Texas state Senator Wendy Davis (Wikipedia)
MECHANICSVILLE, Va.—The National Review Online, in a recent post best described as a slimy attack on a woman running as Democratic nominee for governor of Texas, demonstrated the maxim that: “There are three kinds of lies: lies, damned lies, and statistics” (Twain 1907, p. 471).
In a blog post entitled, “Wendy Davis’s Convenient Abortion Stories,” The blogger, Dustin Siggins, takes Texas gubernatorial candidate Wendy Davis to task for what he describes as her account—in a just published autobiography— of two past abortions that he claims are “highly improbable.” Furthermore, he demands documentation from her or her campaign to back up her claims.
In her book, Davis wrote she had her first abortion for an ectopic pregnancy. An ectopic pregnancy is one in which the embryo implants in tissue outside of the uterus—a highly dangerous, even deadly, condition for the mother to be. Her second abortion, in 1997, was because the fetus suffered from a severe brain abnormality.
After describing Davis’ claims, Siggins cites anti-abortion sources who coughed up the usual litany of statistics that suggest women who have had abortions suffer from increased rates of substance abuse and other mental disorders. For example, he quotes Cheryl Sullenger, an “analyst” for the anti-abortion group Operation Rescue:
“Women who have abortions are tragically 154 percent more likely to commit suicide than women who do not have abortions. They are also 144 percent more likely to abuse subsequent children and 500 times more likely to suffer from substance abuse after their abortions, according to a 2000 report in the American Journal of Drug and Alcohol Abuse,” Sullenger explains.
The quote is confusing. Are all of these claims made in a “2000 report in the American Journal of Drug and Alcohol Abuse“? What report? I did find a “2000 report in the American Journal of Drug and Alcohol Abuse” that addressed at least one of the issues cited in the quote. The paper, “Abortion and Subsequent Substance Abuse,” by David C. Reardon and Philip G. Ney (Readon and Ney 2000) that does claim women who have had an abortion are “five times” (which equals 500 percent, but which sounds far less scary) more likely to report substance abuse after an abortion—specifically of a first pregnancy.
As far as I can tell, Reardon and Ney mention suicide once in reference to a study based on interviews with 30 women who had previously had abortions. According to Reardon and Ney, 10 percent of those interviewed in the referenced study reported suicide attempts. It is hard to interpret that figure as to whether abortion increases suicide risk: according to the Centers for Disease Control and Prevention the percentage of the population that considers suicide or, more seriously, makes a suicide plan varies widely depending on the age, gender or ethnicity group under consideration.
There are a number of studies that have suggested that a prior abortion is associated with an increased suicide risk. All of the studies that make such claims are correlational, but the fact is that correlation reveals nothing about causality. In the studies that I have reviewed, it is clear that other factors—such as lack of emotional or financial support—cannot be ruled out as drivers of suicide risk. For example, Gissler et al., (1996) found that “Women who had committed a suicide tended to come from lower social classes and were more likely to be unmarried than other women who had had a completed pregnancy.” They concluded that “The increased risk of suicide after an induced abortion indicates either common risk factors for both or harmful effects of induced abortion on mental health.”
The availability of emotional or financial support does seem to affect the risk of subsequent substance abuse. For example, Pedersen (2007) found that “… those women who still lived with the father of the aborted fetus were not at increased risk” of abusing alcohol or marijuana.
Note that the the Reardon and Ney study was published in 2000. Siggins conveniently ignores more recent research that casts doubt upon the link between abortion—at least a single abortion—and mental illness or substance abuse. Below are excerpts from a sample of that contradictory research.
Steinberg and Russo (2008) found that a host of factors, such as “pre-pregnancy anxiety symptoms, rape history, age at first pregnancy outcome (abortion vs. delivery), race, marital status, income, education, subsequent abortions, and subsequent deliveries” accounted for much of the association between first pregnancy outcome and later anxiety. For women with just one abortion, Steinberg and Russo did not find any relationship between initial pregnancy result and generalized anxiety disorder, social anxiety, and post-traumatic stress disorder. They did find a relationship between multiple abortions and subsequent social anxiety and post-traumatic stress disorder. Pre-pregnancy mental health disorders and exposure to violence explained much of that relationship. They concluded that “Researchers and clinicians need to learn more about the relations of violence exposure, mental health, and pregnancy outcome to avoid attributing poor mental health solely to pregnancy outcomes.”
Major et al., (2009) conducted a meta-analysis of research into the relationship between abortion and mental health. They found that:
Major methodological problems pervaded most of the research reviewed. The most rigorous studies indicated that within the United States, the relative risk of mental health problems among adult women who have a single, legal, first-trimester abortion of an unwanted pregnancy is no greater than the risk among women who deliver an unwanted pregnancy. Evidence did not support the claim that observed associations between abortion and mental health problems are caused by abortion per se as opposed to other preexisting and co-occurring risk factors. Most adult women who terminate a pregnancy do not experience mental health problems.”
They did note that some women do experience issues after an abortion and conclude that, “It is important that women’s varied experiences of abortion be recognized, validated, and understood,” which is sound advice.
Another meta-analysis the same year found the same thing. Robinson et al., (2009) cited some of the methodological problems that plague studies such as the ones Siggins cited as evidence of the harms caused by abortion: “poor sample and comparison group selection; inadequate conceptualization and control of relevant variables; poor quality and lack of clinical significance of outcome measures; inappropriateness of statistical analyses; and errors of interpretation, including misattribution of causal effects.”
Robinson et al., selected studies that avoided those methodological issues and came to similar conclusions that Major et al., did: “The most consistent predictor of mental disorders after abortion remains preexisting disorders, which, in turn, are strongly associated with exposure to sexual abuse and intimate violence.”
Finally, Steinberg and Finer (2011) reanalyzed the data from a study that had found a relationship between abortion and adverse mental health outcomes. Steinberg and Finer could not replicate the original findings:
Using the US National Comorbidity Survey (NCS), Coleman, Coyle, Shuping, and Rue (2009) published an analysis indicating that compared to women who had never had an abortion, women who had reported an abortion were at an increased risk of several anxiety, mood, and substance use disorders. Here, we show that those results are not replicable. That is, using the same data, sample, and codes as indicated by those authors, it is not possible to replicate the simple bivariate statistics testing the relationship of ever having had an abortion to each mental health disorder when no factors were controlled for in analyses (Table 2 in Coleman et al., 2009). Furthermore, among women with prior pregnancies in the NCS, we investigated whether having zero, one, or multiple abortions (abortion history) was associated with having a mood, anxiety, or substance use disorder at the time of the interview. In doing this, we tested two competing frameworks: the abortion-as-trauma versus the common-risk-factors approach. Our results support the latter framework. In the bivariate context when no other factors were included in models, abortion history was not related to having a mood disorder, but it was related to having an anxiety or substance use disorder. When prior mental health and violence experience were controlled in our models, no significant relation was found between abortion history and anxiety disorders. When these same risk factors and other background factors were controlled, women who had multiple abortions remained at an increased risk of having a substance use disorder compared to women who had no abortions, likely because we were unable to control for other risk factors associated with having an abortion and substance use. Policy, practice, and research should focus on assisting women at greatest risk of having unintended pregnancies and having poor mental health—those with violence in their lives and prior mental health problems.
I have yet to find a paper to substantiate the claim that a prior abortion increases the risk of abuse of subsequent children. I cannot assert that such papers do not exist, but they do not come up prominently in search engines. If they do exist, my educated guess is that the results are as equivocal as the claims that abortion “causes” increased risk of substance abuse or suicide.
It seems clear that Siggins reporting is—at best—unbalanced with respect to claims of the risks to women’s mental or physical health from abortions.
At worst, his reporting is outright biased and arguably misleading. His next paragraph mentions other reports linking abortion to subsequent mental health issues in women. He links to four of those reports—all on the site LifeSiteNews.com.
I am sorry, but given the site’s encouragement of “pro-life, pro-family” people to subscribe to its news feed or “Like” its Facebook page, I remain unconvinced of LifeSiteNews’ ability to produce fair, balanced and accurate reporting on abortion and related issues.
———
So far, nothing I have discussed justifies my description of Siggins’ report as a “slimy attack” on Wendy Davis. Sloppy, yes. Not slimy.
Yet.
Now we get to the slimy bit. Siggins quotes Sullenger in alleging that:
“… it is extremely rare—if not non-existent—for a woman to have an abortion because the pregnancy posed a risk to her life. As for fetal anomalies, it simply isn’t necessary to abort a child because he or she is sick or has a medical condition.”
“It would be disturbing to think that she may be using her abortions as a way to gain political favor with Democratic voters,” Sullenger added.
Sullenger’s claim that it is rare for a woman to have an abortion because of a threat to her health is demonstrably false. Furthermore, to claim that it isn’t necessary to abort a fetus because of a medical condition is irrelevant to the dilemma posed by such a situation. Necessary or not, rational people can disagree over whether letting such a complicated pregnancy come to term is prudent, rational—or even ethical. Sullenger does not have standing to make that decision for everyone else.
Siggins thickens the fog of falsehood with this paragraph:
“Sullenger’s analysis matches that of a 2004 Guttmacher Institute survey [Finer et al., 2005] of women who had abortions. The survey found that only 4 percent said that ‘their most important reason’ for having an abortion was ‘physical problems with my health,’ and 3 percent named ‘possible problems affecting the health of the [baby].’ “
The problem with Siggins’ claim here—and it is a big problem—is that those are not the numbers given in the Guttmacher Institute study. The relevant data are presented in Table 2 of the paper. The actual percentage of women citing “Possible problems affecting the health of the fetus” is 13 percent in 2004. The actual percentage of women citing “Physical problem with my health” is 12 percent in 2004. The percentages given in the Guttmacher study are more than three times higher than what Siggins said they were—that is not some mere rounding error.
If Siggins is this sloppy with such basic facts, one wonders where else his reporting fails to conform with facts.
Siggins is journalistically irresponsible for presenting Sullenger’s claims as self-evident truths. He is morally irresponsible for using those false truths as cudgels with which to bludgeon a woman who dares challenge the Texan patriarchy, as when he writes, “The Davis campaign did not respond to questions about whether Davis’s highly unusual abortions were matched by any medical evidence, doctor statements, or public verification from her ex-husband or two daughters.” (Emphasis mine.)
Given that more than 10 percent of women who have had abortions say they have done so because of their own health or because of serious problems with the fetus, one cannot claim such abortions are “highly unusual” as Siggins does. Rather, they are quite common.
And even if his numbers had been accurate, consider this:
According to the U.S. Census Bureau, there were 113 million women of reproductive age (between 18 and 44) in the United States in 2010 (Howden and Meyer 2011).
According to the Guttmacher Institute (2014), half of American women will have had an unwanted pregnancy by the time they reached the age of 45—dividing 113 million by two gives us 56,500,000 women who will have had an unwanted pregnancy by the time they reach 45.
According to the Guttmacher Institute (2014), 30 percent of those unwanted pregnancies will end in an abortion by the time the women reach—multiplying 56,500,000 by 30 percent gives 16,950,000 abortions.
Now, using Siggins false numbers, only 4 percent of women have an abortion because of their health and 3 percent have an abortion because of possible problems affecting the health of the fetus—multiplying 16,950,000 by 4 percent gives 678,000 abortions because of maternal health; multiplying 16,950,000 by 3 percent gives 508,500 abortions because of fetal health. Despite what Siggins claims, neither figure can objectively be called “highly unusual.”
Using the Guttmacher Institute’s actual percentages for the number of abortions because of maternal health (12 percent) and fetal health (13 percent) gives more than 2 million abortions in each case.
Again, neither figure can be called “highly unusual.”
Siggins begins his concluding section with the claim that “Davis’s abortion claims are hard to take seriously in light of the Guttmacher statistics,” and he finishes with “Maybe she had the abortion, maybe she didn’t. Maybe her reasons were as compelling as she claims. But the reasons Davis gives for having had her abortions are unproven and statistically unlikely.”
Given the “Guttmacher statistics,” it seems clear that his are the claims that cannot be taken seriously, and that he owes Davis—and arguably all women—an apology.
REFERENCES
Coleman, Priscilla K., Catherine T. Coyle, Martha Shuping, and Vincent M. Rue. 2009. “Induced abortion and anxiety, mood, and substance abuse disorders: Isolating the effects of abortion in the national comorbidity survey.” Journal of Psychiatric Research 43 (May): 770-776.
Finer, Lawrence B., Lori F. Frohwirth, Lindsay A. Dauphinee, Susheela Singh and Ann M. Moore. 2005. “Reasons U.S. Women Have Abortions: Quantitative and Qualitative Perspectives.” Perspectives on Sexual and Reproductive Health, 2005, 37 (Sep.): 110-118.
Gissler, Mika, Elina Hemminki, and Jouko Lonnqvist. 1996. “Suicides after Pregnancy in Finland, 1987–94: Register Linkage Study.” BMJ 313 (Dec. 7): 1431-1434.
Guttmacher Institute. 2014. Induced Abortion in the United States. https://www.guttmacher.org/pubs/fb_induced_abortion.html (accessed Sept. 11, 2014).
Howden, Lindsay M., and Julie A. Meyer. 2011. Age and Sex Composition: 2010. Washington, D.C.: United States Department of Commerce: U.S. Census Bureau. C2010BR-03.
Major, Brenda, Mark Appelbaum, Linda Beckman, Mary Ann Dutton, Nancy Felipe Russo, and Carolyn West. 2009. “Abortion and mental health: Evaluating the evidence.” American Psychologist 64 (Dec.): 863-890.
Pedersen, Willy. 2007. “Childbirth, abortion and subsequent substance use in young women: a population-based longitudinal study.” Addiction 102 (Nov. 19): 1971-1978.
Reardon, David C. and Philip G. Ney. 2000. “Abortion and Subsequent Substance Abuse.” American Journal of Drug and Alcohol Abuse 26 (1): 61–75.
Robinson, Gail Erlick, Nada L. Stotland, Nancy Felipe Russo, Joan A. Lang, and Mallay Occhiogrosso. 2009. “Is There an ‘Abortion Trauma Syndrome’? Critiquing the Evidence.” Harvard Review of Psychiatry 17 (Jan.): 268-290.
Steinberg, Julia Renee, and Nancy F. Russo. 2008. “Abortion and anxiety: What’s the relationship?” Social Science & Medicine 67 (July): 238–252.
Steinberg, Julia R., and Lawrence B. Finer. 2011. “Examining the association of abortion history and current mental health: A reanalysis of the National Comorbidity Survey using a common-risk-factors model.” Social Science & Medicine 72 (Jan.): 72-82.
Twain, Mark. 1907. “Chapters from My Autobiography. XX.” North American Review 618 (July 5): 465-474.
Lies, damned lies, and abortion statistics
Posted by AbyssWriter on 9/11/14 • Categorized as Commentary
Texas state Senator Wendy Davis (Wikipedia)
MECHANICSVILLE, Va.—The National Review Online, in a recent post best described as a slimy attack on a woman running as Democratic nominee for governor of Texas, demonstrated the maxim that: “There are three kinds of lies: lies, damned lies, and statistics” (Twain 1907, p. 471).
In a blog post entitled, “Wendy Davis’s Convenient Abortion Stories,” The blogger, Dustin Siggins, takes Texas gubernatorial candidate Wendy Davis to task for what he describes as her account—in a just published autobiography— of two past abortions that he claims are “highly improbable.” Furthermore, he demands documentation from her or her campaign to back up her claims.
In her book, Davis wrote she had her first abortion for an ectopic pregnancy. An ectopic pregnancy is one in which the embryo implants in tissue outside of the uterus—a highly dangerous, even deadly, condition for the mother to be. Her second abortion, in 1997, was because the fetus suffered from a severe brain abnormality.
After describing Davis’ claims, Siggins cites anti-abortion sources who coughed up the usual litany of statistics that suggest women who have had abortions suffer from increased rates of substance abuse and other mental disorders. For example, he quotes Cheryl Sullenger, an “analyst” for the anti-abortion group Operation Rescue:
The quote is confusing. Are all of these claims made in a “2000 report in the American Journal of Drug and Alcohol Abuse“? What report? I did find a “2000 report in the American Journal of Drug and Alcohol Abuse” that addressed at least one of the issues cited in the quote. The paper, “Abortion and Subsequent Substance Abuse,” by David C. Reardon and Philip G. Ney (Readon and Ney 2000) that does claim women who have had an abortion are “five times” (which equals 500 percent, but which sounds far less scary) more likely to report substance abuse after an abortion—specifically of a first pregnancy.
As far as I can tell, Reardon and Ney mention suicide once in reference to a study based on interviews with 30 women who had previously had abortions. According to Reardon and Ney, 10 percent of those interviewed in the referenced study reported suicide attempts. It is hard to interpret that figure as to whether abortion increases suicide risk: according to the Centers for Disease Control and Prevention the percentage of the population that considers suicide or, more seriously, makes a suicide plan varies widely depending on the age, gender or ethnicity group under consideration.
There are a number of studies that have suggested that a prior abortion is associated with an increased suicide risk. All of the studies that make such claims are correlational, but the fact is that correlation reveals nothing about causality. In the studies that I have reviewed, it is clear that other factors—such as lack of emotional or financial support—cannot be ruled out as drivers of suicide risk. For example, Gissler et al., (1996) found that “Women who had committed a suicide tended to come from lower social classes and were more likely to be unmarried than other women who had had a completed pregnancy.” They concluded that “The increased risk of suicide after an induced abortion indicates either common risk factors for both or harmful effects of induced abortion on mental health.”
The availability of emotional or financial support does seem to affect the risk of subsequent substance abuse. For example, Pedersen (2007) found that “… those women who still lived with the father of the aborted fetus were not at increased risk” of abusing alcohol or marijuana.
Note that the the Reardon and Ney study was published in 2000. Siggins conveniently ignores more recent research that casts doubt upon the link between abortion—at least a single abortion—and mental illness or substance abuse. Below are excerpts from a sample of that contradictory research.
Steinberg and Russo (2008) found that a host of factors, such as “pre-pregnancy anxiety symptoms, rape history, age at first pregnancy outcome (abortion vs. delivery), race, marital status, income, education, subsequent abortions, and subsequent deliveries” accounted for much of the association between first pregnancy outcome and later anxiety. For women with just one abortion, Steinberg and Russo did not find any relationship between initial pregnancy result and generalized anxiety disorder, social anxiety, and post-traumatic stress disorder. They did find a relationship between multiple abortions and subsequent social anxiety and post-traumatic stress disorder. Pre-pregnancy mental health disorders and exposure to violence explained much of that relationship. They concluded that “Researchers and clinicians need to learn more about the relations of violence exposure, mental health, and pregnancy outcome to avoid attributing poor mental health solely to pregnancy outcomes.”
Major et al., (2009) conducted a meta-analysis of research into the relationship between abortion and mental health. They found that:
They did note that some women do experience issues after an abortion and conclude that, “It is important that women’s varied experiences of abortion be recognized, validated, and understood,” which is sound advice.
Another meta-analysis the same year found the same thing. Robinson et al., (2009) cited some of the methodological problems that plague studies such as the ones Siggins cited as evidence of the harms caused by abortion: “poor sample and comparison group selection; inadequate conceptualization and control of relevant variables; poor quality and lack of clinical significance of outcome measures; inappropriateness of statistical analyses; and errors of interpretation, including misattribution of causal effects.”
Robinson et al., selected studies that avoided those methodological issues and came to similar conclusions that Major et al., did: “The most consistent predictor of mental disorders after abortion remains preexisting disorders, which, in turn, are strongly associated with exposure to sexual abuse and intimate violence.”
Finally, Steinberg and Finer (2011) reanalyzed the data from a study that had found a relationship between abortion and adverse mental health outcomes. Steinberg and Finer could not replicate the original findings:
I have yet to find a paper to substantiate the claim that a prior abortion increases the risk of abuse of subsequent children. I cannot assert that such papers do not exist, but they do not come up prominently in search engines. If they do exist, my educated guess is that the results are as equivocal as the claims that abortion “causes” increased risk of substance abuse or suicide.
It seems clear that Siggins reporting is—at best—unbalanced with respect to claims of the risks to women’s mental or physical health from abortions.
At worst, his reporting is outright biased and arguably misleading. His next paragraph mentions other reports linking abortion to subsequent mental health issues in women. He links to four of those reports—all on the site LifeSiteNews.com.
I am sorry, but given the site’s encouragement of “pro-life, pro-family” people to subscribe to its news feed or “Like” its Facebook page, I remain unconvinced of LifeSiteNews’ ability to produce fair, balanced and accurate reporting on abortion and related issues.
———
So far, nothing I have discussed justifies my description of Siggins’ report as a “slimy attack” on Wendy Davis. Sloppy, yes. Not slimy.
Yet.
Now we get to the slimy bit. Siggins quotes Sullenger in alleging that:
Sullenger’s claim that it is rare for a woman to have an abortion because of a threat to her health is demonstrably false. Furthermore, to claim that it isn’t necessary to abort a fetus because of a medical condition is irrelevant to the dilemma posed by such a situation. Necessary or not, rational people can disagree over whether letting such a complicated pregnancy come to term is prudent, rational—or even ethical. Sullenger does not have standing to make that decision for everyone else.
Siggins thickens the fog of falsehood with this paragraph:
The problem with Siggins’ claim here—and it is a big problem—is that those are not the numbers given in the Guttmacher Institute study. The relevant data are presented in Table 2 of the paper. The actual percentage of women citing “Possible problems affecting the health of the fetus” is 13 percent in 2004. The actual percentage of women citing “Physical problem with my health” is 12 percent in 2004. The percentages given in the Guttmacher study are more than three times higher than what Siggins said they were—that is not some mere rounding error.
If Siggins is this sloppy with such basic facts, one wonders where else his reporting fails to conform with facts.
Siggins is journalistically irresponsible for presenting Sullenger’s claims as self-evident truths. He is morally irresponsible for using those false truths as cudgels with which to bludgeon a woman who dares challenge the Texan patriarchy, as when he writes, “The Davis campaign did not respond to questions about whether Davis’s highly unusual abortions were matched by any medical evidence, doctor statements, or public verification from her ex-husband or two daughters.” (Emphasis mine.)
Given that more than 10 percent of women who have had abortions say they have done so because of their own health or because of serious problems with the fetus, one cannot claim such abortions are “highly unusual” as Siggins does. Rather, they are quite common.
And even if his numbers had been accurate, consider this:
According to the U.S. Census Bureau, there were 113 million women of reproductive age (between 18 and 44) in the United States in 2010 (Howden and Meyer 2011).
According to the Guttmacher Institute (2014), half of American women will have had an unwanted pregnancy by the time they reached the age of 45—dividing 113 million by two gives us 56,500,000 women who will have had an unwanted pregnancy by the time they reach 45.
According to the Guttmacher Institute (2014), 30 percent of those unwanted pregnancies will end in an abortion by the time the women reach—multiplying 56,500,000 by 30 percent gives 16,950,000 abortions.
Now, using Siggins false numbers, only 4 percent of women have an abortion because of their health and 3 percent have an abortion because of possible problems affecting the health of the fetus—multiplying 16,950,000 by 4 percent gives 678,000 abortions because of maternal health; multiplying 16,950,000 by 3 percent gives 508,500 abortions because of fetal health. Despite what Siggins claims, neither figure can objectively be called “highly unusual.”
Using the Guttmacher Institute’s actual percentages for the number of abortions because of maternal health (12 percent) and fetal health (13 percent) gives more than 2 million abortions in each case.
Again, neither figure can be called “highly unusual.”
Siggins begins his concluding section with the claim that “Davis’s abortion claims are hard to take seriously in light of the Guttmacher statistics,” and he finishes with “Maybe she had the abortion, maybe she didn’t. Maybe her reasons were as compelling as she claims. But the reasons Davis gives for having had her abortions are unproven and statistically unlikely.”
Given the “Guttmacher statistics,” it seems clear that his are the claims that cannot be taken seriously, and that he owes Davis—and arguably all women—an apology.
REFERENCES
Coleman, Priscilla K., Catherine T. Coyle, Martha Shuping, and Vincent M. Rue. 2009. “Induced abortion and anxiety, mood, and substance abuse disorders: Isolating the effects of abortion in the national comorbidity survey.” Journal of Psychiatric Research 43 (May): 770-776.
Finer, Lawrence B., Lori F. Frohwirth, Lindsay A. Dauphinee, Susheela Singh and Ann M. Moore. 2005. “Reasons U.S. Women Have Abortions: Quantitative and Qualitative Perspectives.” Perspectives on Sexual and Reproductive Health, 2005, 37 (Sep.): 110-118.
Gissler, Mika, Elina Hemminki, and Jouko Lonnqvist. 1996. “Suicides after Pregnancy in Finland, 1987–94: Register Linkage Study.” BMJ 313 (Dec. 7): 1431-1434.
Guttmacher Institute. 2014. Induced Abortion in the United States. https://www.guttmacher.org/pubs/fb_induced_abortion.html (accessed Sept. 11, 2014).
Howden, Lindsay M., and Julie A. Meyer. 2011. Age and Sex Composition: 2010. Washington, D.C.: United States Department of Commerce: U.S. Census Bureau. C2010BR-03.
Major, Brenda, Mark Appelbaum, Linda Beckman, Mary Ann Dutton, Nancy Felipe Russo, and Carolyn West. 2009. “Abortion and mental health: Evaluating the evidence.” American Psychologist 64 (Dec.): 863-890.
Pedersen, Willy. 2007. “Childbirth, abortion and subsequent substance use in young women: a population-based longitudinal study.” Addiction 102 (Nov. 19): 1971-1978.
Reardon, David C. and Philip G. Ney. 2000. “Abortion and Subsequent Substance Abuse.” American Journal of Drug and Alcohol Abuse 26 (1): 61–75.
Robinson, Gail Erlick, Nada L. Stotland, Nancy Felipe Russo, Joan A. Lang, and Mallay Occhiogrosso. 2009. “Is There an ‘Abortion Trauma Syndrome’? Critiquing the Evidence.” Harvard Review of Psychiatry 17 (Jan.): 268-290.
Steinberg, Julia Renee, and Nancy F. Russo. 2008. “Abortion and anxiety: What’s the relationship?” Social Science & Medicine 67 (July): 238–252.
Steinberg, Julia R., and Lawrence B. Finer. 2011. “Examining the association of abortion history and current mental health: A reanalysis of the National Comorbidity Survey using a common-risk-factors model.” Social Science & Medicine 72 (Jan.): 72-82.
Twain, Mark. 1907. “Chapters from My Autobiography. XX.” North American Review 618 (July 5): 465-474.
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