The Sunday Times wants women to be more grateful for their unwanted pregnancies

Today the media has vomited up a delightful little piece of rhetoric, twice by The Sunday Times, once under the title “IVF babies aborted as mothers lose in love” and once as “Scandal of aborted IVF babies“,* along with the The Mail on Sunday parroting the The Times‘s findings under the headline “Dozens of IVF babies aborted ‘after women change their minds about becoming a mother’“.

All the articles are based on the news that 80 abortions per year are carried out to terminate foetuses produced by IVF treatment. That’s the entirety of the factual content of the articles. The statistics that this is based on actually seem to have been released two years ago. Oddly, The Times claims it had to use the Freedom of Information act to prise these data out of the Human Fertility and Embryology Authority (HFEA)’s hands, and the paper carries a snide dig from Dr. Mohamed Taranissi that the HFEA should be “much more open with the data they have” (the paper of course neglects to mention that Taranissi and the HFEA have a somewhat fraught relationship, and that he might not give the most unbiased opinion). In fact, you can download these statistics from the HFEA’s website and have a play with them yourself, although be advised they are in a rather human-unfriendly format.

80 post-IVF abortions, up to half of which are performed on women aged 18-34. Note the use of the word “up to half”, not just “half”. This will be relevant later.

The papers however see this as a clear cause for indignation. “Jilly, who does not want to be identified, is one of a growing number of young women who have chosen to abort foetuses for “social” reasons after fertility treatment,” thunders The Times. They attempt a flimsy justification – “These women [18-34 year olds] — usually the healthiest — are the least likely to conceive babies with abnormalities, suggesting a “social” reason may have led to the decision” – but there are several flaws with the argument (an argument that only appears in the shorter version of the article, interestingly enough). First of all, reproductively healthy couples tend not to need IVF treatment (there are of course lesbian and transgender couples who need to use IVF treatment if they want genetically related children, but the data doesn’t differentiate between the reasons for undergoing IVF), so while 18-34 year olds in general may be healthier and more fertile, you can’t translate that blindly into the realm of IVF patients. Secondly, 18-34 year olds are far more likely to be trying for a first child. People with a history of successful births are going to be more likely to have their future births be successful too, while people with a history of miscarriage or abnormality might be more reluctant to try again – especially since IVF on the NHS specifically screens out couples with a history of mutation or foetal abnormality. Finally, they don’t mention what proportion of 18-34 year olds seek IVF in the first place, and here, the numbers are surprising.

By far, the largest segment of the population seeking out IVF are women in this age range. 408,702 18-34 year olds have received IVF treatment since 1991, compared to 373,308 35-50 year olds. In total, 52% of women who received IVF were in this range. Since The Times used that delightful phrase “up to”, we can be sure that already the first part of their thesis has been blown apart – 18-34 year old IVF patients are less likely than their older counterparts to seek abortion.

Secondly, by “up to 50%”, what they actually mean is 42%. That’s a lot less than 52%, so clearly, the bulk of abortions are performed for older women – conveniently, the ones The Times just told us were more likely to experience foetal abnormality. It turns out that 0.13% of 18-34 year old IVF treatments subsequently seek a termination, compared to 0.19% of 35-50 year olds. By comparison, 2.1% of 18-34 year olds sadly experienced a miscarriage, compared with 2.6% of 35-50 year olds (and given that the miscarriage rate is much higher than the abortion rate, why isn’t The Times or the “pro-life” Mail decrying these numbers and demanding better pre-natal care?). If we naïvely assume that the rate of foetal abnormalities is correlated to the rate of miscarriages, we can see that foetal health appears to be more of a reason for termination among 18-34 year olds than than older women. I think we can call The Times‘s ‘”social” reasons’ bullshit out for what it is.

A graph demonstrating the rates of IVF and abortion by age group

The 18-34 age group clearly has a far lesser abortion rate in proportion to the total number of abortions carried out than the the other age groups

Now let’s look at the half of the data – those 80 abortions every year. Let’s get a little perspective first. In 2007, 51,521 women received IVF treatment. If 80 received abortions, that’s a very small percentage – 0.18% in fact. Secondly, to obtain the average of 80 abortions per year, several years of the data have been skipped out – most likely, the early 1990s. Secondly, post IVF abortions spiked at 110  in the late 90s, and then dropped sharply before rising slowly for most of the last decade (the data shows a sharp decline in 2008, but the data appears to run out on June 30th, so I think that’s just an artefact).

A graph displaying the number of post IVF-abortions carried out each year

The data as the Sunday Times would like us to interpret it.

So from first glance, while it’s wildly exaggerated, there does seem to be a kernel of truth in there. The post-IVF abortion rate does appear to have risen over the last decade. Except… this doesn’t take into account the fact that the IVF rate has also risen. If you take the recent increase in IVF treatment into account, then, year-on-year, there has been a consistent decline in the rate of post-IVF abortions – quite possibly related to the relaxation of rules on paternity allowing more healthy LGBT couples to receive treatment (curiously the very cause The Daily Mail campaigned against a few years ago. You’d think they’d be happier about anything that reduced the abortion rate).

The adjusted graph, showing a decline in the rate of post IVF-abortions since 2005.
A close up, showing more clearly the decline.

The data, once adjusted for the increase in IVF treatment

But wait, there’s even more problems with the article.

IVF is notorious for its propensity to cause multiple births. Women are often implanted with 2 or in some cases 3 embryos, since the odds of one successfully implanting is fairly low. Occasionally all of the embryos will implant, and this leaves unlucky women with more embryos than they wanted. The Sunday Times‘s statistics don’t differentiate between the different reasons for termination, but luckily, the HFEA’s data tells you how many live births resulted from each IVF session. It turns out, 25% of women who had an abortion post-IVF went on to give birth to at least one child, so clearly, the only thing “scandalous” about a least of a quarter of the abortions is women controlling their own fertility – which is precisely the point of IVF treatment anyway.

Like I said, the HFEA tables don’t include the reason for the termination, but 10 seconds of Googling turned up this article, from The Journal of Human Reproduction: “Why do some women undergo termination of pregnancy after successful IVF treatment?” It’s an opinion piece, but it links to a number of studies on post-IVF abortions. The data are all quite old, but in late 1980s France, the largest dataset available, somewhere on the order of 83% of post-IVF abortions were therapeutic – and this doesn’t include “reductions” (abortion of some but not all the foetuses). To claim less than 17% of women (bear in mind this a small sample, so admittedly variation in this number could be quite large) are “most” is just downright stupid.

Finally and most importantly, so what? All the examples of “social” abortions given by The Sunday Times are cases where women have split up or run into problems with their partners, or realised they weren’t ready to have children. If these women had conceived normally, no-one would bat an eyelid at the fact that a few of them decided to terminate their pregnancy. Surely if women have the right to control their fertility with IVF, don’t they have the exact same right to control it with abortion, should their circumstances change? No-one takes IVF or abortion lightly, no matter what the papers may try to claim, with their horror quotes about how “these women can’t be surprised to be pregnant”, and that they’re “treating babies like designer goods” (a quote from Ann Widdecombe, who I’m sure is a completely unbiased authority on embryology).

The only halfway decent argument that post-IVF abortion is bad comes buried deep in the text, where it points out that IVF treatment costs £5,000 per cycle; if we assume every single woman who had a complete termination (i.e. one not performed just to prevent a multiple birth) did it for non-clinical reasons, that comes to a cost of £300,000 per year. Of course, the cost of performing the 52,521 IVF cycles carried out in 2007 is £262,605,000, so that £300,000 is a drop in the ocean. Furthermore, the NHS doesn’t fund most IVF – they’ll only fund it in younger women, and as we’ve seen, younger women have a lower abortion rate than older women. Given that the NHS does not, in fact, own a crystal ball, and can’t predict which women will suffer a change of circumstances, and which IVF cycles will result in abnormal foetuses, it’s stupid to try and use any kind of money saving argument to block post-IVF abortion. Women will continue to have IVF treatment, and instead find themselves saddled with unwanted pregnancies that they are unable to terminate.

The clear message from both of the articles is that we’re meant to see women who seek abortions after IVF treatment as ungrateful or greedy. There’s lots of talk of women “changing their minds”, Ann Widdecombe’s quote about “treating babies like designer goods”, and of course the scare quotes around The Sunday Times‘s use of the word “social”. Even the HFEA’s spokesperson, who you’d think would be neutral, calls every abortion “a tragedy”. The commenters have certainly picked up on the dog-whistles sickeningly well.

From The Times:

Surely we should ask those who wish to have IVG and/or abortions to pay for it themselves rather than be funded by tax-payers money. There is something sick with a society that aborts babies on the one hand while giving women fertility treatment to have them on the other.

Sometimes I wish there really was a hell. What superficial low life these people must be and more fool a health service that allows these people to make clowns of them. Perhaps it’s time for a private health care system where you pay for you’re own mickey taking IVF sessions.It’s all disgusting but not really surprising given the general lethergy, profligacy and lack of morality that the last Labour government positvely encouraged.

This comes under my list of ASIIUS Another Stupid Idea Imported from US.
This one is that many people now treat sex as a sport or hobby. The idea that sex produces babies has been pushed to the back of their minds or even out of their heads completely.
On another aspect. In the next few years there will be a surge in people wanting to remove all those trendy tattos they are getting now on the NHS. There should be big signs in hospitals and doctors’ surgeries warning that in no circumastances will tattoos be removed by the NHS, no matter how much you claim it is affecting your psychology. You should have thought of that before! It will be only on the private services and it will be expensive.

(I had no idea that Americans invented the idea of having sex for fun! Perhaps everyone should write America a thank-you note.)

Meanwhile, from The Mail:

This is absolutely outrageous. I have been trying to get pregnant for 3 years and will be starting IVF soon. How could women do this. You should think yourself lucky if you get pregnant at all. It makes me mad that these lives are being thrown away while other women struggle to get pregnant in the first place.

The babies/pregnancies to some of these people are obviously just cosmetic, inconvenient and disposable. It is a real shame for those who have abortions for medical reasons and also those who have IVF because they desperately want a child and will love and cherish it.
If the above is true then maybe it’s time people started contributing toward these procedures. It is disgusting that there is not enough money sometimes to treat sick people or give IVF to those who truly will make the best of it but you can spend money on things like this.

Stupid selfish cows.

I hope the newspapers realise what attitudes they’re fomenting every time they post an article that twists the truth and demonises women so badly.

(All my data used is available in .xlsx format. Contact me if you want a copy.)

* As a postscript to yesterday’s post, you can see the pigeonholing of the news very clearly here. One of those articles is categorised under “Women” and the other under “Health”. I dare you to guess which is which.

Edit: Post was edited to correct stat about implantation rates.

Edit 2: RH Reality Check has an interesting article about the reasons behind this media treatment here.

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  1. #1 by ukenagashi on Sunday, 6th June 2010 - 16:04 UTC

    OMG those comments! Just… GET OFF YOUR JUDGEMENT HORSE.

  2. #2 by Chris on Sunday, 6th June 2010 - 16:53 UTC

    It’s an interesting one.

    I get your statistics, and it’s not really a surprise that the papers misrepresented it a bit – although I don’t think the errors they made were so huge that I would have been motivated to write such a long post lol.

    The only two bits I disagree with are:

    1. “Women are often implanted with 3 or 4 embryos, since the odds of one successfully implanting is fairly low.”.

    I think the current trend is very much more towards 2, or even 1, due to the likelihood of multiple pregnancy, and a recent study suggesting that multiple embryos actually decrease chances of implantation. (Link can be found somewhere here I suspect).

    2. “If these women had conceived normally, no-one would bat an eyelid at the fact that a few of them decided to terminate their pregnancy”.

    I would, and I think a few others would too. But I imagine, based on the tone of your article, you are not terribly into the whole “Man, there’s an awful lot of state sanctioned murder going on” thing.

    Anyways, thanks – an interesting read, and rational assessment of statistics is something that should be venerated a lot more!

    Chris

    • #3 by atomicspin on Sunday, 6th June 2010 - 17:13 UTC

      Yeah, I don’t know quite how the article got to be so long. I really just wanted to take apart every assumption of the article – that it’s mostly young women getting post-IVF abortions, that the rate is rising, that most post-IVF abortions are non-clinical, and that post-IVF abortion is somehow worse than regular abortion; regardless of your personal views, given that women don’t ever get IVF treatment while planning to abort it later, I hope it’s clear that post-IVF abortion is morally no different to abortion under normal circumstances.

      By “wouldn’t bat an eyelid”, I meant that it wouldn’t be considered newsworthy. “A few women’s circumstances change, makes having a child untenable” would never be the headline in any paper, and phrasing it in terms of IVF is just a dishonest way to bash women who use fertility treatment.

      Thanks for the info on single embryo treatment. I had a quick look at the data from the HFEA database and it seems the vast majority of implantations in the last 3 years involved two embryos (16,594 used no embryos, 14,770 used one, 82,474 used two, 4,332 used three and only 1 used four). I’ll correct that; though it doesn’t change the main gist of the argument – that 25% of post-IVF abortions are to correct for the imprecision of the treatment.

      • #4 by Chris on Sunday, 6th June 2010 - 18:48 UTC

        “I hope it’s clear that post-IVF abortion is morally no different to abortion under normal circumstances.”

        I agree, that if we look at it purely morally they are equal, in that murder is murder. It’s a pretty obvious logical line to me; and doing it in IVF, normal pregnancy, to a 29 week year old foetus or a 3 week old baby are all equally morally reprehensible.

        However, I think the argument here must take into account the financial aspect; with the NHS having limited funds, is it “ethically” worse to spend £20,000 getting a woman pregant and then murder it?

        Obviously it’s a difficult argument, one further confounded by the fact that abortion is the most cost effective procedure available on the NHS, followed shortly by any operations that fail and result in immediate death; because the ceased life involved will never cause further expense for the health service. If we use an ethical line purely decided by finance, the NHS expenditure on cyanide is going to end all arguments on, well, any subject.

        My personal opinion is that with approximately 60,000 children in care (and with 11 million orphans in Africa), the NHS has absolutely no place paying for IVF.

        My point really is that your article complains about the poor maths and logic in what does make the news. I think I am equally frustrated by the rather more distressing figures that don’t make the news.

        • #5 by atomicspin on Sunday, 6th June 2010 - 19:14 UTC

          Women aren’t getting pregnant just so they can have abortions, though. We’re not spending £20,000 so women can have abortions. We’re (or in most cases, they’re, since NHS IVF funding is limited) spending money to help them become pregnant, and if they later realise that the whole thing was a mistake, exactly the same legal safety nets are available to them as to every other woman.

          Obviously I know from your debates with Nick on Facebook that you’re not going to change your mind on the “abortion is murder” issue, so I’m not going to touch on that.

          The issue of aid to Africa is valid to a point, I suppose, but then, in a world with 11 million orphans in Africa, we have no place paying for… anything, really. I’m not sure what your point about care is; while the country does need more foster parents and adoptive parents, forcing people to take up this role based solely on their genetic predisposition to infertility seems unfair.

          And if we do play the finances game, a child born through IVF will go on to become a taxpayer, and on average, a net gain to the Treasury.

          • #6 by Chris on Sunday, 6th June 2010 - 19:30 UTC

            No, obviously they aren’t intentionally having IVF to abort, but I think the issue is that maybe if we are going to spend £20,000 on getting people pregnant, should we not have more precautions before allowing IVF? Ie. is it not a failure of the system to allow people IVF when they may be in relationships that might not be stable.

            I’m not saying the state should dictate relationship stability, nor that every woman that had an abortion in that situation was clearly in a rubbish relationship: only that since there are very stringent controls on people and couples adopting, should we not have those same controls for IVF, since it is such a huge waste of money to pay for IVF and then abort it.

            My Africa and care point is that we should all be incentivised to adopt. My wife and I looked into adopting African orphans, just the first cost is paying £6,000 for a social worker to assess my house. Yet we can get IVF for free?

            Life is unfair, its unfair to the orphans and children in care, and thus those who desperately want a child should probably be more encouraged to adopt those children most in need? And by not doing this, the state is biasing further against those children in care, who without state intervention end up 50x more likely to end up in prison, as well as homeless and pregnant themselves.

            Would happily debate the abortion thing at some point – I love rational argument (Nick gets a wee bit tired of it).

            Man, I should get back to revising. Grr.

            • #7 by Chris on Sunday, 6th June 2010 - 19:52 UTC

              I love how this keeps indenting. What happens if there were like 10 more replies?

              • #8 by atomicspin on Sunday, 6th June 2010 - 20:11 UTC

                The max is 10, I think? Then it spits out a new thread to start again on.

            • #9 by atomicspin on Sunday, 6th June 2010 - 20:11 UTC

              Thanks but no thanks. There is an entire internet on which to debate abortion. I’d rather do something more constructive with my space and energy than host a pointless debate for the sake of debate on such a contentious issue as abortion.

              And please do keep in mind that this blog is, ultimately, my space. I have no problem with debate up to a point, but as I said, a blind back-and-forth of “Abortion is murder” / “Her body, her choice” is not to help anyone, least of all the other commenters this space is shared with.

              On the child care point, all I’m going to say is that you really do foster parents and the infertile a disservice. Foster parenting is an incredibly difficult and demanding job, which can’t simply be foisted on everyone, and that doesn’t make people who seek IVF treatment lazy or wasteful or unfair for not taking it on.

              • #10 by wickedday on Sunday, 6th June 2010 - 20:36 UTC

                On the subject of adoption and/or fosterage, though, given the number of wanted children who already end up in care for whatever reason and then lack adopters, it seems downright irresponsible to add to the burden on the adoption system by encouraging/compelling people to continue pregnancies they do not want.

                Chris, it’s exceedingly rare to find anyone anti-abortion on the internet who can carry on a civil debate for more than about three words, and for that I commend you.

                I think most people, regardless of their views on abortion, would be discomfited by your example of a 29-week foetus being aborted – particularly as a premature birth at that point might well survive. However, elective abortions beyond 24 weeks (and there’s been moves to take that to 22) aren’t permitted in this country, and so any foetus terminated after that point was either nonviable or killing its mother.

                It may interest you to know that 87% of UK abortions are carried out before the 12-week mark, long before the foetus has (for example) the ability to feel pain. If you don’t object to the killing of adult, pain-feeling animals, I don’t think an objection on humane grounds (can’t think of a better way to phrase that) to early-term abortion really stands.

                If you’re sincerely against killing living things and are therefore an anti-death-penalty, anti-war vegetarian, I guess we’ll just have to agree to disagree on the abortion front.

                (Sorry if this is a derail. Will cease if requested.)

              • #11 by atomicspin on Sunday, 6th June 2010 - 21:15 UTC

                I don’t mind any derailing; let’s face it, derailed threads are always the most interesting things on the internet!

                Good point on adoption – kicking myself slightly for not seeing it.

              • #12 by Chris on Monday, 7th June 2010 - 7:03 UTC

                I agree on the derailed topics are the most interesting things. I also think that the moral value of abortion is relevant to a discussion comparing relative morality of abortion within and without IVF (and IVF itself). But tell us to stop, and we will (although I wanted to keep going until the indent took us out, but it stopped sadly).

                On doing foster parents and the infertile a disservice, I object a little. I didn’t say we should ban all IVF for the infertile, just that adoption should be given a lot more prominence both on a moral “let’s help the orphans” level, and on a financial level.

                In terms of stimulus to adoption, its a lengthy (two years plus) initial involvement, with stringent checks on housing, relationship quality and desire to have children, with costs, such as improving ones home, and if you try to adopt from abroad, no government help whatsoever.

                Whereas IVF is offered to all who fit the 23-39 1 year of attempted pregnancy criteria. There are no relationship checks, no house checks, no desire for children checks, and the process rolls into place within weeks to months. And the NHS pays in full for up to 3 cycles, costing (approximately) £60,000.

                To me, that is an unfair bias towards the infertile. I’m not saying adoption or fostering are easy, children often suffer from displacement syndrome or other issues; but this is worsened by the extra years in care spent by a longwinded application system.

                Regarding abortion, yup I am a vegetarian. Not necessarily anti war in all situations, because ultimately that can hurt more than heal – was WWII wrong for example – but yes, I think killing stuff is generally wrong.

                Abortion however, involves drawing an arbitrary line, one of “the foetus becomes a viable child at this point”. Ask a 12 week pregnant woman who plans to keep continue their pregnancy what’s inside them, and they will call it a “baby”, not a lifeless collection of cells.

                The argument that “it wouldn’t survive if it were born now” seems a little weak; a 1 year old baby won’t survive unless it is fed and nurtured, the only difference is one is inside a womb.

                On your first point, that for some reason I am answering last, the adding to the burden issue, a lot of old people are ending up in care. Is it time to encourage they be “aborted” against their will?

                My real issue here is one of choice; I have less problem with euthanasia, or suicide, where a person decides “I wish to die”. My problem is that I am hugely pro choice; I think that unborn babies deserve the right to grow old enough to decide whether or not they wish to die.

              • #13 by ukenagashi on Monday, 7th June 2010 - 13:04 UTC

                Just a small point, Chris – the reason people might take issue with this is that your definition of pro-choice completely erases the choice, feelings and autonomy of the woman. It effectively reduces us to incubators while implying that we are incapable of deciding what’s best for us and the foetus.

                I’m sure you can see how that is infuriating on many, many levels.

              • #14 by Chris on Monday, 7th June 2010 - 17:45 UTC

                I don’t want to offend you, but within my definition of “choice” I refer to the majority of abortions which take place in a situation where two people partook of consensual sex: ie. made a choice.

                The issue of non consensual sex is a very different moral playing field, and I want to stress the massive amount of compassion, love and support that should be shown to women in those circumstances.

                However, in the vast majority of terminations, this is not the case, and whilst compassion is still of vital importance, it is a poor excuse for ending a life.

                Thus this doesn’t erase the choice, feelings and autonomy of the women: it increases the weight and value of the choices they do choose to make. One thing I feel is sad is the sexist approach of society to the situation: the “woman’s right to choose”?

                What about the choice, feelings and autonomy of the man? Are they not “completely erase[d]” by law that effectively reduces men to sperm producers who have no say to whether their offspring is allowed to live, but are forced to provide lifelong financial support to a child if a woman exercises her “sole right”?

                In my training to become a (non-judgemental and loving) post-abortion counsellor, one issue we see is that of men approaching the service, when their child has been taken away from them, and they have absolutely no legal or societal right to protest; after all, it’s not their choice.

                You said that:
                Proposing that “making a choice to have sex includes accepting a risk of parenthood” implies that woman “are incapable of deciding what’s best for us and the foetus”.

                Firstly I think that responsibility is the role of both parties, and both should have equality in that situation, and in any decision that is made.

                But secondly, that implies the statement “I’m unexpectedly pregnant. It would be better for a child to be dead than be raised by me” is the best possible choice for an unborn child.

                How about my opinion on adoption and IVF though? As a trained medical professional, adoption has never been mentioned as an option to me, in any situation where I would be talking to a client. I have recieved training on IVF, on infertility, on unexpected pregnancy, on abortion; yet adoption has never come up. Surely that is a failure – why shouldn’t adoption become an offered choice alongside IVF, with the financial and moral implications of choosing to spend a great of money rather than adopt a baby already created and living a deprived life?

              • #15 by Chris on Monday, 7th June 2010 - 17:55 UTC

                @ukenagashi Just to clarify, I wasn’t trying to quote you on “making a choice to have sex includes accepting a risk of parenthood”, it was just a horribly long sentence I saw no good way of shortening, so I added some “” to try and break it up a little. Poor punctuation, do forgive me!

  3. #16 by wickedday on Sunday, 6th June 2010 - 18:02 UTC

    Yes, because IVF never goes wrong at all, and is not inherently skewed towards couples who have had trouble conceiving viably.

    This is ridiculous but sadly unexpected, and I’m glad that you’ve taken the time to dig through the figures and work out just how unfounded this all is.

    • #17 by atomicspin on Sunday, 6th June 2010 - 18:33 UTC

      I hadn’t even meant for it to get so long – I originally just planned to double check the data and point out that making veiled assertions about women being greedy or unthinking is not a valid way for a respectable paper (which The Sunday Times certainly is) to cover any story about abortion.

      But I love playing with statistics, and half an hour messing about with them just showed how misleadingly written the whole thing is, and on issues as important as abortion and IVF, seeing the info being so harmfully distorted just made me angry enough to write out a whole two-thousand word post.

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