When a person contemplates terminating a pregnancy by induced abortion they may go online for information. There, they will find an incredible array of misinformation and disinformation. Online platform companies like Meta, the parent company of Facebook, Twitter, and Google, struggle to monitor and police online misinformation in general, but those challenges seem especially complex for them when it comes to abortion. These platforms claim to encourage free speech and because abortion is felt by some to be a political, religious, and ethical issue the platforms appear confused about when something posted is in fact misinformation.
The online platforms often neglect to recognize that induced abortion is a medical issue and that there are many things being posted about it that are clearly incorrect. “Perhaps no medical procedure is subject to more misinformation than abortion,” wrote Jenna Sherman in the Scientific American in June, “and social media and search engine companies have been too stagnant in their efforts to stop the spread.”
So it is important to get the facts straight about abortion and then to do all we can to counteract misinformation and disinformation about it. There are two ways to accomplish an induced abortion, by taking medication and by surgery. Despite what one may read on the internet, both are safe. In fact, having an abortion is safer than having a baby. A study published ten years ago showed that a woman is 14 times more likely to die during childbirth than from complications of having an abortion.
Half of Induced Abortions are Medical
About half of induced abortions in the U.S. are now accomplished by medication according to the Guttmacher Institute and that rate may go up with the recent overturning of the Roe v. Wade decision by the U.S. Supreme Court. Contrary to misinformation often posted on the internet, the “morning after pill” is not the same as the “abortion pill.” Experts agree that morning after pills, which contain the hormone progestin and must be taken within a few days of unprotected intercourse, interfere with ovulation and fertilization and do not cause abortion. Medical abortion on the other hand involves taking two drugs, mifepristone and misoprostol, and is approved by the FDA for use up to 10 weeks of pregnancy. Medical abortions are safe and effective.
There is some concern that medications for preventing pregnancy and for medical abortion will become less available in the U.S. after the recent Dobbs decision that overturned the constitutional right to an abortion. There has been an increase in online chatter about alternatives to FDA-approved medications for abortion, including a variety of herbs. However, no herb has ever been proven to be an effective abortifacient and in fact taken in high doses there have been reports of severe toxicity and even deaths.
The alternative to medical abortion is surgical abortion. More than 90% of surgical abortions in the U.S. are performed before the 13th week of pregnancy by an aspiration procedure. Fewer than one percent of induced abortions occur in the third trimester, although these abortions later in pregnancy seem to get the most attention from anti-abortion activists. Abortions after 21 weeks are sometimes done because of the detection of severe fetal abnormalities or because the life of the mother is threatened.
Medical and Surgical Abortions Are Both Safe Procedures
Claims that induced abortion increases the risk for infertility, breast cancer, and mental health problems are incorrect. We know this from many studies, the most important of which is probably the Turnaway Study, which followed more than 1000 pregnant women for five years, beginning in 2007. Prior to the Turnaway Study, a number of reports in the literature suggested that there were increased mental health risks for women who had undergone elective abortion, but these studies were all fatally flawed. A key reason for the problem with them is that they did not control for preexisting mental health problems in women who underwent abortion and therefore could not determine if the abortion itself was really associated with any increase in risks. The Turnaway Study handled this problem in a very creative way: by comparing women who had an abortion to women who sought an abortion but were denied one because their pregnancies had gone beyond the time limit that the facility where they sought an abortion allowed, the investigators were able to assemble very well-matched groups for comparison.
The leader of the study, Diana Greene Foster, professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the University of California, San Francisco, recently wrote about the findings of the study in the journal Science: “Women unable to obtain an abortion said they had more symptoms of anxiety lower self-esteem, and lower life satisfaction. They were more likely to report ‘fair or poor’ health than those who had received abortions.” In a series of more than 50 papers published by Turnaway Study investigators, Foster noted it was also shown that women who were denied abortions were more likely to have lasting financial problems, to be unemployed, and to live below the federal poverty line compared to women who were able to obtain abortions. There is no link between having an abortion and future fertility problems and abortion does not increase the risk for breast cancer.
One thing that is also clear is that restricting access to abortion will have its greatest adverse effect on people who belong to traditionally marginalized groups. According to scientists from the University of Pennsylvania, “it is well-established that anywhere from a quarter to a third of people who receive an abortion annually are Black, and the majority are low income.” The maternal mortality rate for Black women in the U.S. is more than double the rate for white women, meaning that unwanted pregnancies among Black women will cause, among other adverse outcomes, a disproportionate increase in maternal deaths.
Regardless of one’s political, religious, and moral opinions about induced abortion, there are several things we know from research studies that belie rampant misinformation. Both medical and surgical abortions are effective and safe. There is no increase in maternal physical or mental health problems associated with having an abortion. In fact, childbirth is far riskier than having an abortion. Women who are denied an abortion suffer increased risks for unemployment, poverty, and ongoing financial and other social problems. The adverse outcomes associated with being denied an abortion disproportionately affect women of color, women with low-income, and members of traditionally marginalized groups.
While there will be differences of opinion about induced abortion, it is critically important that the available science not be distorted in these debates. Evidence tells us that abortion is safe, and that restricting abortion causes physical and mental health problems as well as a host of poorer socioeconomic and life satisfaction outcomes. We hope that people contemplating an elective abortion will have access to accurate scientific information and that this information plays a prominent role in legislative and judicial proceedings about abortion.
criticascience 