, in various parts of the world all have deeply embedded this very deep fear that children have that their parents might kill and eat them. And of course abortion comes very close to that.
  
  “And so it creates an enormous distrust of your parents. And if you can’t trust your parents then it is likely that you are not going to trust parent-like figures: teachers and everybody… priests. How can you people like that who take life, innocent life, or don’t protect it as much as they should?”

Analysis:
It should be abundantly clear that the results of this “study” should not be given any consideration given the absolute academic dishonesty and unethical pseudoscience involved in its publication.

Not only do 30 percent of women worry abortion impacts fertility, but family-associated joy may be harder to find.

Article Cited: The Abortion Myth Many Women Still Believe

• Citing an article on women’s belief in the myth that future fertility is negatively affected by abortion (and why that myth is wrong) is probably the most inadvertently honest part of Focus on the Family’s entire webpage.
• Women’s Health expert Jennifer Wider, M.D., counters that myth, emphasizing that “having an abortion will not impact your future fertility. If performed in a safe, clean setting with a qualified health care provider, there is no scientific evidence supporting the claim that a medical or surgical abortion will cause infertility.”

This study found a higher frequency of child-directed aggression.

Study Cited: Induced Abortion and Child-Directed Aggression Among Mothers of Maltreated Children

• This study was done by Priscilla Coleman, who belongs to the group of pseudoscience “experts” profiled at length above.
• Her peer-critics have outlined the following judgments of her work:
  — Researchers were unable to reproduce her results on abortion and mental health despite using the same dataset, and have described her findings as “logically inconsistent” and potentially “substantially inflated” by faulty methodology — for example, they found higher rates of depression in the last month than other studies found during respondents’ entire lifetimes
  
  — She did not distinguish between correlation and cause, so the direction of causality could be reversed (rather than abortion leading to psychiatric problems, psychiatric problems could lead to abortion).
  
  — She and her fellow authors operate with strong political views regarding abortion, and unfortunately their biases appear to have resulted in serious methodological flaws in the analyses. They are involved in building a literature to be used in efforts to restrict access to abortion.

Analysis:
All of the information and criticisms outlined in the previous commentary apply here as well.

The impact on families doesn’t end there; studies indicate that having an abortion and/or any occurrence of unnatural family planning increases the likelihood of divorce up to two-fold.

Study Cited: The influence of contraception, abortion, and natural family planning on divorce rates as found in the 2006–2010 National Survey of Family Growth

• According to his faculty page at Marquette University’s College of Nursing, Richard Fehring is “one of the prime developers of the Marquette Method of natural family planning.”
• He also belongs to the Catholic Medical Association and the University Faculty for Life.
• Both of these factors constitute conflicts of interest that could influence the design, methods, results, and interpretations of his study.
• Furthermore, many of the “studies” he cites within this one are similarly problematic for the same reasons. He also often cites his own studies in addition to an opinion by Pope Paul VI that “the use of artificial methods of contraception would result in the dissolution of the marital bond due to the separation of fertility and sexuality, i.e., the procreative and intimate bonding characteristic of marital conjugal relationship.”

Analysis:
Once again, it should go without saying that these kinds of information sources are problematic for obvious reasons.

When I set out in equal parts whim and curiosity to complete this review, I did so with as objective a view as possible and the expectation that I would likely be proven wrong on a point or two by the data provided by Focus on the Family.

While there were a couple of minimally-accurate points on their webpage, I was shocked and incredibly frustrated to see the level of misrepresentation and outright dishonesty that Focus on the Family is willing to go to in order to manipulate pro-life activists and voters into supporting and contributing to their cause, both socially and monetarily.

The accuracy of the information we base our views on is vital, as is the awareness of any bias it might suffer from. Something I’ve found in my experiences of debating with conservatives is that they often accuse the “mainstream media” of having a liberal bias, but instead of seeking out center-oriented sources of news and information, they fully embrace conservative and far-right media — which objectively suffers from a great deal of both bias and factual inaccuracy.

When discussing source reliability and bias, I always refer people to Ad Fontes Media’s Media Bias Chart. Ad Fontes Media is a “public benefit corporation with a mission to make news consumers smarter and news media better.”

Click this link for the interactive, searchable version.

FAQs about their methodology can be found here, and an in-depth explanation here, but in essence is this:

“Each individual article and episode is rated by at least three human analysts with balanced right, left, and center self-reported political viewpoints. That is, at least one person who has rated the article self-identifies as being right-leaning, one as center, and one as left-leaning. Articles and episodes are rated in three-person live panels conducted in shifts over Zoom.

“Analysts first read each article and rate them on their own, then immediately compare scores. If there are discrepancies in the scores, they discuss and adjust scores if necessary. The three analysts’ ratings are averaged to produce the overall article rating. Sometimes articles are rated by larger panels of analysts for various reasons–for example, if there are outlier scores, the article may be rated by more than three analysts.”

In closing, I would implore everyone, regardless of their personal religious or political views, to be skeptics, mindful of the possibility for bias and inaccuracy in the sources of information they rely on.

The last year has proven the deadly nature of misinformation more immediately than previous years, but it always presents a threat to both our individual and collective wellbeing.

Whether it’s in the form of pitting conservatives against specific scapegoats (undocumented immigrants, Muslims, and the poor, to name a few) or of providing them with false information to fuel their confirmation bias and cognitive dissonance, misinformation contributes negatively to social discourse and our democratic process — the direct results of which we saw on January 6th.

We’re in an information crisis, and the only way out is through purposeful rejection of false data and sources and a meaningful search for the contrary. We all have the right to our own beliefs, but we cannot “agree to disagree” on facts.