Screening for Risk Factors Will Prevent Unwanted and Unsafe Abortions, Lower Abortion Rates

An Elliot Institute law review article published in the latest issue of The Journal of Contemporary Health Law and Policy concludes that the number of women suffering abortion-related injuries can be dramatically reduced through better pre-abortion screening.

The article includes an analysis of 63 medical studies identifying risk factors that predict negative psychological reactions to abortion. Elliot Institute director Dr. David Reardon, who authored the review, writes that most abortion clinics fail to screen for even the best known risk factors.

He prefaces his explanation for this failure with a citation to a New York Times article examining how tough competition in the abortion industry has led to extreme cost-cutting measures.

Times reporter Gina Kolata found that if the cost of abortion had kept pace with the cost of other health care services, a typical first-trimester abortion would cost around $2,250 today. Instead, the cost is around $300–about the same as was charged in 1973.

“It appears that the cost of doing abortions has been kept low because individualized pre-abortion screening and counseling has been eliminated,” Reardon said. “Instead of receiving personalized counseling, women face a brief, one-size-fits-all intake process.

“By means of this ‘assembly-line’ processing, women are more efficiently slotted into tight surgical schedules. But it also means that those women who would otherwise be identified as poor candidates for abortion are being exposed to unsafe abortions.”

While more research into abortion complications should still be done, says Reardon, who has authored numerous studies on abortion risks, the existing research has identified the key risk factors for reliably identifying those women who are at greatest risk of the most severe negative reactions.

One of the most important risk factors is when women feel pressured by others — parents, male partners, employers, or others — to abort against their own moral beliefs or maternal desires. Research indicates that as many as that 30 to 60 percent of all women having abortions fit into this category.

Better screening and counseling would help provide these women with the information they need to resist pressure from others. In many cases, counselors could intervene to help explain to those pushing for the abortion why abortion is unadvisable and why they should support the woman’s desire to carry her baby to term.

This new law review article may help support a new Missouri law that requires abortionists to evaluate patients for:

  • “indicators and contraindicators,” and
  • “risk factors, including any physical, psychological, or situational factors which would predispose the patient to or increase the risk of experiencing one or more adverse physical, emotional, or other health reactions.”

Better pre-abortion screening may provide the least controversial means of reducing abortion rates, Reardon says.

“I can’t imagine how the courts could oppose these efforts to protect women from unnecessary, unwanted, and unsafe abortions,” Reardon said. “No doctor has a right, much less a duty, to perform a contraindicated abortion, especially when the woman hasn’t even been told that she is at a much greater risk of suffering negative reactions.

“Any court that upheld such a distorted right would set a precedent that would undermine the basis of all medical ethics. Even those judges who are most protective of easy access to abortion are unlikely to put the profit margins of the abortion industry ahead of the welfare of women.”

* * *

Sources

David C. Reardon, “The Duty to Screen: Clinical, Legal and Ethical Implications of Predictive Risk Factors of Post-Abortion Maladjustment,” The Journal of Contemporary Health Law & Policy, 2003; 20(1):33-114.

Gina Kolata, “As Abortion Rate Decreases, Clinics Compete for Patients,” New York Times, Dec. 30, 2000, A13.

Originally published in The Post-Abortion Review 12(2) April-June 2004. Copyright 2004 Elliot Institute.


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