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.
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).
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).
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.