Planned Parenthood Is Guilty of Negligent Screening

For Immediate Release
December 29, 2015

By David C. Readon, Ph.D.

Congressional hearings into Planned Parenthood should look beyond the deceptive fetal tissue donation forms they ask women to sign. These misleading disclosure forms typify a larger pattern of deception and exploitation.

An even more shocking abuse lies in the fact that Planned Parenthood abortionists know that the majority of women entering their abortion clinics have multiple risk factors for psychological maladjustments following an abortion. But they don’t screen for these risk factors, much less give each patient a medically informed assessment of risks versus benefits based on each woman’s unique risk profile.

Specifically, Planned Parenthood is guilty of negligent pre-abortion screening and counseling. This isn’t by accident. It’s not an oversight. It is a practice designed to advance their own financial and sociopolitical interests.

Plus, under current law, they can get away with it. Loopholes in the law allow abortion providers to evade any financial liability for psychological problems that are triggered or aggravated by abortion.

In short, while Planned Parenthood claims it is simply promoting a “pro-choice” alternative, what they are actually doing is promoting a “poor-choice” alternative.  Women deserve better.

Abortion Has Known Risks

Compared to similar women who give birth, women who abort experience significantly elevated rates of psychiatric disorders,[1,2,3,4,5,6,7,8,9] substance use,[4,5,10,11] suicidal behaviors,[4,5,12,13,14] post-traumatic stress disorders,[6,15,16] sleep disorders,[17] a worsening of general health,[18] and elevated rates of recourse to medical treatments.[19,20] In addition, each exposure to abortion reduces a woman’s life expectancy.[21]

Most notably, besides all these risks, abortion also lacks any measurable benefits.

Specifically, not a single study has identified any statistically significant benefits for women who have abortions compared to women who give birth to unplanned pregnancies . . . or compared to any other group of women.[22]

This is the conclusion of Dr. David Fergusson, a self-described pro-choice atheist,[23] based on his own systematic review of the literature, including his own 30-year longitudinal study of 1,265 subjects who have been studied from birth through 30 years of age.

Fergusson isn’t a biased pro-lifer. In fact, his conclusions have not led him to advocate against abortion in any way. He has no moral objections to it.

But as a scientist, Fergusson argues against the intellectual fraud of abortion providers who perform abortions based on the spurious claim that it will produce some hoped for or imagined psychological benefits for women compared to giving birth. There is not a shred of scientific evidence to support such optimism. No claimed benefits of abortion have ever been statistically validated. But abortion does have known risks.

Some Women Are Known to Be At Higher Risk

Research has consistently shown that there are certain groups of women who are most vulnerable to negative reactions to abortion. In fact, even the hand-picked team of pro-choice psychologists who issued the Report of the American Psychological Association Task Force on Mental Health and Abortion in 2008 acknowledged the following 15 risk factors which can be used to identify the women who are at greater risk of psychological problems after an abortion.[24]

• “terminating a pregnancy that is wanted or meaningful”
• “perceived pressure from others to terminate a pregnancy”
• “perceived opposition to the abortion from partners, family, and/or friends”
• “lack of perceived social support from others”
• “low self-esteem”
• “a pessimistic outlook”
• “low perceived control”
• “a history of mental health problems prior to the pregnancy”
• “feelings of stigma”
• “perceived need for secrecy”
• “exposure to antiabortion picketing”
• “use of avoidance and denial coping strategies”
• “feelings of commitment to the pregnancy”
• “ambivalence about the abortion decision”
• “low perceived ability to cope with the abortion prior to the abortion”

Indeed, the above list makes clear that one needs to carefully parse the APA’s summary conclusion 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 than if they deliver that pregnancy.” This highly nuanced assertion was widely misreported as concluding that there are no mental health risks to abortion.

Look again. First, the APA claims abortion has “no greater” risks compared to delivery—referring  mostly to the incidence rate for post-partum depression. It doesn’t claim any benefits, only comparatively equal risks.

Secondly, and more importantly, even this modest claim of “safety” is limited to adult women (excluding adolescents), those whose pregnancies are unplanned (excluding those who had any openness to or desire for pregnancy), those who have only a single abortion (excluding those with multiple exposures to abortion), those for whom the abortion is entirely elective (excluding those who experienced any pressure or coercion, or those for whom fears of health complications led to a therapeutic abortion), and those who abort in the first trimester (excluding those who abort after 12 weeks gestation).

Notably, the vast majority of women having abortions have one or more of these risk factors. For example, approximately 64 percent of women with a history of abortion report that they felt pressured by one or more people to do so.[25] In addition, approximately half of all women aborting on any given day have a prior history of abortion.[26] Further, about 15 percent of abortions are for adolescents, and about 8 percent of abortions are after the first trimester.[27] Throw in the need for secrecy, ambivalence, or any of the other 15 risk factors acknowledged by the APA, and it’s clear that most women having abortions have two or more of these risk factors.

Planned Parenthood’s Own Research on Risk Factors and Screening

The APA Task Force was by no means the first to recognize that negative reactions to abortion may be anticipated on the basis of prior personality traits (such as low self-esteem or prior history of depression) or identifiable circumstances (such as feeling pressured to abort or feelings of commitment to the pregnancy).

For example, in 1973, Planned Parenthood itself published a study identifying several pre-existing risk factors that could be used to identify the women who were most likely to experience subsequent psychopathology and other negative symptoms as measured 13-16 months later.[28] Based on these findings, the researchers recommended that computer-scored “screening procedures to identify such [higher risk] patients could easily and inexpensively be instituted by hospitals and private physicians” at a cost of less than a dollar each.

Did Planned Parenthood implement these pre-abortion screening recommendations? No. In fact, they are opposed to screening for statistically significant risk factors.[29]

Negligent Screening Hurts Women But Enriches the Abortion Industry

Bottom line: Planned Parenthood knows that the majority of women coming into abortion clinics have multiple risk factors for post-abortion psychiatric distress. But there is no systematic screening for these risk factors. Why?

First, because abortion providers have a financial incentive to spend the least amount of time with each woman. One of their highest goals is to provide fast, cheap abortions. Planned Parenthood’s one-sized-fits-all abortion counseling is incompatible with individualized screening that would then require individualized counseling.

Second, from the viewpoint of population control zealots, many of the same risk factors that predict which women will have the most emotional problems after an abortion actually align with the same criteria for women they historically argued should be sterilized—including, for example, women with prior mental health issues.[30]

Third, the goal of providing cheap, no-questions-asked abortions is an integral part of Planned Parenthood’s historic and deeply-rooted eugenic population control agenda. After all, if abortion, as a social engineering tool, can be used to reduce the burden on society caused by the birth of “unfit” children, keeping abortion on request affordable to the poor is a “social good.”

Advancing the “social good” of fewer births, especially among the marginalized, may explain why Planned Parenthood’s counseling practices minimize disclosure of abortion risks.[31] It may also explain why some abortion counselors deliberately reinforce the arguments of the partners, parents, employers or others pressuring women to abort in order to persuade ambivalent patients that abortion is the “best option” for everyone.[32]

Negligent Pre-Surgical Screening is Unique to the Abortion Industry

Everywhere else in medicine, doctors screen for risk factors . . . precisely to identify those subgroups of patients for whom a possible treatment option may be contraindicated or is unlikely to produce the desired benefits.

For example, Lasik surgery is a common elective procedure performed nearly four million times per year. But ethical physicians do not perform it without appropriate pre-surgical screening. Indeed, pre-surgical screening for Lasik patients results in approximately 25 percent of patients being declined for Lasik treatment on the initiative of the attending physician[33]—precisely because the doctor’s own best medical judgment is that it will not benefit the patient.

But do abortionists turn away women with multiple risk factors for abortion complications, or even discourage these most vulnerable women from having abortions? No.

The simple fact is that abortionists seldom turn away patients. If you have the money, they will do the abortion.

In fact, abortionists will typically deny any responsibility for determining if an abortion is more likely to benefit or harm a woman’s well being. They insist they are not social workers. The choice is the woman’s alone and they are just there doing her bidding.

But such a “buyer beware” medical service is an inversion of normal medical ethics. It is analogous to a woman walking into a doctor’s office and saying, “I have a lump in my breast and need a mastectomy,” and the doctor responding, “Okay. Jump up on the table and I’ll take it right off.”

Simply doing what a patient asks for, without any evaluation of risks or options, is not the practice of medicine . . . it is medical malpractice.

But this is exactly what Planned Parenthood and other abortion providers are guilty of. They are facilitating and encouraging women of all ages and education levels to self-diagnose.

Moreover, they do not even assist in the self-diagnosis process!

Instead, abortionists insist that women seeking abortions already know everything they need to know . . . as if an innate knowledge of abortion’s risk factors and risk/benefit ratios is embedded in women’s DNA. They even go so far as to insist that laws requiring full disclosure of all statistically significant medical research on risks and risk factors associated with abortion are an insult to women’s intelligence.

In short, Planned Parenthood believes in abortion on request, no questions asked. No matter the circumstance, whenever a woman asks for abortion, their response is, “Jump up on the table and we’ll take it right out.”

Is such blind obedience to this self-diagnosis what women really want from their doctors?  Many, perhaps most, are highly uncertain what to do. And clearly the vast majority have no prior education regarding abortion risk factors and all the medical studies examining risks associated with abortion.

What we do know, with certainty, is that women overwhelmingly want to be informed of all statistically significant risks, especially when considering elective surgeries like abortion.[34]

Abortionists Use Unified Negligence to Evade Liability

Ironically, Roe v Wade rejected the idea that women have an absolute right to abortion precisely because it is a medical procedure that inherently has risks. The Roe decision concluded with the emphatic statement that “the abortion decision in all its aspects is inherently, and primarily, a medical decision, and basic responsibility for it must rest with the physician. If an individual practitioner abuses the privilege of exercising proper medical judgment, the usual remedies, judicial and intra-professional, are available.”[35] [emphasis added]

Put another way, if abortion is contraindicated due to any physical, psychological, and social reasons,[36] the Supreme Court recognizes that physicians have a right and duty to refuse to perform an unsafe or unnecessary abortion. In this regard, if doctors fail to exercise “proper medical judgment,” the Roe Court declared, they should be exposed to “the usual remedies” of lawsuits, loss of their licenses, or even criminal prosecution.

So, if abortionists aren’t screening for known risk factors, as I have asserted, why aren’t they being sued by the hundreds of thousands of women entering post-abortion counseling programs every year?

Unfortunately, abortion providers are protected from any meaningful liability because of two loopholes in tort law.

First, the “standard of care” for pre-abortion screening is defined by the common practice of abortion providers themselves. So, as long as all abortion providers agree to ignore the psychological risks of abortion, or at least refuse to testify against other abortion providers who neglect to screen for these risk factors, it is nearly impossible for injured women to prove that they were given substandard, much less negligent, medical care.

As long as abortion providers all simply perform abortions on request—without screening and without offering each woman a medically informed risk/benefit analyses—it is extremely hard for a malpractice attorney to prove negligent screening. If the standard of care is low enough, there is no risk of plaintiffs proving negligence.

Second, and even more problematic, tort law generally precludes recovery of damages for emotional distress unless it is the result of physical injury. For example, if you suffer emotional distress after almost being hit by a car, you can’t sue. Only if you are hit are you then entitled to damages for pain, suffering, post-traumatic stress and sleep disorders.

Thus, absent any physical injury following an abortion, abortionists are shielded from any liability for psychological injuries attributed to abortion. This simplifies the math: no liability = no need for screening + more abortions + more profit + more injured women.

The Solution:  Put the Standard of Care for Screening into Statute

As we have seen, even pro-abortion mental health professionals, and Planned Parenthood’s own publications, have acknowledged the existence of risk factors for post-abortion psychological problems. For the reasons discussed above, these risk factors are routinely ignored by abortion providers, at least in part because there is no financial downside, only an upside, for doing so.

It doesn’t have to be that way. The standard of care for pre-abortion screening can be put into statute.[37] This would eliminate the burden on plaintiffs to find abortion providers to testify that the defendant’s pre-abortion screening was negligent. At the same time, tort law can be amended to require doctors to give women an informed medical opinion based on their unique risk profile and to give women a right to sue for negligent screening and psychological injuries associated with abortion.

Bill Clinton famously opined that abortion should be “safe, legal, and rare.” It is obvious that pre-abortion screening should be employed to identify the women at greatest risk of unsafe abortions.[38] If it so happens to be true that the majority of women are at risk, then perhaps this will also make abortions rare.

What I do know is this: “poor-choice” advocates are profiting from countless women who will continue to undergo unwanted, unsafe, and unnecessary abortions. Planned Parenthood officials should be grilled by congressional investigators on why and how they justify their failure to establish a systematic methodology for pre-abortion screening and counseling which will properly protect women from unwanted, unsafe, and unnecessary abortions.

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David C. Reardon, Ph.D., has published numerous peer reviewed medical studies on the aftereffects of abortion on women and is a leading advocate of post-abortion healing ministries.

References

[1] Giannandrea S a M, Cerulli C, Anson E, Chaudron LH. Increased risk for postpartum psychiatric disorders among women with past pregnancy loss. J Womens Health (Larchmt). 2013;22(9):760-768. doi:10.1089/jwh.2012.4011.

[2] Broen AN, Moum T, Bødtker AS, Ekeberg O. The course of mental health after miscarriage and induced abortion: a longitudinal, five-year follow-up study. BMC Med. 2005;3:18. doi:10.1186/1741-7015-3-18.

[3]Munk-Olsen T, Bech BH, Vestergaard M, Li J, Olsen J, Laursen TM. Psychiatric disorders following fetal death: a population-based cohort study. BMJ Open. 2014. doi:10.1136/bmjopen-2014-005187.

[4] Fergusson DM, Horwood LJ, Boden JM. Does abortion reduce the mental health risks of unwanted or unintended pregnancy? A re-appraisal of the evidence. Aust N Z J Psychiatry. 2013;47(9):819-827. doi:10.1177/0004867413484597.

[5] Coleman PK. Abortion and mental health: Quantitative synthesis and analysis of research published 1995-2009. Br J Psychiatry. 2011;199(3):180-186.

[6] van den Akker O. The psychological and social consequences of miscarriage. Expert Rev Obstet Gynecol. 2011;6(3):295-304. doi:10.1586/eog.11.14.

[7] Reardon DC, Cougle JR, Rue VM, Shuping MW, Coleman PK, Ney PG. Psychiatric admissions of low-income women following abortion and childbirth. CMAJ. 2003;168(10):1253-1256.

[8] Coleman PK, Reardon DC, Rue VM, Cougle J. State-funded abortions versus deliveries: a comparison of outpatient mental health claims over 4 years. Am J Orthopsychiatry. 2002;72(1):141-152.

[9] Fergusson, D. M., Horwood, L. J., & Boden, J. M. (2008). Abortion and mental health disorders: Evidence from a 30-year longitudinal study. British Journal of Psychiatry, 193(6), 444–451.

[10] Coleman PK. Induced abortion and increased risk of substance abuse: a review of the evidence. Curr Womens Health Rev. 2005;1(1):21-34. doi:10.2174/1573404052950311.

[11] Steinberg JR, McCulloch CE, Adler NE. Abortion and mental health: findings from the national comorbidity survey-replication. Obstet Gynecol. 2014;123(2 Pt 1):263-270.

[12] Shadigian E, Bauer ST. Pregnancy-associated death: a qualitative systematic review of homicide and suicide. Obstet Gynecol Surv. 2005;60(3):183-190.

[13] Morgan CL, Evans M, Peters JR. Suicides after pregnancy. Mental health may deteriorate as a direct effect of induced abortion. BMJ. 1997;314(7084):902; author reply 902-903.

[14] Tischler C, Adolescent suicide attempts following elective abortion. Pediatrics, 1981; 68(5): 670-1

[15] Daugirdaitė V, van den Akker O, Purewal S. Posttraumatic Stress and Posttraumatic Stress Disorder after Termination of Pregnancy and Reproductive Loss: A Systematic Review. J Pregnancy. 2015;2015:1-14. doi:10.1155/2015/646345.

[16] Zulčić-Nakić V, Pajević I, Hasanović M, Pavlović S, Ljuca D. Psychological problems sequalae in adolescents after artificial abortion. J Pediatr Adolesc Gynecol. 2012;25(4):241-247.

[17] Reardon DC, Coleman PK. Relative treatment rates for sleep disorders and sleep disturbances following abortion and childbirth: a prospective record-based study. Sleep. 2006;29(1):105-106.

[18] Ney PG, Fung T, Wickett AR, Beaman-Dodd C. The effects of pregnancy loss on women’s health. Soc Sci Med. 1994;38(9):1193-1200. doi:10.1016/0277-9536(94)90184-8.

[19] 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. Am J Med Qual. 2001;16(3):99-106. http://www.ncbi.nlm.nih.gov/pubmed/11392176. Accessed July 17, 2015.

[20] Berkeley D, Humphreys PC, Davidson D. Demands made on general practice by women before and after an abortion. J R Coll Gen Pract. 1984;34(263):310-315.

[21] Coleman PK, Reardon DC, Calhoun BC. Reproductive history patterns and long-term mortality rates: A Danish, population-based record linkage study. Eur J Public Health. 2013;23(4):569-574. doi:10.1093/eurpub/cks107.

[22] Fergusson DM, Horwood LJ, Boden JM. Does abortion reduce the mental health risks of unwanted or unintended pregnancy? A re-appraisal of the evidence. Aust N Z J Psychiatry. 2013;47(9):819-827. doi:10.1177/0004867413484597.

[23] Grimm, N. Higher risk of mental health problems after abortion: report. Australian Broadcasting Corporation. 03/01/2006.

[24] Major B, Appelbaum M, Beckman L, Dutton MA, Russo NF, West C. Report of the APA Task Force on Mental Health and Abortion. Washington, DC: American Psychological Association; 2008. http://www.apa.org/pi/women/programs/abortion/mental-health.pdf. See pages 11 and 92.

[25] Rue VM, Coleman PK, Rue JJ, Reardon DC. Induced abortion and traumatic stress: a preliminary comparison of American and Russian women. Med Sci Monit. 2004;10(10):SR5-R16.

[26] Cohen, Susan A. Repeat abortion, repeat unintended pregnancy, repeated and misguided government policies. Guttmacher Policy Review 2007 10(2):8-12.

[27] Centers for Disease Control and Prevention. (2013, November 29). Abortion Surveillance–United States, 2010. (See Tables 3 and 5) – See more at: http://www.childtrends.org/?indicators=teen-abortions#sthash.EOAd8JkH.dpuf

[28] Robert Athanasiou et al., Psychiatric Sequelae to Term Birth and Induced Early and Late Abortion: a Longitudinal Study Fam. Plann. Perspect. (1973); 5; 227-31.

[29] Abourezk, K. Planned Parenthood files suit over Nebraska abortion law. Lincoln Journal Star. June 28, 2010.

[30] Chase, Allan. The Legacy of Malthus: The Social Costs of The New Scientific Racism. New York: Knopf, 1977

[31] Sobie, A. All Abortion Risks Must Be Disclosed, Appeals Court Rules: Argument to Invert Traditional Medical Standards Rejected.  AfterAbortion.org. July 26, 2012.

[32] Reardon, David. Aborted Women Silent No More. Chicago: Loyola University Press. 1987.

[33] Ulene, V. Life with Lasik: a closer look. Los Angeles Times, June 16, 2008. Accessed 11/0/2015.  http://articles.latimes.com/2008/jun/16/health/he-themd16.  And also, Neergaard, L. Lasik worries? Some may see better with alternatives. Fox News. April 28, 2008 .

[34] Coleman PK, Reardon DC, Lee MB. Women’s preferences for information and complication seriousness ratings related to elective medical procedures. J Med Ethics. 2006;32(8):435-438. doi:10.1136/jme.2005.014274.

[35] Roe, 410 U.S. at 166.

[36] A physician’s determination whether to abort should be made “in light of all attendant circumstances—psychological and emotional as well as physical—that might be relevant to the well being of the patient.” Colautti v. Franklin, 439 U.S. 379, 394 (1979). Family size, financial concerns, mental health, and physical health are all issues in making a medical recommendation for abortion. “All these are factors the woman and her responsible physician necessarily will consider in consultation.” Roe, 410 U.S. at 153. The duty to evaluate this medical decision is especially weighty, because “Abortion is inherently different from other medical procedures, because no other procedure involves the purposeful termination of a potential life.” Harris v. McRae, 448 U.S. 297, 325 (1980).

[37] See the Prevention of Coerced and Unsafe Abortions Act at www.StopForcedAbortions.org

[38] Reardon DC. Making Abortion Rare: A Healing Strategy for a Divided Nation. Springfield IL: Acorn Books; 1996.

 

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