Can bad science lead us to draw wrong conclusions about the world we live in? “Of course it can“, we are inclined to think. And if so, can this have real-life consequences? Investigating these meta-questions is not as easy as it might seem, for it would require an exact manner to distinguish the good from the bad science, and it would require a subject that has been thoroughly investigated in both the ‘good’ and the ‘bad’ ways to compare the outcomes.

One such subject would be the vast amount of research done on the psychological consequences of undergoing an induced abortion. This heavily researched (and heavily debated!) subject focusses primarily on the questions whether or not a women has a higher chance of suffering from anxiety, feeling of guilt, depression, or (other) mental disorders caused by undergoing an induced abortion. The conclusions drawn in the vast literature on this basic question vary form an abortion having no consequences, to an abortion having a negative impact on the psychological well-being of a woman.

Charles, Polis, Sridhara and Blum (2008) did a systematic review of this literature. Interestingly, they did not only classify the findings, but also derived a set of guidelines by which to evaluate the methodological quality of each research paper.

Analytical studies were rated on a scale from Excellent to Very Poor using five major criteria: (1) use of an appropriate comparison group; (2) use of valid mental health measures; (3) control for preexisting mental health status; (4) control for confounders; and
(5) whether there was comprehensive exploration of the research question. (p. 437)

Trained researchers would find it difficult to disagree with these ‘five guidelines for quality research’. However, hardly any of the studies they evaluated did comply with all of them. Try to imagine what the consequences of failing to comply with any of these guidelines might be. For instance, it is known that mental health status relates to the chance of becoming pregnant unintendedly, and subsequently it relates to the decision whether or not to keep the baby. Not taking that into account would attribute the difference in mental health between women who have had an abortion, and women who did not, to the abortion, whereas these differences in fact were already present before the abortion. A similar argument goes for taking into account differences regarding age, educational level, and religious conviction: these characteristics all relate to both mental health and the odds of having an unintended pregnancy and / or an abortion. As a last example, the groups of women that are compared should be as equivalent as possible, except for having had an abortion. However, studies compared women having had an abortion with, for example, the general population, or just with women having carried out their pregnancy. This practice does not allow for causal inference, for it cannot exclude the effects of pregnancy intentions.

In total, Charles et al. evaluated 21 studies, the methodological quality of which varied widely, as did their conclusions on the consequences of an abortion. Their most fascinating finding was that a relation exists between the methodological quality of a study and the conclusions drawn in it: the better studies hardly found any consequences from undergoing an abortion, whereas the poorer quality studies did find negative consequences of an abortion. In other words: bad science tends to overestimate the consequences of an induced abortion.
Generally, these differences are due to the fact that the studies with poor methodology did not take into account differences between women prior to the abortion, thereby attributing differences between women in mental health to having had an abortion, whereas in fact these differences were pre-existing.

There we have it: bad science distinguished from good science, and different outcomes. So, yes, bad science indeed leads to wrong outcomes and in real life, this can have consequences. In the policy-discussions on induced abortion, the possibility of negative consequences of an abortion plays an important role. It would depend on which research papers the policy makers turn to, what their stand on the issue would be.

The question that remains is now: can we trust policy makers to distinguish the good from the bad (science)?

V CHARLES, C POLIS, S SRIDHARA, R BLUM (2008). Abortion and long-term mental health outcomes: a systematic review of the evidence Contraception, 78 (6), 436-450 DOI: 10.1016/j.contraception.2008.07.005

A lot has been written about this, as well as on what exactly should be interpreted as polarisation. Methodologically inclined literature seems to be debating this to some extent, but at least agree that it has to do with an increasingly broad distribution of attitudes or opinions. In less technical terms, this means that the opinions of large number of people in society differ in increasing amounts. so, we’re talking about polarisation of the general public, instead of the polarised activities of either pro-life, or pro-choice organisations.

What, then, has this to do with Women on Waves in Valencia? Women of Waves is a “Dutch non-profit organisation concerned with women’s human rights. Its mission is to prevent unwanted pregnancy and unsafe abortions throughout the world.” (Quoted from their web-site.) The use boats to go to countries in which abortion is restricted of prohibited by law, allow women who want to have an abortion aboard, sail to international waters, let the women have an induced abortion, and then sail back to the national waters of the country they started. Since national legislature is not in effect in international waters, the national abortion bans are neither. What the Women on Waves do, it seems, is perfectly legal. But, it also raises controversy.

There is a lot to say about Women on Waves, both in favour in against, but I will remain neutral on this one. However, the news coverage on their recent arrival in Valencia, Spain, made clear to me another effect their actions has. As a sociologist, I’m interested in the unintended consequences of peoples’ actions, and I think that the presence of Women on Waves in a country or city might have a polarising consequence. Both pro-choice organisations (who invited Women on Waves), and pro-life organisations rallied in the Spanish harbour. They both use all the energy they have to bring their views to the attention of the larger public.

Sure, none of these organisations will have changed their positions. However, I think that the presence of both types of organisations, their rallying, and the coverage in the news of these events, might have forced people in Valencia, Spain, and perhaps even abroad, to form their opinions on induced abortion. This can either be in favour, or against, but the increased visibility of the abortion-debate must have decreased the number of people who aren’t really aware of the issue, or have never given much thought about it.

It is not the goal of Women on Waves to change peoples’ attitudes, but to allow women to have an abortion. Nevertheless, I think it might have had an unintented consequence of (slightly) polarising the abortion debate. Again, an interesting phenomenon for sociological study, and again it is just there to be found in the news. I love my job!

The body of literature on this subject is vast and has interesting titles as ‘Culture Wars’, and ‘Before the Shooting Begins’. The Culture Wars hypothesis, proffered by Hunter, basically states that Americans’ attitudes have increasingly been formed by two diverging fundaments. One important aspect of the Culture Wars is the (strong) impact of religious doctrine on many Americans’ life.

To get a good feeling of what is going on in these ‘Culture Wars’, I try to read more than just academic literature. Besides newspapers and, of course, what the U.S. Presidential candidates state about abortion, I recently discovered a blog named ‘Dispatches from the Culture Wars’.

Some interesting posts (or would Ed Brayton (the author) refer to them as ‘dispatches’) are to be found there. For instance, Brayton mentions a school that is . I find it interesting to read what people have to say about that, and this blog quotes quite a few. Also, do read the comments: it’s Culture Wars all over again (especially pay attention to the comment of ‘mroberts’ and the reactions to that).

Other contributions are evenly interesting: Apparently, in America you can get forced to go to rehab that works on religious principles, even when you’re not religious. Texas schools are encouraged to use aunconstitutional religious curriculum, for which some schools already have been sued. On this blog, I found a link to an organisation called Americans for Truth”. And there is much more to be found.

Sure, the author of ‘Dispatcher from the Culture Wars’ has taken his own stand in the debate, and for academic purposes it will not make sense to accept all for truth. But that’s not the point: this blog is a very interesting read if you’re interested in the formation of Americans’ opinions and the impact that religion has on that.

UPDATE:
Just hours after writing this blog, Ed Brayton updated his blog with a short article on Sarah Palin not being able to state Supreme Court rulings on induced abortion, other than Row vs. Wade I’ve added the movie here as well, so please let me know what you think about it.

Building upon the paper written by Jelen et al. (1993) that I wrote about a few days ago, I’d like to bring to your attention a more recent paper by Dutch researchers. ((Desclaration of interest: I personally know and work with most of the authors of this paper. Thereby, please don’t regard this blog as neutral, or possibly critical, review, but rather as a — hopefully — interesting perspective and notification of fascinating research.)) It also addresses attitudes toward abortion in Western Europe, but does so in a rather more advanced manner. As might be expected from an article written 15 years later, much developments have been made in the research on public opinion regarding induced abortion, both on a theoretical level, as well as on a methodological level. Let’s take a look at the outcomes of those improvements.

The authors state three main mechanisms on which the formation of attitudes toward induced abortion is based. At first, it is known that people adjust their opinion to ruling legislation in the country they live in. Secondly, based on the seminal work by Émile Durkheim, the authors state that in general people adjust their norms (and thereby attitudes) on topics to the norms prevalent in the (intermediary) groups they are a member of. Thirdly, previous research found that people tend to adjust their opinion to what is commonly thought to be good, or commonly done, in the ‘public domain’. They refer to this as the ‘marketplace of opinions and behaviour’.

Based on these three fundamental mechanisms, several interesting hypotheses are formulated, of which I will name only a few. Generally, it is expected that due to educational expansion people have become more liberal between 1981 and 2000. This is also, to some extend, expected due to a general trend toward more liberal legislation of induced abortion in Western Europe during the last few decades. Most churches object against (the possibility of) induced abortion, with the Catholic church expressing the most pronounced pro-life stance. It is thus hypothesised that members of more strict churches will object against induced abortion more strongly. Regarding the ‘marketplace of opinions and behaviour’, it is expected that people will express more favourable opinions toward the possibility of abortion when living in a country with high abortion ratio’s.

The authors tested these (and other) expectations on 14 European countries, with a time-span between 1981 and 2000. This was done by performing multilevel regression analyses on data from the European Value Survey. Some of the findings that I find especially interesting, is that when one lives in a country with many non-religious people, one tends to have fewer objections against induced abortion. Also, when more induced abortions are performed in a country (measured by abortion ratio’s), people tend to have more liberal attitudes on this subject. The authors accounted for some causality issues by taking the abortion ratio measured two years prior to the measurement of the attitude. Also, it was found that while members of a church and frequent church attendants have relatively negative attitudes towards induced abortion (compared with non-members and infrequent attendants), this impact waned over time. No differences between Protestants and non-members were found. Finally, by taking into account several demographic variables, educational level and religious denomination of respondents, and different levels of religiousness and abortion ratio’s of countries, the authors were able to explain much of the between-country differences in attitudes towards abortion.

Reference

Ariana Need, Wout Ultee, Mark Levels, Marike van Tienen (2008). Mening over abortus in West-Europa, 1981-2000 Mens en Maatschappij, 83 (1), 5-22