THE
CRUX OF THE MATTER
Due
to the necessary fact checks on each of Joyce Arthur’s allegations,
I am nervous that some readers may get bogged down by the required
and detailed responses.
Accordingly,
I have first provided a preliminary chapter on the most critical
complaint. That is, according to Ms. Arthur, many or most CPCs in
Canada provide misleading and inaccurate information on the subject
of abortion.
This
most important preliminary chapter is titled: Abortion
Procedures and Risks.
For
those of you not faint of heart, you can continue on with my report
which more extensively responds to Ms. Arthur’s other false claims.
I. Abortion Procedures and Risks
The
most critical false complaint by Arthur is that CPCs in Canada
provide misleading and inaccurate information on abortion.
What
Arthur knows – and yet conceals – is that the actual CPC
abortion-related information is sourced from obstetricians, medical
ethicists and the abortion providers themselves.
For
example, according to Brian Norton, a board member with the Canadian
Association of Pregnancy Support Services (CAPSS)
(http://www.capss.com/our-board-of-directors/),
the physical risks to abortion outlined in the CAPSS client brochure
comes directly from, and is not limited to, abortion providers such
as BC Women’s Hospital, Brampton Women’s Clinic, Clinique
Médicale Fémina (Montréal), Hamilton Health Sciences, Kensington
Clinic, Kootenay Boundary Regional Hospital, Women’s College
Hospital (Toronto) and Women’s Health Clinic (Winnipeg).
If
Ms. Arthur truly believes the content is not accurate, she should
conduct her “misinformation” assault not on CPCs but on the
primary sources. Namely, Canadian abortion clinics and hospitals
providing abortion services.
Further,
Ms. Arthur should run a concurrent “misinformation” campaign
against pro-choice affirmed peer-reviewed epidemiological studies.
I conducted a fact check of Arthur’s
allegations and what written material is available to clients from
most, if not all, CAPSS member CPCs. Arthur’s “homework” is
found wanting. She is dishonest. Again.
In case you are thinking I
am making this up, let me provide you with the precise word-for-word
abortion information from the 2017 CAPSS client brochure (available
from all member CPCs), titled: Abortion
Adoption Parenting: an informational guide for unplanned pregnancy.
On Abortion Procedures (from brochure page 4)
The
option of abortion – abortion procedures
There are
various abortion procedures available during different stages of
pregnancy. In Canada, 90% of abortions are done in the first 12 weeks
of pregnancy, avoiding the added risks associated with later term
abortions. An ultrasound may be given before an abortion to determine
the stage of pregnancy and also afterwards to determine if the
abortion is complete. Depending on the type of abortion, the
procedure may take between 5–30 minutes, with the entire process
being generally less than 2 hours.
Medical
abortions
(typically
up to 7 weeks) –
There are 2 methods of medical abortion available in Canada. The
first is a combination of methotrexate and misoprostol, and the
second is a combination of mifepristone (also called mifegymiso) and
misoprostol. Methotrexate is usually given by injection while
mifepristone is a pill which is swallowed. Misoprostol is a pill
which may be self-administered into the vagina or swallowed.
Methotrexate is a chemotherapy drug which stops cell growth.
Mifepristone blocks two hormones which are necessary for pregnancy to
continue. Misoprostol causes the uterus to contract and expel the
embryo. Cramping and bleeding will occur as the uterus contracts and
as the embryo is expelled.
Medical
abortion may take several days to complete and require 1 to 3 visits
to the abortion provider. If an incomplete abortion occurs then a
surgical procedure may be required.
Surgical
abortions
–
With each of the following surgical procedures, the cervix will be
dilated (opened) to allow instruments to enter the uterus. Dilation
may be done using misoprostol, laminaria (seaweed sticks), an osmotic
dilator (expanding sponge) or metal rods. A local anaesthetic, as
well as medication to reduce pain, blood loss and risk of infection,
may be given. The tissue removed from the uterus may be examined to
identify fragments of the embryo or fetus and the placenta.
vacuum
aspiration and
dilation
& curettage: D&C (1st
Trimester) –
After dilation, abortion is performed by inserting a long tube
(cannula) into the uterus. After the contents are removed by suction,
a procedure using a loop-shaped instrument (curette) may also be
required to scrape the wall of the uterus.
dilation
& evacuation: D&E (2nd
Trimester) –
This method requires 2 appointments. After 24 hours of dilation, this
procedure is performed with the use of both suction and scraping used
in 1st trimester abortions (above), and the use of forceps to remove
fetal parts. For abortions in the late 2nd trimester, prior to the
procedure, a needle may be placed into the fetal heart with
ultrasound guidance and potassium chloride injected to ensure the
fetus is not alive prior to evacuation.
induction
of labour (2nd
Trimester) –
In the 2nd trimester, as an alternative to D&E, sometimes labour
is induced and the fetus delivered. As above, potassium chloride may
also be used prior to induction of labour.
No
misinformation on the abortion procedures in Canada. Totally
accurate. Totally current.
It
is Ms. Arthur who misinforms her own readers about CPCs in Canada.
On Possible Risks to Abortion (from brochure page 5)
The
CAPSS client brochure begins this one-page section with the following
introductory statement, in an increased font size and in colour:
Thousands
of abortions are performed every year in Canada, and are considered
to be a safe medical procedure. However, as with any medical
procedure, there are potential risks that you need to consider before
making a final decision.
Totally
accurate. Unmistakably clear.
The
brief CPC information pertaining to emotional risks is attested by
abortion providers and pro-choice affirmed epidemiological studies.
Though routinely buried by Ms. Arthur and her ARCC political
organization, these possible risk factors are in fact acknowledged by
other
pro-choice organizations in Canada.
On Emotional Risks
Arthur falsely accuses CPCs for frequently using the term “Post
Abortion Syndrome”. But more overriding, she has a deep disdain of
any term acknowledging abortion-related grief. From her 2016 report:
“many [CPCs] promote misinformation such as
the existence of ‘Post-abortion Syndrome,’ which is not a
medically recognized condition.”
“48% (79) mentioned negative psychological
consequences, primarily in the context of ‘Post-abortion Syndrome’,
which is not medically recognized.”
“20% of sites specifically mentioned ‘Post-Abortion Syndrome,’
while 16% did not specifically name ‘Post-Abortion Syndrome’ but
listed what many anti-abortion groups believe are its symptoms. 51%
of sites offered post-abortion counselling at their centres.”
“Figure 4.1: Group 1: 19.9% (n=33) of
websites mention or discuss ‘Post-Abortion Syndrome.’ Group 2:
16.3% (n=27) did not name the fictitious syndrome but instead
described symptoms that anti-abortion groups often claim it
comprises. Group 3: 50.6% (n=84) offered post-abortion counselling.”
“presenting ‘Post-abortion Syndrome’ as
real and common (48% of sites). Neither of these claims are supported
by evidence (NARAL 2016).”
“Almost half of centres – 48% (79) –
claimed on their websites that abortion results in negative
psychological consequences, including depression, suicidal thoughts,
or ‘Post-Abortion Syndrome’.”
First, let me first address the fact that
Arthur is once again fudging the figures – this time on “Post
Abortion Syndrome” being a widespread term on CPC websites. Later,
I will speak to the more central issue of abortion and emotional
risks.
As we have seen above, Arthur is highly
critical of CPCs in Canada for using the designation “post abortion
syndrome”. She states in her report that 79 websites use the term
“post-abortion syndrome” or use some kind of reference to
emotional pain of women after abortion.
Reviewing the 79 websites for myself, this is what I discovered.
When I began my research initially, I
discovered that a total of two of these 79 sites had used the word
“post-abortion syndrome”:
The Back Porch in Edmonton, Alberta (#9):
“The most common emotional risk is
Post-Abortion Syndrome (PAS), which is closely related to Post
Traumatic Stress Disorder (PTSD).”
Pregnancy Help Centre Durham also uses the
term:
“If you are struggling with guilt, sleep
disturbances, depression, intruding thoughts, feelings of despair,
and/or thoughts to harm yourself, you may be experiencing symptoms of
post-abortion syndrome.”
However recently when I rechecked the two sites I noticed that
neither of these sites used the term post-abortion syndrome any
longer.
Arthur would have unsuspecting readers believe that 79 CPC sites use
the term, when only two in fact did; currently none of the 79
sites use the term.
Deceit? Misinformation? Fabrications? What can we call it?
So I then connected with a CAPSS representative on this subject and I
learned that Post Abortion Syndrome (PAS) is not, in fact, a term
CAPSS member centres use. For the emotional pain women describe to
their centre staff, the common terms used by CPCs are “post
abortion stress” or “post abortion grief”.
Further, having reviewed the website used by all Birthright centres,
they also do not refer to Post Abortion Syndrome (PAS), as Arthur
also dishonestly implies.
Below is the actual “position” of this term for CAPSS member
centres, which – wait for it –Arthur knows. She and each
of her board members received a written hard copy from CAPSS, years
ago.
CAPSS
informed Arthur and ARCC that their centres do not use the term PAS,
and then gave the following explanation:
Years
ago, various prolife professional counsellors and physicians in the
USA used the term “post abortion syndrome” when describing the
very severe cases of abortion grief. That was, and still is today in
medical circles, a labeling misnomer. Post abortion syndrome – i.e.
as a “post-traumatic stress disorder” – is not recognized in
the Diagnostic and Statistical Manual of Mental Disorders. When
describing the emotional pain of abortion, CAPSS centres in Canada
use “post abortion stress” or “post abortion grief”. In fact,
since the very inception of CAPSS in 1997, “post abortion syndrome”
has never been used in any CAPSS publication – whether in
membership documents, volunteer training manuals, or brochures.
Having
said that, there are excellent US produced publications on abortion
grief and recovery which have used (and some still do use) this term.
This is regrettable. The misnomer becomes fodder for unhelpful
politicization (whether ‘prochoice’ or ‘prolife’), thus
hijacking an important conversation on abortion grief and
methodologies of care and healing.
Is
there any integrity left within the ARCC organization?
Moving
on from Arthur’s word games, I now will discuss the matter of
emotional risks to abortion.
Here’s
the thing. There are all kinds of organizations (including abortion
clinics) other
than CPCs
who also discuss the emotional risks of abortion.
(Also note that Arthur’s percentages and
numbers of clinics detailed above who are “guilty” of identifying
these emotional consequences of abortion are also wrong since
Arthur’s CPC counts in her report are wrong. More on this later.)
Here
is the CAPSS client brochure’s content on possible emotional risks
along with references of which organizations identify these risks:
Emotional
After
an abortion many women feel some relief, while others have negative
emotions. Reactions may be immediate, or feelings may arise years
later. Responses vary. They depend on a woman’s age, stage of
pregnancy, religious or cultural beliefs, previous mental health, or
whether she is being pressured by others into having an abortion.
Women
who experience negative emotions after an abortion have reported the
following reactions: 4
• Sadness
• Guilt
or shame
• Emotional
numbing
• Depression
• Nightmares
or flashbacks of the abortion
• Alcohol
and drug abuse
• Having
thoughts of suicide
As
an endnote source, the CAPSS client brochure states (on page 8):
4.
Sources: Canadian abortion providers (references available on
request). Also see BC Women’s Hospital, “Coping with Ending a
Pregnancy,”
http://www.bcwomens.ca/health-info/sexual-reproductive-health/abortion-services
(accessed March 2017). Also see P.K. Coleman, “Abortion and mental
health: quantitative synthesis and analysis of research published
1995-2009,” British
Journal of Psychiatry
199, (2011): 180-86; D.M. Fergusson, J.L. Horwood and J.M. Broden,
“Abortion and mental health disorders: Evidence from a 30-year
longitudinal study,” British
Journal of Psychiatry
193 (2008): 444-451; N.P. Mota, M. Burnett and J. Sareen,
“Associations between abortion, mental disorders, and suicidal
behaviour in a nationally representative sample,” Canadian
Journal of Psychiatry
55, no. 4 (2010): 239-247.
Also on this topic of post abortion grief is
the fact that there are organizations whose entire reason for
existence is to help women heal and recover from their abortion
grief. See:
Another source which you may find of interest is the Canadian
publication, Complications: Abortion’s Impact on Women
(2013), by the deVeber Institute for Bioethics and Social Research. I
draw your attention to Section III “The Psychological and Social
Impact” and Section IV “Women’s Voices: Narratives of the
abortion experience.”
If you doubt that some women experience pain, loss, grief – call it
whatever you like – from abortion, I suggest you Google “recovering
from abortion grief” and see the resources that come up.
For those women who experience no grief from their abortions, that is
wonderful and they are fortunate. But for those who do experience
something other than relief, why would Arthur insist that the
emotional pain these women experience after abortion isn’t
real? And that CPCs, in providing help to these women, are “deceitful
and misleading” women, and that CPCs provide “direct
misinformation” to these women?
By making these false allegations Arthur belittles and marginalizes
women who do experience these very real feelings and emotional
suffering after abortion. PostAbortion Community Services (PACS)
is one of many abortion recovery outreaches, nationwide,
collaborating with CPCs. Program director Doreen Yung informs me that
PACS has been helping women seeking healing from abortion grief for
25 years. PACS offers peer counselling, support groups and recovery
retreats.
In addition to self-referrals, Yung says clients are referred to them
by (pro-choice and pro-life) physicians and agencies. Perhaps to
Arthur’s chagrin, PACS has also received referrals from abortion
providers.
Abortion Breast Cancer link – truth or fiction?
Regarding
informed consent on physical risks to abortion, with
only one exception,
CPCs note the same risks conveyed by abortion providers and
pro-choice medical researchers. In fact, abortion clinics have a much
longer and detailed list of the physical risks. Here is the CAPSS
client brochure’s entire content on possible physical risks:
Physical
•
Heavy
bleeding
•
Infection
•
Increased
risk of premature births in subsequent pregnancies1
•
Damage
to cervix or uterus, including a small risk of infection or
scarring2
that can be associated with infertility or miscarriage
that can be associated with infertility or miscarriage
•
Possible
link to breast cancer *
*
controversial; see
endnote 3
For
endnote #1 (above), the following source is noted on page 8: P. Shah
and J. Zao, “Induced termination of pregnancy and low birthweight
and preterm birth: a systematic review and meta-analyses,” British
Journal of Obstetrics and Gynaecology
116, (2009): 1425-42; H.M. Swingle, T.T. Colaizy, M.B. Zimmerman and
F.H. Morriss, Jr., “Abortion and the risk of subsequent preterm
birth: a systematic review with meta-analyses,” Journal
of Reproductive Medicine
54, no. 2 (2009): 95-108.
For
endnote #2, the following detail is noted on page 8: Asherman
syndrome, or intrauterine adhesions/scarring or synechiae.
As
mentioned, there is only one risk factor that the medical community
is in disagreement about. This concerns the worldwide epidemiological
research on a possible link to breast cancer. Many studies reveal a
link. Many studies do not.
From
endnote #3, on page 8 of the brochure: The association between
abortion and breast cancer is controversial. “Out of 73 published
worldwide studies done to date, 56 show a positive association, of
which 35 are statistically significant, while a total of seventeen
studies show no link.” From I. Gentles, A. Lanfranchi and E.
Ring-Cassidy, Complications:
Abortion’s Impact on Women (Toronto:
The deVeber Institute for Bioethics and Social Research, 2013), 125.
The 3 most recent studies (2014) conclude a link. For example: Y.
Huang, X. Zhang, W. Li, F. Song, H. Dai, J. Wang et al., “A
meta-analysis of the association between induced abortion and breast
cancer risk among Chinese females,” Cancer
Causes & Control 25,
no. 2 (2014): 227-236. More research is needed.
The
two other most recent studies also reveal a possible ABC link (not
noted in the above endnote due to space):
U.
Takalkar et al, “Hormone Related Risk Factors and Breast Cancer:
Hospital Based Case Control Study from India,” Research
in Endocrinology
2014, (April 2014) Article ID 872124, DOI: 10.5171/2014.872124; and
A. E. Lanfranchi and P. Fagan, “Breast Cancer and Induced Abortion:
A Comprehensive Review of Breast Development and Pathophysiology, the
Epidemiologic Literature, and Proposal for Creation of Databanks to
Elucidate All Breast Cancer Risk Factors,” Issues
in Law and Medicine
29, no. 1 (Spring 2014): 3-133.
If of interest, here I
lift some commentary on this ABC subject from CAPSS rebuttal
publication (pages 17, 21-22):
[Eight] years ago, a committee of the American College of
Obstetricians and Gynecologists said: “More rigorous, recent
studies demonstrate no causal relationship between induced abortion
and a subsequent increase in breast cancer risk.” Committee on
Gynecologic Practice, “Induced Abortion and Breast Cancer Risk,”
ACOG Committee Opinion No. 434 (Washington: American College
of Obstetricians and Gynecologists, 2009).
And from another recent publication is the following (puzzling)
observation: “As for the
epidemiological evidence, most scientists worldwide, except
in the US, agree that induced
abortion is a known risk for breast cancer” (emphasis added).
Gentles, Lanfranchi, and Ring-Cassidy, Complications, 90.
This publication cites and discusses the various worldwide
studies.
“This discussion must not be ideological nor fall into the trap of
epistemic closure,” the CAPSS rebuttal contends. “We must go
where the evidence leads.” The author continues, “Debates on this
controversial risk most often concern whether methodologies of
particular studies are flawed. But politically predetermined
editorial biases are far worse and do much more harm. Women
deserve better.”
For
the sake and safety of women’s health, CPCs recommend more
research. I most certainly concur. I trust you, the reader, do as
well.
With
this preliminary chapter “Abortion Procedures and Risks”
concluded, now to the other erroneous allegations by Ms. Arthur.
Tomorrow: Other Erroneous Allegations
Tomorrow: Other Erroneous Allegations
Patricia, you ask, "why would Arthur insist that the emotional pain these women experience after abortion isn’t real?" To admit that there could be real emotional pain following abortion would undoubtedly cause one to then ask oneself: WHY would there be emotional pain? Maybe that is something Ms. Arthur cannot face reflecting upon.
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