by The retraction of three peer-reviewed articles prominently cited in court cases on the so-called abortion pill – mifepristone – has brought a group of papers from anti-abortion researchers to the scientific light.
Seventeen sexual and reproductive health researchers are demanding that four peer-reviewed studies by anti-abortion researchers be retracted or amended. Critics argue that the papers are “fatally flawed” and expose the scientific consensus to courts and lawmakers who lack the scientific training to understand their methodological flaws.
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Although some papers date back to 2002, the group argues that the stakes have never been higher now – in the post-Roe v Wade era. State and federal courts regularly hear cases about near-total abortion bans, attacks on in vitro fertilization and efforts to give human rights to fetuses.
“When we saw the meta-analysis presented over and over again – in the briefs for the Dobbs case” that turned Roe v Wade “and state cases” to restrict abortion, “the concerns really rose. ,” said Julia Littell, a retiree. Bryn Mawr professor and social researcher with expertise in statistical analysis.
Meta-analysis is a type of research that uses statistical methods to combine studies on the same topic. Researchers sometimes use these analyzes to examine the scientific consensus on a topic.
Littell was “disturbed” by a paper that said women experience a significant increase in mental health problems after an abortion – largely because of the paper’s research methods.
Of the 22 studies cited by the meta-analysis, 11 were the sole author of the paper itself. The meta-analysis “failed to meet any published methodological criteria for systematic reviews” and did not adhere to recommendations to avoid statistical dependencies, according to a criticism published in the British Medical Journal (BMJ).
Major scientific bodies have found no evidence to suggest that abortion causes increases in mental health problems. The best predictor of a woman’s mental health after an abortion is her previous health. In addition, there is substantial evidence that women who are denied abortions are psychologically and financially harmed.
Since its publication, this 2011 meta-analysis has drawn concern. Still, it remains in the scientific record a dispute that the 17 authors of the BMJ criticism, including Littell, say goes beyond mere scientific disagreement.
The paper was cited in 24 federal and state court cases and 14 parliamentary hearings in at least six countries.
Dr. Chelsea Polis, a reproductive health scientist in New York City, who helped assemble the group of academics, says that “concerns about the meta-analysis on abortion and mental health that have been published … are based on being, in my opinion professional, thoroughly methodical. faulty”.
The researcher who wrote the article, Priscilla Coleman, a retired professor from Bowling Green State University in Ohio, responded to calls for retractions with legal threats and descriptions of a conspiracy. She said the calls for retraction were “an organized effort to remove professional literature and remove studies showing that abortion increases the risk of mental health problems in order to affect the legal status of abortion”.
Since the supreme court rejected the constitutional right to abortion and allowed 21 states to greatly restrict or ban the procedure, a series of retractions and investigations show that the scientific community is slowly beginning to reassess work cited in these court cases.
“We’re making claims with legal force behind them to appear, and that’s causing people to look at a lot of this research differently,” said Mary Ziegler, a law professor at the University of California Davis, and an expert on the history of reproduction.
Another author whose work is at the center of the BMJ review is David C Reardon, a long-time opponent of abortion. The 2002 study by Reardon, also published in the BMJ, is now under investigation.
BMJ said in a statement that “the issue is still under consideration by our research integrity team”, and that their final decision would be made “publicly once we have completed our internal process”.
Reardon trained as an engineer, but found his calling in research that linked abortion to poor mental health. He founded the Elliot Institute in Illinois, an openly anti-abortion nonprofit organization, to conduct that research.
Today, Reardon is affiliated with the Charlotte Lozier Institute, which is funded by one of the most powerful anti-abortion campaign organizations in the United States, Susan B Anthony Pro-Life America. Reardon also co-authored two of the articles retracted before the supreme court hearings, both by a colleague at the Lozier Institute. Reardon did not respond to multiple requests for comment.
According to analysts of the literature and experts such as Julia Steinberg, associate professor of family science at the University of Maryland School of Public Health and co-author of a recent critique of these studies in BMJ, the science is not in dispute. “Rates of mental health problems for women with unwanted pregnancy were the same whether they had an abortion or gave birth”, an analysis by the UK’s National Collaborating Center for Mental Health found in 2011. That review was cited as one of the best. by the US National Academies of Sciences, Engineering and Medicine, in its own 2018 review of the issue.
Other reviews, such as one from 2009 by the American Psychological Association, found evidence that did not support the claim that observed associations between abortion and mental health problems are caused by abortion per se.
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“One can be pro-choice or pro-abortion or anti-abortion, but still understand what the science says about abortion and mental health,” Steinberg said.
Although scientific integrity issues may seem academic, they can have a concrete impact on policy in the post-Roe US.
One of the few cases of scientific retractions to break through to the general public was in Texas, where a federal court relied heavily on two studies in a decision to invalidate the approval of mifepristone – better known as the “abortion pill”.
The case was appealed all the way to the supreme court, where it was heard in March in oral arguments in Alliance for Hippocratic Medicine v FDA. Just weeks before the judges were set to hear the case, and as almost the entire scientific community was screaming about the “junk science” at its core, Sage Publications retracted the much-cited studies. However, the article’s claims remained in brief before the court, and one of the most conservative justices, Samuel Alito, cited them as evidence.
Like Reardon, Coleman’s paper was recently retracted, this one in Frontiers in Psychology in 2022. The journal said publicly that the paper “did not meet publication standards”. Notably, one of the paper’s reviewers also worked at the Lozier Institute. Coleman unsuccessfully sued the magazine over its decision to withdraw. The court ruled against Coleman in March 2023, Frontiers told the Guardian.
Coleman’s 2011 meta-analysis, published in the British Journal of Psychiatry, was also involved in a heated withdrawal fight in the UK. The first calls to retract the article came soon after it was published in 2012.
It was again submitted to journal editors in 2022 after the BJP formed a research integrity group. “Spurred by a strong agreement with” the importance of scientific integrity, Polis said, “I led a group of 16 scholars to summarize and present our concerns about Coleman’s meta-analysis again to the BJP.”
In response to these concerns, the BJP set up an independent panel of experts to investigate. The panel recommended withdrawing Coleman’s article, but the Royal College of Psychiatrists, the professional society that publishes the BJP, overruled it. The move prompted the resignation of independent panel members and several editorial board members.
Later reports appearing in the BMJ included panel members saying they believed the college refused to withdraw because they may not have had comprehensive legal coverage in the United States. Coleman threatened to sue – twice – according to letters obtained by the BBC.
Although Coleman denied that her legal threats contributed to the BJP’s decision not to withdraw her study, she said that the help of attorneys was important in defending her work.
“I have spent the last two years aggressively defending three of my own articles and without the financial resources to hire highly competent lawyers and the time and opportunity to write long lies, the impact could be very harmful,” said Coleman.
The Royal College of Psychiatrists responded to inquiries from the Guardian by sending a 2023 statement regarding its decision. That statement read, in part: “After careful consideration, given the length of time since the original article was published, the widely available public debate on the paper, including the letters of complaint on already available alongside the article online, and the fact that the article was already subject to a full investigation, it was decided to reject the request for the article to be withdrawn.” The statement added: “We now consider this matter closed.”
Coleman has also defended her work when she testified in US courts, including a hearing in Michigan where she said she was “not retracted from her study”.
Steinberg said: “That’s very disturbing.”
Coleman “didn’t even have to admit she made an error”, she said.
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Researchers also called for a 2009 article in the Journal of Psychiatric Research by Coleman and anti-abortion activists Catherine Coyle and Vincent Rue to be retracted. This article has also been under fire for years and even publicly debunked.
Despite apparent flaws, Coleman included this 2009 article in her meta-analysis, which critics say compounds the errors.
In addition, the authors of the BMJ review asked that anxiety be reported along with a 2005 article in the Journal of Anxiety Disorders by Coleman, Reardon and Florida State University psychology professor Jesse Cougle.
Ivan Oransky, one of the founders of the Retraction Watch blog, said that while retractions had become more common, they were not common enough to correct the scientific record. About one paper in 500 is retracted today, but perhaps as many as one in 50 should be, he said.
“All it does is further call into question what great value is being added to these multi-billion dollar publishing companies,” Oransky said. For critics of the scientific publishing industry, like Oransky, the response shows that flawed studies cited by the courts are a “sign” of problems with publishers, rather than a failure of the courts.
To Littell, the solution is clear: “We need to be publishing fewer papers, better work, better science.”
