Recently when the largely manufactured ‘scandal’ surrounding pro-life counselling and crisis pregnancy centres (CPCS) hit the headlines, some members of the pro-life movement were extremely keen to denounce un-scientific or allegedly un-ethical practice and disassociate themselves from such groups, in order that they would not be tarred with the same brush.

While this was understandable in many ways, I have come to the conclusion that harsh and over-the-top criticisms (of which I have been personally guilty myself) should be avoided where possible and any  public critique or correction should be done with charity. With that in mind, it is nonetheless important that if the pro-life movement wants to be afforded any credibility, that we do not seek to ignore or brush under the carpet any errors but rather confront the charges often laid at our door by pro-choicers and if they have any validity, publicly seek to address any shortcomings both in terms of attitudes, approaches and information given out to women.

It is in this spirit that I therefore wish to offer the following comment.

This morning, a story has appeared in the Daily Mail, regarding the case of a pregnant woman who was seconds away from taking pills to terminate her pregnancy following a diagnoses of pre-natal death. Fortunately the mother insisted upon a second scan when she returned to the hospital a few days later which demonstrated that her baby was in fact alive. The little girl has now been born, is making good progress despite being born with some congenital abnormalities, the NHS trust involved has come to an out of court settlement and most importantly changed their procedures to ensure that women are always given access to a second scan to confirm the original diagnoses before taking any action to end the pregnancy.

Admittedly I am extremely sensitive about this topic, not least because it is about now that I would have been giving birth to our baby Raphael, had he or she lived. Nonetheless, it was disappointing to see this story being picked up and spun by the normally responsible Life Charity, as follows:

I’m not denying that it is an important pro-life story and no doubt it will be picked by SPUC in their regular news round-up, however there is little point in highlighting a problem, without suggesting a viable solution. The point which is being missed, not only by the Daily Mail, but also by LIFE, is not that a woman should have multiple scans as screening is allegedly often wrong, rather that she should have access to a second independent expert opinion, as soon as possible after the original diagnosis.

In the case of Mrs Wiggins, the lady featured in the story, she should not have been sent home without a second opinion or confirmation as to the status of the baby. A second scan should not be offered days later, or immediately preceding a termination, but on the same day as the diagnosis. No woman beyond 10 weeks in pregnancy should be sent home with a provisional diagnosis that her baby has probably died but she needs to come back a few days later or in a week’s time to confirm.

If you are told that your baby has died, you should be in no doubt whatsoever, and, to be fair, cases like this are thankfully rare. Recently there has been a question mark over the diagnoses of early miscarriages, which means that organisations concerned with maternal health need to work together to ensure that existing guidelines are adhered to and the advice given to women should include advice to seek a second opinion as well as a wait and see approach before terminating a suspected silent miscarriage in the very early stages, where there is often a margin of error in terms of  dates and measurements.

I found the story distressing, as would any woman who had experienced a silent miscarriage, because like Mrs Wiggins I only had one scan and this therefore raises the horrifying possibility that I may have terminated a living child. In my case I am as confident as I can ever be that the baby had died, for a number of reasons. Firstly, the person carrying out the scan spent quite a long time examining the baby in silence before telling me that there was no heartbeat and I could see for myself that the baby was not moving. Secondly, the scan was not carried about by a midwife on a maternity ward, but a qualified  radiographer who specialised in ultrasound. Thirdly, her diagnosis was not only confirmed by her colleague recording the measurements, but a third party, whom she immediately telephoned and asked them to come to verify her findings. So while the scan  took place on a single occasion, it was confirmed by 3 different medical professionals.

This should be the model of care for all women in order to minimse distress and enable them to take the decision as to their next course of action. In my case what continued to cause distress, was due to the fact that this had occurred at the end of the first trimester, my body had not acknowledged that the baby had died and so was continuing to chuck out pregnancy hormones meaning that the foetal sac was still growing and I was still feeling pregnant and growing larger. As can be imagined I am acutely sensitive to any suggestion that I may have inadvertently killed a healthy baby, as would most women be who were in a similar situation. Casting doubt over whether or not the diagnoses were correct, is irresponsible unless you are going to offer supportive resources.

Which is why pro-life groups need to ensure that they don’t jump on sensational stories which could compound the hurt and distress of women, but offer a measured response, including reassurance that these cases are in the minority and that if there is room for any doubt, then women should not rush to terminate a suspected silent miscarriage. Better still join forces with miscarriage support groups to campaign for better treatment.

What doesn’t help is using this case to cast doubt upon the reliability of pre-natal screening. Recently there have been some notable mistakes with parents mistakenly told that their babies are disabled, but in the majority of cases, the diagnoses are correct and parents take the agonising decision to abort after several detailed scans at a later stage. While we must objectively state that such abortions cannot be condoned, neither should we do anything to compound the grief and trauma of the parents, including casting doubt on pre-natal screening and diagnoses.

Pre-natal screening is not in an of itself an evil – so long as it is used for therapeutic effect, to heal and cure babies and advance the cause of fetal and neo-natal medicine which should be curative. While we should be wary that there is scope for error, neither should we reject screening as unhelpful or out of hand. Personally if one of my children were to be born with a disability I would want to know in order that we could adequately prepare and be in a position to support our child and provide optimum care.

The right of disabled babies and children to life, should not be conflated with issues surrounding misdiagnosis and pre-natal screening not least because it runs the risk of implicitly condoning or justifying those cases where the diagnoses is correct.

Pointing out that sometimes mistakes in pre-natal screening can occur should always be accompanied by relevant advice and support in case you are affected by these issues. It’s always tempting to maximise the pro-life element of these stories and jump on the outrage bandwagon but not always the most responsible course of action.

Pro-life must always be pro-woman, it must remember that it has a duty of care to all women, which includes those of us who have experienced the pain of miscarriage and abortion. That must by necessity include telling the truth but neither must it install a sense of fear, panic or distress in those who are struggling in the aftermath of losing a child, but instead offer sensible advice, reassurance and accurate medical information and access to counselling and healing for women who may be affected.

Since I wrote yesterday’s post regarding the brouhaha surrounding pro-life Crisis Pregnancy Counselling Centres, (CPCs) some valuable additional information has come to light.

Speaking with one of the groups involved yesterday, it appears that all is not quite as would seem in terms of this ‘damning’ video coverage. Firstly, the undercover reporter made 4 separate visits to the counselling centre and repeatedly pushed the issue with regards to breast cancer. Not having got what she wanted, they then went to find another centre who would indeed tell them what they wanted to hear, although it’s worth replaying the video recording or watching if you have not already done so. What was said, was not the most scientific, but neither was it the most outrageous lie.

With hindsight we can think of better ways that this information could be phrased and instead of  pro-life groups splitting into factions, actually we all ought to be supporting each other in terms of developing best practice. It’s not often that I agree with   SPUC, but in this instance, Paul Tully’s statement regarding groups who provide pro-life counselling for women, is bang on the money. They are truly heroic. Unlike the abortion clinics or sex education providers they receive absolutely no government money (which calls into question the whole issue as to whether or not they should be regulated) and they provide help and assistance to women on the very fringes of society, typically those in low socio-economic groups who do not qualify for any sort of government help. Pro-life counselling groups, do not just counsel but they provide very real support, such as money, housing, shelter, accommodation, employment and skills-based training, life-skills and in some cases literally put food on the table for starving pregnant women. Their support is wholly unconditional, if you are pregnant and going to suffer as a result of carrying your pregnancy to term, they will provide support for you for as long as you need it.

One has to ask how representative this video tape is of an ordinary undecided pregnant woman’s experience. If the groups are guilty of anything it is of naivety, although my understanding is that they regularly receive time-wasting visitors, whom they are able to see off at the first pass, who ask suspicious questions and repeatedly request to be shown graphic images. That is not the typical reaction of a woman facing an unplanned pregnancy and neither is an in-depth grilling on potential negative consequences of abortion.

That is not to defend the the poor phrasing or, misleading information but interestingly the Telegraph reports have not included any of the accompanying literature which does include some of the statistics.

We should also remember what counselling is – as Jack Scarisbrook of LIFE said a few years ago, it is not about imparting information, but allowing a safe space away from pressures for a woman to consider all of her options. A Catholic group may well take issue with the idea of non-directive counselling, because the counsellor must allow a woman to come to her own decision, even if that entails aborting her baby. However where counselling is provided by a group like LIFE for example, it is highly likely that a woman who has come to explore her options is undecided and therefore the counsellor will help her uncover the negative feelings about her pregnancy and decide whether or not they are valid, without actually advocating any course of action. It is undeniable that a woman who is feeling unsure about whether or not to abort, when given a safe opportunity to explore her feelings will more often than not choose a positive outcome for her baby.

In terms of Catholic counselling, the idea that women are pushed, cajoled, or pressurised is again a fallacious one. A counselling session will not force a woman who is unwilling to continue her pregnancy to term, to do so. The only  ‘damage’ which could be done, is that having had her conscience pricked and been exposed to a point of view which seeks to emphasise the humanity of the unborn, she could then be more prone to feelings of guilt, which begs the question as to whether or not the decision was indeed the right one for her. Guilt does not simply spring from someone pointing out an opposing ideological stance.

As to the medical data this is always supplementary information and incidental to the main decision which is always ‘can I cope with a pregnancy and young baby at this point in time’,  but so long as it is presented factually and accurately, then it would be doing a great disservice to women to deny that issues and complications can and do arise post-abortion. Cases of women who were persuaded against abortion purely because of health risks are rare, although Courtney Kardashian seems to have been swayed and has not as yet expressed any regrets. In fact she consulted her doctor to learn more about the risks who said this:

“My doctor told me there is nothing you will ever regret about having the baby, but he was like, ‘You may regret not having the baby.’ And I was like: That is so true. And it just hit me. I got so excited”

How very unscientific! How very ideological! How dare he give her such an opinion, instead of a neutral assessment of the data!

And this is the point. If the NHS was subject to secret filming of what was said to patients there would be a scandal on a daily basis. Medical staff are instructed to give you information in clear, plain and understandable English, instead of lapsing into scientific jargon. They are supposed to couch things in terms one can understand. Of course they shouldn’t come out with falsehoods or give you an opinion upon a best course of action, but they frequently do and often in very strong terms.

This is often at its most pronounced in terms of pregnancy – I have frequently been told in a very forceful manner what I ought to do both in terms of how I should deliver a child and contraceptive measures. In two pregnancies, I have been advised that I ought to consider abortion by members of the NHS on what constituted social grounds, namely the spacing of my children. Like many Catholic women we have received the obligatory hectoring post childbirth about our ‘irresponsible’ use of Fertility Awareness. Frankly that is infinitely worse than what we have seen in the pro-life counselling centres yet this happens on a daily basis on the NHS. Clinical judgement always brings an element of personal opinion into the equation. Telling a woman that she ought to have an abortion and then, as happened in my pregnancy in 2012, that she ought to go for counselling to consider it further when I refused, is in many ways worse as there is little choice when it comes to whether or not to use the NHS and staff judgement carries considerable authority.

All this worry and angst is solely driven by the pro-choice brigade – god forbid that a woman may feel anything less than wonderful following an abortion. No-one wants to see post-abortive women punished or made to go through unnecessary anxiety, but neither should pro-choice be allowed to dictate the framework here, which is one of medicalising an issue of moral judgement and closing down any viewpoint which seeks to persuade that abortion could in any way be wrong.

Two years ago, Telegraph columnist Tim Stanley wrote a fascinating piece about the success of the pro-life lobby in America, noting that they had borrowed the left’s language of health and safety and used regulation to good effect in terms of forcing clinics to ensure women’s safety. The reverse is happening over here. The liberal establishment are propping up the government-funded abortion and sex education industry to make morals a matter of medics. We are seeing this in campaigns for statutory sex education and best practice which seek to exclude parents who may not share the state agenda or curriculum in providing the correct ideology and now we see it in terms of the abortion industry and counselling which needs to be on the clinics’ terms.

Pro-lifers should not capitulate or hand-wring, counsellors need to ensure that they get their house in order, that women are given the facts and information that they need but neither should we forget that at least two lives are always at stake.

Perhaps in an attempt to be ‘balanced’ following their excellent exposes of breaches of the law carried out by abortion clinics in 2012, the Daily Telegraph have decided to set their sights on the other side of the coin, and targeted pro-life crisis pregnancy centres as being their latest target of ire.

The formidable investigative journalism carried out by the Telegraph last year, never sat particularly well with their attempt to hitch their wagon to the online feminism zeitgeist. There was always some dissonance between their condemnation of gender-selective abortion and wholesale abuses of the law such as clinics having batches of forms pre-signed by doctors who would never actually have any contact with the patient, let alone examine them, and the timbre of articles carried in their new Wonder Women section, launched last year, which has been populated by predominantly pro-choice feminists.

Emma Barnett, editor of Telegraph Wonder-Women, has written 5 articles in the past 24 hours, busting ‘abortion myths’, reporting unscientific things said in two crisis pregnancy centres, outraging women by reporting on how people could be scarred for life or be manipulated into taking a certain decision, by non regulated pregnancy centres. There’s another op ed by deputy women’s editor, Lousia Peacock, breathily mouthing “since when did Britain become pro-life America?

Perhaps having failed in their previous attempts to force discussion, the Telegraph are looking for an easy ‘win’ such as the crisis pregnancy centres, however despite their interactive map, showing the location of every single crisis pregnancy centre, they have only been able to find two, who gave out contentious information. How many other centres did they actually attend? Acres of bandwidth and ink will be spilt with post-abortive women justifying their decision, and saying how harmful it would have been if anyone told them it was wrong or how they felt guilty, however will anyone talk to those women who feel that they were bounced into abortion and not given comprehensive information by abortion clinics? And if a woman feels guilty following an abortion, blaming those who gave her an alternative point of view which pricked her conscience is dishonest. Autonomy means taking control and owning our decisions, no matter what someone else may think of them. So another woman may choose not to abort following a session at a CPC. What’s the biggie? Is it really such a worry if women decide not to abort because they are worried about the physical risks?

Before we go any further, let’s consider the accusations and their implications. Emma Barnett is concerned that women may be persuaded to keep their babies upon the basis of unsound scientific evidence. It’s not up there with aborting a baby because of their gender or not even bothering to examine a patient, or follow proper safeguards which could prevent a coerced or forced abortion. Only last week one organisation tweeted that they had spotted a woman being shouted at by a male  and hustled to get inside the clinic, when she appeared to be hesitating.

While women facing crises have a right to access reliable and factual information, the decision as to whether or not to have an abortion will always be based upon her own subjective ideology and interpretation of her circumstances. She will put her own interpretative lens on the science, whether that be with regards to the humanity of the fetus, or the weighing up of risks.

The accusation that having an abortion will make women child sex abusers is sensational and not what was actually said, which was as follows:

 “an increased statistical likelihood of child abuse” because women had to break “natural barriers that are around the child that you don’t cross” in order to terminate a pregnancy.

There is a link between abortion and mental health problems, including depression, substance abuse, violence, replacement pregnancies and difficulties in bonding with subsequent children. That is not to say that every single woman who has an abortion is going to experience such difficulties, but these are also factors which are linked to child abuse. Nowhere did the counsellor mention that the abuse would be of a sexual nature, emotional abuse can be every bit as damaging and neither did she say that this was a foregone conclusion or inevitability. There are individual clinical assessments linking post-abortion trauma with subsequent child abuse. (1)

While this might not be the wisest thing to say, neither is it as outrageous as the headlines would suggest. I would baulk at the suggestion that due to an abortion I am at risk of abusing my precious children, (the root of abuse is complex, abortion can be but one factor in the sequelae) but I would openly accept and acknowledge that the anti-natal depression I experienced in all of my pregnancies, especially the unplanned ones, have their root in the fact that I aborted my first baby. In any event, the counsellor in no way said that post-abortive women are likely to sexually abuse children.

In terms of the breast cancer link, an extremely recent meta-analysis of studies of Chinese women having induced abortions (as is common due to the one child policy) showed that just one abortion will increase the risk of breast cancer by 44%.  Two abortion will increase the risk by 76% and the risk will almost double following three abortions or more. The meta-analysis covered 36 studies, covering 14 provinces in China, comparing the risk of breast cancer amongst post-abortive women and those who had never had an abortion. This came following a similar study in Bangladesh indicating that women who had an abortion were 20% more at risk of developing breast cancer. The Chinese study was published in a prestigious medical journal Cancer Causes Control, confirmed the pioneering work of Dr Joel Brind and challenged the consensus held by professional bodies such as the Royal College of Gynaecologists and Obstetricians. There are now over 50 studies showing a positive link between breast cancer and abortion – these cannot be ignored.

One can argue over the statistical analysis, as indeed a leading  male pro-choicer frequently attempts to do, but the science is simple.

Induced abortion boosts breast cancer risk because it stops the normal physiological changes in the breast that occur during a full term pregnancy and that lower a mother’s breast cancer risk. A woman who has a full term pregnancy at 20 has a 90% lower risk of breast cancer than a woman who waits until age 30.

Breast tissue after puberty and before a term pregnancy is immature and cancer-vulnerable. Seventy five percent of this tissue is Type 1 lobules where ductal cancers start and 25 percent is Type 2 lobules where lobular cancers start. Ductal cancers account for 85% of all breast cancers while lobular cancers account for 12-15% of breast cancers.

As soon as a woman conceives, the embryo secretes human chorionic gonadotrophin or hCG, the hormone we check for in pregnancy tests.

HCG causes the mother’s ovaries to increase the levels of estrogen and progesterone in her body resulting in a doubling of the amount of breast tissue she has; in effect, she then has more Type 1 and 2 lobules where cancers start.

After mid pregnancy at 20 weeks, the fetus/placenta makes hPL, another hormone that starts maturing her breast tissue so that it can make milk. It is only after 32 weeks that she has made enough of the mature Type 4 lobules that are cancer resistant so that she lowers her risk of breast cancer.

Induced abortion before 32 weeks leaves the mother’s breast with more vulnerable tissue for cancer to start. It is also why any premature birth before 32 weeks, not just induced abortion, increases or doubles breast cancer risk.

By the end of her pregnancy, 85% of her breast tissue is cancer resistant. Each pregnancy thereafter decreases her risk a further 10%.

Spontaneous abortions in the first trimester on the other hand don’t increase breast cancer risk because there is something wrong with the embryo, so hCG levels are low. Another possibility is that something is wrong with the mother’s ovaries and the estrogen and progesterone levels are low. When those hormones are low, the mother’s breasts do not grow and change.

Pointing this out to women is not harmful or manipulative – if we are talking about making an informed decision, why should a woman not be made aware of the significant consensus of medical opinion that holds that abortion carries a breast cancer risk. Why should she be deemed incapable of interpreting the information for herself, even if she decides to ignore it, or comes to the conclusion that it is flawed?

The other ‘scandalous’ piece of advice is that abortion can increase the risk of infertility or carrying a future pregnancy to term. Clearly the stat of 25% is wrong, there is no need to make fallacious claims and to do so damages the pro-life cause, however it would be wrong to deny that abortion carries no medical risk, especially if it is surgical; there is always a risk of infection and scarring when introducing surgical instruments into bodily cavities. Anecdote is not the plural of data, but a friend of mine had difficult conceiving following the removal of a Fallopian tube due to an ectopic pregnancy. The ectopic pregnancy was caused by scarring – she had previously had three abortions. Someone else I know of reported cervical scarring requiring emergency surgery post an abortion. When she reported excruciating pain and bleeding immediately following the surgery, the clinic were disinterested. I was warned of the risk of uterine rupture when offered a surgical procedure following the death of our unborn baby – why would abortion be any different?

Furthermore any injuries, complications or infections post abortion are not counted in official statistics if they present or are reported once the woman has left the abortion clinic premises. If you go to the doctor or A&E with a post operative infection following an abortion, it will not be included in the clinic’s official figures.

Pointing out associated risks to abortion is no different to an anaesthetist being filmed pointing out the risks of surgery or anaesthetic or a pharmacist reading out the manufacturer’s leaflet that accompanies medication. Pro-lifers should not undermine their authority with incorrect information, there is no need to do so, we should condemn this practice, but it is irresponsible reporting to over sensationalise what was actually said.

Naturally the Telegraph’s report has caused a massive media sensation, with calls for these centres to be shut down and monitored because they do not provide ‘medically accurate’ information. Abortion is rarely simply a medical decision, there has not been a case in the UK of a woman needing to have an abortion to save her life, for many many years, it is always a moral judgement, which takes into account various clinical factors.

It is impossible to take a neutral stance upon abortion from a counselling perspective, even if you are supporting a woman to come to her own decision, regardless of what that decision is, that is in itself an ideological stance, taking the view that whatever a woman decides is right. We don’t apply such reasoning in other circumstances, it is not deemed acceptable to terminate a full term pregnancy on the grounds of gender for example, simply because a woman decides that it is not right for her.

Every single organisation that provides abortion counselling has an agenda of some sort or another. One cannot shut down organisations who are aiming to counsel women with crisis pregnancies simply because they are not providing what is deemed to be ‘acceptable’ medical interpretation. Where clinics are providing erroneous information then obviously they need to sharpen up their practice, but it’s likely that organisations such as these will soon establish a bad reputation locally. Ultimately no-one forces women to attend them, no-one forces women to listen to their advice and no-one forces a woman to continue an unwanted pregnancy, not even these allegedly reckless organisations.

It is also grossly unfair of the Telegraph to conflate independent local organisations with LIFE, who regardless of where one stands on their counselling provision, are accredited by BCAP and for good or ill provide non directive counselling.

If a woman wants an abortion, the Telegraph has demonstrated how easy it is for her to obtain one, no questions asked, paid for by the NHS up until 24 weeks.

Throwing in the old canards about being linked to religious organisations and throwing in the inevitable comparisons to the US (which allowed butchers such as Kermit Gosnell to operate) is an attempt to whip up fear, as is the mandatory reference to 40 days for life, who have successfully been conducting peaceful incident free vigils for the past four years in the UK. There has been no incidents of pro-life violence, nor are there any proposed bills limiting abortion in the offing, so the comparisons with the US are moot.

When I was pregnant with the baby I aborted, Marie Stopes gave me no medical information whatsoever, aside from what the procedure would entail, which they massively downplayed. I did not even know that I was receiving ‘counselling’. I told the counsellor why I wanted an abortion and she nodded grimly, adding that I had no choice and was not equipped to have a baby, it would be irresponsible. Impartial medical advice or ideological?

Why shouldn’t a religious organisation attempt to promote an alternative point of view which might persuade women that not only can they keep their babies but they are capable of being good mothers? Why can’t an organisation propose the point of view that a woman is at risk of harm from abortion?

This is an attempt to close down any point of view which might seek to persuade a pregnant woman that abortion is the wrong decision, using a contentious definition of ‘harm’. It is never harmful for a woman to decide not to kill her unborn baby, only a paternalism or totalitarianism would state otherwise. Who are we to decide that women shouldn’t be advised that abortion is not a good option, whether that be on ideological, moral or medical grounds?

The only real scandal here is that the failure to acknowledge compelling medical evidence linking breast cancer to abortion and the refusal to include post abortion complications presented after leaving the clinic in official statistics.

The scandal is trying to pretend that the decision to abort is solely a medical or clinical one and that arguments about the development or humanity of the foetus are irrelevant. The scandal is the attempt to deny that abortion can cause very real harm to women. The scandal is the attempt to close down debate on the harmful effects of abortion and deprive women of all the information they need. And if no organisation with any abortion activists should be allowed to give advice, as Nadine Dorries proposes, that would rule out abortion clinics too, who actively promote and market abortion. The head of BPAS is a frequent public abortion apologist.

The outrage being whipped up here is that a woman facing an unplanned or crisis pregnancy  might be told that abortion is not alright, is not the solution,  ends the life of an unborn child and could cause her long term harm. And that would never do.

(1) Benedict, et al., “Maternal Perinatal Risk Factors and Child Abuse,” Child Abuse and Neglect, 9:217-224 (1985); P.G. Ney, “Relationship between Abortion and Child Abuse,” Canadian Journal of Psychiatry, 24:610-620, 1979; Reardon, Aborted Women – Silent No More (Chicago: Loyola University Press, 1987), 129-30, describes a case of woman who beat her three year old son to death shortly after an abortion which triggered a “psychotic episode” of grief, guilt, and misplaced anger.