There are few topics in modern discourse quite as divisive, as fraught with misunderstanding and as rooted in deeply-held conviction as abortion.

Those on the pro-choice side of the spectrum argue that it is a woman’s right to choose whether she carries a pregnancy to term or not. On the other side, anti-abortion activists insist that from the moment of conception a foetus has an inalienable right to existence. In recent years, polarisation has increased and the topic has become exceptionally politically partisan, with the personal and political aspects increasingly difficult to separate.

Amid all the passionate argument, it is easy for misunderstandings and fictions to fill the void between opposing ideologies. Yet if we are to have a reasoned discussion about abortion rights, we have to jettison the persistent falsehoods that cloud the topic. If we are to choose reason over rhetoric, it is worth addressing some of the more pernicious myths that emerge each time the abortion question is raised.



Abortion leads to depression and suicide

Of all the myths surrounding abortion, I feel that the assertion that it leads to depression and suicide must rank as the most odious. It is a perennial favourite of anti-abortion groups. Anti-abortion campaigners call it PAS – post-abortion-syndrome, a term coined by Dr Vincent Rue. Rue is a prolific anti-abortion campaigner who testified before the US Congress in 1981 that he had observed post-traumatic stress syndrome in women who had undergone abortions. The claim rapidly mutated into the ominous and potent suggestion that abortion leads to suicide and depression. Yet despite the ubiquity of this claim by anti-abortion advocates, PAS is not recognised by relevant expert bodies. It does not appear in the DSM-V (the handbook of mental health), and the link between abortion and mental health problems is dismissed by organisations tasked with mental health protection including the American Psychological Association, the American Psychiatric Association and the Royal College of Obstetricians and Gynaecologists.



The reason for this dismissive attitude is simple: despite years of research there is no evidence that PAS exists. The hypothesis that women who undergo an abortion have worse mental health outcomes than those that don’t is at heart a scientific claim and can be tested as such. One recent study in Denmark charted the psychological health of 365,550 women, including 84,620 who’d had abortions. They found neither an increase in psychological damage, nor any elevated risk of suicide. This finding isn’t especially surprising, as previous investigations found that provided a woman was not already depressive then “elective abortion of an unintended pregnancy does not pose a risk to mental health”. In an article for the Journal of the American Medical Association entitled “The myth of the abortion trauma syndrome” , Dr. Nada Stotland eloquently stated the disconnect between the message of anti-choice organisations and the peer-reviewed literature on the subject: “Currently, there are active attempts to convince the public and women considering abortion that abortion frequently has negative psychiatric consequences. This assertion is not borne out by the literature: the vast majority of women tolerate abortion without psychiatric sequelae”, a conclusion echoed in systematic reviews.

But despite the science simply not supporting the assertions of the anti-abortion brigade, the myth persists. In a relatively recent move, some US states now require physicians to warn women seeking an abortion of the dangers to their mental health, in spite of the complete lack of scientific justification for doing so. In South Dakota, a 2005 state law not only mandated this perversion of informed consent, but also added a reprehensible smattering of emotional manipulation by insisting women be told they are terminating “a whole, separate, unique, living human being”. The jarring disconnect between scientific best evidence and the practices enforced by legislation is worrying, expressed with weary regret by the Guttmacher institute: “ ... anti-abortion activists are able to take advantage of the fact that the general public and most policy-makers do not know what constitutes “good science ... to defend their positions, these activists often cite studies that have serious methodological flaws or draw inappropriate conclusions from more rigorous studies”.

Contrary to the assertions of anti-abortion activists, the majority of women granted an abortion report relief as their primary feeling, not depression. The research also unveils a subtle but important corollary; whilst women are don’t generally suffer long-term mental health effects related to the abortion, short term guilt and sadness was far more likely if the women came from a background where abortion was viewed negatively or their decisions decried. Given this is precisely the attitude fostered by anti-abortion activists, there is a dark irony at play when organisations of this ilk increase the suffering of the very women they claim to help.



Abortion causes cancer

As if abortion were not already an emotive enough issue, elements of the anti-abortion movement have long postulated that women who elect to have an abortion are at a much increased risk of cancer, particularly of the breast. This is absolute unbridled nonsense of the highest order - the abortion-breast-cancer conjecture (ABC) was championed by prominent born-again Christian and anti-abortion campaigner Dr Joel Brind in the early 1990s. This alleged link is not supported by the scientific literature, and the ostensible link between breast cancer and induced abortion is explicitly rejected by the medical community.



But whilst there is scant scientific evidence for the ABC hypothesis, this didn’t stop the administration of George W. Bush altering the National Cancer Institute (NCI) website to suggest that elective abortion may lead to breast cancer in the early 2000s. The medical community reacted with disgust, and the New York Times slammed the rhetorical duplicity of the Bush administration as an “egregious distortion”. The NCI convened a workshop to look at the evidence in February 2003, and concluded that the hypothesis was devoid of any supporting evidence and was political rather than medical in nature. After this stinging rebuke, Brind resorted to hackneyed conspiracy theory, claiming that it was a “corrupt federal agency” and dedicated to “protecting the abortion industry”, as well as directing his ire towards the mainstream medical community.

Claims that abortion increases the risk of cancer are not credible, a position supported by bodies worldwide, including the WHO, the National Cancer Institute, the American College of Obstetricians and Gynaecologists and the Royal College of Obstetricians and Gynaecologists. Yet the ABC myth is still a potent weapon in the arsenal of anti-abortion campaigners. In 2005, Canadian anti-abortion protesters put up posters alleging a cover-up by national cancer bodies. Even today, some US state legislation demands physicians warn women about the risk despite the complete absence of a reason to suspect there is one. As an article in Medical History explains, this continuing focus on the non-existence of a link is the culmination of the “... anti-abortion movement’s efforts, following the violence of the early 1990s, to regain respectability through changing its tactics and rhetoric, which included the adoption of the ABC link as part of its new ‘women-centred’ strategy.”





Abortion reduces fertility

The suggestion that abortion can damage fertility is understandably terrifying, but based on out-dated understanding of abortion techniques. Early surgical abortions tended to be performed using a dilation and curettage (D&C) method, with an inherent but small risk of scarring that could potentially lead to complication. However, this technique is obsolete, replaced with a much safer and effective suction method in the early 1970s. In the 21st century, the WHO recommend a suction-based technique for surgical abortion, rendering the risk to future fertility negligible.

On top of this, across most of Europe the majority of abortions now take place early in the pregnancy, below 9 weeks. Abortions at this early stage are medical in nature, using compounds such as mifepristone (RU-486) which induce miscarriage. There is no evidence that either medical or modern surgical abortion impacts future fertility.

The foetus can feel pain

One of the most inflammatory arguments against abortion is rooted in the assertion that the foetus can feel pain, and that termination is therefore a brutal affair. This is extremely unlikely to be true. A foetus in the early stages of development lacks the developed nervous system and brain to feel pain or even be aware of their surroundings. The neuroanatomical apparatus required for pain and sensation is not complete until about 26 weeks into pregnancy. As the upper limit worldwide for termination is 24 weeks, and the vast majority of pregnancies are terminated well before this (most in the first 9 weeks in the UK), the question of foetal pain is a complete red herring. This is reflected in the Royal College of Obstetricians and Gynaecologists’s report on foetal pain, which concludes “... existing data suggests that cortical processing and therefore foetal perception of pain cannot occur before 24 weeks of gestation”.

Despite its complete lack of veracity, this myth remains a powerful one, and in several US states legislation dictates that doctors can be fined for not warning women that the foetus might experience pain, despite the scientific advice suggesting “proposals to inform women seeking abortions of the potential for pain in foetuses are not supported by evidence. Legal or clinical mandates for interventions to prevent such pain are scientifically unsound and may expose women to inappropriate interventions, risks, and distress.”





Reducing access to abortion decreases demand for abortion

Anti-abortion campaigners often operate under the implicit assumption that additional hurdles towards obtaining abortions will decrease the number of abortion performed; this is demonstrably false. Reducing access to abortion doesn’t quell the demand for abortion, and making abortion illegal simply makes abortion less safe. Evidence suggests that the abortion rate is approximately equal in countries with and without legal abortion. A 2012 Lancet study found that regions with restricted abortion access have higher rates than more liberal areas, and restricted regions had a much higher incidence of unsafe abortion. Worldwide, about 42 million women a year choose to get abortions, and of these about 21.6 million are unsafe. The consequences of this are grim, resulting in around 47,000 maternal deaths a year. This makes it one of the leading causes of maternal mortality (13%), and can lead to serious complications even when survived.

In the developed world where international travel is affordable, abortion restrictions make even less sense. Ireland, for example, has incredibly restrictive abortion laws, a hangover from the days when it was the last outpost of the Vatican in Europe (a situation I’ve alluded to before). But whilst the Irish anti-abortion lobbyists boast of Ireland being abortion-free, this sanctimonious gloat ignores that fact that an average of 12 women a day travel to Britain for abortions, with others procuring abortificants online. These extra barriers do not dissuade women from seeking terminations, they merely add emotional and financial obstacles to obtaining them.

These are just some of the claims which surface, hydra-like, when abortion is discussed, and this article is by no means comprehensive. Abortion is an emotive issue, and there is an an entire spectrum of positions which one might subscribe to. And of course, people have every right to hold any opinion they like. But we do not have the right to invent our own facts, and perpetuating debunked fiction helps no one. Such cynical truth-bending is not only intellectually vapid, it compounds an already difficult situation many women face, substituing emotive and sometimes manipulative fabrications in lieu of clear information.

Dr David Robert Grimes is a physicist and cancer researcher at Oxford University. He is a regular Irish Times columnist and blogs at www.davidrobertgrimes.com. He was joint winner of the 2014 John Maddox Prize for Standing up for Science.