Making contraception cheaper does not reduce a country’s abortion rate

You would think that there would be a correlation between the affordability of contraception and the abortion rate of a country. That is to say, the cheaper contraception is, the lower the rate of abortion should be. Not so, a new study from the Nordic countries suggests.

The aim of the study, which was published on the journal of the Nordic Federation of Societies of Obstetrics and Gynaecology, is to describe and compare contraceptive use, fertility, birth, and abortion rates in Denmark, Finland, Iceland, Norway, and Sweden.

In the European context, the Nordic countries are among those with the highest user rates of hormonal methods (like ‘the Pill’) and intrauterine devices and the overall use of contraception has remained relatively stable in recent years.  From roughly 1975 until the mid-1990s the abortion rate declined from a high in Denmark and in Finland, increased in Iceland and remained stable in Sweden and Norway.

“There was no clear correlation between the contraceptive user rates and abortion rates”, over this period, the study concludes.

For example, Sweden has a somewhat higher abortion rate than Denmark even though various Swedish counties subsidise contraception and Denmark does not. If making contraception more affordable reduces the abortion rate, then Sweden should have a lower abortion rate than Denmark. (In Sweden about one in four pregnancies ends in abortion. In Denmark the rate is about one in five).

This seems to be confirmed by the findings of another study, published in 2014 in the BioMed Central Public Health journal, on the reimbursement of hormonal contraceptive and the frequency of induced abortion among teenagers in Sweden.

The study found that no correlation can be found between the cost of hormonal contraceptives and the rates of abortion.

As mentioned, in Sweden the provision of family planning centres are decided by each county separately. So, there are differences in the amount of reimbursement of contraceptives between counties. The study tested the hypothesis that costs for contraceptives are a deciding factor and have an impact on the abortion rates.

Here is the result: “No clear connection is found in this paper between actual sales of hormonal contraceptives, induced abortion or the relation between different counties with different amount of reimbursement among young women 15-19 years. Our study suggests that in a modern welfare society there is neither a straight agreement between induced abortion and the amount of prescribed and dispensed hormonal contraceptives, nor reimbursement and rates of induced abortion, not only in Sweden, but also, in comparison with other Nordic countries.”

In the county of Stockholm, for instance, a fall in dispensed hormonal contraceptives was not paralleled to a rise in the numbers of abortion. (Something similar was recently noted in the UK, where the expenditure cuts in the programmes to reduce rates of teen pregnancies was found to be associated with reductions, rather than increases, of those rates).

The study also noted that Finland has no reimbursement at all for hormonal contraceptives and from 2004 has had a steady drop in the number of induced abortions.

It concluded that abortion rates among teenagers are multifactorial, they don’t depend much on the availability and cost of contraception but rather on “attitudes, education, religion, tradition or cultural differences”.

Assisted suicide comes before the Oireachtas Justice Committee

It is worrying that the topic of assisted suicide is even before our politicians, because it means some of them want us to legalise it, but the matter was considered by the Oireachtas Committee on Justice and Equality on Wednesday. Fortunately, it heard from an excellent witness in the form of Dr Regina Mc Quillan of the Irish Association for Palliative Care. She said that the introduction of assisted suicide or euthanasia would put vulnerable people at risk.

Dr McQuillan said we should reject the idea that ‘dying with dignity’ is associated with the right to assisted suicide or euthanasia. Moreover, “the acceptance of assisted suicide and euthanasia could lead to an under investment in palliative care research and service delivery, as they might be promoted as cheaper options than appropriate health care provision.”

In the previous Dail, a Private Member’s Bill by John Halligan TD was introduced in favour of assisted suicide but it didn’t proceed beyond the first stage and it was then withdrawn. Currently, the Justice Committee is considering possible recommendations in this area.

Dr Mc Quillan maintained that while healthcare professionals have a duty to respect the values and the wishes of the patients, individual autonomy is not an absolute but it must be balanced with consideration of the needs of society as a whole. Legislating in favour of assisted suicide or euthanasia may put pressure on vulnerable people, including the unwanted, the rejected, the lonely, and the emotionally vulnerable who may elect to hasten death as to avoid a sense of being a burden on family and society. Changing the law will endanger the lives of many.

Two representatives of Right to Die, Tom Curran and Michael Nugent, also presented their arguments in favour of euthanasia and assisted suicide. In the past, Tom Curran had helped deputy Halligan in drafting his Private Members Bill and was also involved in a famous constitutional challenge to the law on suicide. In his submission he asked: “if it is legal for rational person to take their own life why is assisting a person to do something that is legal a crime?”

A good response to this question came from Dr Regina Mc Quillan: “the decriminalisation of suicide was a recognition that those who survive a suicide attempt need treatment, not prosecution. Suicide is rightly considered a blight on society and there are many efforts made to reduce it. That there are some people for whom suicide is considered appropriate may suggest that there are people whose lives are not deserving of the same level of protection.”

Dr Mc Quillan also said that it is not possible to put adequate safe-guards in place and, if the law will be changed, the drive to improve the care of people with life-limiting illnesses by education, service development and research may be compromised.

More experts will be heard next week and we will keep you updated.  If you want to read about euthanasia in other countries, see here.

Minister Harris should heed scandals engulfing abortion clinics overseas

Health Minister Simon Harris intends passing a law that will regulate ‘rogue’ pro-life agencies that give bad advice to women. We don’t have any abortion clinics here and hopefully never will, but Minister Harris might like to pay attention to the scandals engulfing abortion clinics overseas, for example in the Netherlands and Britain. There is not the slightest reason to think similar things could not happen here.

In the Netherlands, almost half of abortion clinics have been closed after two newspaper investigations exposed a massive financial fraud.    CASA clinics, which are responsible for nearly half of the 31,000 abortions per year in the Netherlands, have allegedly committed fraud worth a massive €15 million to date. The clinics have been accused of irregular billing practices for public subsidies, including claims for deep sedation and overall anesthesia that were never performed.

The “Follow the Money” investigative website reports: “Consultations to clients were charged separately while they were already included in the price of a treatment. Foreign clients were overcharged for a second trimester abortion.” Health insurers were reimbursing certain operations on the assumption the were carried out by medical specialists. They were instead the work of basic physicians, for which lower rates apply.

Last week, all the seven CASA clinics have been declared bankrupt and shot down. Eight other abortion clinics, from other companies, are still in operation but some of them are also under investigation. The whole Dutch abortion industry has been exposed and at risk of further closures.

Meanwhile in Britain, the employment of non-qualified personnel has been highlighted by the Care Quality Commission (CQC), following investigations on the Marie Stopes International clinics (MSI). Last year it was found that MSI put women at risk by failing to adequately train their staff and neglecting to obtain proper consent from patients.

According to the Guardian, “Doctors in one location, who were observed obtaining consent from a woman with a learning disability, failed to ensure she understood the procedure and handled the consultation “poorly and insensitively” … Some staff obtaining consent from patients also appeared to have insufficient knowledge of procedures.” Marie Stopes International had to suspend surgical abortions for girls under 18 and vulnerable women for a period after concerns were raised by the CQC about patient safety.

A further investigation this year found that staff were offered bonuses to persuade women to have abortions. The report states that: “staff were concerned that ‘Did Not Proceed’, the term used when women decided not to proceed with treatment, was measured as a key performance indicator and linked to their performance bonus. They felt that this encouraged staff to ensure that patients underwent procedures.” They discovered that it is common practice in Marie Stopes clinics to contact women that changed their minds about having an abortion and offer them a new appointment.

Some representatives of the abortion business were invited as “experts” at the Citizens’ Assembly and at the Oireachtas Committee on the 8^th Amendment. These scandals were not highlighted.

Marie Stopes International is already operating in Northern Ireland and if abortion is introduced in the Republic we can expect that those clinics will operate here as well. As mentioned, Minister Harris seems to be concerned about crisis pregnancy agencies with a prolife ethos. What some of them have been accused of is nothing compared to the scandals mentioned above, scandals our own media haven’t bothered to highlight either.

Shielding students from uncomfortable opinions does them no favours

Identity politics is killing critical thinking in the university. I have been in UCD for fifteen years, first as a PhD student, then as a tutor and currently as a lecturer. I am also research officer for the Iona Institute. If you believe in rumors or conspiracies theories, I should qualify as the best candidate to be the mastermind of Katie Ascough’s election as president of the UCD Students’ Union (UCDSU). Unfortunately, I have never had the pleasure to meet Miss Ascough in my life.
In the current issue of the University Observer, the official paper of the UCDSU, the Iona Institute and its malefic influence is mentioned in three different articles. Rather than tackle their highly paranoid view of us, I will take this opportunity instead to highlight the alarming restrictions now being placed on contemporary university life and debate.
In my youth, I was a national leader of the national federation of university students and this is probably why I take student activism and participation, which are a good example of civic commitment, seriously. Not everybody does. In UCD, earlier this year, 90% of students did not vote for the election of their union officers. Even when they ousted Katie Ascough, attracting interest internationally, 80% of the students didn’t care to cast a vote.
Why are students disengaged from the Union that purports to represent them? Their apathy has many reasons. Some might be happy with how things are, others, more likely, might find a student union irrelevant. But there is another significant reason that needs to be addressed because it questions the nature of university education itself, today more than ever.
The Students’ Union is not only unable to embrace the plurality of views of its members but, in promoting divisive identity politics rather than fair representation, it alienates its own members. When, rarely, the frustration of some students takes the form of a challenge rather than mere indifference, the Union chastises them. This happened in 2013, for instance, when a student’s request to leave the Union was denied by the UCDSU. Fortunately, the Independent Appeals and Disciplinary Board ruled that they were wrong and couldn’t force someone to stay in the Union against his or her will.  More here: http://collegetribune.ie/ucdsu-suffers-first-disaffiliation-in-its-history/
And it happened again with the election of an ‘outsider’ such as Katie Ascough.  “There were reasons for impeachment that appeared before she got in the door”, writes the editor of the University Observer. The defenders of the official orthodoxy, who called for her removal from the very minute she was elected, didn’t had to wait long to find a ‘good’ pretext. These reasons are the views she shares with her father, a member of the Muslim Brotherhood. Oops, sorry, I meant to say of the Iona Institute. The Muslim Brotherhood would be more acceptable to the establishment in Ireland nowadays.
Last week prolife speakers from Ireland were shouted down by representatives of the Oxford Student Union. The same is likely to happen soon in our best universities too, given the current climate. In a predictable attempt to defend those bullies, the leader of the Oxford SU tweeted “Bodily autonomy is not up for debate; it is not a question of opinion.”
Quite the opposite. The university, as an institution, was founded in the Middle Ages on the principle that everything should be up for debate and no opinion should remain unquestioned. Otherwise, it is not a place for critical inquiry but for propaganda. Unfortunately, a growing deficit in viewpoint diversity is evident not only among students but also among lecturers. However, shielding students from arguments that they might find uncomfortable is a disservice to them and the truth.
I appreciated the ingenuous sincerity of the editor of the University Observer who told her readers to “avoid reading the articles of columnists who are part of the IONA institute.” She interprets wonderfully the fashionable misunderstanding of the university as a safe place where certain opinions should be avoided because they are likely to offend, cause conflict, trigger warning. She believes that her role as editor of the Students’ Union paper is to invite students to limit their sources of knowledge, for their own good. I doubt anyone will listen but this attitude betrays an ideology that kills university life.
Cardinal Newman, so dear to UCD, in discussing and rejecting the exclusion of dangerous books from the curriculum so as to preserve students from the threats of reality, said: ‘It is not the way to learn to swim in troubled waters, never to have gone into them’. Students should face all kinds of opinions and make up their own minds.
If the Students’ Union wants to regain legitimacy it should aim at reaching all sorts of students, particularly those who are ideologically more distant from the stereotypical activist. The Ascough case was a lost opportunity.

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Post scriptum:  The University Observer has contacted me to clarify that the editorial was written not by the Editor but by the Deputy Editor.