Cause and Effect and Convergance...

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Re: Cause and Effect and Convergance...

Postby kuwano » Thu Feb 25, 2016 6:54 am

Keep The Reason wrote:
Abortion and Mental Health
Evaluating the Evidence
Brenda Major University of California, Santa Barbara
Mark Appelbaum University of California, San Diego
Linda Beckman Alliant International University, Los Angeles
Mary Ann Dutton Georgetown University Medical Center
Nancy Felipe Russo Arizona State University
Carolyn West University of Washington, Tacoma

The authors evaluated empirical research addressing the relationship between induced abortion and women’s mental health. Two issues were addressed: (a) the relative risks associated with abortion compared with the risks associated with its alternatives and (b) sources of variability in women’s responses following abortion. This article reflects and updates the report of the American Psychological Association Task Force on Mental Health and Abortion (2008). Major methodological problems pervaded most of the research reviewed. The most rigorous studies indicated that within the United States, the relative risk of mental health problems among adult women who have a single, legal, first-trimester abortion of an unwanted pregnancy is
no greater than the risk among women who deliver an unwanted pregnancy.

Evidence did not support the claim that observed associations between abortion and mental health problems are caused by abortion per se as opposed to other preexisting and co-occurring risk factors. Most adult women who terminate a pregnancy do not experience mental health problems. Some women do, however. It is important that women’s varied experiences of abortion be recognized, validated, and understood.


I highlighted the section in red because the study does point out that women who are most likely to get abortions (the poor, minorities, etc.) also show a marked increase in such risks ANYWAY, simply by being poor and a minority. You're about as likely to become a drug user or an alcoholic or depressed by being poor and/or in a minor ethnicity, whether or not you have an abortion.

Also, a key element to the article points out that what is MORE likely to cause such depressions is the cultural environment one finds oneself in. In the USA in California, a woman who has had an abortion is not looked at with harsh judgement or despised. In Mississippi, can we say the same? I doubt it. I would think women who get abortions in these backwards states are pariahs and are treated as such. So -- let's be sure you know the underlying causes here. And abortion that is pretty much indistinguishable from a natural miscarriage is not likely to traumatize someone, whereas community condemnation, poverty, and stunted opportunities due to race we know for a FACT offers such outcomes.
So keep that in mind.


Hi KTR I thought I'd comment on this as I know the APA review pretty well and the academic literature on abortion and mental health. The APA review is one of 4 systematic reviews (there was one by Charles et al published in Contraception, a report published by the Academy of Royal Colleges, and a further one by Coleman published in the British Journal of Psychiatry) that have sought to look comprehensively at the literature. I'm a little out of date now so I may have missed some more recent ones.

Coleman's meta-analysis (which combines data across studies statistically) suggests there is a statistically significant difference across most outcomes - but her methods were fairly weak and so the findings can't really be trusted. She clearly takes a pro-life stance, but its also clear that Brenda Major takes a pro-choice stance as do the authors of the Academy of Royal Colleges, I'm unsure about Charles and co-authors - so I think biases go both ways which often happens when the data is weak.

I'm of the view that the data can't really tells us one way or the other. With some justification the APA's main conclusions are driven largely by the study by Gilchrist et al which specifically looks at women with unwanted pregnancies - very few studies have such data so its an important study. But on the other hand it was conducted in the 1970s and the analytical methods we use now weren't actually developed then so there are some limitations to it.

What we tend to find in most studies in the area is that there are generally in the direction of increased risk of mental health problems, with some reaching statistical significance and others not. The only report to really look at the quality of data in a validated and transparent way was the Academy of Royal Colleges and found that for all outcomes the evidence was of low or very low quality. So my view is that there are strong opinions both ways but actually the data is not good enough to really make a judgement.
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Re: Cause and Effect and Convergance...

Postby Simplyme » Thu Feb 25, 2016 8:14 am

This is a fruitless path down which to go. Overall, there's no statistical significant deleterious effects. "What might be" is really just a time wasting exercise in futile speculation when we already know the outcomes from research.


Speculation is all they got.

Speculation - the forming of a theory or conjecture without firm evidence.


It comes with there territory.
I find it rather amusing, when thought of as ignorant or stupid(though I can be on many subjects). Especially by those who believe in a deity up in heaven watching our every move, and rewarding or punishing us after we have expired.
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Re: Cause and Effect and Convergance...

Postby Keep The Reason » Thu Feb 25, 2016 10:30 am

kuwano wrote:Hi KTR I thought I'd comment on this as I know the APA review pretty well and the academic literature on abortion and mental health. The APA review is one of 4 systematic reviews (there was one by Charles et al published in Contraception, a report published by the Academy of Royal Colleges, and a further one by Coleman published in the British Journal of Psychiatry) that have sought to look comprehensively at the literature. I'm a little out of date now so I may have missed some more recent ones.

Coleman's meta-analysis (which combines data across studies statistically) suggests there is a statistically significant difference across most outcomes - but her methods were fairly weak and so the findings can't really be trusted. She clearly takes a pro-life stance, but its also clear that Brenda Major takes a pro-choice stance as do the authors of the Academy of Royal Colleges, I'm unsure about Charles and co-authors - so I think biases go both ways which often happens when the data is weak.

I'm of the view that the data can't really tells us one way or the other. With some justification the APA's main conclusions are driven largely by the study by Gilchrist et al which specifically looks at women with unwanted pregnancies - very few studies have such data so its an important study. But on the other hand it was conducted in the 1970s and the analytical methods we use now weren't actually developed then so there are some limitations to it.

What we tend to find in most studies in the area is that there are generally in the direction of increased risk of mental health problems, with some reaching statistical significance and others not. The only report to really look at the quality of data in a validated and transparent way was the Academy of Royal Colleges and found that for all outcomes the evidence was of low or very low quality. So my view is that there are strong opinions both ways but actually the data is not good enough to really make a judgement.


Then we are left with asking the actual women. And we have to carve out the other mitigating factors.

For instance, let's say a women is raised in a gang-banger environment. Her statistical chances of being a drug user, depressed, alcoholic, etc. goes up on those factors alone whether or not she has any abortions. But her statistical chance of being pregnant out of wedlock goes up. The common denominator here is the environment in which she is raised which is far more an indicator of her life's path than any other factor.

As you can tell by Stacie's random sampling, of 5 women who live in an environment different than that which leads to a proclivity of such consequences, seem to be doing fine. they aren't drug users, alcoholics, or particularly depressed.

Even "depression" is misaligned here. Depression is a clinical illness with specific causes. You can be depressed and never have an abortion living in poverty etc. It's like the flu. You can "catch it" regardless of your class, environment or status.

Finally, at best we can conclude it's all neutral anyway. Therefore, if we can't tell one way or the other, we cannot use it to block a woman's right to her own reproductive destiny. That is the primary right here. A woman has the right to decide if she wishes to be a mother. That's the only right we can protect and everything else is superfluous to that point.
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Re: Cause and Effect and Convergance...

Postby kuwano » Thu Feb 25, 2016 11:01 am

Keep The Reason wrote:Then we are left with asking the actual women. And we have to carve out the other mitigating factors.

For instance, let's say a women is raised in a gang-banger environment. Her statistical chances of being a drug user, depressed, alcoholic, etc. goes up on those factors alone whether or not she has any abortions. But her statistical chance of being pregnant out of wedlock goes up. The common denominator here is the environment in which she is raised which is far more an indicator of her life's path than any other factor.


That's the problem the studies that have been conducted have tried to do that although mostly unsuccessfully. But its actually not that easy to do in practice - partly because there isn't much decent funding for the research. If we had the resources we could compare a cohort of women with unplanned/unwanted pregnancies and adjust for these factors in statistical models but actually doing this with minimal funding means most of the studies in the area just don't answer the question we want to answer. That's why the findings from Gilchrist et al, who conducted their study before I was born, are still largely relied on.

As you can tell by Stacie's random sampling, of 5 women who live in an environment different than that which leads to a proclivity of such consequences, seem to be doing fine. they aren't drug users, alcoholics, or particularly depressed.

Even "depression" is misaligned here. Depression is a clinical illness with specific causes. You can be depressed and never have an abortion living in poverty etc. It's like the flu. You can "catch it" regardless of your class, environment or status.

Finally, at best we can conclude it's all neutral anyway. Therefore, if we can't tell one way or the other, we cannot use it to block a woman's right to her own reproductive destiny. That is the primary right here. A woman has the right to decide if she wishes to be a mother. That's the only right we can protect and everything else is superfluous to that point.


I don't think we can conclude its neutral - as we just don't know given the poor quality of research. Induced abortion might not increase mental health or maybe it does - I don't think we know.

But I agree its two different issues whether induced abortion is ethical and whether it is increases risk of mental health problems (although if we had better data that maybe would be able to inform the issue). In the UK (I think New Zealand too who have a similar law) its a little more complex as the main reason for a doctor to approve an abortion here is that there is psychological or physical risk to the pregnant woman. But in practice, its unheard of that a doctor would not approve of an abortion if the woman had expressed that choice.
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Re: Cause and Effect and Convergance...

Postby Stacie Cook » Thu Feb 25, 2016 6:01 pm

Keep The Reason wrote:
Stacie Cook wrote:I never said every woman will be led to depression and drugs. I said it is a possibility and a likelihood for at least some percentage of women. Maybe not a 'significant' percentage, but it's still percentage enough.
As humans we are all so different. When a situation arises, we deal with the situation in different ways. Among women who have had abortions, there is going to be a myriad of reactions and how each deals with it. The reactions will range from being depressed, suicidal, a burden on society, etc to women who have dealt with it on a manageable level and are able to have normal lives. Again, the point is that no matter where she falls on the pendulum, I think there is a likelihood she will always thoughts about the experience. It may or may not show on the outside. It may or may not have ill effects on society. You can get on with life and yet still be impacted by a significant event that happened. I think it is minimizing to think otherwise. That's all I am saying.


It's a possibility that it will also lead them to Jesus. Or chocolate ice cream. Or to ball room dancing. Or to ski-less water skiing.

This is a fruitless path down which to go. Overall, there's no statistical significant deleterious effects. "What might be" is really just a time wasting exercise in futile speculation when we already know the outcomes from research.


I don't see it as time-wasting. I see it as information to be used in counseling/helping women who are debating on whether to have an abortion or not. Helping them to see possibilities of their life ahead no matter what decision they made.

And just to point out, of the women I mentioned, one is not doing fine. She *is* depressed. Struggling with why she made the decision.
Another one had to use a surrogate to have more children. That is a pretty significant effect in my mind.
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Re: Cause and Effect and Convergance...

Postby Keep The Reason » Thu Feb 25, 2016 8:18 pm

Here's the world you want to open up:

Link

Arrested for Having a Miscarriage? 7 Appalling Instances Where Pregnant Women Were Criminalized

Anti-abortion laws hurt all women, including those who are against abortion.

By Janet Allon / AlterNet

November 12, 2014

It does not really matter whether a woman is pro- or anti-abortion. In states like Tennessee, with its freshly passed anti-abortion amendment, you can be arrested for having a miscarriage.

An alarming number of women are being arrested, prosecuted and jailed just for losing their pregnancies. In addition to anti-abortion measures, you can thank the advance of “personhood” fights for embryos, fetuses and even fertilized eggs for that.

In a recent op-ed for the New York Times, Lynn M. Paltrow and Jeanne Flavin of the National Advocates for Pregnant Women offer up some of the most egregious cases of the criminalization of pregnant women. "Since 2005, we have identified an additional 380 cases, with more arrests occurring every week,” they write. “This significant increase coincides with what the Guttmacher Institute describes as a 'seismic shift' in the number of states with laws hostile to abortion rights.”

Here are their six most horrifying examples, with lots more to come.

1. A critically ill, 27-year-old Washington D.C. woman was 26 weeks pregnant when a judge ordered her to have a Cesarean section. He did so with the understanding that the procedure would very likely kill her. It did. The baby died as well.

2. A pregnant woman in Iowa fell down a flight of stairs and went to the hospital. The hospital reported her to the police who arrested her for “attempted fetal homicide.”

3. A Utah woman gave birth to twins, one of which was stillborn. Her doctors blamed the death on her decision to delay a C-section. She was arrested for fetal homicide.

4. A Louisiana woman checked in to a hospital due to vaginal bleeding. She was locked up for a year on charges of “second-degree murder before medical records revealed she had suffered a miscarriage at 11 to 15 weeks of pregnancy.”

5. A Florida woman “was held prisoner at a hospital to prevent her from going home while she appeared to be experiencing a miscarriage. She was forced to undergo a Cesarean.” She still lost the baby, and her two small children at home were left without her while she was held. A state court ruled that this detention was wrong, although it would have been fine if she was further along in her pregnancy.

6. Another Florida woman who went into labor at home was picked up by a sheriff, driven to the hospital and forced to have a Cesarean against her will. She filed suit, and the court concluded that the woman’s personal constitutional rights “clearly did not outweigh the interests of the State of Florida in preserving the life of the unborn child.”

7. A severely depressed, pregnant 22-year-old woman in South Carolina tried to commit suicide. She was jailed for child abuse.

This does not count all the women who have been arrested for drinking alcohol or using illegal drugs
.

And

Link

In a piece at RH Reality Check, the paper's authors detail some of the examples they found in their search of legal and public records, as well as media accounts. Here are just a few of them they include: 

A Louisiana woman was charged with murder and spent approximately a year in jail before her counsel was able to show that what was deemed a murder of a fetus or newborn was actually a miscarriage that resulted from medication given to her by a health care provider.In Texas, a pregnant woman who sometimes smoked marijuana to ease nausea and boost her appetite gave birth to healthy twins. She was arrested for delivery of a controlled substance to a minor.A doctor in Wisconsin had concerns about a woman's plans to have her birth attended by a midwife. As a result, a civil court order of protective custody for the woman's fetus was obtained. The order authorized the sheriff’s department to take the woman into custody, transport her to a hospital, and subject her to involuntary testing and medical treatment.

Fifty-two percent of the women in the cases they found  were African American. Seventy-one percent were likely low income, as they were represented by indigent defense in the legal case. Sixty-nine percent were under the age of 30, and 56 percent were in the South. And, lest you think these are mostly old cases, they found more than 25 in 2005, the last year included in the paper. The authors also said that, while not included in this research, they are aware of at least 250 cases since 2005.


Look I'm sorry your friend is depressed about it but that's not what's known as clinical depression and if she is clinically depressed there's medication for it. These case listed above and the guarantee that authoritarian schmucks are going to ramp this kind of thing up against women is vastly more catastrophic. If aborting a zygote is going to lead to drugs, alcoholism and clinical depression, well so is forced parenthood, and so is jail time for having a glass of wine when pregnant or having what someone else thinks is a "suspicious miscarriage".

No thanks. We already have the palpable stirrings of a totalitarian dictatorship blossoming under a Donald Trump candidacy, we don't need to add thought crime and fetal criminalization laws to this once proud free nation.
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Re: Cause and Effect and Convergance...

Postby Keep The Reason » Thu Feb 25, 2016 10:31 pm

Regarding the claim that one of these women had to go to a surrogate, it's very rare that an abortion or even multiples will create such a problem.. I'll bet that your friend has no damage but simply has a challenge with getting pregnant.

Link

the possibility of fertility problems is the about the same as if you had never had any abortions -- abortion does not affect fertility. Because you have gotten pregnant in the past indicates you are fertile and you can most likely get pregnant again. Statistically, women become less fertile as they get older, but statistics cannot predict fertility in any one individual.

You can learn about when your body is fertile to help you become pregnant when it's the "right" time for you.

Statistically, past abortions have very little impact on future child-bearing ability. Again, statistics cannot predict any one individual's situation.

Post-abortion complications are rare - they occur in fewer than 1% of abortions. Only some abortion complications lead to inability to become pregnant, due to scar tissue, if the uterus or cervix was perforated or became infected post-abortion.
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