Doctors wrestle with South Dakota abortion law.

The law, lawyers, and the court.
Aug. 19 2008 6:20 PM

Script Doctors

The dilemma facing South Dakota's abortion providers: Mislead your patients or break the law.

(Continued from Page 1)

That's not the same position that the state took before the 8th Circuit, according to Evans, when the attorney general's office said it could accept variations on the statutory language as long as the basic meaning was preserved. And so whether Planned Parenthood must follow the statute's script precisely will be one of the fights waged before Judge Shrier, who will probably hear the case this fall. (Also on the fall calendar: a November referendum in South Dakota that would ban almost all abortions.)

While the parties parry and feint and wait for their next day in court, the American Psychological Association is trying to put to rest the unsupported claim that abortion causes mental-health problems. The area of controversy is broader than suicide: Researchers who are abortion opponents have also claimed that the procedure is linked to heightened risk of depression and drug abuse. In the last few years, some of their work has been published in peer-reviewed medical journals. The APA assigned a task force to review all the relevant scientific literature and assess "the relative risk of mental health problems associated with abortion compared to its alternatives."

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The APA task force report, published last week, concluded that "the majority of studies suffered from methodological problems, often severe in nature." One large and recurring flaw: Studies often fail to compare women who have abortion with women who keep unplanned pregnancies. That's the proper control group, the task force said, because women who plan to give birth differ from those who don't in ways that bear on mental health. Women whose pregnancies are unplanned tend to be poorer, as a group, and they are more likely to engage in risky behavior.

The task force authors conclude, "The best scientific evidence published indicates that among adult women who have an unplanned pregnancy therelative risk of mental health problems is no greater if they have a single elective first-trimester abortion than if they deliver that pregnancy." There is evidence that late-term abortions because of birth defects are understandably hard on women. And in general, the task force recognized that women who have abortions sometimes feel "sadness, grief, and feelings of loss." Some also experience depression and anxiety. But the authors found no evidence that abortion causes those reactions, any more than giving birth does. Postpartum depression, after all, is real and relatively common.

The task force report ends with a call for well-designed research that would settle the question of abortion's mental-health implications "once and for all." That would be nice. But in the meantime, the APA report probably won't persuade the South Dakota legislature to change its mind about ordering doctors to march their abortion patients through made-up mental-health risks. The right attacked the APA task force as biased and dismissed its work right from the start. Those critics are no happier now that the report is out. It's a truism that when science and politics tangle, facts often don't much matter. At the moment, women getting abortions in South Dakota are caught in that snarl.

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