Do Abortions Harm Women?

I understand that there are 1.3 million abortions per year in the United States and there must be many times that many performed per year worldwide. I would bet dollars to donuts (a large amount against a very small amount) that there are abortions performed badly in some places, and it there are it is a sure thing that they injure some women; that was the experience in the United States before abortions were legalized and thus moved to medical facilities where they could be attended by trained physicians.

The question might alternatively be asked, do properly performed abortions harm some women? My guess is that they must. If people do anything a million times a year, some people will almost surely be harmed. However, we don't ban driving simply because tens of thousands of people are killed every year in auto accidents. We conclude that the benefits of driving outweigh even the heavy toll of auto accidents.

Incidentally, no one seems to object to the state regulating abortions to the degree that the patient can be assured that the practitioner is adequately trained and experienced to perform the procedure safely, and that the facility is appropriately staffed and equipped. The partial birth abortion controversy is about the limits of state regulation of the procedure.

So perhaps the question is, do the benefits to women from properly performed abortions outweigh the risks. Our current policy is to leave the decision to each women who is contemplating an abortion: do the benefits to her outweigh the risks to her. Of course, for such a system to work well, we have to assume that the women can make informed judgments on the issue. That is why it makes sense that physicians explain the medical and psychological risks to women contemplating having an abortion, and why people not considered able to make informed judgments themselves have the decision made by appropriate surrogates.

However, there is a movement now to have the state declare that the risks to women are so large (and unrecognized?) that more regulation of abortion is required as a public policy (as we deny driving licenses to some people on the basis that they constitute too great a risk to themselves and others). There seems to be some controversy over the actual level of risks to women who have abortions, especially risks of adverse psychological affects in the years following the procedure. It should be noted that the psychological and psychiatric professional organizations deny that there is an adequate scientific basis for such a claim, but apparently it is made, and apparently such a claim was cited by a Justice of the Supreme Court in a recent decision.

Unfortunately, it seems to me that it would be devilishly difficult to do an adequate scientific study of such an issue. First, simply asking women who had had abortions in the past might affect their feelings negatively. Indeed, I think there may be some real abuses created by anti-abortion activists using group dynamics to induce painful "pseudo-memories" in women who had had abortions. Not only may the data be suspect, but the ethics of the research could be questionable.

Second, how do you assure that reports of benefits from abortions were truthful reported, or if truthful that they were real. After all, one is asking the respondent to report on what was gained by avoiding a life as a mother. How accurate are we in predicting future happiness? How truthful are we with ourselves much less outsiders with clipboards about the outcome of important personal decisions.

But how do you compare women who decided that the benefits of an abortion outweighed the negatives with women who made the opposite decision? If there are negative post-abortion results, how would you ever ascribe them to the abortion, rather than to some preconditions that caused the woman to seek an abortion, of for that matter to subsequent events which are (inaccurately) ascribed to the abortion.

And of course, women are not the only people involved in abortions, and if the state is to make such a decision it would seem to me that it should weigh all the costs and all the benefits.

Perhaps the right question is whether we rely too much on abortion to avoid the birth of unwanted babies. I think the answer to that one is obvious. Other means of contraception seem to be preferable, and the more choices and the more informed people are as to those choices, the more likely they will chose better approaches.