Politics & Policy

Planned Parenthood Polices Itself

It paid for the studies purporting to show the safety of its medical abortions.

If the tobacco industry paid for two studies to refute the claim that tobacco hurts your health, and the major premise of both studies was that the manufacturers of tobacco products reviewed their records and did not find any association between tobacco and ill health, would we believe them?

So, now we have two studies in the last three years, funded by Planned Parenthood and conducted by Planned Parenthood employees, that say that somehow Planned Parenthood facilities do “safer” pharmaceutical abortions than any anywhere else in the world where women use the same medications.

What is the difference between these two Planned Parenthood studies and other studies? Other studies look at the actual medical record of women who have abortions, a complete medical record owned by the state. The Planned Parenthood studies look at “Planned Parenthood’s records” and use “complications reported to Planned Parenthood” and, lo and behold, the Planned Parenthood studies show very few medical-abortion customers came back to Planned Parenthood with a problem.

Planned Parenthood authors claim that this demonstrates that medical abortion is “very safe.” But another, perhaps more cynical conclusion is that the lack of complaints in the Planned Parenthood records may stem from the fact that many women with problems do not go back to Planned Parenthood to get their problems taken care of, especially not to the Planned Parenthood clinics that have circuit-riding abortionists who are present only for the abortions and not for follow-up care.

What happens to a woman who, for example, hemorrhages at night after her abortion? Will she go to the Planned Parenthood clinic that is closed after 5 p.m.? Or will she go for treatment to the local emergency room? The authors of the first Planned Parenthood study say this: “Some patients may have experienced a significant adverse event or outcome, but did not follow up after their medical abortion.” The 2015 Planned Parenthood study states: “Compared with patients at 43 to 49 days of gestation, patients at higher gestational ages were more likely to be lost to follow-up.”

This is an extremely interesting comment, since it is the women at higher gestational ages who are most at risk of hemorrhage and other complications — the higher the gestational age, the greater the risk. So the patient population most likely to experience a complication is exactly the patient population for which this 2015 study has the least information.

If the woman doesn’t go back to Planned Parenthood, then Planned Parenthood has “no record” of any problem. Very convenient. How many women don’t follow up after their abortion? The 2015 Planned Parenthood study states that between 15 and 46 percent of patients don’t come back after an abortion. The 2013 Planned Parenthood study did not even publish how many women didn’t follow up. Both studies calculate a “rate” of complications by taking the number of women they recorded in their clinics who reported problems to Planned Parenthood and then dividing that number by the number of abortions they sold. This gives a falsely low number because the number of women with problems in the Planned Parenthood records is much lower than the actual number of women with problems.

#page#The authors of these Planned Parenthood studies assumed that all the women who didn’t come back to Planned Parenthood were completely free of problems. It is more likely that these women had problems that were handled by another doctor, and so the follow-up was done by another doctor. Planned Parenthood has no mechanism for tracking complications handled by emergency rooms or other doctors. So, they have “no record of problems” for these women. This makes the rate of complications seem much lower than they are reality, because both Planned Parenthood studies calculate only the complications “reported to Planned Parenthood clinics.”

So how do these two Planned Parenthood studies compare with studies done by researchers who are not paid by Planned Parenthood and who use data from a real medical record?

A major review of nearly 7,000 abortions performed in Australia using a similar dose of medical abortion drugs in 2009 and 2010 found that 3.3 percent of patients required emergency hospital treatment, in contrast to 2.2 percent of patients who underwent surgical abortions. Women receiving medication abortions were admitted to hospitals at a rate of 5.7 percent following the abortion, as compared with 0.4 percent for patients undergoing surgical abortion.

The largest and most accurate study of medication abortions was published in 2009 and consists of a review of actual medical records from 22,368 women who were administered abortion drugs at a dose similar to that used in the Planned Parenthood studies. These 22,368 women were then compared with 20,251 women who underwent surgical abortions. According to this study, women had four times as many serious complications with medication abortions than with surgical abortions. These complications included hemorrhaging in approximately one out of six women (15.6 percent). More than three out of every 50 women (6.7 percent) had fetal tissue left inside, most of whom (5.9 percent) required surgery to get the tissue out. According to this study, the rate of these complications was higher with medical abortion than with surgical abortion.

In fact, there are six studies published in the last six years, with similar results. These studies looked at women who had medical abortions using the same doses of drugs as in the Planned Parenthood studies. The studies from Australia and Finland, cited above, used the actual medical records of women in countries with socialized medicine, not “complications reported to Planned Parenthood.” These six studies all show that the rate of necessary surgery after a medication abortion varies from 3.4 to 5.9 percent. That means that somewhere around one out of every 20 women who get a medical abortion will need surgery for hemorrhage or because of tissue left inside. And about one out of 100 of those will be emergency surgeries for life-threatening hemorrhage. Hemorrhage is the most common complication from medical abortion.

In surprising contrast, the 2013 Planned Parenthood study shows very few women treated for hemorrhage. In fact, the complication reported to Planned Parenthood in three out of four cases in the 2013 study was ongoing pregnancy. Since it is well established that hemorrhage is the most common complication from medical abortion, isn’t it strange that the most common complication that Planned Parenthood has on its records is ongoing pregnancy? Where did all the hemorrhages get treated? Not at Planned Parenthood, apparently. Nor do these women get counted in the Planned Parenthood–funded studies that advertise that medical abortion is “safe.”

Far from demonstrating that medical abortion is safe, these two Planned Parenthood–funded studies mostly demonstrate how poorly Planned Parenthood tracks its own abortion complications.

— Donna Harrison, M.D., is a board-certified obstetrician and gynecologist and executive director and director of research and public policy for the American Association of Pro-Life Obstetricians and Gynecologists. She publishes on the adverse events associated with medical abortion.

Donna Harrison — Donna Harrison is a board-certified obstetrician and gynecologist, and executive director of the American Association of Pro-life Obstetricians and Gynecologists (AAPLOG).

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