Debating, With Facts

The following is a longer version of a letter from the May 17, 2017, print issue.

I have always said that the most important part of my Princeton education was not what I learned, but how I learned. I learned how to think critically, articulate my thoughts clearly, and to assess the quality of information presented to me. The Day of Action panel discussion on reproductive rights (On the Campus, April 12) did an injustice to this Princeton tradition. According to this account, the panelists presented information that was at best misleading and at worst flat-out wrong. To start with, there’s this paragraph:

“[Ana] Samuel [’00 *02] advised listeners to support pregnancy shelters and equip women with an ‘abortion safety checklist’ that includes information about greater risks for conditions such as placenta previa, future premature births, and mental distress.”

Those “greater risks” do not exist. The myth that women who choose to terminate early in pregnancy suffer “abortion trauma syndrome” is, as I said, myth. A study from 2009 found serious methodologic errors in the supporting “evidence” for this syndrome. Women who have a previous history of depression are at risk for recurrence, as they would be if they carried to term. There is no evidence that the risk of post-abortion depression is greater than the risk of postpartum depression.

I have searched Google Scholar as well as PubMed and cannot find any evidence that elective first-trimester abortion increases the risk of placenta previa or future premature births. Low socioeconomic status and poor access to prenatal care both increase the risk of prematurity. Women in those circumstances are also more likely to terminate, if they have access to services. Correlation does not equal cause and effect.

Then there’s Professor John Londregan’s question: “[S]hould we go the lengths of being willing to kill someone in order to affirm the autonomy of another individual, given that the pregnancy process isn’t a permanent one and given that it is a part of our natural life cycle?” Pregnancy may be a part of our natural life cycle (most likely not his life cycle, though). It is also a major cause of death and disability in the developing world. Even in industrialized countries with better maternal-health outcomes than the United States, pregnancy still carries a much greater risk of death and disability than any elective termination procedure. It is absurd to suggest that because something is “natural,” we should force people to experience it.

Professor Londregan is apparently willing to kill women to affirm the rights of fetuses. Again, the evidence is clear: When abortion is illegal or difficult to access, more women die. They die from pregnancy complications, like eclampsia, that can't be treated without terminating the pregnancy. They die from infections and other illnesses that can't be treated effectively without risk of injury to the fetus. They will die from illegal abortions, because women have sought abortions throughout recorded history and will continue to do so.

We also have evidence of effective approaches to reduce the number of abortions: increase access to birth control, improve sex education for teenagers, and provide medical care, social, and financial support for women who wish to carry to term. Most women who seek elective termination in the United States already have children. They understand that pregnancy is “temporary” and that it is “part of the natural life cycle.” They seek termination most often because they can’t afford another child. If Professor Londregan and his colleagues would like to reduce the number of abortions, I urge them to stop promulgating falsehoods and work to improve contraception access and support for prenatal care, infant nutrition, and early-childhood education.

There is a vigorous debate to have about the role of government in regulating the private lives of citizens. That’s a discussion worth having – as long as we are honest about the facts.