Therapeutic Influence in Abortion Counseling and Procedures: Creating the Illusion of Well-Being


Smoking

According to the American Cancer Society and the Centers for Disease Control, smoking is estimated to cause about 30% of all cancer deaths. Smoking increases the chances of a woman dying from lung cancer by nearly 12 times and triples the risk of dying from heart disease among middle aged men and women. On average, U.S. women lose 14.5 years of life because they smoked. Each year from 1995-1999, smoking caused more than 178,000 deaths of women. The likelihood of women dying from lung cancer has greatly increased since the legalization of abortion. In 1971-73, the rate of death from lung cancer of U.S. females was 12.7 per 100,000 population. By 1994, it had risen to 42 per 100,000 population57.

At least three studies have found that induced abortion increases the incidence of smoking in women. A Scottish study correlated the number of cigarettes smoked by women with post-abortion anxiety with the most anxious women having the heaviest smoking habits.

A Swedish study found that postabortion women were more likely to smoke and more likely to be heavier smokers than light smokers when compared with parity matched controls or Swedish women generally. A South African study of women who sought and obtained abortions on psychiatric grounds were more likely to report increased tobacco or substance abuse (14.7%) compared to women who sought abortion on psychiatric grounds, were refused abortion, and had a variety of other pregnancy outcomes (7.2%). Interviews with women in Los Angeles or Montreal who were in a clinic for a pregnancy test found that women continuing a pregnancy to term reported reducing their incidence of smoking, while those who had abortions did not report any change in their smoking behavior58.

Researchers have found that women are more likely than men to smoke in an attempt to alleviate emotional problems. Pregnant women also report that they smoke because they are under stress or feeling upset. Several studies have found that a prior induced abortion is a significant risk factor for depression or anxiety in a subsequent pregnancy. Thus, the higher incidence of smoking in postabortion women compared to women with other reproductive outcomes, may be due to the need to alleviate the effects of abortion-related emotional problems. This higher incidence was confirmed by a Danish study which found that women whose last pregnancy ended in abortion were more likely to be smoking during a subsequent pregnancy and the least likely to stop smoking during their pregnancy compared to women whose last pregnancy ended in childbirth or to women with no previous pregnancies.

Studies on the incidence of smoking and reproductive history among British, Swedish, Danish, Eastern European, Arab and Jewish, Hong Kong as well as U.S. women have consistently found that a history of induced abortion significantly increases the incidence of smoking compared to other pregnancy outcomes.

The incidence of smoking increases as the number of prior abortions increases. A study published in 1980 found that women patients entering Boston Hospital had smoking rates of 31.7% with no prior induced abortion, 40.3% with one prior abortion, and 51.7% with two or more prior induced abortions59. In a Washington state study of 6,541 white women who delivered a child between 1984-87, 41.6% of the women smoked during this pregnancy if they had a history of 4 or more induced abortions compared with 31.0% (2 prior abortions), 28.1% (1 prior abortion) or 18% (no prior abortion)60. It appears that the effects of induced abortion increase the percentage of women who smoke as much as 3% to 10%, depending upon the study. There is also evidence that induced abortion increases the likelihood of heavy smoking among women who smoke.

Breast Cancer

The American Cancer Society estimated that there would be 178,700 new cases of invasive breast cancer in 1998 and an estimated 43,500 women would die from breast cancer in 1998. One out of eight U.S. women will have breast cancer in her lifetime61. According to the Centers for Disease Control, 45-50% of U.S. women undergo induced abortion of their first pregnancy, most often by age 20-24. It is well established that an early full-term childbirth has a protective effect against breast cancer62. A significant number will abort their only pregnancy (19% in one study) and thus be at risk for breast cancer due to lack of childbirth. Women who delay childbirth until age 30 or more do not benefit from the protective effect due to early childbirth. An increasing number of live born children, as well as breast-feeding have also been found to have an independent protective effect against breast cancer63. Whether or not induced abortion is an independent risk factor for breast cancer is controversial. However, a majority of studies have found that induced abortion is a small increased risk factor (approximately 30% overall) for breast cancer. Based on these findings, it has been estimated that the independent risk of induced abortion adds at least 40,000 cases of breast cancer among U.S. women each year64.

Ovarian Cancer

The American Cancer Society estimated that 25,400 new cases of ovarian cancer would occur in U.S. women in 1998 and that 14,500 women would die from ovarian cancer in 1998.(61) It is well established that women who never have children are more likely to die from ovarian cancer compared to women who have live-born children65. It has also been found that the risk of ovarian cancer decreases as the number of term pregnancies increases66. In contrast, incomplete pregnancies, including induced abortion, appear to offer either no protection against ovarian cancer, or provide a reduced level of protection compared with childbirth67.

Conclusions

Various counseling techniques are used to manipulate the woman to obtain an abortion while she frequently is in a state of crisis where she is vulnerable to the suggestions of others. Pre-existing beliefs about abortion may be altered and a variety of coping methods substituted. In many instances, the woman appears to be carrying out self-punishing or self-destructive impulses or attempting to punish another. The fetus or unborn child may be seen as an aspect of the "bad self'' which must be eliminated. Counseling techniques deny the existence of another human being as part of the attempt to manipulate the sense of well-being of the woman.

Drugs are used prior to and during the abortion process to alleviate stress and anxiety, pain and moral concerns, obtain cooperation of the woman, perpetuate existing denial and as an aid in creating the illusion of well-being.

Abortion counseling attempts to create the illusion that abortion is "safe" and that childbirth is more dangerous than abortion. While it is true that few women immediately die from induced abortion, there is substantial and reliable evidence that deaths from suicide and accidents shortly thereafter are much higher among postabortion women compared to postpartum women. Prior induced abortion also contributes to pregnancy-related deaths in women during childbirth from infection or obstetric hemhorrage. A substantial number of postabortion women exhibit increased drug and alcohol abuse and smoking with both short-term and long-term adverse health effects including premature death. Childbirth protects against breast cancer while induced abortion does not. Childbirth protects against ovarian cancer while induced abortion provides no protection or a lesser degree of protection compared to childbirth.

Footnotes:

1. The Culture of Narcissism, Christopher Lasch (1979) p.33 [Back]

2. The Triumph of the Therapeutic: Uses of Faith After Freud, Phillip Rieff (1966) p.13; see also The Influence of Therapeutic Culture on Abortion Decisions of the U.S. Supreme Court, Thomas Strahan, Association for Interdisciplinary Research in Values and Social Change Research Bulletin 16(4):1-8, Jan Feb 2002 [Back]

3. Informed Consent in Crisis Pregnancy and Abortion, W Bren and A Brett. Journal of Christian Health Care 5(1):3-10, 1992; Therapeutic Abortion: Clinical Aspects, E Senay, Archives of General Psychiatry 23:408-415, 1970; The experiences of women who face abortions, V Slonim-Nevo, Health Care for Women Int'l 12(3):283-292, 1991 [Back]

4. Abortions: Predicting the Complexity of the Decision-Making Process, ML Friedlander et al, Women and Health 9(1):43-54, Spring 1984 [Back]

5. Abortion Counselling - A New Component of Medical Care, Uta Landy, Clinics in Obstetrics and Gynecology 13(1):33, March 1986 [Back]

6. Abortion, adoption, or motherhood: An empirical study of decision-making during pregnancy, MB Bracken et al, Am J Obstet Gynecol 130(3):251, Feb 1978 [Back]

7. In a Different Voice: Psychological Theory and Women's Development, Carol Gilligan (1982) p.74 [Back]

8. Crisis Counseling, Howard W. Stone (1976) [Back]

9. Developmental Profiles of Adolescents and Young Adults Choosing Abortion: State Science, Decalage, and Implications for Policy, V Foster and NA Sprinthall, Adolescence 27 No.105:655, Fall 1992 [Back]

10. The Dance of Deception, Harriet G Lemer (1993) p.l87 [Back]

11. Women Who Love Too Much, Robin Norwood (1985) xiv [Back]

12. Why Do Women Have Abortions?, A Torres and JD Forrest, Family Planning Perspectives 20(4):169, July/Aug 1988 [Back]

13. Written on the Heart. The Case for Natural Law, J Budziszewski (1997) p.140 [Back]

14. The Anatomy of Bereavement, Beverly Raphael (1983) p. 238 [Back]

15. Testing a Model of the Psychological Consequences of Abortion, WB Miller et al in The New Civil War. The Psychology, Culture, and Politics of Abortion, ed. LJ Beckman and S Marie Harvey (1998) p.235-267 [Back]

16. Coping with Abortion, L Cohen and S Roth, Journal of Human Stress 10:140-145, Fall 1984 [Back]

17. The rhetoric of visual images: an analysis of pro-choice/pro-life films, Barbara Pickering, Dissertation Abstracts Int'l 54:1149A, Oct 1993 [Back]

18. Regulating Abortion Services (letter), Virginia P Riggs, MD, New England Journal of Medicine, Feb 7, 1980, p.350 [Back]

19. Passage Through Abortion, Mary K Zimmerman (1977); Psychological Problems of Abortion for the Unwed Teenage Girl, Cynthia Martin, Genetic Psychology Monographs 88:23-110, 1973; Reflections on repeated abortions: The meanings and motivations, Susan Fisher, Journal of Social Work Practice 2(2):70-87, May 1986 [Back]

20. Pregnancy, miscarriage and abortion, Dinora Pines, International Journal of Psychoanalysis 71:301, 1990 [Back]

21. Psycho-Social Aspects of Induced Abortion, Beverly Raphael, Medical Journal of Australia 2:35-40, July 1, 1972 [Back]

22. Sloan v. Women's Community Health Center, Case No. 196CC2100, Greene County, Missouri [Back]

23. Discomfort after Outpatient Abortion Using Paracervical Block: A Comparison between Two Opioids and One Non-Opioid Drug for Premedication, J Jakobbson et al, Gynecol Obstet Invest 30:71-74, 1990 [Back]

24. Pregnancy Termination: Techniques, Risks and Complications and Their Management, Robert Castadot, Fertility and Sterility 45(1):5-16, Jan 1986 [Back]

25. A consideration of ketamine dreams, P Hejja et al, Can Anaesth Soc J 22(1):100-105, Jan 1975 [Back]

26. Counseling Implications in a Client's Choice of Anesthesia During a First or Repeat Abortion, Glenda Polk-Walker, Nursing Forum 28(1): 22-27, 1993 [Back]

27. Pain of First Trimester Abortion: A study of psychosocial and medical predictors, E Belanger et al, Pain 36:339-350, 1989 [Back]

28. Aborted Women: Silent No More, David Reardon (1987 [Back]

29. The Impact of Mid-Trimester Abortion Techniques on Patients and Staff, N Kaltreider et al, Am J Obstet Gynecol 135:235, 1979 [Back]

30. The Abortionist as Craftsman, Abbott, Human Life Review 22:23, 1996 [Back]

31. Psycho-Social Stress Following Abortion, Anne Speckhard (1987) p.79-80 [Back]

32. Safety of Abortion. National Abortion Federation website www.prochoice.org. 12/30/2001 [Back]

33. Facts About Early Abortion. Planned Parenthood of Northwest Indiana. Rev 7/86 [Back]

34. Pregnancy-related mortality in the United States, 1987-1990, CJ Berg et al, Obstet Gynecol 88(2):161-167, 1996 [Back]

35. Ectopic pregnancy concurrent with induced abortion: Incidence and Mortality, HK Atrash et al, Am J Obstet Gynecol 162:726, 1990 [Back]

36. Induced Abortion and Ectopic Pregnancy in Subsequent Pregnancies, CS Chung et al, Am J Epidemiol 115(6):879, 1982; Induced abortions and risk of ectopic pregnancy, F Parazzini et al, Human Reproduction 10(7):1842, 1995; Risk of Ectopic Pregnancy and Previous Induced Abortion, C Tharux-Deneux et al. Am J Public Health 88(3):401, 1998 [Back]

37. Risk factors for major obstetric haemorrhage, RW Stones et al, Eur J Obstet Gynaecol and Reprod Biol 48:15, 1993 [Back]

38. The Impact of Multiple Induced Abortions on the Outcome of Subsequent Pregnancies, A Lopes et al, Aust NZ Obstet Gynaecol 31(1):41,1991; Pregnancy Complications Following Legally Induced Abortion, EB Obel, Acta Obstet Gynecol Scand 58:485, 1979; Concomitant and repeated happenings of complications of the third stage of labour, MH Hall et al, Br J Obstet Gynaecol 92:732, July 1985 [Back]

39. The association of placenta previa with history of cesarean delivery and abortion: A meta-analysis, CV Anath et al, Am J Obstet Gynecol 177:1071, 1997 [Back]

40. The epidemiology of placenta previa in the United States, 1979 through 1987, S Iyasau et al, Am J Obstet Gynecol 168:1414, 1993 [Back]

41. Reproductive history and the risk of neonatal sepsis, M Germain et al, Paediatric and Perinatal Epidemiol 9:48, 1995; Prior pregnancy outcome and the risk of intraamniotic infection in the following pregnancy, MA Krohn et al, Am J Obstet Gynecol 178:381, 1998 [Back]

42. Suicides after pregnancy in Finland, 1987-94: register linkage study, M Gissler et al, Br Medical Journal 313:1431, Dec 7,1997 [Back]

43. Pregnancy-associated deaths in Finland, 1987-1994 - definition problems and benefits of record linkage, M Gissler et al, Acta Obstet Gynecol Scand 76:651, 1997 [Back]

44. Mental Disorders After Abortion, B Jansson, Acta Psychiatrica Scandinavica 41:87, 1965 [Back]

45. Risk of Admission to Psychiatric Institutions among Danish Women Who Experienced Induced Abortion: An Analysis Based on a National Record Linkage, R. Somers, Dissertation Abstracts Int'l, Public Health 2621-B, 1979 [Back]

46. State-funded abortions vs. deliveries: A comparison of subsequent mental health claims over 6 years, PK Coleman, D Reardon, Poster session presented at the American Psychological Society 12th Annual Convention, Miami, FL, June, 2000 [Back]

47. Report of the Committee on the Abortion Law, RF Badgley et al, Ottawa: Supply and Services, 1977 pp.313-321 [Back]

48. Suicide Deaths Associated with Pregnancy Outcome: A Record Linkage Study of 173,279 Low Income American Women, D Reardon et al, Clinical Medicine & Health Research, clin med 2001 030003 v.l (April 25,2001) [Back]

49. Sexual Experience and Drinking Among Women in a U.S. National Survey, A Klassen and S Wilsnack, Archives of Sexual Behavior 15(5):363, 1986; Women's Drinking and Drinking Problems: Patterns from a 1981 U.S. National Survey, R Wilsnack, S Wilsnack, and A Klassen, Am J Public Health 74:1231, 1984 [Back]

50. Alcohol-Related Relative Risk of Fatal Driver Injuries in Relation to Driver Age and Sex, Paul Zodor, J Stud Alcohol 52:302, 1991 [Back]

51. Physical and Psychological Injury in Women Following Abortion: Akron Pregnancy Services Survey, LH Gsellman, Association for Interdisciplinary Research in Values and Socia Change Newsletter 5(4):1-8, Sept/Oct 1993 [Back]

52. Abortion and Subsequent Substance Abuse, D Reardon and PG Ney, Am J Drug Alcohol Abuse 26(1):61, 2000 [Back]

53. Psycho-Social Stress Following Abortion, Anne Speckhard (1987); Aborted Women. Silent No More, D Reardon (1987); Abortion Trauma. 9 Steps to Recovery, Jeanette Vought (1991) [Back]

54. Drug Use and Other Determinants of Premarital Pregnancy and Its Outcome: A Dynamic Analysis of Competing Life Events, K Yamaguchi and DB Kandel, J Marriage and the Family 49:257, 1987 [Back]

55. Characteristics of pregnant women who engage in binge alcohol consumption, J Gladstone et al, Can MedAssoc J 156(6):789, 1997 [Back]

56. Cocaine Use During Pregnancy: Prevalence and Correlates, DA Frank et al, Pediatrics 82(6):888, Dec 1988. For additional references on substance abuse and abortion see Detrimental Effects of Abortion. An Annotated Bibliography with Commentary, 3rd Edition, Thomas Strahan (2001) pp. 83-88 [Back]

57. Annual Smoking - Attributable Mortality, Years of Potential Life Lost, And Economic Costs - U.S., 1995-1999, MMWR 51(14) 300, April 12, 2002; American Cancer Society, Surveillance Research, 1998 [Back]

58. For references on smoking and abortion in this section see Detrimental Effects of Abortion. An Annotated Bibliography with Commentary, 3rd Edition, Thomas Strahan (2001) pp.88-94 [Back]

59. Association of Induced Abortion with Subsequent Pregnancy Loss, A Levin et al, JAMA 243:2495, June 27, 1980 [Back]

60. Low Birth Weight in Relation to Multiple Induced Abortions, MT Mandelson et al, Am J Public Health 82(3):391, March, 1992 [Back]

61. Cancer Facts & Figures - 1998, American Cancer Society [Back]

62. Age at First Birth and Breast Cancer Risk, B MacMahon et al, Bulletin. World Health Organization 43:209, 1970; Effect of Family History, Body Fat Distribution and Reproductive Factors on the Risk of Postmenopausal Breast Cancer, New Eng J Med 326:1323, 1992; Exogenous Estrogens and Other Risk Factors in the Epidemiology of Breast Cancer, JL Kelsey et al, J Nat Cancer Inst 67(2):327, 1981 [Back]

63. The Independent Associations of Parity, Age at First Full Term Pregnancy and Duration of Breast Feeding with the Risk of Breast Cancer, PM Layde et al, J Clin Epidemiol 42(10:963, 1989; A case-control study of parity, age at first full term pregnancy, breast feeding in Taiwanese women, FM Lai Proc et al Natl Sci Council Rep China B 20(3):71,1996 [Back]

64. Induced abortion as an independent risk factor for breast cancer: a comprehensive review and analysis, J Epidemiology and Community Health 50:481, 1996 [Back]

65. Does Pregnancy Protect Against Ovarian Cancer?, V Beral et al, The Lancet, May 20, 1978, p.1083-1087; Case-Control Study of Borderline Ovarian Cancers: Reproductive History and Exposure to Exogenous Female Tumors, BL Harlow et al, Cancer Research 48:5849. 1988 [Back]

66. Characteristics Relating to Ovarian Cancer Risk: Collaborative Analysis of 12 U.S. Case-Control Studies.ll. Invasive Epithelial Ovarian Cancers in White Women, Am J Epidemiol 136(10): 1182, 1992; Univariate and multivariate analysis of risk factors for ovarian cancer: case-control study, Mexico City, BA Mendez-Moran et al, Arch Med Res 26(3):245, 1995 [Back]

67. Incomplete pregnancies and the risk of ovarian cancer, M-T Chen et al, Cancer Causes and Control 7:415, 1996; see generally Childbirth as Protective of the Health of Women in Contrast to Induced Abortion I. Breast, Ovarian and Endometrial Cancer, Association for Interdisciplinary Research in Values and Social Change Research Bulletin 12(2): 4-7, 1998 [Back]

1, 2,