Showing posts with label RCOG. Show all posts
Showing posts with label RCOG. Show all posts

Tuesday, 26 July 2011

Just How Big A Discrepancy Is There In The “Official Figures” For Complications Following Abortion...?

The British Pregnancy Advisory Service and Marie Stopes International are not the only groups in this country who seem to ignore the facts regarding possible sequelae following abortion. The Department of Health and the Royal College of Obstetricians & Gynaecologists are even worse, considering they have a duty to protect the health of the nation including women.

Nonetheless, it is not all bad news – as we can see from the Abortion Statistics for 2010. Thankfully, these indicate that an increasing number of young gynaecologists continue to refuse to perform abortions. This is very encouraging.

It began at around the Millennium when the Young Doctors Division of the BMA revolted. They were led by a young atheist and they put forward a Motion at the BMA Annual Conference requiring that hospitals should respect the conscience clause in the Abortion Act. The common situation at that time was that consultant gynaecologists would agree to abortions virtually on demand – and then require their juniors to carry out the operations! Our young atheist doctor had witnessed all too often the pressure brought to bear on colleagues with a conscientious objection to abortions being forced to do them; if they refused their careers in obstetrics and gynaecology ended.

However, the Motion at the BMA Annual Conference was passed with a huge majority. As a result, BMA officers who were anything but pro-life were compelled to demand that the Department of Health (DoH) should circulate all NHS hospitals telling them that they had to implement the conscience clause in the Abortion Act. Consultants either had to carry out the abortions themselves or make alternative arrangements.

This resulted in NHS-funded abortions being carried out in the private sector (or Independent Sector as classified by the DoH). It was followed by a gradual increase of young men and women entering obstetrics and gynaecology who had a conscientious objection to abortion. It also led to an increase in NHS-funded abortions being carried out by the BPAS and Marie Stopes Clinics. In the year 2000, only 29% of NHS abortions were done in Independent Clinics. By 2005, this had increased to 44% and in 2010, it had gone up to 59%. Only 37% were being done in NHS hospitals.

Tragically, this is not good news for the unborn baby: s/he can still be killed on demand. However, it is otherwise good news in that gradually we have very much more caring doctors serving our women and their babies. Muslim women – I am glad to say – are far more forthright in demanding to be cared for by a doctor of their own faith or by a Christian. The ones who are very slow in coming forward are the Christians. We should do everything we can to encourage Christian women (and others who are pro-life) to demand that they and their babies should be cared for by doctors who do not do abortions. This is possible under NHS Patients’ Rights.

Come to that, I know a considerable number of agnostic women who would not want to be manhandled by some gynaecologist who has just killed a few infants – albeit that they were unborn. You don’t have to be a believer to object.

Moreover, it is not all that easy for Marie Stopes and BPAS to hire doctors to operate their surgical programmes. That is why they are so keen on medical abortions such as RU486.

Marie Stopes’ witnesses actually had the nerve to complain to one Parliamentary Select Committee about the refusal of young doctors to do abortions and the problems it created. It also explains the drive at European and world-level to get Motions passed denying the right of nurses and doctors to conscientious objections in being involved in abortions.

One can also see quite clearly why we are faced with the drive to have abortions carried out in General Practitioners’ surgeries on the approval of only one doctor. And they are not sticking at doctors being in charge. They are playing safe and trying to get the law changed so that nurses can carry out the medical abortion procedure.

The claim that they are doing this for the sake of speed and the care of women is utter bunkum. Even the inadequate figures provided in the NHS abortion statistics show that medical abortions are more dangerous than surgical abortions. The NHS claims that total complications from abortions in 2010 amounted to 287 with 122 from surgical abortions and 165 from medical abortions. This, despite the fact, that only 43% (81,512) are medical procedures  as compared with 57% (108,062) of surgical cases.

Moreover, this is by no means the least of the DoH sins against women. In “Abortion Statistics for 2010”, at the bottom of the page showing complication rates by procedure and gestation, there is a footnote telling us “complications include: haemorrhage, uterine perforation and/or sepsis and are those reported up to the time of discharge from the place of termination”.

This is ludicrous. To my mind it amounts to criminal negligence in view of the fact that an increasing number of patients are discharged on the day of termination and a majority of others remain in the hospital/clinic for only two or three days at the most.

The Abortion Act requires notification forms (which includes complications) to be returned within seven days of the abortion taking place. However, when the law first came into force patients stayed in hospital for at least two or three days. Even then, responsible gynaecologists thought this was far too short a period to allow for the discovery of complications.

Quite often infections are not evident for days or even a week or more after termination; haemorrhages may not occur until a week or so (one doctor told me that a patient was admitted to his hospital haemorrhaging a full month after she had been aborted in a “charity clinic”).  Only last week, a woman contacted me saying that she was finally admitted to hospital for corrective surgery six months after her abortion in an “independent place” and, again, two months later for a further minor procedure.

Uterine perforation may consist of only a tiny “track” (like a “pin prick”) which does not become evident for some time – and may not be discovered until the woman’s womb ruptures during a further pregnancy. This also applies to weakening of the cervix which may not become evident until in a further pregnancy it is found that the neck of the womb is unable to contain the pregnancy to full term.

Furthermore, although all hospitals are supposed to check for Chlamydia in abortion patients, only 84% report having “offered” it to patients. The spread of Chlamydia in the body caused by abortion can result in horrendous complications leaving a woman infertile and suffering intense pain at periods throughout her life unless she has a complete hysterectomy. (I have known personally several women who were so afflicted. One of the girls to whom I was very close had started on a series of affairs following sexual abuse by her father from the age of 7).

When I look at the so-called number of complications following abortions I cannot help but recall that when the House of Lords Select Committee on the Assisted Dying For the Terminally Ill Bill visited Oregon they were informed repeatedly by medical witnesses that with more than 200 assisted suicide deaths there had been no complications. Professor The Lord McColl of Dulwich (Professor of Surgery, Guy’s Hospital, London) commented that if any surgeon or physician had said he did 200 procedures without any complications he would know there was something amiss.

“We come here and I am told there are no complications. There is something strange going on here.” [House of Lord Select Committee on the Assisted Dying for the Terminally Ill Bill {HL}.Volume II: Evidence. Apr 4, 2005. p.334, Q.956.]

Looking at the DoH Abortion Statistics for 2010 the figures show a total of 287 complications from 189,574 abortions. That makes one complication for every 660 procedures, well over three times the number queried by Professor Lord McColl.

I reckon there is something even stranger going on in our neck of the woods, with the DoH and the rest of the pro-abortion lobby. However, it is no good us thinking that we will leave the protesting to the women who have suffered. Every one of us can do something. At the least we should protest to our MPs (and in letters to newspapers) about the total lack of care shown by the DoH in reporting only complications resulting from abortion up to the time of discharge from the place of termination. And I think we can also safely query – without looking foolish  just how many complications are overlooked at the time of discharge!

As I have already said, it is criminal negligence. No wonder they can claim such a low rate of complications.

Tuesday, 14 June 2011

LIFE, BPAS and How a Tragic Few Becomes a Devastating Number

They will not let it go... that is, the opponents of the LIFE appointment to the Department of Health’s Independent Advisory Group on Sexual Health and HIV.

The National Union of Students has circulated amongst its members the draft of a suggested letter to Anne Milton MP, the Government Minister responsible, in which they claim that LIFE “offers no sexual health services” (untrue – LIFE provides quality Relationship and Sexual Education, in addition to its work supplying BAPC-accredited non-directional counselling for women in crisis pregnancy and post-abortion, amongst a host of other services) and that the message promoted by LIFE is “far from evidence based”... an echo of the claim made by Mrs. Ann Furedi (see below), Chief Executive of the British Pregnancy Advisory Service (BPAS).

In an article on Spiked Online, she told us that she is not opposed to the LIFE appointment on the grounds that they take an absolute stand against abortion. She is opposed to their appointment because – she claims – it:
… alters the consensus that discussion on policy should be informed by scientific fact and medical evidence… My objection to Life is not that it stands by a particular set of views and values, but that it is seemingly casual as to the clinical evidence on which these views are based. To borrow from former MP Dr Evan Harris, ‘Life representatives are entitled to their own opinions, but they are not entitled to their own facts’.
And neither are Mrs. Furedi or the said Dr. Evan Harris (former MP)! Mrs. Furedi continues:
… I accept that Life can argue that the morning-after pill is immoral; but I cannot accept that the group should have a platform to argue, as it does, that emergency contraception damages women’s health (it doesn’t) or that it is a method of abortion (it isn’t – crucially it doesn’t work if you are pregnant!). Similarly I can accept that Life believes that abortion is wrong; but not that the Department of Health should indulge the group’s poorly substantiated fantasy that it causes breast cancer, infertility and post-abortion psychosis.
In putting forward her contentions, Mrs. Furedi, it seems, simply moves the goal posts or ignores the evidence.

Her claim that emergency contraception (the Morning After Pill) does not cause abortions is based on the fantasy that pregnancy begins only with implantation of the embryo in the womb. That is clearly incorrect. When women use pregnancy tests that check for the presence of Early Pregnancy Factor (EPF) – note that term – using an enzyme assay, this is done within 48 hours of fertilisation. Implantation  occurs about a week or up to 10 days later. As Carlson states:
Human pregnancy begins with the fusion of an egg and a sperm... the fertilised egg, now properly called an embryo, must make its way into the uterus, where it sinks into the uterine lining (implantation) to be nourished by the mother.” (Bruce M. Carlson, Human Embryology and Developmental Biology, St. Louis, MO: Mosby, 1994, pg. 3, emphasis added)
The fact is that pregnancy begins at the beginning, with the fertilisation of the ovum. If there were no embryo there would be no implantation to enable the continuation of pregnancy!

When researching on known possible risk factors connected with the morning-after pill, my friend Josephine Quintavalle – of the Pro-Life Alliance and CORE – sent me two patient information leaflets, one from Bayer Australia. Although Bayer refers to Levonelle as “emergency contraception”, they actually let the cat out of the bag in the same leaflet. They warn that a woman should not take Levonelle:
[if] you have previously had unprotected intercourse more than 72 hours earlier in the same menstrual cycle, as you may already be pregnant.” (emphasis added)
There is no suggestion there that pregnancy does not begin until implantation of the embryo. Perhaps they should let Mrs. Furedi know!

Moreover, we know that from the first moment the embryo is alive by the very fact that it can die or be killed… as with the mother taking the morning-after pill. We know that s/he is human; s/he can be attributed to no other species than homo sapiens. We are killing a conceived human being.

Moreover, we know that from the first moment the embryo is alive by the very fact that it can die or be killed… as with the mother taking the morning-after pill. We know that s/he is human; s/he can be attributed to no other species than homo sapiens. We are killing a conceived human being.

Germaine Greer (right) wrote of the manner in which women are being deceived in The Whole Woman:
These days, contraception is abortion because... pills cannot be shown to prevent sperm fertilising an ovum. Whether you feel the creation and wastage of so many embryos is an important issue or not, you must see that the cynical deception of women by selling abortifacients as if they were contraceptives is incompatible with the respect due to women as human beings.” (Greer G., The Whole Woman, London: Doubleday, 1999, pp. 92-93.)
As most people are fully aware, Miss Greer is certainly not Pro-Life. On the other hand, she is straightforward and very much more intelligent than most Guardian writers and readers and those in the pro-abortion lobby. In any case, standard textbooks on embryology affirm that:
… human development begins after the union of male and female gametes or germ cells during a process known as fertilisation (conception).” (Essentials of Human Embryology, Keith L Moore, Blackwell/Decker 1988, cf. Basic Human Embryology, Williams PL, Wendell-Smith CP, pg. 36, Pittman 2nd edition, reprint 1978; The Developing Human: Clinically Oriented Embryology, Keith L Moore MSC, 1976, Update, 19th March 1997, pg. 417)
Now we come to Mrs. Furedi’s claim about the safety of the morning-after pill. Here, I will begin by citing Sir Liam Donaldson. In 2003, he wrote as the Chief Medical Officer for England & Wales to all physicians in the country, warning that the Morning After Pill dramatically increased the chances of ectopic pregnancy, a life threatening condition. He also ordered the drug’s manufacturers to change the wording of patient information leaflets to make it clearer that there is a risk of ectopic pregnancy. Similarly, the current Bayer information leaflet warns:
If Levonelle-1 does not work, you could be pregnant. Your doctor will order a pregnancy test. If stomach pain is severe you should see your doctor immediately as on rare occasions a tubal pregnancy could occur.
Bayer, in fact, does not deny it – any more than they deny that in rare cases taking the “Morning After Pill” can also cause depression, anxiety symptoms, insomnia, libido disorders, and irritability (as well as more commonly nausea, vomiting, dizziness, tiredness and stomach pain).

We also have to tackle head-on Mrs. Furedi’s claims regarding the safety of abortion – although I note that she does not refer to the possibility of damage to the cervix resulting in subsequent pregnancies ending in miscarriage and foetal mortality. (Maybe she feels this does not count!)

If we examine the United Nations Yearbooks for the last decade or so we will see that after Poland changed its abortions laws in the nineties (to a general ban) there was a considerable drop in foetal deaths. Foetal Deaths fell to 5.6 per 1000 live births in 1996, 4.9 in 1999, 3.8 in 2004, and 3.4 in 2008. In comparison, the figures for the United Kingdom were 4.1 in 1996, 5.3 in 1999, 5.5 in 2004 – after which there are no figures for the United Kingdom included in the UN Demographic Year Book for 2008. We have to wonder why the UK with all our advanced technology has failed to report the incidence of foetal deaths for publication in the UN Demographic Yearbook!

Recently I discovered an article written by the late Charles Francis QC in which he wrote:
Although the British Journal of Obstetrics and Gynaecology is loath to publish any material suggesting abortion elevates the pre-term labour risk, an e-mail by its editor-in-chief, Professor Philip Steer, to a colleague let the cat out of the bag when his e-mail inadvertently reached the public domain. He wrote that ‘the link between TOP [termination of pregnancy] and pre-term labour... none of us dispute, the evidence is already overwhelming’. Many British gynaecologists would have performed abortions or referred patients for abortions without any warning of this risk. In these circumstances, one can understand the reluctance of the Royal College of Obstetricians and Gynaecologists (RCOG) to publicly admit this risk.
Philip Steer is Emeritus Professor of Obstetrics & Gynaecology at Imperial College and is Consultant obstetrician at the Chelsea & Westminster Hospital. He has been Editor-in-Chief of the British Journal of Obstetrics & Gynaecology (BJOG) since 2005. Among his clinical interests are high-risk pregnancy and recurrent mid-trimester loss. (He has co-edited High Risk Pregnancy: Management Options). It is interesting that under his editorship in September 2009, the BJOG carried a major paper by P.S. Shah et al on Induced termination of pregnancy and low birthweight and pre-term birth: a systematic review and meta-analyses. In the Background to the paper it states:
… first or even second trimester induced termination of pregnancy (I-TOP) are often considered minor and benign procedures: however, some studies report significant consequences to childbearing potentials and possibilities of LBW (Low Birthweight) and  PT (Pre-term) births…
The paper also refers to “overt or covert infection [infection can lead to subsequent sterility]… scarred tissue that may increase the probability of faulty placental implantation and subsequent placenta previa”.

Using data from 37 prior published studies, P.S. Shah reported:

•  One induced abortion increases the risk for Pre-Term Birth (<37 weeks) in a subsequent pregnancy by 36% (RR 1.36).
•  Two or more induced abortions increases that risk by 93% (RR 1.93 – nearly double).
•  One induced abortion increases the risk of Low Birth Weight (<5_pounds) by 35% and more than one induced abortion increases that risk to 72%.

Low-birthweight babies are at increased risk of serious health problems as newborns, lasting disabilities and even death. One example of possible disability is increased risk of cerebral palsy – or do we not count that as so important?

Now we come to Mrs. Furedi’s claims regarding “poorly substantiated fantasy that (abortion) causes breast cancer, infertility and post-abortion psychosis”.

I would be the first to admit that there is some controversy regarding possible links between abortion and breast cancer. We also have to remember that a risk is just that, and not a certainty. Nonetheless there is a mountain of evidence showing possible links between abortion and increased risks of breast cancer – which is after all a devastating disease. The Breast Cancer Prevention Institute provides annotations for any number of peer reviewed papers on the subject. At the latest count, 27 out of 33 worldwide studies have independently linked abortion with breast cancer. With only six studies claiming no link as compared with 27 providing evidence indicating that there is a risk one would think that women should at least be least be accorded the dignity of being told the consensus worldwide and let them make their own decisions.

The Breast Cancer Prevention Institute was founded by Joel Brind PhD (right), who is Professor of Biology and Endocrinology at Baruch College of the City University of NY, where he has been teaching since 1986. His research on the connections between reproductive hormones and human disease has included breast cancer since 1982. In 1996, he published a peer-reviewed research paper on the subject, Induced Abortion as an Independent Risk Factor for Breast Cancer: A Comprehensive Review and Meta-Analysis, which he wrote in collaboration with colleagues at the Pennsylvania State College of Medicine. It appeared in the October, 1996 issue of the Journal of Epidemiology and Community Health, published by the British Medical Association and the basic scientific facts into it in possible causes of breast cancer are as sound today as they were then. Joel Brind makes no secret of the fact that he is Pro-Life.  Notwithstanding, his research is and always has been absolutely meticulous and cannot be ignored.

We also have to look at the whole problem from the point of view of the UK medical profession. There has been a phenomenal increase in the rates of breast cancer during the past few decades and if our gynaecologists now admitted the possibility of any such risk would they open themselves to being sued by their patients?

Increasingly, I think that ideology comes before medicine and care for the patient. There has also been a phenomenal increase in infertility and – although we have to take into account the decision of an increasing number of women to leave childbearing until later in life and the possible side effects of long- term use of the oral contraceptive – there is little doubt that abortion can result in infertility.

Just as demeaning to the dignity of women is the refusal even to consider that abortion can cause devastating trauma in some cases. For many years we have known that abortion increases the risk of suicide and self-harm in women. An epidemiological study (Injury deaths, suicides and homicides  associated with pregnancy, Finland 1987–2000, Gissler et alEuropean Journal of Public Health (2005), 15:459-463), was conducted by Finland’s National Research and Development Centre for Welfare and Health. The comprehensive three-year study of the entire population of women in Finland found that, compared to women who have not been pregnant in the prior year, deaths from suicide, accidents and homicide are 248% higher in the year following an abortion. The study also found that a majority of the extra deaths among women who had abortions were due to suicide. The suicide rate among women who had abortions was six times higher than that of women who had given birth in the prior year and double that of women who had miscarriages. The researchers looked at data between 1987 and 2000 on all deaths among women of reproductive age (15 to 49).

It is also important to look at the work of international authority Professor David Fergusson (right), who runs the Christchurch Health & Development Study, at the University of Otago in New Zealand. Their work (Abortion in young women and subsequent mental health, Fergusson DM et alJournal of Child Psychology and Psychiatry (2006) 47(1): 16-24; Abortion among young women and subsequent life outcomes, Fergusson DM et al,  Perspectives on Sexual and Reproductive Health 39(1): 6-12; Abortion and mental health disorders: evidence from a 30-year longitudinal study, Fergusson DM et al, British Journal of Psychiatry (2008) 193: 444-451; Reactions to abortion and subsequent mental health, Fergusson et alBritish Journal of Psychiatry (2009) 195: 420-426) covers data gathered on pregnancy of a birth cohort of over 500 women studied to the age of 30. Professor Fergusson is quite openly in favour of a woman’s right to choose abortion and was at first surprised by the evidence his study uncovered. When he was attacked (as was inevitable by the pro-abortion lobby), he insisted that although he still supports a woman’s right to choose – equally the woman has a right to know what she is choosing. The 2008 research paper indicated that women who had abortions were three times more likely to develop a drug or alcohol addiction and had an overall rate of mental disorder that was about 30% higher than others in the study. In this study, Professor Fergusson and his fellow researchers reported:
This evidence clearly poses a challenge to the use of psychiatric reasons to justify abortion. There is nothing in this study that would suggest that the termination of pregnancy was associated with lower risks of mental health problems than birth.
Even the Royal College of Psychiatrists has admitted that there is so much evidence suggesting an increase in the risk of psychological problems following abortion, that women should be given counselling before they make a decision. As Fergusson (et al) concludes:
... there is now growing evidence for two major conclusions about abortion and mental health. First, exposure to abortion is an adverse life event which is associated with a modest increase in risks of mental health problems. Second, the mental health risks associated with abortion may be larger, and certainly are not smaller, than the mental health risks associated with unwanted pregnancies that come to term.” (Fergusson et al, reply to Rowlands and Guthrie on Abortion and mental health, in The British Journal of Psychiatry (2009), 195: 84)
The actual figures of psychological sequelae quoted by Fergusson et al are 1.5% to 5.5%. That may seem very much a minority to BPAS  and Marie Stopes workers. However, with 180,000-plus abortions p.a., in reality it amounts at the very least to around 2,700 women psychologically damaged annually... year in and year out! Having listened on the telephone or sat opposite a considerable number of women telling their abortion stories, I find the human cost absolutely devastating.

Elsewhere (see Fergusson's editorial, Abortion and mental health, in Psychiatric Bulletin (2008), 32 (9): 322), Professor Fergusson comments have challenged pro-abortion advocates by stating the simple truth that there has been no study in the world to show that abortion can cure any psychological problem or illness. Certainly, the pro-abortion lobby in this country has never produced any such evidence. Yet, the latest publication of Abortion Statistics for England & Wales (2010) shows of 196,109 abortions 99.96% of Ground C-only terminations (representing 185,291 of all abortions) were performed because of risk to the woman’s mental health. That is frightening when one considers the number of them who are now at risk of possible mental disorders.

Mrs. Furedi’s loquacity on “fact based science”, which she usually follows by talking absolute tosh – could be funny were it not for the BPAS counsellors. One presumes that they must follow the example of their Chief Executive when counselling girls on abortion... assuring them that it is all absolutely safe. In view of the available evidence there is no way this can be described as “impartial”, the Department of Health should most certainly delete them from its published list of “recognised pregnancy advisory services”.

In the meantime, they obviously made a wise decision in excluding BPAS from the Independent Advisory Group on Sexual Health and HIV – which now includes LIFE. We should all make a point of congratulating Anne Milton MP (above), the Government Minister responsible.