Planned Parenthood Exhibit 19
Planned Parenthood Advances False Mantra that Abortion is Safer than Childbirth
Planned Parenthood, the nation’s largest abortion provider, advises that abortion is safer than childbirth. Planned Parenthood’s claim not only lacks support from the medical community,[i] it also makes an “apples-to-oranges” comparison. The deceptive statement adds to Planned Parenthood’s failure to adequately inform women about the serious risks abortion poses to their health and safety, further denying women the right to make fully-informed healthcare decisions.
On its website, under “How Safe is the Abortion Pill?” Planned Parenthood states: “The risk of death from medication abortion is much less than from a full-term pregnancy or childbirth.”[ii]
Under “How Safe Are In-Clinic Abortion Procedures?” Planned Parenthood’s website states: “Even though in-clinic abortion procedures are generally very safe, in extremely rare cases, very serious complications may be fatal,”[iii] and that “the risks increase” with abortions performed later in pregnancy.[iv]
Rather than explaining which serious complications increase from the abortion procedure, and how they increase, Planned Parenthood instead advises that “it may help” to “compare [the risk of abortion] to the risk of childbirth.”[v] Planned Parenthood then asserts—and with no citations to medical journals—that “[t]he risk of death from childbirth is 11 times greater than the risk of death from an abortion procedure during the first 20 weeks of pregnancy.”[vi]
Planned Parenthood’s counsel “may help” its abortion business, but the advice is inaccurate.
As AUL Senior Counsel Clarke Forsythe documents in his recent law review article, “A Road Map Through the Supreme Court’s Back Alley,” the mantra that “abortion is safer than childbirth” is “based on a mechanical comparison of the published abortion mortality rate and the maternal (childbirth) mortality rate,” i.e., the number of women who die from abortions compared to the number of women who die from childbirth.[vii] Despite Planned Parenthood’s attempts to compare these two rates, the “two published rates are not comparable, and do not give an accurate picture about the risks of abortion.”[viii]
One cannot accurately compare these two rates because they measure two different statistics. The abortion mortality rate reflects the number of women who have died from legally induced abortions divided by 100,000 legal abortions. The childbirth mortality rate reflects the number of women who have died divided by 100,000 live births.
Abortion Mortality Rate = Known Induced Abortion-Related Deaths/100,000 Legal Abortions
Childbirth Mortality Rate = Maternal Deaths /100,000 Live Births
Planned Parenthood’s promotion of this comparison to women considering an abortion implies that an abortion is safer than continuing a pregnancy. However, “using live births instead of pregnancies shrinks the denominator (since pregnancies are a larger group, and some end in miscarriage or stillbirth) and thereby inflates the maternal mortality rate.”[ix]
Planned Parenthood’s assertion that abortion is safer than childbirth—which carries the implication that abortion is safer than continuing a pregnancy—is intellectually dishonest because it relies on ratios with two fundamentally different denominators.
Incomparable denominators are not the only serious problem with Planned Parenthood’s calculus.
The accuracy of each rate is wholly dependent on a correct number of deaths—the numerator.[x] The precise number of “abortion-related deaths”—the numerator in the “Abortion Mortality Rate”—is unknown because “there is no uniform, mandatory tracking and reporting system of abortion deaths (mortality) or injuries (morbidity) at the state or federal level.”[xi] Thus, the lack of reporting requirements prevents an accurate count of the number of women who die from abortion.
In addition, there exists a societal bias against self-reporting and only direct deaths (where the direct cause of the woman’s death is abortion as opposed to the abortion being the indirect cause of the woman’s death) are included in the abortion mortality rate’s numerator, which further distorts this number.
Likewise, the accuracy of the denominator in the abortion mortality ratio—100,000 legal abortions—is questionable. It is not a formally certified number. The annual count by the U.S. Centers for Disease Control and Prevention (CDC) and AGI differ by 15%.[xii]
Conversely, the “childbirth mortality rate is defined by the (CDC) as all maternal deaths per 100,000 live births, rather than pregnancies.”[xiii] Maternal death from childbirth numbers are more complete than abortion-related deaths because most states link to birth and death certificates, as well as include both direct and indirect deaths, like homicides and suicides. In addition, the 100,000 live births denominator excludes all pregnancies that end by miscarriages, ectopic pregnancies, and still births, and the time period covers pregnancy and one year after birth.
Notably, in 2004, Dr. Julie Gerberding, then-director of the CDC, discouraged a comparison of the mortality rates for abortion and childbirth, warning that they cannot be compared because they are different measures. She emphasized that the two rates “are conceptually different and are used by CDC for different public health purposes.”[xiv]
Planned Parenthood’s presentation of abortion as safer than childbirth is an incongruous and misleading comparison. And women are the ones harmed by Planned Parenthood’s deception.
Researchers have found that 83 percent of women who seek abortion counseling have no prior knowledge about the abortion procedure.[xv] Thousands of women have stated that they did not receive adequate counseling from abortion providers.[xvi] Further, 85 percent of women surveyed in one major study believed they were misinformed or denied relevant information during their pre-abortion counseling.[xvii]
In its Code of Ethics, the American Medical Association (AMA) indicates that “the physician’s obligation is to present the medical facts accurately to the patient.”[xviii] But, as documented by earlier exhibits, Planned Parenthood denies women the ability to exercise true “choice” by failing to inform women of the full range of risks inherent in abortion. Deceiving women to believe that abortion is safer than childbirth further exposes the falsehood of Planned Parenthood’s “trusted provider” mantra.
[i] Numerous medical studies now demonstrate the health risks—both physical and psychological—of elective abortion, undermining earlier claims that abortion is safer than childbirth. See, e.g., J.M. Thorp et al., Long-Term Physical and Psychological Health Consequences of Induced Abortion: Review of the Evidence, Obstet. & Gyn. Survey 58:67 (2003); D.C. Reardon et al., Deaths Associated with Abortion Compared to Childbirth: A Review of New and Old Data and the Medical and Legal Implications, available at http://www.afterabortion.org/research/DeathsAssocWithAbortionJCHLP.pdf (last visited Aug. 29, 2011) and originally published at 20 J. Contemp. Health Law & Pol’y 279 (2004); D.C. Reardon et al., Deaths Associated with Pregnancy Outcome: A Record Linkage Study of Low Income Women, S. Med. J. 95:834 (2002). Moreover, when research on the abortion-breast cancer risk is factored in, the risk of dying from an abortion is found to exceed the risk of dying from childbirth by orders of magnitude. See J. Brind et al., Induced Abortion as an Independent Risk Factor for Breast Cancer: A Comprehensive Review and Meta-Analysis, J. Epidemiol. Cmty. Health 50:481-96 (1996). Furthermore, national studies from Finland, Australia, and the United States reveal a two-to-seven fold increased incidence of death from suicide, homicide, and violent death in women who have undergone abortions as opposed to women who have carried their pregnancies to term or women who have never been pregnant. See Gissler, et al., Injury, Deaths, Suicides and Homicides Associated with Pregnancy, Finland, 1987-2000, 15 Eur. J. Pub. Health 459 (2005); Cougle et al., Generalized Anxiety Following Unintended Pregnancies Resolved Through Childbirth and Abortion: A Cohort Study of the 1995 National Survey of Family Growth, 19 J. Anxiety Disorders 137 (2005); Gissler et al., Methods for Identifying Pregnancy-Associated Deaths: Population-Based Data from Finland 1987-2000, 18 Pediatric Perinat. Epidemiol. 448 (2004); Cougle et al., Depression Associated with Abortion and Childbirth: A Long-Term Analysis of the NLSY Cohort, 9 Med. Sci. Monitor 147 (2003); Gissler et al., Suicides after Pregnancy in Finland, 1987-1994: Register Linkage Study, 313 Brit. Med. J. 1431 (1996). Notably, a major study by a pro-abortion researcher found that the risk of suicide was three times greater for women who aborted than for women who delivered. See D.M. Fergusson et al., Abortion in Young Women and Subsequent Mental Health, J. Child Psychol & Psychiatry 41(1):16 (2006).
[ii] See http://www.plannedparenthood.org/health-topics/abortion/abortion-pill-medication-abortion-4354.asp (last visited Sept. 7, 2012).
[iii] See http://www.plannedparenthood.org/health-topics/abortion/in-clinic-abortion-procedures-4359.asp (last visited Sept. 7, 2012).
[v] See http://www.plannedparenthood.org/health-topics/abortion/in-clinic-abortion-procedures-4359.asp (last visited Jun. 25, 2012). Notably, this deceptive mantra appears frequently in Planned Parenthood materials. For example, in its Fact Sheet on Late-Term Abortions, Planned Parenthood alleges that “abortion after the first trimester is as safe as/or safer than carrying a pregnancy to term,” and then proceeds to attempt to compare the risk of a woman dying from an abortion to the risk of a woman dying from childbirth. See http://www.plannedparenthood.org/files/PPFA/fact_abafterfirsttrimester_2011-04.pdf (last visited Jun. 24, 2012).
[vi] See http://www.plannedparenthood.org/health-topics/abortion/in-clinic-abortion-procedures-4359.asp (last visited Sept. 7, 2012).
[vii] Clarke D. Forsythe & Bradley N. Kehr, A Road Map Through the Supreme Court’s Back Alley, 57 Villanova L. Rev. 45 (2012).
[viii] Id. See also David C. Reardon et al., Deaths Associated with Abortion Compared to Childbirth—A Review of New and Old Data and the Medical and Legal Implications, 20 J. CONTEMP. HEALTH L. & POL’Y 279, 318 (2004).
[ix] Id. The use of live births as the denominator is dictated by the World Health Organization (WHO) for purposes of enhancing international comparability. See also Letter from Julie Louis Gerberding, Dir., Ctrs. for Disease Control and Prevention, to Walter M. Weber, Senior Litig. Counsel, Am. Ctr. for Law & Justice (Jul. 20, 2004), reprinted in Amicus Brief of the Am. Ctr. For Law & Justice in Support of Petitioner add. At *24, Gonzales v. Carhart, 550 U.S. 124 (2007) (No. 05-1382), 2006 U.S. S. Ct. Briefs LEXIS 613.
[x] Clarke D. Forsythe & Bradley N. Kehr, A Road Map Through the Supreme Court’s Back Alley, 57 Villanova L. Rev. 45 (2012).
[xi] Id. Only estimates are available. See generally David Grimes, Estimation of Pregnancy-Related Mortality Risk by Pregnancy Outcome, United States, 1991 to 1999, 194 AM. J. OBSTETRICS & GYNECOLOGY 92 (2006). Researchers from the Alan Guttmacher Institute (AGI) hinted at the problems with the CDC incidence data, though with understatement: “The estimates presented in this report are subject to some limitations and should be considered provisional. First, not all states are included; the estimates assume that changes in abortion incidence in the excluded states are similar to the overall trend seen in the reporting states. Second, the completeness of abortion reporting to state health departments can vary from year to year. We attempted to exclude all states that had inconsistent reporting, but if (for example) reporting improved in some states we included, it would mean that earlier state reports were too low and that the percentage decline we calculated was too small. In such cases, our new estimates of the number of abortions would be too high.” LAWRENCE B. FINER & STANLEY K. HENSHAW, GUTTMACHER INST., ESTIMATES OF U.S. ABORTION INCIDENCE, 2001-2003, at 3 (2006), available at http://www.guttmacher.org/pubs/2006/08/03/ab_incidence.pdf (last visited Sept. 11, 2012).
[xii] Clarke D. Forsythe & Bradley N. Kehr, A Road Map Through the Supreme Court’s Back Alley, 57 Villanova L. Rev. 45 (2012).
[xiv] Id. See also Letter from Julie Louis Gerberding, Dir., Ctrs. for Disease Control and Prevention, to Walter M. Weber, Senior Litig. Counsel, Am. Ctr. for Law & Justice (Jul. 20, 2004), reprinted in Amicus Brief of the Am. Ctr. For Law & Justice in Support of Petitioner add. At *24, Gonzales v. Carhart, 550 U.S. 124 (2007) (No. 05-1382), 2006 U.S. S. Ct. Briefs LEXIS 613.
[xv] David C. Reardon, Aborted Women-Silent No More (Chicago, IL: Loyola University Press, 1987) 101 (1987).
[xvi] See, e.g., id. at 16-17, 335.
[xviii] Am. Med. Ass’n, AMA Code of Ethics, Opinion 8.08 Informed Consent, available at http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion808.shtml (last visited March 27, 2011).