Background

Anderson has participated in many Christian organizations that advocate for abstinence until marriage and against access to safe abortion care (e.g., Abstinence—Now Until Marriage and March for Jesus).

Controversy

Anderson was chastised by a federal judge while testifying on behalf of a sweeping Texas law that has resulted in many clinic closures across the state. Anderson admitted that his declaration was “wordsmithed” by serial anti-abortion legal consultant Vincent Rue, who has himself been discredited.

As the Austin Chronicle reported, “When questioned about Rue’s influence on his testimony, Anderson downplayed the degree of involvement, saying the legal draft was a ‘team effort’ and ‘a collaboration.’ Anderson said Rue provided sources for his testimony, including material from the Susan B. Anthony List, a national anti-choice group. When asked about the group’s ideological motivations, Anderson conceded the source ‘risks bias, but still validates the need for the law.’”

Anderson told Rewire that he wrote “my whole reports.” He said in the example of the Texas case, “wordsmithing” referred to “grammar and spelling.”

“I think when people can’t address the issue, then they try to attack your integrity,” Anderson said in a phone interview. “And I think that’s why everybody is trying to make it a big deal that I didn’t write my report or somebody didn’t write their report. … Vince Rue is just an employee of the different states. I enjoyed working with him. But I wrote the reports.”

“I think the admitting privileges is protective of women,” he added. “There are so many physicians that have been ill-trained or haven’t had enough training to do safe, competent abortions. And the scrutiny of the medical admitting privileging process is very protective of women.”

Anderson’s testimony has also been discounted by the Alabama Federal District Court, which cast doubt not only on his accuracy but on his honesty, as well.

In an opinion from August 2014 in Planned Parenthood Southeast, Inc., et al., v. Luther Strange, Judge Myron H. Thompson wrote:

Drs. [John] Thorp and [James] Anderson each opined that proper care for even the simplest complication would require detailed knowledge about the patient’s history, reproductive goals, and other information. However, the court discredits Dr. Anderson’s testimony on this point due to concerns about his judgment or honesty as described in the forthcoming supplemental opinion.

In late October, Thompson issued a supplemental opinion detailing how the court determined whether or not to throw out parts of expert witness testimony.

In this opinion, Thompson explained that the court admitted most of Anderson’s testimony but said “the court did not find his opinions credible,” primarily because Anderson had testified that a supplemental report he signed had been drafted by Vincent Rue and that he had not verified the content in the report. Anderson had also testified that he knew little of Rue’s background.

“Anderson’s court testimony about the supplemental report raised serious questions about his credibility,” Thompson wrote. “It became apparent that Rue’s involvement in drafting this supplemental report reached beyond the typical involvement of an attorney or litigation consultant in helping an expert put his opinions into words or providing background research. Anderson presented the supplemental report as his own work by virtue of his signature at the bottom.”

“The court was struck by the flimsiness of Anderson’s basis for reliance on Rue and by his failure to obtain basic information about the affiliations, credentials, or employment of the consultant whose report he submitted as his own,” Thompson continued. “[E]ither he has extremely impaired judgment; he lied to the court as to his familiarity with Rue; or he is so biased against abortion that he would endorse any opinion that supports increased regulation on abortion providers. Any of these explanations severely undermines Anderson’s credibility as an expert witness.”

In Alaska’s 2003 lawsuit involving a parental involvement statute, plaintiff Planned Parenthood of Alaska argued that Anderson’s delivered testimony “carries very little weight in assessing the safety of abortion in Alaska. He has not treated minors for the past 9 years, and his experience is limited to Virginia.  … Dr. Anderson informs patients of his personal preference for them to carry to term … and, despite his belief that parents should be involved in pregnancy-related care, contraception, and STD treatment, has actively campaigned only for a parental involvement for abortion. … Dr. Anderson further believes that parents refusing consent for abortion would be a positive effect of the act.”

Influence

Anderson has testified in support of anti-choice policies in courts across the country, particularly state laws that require abortion providers to acquire admitting privileges at nearby hospitals. Among the cases Rewire has identified, Anderson has testified regarding laws passed or challenged in Alabama, Alaska, Mississippi, North Dakota, Texas, and Wisconsin.

Anderson has given similar testimonies in each case, essentially arguing that being able to provide continuity of care in a hospital following an emergency is best medical practice. He has also argued that abortion providers should be required to have admitting privileges at local hospitals in order to ensure that the same person who performs an abortion can continue the patient’s care should the patient require hospitalization.

As an expert witness in July 2012, defending a Mississippi law requiring that abortion providers be board certified in obstetrics and gynecology and that they maintain admitting privileges at a local hospital, Anderson argued (as he did in North Dakota):

I have worked in local Emergency Rooms across Virginia for over thirty years. When women have come to the Emergency Room with complications related to an abortion, never once have I received a phone call initiated by the provider conveying information about the abortion, the young woman’s condition or potential complications. I have always had to evaluate the situation, come to my own conclusions and initiate what I thought was appropriate treatment. This definitely created some time delays that were not in the patient’s best interest. I have called many abortion clinic physicians but never once has the provider come the Emergency Room to assume care. I have always had to call a staff physician. This then creates another delay since the staff physician is taking care of his/her own patients but now must change his/her schedule to assume the care of someone else’s patient. These delays can have life-threatening implications when dealing with hemorrhage or infection.

Anderson also testified:

If a physician cannot obtain privileges for the specific requested procedures at his or her local hospital, then in my expert opinion, the physician is not qualified to do the surgical procedures that have life-changing or life-threatening impact.

Mississippi’s clinic was unable to fully comply with the law because the nearby hospitals denied privileges to the clinic’s providers; still, a Fifth Circuit judge struck down the law as unconstitutional because it would have had the effect of making abortion inaccessible in the state.

In his Mississippi testimony, Anderson made sweeping claims containing many assumptions and generalizations about what women writ large would do when faced with health-care decisions.

“If a woman knows her physician does not practice at a local hospital, then she is faced at that moment with having to change physicians and possibly have to wait in a crowded Emergency Room to see a doctor she has never met,” he said. “If she knows her physician does not practice at the hospital, she will likely put off going to the hospital as long as possible.”

Anderson’s statements were cited as footnotes to the state’s assertion that the Mississippi laws were justified to protect women. In a July 2012 legal brief, Mississippi Special Assistant Attorney General Benjamin Bryant cited quotes from Anderson given in a declaration submitted for the court, wherein he argued that the admitting privileges and OB-GYN requirements were beneficial to protecting the health and safety of women. Bryant also cited Anderson’s declaration in reference to a claim that there is no evidence plaintiffs would be unable to comply with the law.

Background

Since the early 1990s, Brind has co-authored studies attempting to prove the abortion-breast cancer link. He has testified before state legislatures and in the courts in favor of abortion restrictions. In 1999 Brind co-founded the Breast Cancer Prevention Institute with Angela Lanfranchi.

Based in Somerville, New Jersey, this organization describes itself as a nonprofit that “educates health care professionals and the general public through research publications, lectures, and the internet, on ways to reduce breast cancer incidence.” But the group seems to have a pretty singular focus on promoting a cause-and-effect relationship between abortion and breast cancer and hormonal birth control and breast cancer.

The Breast Cancer Prevention Institute reported approximately $35,000 in net assets in 2011 to the Internal Revenue Service; between 2003 and 2011 the group received approximately $1,500 in small donations from the Charles and Mary Crossed Foundation; the Rochester Area Community Foundation; and General Electric’s charitable entity, the GE Foundation, according to tax filings.

Brind believes wholeheartedly that abortion significantly increases the risk for breast cancer, even though major national cancer and medical institutions have been unable to find evidence of such a risk within the medical literature. In a phone interview with Rewire, Brind said scientific literature on breast cancer he read in the early 1980s, combined with his work on sex steroid synthesis and his subsequent research, convinced him of a causal relationship between abortion and breast cancer.

“Abortion is the single most avoidable risk factor for breast cancer,” he said.

Brind contends that many studies show a positive correlation between abortion and breast cancer but that pro-choice politics have stifled these studies.

“Abortion increases the risk of breast cancer,” he said. “There’s absolutely zero doubt about it in my mind. The strength of the evidence is such that if it weren’t politically loaded, there would be zero doubt about it in anybody’s mind.”

Though Brind has testified to this link in state legislatures and in the courts, he told Rewire he does not think the procedure should be banned based on this purported risk, but that women seeking an abortion should be informed that an abortion will increase their risk for breast cancer. He said he is “pro-life” and would like to see abortion become a rare event. Brind did say, however, that “abortion is not good for women,” citing other invented theories that abortion causes mental illness and that it negatively affects subsequent pregnancies.

“I’m not really terribly concerned about the legality of abortion,” he said.

“It’s all a matter of information with being able to make an informed choice,” he added. “If women actually knew that abortion is really not very safe, then even if it’s legal, it would be rare. And that would be a very good turn of events. Because people don’t do things that they perceive as dangerous.”

Brind rejected the notion that he is trying to promote a false scientific theory in an effort to end abortion.

Controversy

Among the early research that convinced Brind that abortion causes breast cancer was a 1980 study wherein biologists exposed female rats to a cancer-causing chemical and found a higher rate of cancer among the rats that had been given abortions compared to those that had given birth,  reported Barry Yeoman and Michael Lewis in the February 2003 issue of Discover magazine.

Attempting to prove the abortion-breast cancer correlation, Brind enlisted two endocrinologists at Pennsylvania State College of Medicine—both abortion opponents—and Vernon Chinchilli, a biostatistician at Penn State, and they conducted a meta-analysis of several studies that include data on induced abortion and incidence of breast cancer. Brind and his co-authors found a relative risk of 1.3 on a scale where 1.0 means no risk and 2.0 means a demonstrated risk.

The article, which was published in the Journal of Epidemiology & Community Health in October 1996, concluded that, “the results support the inclusion of induced abortion among significant independent risk factors for breast cancer,” even though “the increase in risk was relatively low.”

The article was met with wide skepticism and accusations that there was a lack of consistency in the data among the studies the team analyzed. Yeoman and Lewis reported that Chinchilli had expressed doubts that they could make conclusions about the relationship between breast cancer and abortion based on their work.

Soon after Brind’s study was published, an epidemiologist in Denmark published a paper in the New England Journal of Medicine that analyzed the records of 1.5 million Danish women over a 43-year period and found that women who had abortions developed breast cancer at the same rate as those who had not had abortions.

In 2002, the National Cancer Institute scrubbed from its website a statement saying that current scientific evidence does not point to a higher risk of breast cancer among women who have abortions. The scrubbing was prompted by a letter U.S. Rep. Christopher Smith (R-New Jersey) wrote to the Secretary of Health and Human Services citing Brind’s 1996 study, according to Barry Yeoman and Michael Lewis’ reporting.

Subsequently, the National Cancer Institute held a workshop in 2003 to investigate thoroughly the correlation between breast cancer and “reproductive events.” Among the conclusions of the workshop was that “induced abortion is not associated with an increase in breast cancer risk.”

Brind was the sole dissenter of this conclusion at the workshop; he told Rewire that there likely would have been other dissenters had they not feared losing grant money from the National Cancer Institute, which he said holds the purse strings for cancer research. Brind claims the workshop was biased and does not consider the organization’s findings valid. Again, he was the sole dissenter and the sole member to have expressed such views.

Influence

Brind’s work has been influential in providing a basis for legislation, even though major medical institutions do not support his conclusions.

As Barry Yeoman and Michael Lewis reported in the February 2003 issue of Discover magazine, as of 2003, Brind had testified about an abortion-breast cancer link in courthouses and statehouses in Alaska, Arizona, Florida, Massachusetts, New Hampshire, North Dakota, and Ohio, and at least 18 states had considered laws requiring clinics to “disclose” the link, with Mississippi and Montana passing such measures.

Today, at least five states require abortion providers to tell women that abortion increases the risk for breast cancer before they can have an abortion, according to the Guttmacher Institute.

Brind has testified in support of abortion restrictions and against both medication abortion and the birth control pill in several state and federal lawsuits; most recently his Breast Cancer Prevention Institute filed amicus briefs in support of plaintiffs suing the federal government so as not to comply with the birth control benefit.

In 1997, Brind served as the star witness for a religious group called Christ’s Bride Ministries, which had posted ads in subway stations, on subways, and on buses in Pennsylvania that said, “Women Who Choose Abortion Suffer More & Deadlier Breast Cancer.”

After the Southeastern Pennsylvania Transportation Authority removed the ads on the basis that they were promoting misinformation, Christ’s Bride Ministries sued.

Brind testified that the ads reflected the truth. Though Christ’s Bride Ministries won the lawsuit on free-speech grounds, that case was later cited in support of a lawsuit filed against an abortion clinic in Fargo, North Dakota.

In 1999, an anti-choice activist named Amy Jo Kjolsrud sued the clinic claiming it had violated the state’s false advertising statute by stating in its brochures that there was no evidence that abortion causes breast cancer. Brind also testified in that lawsuit, arguing that the clinic was peddling false information. The North Dakota Supreme Court dismissed the case on the grounds the plaintiff had no standing and thereby affirmed the trial court’s finding that the abortion clinic had not violated the statute.

Brind has testified in support of an Alaska parental involvement abortion law. In 2003, plaintiffs in the case criticized the use of Brind as an expert witness. They pointed out that Brind has no formal education or training in epidemiology, and that his single peer-reviewed article on the topic of abortion and breast cancer suffered from serious methodological flaws. They further argued that Brind’s “background and experience, were of limited value to the Court in assessing the evidence regarding an alleged link between abortion and breast cancer, which is based on epidemiological studies.”

Brind continues to write about this disproven abortion-breast cancer link; recently he promoted a Chinese study claiming such a correlation in conservative publications such as Life News and National Review Online. He told Rewire that he regularly conducts workshops for the National Right to Life Committee and writes for the organization’s journal.

Background

Bush serves on the boards of several anti-choice medical groups and networks of so-called crisis pregnancy centers. She is the CEO and president of the Medical Institute for Sexual Health (MISH), a nonprofit in Austin, Texas, which supplies sex-ed materials for public schools and community programs that teach abstinence until marriage as the primary approach to avoiding unwanted pregnancies and sexually transmitted infections.

The Institute mirrors other organizations that have secular, medical-sounding names but are actually rooted in socially conservative ideology. Its stated objective, according to recent tax filings, is to “empower safe, healthy living by communicating objective and scientific sexual health information.” Despite this promise of objective science, the Institute sometimes promotes ideas driven by speculation and selectively interpreted data.

A recent blog post suggests that pornography might lead to erectile dysfunction in men, but the study it references in no way makes this claim. The Medical Institute opposes masturbation and promotes the idea of “secondary virginity,” neither of which are scientific positions.

In 1999, the Institute published a monograph detailing supposed “health implications associated with homosexuality,” which has been used by organizations intent on suppressing LGBTQ rights, such as the Family Research Council and Exodus Global Alliance. The monograph suggests that just being gay increases one’s risk for a host of both acute and lifelong diseases. Rather than offering information on how to prevent or minimize the risk of sexually transmitted infections, the monograph implies that making the “lifestyle or behavior choice” not to be gay will reduce negative health consequences.

Controversy

In lectures and interviews, Bush singles out abortion as the sole culprit responsible for disproportionately high incidences of premature birth and, subsequently, high infant-mortality rates in Black communities. Her stature as a respected Black OB-GYN in Mississippi—a state with one of the highest infant mortality rates among Black people in the country—adds potency to her various unfounded claims.

But Bush, a licensed physician and a fellow of the American College of Obstetricians and Gynecologists, appears to ignore the many health and socioeconomic factors that contribute to the risk of premature birth, according to the Centers for Disease Control and Prevention. These include being pregnant with multiples; low or high maternal age; low maternal income; stress; and prior pre-term births.

Bush has also become a leading proponent of the myth that legal abortion in the United States is part of a covert genocidal plot targeting Black people.

Speaking to the anti-choice group the Commission for Reproductive Health Service Standards in 2013, after Democratic New York Gov. Andrew Cuomo proposed expanding protections for abortion access in his state, Bush echoed a baseless, oft-repeated accusation that Planned Parenthood strategically places its clinics in majority-Black neighborhoods.

“With the abortion rate … high in the African-American community, it is expected that we will eventually become less and less of the population and may become extinct,” Bush said. “That is unconscionable when you consider that most of the abortions, the abortion clinics are in the Black minority communities. So, it appears we’re being targeted, and that concerns me.”

In fact, there are actually more Planned Parenthood clinics in majority-white neighborhoods, according to the Guttmacher Institute and the Washington Post.

Influence

Bush has influenced health policy from within the highest levels of government.

In 2002, President George W. Bush’s administration appointed her to serve on the Centers for Disease Control and Prevention Advisory Committee on HIV and STD Prevention. Under this administration, Freda Bush’s Medical Institute for Sexual Health began receiving federal funds, primarily through the Administration for Children and Families’ Community-Based Abstinence Education program. The Obama administration continued to fund the Medical Institute through 2010. All told, Bush’s nonprofit received nearly $1 million between 2007 and 2010.

At the state level, Republican Mississippi Gov. Phil Bryant appointed Bush to serve on the Mississippi Teen Pregnancy Prevention Task Force between 2012 and 2015. In 2013, this task force crafted a new law revising who must report potential sexual abuse of minors, which implicated abortion providers by requiring that aborted fetuses must be collected from individuals younger than 15. The law, extraordinarily, required hospitals to collect and submit cord blood from all minors who have babies.

Former Gov. Haley Barbour appointed Bush in 2010 to serve as chair of the board of directors of the national Federation of State Medical Licensure Boards.

In 2011, Bush helped campaign for Mississippi’s constitution to adopt a so-called personhood amendment that would declare fertilized eggs legal persons. The failed amendment would have effectively criminalized abortion and some forms of contraception.

At the time, Bush told CNN that the Mississippi bill was crafted in an attempt to challenge the constitutionality of Roe v. Wade. Bush defended the proposed amendment’s lack of exceptions for victims of rape and incest, telling the Huffington Post that most women consider children conceived from rape a blessing.

“Women who have borne a child conceived in rape testify that the baby is a blessing, rather than have an abortion, which essentially continues the assault,” she said. “Adoption is always a loving option.”

Bush has also written books and articles decrying the hazards of casual sex, including the 2008 book Hooked: New Science on How Casual Sex is Affecting Our Children, co-authored by Medical Institute founder Dr. Joe McIlhaney. Hooked has been used as a textbook in some California public schools, according to the Huffington Post. The book was featured at a 2015 legislative session on sex ed in opposition of bill HB 459 (to mandate “comprehensive sexuality education”), hosted by Hawaii state Rep. Bob McDermott (R-Ewa Beach).

Background

Calhoun is heavily involved in the anti-choice political movement and has written that he incorporates his fundamentalist Christian worldview in his professional practice.

In a 1995 article published in the Journal of Biblical Ethics in Medicine, Calhoun and co-author Dr. Nathan J. Hoeldtke write:

“Since we serve a transcendent God as created beings with souls, we may never destroy human life created in the image of that transcendent God, except as commanded by Him. … As Christian physicians we clearly receive the call to be God’s ambassadors within our profession. The work we do must be consistent with the guidelines set forth in His Scripture, since we represent Him. This means renewed thinking about how to approach the unborn child and the family of a child who will die in utero or live a short time ex utero.

In that article, Calhoun and Hoeldtke outline what they call perinatal hospices as an alternative to abortion, even in circumstances when the fetus is terminally ill.

The concept of perinatal hospices, which Calhoun says he helped pioneer, is for women to carry their nonviable fetuses until the fetus dies in utero and is delivered by a doctor.

“Most birth defects are not as gruesome in appearance as patients imagine,” Calhoun and Hoeldtke write, explaining that they see it as their duty as “Christian physicians” to provide an alternative for “patients who choose not to kill their unborn children who have severe chromosomal or anatomic anomalies.”

Controversy

In June 2013, Calhoun wrote a letter to West Virginia Attorney General Patrick Morrisey claiming, “We commonly (I personally probably at least weekly) see patients at Women and Children’s Hospital with complications from abortions at these centers in Charleston.”

As Rewire reported, S. Andrew Weber, the vice president and administrator of the hospital where Calhoun works, contradicted Calhoun’s claims. After studying records, Weber found, at most, five documented complications from abortion in 2012—a far cry from the number that Calhoun claimed to have seen.

Calhoun, despite multiple requests from Rewire, never provided evidence to support his claims.

Calhoun has made many other unsupported claims over the years.

Commenting on a series of new crisis pregnancy centers in Russia in a 2011 press release, Calhoun said (emphasis in original):

Abortion is not safe; actually has higher rates of maternal mortality when compared by appropriate gestational age controls; is associated with increased risk for breast cancer (in first pregnancies ending in elective abortion); is associated with increased risk for preterm birth by 30-60%; is associated to increased risk for death by all causes; and is associated with significantly increased risk for psychological damage (including suicide and major depression).

An article Calhoun co-authored with a staff attorney of the anti-choice Americans United for Life (AUL) was submitted to the West Virginia attorney general’s office to help bolster the state’s investigation into abortion complications following the Kermit Gosnell scandal, Rewire learned from a public records request.

The article, “Significant Potential for Harm: Growing Medical Evidence of Abortion’s Negative Impact on Women,” makes false and hyperbolic claims and misrepresentations about the risks of abortion that conflict with medical consensus on the subject, such as “the risk of mortality is higher following abortion than it is following childbirth.”

Dr. David Grimes, former chief of the Abortion Surveillance branch at the Centers for Disease Control and Prevention and a leading national researcher on abortion and reproductive health, disputes these claims. Taking just one specific example, Grimes told Rewire that no credible organization agrees that abortion is linked to future premature births.

“Reviews conducted by six leading medical and public health organizations, including the American College of Obstetricians and Gynecologists, the American Public Health Association, the World Health Organization, the American Academy of Pediatrics, the Royal College of Obstetricians and Gynaecologists, and the Centers for Disease Control and Prevention have concluded there is no effect of abortion on prematurity,” he wrote in an email to Rewire.

Curtiss Hannum, a nurse practitioner and the vice president of programming and center affairs for the Women’s Centers—a network of four reproductive health clinics on the East Coast that provide abortions—also told Rewire that many of the claims in the article are inaccurate and distorted and that abortion is an overwhelmingly safe procedure when it is “legal, accessible, and performed in reputable facilities.”

Hannum accused Calhoun of acting dangerously in his perpetuation of falsehoods about abortion, particularly when he holds an influential post at his university. “Distributing false statements that don’t accurately reflect what the research shows is dangerous, and I think certainly does a great disservice to women in terms of their understanding of what the procedure is.” Hannum added that Calhoun’s misuse of information does “nothing” to advance his field.

Influence

Calhoun testified before the U.S. House of Representatives in 2012 in favor of a federal ban on abortion at 20 weeks.

During the debate over West Virginia’s 20-week abortion ban (a bill that was vetoed by the governor), a  letter Calhoun drafted—peddling unfounded claims that fetuses feel pain at 20 weeks because they react “when they feel the needle” during an amniocentesis—was read aloud by an anti-choice advocate during a hearing.

Background

Chireau sits on the board of several anti-choice groups, including the American Association of Pro-Life Obstetricians & Gynecologists (AAPLOG) and Americans United for Life (AUL). Chireau does not believe in comprehensive sex education as a means of preventing teen pregnancy; rather, she supports abstinence-only education and teenage pregnancy prevention programs that “emphasize interventions to: increase abstinence, delay sexual initiation, improve decision-making skills, [and] strengthen families.”  

Influence

In July 2014, Chireau testified in front of the U.S. Senate Judiciary Committee against a federal bill, the Women’s Health Protection Act, which would invalidate many state abortion restrictions, particularly those that “single out the provision of abortion services for restrictions that are more burdensome than those restrictions imposed on medically comparable procedures,” “do not significantly advance women’s health or the safety of abortion services,” and “make abortion services more difficult to access.”

In Chireau’s testimony, she claimed, “The risk for mental health problems was increased 55 percent in women who had induced abortion compared with those who gave birth.”

However, the article by Priscilla Coleman, on which Chireau based this testimony, has been thoroughly challenged. Coleman’s British Journal of Psychiatry  study—which claimed that women who have had one or more abortions experience an 81 percent increased risk for mental health problems—was also criticized in the same journal by researchers who claimed it violated guidelines for conducting meta-analyses; failed to state conflicts of interest, including the author’s “agenda-driven bias”; failed to evaluate the quality of the studies included; did not adhere to its own inclusion criteria; and included studies that did not adjust for mental health disorders diagnosed before a woman became pregnant.

In her same congressional testimony, Chireau suggested that the number of women who die or experience serious complications as a result of abortion is likely higher than what has been reported.

“I believe the lack of oversight, reporting, data collection and monitoring of the abortion industry in the United States has caused the true extent of harm to women caused by this procedure to be understated,” she said. “No other commonly performed procedure, which is potentially associated with injury or death to a patient, receives so little scrutiny. This lack of accountability in abortion service provision has contributed to other social ills such as enabling the cover-up of the sexual abuse of minors, human trafficking, rape and the exploitation of women.”

These claims have been roundly contradicted by overwhelming evidence provided by state attorneys general and health departments, including in states that are aggressively hostile to abortion rights.

Chireau also cited a 2009 study conducted in Finland that found a higher rate of hemorrhage and “adverse events” (particularly from medication abortion, as opposed to surgical) among women in Finland than other studies have. The study found that 20 percent of women who had an abortion via medication experienced adverse events (highest among them hemorrhage and incomplete abortion), compared with 5.6 percent of women who had a surgical abortion.

Chireau used the study to imply that abortion complications in the U.S. are probably higher than what is usually represented in the medical literature. “These statistics represent a significant burden of disease; if applied to the United States, where 1.3 million abortions are performed annually, this translates to 260,000 adverse events per year,” Chireau said. “While these statistics are troubling, they are impossible to verify in the United States, where abortion surveillance is incomplete and inadequate.”

However, Chireau mischaracterized the findings of the study, specifically that the authors concluded that “[b]oth methods of abortion are generally safe, but medical termination is associated with a higher incidence of adverse events. These observations are relevant when counseling women seeking early abortion.”

Regarding this study, the New York Times Magazine’s Emily Bazelon pointed out:

The authors of the Finnish study, however, say that the method of data collection by health officials may have inadvertently inflated the numbers. They conclude that “serious, ‘real’ complications” are rare.

Chireau declined our requests for an interview.

Background

Through her scholarly research work, Coleman has attempted to prove a causal link between abortion and mental illness and drug abuse. She has served as an expert witness in several critical abortion-related legal cases, and she has testified in defense of anti-choice policies before Congress and state legislatures, the United Nations, and before advocacy groups.

In 2006 Coleman co-founded the nonprofit Alliance for Post-Abortion Research and Training with Vincent Rue and Catherine Coyle.

In 2011, Coleman founded the nonprofit World Expert Consortium for Abortion Research and Education (WECARE), which, according to its website, “brings together credentialed scientists with a research program on the physical, psychological, and/or relational effects of abortion on women and those closest to them to engage in international research collaboration, scientific information dissemination, professional education, and consultation.”

WECARE’s website lists several anti-choice scholars as being “experienced and available to offer expert testimony for litigation involving abortion,” including Byron Calhoun, Monique Chireau, Elard Koch, and Angela Lanfranchi.

Controversy

Coleman’s critics have argued that she has purported to show causation between abortion and mental health problems, when really she has only been able to prove association.

In 2009, Coleman and co-authors Catherine Coyle, Martha Shuping, and Vincent Rue published a study in the Journal of Psychiatric Research that received particularly strong criticism, even from the journal’s own editor.

The study analyzed the relationship between induced abortions and a range of diagnosed mental health disorders using the National Comorbidity Survey data for 1990 through 1992. Coleman’s team compared women who reported having at least one abortion with those who had not. They found that women who had reported having an abortion were likelier to be at a significantly increased risk for 12 out of 15 anxiety, mood, and substance abuse disorders, including panic disorder, post-traumatic stress disorder, agoraphobia, alcohol and drug abuse, bipolar disorder, and depression.

Other researchers have been unable to replicate Coleman’s findings.

Julia R. Steinberg, an assistant professor of health psychology at the University of California, San Francisco, and Lawrence B. Finer, the director of domestic research at the Guttmacher Institute, published their own research paper in the January 2011 issue of Social Science & Medicine.

In their analysis of the data, attempting to use Coleman and her colleagues’ methods, Steinberg and Finer produced percentages of women with mental health disorders by abortion history that were in some cases five times smaller than those reported by Coleman’s team.

Steinberg and Finer additionally analyzed the data using a different framework, comparing women who had had abortions to women who had ever been pregnant. Coleman’s team had only compared women who reported having one or more abortions to women who had not reported having an abortion. After controlling for prior mental health and violence experiences, Steinberg and Finer found “no significant relation … between abortion history and anxiety disorders.”

In response to Steinberg and Finer’s article, Coleman’s team published a statement of error, with a correction, in the August 2011 issue of the Journal of Psychiatric Research. The researchers attributed “discrepancies” to a few weighting errors but attested that “the overall pattern of the results has not changed very much.”

But in fact, when Coleman and her colleagues published their corrected dataset, they revealed how they had arrived at skewed figures showing positive correlations between abortion and various mental disorders.

From the National Comorbidity Survey data Coleman’s team had used, it was possible to measure the onset of the mental disorder and other lifetime events, such as abortion. Steinberg and Finer believed that in order to measure the effects of abortion on mental health, problems would need to be diagnosed within 30 days of respondents’ abortions—the same time frame that Coleman and her colleagues had indicated they had used.

But after Steinberg and Finer began challenging her team’s findings, Coleman began to change her explanation of how her team generated their data.

She responded to a 2010 Washington Post blog post on the controversy, by claiming the team had looked at women who were diagnosed with a mental illness within 12 months of her abortion.

In fact—as her team would admit in a letter to the editor published in the March 2012 issue of the Journal of Psychiatric Research—Coleman and her colleagues had used lifetime measures. They had taken all of the women who had ever been diagnosed with a mental illness at any point in their lives and who had also had one or more abortions and called that relationship causal—regardless of whether the mental illness or the abortion came first.

“The use of lifetime diagnoses, which readers are led to believe are 30-day diagnoses, renders the findings meaningless and provides no support for a number of statements that remain in the paper,” Steinberg and Finer wrote in their own letter to the editor in the same issue of the journal.

The journal’s editor, Alan F. Schatzberg—along with the principal investigator of the National Comorbidity Survey that Coleman’s team used, Ronald C. Kessler—weighed in as well. They sided with Steinberg and Finer:

Steinberg and Finer criticize Coleman et al. (2009) for treating lifetime mental disorders as the outcome in their analysis, as some of these disorders might have occurred prior to the abortion. Coleman defended her use of lifetime diagnoses by saying that this was done purposefully to “capture as many cases as possible.” She also cited a recent paper in a Canadian journal (Mota et al., 2010) as well as her own review of many previous studies (Coleman, 2011), a number of which used similar methods and came to conclusions similar to those in her analysis, to support her use of lifetime disorders. We find these arguments unpersuasive.

Schatzberg and Kessler concluded that “the Steinberg-Finer critique has considerable merit and that the Coleman et al. (2009) analysis does not support their assertions that abortion led to psychopathology in the NCS data.”

But the Journal of Psychiatric Research never retracted Coleman’s study—even though the editor said its conclusions are false. And Coleman has used that fact to her advantage.

In a National Right to Life News article from March 13, 2012, Coleman blamed the controversy surrounding her 2009 article on “media bias” and “irresponsible journalism.” She dismissed the stated flaws, writing, “We responsibly addressed this error and the paper was never retracted by the journal.”

“Continued mainstream efforts to deny the significant distress that easily affects a minimum of 20 percent of those who abort are dishonest and disrespectful,” Coleman wrote. “Moreover, such efforts have, and will become even less effective, because we all likely know at least one person, who has had trouble coming to terms with an abortion experience. These women are everywhere and their voices are echoed in honestly collected and reported data.”

In a response to Rewire’s request for an interview, the Journal of Psychiatric Research’s managing editor, Rebecca Wyse, said in an email that the publication does “not comment on papers to the media other than what we publish.”

But in March 2012, Schatzberg suggested to Reuters that a committee had been formed to consider what to do with the Coleman article.

The Guttmacher Institute was met with silence after reaching out to the Journal of Psychiatric Research multiple times in 2012 and 2013, urging the editor to retract the study.

The impact of Coleman’s erroneous claims continues to be far-reaching, and their influence spread even wider once Coleman published a meta-analysis of abortion research in the September 2011 issue of the British Journal of Psychiatry, which included in its analysis her flawed Journal of Psychiatric Research study.

Coleman’s British Journal of Psychiatry study—which claimed that women who had obtained an abortions experienced an 81 percent increased risk for mental health problems—was also criticized in the journal by researchers who claimed it violated guidelines for conducting meta-analyses; failed to state conflicts of interest, including the author’s “agenda-driven bias”; failed to evaluate the quality of the studies included; did not adhere to its own inclusion criteria; and included studies that did not adjust for mental disorders diagnosed before a woman became pregnant.

Coleman declined Rewire’s request for an interview, writing in an email, “I do not have much in confidence in mainstream media outlets accurately reflecting my work or the broader topic of abortion and mental health.”

Influence

Despite these problematic discoveries, Coleman’s work continues to be used by lawmakers and anti-choice activists as evidence that abortion is harmful to women and thus should be banned or heavily restricted.

In 2005, Coleman testified before the South Dakota Legislative Task Force to Study Abortion; the task force had been created through legislation sponsored by an anti-abortion Republican state representative. The task force included a majority of abortion opponents and produced a biased report alleging that abortion harms women and was used to support a host of anti-choice laws, including two abortion bans.

According to the report, which summarized her testimony, Coleman claimed that the decision to have an abortion violates one’s conscience and thus reduces women’s “cognitive functioning.”

The report reads:

When a decision involves a violation of one’s conscience, regression in cognitive functioning enables women to cope with the decision. Coleman cited studies indicating that abortion-related reasoning in young women is significantly lower than their general reasoning abilities. There can be no doubt that a pregnant mother considering an abortion is under stress, in crisis, and is vulnerable to the suggestions of others. However, after the stressfulness of the decision and the procedure have ended, women’s cognitive abilities return to normal, often ushering in feelings of pronounced guilt, sadness, and regret.

In South Dakota, Coleman submitted declarations in the case Planned Parenthood Minnesota, North Dakota, South Dakota v. Rounds.

Coleman served as a reviewer for a report produced by the American Psychological Association Task Force on Abortion and Mental Health in 2007.

In Congress, Coleman testified during a 2009 hearing on post-partum depression.

In Ohio, Coleman testified in defense of 2011’s Senate Bill 72, a proposal to ban abortions once viability is confirmed except when the pregnant woman’s life is threatened.

In 2013, Alaska state Sen. John Coghill (R-Fairbanks) called on Coleman, as well as Dr. John Thorp, as an expert witness to defend his bill prohibiting state funding for abortions deemed by doctors to be medically necessary on account of mental illness.

Coleman argued that not only is mental illness never a reason to necessitate an abortion—abortion causes mental illness.

“I am of the opinion that abortion is never justified based on mental health grounds and abortion should not be paid for by the state of Alaska due to the presence of any form of mental illness in women,” said Coleman, as reported by the Anchorage Daily News. She cited her own research to claim an “association between abortion and declining mental health status.”

But upon learning of Coleman’s questionable scholarship, Alaska state Sen. Bill Wielechowski (D-Anchorage) expressed deep concerns about the state’s reliance on her testimony.

“You’re referring to one paper where there was an error that was corrected and the article stands,” Coleman told Sen. Bill Wielechowski (D-Anchorage) upon questioning during the Alaska Senate committee hearing.

“I thought the qualifications were impressive, but it seemed clear to me at the time that their testimony was ideologically driven,” Wielechowski told Rewire in a phone interview, referencing Coleman and the two other expert witnesses Coghill called to defend the law.

“At least one of the expert witnesses had been thoroughly debunked. And that’s always a danger when you’re trying to get objective, credible information, independent information about whether or not this legislation is good or bad .… And it really threatens the process when you have biased, partisan, ideological experts who come in and attempt to tip the scales in one direction or another.”

Coleman’s work is routinely cited in state and federal cases, such as:

• Alaska Family Action, an anti-choice public policy organization, cited Coleman’s research in an amicus brieffiled in Planned Parenthood of the Great Northwest v. Alaska.
• Arizona’s 2012 HB 2036, which requires doctors who provide abortions to secure admitting privileges at a nearby hospital and institutes a ban on abortion at 20 weeks, cites Coleman’s work.
• In Massachusetts, Coleman’s work was cited in an amicus briefin the Supreme Court case Eleanor McCullen v. Martha Coakley.
• In Maine, Coleman’s work was cited in testimonyfrom Americans United for Life in support of 2011’s Legislative Document 116, a bill requiring women to wait 24 hours before they can receive an abortion.
• In Montana, Coleman’s work was citedin meeting minutes for 2009’s SB 46, which would have given “personhood” rights to unborn fetuses, effectively criminalizing abortion.
• In North Dakota, Coleman’s work was citedin MKB Management Corp v. Stenehjem in 2013.
• In Congress, Coleman’s research was citedin a testimony from Helen M. Alvaré in favor of the 2014 “No Taxpayer Funding for Abortion Act.”
• Coleman’s research was cited in an amicus brieffrom Eagle Forum in Gonzales v. Carhart in 2006.
• Americans United for Life wrote aboutColeman’s 2011 examination of 22 studies on abortion and mental health, a meta-analysis which she published in the British Journal of Psychiatry.

Coleman’s influence has reached beyond the legislature and the courts and into medical literature.

Over the past decade, Coleman has, according to her CV, peer-reviewed many articles in various medical, psychology, and health journals, including the British Journal of Psychiatry; Depression and Anxiety; Infant and Child Development; the Journal of the American Board of Family Practice; the Journal of Medical Ethics; the Journal of Reproductive and Infant Psychology; the Journal of Women’s Health and Gender-Based Medicine; The Lancet; Obstetrics and Gynecology International; Psychology, Health, and Medicine; and Social Sciences and Medicine.

Background

Collett helps states defend laws that restrict abortion and ban same-sex marriage. She has served as a special assistant attorney general for Oklahoma and Kansas and has litigated several high-profile cases involving abortion and marriage equality, according to her professional biography.

Collett has authored several articles denoting how her religious beliefs influence her legal practice, including “‘The King’s Good Servant, But God’s First,’ the Role of Religion in Judicial Decisionmaking” and “The Supreme Court’s Confused (and Confusing) Understanding of the Creation and Taking of Human Life.”

Controversy

Speaking at Harvard University in 2012 about Roe v. Wade at an event co-sponsored by the anti-choice group Law Students for Life, Collett said it was “sad” that when states successfully implement an abortion ban, they usually include an exception for rape.

Collett said that most Americans believe abortion is acceptable in the case of rape and offered as an example South Dakota’s 2006 abortion ban (later overturned), which did not include a rape or incest exception.

[Many Americans] believe that when women have consensually engaged in sexual intercourse, the natural consequence is, on occasion, pregnancy, and there is no injustice in forbidding them in terminating that pregnancy. But where a woman has not consensually engaged in the activity that we know can result in pregnancy, that we ought to at least allow her some window of opportunity.

Not arguing for it, I’m trying to explain why so many of our fellow citizens, who even self-identify as pro-life, think the rape cases are different, think the responsibility of people who did not even engage in the activity they know could be procreative should be excused for some brief period of time.

In response to an audience question related to rape exceptions, Collett said, “No, I think there will always be a rape exception” and added, “I think that’s sad.”

Collett also argued during her speech that most women who become pregnant through rape do not choose abortion, referencing a study published in the late 1970s—often promoted by the anti-choice community—that reported that 75 percent to 85 percent of women who become pregnant from rape do not choose abortion.

A longitudinal survey published in 1996 in the American Journal of Obstetrics & Gynecology—which estimated that more than 32,000 pregnancies result from rape annually—reported that about 50 percent of pregnant rape victims chose abortions, 32 percent opted to keep the baby, 6 percent opted for adoption, and 12 percent miscarried. But, according to the study, 32 percent of the rape victims overall did not discover they were pregnant until the second trimester.

Influence

Collett testified as an expert witness in support of two abortion laws in Alaska that required a parent’s involvement before a minor could obtain an abortion. In both lawsuits, plaintiffs (unsuccessfully) requested that Collett’s testimony be excluded because, they argued, she based her testimonies on statistics she looked up and studies she read, when she is neither social scientist nor demographer. Plaintiffs argued that she was, therefore, not qualified to testify as an expert in these cases.

Planned Parenthood of Alaska filed the first lawsuit in 1997, challenging a new state law that required a parent to consent before a minor could obtain an abortion. The lawsuit concluded in 2007 after the Alaska Supreme Court found the law unconstitutional. In that case, the Center for Reproductive Rights (CRR), representing the plaintiffs, objected to Collett’s testimony primarily because she testified about the purported impact another parental involvement law had in a different state, Texas.

Janet Crepps, senior counsel for CRR’s U.S. Legal Program, told Rewire that Collett was not qualified to offer the information that dominated her testimony.

“What she did was she went onto the website where there is publicly available information, like how many births there were to a certain age group, how many abortions there were, and she offered testimony that the parental involvement requirement in Texas had had a certain impact,” Crepps said.

“And our objection was that she was not qualified to offer that kind of information, because she’s not a social scientist and she couldn’t take into account confounding variables, such as a reduction overall in the abortion rate throughout the country, whether there had been a change in sex education or access to birth control. And she was just offering raw numbers the way you or I could go to the website and say, ‘Oh, look, here’s how many abortions that were before the law, and here is how many that were after the law, so the law must be having X effect.’”

The judge allowed the testimony.

Planned Parenthood of Alaska sued the state again in 2010 over another parental involvement law, this time passed as a ballot initiative. This law required a parent to be notified before a minor could have an abortion. The law was largely held up in court but is now on appeal before the Alaska Supreme Court. Crepps said Collett testified as to what sociology studies showed regarding violence against pregnant teens in Alaska, and again CRR protested that she lacked the qualifications to make such claims.

“We objected again because she’s not a social scientist, and the fact that she’s read a bunch of studies doesn’t in my opinion make her an expert,” Crepps said. “But the judge let that testimony in.”

In 2010, Collett helped fight a constitutional challenge to Oklahoma’s law mandating that all women who seek abortions must first submit to a mandated vaginal ultrasound, which she had advocated for the year before.

She testified in favor of 20-week abortion bans in Nebraska and Idaho, where she argued that the laws would likely prevail in a constitutional challenge.

“Recognition of a compelling state interest in the protection of pain-capable unborn children does not require the Court to reject a woman‘s liberty interest in obtaining an abortion or the balancing framework of Casey—it only asks the Court to recognize the legislature’s ability to weigh and rely upon new scientific evidence supporting a strong state interest in regulating abortions 20 weeks post fertilization,” Collett said in her testimony before the Idaho Legislature in March 2011.

Collett’s arguments, and her reference to “scientific evidence,” relate to the claims by anti-choice activists that a fetus can feel pain at 20 weeks’ gestation.

However, scientific consensus is that fetuses do not experience pain at 20 weeks.

In 2012, Collett testified before the Constitution subcommittee of the U.S. House Committee on the Judiciary in support of a proposed federal law that would prohibit transporting minors seeking an abortion across state lines to circumvent parental involvement laws. Collett, who has also written about the law, cited studies to suggest that female minors seeking abortions were likely being pressured by older boyfriends:

[A]s this Congress learned through a congressional report from the Center for Disease Control, two-thirds of the fathers of teenage mothers are age 20 years or older, suggesting that there is in fact differences in power and status between the sexual partners. In addition to that, a survey of 1,500 unmarried minors having abortions revealed that among the minors who reported that neither parent knew of the abortion, 89 percent said that a boyfriend was involved in deciding or arranging the abortion, and 93 percent of those 15 and under said that the boyfriend was involved.

Collett ran for Congress in 2010 to represent Minnesota, where she had moved that same year.

Background

In white papers and other writings, Condic asserts that her scientific background gives her certainty that human life begins when sperm and egg form a zygote. Abortion opponents frequently cite Condic’s work to support legislative bans on abortion.

Condic is also outspoken in her view that using fetal tissue for medical research is both unnecessary and immoral.

Condic’s religious beliefs imbue her scientific work. In 2014, she was appointed as a corresponding member of the Pontifical Academy for Life, an international group of physicians and scholars founded by Pope John Paul II to, according to its website, “study questions and issues connected with promotion and defense of human life from an interdisciplinary perspective.”

Condic is an associate scholar with the Charlotte Lozier Institute, the Susan B. Anthony List’s self-described “education and research arm.”

In a 2008 white paper written for the Westchester Institute for Ethics & the Human Person, from which one of her Charlotte Lozier articles was adapted, Condic writes that “non-arbitrary criteria must be established to determine when living human cells give rise to a new individual human being.” This is in direct counter to what many scientists—and, often, pro-choice politicians—argue, that cellular life exists on a continuum and the exact point when human life “begins” is unknowable.

Sperm-egg fusion is the hard starting point for Condic. She writes that when a sperm and egg join, they produce a brand-new cell type: a one-cell embryo, also known as a zygote. Condic says this new cell is not merely another human cell, but rather a separate human organism, because of its complex structure and ability to “carry on the activities of life by means of organs separate in function but mutually dependent.”

Other academics argue, however, that there is a difference between an individual human cell and a fully formed human being. For example, Harvard University professor and philosopher Michael J. Sandel argues for the use of embryonic stem cell research based partly on the distinction he draws between a microscopic single cell and a fully formed human being.

Controversy

Condic has testified before Congress and state legislatures in favor of both 20-week abortion bans and laws that require doctors to administer anesthesia to the fetus before an abortion, all based on the disputed premise that fetuses can feel pain before 20 weeks.

Scientists have debated and considered at what point fetuses can begin to feel pain. Though the debate is not closed, mainstream scientists and medical institutions say research points to the third trimester, which begins at 28 weeks’ gestation, rather than 20 weeks’ gestation.

In 2005, the Journal of the American Medical Association published an exhaustive review of evidence and concluded, “Evidence regarding the capacity for fetal pain is limited but indicates that fetal perception of pain is unlikely before the third trimester.”

Most persuasive to the researchers was the fact that connections between the thalamus and the cortex usually do not develop before at least 23 weeks’ gestation. They argue that these connections are needed for pain perception. The Royal College of Obstetricians and Gynaecologists in the United Kingdom published a review of “fetal awareness” in March 2010, concluding that the cortex is likely necessary for pain perception.

The American Congress of Obstetricians and Gynecologists (ACOG) asserts that laws claiming that fetuses are capable of experiencing pain before 20 weeks are not based in science. Rather, ACOG says that supporters of fetal pain legislation, like Condic, typically only present studies that support their anti-choice views.

But Condic’s broader argument on this issue is that pain is complex and that it is ultimately impossible to know exactly when, to what extent, or how fetuses experience pain. Thus it is best to assume they do, and to create law accordingly.

“Importantly, our inability to fully understand someone else’s experience of pain does not prevent us from making rational and prudent judgments about painful situations and how they obligate us to behave,” she has testified before Congress. “We do not justify inflicting pain on another person by saying, ‘I can’t possibly know how anyone else experiences me punching them in the face, therefore I am not obligated to restrain from this behavior.’”

Condic declined to be interviewed for this profile. In an email, she told Rewire, “My conclusions regarding fetal pain are not merely false claims made by someone in support of a (presumed) political agenda.  Rather, they are reasoned conclusions from the overwhelming preponderance of the evidence that constitutes the ‘mainstream science’ in this field.”

Influence

In the 2010 case Sherley v. Sebelius, Condic submitted an amicus brief in support of the lawsuit, which sought to prevent the National Institutes of Health from funding embryonic stem cell research. Condic argued that the human embryo is a distinct, individual human being, not a collection of cells. Plaintiffs ultimately failed in their legal challenge.

In 2011, Condic provided a declaration in defense of the State of Indiana in a legal challenge to a law prohibiting any state agency from contracting with or otherwise funding any abortion provider, even if the money were to fund non-abortion related services. Condic’s declaration focused on the argument that a zygote is a human being; thus abortion is immoral. Plaintiffs were ultimately successful at blocking this law.

In an amicus brief submitted in May 2013 in one of the many federal challenges to Obamacare’s birth control benefit, Gilardi v. Sebelius, Condic is listed among scientific advisers who assisted anti-choice groups the Breast Cancer Prevention Institute, the Polycarp Research Institute, and the Coalition on Abortion Breast Cancer in preparing the brief.

The brief argued that the birth control benefit violated religious freedom laws and did not advance a government interest in promoting women’s health because oral contraceptives “increase risk of disease instead of decreasing it.”

The independent medical group the Institute of Medicine had recommended that the Obama administration include in its health-care law insurance coverage of contraceptives without co-pay, “so that women can better avoid unwanted pregnancies and space their pregnancies to promote optimal birth outcomes.”

(As with all medications, oral contraceptives are associated with certain risks, including risk of blood clotting and risks of breast, cervical, and liver cancer. However, the National Cancer Institute notes that oral contraceptives are also associated with reduced risk of endometrial and ovarian cancer.)

In the same month, Condic testified before the U.S. House of Representatives in favor of a bill that would have banned abortion at 20 weeks’ gestation. She argued there is evidence that the “neural circuitry responsible for the most primitive response to pain, the spinal reflex, is in place by eight weeks of development.” The federal bill died in the House.

Condic’s testimony that fetuses likely feel pain as early as eight weeks’ gestation has been cited in proposed abortion restrictions at the federal and state level, such as Utah’s Abortion Anesthesia Bill, signed into law in 2016. A first of its kind, this law requires that physicians administer anesthesia to a fetus before administering an abortion at 20 weeks’ gestation or later.

State Rep. Keven Stratton (R-Orem), who sponsored the Utah bill, cited Condic’s testimony in his support of the law. The policy has yet to be enforced because the state has failed to provide abortion providers with guidance on how to comply, according to the Associated Press.

Background

Delgado is the medical director of the Culture of Life Family Services, a nonprofit family-medicine practice based in Escondido, California, with a second location in San Diego. The organization follows the teachings of the Catholic Church. In addition to offering prenatal care, well-child visits, and adult physicals, the practice offers free “spiritual direction” from local pastors and deacons, as well as free “crisis pregnancy care.”

Trained in an obscure Catholic fertility method called NaProTECHNOLOGY (which stands for Natural Procreative Technology), Delgado is an outspoken opponent of abortion. The Culture of Family Life Services opposes abortion, as well as all forms of contraception except for natural family planning, referred to on the website as the “moral method of contraception.”

But as Delgado told a radio caller on a recent broadcast of a Catholic radio program he frequents called Catholic Answers Live, he believes that natural family planning—essentially tracking one’s ovulation cycle—should only be used in conference with God and only for “just and serious reasons.”  

Controversy

Delgado did not invent the idea of “abortion pill reversal.” Dr. Matthew Harrison, a family doctor in Charlotte, North Carolina, pioneered the abortion pill reversal treatment in 2014.

Delgado told the Arizona Capitol Times in 2015 that the theory behind his treatment is inspired by the principles of NaProTECHNOLOGY, which, like Delgado, Harrison learned about at the Pope Paul VI Institute for the Study of Human Reproduction, a research and training clinic in Omaha, Nebraska, that trains doctors to practice reproductive medicine in line with Catholic teaching.

When it comes to matters of infertility, NaProTECNOLOGY strongly relies on the use of progesterone to prevent miscarriage. However, as the Arizona Capitol Times reported, the Pope Paul VI Institute does not teach abortion pill reversal.

But Delgado is credited with popularizing the notion of abortion pill reversal. He and Dr. Mary Davenport, who also trained at the Pope Paul VI Institute, co-authored a summary of case reports published in the Annals of Pharmacotherapy in 2012, purporting to show evidence that medication abortions can be undone by a specific medical protocol.

That paper was found to be seriously flawed by several doctors and scientists, as well as by the American Congress of Obstetricians and Gynecologists (ACOG). But it was heralded in the anti-choice movement.

Most abortion providers in the United States follow the medical regimen approved (and recently updated) by the Food and Drug Administration. On day one the patient goes to her doctor’s office or to an abortion clinic and takes the first dose of medication: mifepristone, designed to starve the fetus of the hormone progesterone, which it needs to grow and thrive. Two days later, usually at home, the patient takes the second dose: misoprostol, designed to expel the fetus.

Delgado and Davenport compiled case studies of six women who underwent the first step of a medication abortion—in other words, just the mifepristone—and then underwent multiple intramuscular injections of progesterone. (Initially there were seven women in this group, but one dropped out.) Of the six, four of the women stayed pregnant and went on to give birth to healthy babies.

Based on that, Delgado and Davenport concluded that administering progesterone after the first phase of a medication abortion effectively “reverses” said abortion.

Scientific and medical experts have excoriated this “research,” arguing that the population studied—six people—was minuscule.

ACOG has spoken out against the validity of this study and the practice, stating: “There are no reliable studies to prove that any treatment reverses the effects of mifepristone.”

Even more concerning, ACOG notes, is the fact that the researchers did not employ a control group of any kind. Thus, it is impossible to know what led to the continued pregnancies. Delgado and Davenport just assume, without any evidence, that the progesterone injections caused the pregnancies to continue.

The logic driving Delgado’s design is that the mifepristone has blocked the fetus from vital progesterone. Therefore, injecting the pregnant woman with a high amount of synthetic progesterone immediately and throughout her pregnancy will increase the chances that her fetus will survive and thrive.

But ACOG argues that just not taking the misoprostol will increase the chances that a pregnancy will continue. The organization has also stated that this protocol could potentially be dangerous.

“Progesterone, while generally well tolerated, can cause significant cardiovascular, nervous system, and endocrine adverse reactions as well as other side effects,” ACOG says.

 Influence

Despite the lack of evidence supporting abortion pill reversal, Arizona became the first state, in 2015, to pass a law forcing physicians to tell abortion-seeking patients that a “reversal” to abortion exists.

Planned Parenthood challenged this law, arguing it was unconstitutional to force doctors to lie to or mislead their patients. The state eventually repealed the law, after failing to find an expert witness to defend Delgado’s protocol.

Conservative lawmakers have nevertheless continued to propose similar laws.

Arkansas, South Dakota, and Utah have passed such laws. In addition to requiring doctors to tell their patients something unsupported by actual evidence, these laws require states to set up a website showing where patients can access abortion pill reversal services, which leads to Delgado’s Culture of Life Services website, as well as his abortion pill reversal hotline.

Similar laws have been introduced in California, Colorado, Georgia, Idaho, Indiana, and North Carolina.

More and more so-called crisis pregnancy centers are trying to incorporate abortion-pill reversal services, as more of these centers strive to be recognized as health-care clinics to rival Planned Parenthood facilities.

Background

Harrison is an anti-choice activist who frequently claims that abortion is a harmful procedure; she especially opposes medication, as opposed to surgical, abortion.

Harrison’s status as a medical professional and an OB-GYN lend credibility to her anti-choice views, and she is often quoted by mainstream media outlets, such as the New York Times, CNN, and NPR as a reliable source on the issues of abortion and contraception. Yet despite Harrison’s medical degree, her claim to fame is that of an ideologue and an anti-choice activist, who is paid by taxpayers to defend laws limiting women’s access to health care using discredited or fringe studies rather than broadly accepted medical evidence.

Harrison is outspoken in her views that, despite all evidence to the contrary, emergency contraceptives such as Plan B and ella can cause abortions. The accepted medical definition of pregnancy is the implantation of a fertilized egg, and the accepted medical definition of abortion is a process that terminates an established pregnancy, not one that merely prevents implantation.

Plan B, colloquially known as the “morning-after pill,” works to prevent ovulation and thus does not terminate an existing pregnancy, but rather prevents one.

Though the data on how exactly ella works is currently less definitive than that on Plan B, studies have shown that ella only works on women who have not ovulated. Anti-choice activists frequently refer to ella as the “week-after pill” because it can be used up to five days after intercourse. Harrison was quoted in an NPR story last year saying ella “kills embryos.”

“[I]t kills embryos before they implant, and it kills embryos after they implant,” she said.

In large part, Harrison’s claims that Plan B and ella prevent fertilized eggs from implanting in a woman’s uterus and thus constitute abortions rest on speculation unsupported by evidence. Specifically, Harrison says that the high efficacy rates of these drugs must mean that they’re preventing pregnancies post-ovulation. Harrison also points out that ella and the abortion-inducing drug Mifeprex are chemically similar, and wrongly assumes that they therefore work the same way.

Harrison declined to speak to Rewire for this story, and any future stories. In fact, she said she would consider further inquiries on her work from our reporters to constitute a form of harassment.

“In light of the previous articles that I have read on Rewire, I decline to talk to you or any other reporter from your magazine, and I will consider any further attempts to contact me as an act of harrassment [sic],” Harrison said in an email.

Controversy

Harrison served as an expert witness in MKB Management Corp v. Burdick, an unsuccessful constitutional challenge to a 2011 North Dakota law restricting medication abortions. Among other provisions, the law mandated that abortion-inducing drugs could only be administered using the Food and Drug Administration protocol outlined on the original label of the drugs—despite the fact that the FDA approves “off-label” use of its drugs. The plaintiffs—the sole remaining abortion clinic in North Dakota, Red River Women’s Clinic in Fargo—argued that there was no medical basis for the restriction.

District Judge Wickham Corwin ruled in the plaintiffs’ favor in 2013 and heavily criticized Harrison’s testimony. He said Harrison’s argument that the FDA has prohibited or discouraged the off-label use of the abortion-inducing drug mifepristone “proceeds on an impossibly flawed premise.” The state appealed the case to the North Dakota Supreme Court; the court upheld the law in October 2014.

Plaintiffs had filed a motion requesting that part of Harrison’s testimony be stricken from the record, arguing that she lacked the expertise to make certain claims and that some of her conclusions lacked factual basis.

In response to the motion, Judge Corwin agreed with some of plaintiffs’ arguments and concluded, “No direct testimony from Dr. Harrison will be permitted regarding the regulatory role played by the FDA, the process that led to the approval of mifepristone or Mifeprex, or the legal effect of any of this.”

Corwin disputed Harrison’s main argument that the FDA prohibits or discourages the off-label use of the abortion-inducing drug mifepristone. He explained that the FDA regulates the marketing and distribution of drugs but cannot regulate the practice of medicine or how physicians administer the drugs.

He also called out Harrison’s references to malpractice and patient abandonment in her affidavit as “gratuitous, irrelevant, and inappropriate.”

Influence

Harrison’s false claims that birth control causes abortion were at the center of the recent battles over the birth control benefit in the Affordable Care Act.

The benefit requires, among other things, that all insurance plans cover a range of preventive care without a co-pay, including all forms of contraception approved by the Food and Drug Administration.

A number of religious organizations and privately held corporations claiming “religious exemptions” objected to the provision, claiming despite all evidence that the ACA requires them to cover abortion-inducing medication in violation of their religious beliefs. This view ultimately prevailed before the U.S. Supreme Court in the Hobby Lobby decision, in which the arts-and-crafts chain was found to have religious beliefs protected by the Constitution.

During the course of the litigation and the public debate surrounding it, opponents of the birth control benefit relied heavily on the false argument that birth control causes abortion perpetuated by Harrison and others.

In addition to influencing the arguments others make in court, Harrison’s arguments have had direct impact in legal proceedings, as well as congressional and state legislative hearings.

In a petition to the Supreme Court filed June 2013, Harrison’s previous declarations were cited in the Oklahoma case Cline v. Oklahoma Coalition for Reproductive Justice, related to banning the off-label use of the medication abortion drug RU-486 (also known as mifepristone).

Background

Harvey writes for Reproductive Research Audit (RRA), an online project of  the social conservative Center for Morality in Public Life, a nonprofit founded in 2010, which also publishes Ethika Politika—another conservative blog.

RRA’s stated mission is “to shine a light on the methodology of scientific studies on reproductive health issues, exposing their bias, flaws and propensity to ignore data that does not support a pre-determined political agenda,” according to its website. The site has an explicitly conservative Christian perspective, also apparent from the group’s LinkedIn profile.

Controversy

Despite RRA’s stated goal of exposing the flaws in others’ research, Harvey’s own scholarship in at least one instance was so flawed that one of her papers had to be scrubbed from the site.

In July 2013, Reproductive Research Audit published an article written by Harvey that attempted to discredit a Guttmacher Institute study published in the August 2013 issue of the Journal of Women’s Health. This study, authored by Rachel Jones and Jenna Jerman, reported how far women had to travel to access abortion services in 2008. Harvey—who later admitted that she had not read the full study—invented numbers and produced a faulty analysis claiming Guttmacher’s study had actually shown that average distances to abortion clinics were not very far (contrary to what the study showed).

“In fact, abortion may be more accessible than other elective outpatient surgeries, even medically-necessary procedures,” Harvey wrote in the article, which was scrubbed from RRA’s website but is still available online, thanks to the Way Back Machine. “It may actually be closer to the patient than even her own workplace.”

But Harvey’s claims about the Guttmacher study, her analysis, and her conclusion were clearly wrong. The version of the Guttmacher article that Harvey read did not include the researchers’ methodology. So, she made one up.

In her original piece, Harvey wrote:

This study indicates that 71 percent of patients traveled fewer than 25 miles and 85 percent traveled fewer than 50 miles to obtain an abortion (likely round trip).” She continued: “Before explaining why this study indicates ease of access to abortion, there are reasons to suspect that Jones & Jerman’s 25 mile figure is likely a round trip sum, deceptively presented as the distance between the woman’s home and the nearest abortion provider.

In fact, the Guttmacher researchers had not used a round trip as the basis of their calculations. According to Jones and Jerman’s paper, they used the “traveltime” command in Stata—a piece of data analysis and statistical software—to calculate the distance between two sets of points. “[T]he starting and ending points were generated from the latitude and longitude based on the centroid of the woman’s zip code and the centroid of the zip code of the provider where she obtained the abortion,” Jones and Jerman wrote.

When Joerg Dreweke, Guttmacher’s senior policy communications associate,  called out the errors on Twitter, RRA published a correction on its website, in which Harvey admitted that she had not read the full study—but an abstract—and had actually speculated on how the researchers likely conducted their research.

Harvey explained that she never read the study in its entirety because she didn’t want to spend the money (also she doesn’t trust the Guttmacher Institute):

I opted not to purchase the paid version of this article since the public 9-page document presented at a conference showed identical results to the paid abstract and media coverage. Likewise, these results were consistent with another study that presented what were likely round-trip figures (the methodology were omitted) and yielded strikingly similar results as well. This gave me a false impression that there were no substantive differences in the paid version since paid articles published by personnel affiliated with the Guttmacher Institute routinely contain such misrepresentations and omissions.

After the Guttmacher Institute sent Harvey a free copy of the study, RRA published a correction to the story, in which Harvey amended her claim about the Guttmacher study, demonstrated by the revised headline (the strikethroughs are original):

CORRECTION: Guttmacher Study Shows:  Distance to Get an Abortion May Be Shorter Than  Distance to Get to Work

But still blatant errors persisted.

Harvey’s conflation of the terms “median” and “average” continued to produce false results. Dreweke reached out yet again, tweeting, “Tks for correction. But you’re still comparing apples to oranges: median distance for wmn to mean dist for commuters.”

Harvey’s response? “You are right. Mean / Median. Also, rush + international travel /= good work. Lesson learned. I will address this soon.”

But she never did. RRA just took the article down. Michael New (Harvey’s romantic partner, if their tweets are to be believed) authored a subsequent article on the Guttmacher study in September in which he praised the researchers’ methodology as “thorough and rigorous” but argued with their interpretations.

“To state the obvious, one should get the basic facts right when attempting to critique others’ work,” Dreweke told Rewire in an email. “It speaks for itself that Dr. Harvey scrubbed her botched critique of the Guttmacher study from her website.”

Reproductive Rights Audit did not respond to our request for comment.

Influence

Notwithstanding this documented history of fabrication, equivocation, and apparent lack of understanding of basic statistical concepts, Harvey has provided written testimony to the Texas legislature in support of HB 2, whose effects have left 16 remaining clinics in the whole state.

Background

Elard Koch’s recent work is the source of the frequent anti-choice claim that criminalizing abortion will not lead to a rise in illegal abortions and, in turn, a rise in maternal deaths.

In May 2012, the science and medical journal PLOS ONE published a research article written by Koch, Thorp, and five Chilean researchers, which analyzed abortion legislation in Chile and its relationship to a steep reduction in maternal deaths from 1957 to 2007. Abortion in Chile had been legal from 1931 to 1989 in cases where the mother’s health was at risk. After abortion was totally criminalized in 1989, according to the study, the maternal mortality rate continued to decline.

Koch’s team suggested that the decline in maternal deaths resulted from an increase in women’s education levels, access to maternal health facilities, changes in women’s reproductive behavior, and improvements of the sanitary system throughout the country. They also argued that the study “provides counterintuitive evidence showing that making abortion illegal is not necessarily equivalent to promoting unsafe abortion, especially in terms of maternal morbidity and mortality.”

However, Koch’s scholarship is at odds with research by the World Health Organization, which found in a report that in 2008 approximately 20 percent of women aged 15 to 44 lived in countries where abortion was criminalized or heavily restricted. Moreover, the report found that in countries with the most restrictive abortion laws, most of the abortions taking place—and they still are taking place—are “unsafe,” meaning they are performed by untrained providers or in unsafe conditions.

“However,” the WHO notes, “where abortion laws are the least restrictive there is no or very little evidence of unsafe abortion, while legal restrictions increase the percentage of unlawful and unsafe procedures.”

The WHO estimates that unsafe abortion is the cause of approximately 13 percent of pregnancy-related deaths worldwide, and noted that the rate of adverse incidents as a result of unsafe, clandestine abortions is difficult to ascertain because many of the incidents are under- or unreported, especially where the procedure is illegal.

“No records are available on women who had unsafe abortion complications but who did not seek post-abortion care in public facilities. Only the ‘tip of the iceberg’ is, therefore, visible in the number of deaths and the number of women who seek medical care following complications,” the WHO reported.

Controversy

Soon after Koch’s article was published, the Guttmacher Institute released an article review claiming Koch’s study was wrought with “serious conceptual and methodological flaws that render some of its conclusions pertaining to abortion and maternal mortality invalid.”

Among Guttmacher’s concerns were that Chile’s abortion law prior to 1989 was still very restrictive. Guttmacher’s researchers pointed out that it therefore should not be surprising that after Chile’s law was even further restricted, the rate of illegal abortions would not shoot up. Guttmacher also said that Koch and his co-authors relied on “a far too narrow, unreliable evidence base,” only using Chile’s vital registration system to analyze the incidence and results of abortion, which would not capture illegal abortions or resulting deaths. As a result, they concluded that Koch’s claim that restrictive abortion laws do not negatively affect women’s health was not supported by existing evidence.

Koch brushed off the critique in a point-by-point rebuttal, which in part argued that some of Guttmacher’s claims were speculative.

In an email exchange with Rewire, Koch doubled down on his belief that his research undermines the work of the Guttmacher Institute.

“The premise that a less permissive legislation restricting or prohibiting pregnancy termination leads to increased maternal mortality due to complications of clandestine, or illegal, or unsafe abortions is a common notion supported by many agencies worldwide, including the Alan Guttmacher Institute,” Koch said in an email. “Theoretically, in countries exhibiting less permissive legislations such as Chile, maternal deaths should have been higher, because the practice of unsafe abortion should be more frequent. Paradoxically, we found no evidence supporting this conjecture in the Chilean study.”

Koch did concede that it is “not possible to determine the actual magnitude of illegal abortion,” though he asserted that it was nevertheless possible to make judgments about how laws affected maternal morbidity.

“We have thoroughly discussed this issue and concluded that, while it is not possible to determine the actual magnitude of illegal abortion, it is indeed possible to estimate the population at risk of induced abortion in territories where it is prohibited or restricted, such as most of Latin America,” Koch said in an email.

But even a federal judge in Wisconsin has cast doubt on the work of Koch and his co-authors.

In May 2014, one of the co-authors, Dr. John Thorp, testified as part of a colloquy of experts during a court trial hearing over a Wisconsin law requiring abortion providers to obtain admitting privileges at a local hospital. Thorp is an international collaborator with the MELISA Institute, the private research group in Chile that Koch founded.

Speaking on behalf of defendants of the law, Thorp cited the study to answer the question: “What are the health risks, if any, associated with decreasing access to abortion?”

“Chile made abortion or termination of pregnancy illegal in the early 1990s, and rather than see the predicted uptick in maternal deaths saw a continued decline in maternal deaths in Chile after access was severely restricted,” Thorp testified. “So I reject the assumption in No. 8 that the Wisconsin law will decrease access to abortion and that decreased access will result in death or harm.”

Chief Judge William M. Conley pressed Thorp on whether decreasing access to legal abortions would result in an increase in the number of illegal procedures.

“Well, I think the more restrictive you make a law, the more likely there are to be violations of the law,” Thorp replied. “So I agree with your statement.”

A debate between Thorp and Judge Conley ensued:

Conley: And are you of the opinion that illegal abortions are going to be as safe, at least in number of deaths, as legal abortions?

Thorp: I can tell you that in Chile they did the national experiment. And much more restrictive than this little admission/privilege law would ever be, the exact opposite was seen, Your Honor.

Conley: So there were less deaths once it was illegal to perform abortions?

Thorp: Yes, sir. The death rate continued to plummet.

Conley: And I guess it begs the question, isn’t that because they probably—no one was reporting any deaths related to abortion since it was illegal? Consistent with your general assumption that it’s underreported, isn’t it really going to be underreported when it’s illegal?

Thorp: Even if you factored in a 50% underreporting rate, death rates fell. So, no, I don’t think that’s true. So I reject the final premise that a law like this is going to harm Wisconsin women.

The plaintiffs’ expert witness, Dr. Douglas Laube, disagreed with Thorp’s claim.

“I can assure you that if it were illegal, there would be a 100% underreporting and not 50%,” he said. “There are many abortions going on in Chile and most of which are occurring in Santiago. And we know this from communications by our colleagues who are members of our professional college.”

The neutral expert witness in the colloquy, Dr. Serdar Bulun, added his opinion, objecting to the notion of performing an “experiment.”

“I think it would be an unacceptable experiment to, you know, decrease abortion and see if people would die or have, you know, less at this day of age,” Bulun said. “It’s not ethical. I still have the view that if we restrict legal abortion, I don’t think abortion will stop and people will resort to illegal abortions. And I think it’s reasonable to assume that there will be a higher incidence of septic abortions and other complications.”

Influence

Despite the criticisms of his work, Koch’s research continues to be cited by anti-choice activists, including other researchers.

In September 2013, Koch presented some of his findings from the 2012 study at an event at the United Nations co-hosted by Alliance Defending Freedom, a conservative legal nonprofit based in Scottsdale, Arizona, that promotes anti-choice policies.

More recently, anti-choice epidemiologist and professor of obstetrics and gynecology Dr. Monique Chireau—an international collaborator with the MELISA Institute, which Koch founded—referenced the study to argue that criminalizing abortion does not lead to an increase in maternal mortality rates, during a webinar held in October 2014, sponsored by the Center for Bioethics & Human Dignity, “a Christian bioethics research center” at Trinity International University in Deerfield, Illinois.

Soon after the PLOS ONE study came out, Koch and six colleagues published a critique in a Mexican scientific journal of a Guttmacher study estimating hundreds of thousands of clandestine abortions in Colombia.

Koch’s team primarily criticized Guttmacher’s use of convenience sampling and what the writers claimed was “serious selection bias.” Guttmacher defended its study in a July 2012 advisory report claiming Koch misrepresented Guttmacher’s methodology used in the Colombia study and proposed an alternative methodology that “is based on scientifically unsound and illogical assumptions and contains such serious errors that its results are not valid.”

Koch again criticized Guttmacher’s methodology in a study published in the December 2012 issue of the International Journal of Women’s Health, and again Guttmacher accused Koch of making false claims.

Background

Lanfranchi is a longtime anti-choice activist. For years, Lanfranchi has attempted to prove that abortion causes breast cancer through her nonprofit advocacy group the Breast Cancer Prevention Institute, based in Somerville, New Jersey.

The Breast Cancer Prevention Institute reported approximately $35,000 in net assets in 2011 to the Internal Revenue Service; between 2003 and 2011 the group received approximately $1,500 in small donations from the Charles and Mary Crossed Foundation; the Rochester Area Community Foundation; and General Electric’s charitable entity, the GE Foundation, according to tax filings.

Lanfranchi works for several anti-choice groups and frequently travels throughout the world giving lectures asserting that abortion and hormonal birth control cause cancer.

Controversy

In April 2014, Lanfranchi spoke at an anti-choice conference held in McLean, Virginia, called Liberated With Truth. In the presentation, which Rewire attended, Lanfranchi detailed the four ways birth control can kill you. She seriously overstated the risk of cancer associated with the pill on both the American Life League’s “The Pill Kills Women & Babies” and in her frequently presented lecture “The Pill Kills.”

Specifically, Lanfranchi claims that taking the contraceptive pill increases the incidence of breast, cervical, ovarian, endometrial, and liver cancers.

According to the National Cancer Institute, some studies have shown a slightly increased risk of breast cancer for women who take oral contraceptives, particularly among younger women, but “the risk level goes back to normal 10 years or more after discontinuing oral contraceptive use.”

The National Cancer Institute states there is evidence of an association between oral contraceptive use and increased risk of cervical cancer, but that “this increased risk may be because sexually active women have a higher risk of becoming infected with human papillomavirus [HPV], which causes virtually all cervical cancers.” In other words, if there is a correlation between women who take the pill and those who develop cancer, it is more likely to be because those women are sexually active, not because they take the pill.

The National Cancer Institute also notes there is evidence that the pill reduces the risks of ovarian and endometrial cancers. As for Lanfranchi’s statement that the pill puts women at higher risk for liver cancer, the National Cancer Institute says there is an increased risk of benign liver tumors, “but the relationship between oral contraceptive use and malignant liver tumors is less clear.”

In the same presentation, Lanfranchi claimed the pill will “make it more likely you will die a violent death.” She reasoned that the contraceptive pill affects hormones, which can result in women choosing partners with whom they will be incompatible once they cease taking the pill. Building on that doubtful assumption, Lanfranchi then made the astonishing leap of logic that women in relationships with incompatible partners would be at higher risk of being beaten—fatally—by those partners.

Lanfranchi spoke at the World Congress of Families conference in Melbourne, Australia, in August 2014 at the anti-gay, anti-choice annual World Congress for Families Congress.

Influence

Lanfranchi has testified in support of anti-choice legislation before legislatures and in court. She has served as an expert witness in New Jersey.

Background

Like many of the movement’s abortion-providers-turned-foes, Levatino has a compelling conversion story, which he has shared with activists and lawmakers since the late 1980s.

Levatino says the death of his 6-year-old sparked his eventual conversion from a self-described “pro-choice” OB-GYN who provided abortions, to a proponent of banning abortion.

Levatino says that he and his wife, Cecilia, desperately wanted to have a child but could not conceive. So, in 1978, they adopted a baby girl and named her Heather. In 1984, a driver hit and killed Heather while she was playing in front of the family’s house. Levatino says that Heather’s death irrevocably changed the way he viewed his work as an abortion provider.

“I lost my child, someone who was very precious to us. And now I am taking somebody’s child and I am tearing him right out of their womb. I am killing somebody’s child,” he told the audience at the Pro-Life Action League’s Meet the Abortion Providers conference in 1987.

He says he stopped performing abortions altogether in 1985 and went to law school. He and his wife, who sits on the Las Cruces City Council and recently lost a bid for the New Mexico Senate, have served on the boards of a variety of anti-choice organizations and crisis pregnancy centers. They started a nonprofit called Heather’s Place to disseminate graphic descriptions of abortions to legislatures across the country.

Levatino now travels the country decrying abortion generally and later-term abortions particularly, providing graphic descriptions of procedures to his audiences, which have included Congress and state legislatures.

Controversy

Levatino claims, falsely, that abortion is dangerous to women. As evidence he, amazingly, claims to have personally injured scores of women during his eight years providing abortions, and appears to have admitted to fetal homicide.

“I had complications, just like everybody else,” Levatino said at the Meet the Abortion Providers conference. “I have perforated uteruses. I have had all kinds of problems—bleeding, infection—Lord knows how many of those women are sterile now.”

He claims that he sometimes witnessed babies born alive during abortions:

My discomfort came at that point because there was a tremendous conflict going on inside me. Here I was doing my [dialation and curretages], five and six a week, and I was doing salines on a nightly basis whenever I was on call.

The resident on call got the job of doing the salines and there would usually be two or three of those. They were horrible because you saw one intact, whole baby being born, and sometimes they were alive. That was very, very frightening. It was a very stomach-turning kind of existence.

Levatino did not answer our questions regarding whether his claims amount to allegations that he and his colleagues murdered newborn babies, or even an admission of his role in such an alleged crime. Rewire’s searches did not identify any public record of disciplinary proceedings against Levatino.

Influence

Levatino has testified before congressional committees, as well as in federal and state lawsuits. His expert advice has been sought on abortion procedures, as well as on the question of whether a fetus can feel pain at 20 weeks’ gestation.

In October 2015, Levatino testified in a congressional committee hearing about Planned Parenthood’s medical procedures in the wake of the Center for Medical Progress’ discredited video campaign that accused Planned Parenthood of illegally selling fetal organs for profit. He testified that second-trimester abortions are “absolutely gruesome,” and argued that low-income women’s health care would be easily met without Planned Parenthood.

Levatino did not volunteer but answered upon questioning that he had worked for a Planned Parenthood during his medical residency.

In 2014, Levatino testified against physicians in Akron, Ohio, who had been sued for not completing an abortion. A woman had, according to court documents, gone in for an abortion at seven weeks’ gestation and a week later discovered she was still pregnant, though she ultimately decided to continue her pregnancy to term.

Arguing for the plaintiff, Levatino claimed the doctors were negligent. The defense argued that because the woman had a rare disorder that caused her to have two uteruses, she must have had an additional embryo in the second uterus that was not detected by multiple ultrasounds. The judge dismissed the case.  

Levatino co-signed an amicus curiae brief “of former abortion providers” in the Supreme Court case Whole Woman’s Health v. Hellerstedt. That brief argued that abortions are very dangerous and asked the court to uphold the provisions in Texas’ HB 2 law that required doctors providing abortions to have admitting privileges at nearby hospitals, and for abortion clinics to transform into abortion surgical centers. The high court overturned those provisions in June 2016.

Levatino has testified before Congress and several state legislatures in favor of 20-week abortion bans and bans on an abortion procedure called dilation and evacuation, better known as D&E. His modus operandi is to describe later abortion procedures in graphic detail in an effort to disgust and disturb his audiences.

Levatino’s language is highly subjective, and according to San Francisco-based OB-GYN Dr. Pratima Gupta, not in accordance with professional norms.

For instance, this is how Levatino described a D&E abortion to the Kansas Legislature in February 2015 in favor of a proposed law banning the procedure:

The toughest part of a D&E abortion is extracting the baby’s head. The head of a baby that age is about the size of a large plum and is now free floating inside the uterine cavity. You can be pretty sure you have hold of it if the Sopher clamp is spread about as far as your fingers will allow. You will know you have it right when you crush down on the clamp and see white gelatinous material coming through the cervix. That was the baby’s brains. You can then extract the skull pieces. Many times a little face will come out and stare back at you.

Gupta, who currently provides abortions along with a full range of gynecological and prenatal care, including delivery, at Kaiser Permanente, told Rewire in a phone interview that Levatino’s statement is technically accurate but problematic in its subjectivity.

“I think if you were to look at a textbook description [of abortion], it would be just very objective, describing the step by steps without using words like ‘aggressive’ and ‘gruesome,’” Gupta said. “The problem is he also includes a lot of very subjective descriptors and adjectives because of his new stance, I guess, in being an anti-abortion crusader.”

Sometimes Levatino brings along medical tools when explaining how later abortions work, as he did in May 2013 during his testimony before Congress in favor of a ban on all abortions at 20 weeks. Levatino also filmed a series of videos describing later abortion procedures, created by the anti-choice group Live Action, best known for secretly filming inside Planned Parenthood clinics.

Background

New works for multiple anti-choice nonprofits that pose as research institutions. Yet he produces little in the way of his own research. Instead, he regularly criticizes research whose findings show that policies attempting to widen access to abortion and contraception carry public health and economic benefits.

New has authored a few studies in recent years that primarily analyze the effects of state-level anti-abortion legislation, in which he attributes the reduction in abortion rates to abortion restrictions.

He has also been a research associate at the anti-choice website Reproductive Research Audit. (Jacqueline Harvey, with whom he appears to be romantically linked, is also affiliated with RRA.)

Unlike many anti-choice activists, New has been candid about what he sees as a clear goal of anti-abortion legislation. Whereas many activists and bill sponsors talk about how abortion restrictions, such as instituting days-long waiting periods, help women, New has publicly acknowledged the political goal of these types of anti-abortion laws: reducing access to abortion.

In September 2012, New spoke on a panel at the Values Voter Summit, an annual conference for social conservative voters sponsored by the Family Research Council. During his PowerPoint presentation, New said a policy that requires women to make multiple trips to an abortion clinic “raises the costs” of obtaining the procedure and “stops the abortion from happening.”

“The best thing you can do when you get home is support a variety of state pro-life bills, and essentially, if your state has them, they can be strengthened,” New said. “You can strengthen parental-involvement laws, by requiring both parents to be involved. You can strengthen informed-consent laws: Require the woman to see an ultrasound, or require two trips to the clinic. That raises the costs; that stops the abortion from happening. You can lengthen the waiting period. Don’t be like the other states that do 24, 48, 72 hours. Do it for nine months—that’ll stop abortions in your state. I guarantee it.”

In an interview following the panel discussion, New expanded upon his views on the effects of certain abortion restrictions.

“We really know a lot about public funding restrictions, and we know a lot about parental involvement,” New said. “There’s also a body of research—not as large—on informed-consent laws, and the important thing there is they really have to be designed the right way. They typically have to require two separate trips to the clinic. That kind of raises the economic costs of getting an abortion, especially for women in rural areas, women who live far away.”

Controversy

New’s article “Analyzing the Effect of Anti-Abortion U.S. State Legislation in the PostCasey Era,” published in State Politics and Policy Quarterly in March 2011, concluded that “several types of state-level anti-abortion legislation result in statistically significant declines in both the abortion rate and the abortion ratio.”

But upon reviewing the data set New used, California State University-Long Beach professors Marshall H. Medoff (economics) and Christopher Dennis (political science) argued his analysis “contained critical data, measurement, methodological and estimation errors.”

In response to Medoff and Dennis’ findings, published in the September 2014 issue of State Politics and Policy Quarterly, New reexamined his data and published a reassessment in the same issue. In it, he admitted to what he said were a few minor errors but ultimately defended his analysis.

“Most of the errors identified by Medoff and Dennis in my data set of public funding restrictions and parental involvement laws were due to relatively small differences in the specific enforcement dates of these laws. A few errors occurred because in some cases, scholars, antiabortion groups, and abortion rights groups disagree about whether a relatively weak law actually constitutes an antiabortion law. Overall, these errors fail to substantively affect my findings on the impact of either parental involvement laws or public funding restrictions.”

Unsatisfied with New’s reassessment, Medoff and Dennis published another critique, claiming that “in New’s reanalysis he makes many of the same errors as in his original article,” and that his updated work showed anti-choice laws had “no measurable impact on the abortion rate of all women of childbearing age, adult women or teen minors over the period 1985-2005.”

Influence

New has also testified before Congress in favor of anti-choice laws. In March 2012, for example, he testified before the House Judiciary Committee in support of the Child Interstate Abortion Notification Act (CIANA), which would prohibit transportation of a minor across state lines in order to obtain an abortion.

He testified, “I am confident the Child Interstate Abortion Notification Act would lead to both fewer abortions and better public health outcomes for teen girls.”

New claimed that “the knowledge that their parents will be involved with an abortion decision provides teen girls with a strong disincentive to engage in unprotected sexual activity,” based on a 2003 Journal of Health Economics study, which he says found that parental involvement laws reduced the pregnancy rate of 15- to 17-year-olds by 4 to 9 percent.

He cited several findings to support his overarching contention that parental involvement laws disincentivize unprotected sexual activity. He claimed that the 16 studies he reviewed found “that state level parental involvement laws reduce the in-state abortion rate for minors,” by between 13 and 42 percent, based on the studies’ varied reduction rates. He also cited a 2008 Journal of Law Economics and Organization article that found a 12 to 20 percent reduction in the rate of gonorrhea among women and girls under 20 following the passage of parental-involvement-in-abortion laws.

New did note, however, that two studies “found evidence of short term increases in the minor birth rate” following parental involvement laws enacted in Massachusetts and Texas.

Background

After working for about 20 years as a professor of life sciences and molecular genetics at Indiana State University and Indiana University School of Medicine, respectively, Prentice worked for the socially conservative Family Research Council for a decade, where he lobbied the federal government to ban the funding and practice of medical research using embryonic stem cells.

Prentice rejects using fetal tissue for research, arguing it is both unethical and—in contrast to what many researchers say—scientifically unworthy. Many researchers, however, argue that using fetal tissue for research is the gold standard for medical research.

In 2006, children’s neurobiologist Dr. Shane Smith, medical researcher Dr. William Neaves, and pathologist Dr. Steven Teitelbaum called Prentice’s claim that adult stem cells provide treatments for 65 human illnesses misleading, deceptive, and a “falsehood” in a letter published in Science magazine.

Controversy

Since taking the helm of research at the Charlotte Lozier Institute in 2015, Prentice has advocated for banning abortions at 20 weeks, arguing that fetuses are capable of feeling pain at this point. Positions like these have helped to advance a new type of abortion requirement, passed in Utah in 2016, that requires doctors to administer anesthesia to a pregnant patient having an abortion at 20 weeks’ gestation or later. Doctors in the state and elsewhere have argued that sedating women during the procedure puts women at risk of complications.

Founded in 2011, the Charlotte Lozier Institute pushes biased papers and articles (and little in the way of original research) about issues related to reproductive and fetal health, with the ultimate goal of restricting and criminalizing abortion.

In the summer of 2015, an anti-choice front group called the Center for Medical Progress (CMP) launched a series of deceptively edited videos spotlighting Planned Parenthood’s occasional practice of donating fetal tissue for medical research.

The group tried—with no evidence—to show that Planned Parenthood was illegally profiting from the sale of fetal tissue. However, Planned Parenthood has maintained that the few affiliated clinics that have donated fetal tissue have only recouped reimbursement costs in line with federal law. Several state investigations into the organization’s handling of fetal tissue have not found any wrongdoing.

CMP’s campaign against Planned Parenthood sparked a national controversy about fetal tissue research, as well as a congressional panel dedicated to investigating Planned Parenthood and fetal tissue researchers. The U.S. House of Representatives’ Select Investigative Panel of the Energy & Commerce Committee turned to Prentice to “tutor” panel members and their staff about issues related to fetal tissue research. The panel’s final report, submitted to the House of Representatives in December 2016, credits Prentice with influencing the panel’s thinking on these issues.

“Dr. David Prentice of the Charlotte Lozier Institute tutored the Members and Staff alike on the latest trends in biomedical research and helped us sharpen our thinking about the ethical issues associated with the use of abortive fetal tissue,” the report reads.

Influence

In 2004 Prentice wrote a comprehensive review of adult stem cell research for then-President George W. Bush’s U.S. President’s Council on Bioethics.

As part of his role as the research director of the Charlotte Lozier Institute, Prentice’s responsibilities are “to provide and guide testimony to Congress and state legislatures.”

Shortly after CMP released its video campaign targeting Planned Parenthood, the Charlotte Lozier Institute joined the chorus of anti-choice groups defending CMP and advocating that states investigate Planned Parenthood.

Prentice supplied written testimony to legislatures in Arizona and Wisconsin in support of laws banning the sale of fetal body parts, a practice that is already prohibited under federal law. The bills were passed as a political response to the release of the CMP videos. In his testimony on both bills, Prentice went further than arguing that the trafficking of fetal body parts should be illegal (it already is), but stated that using fetal tissue from induced abortions for any purpose is unethical. The Arizona bill was signed into law in 2016, but the Wisconsin bill failed.

In 2015, Prentice testified in support of an unsuccessful Indiana proposal to ban abortion if the pregnant person wants the abortion because of the fetus’ sex or because of a diagnosed disease or abnormality. He likened aborting fetuses diagnosed with diseases as a form of eugenics and argued that advanced prenatal fetal diagnostic tests should only be used to determine whether fetal surgery or medical treatment will be required, not as a precursor to an abortion.

In his role at the Charlotte Lozier Institute, Prentice has also helped coordinate legal expert witnesses with anti-choice views to testify in court in defense of abortion restrictions.

In the fall of 2015, the Arizona Attorney General’s Office reached out to Prentice asking him to find qualified expert witnesses to defend a challenged state law requiring doctors to tell patients that abortion via medication can be reversed—a notion based on one flawed, unscientific paper co-authored by Dr. George Delgado. Emails obtained by Rewire through a public records request indicate that Prentice tried to find witnesses for the attorney general but ultimately came up short. The state eventually repealed the law.

Background

Reardon’s anti-choice advocacy began in the early 1980s, after meeting a woman who claimed to suffer physically and psychologically from an abortion she hadn’t really wanted, according to a 2011 profile on Reardon published in the anti-abortion magazine Celebrate Life.

A lot of his research—which is collected at Reardon’s Elliot Institute—purports to show a causal relationship between abortion and negative mental health effects, such as depression. However, many of the research articles that Reardon has co-authored, upon review by other academics, have been exposed as showing correlation rather than causation.

In 2007, the New York Times Magazine referred to Reardon as the Moses of the anti-abortion movement, in part because of his somewhat revolutionary anti-choice approach. In his 1996 book Making Abortion Rare: A Healing Strategy for a Divided Nation, Reardon suggested that activists change the frame the debate, focusing on the woman having the abortion rather than the fetus.

Reardon’s qualifications relating to abortion are questionable, at best.

Trained as an electrical engineer, Reardon claims to also have a PhD in biomedical ethics from Pacific Western University-Hawaii (PWU).

PWU was featured in a 2004 CBS News story about phony colleges that sell fake degrees, and in 2006 the State of Hawaii shuttered PWU following federal and state investigations into whether the school was essentially a diploma mill. That PhD was Reardon’s sole qualification related to abortion, and yet he does not mention Pacific Western University on his current LinkedIn profile (since taken down).

Reardon’s particular impact has been through the promulgation of the false concept of “post-abortion syndrome,” a roundly debunked notion that women suffer a species of post-traumatic stress after the procedure.

In his writings, Reardon has gone beyond elaborating the fictional “post-abortion syndrome”; he has also made claims about the mental state of rape and incest victims, asserting that abortion will compound the trauma already suffered, and that women in these situations actually want to continue their pregnancies, whether they realize it or not.

“Unlike pregnancies resulting from rape, most incest pregnancies are actually desired, at least at a subconscious level, in order to expose the incest,” Reardon wrote in a 2000 book, Victims and Victors.

In the same book, Reardon wrote of rape survivors that “the victim may sense, at least at a subconscious level, that if she can get through the pregnancy, she will have conquered the rape. By giving birth she can reclaim some of her lost self-esteem.”

In the last couple of years, Reardon has not kept a high profile in the anti-choice movement. Instead, his professional career is now focused on information technology.

On his LinkedIn profile, he self-identified as “Entrepreneur, Inventor, Strategist,” and in recent years he has been involved in several tech firms.

Since 2005, according to his LinkedIn page, Reardon has been the CEO of Qix Information Technology, also known as Qixit (pronounced “kicks it”), based in the St. Louis, Missouri, area. As Reardon described on LinkedIn, Qixit patented 2-Way Micropay, which he claims is “the first and only payment platform that allows users to both spend and receive money through hyperlinks or email, while also collecting superior marketing data on every transaction.” Qixit sells itself as a way for users to make “free money,” by signing up for a free Qixit account, then clicking on ads and filling out surveys.

Reardon has been involved with NovelPoint Security LLC, based in Allen, Texas. This company appears to be what is often referred to as a “patent troll,” a company that prosecutes patent lawsuits without producing its own goods or services.

In 2012 and 2013, NovelPoint sued more than 60 companies over two patents for IT computer security systems invented by Reardon. As Macintosh news site Electronista originally reported, the patents involved “a method for limiting computer access to peripheral devices” and a “network security system allowing access.” As Electronista reported, “[t]he sweeping nature of the patent includes virtually every major PC and electronics builder, including Acer, Apple, ASUS, Dell, HP, Lenovo, Panasonic, Samsung, Sony, and Toshiba.”

While he removed reference to his anti-choice activities from his public LinkedIn profile, the most recent tax filing from the Elliot Institute shows that Reardon earned $45,000 from the organization in 2013.

Reardon did not respond to multiple requests for comment.

Controversy

Reardon co-authored—with Priscilla Coleman, Vincent Rue, and other anti-abortion researchers—a 2003 study published in the Canadian Medical Association Journal, which reported that women who have abortions wind up in psychiatric care at higher rates than women who do not have abortions. That study has been referenced frequently to assert that abortion causes mental illness.

Upon reevaluating the data, Brenda Major, a psychologist at the University of California at Santa Barbara, reported that Reardon and his co-authors did not control for different life circumstances of the women in the study, and argued the study could not prove causation.

Reardon also co-authored several studies with Priscilla Coleman that were cited in Coleman’s heavily criticized meta-analysis of research involving abortion and mental health published in 2011 in the British Journal of Psychiatry.

In one of the many commentaries published in BJP in response to Coleman’s article, scholars Julia H. Littell and James C. Coyne accused Coleman of imparting “agenda-driven bias” in her meta-analysis, and by way of explanation noted that:

David Reardon is a co-author with Coleman on seven articles included in the review and an author on an additional study in the review that does not involve Coleman as a co-author. Reardon is quite explicit about his agenda to instill fear of abortion as a way of facilitating passage of anti-abortion legislation.

In another commentary, published in BJP in response to Coleman’s 2011 meta-analysis, psychiatry scholars Gail Erlick Robinson, Nada L. Stotland, and Carol C. Nadelson argued that “guidelines for proper scientific conduct” were “ignored” in Coleman’s meta-analysis and specifically called out studies co-authored by Reardon.

Coleman presents her conclusions as “an unbiased, quantitative analysis of the best available evidence” concerning the adverse mental health consequences of abortion. Huge numbers of papers by respectable researchers that have not found negative mental health consequences are ignored without comment.

Not surprisingly, over 50% of the “acceptable” studies she uses as her “evidence” are those done by her and her colleagues [Jesse] Cougle and Reardon. The work of this group has been soundly critiqued not just by us, but by many others as being logically inconsistent and substantially inflated by faulty methodologies. As noted by the Royal Society of Obstetricians and Gynaecologists, the authors consistently fail to differentiate between an association and a causal relationship and repeatedly fail to control for pre-existing mental health problems.

The authors of this commentary further assert that:

The “unbiased nature” of most of the studies Coleman has used in her analysis and the Declaration of interest stated as being “none” must be taken with a large grain of salt. Reardon, the leader of this group, has clearly expressed his rhetorical strategy as “we can convince many of those who do not see abortion to be a ‘serious moral evil’ that they should support anti-abortion policies that protect women and reduce abortion rates.”

Reardon has stated that “I do argue that because abortion is evil, we can expect, and can even know, that it will harm those who participate in it. Nothing good comes from evil.” These authors have a clear agenda and publish a steady stream of papers, based on faulty methodology, designed to prove their point.

Influence

Despite having been called out for his flawed analyses, Reardon has been and continues to be influential. In addition to shaping state legislation with overt advocacy and references to his articles, Reardon’s work has also influenced congressional interest in so-called post-abortion syndrome.

In 2004, Rep. Joe Pitts (R-PA) sponsored a bill to allocate $15 million in federal funding for research on “post-abortion depression,” as well as another $1.5 million in grant funding for programs that offer “treatment of post-abortion conditions.” The bill never passed.

Reardon has also pushed the theory that most women are coerced into having abortions. His testimony on this theory—based on anecdotes from women who joined the anti-choice movement—helped influence a report produced by the primarily anti-choice South Dakota legislative task force commissioned by an anti-choice state lawmaker in 2005.

That report led to the passage of a 2005  “informed consent” abortion law, whereby physicians must tell women seeking abortions that they will be at risk of depression and suicide. A 2012 law, also influenced by the report, requires physicians to interview women seeking an abortion, asking them if they have been coerced. The part of the law that requires women be interviewed by anti-choice advocates at a so-called crisis pregnancy center—a facility set up to talk women out of having abortions—is still tied up in litigation.

Reardon’s influence can also be seen in the work of nonprofits set up to counsel women allegedly suffering from the invented syndrome, such as Theresa Burke’s Rachel’s Vineyard, an international network of Catholic-based groups that host weekend retreats intended to counsel women who say they regret their abortions, and Operation Outcry, a project of the Texas-based, evangelical Justice Foundation, which collects affidavits from women who say they have been harmed from abortion to use in litigation involving abortion-related statutes.

Crisis pregnancy centers frequently use research crafted by Reardon and his colleagues to tell women that abortion causes mental harm. Additionally, these centers often claim to offer “post-abortion counseling.”

Background

Rue’s anti-choice career began about three decades ago, largely focused on trying to prove that abortion causes mental illness and should thus be banned. Rue’s wife, Susan Stanford-Rue, claims to have suffered psychological trauma as a result of her own abortion, which she chronicled in her 1986 book Will I Cry Tomorrow?

Both Rue and Stanford-Rue have been involved in various anti-choice organizations. Together they ran the now-defunct Institute for Pregnancy Loss in Jacksonville, Florida. Rue co-founded the Alliance for Post-Abortion Research and Training, which is dedicated to disseminating information purporting abortion’s negative harms.

Rue invented a theory that having an abortion can lead to a type of post-traumatic stress disorder he called “Post Abortion Syndrome,” a term he used in testimony before Congress in 1981. The American Psychological Association does not recognize any such syndrome.

The Academy of Medical Royal Colleges in London conducted a comprehensive review of studies of the emotional effects of abortion between 1990 and 2011 and found that “factors associated with increased rates of mental health problems for women in the general population following birth and following abortion were similar.”

To the extent that women who had abortions experienced mental health issues, these were often linked to the stigmatization of abortion or other social pressures, and pre-existing mental health issues; the study concluded that the best response is to focus on giving pregnant people great support instead of focusing on the resolution of the pregnancy.

Controversy

As early as 1987, medical experts were dismissing Rue’s claims. The late Surgeon General C. Everett Koop—who also opposed abortion—rejected a white paper Rue submitted to Congress when Rue was serving as a special consultant to the surgeon general’s office on abortion morbidity.

In the 1986 case Hodgman v. State of Minnesota, in which Rue testified as an expert witness defending a Minnesota law requiring notification of both parents for minors seeking an abortion, the district court judge wrote, “Dr. Vincent Rue possesses neither the academic qualifications nor the professional experience of plaintiffs’ expert witnesses. More importantly, his testimony lacked the analytical force of contrary testimony offered by plaintiffs’ witnesses.”

In the 1990 district court opinion in Planned Parenthood v. Casey, Judge Daniel H. Huyett wrote of Rue’s co-authored report “The Psychological Aftermath of Abortion”: “After submission for peer review by scientists with the Center for Disease Control, the National Center for Health Statistics and other scientific institutions, his study was found to have ‘no value’ and to be ‘based upon a priori beliefs rather than an objective review of the evidence.’”

In the same opinion, Judge Huyett wrote: “Because Dr. Rue lacks the academic qualifications and scientific credentials possessed by plaintiffs’ witnesses, I conclude that his testimony, which is based primarily, if not solely, upon his limited clinical experience, is not credible. His testimony is devoid of the analytical force and scientific rigor which typified the testimony of plaintiffs’ expert psychologist, Dr. Walker.”

In the 1990 case Planned Parenthood v. Casey, Rue claimed “he had counseled hundreds for problems after abortion,” as reported in The Morning Call. “But under questioning by an attorney for the plaintiffs, Rue said he was not a psychologist and had never performed informed-consent counseling for pregnant women.”

Researchers at the University of California, San Francisco and the Guttmacher Institute showed in 2012 that a study Rue co-authored on “Post-Abortion Syndrome,” originally published in the Journal of Psychiatric Research in 2009, “has fundamental analytical errors that render its conclusions invalid.”

One such error was that Rue and his co-authors “did not distinguish between mental health outcomes that occurred before abortions and those that occurred afterward, but still claimed to show a causal link between abortion and mental disorders.”

Influence

Rue plays a central role in the anti-choice universe by coordinating so-called expert witnesses for state legislative and court hearings in at least five states in recent years, our research found. Many of those witnesses are part of the False Witnesses group—many have been caught lying or misleading the public or the court, have had their scholarship debunked or retracted, and have specious credentials to speak about reproductive health.

Yet, Rue and his roster of experts continue to influence public debate, court cases, and legislation, all while collectively earning hundreds of thousands of dollars. Rue himself has earned at least $195,000 in taxpayer money from his work in these states over the last few years, according to public records obtained by Rewire.

Rue is vehement in his anti-abortion stance. Defending Pennsylvania’s Abortion Control Act (the subject of the landmark Supreme Court case Planned Parenthood v. Casey) in 1990, Rue, one of the state’s expert witnesses, supported the law’s controversial requirement that a woman’s spouse be notified before she could have an abortion.

He also objected to abortion in the case of rape, calling it “capital punishment of the fetus” and a “failure.”

Rue also said that women fundamentally did not understand their own decisions about abortion because, in his view, they were not receiving enough information prior to the procedure. The Morning Call quoted Rue testifying in federal court about women generally: “She feels regret at what occurred. She did not understand what the abortion did to her pregnancy.”

Rue helps craft anti-abortion legal strategy in states across the country, choosing expert witnesses and influencing, or even writing, their reports.

One of his go-to witnesses, James C. Anderson, told Planned Parenthood’s attorney Carrie Flaxman during questioning in May that Rue helped him with “wordsmithing” the report he submitted to the court, as reported by the Madison, Wisconsin, alt-weekly Isthmus. As Isthmus reported:

The Department of Justice has three contracts with Rue, the original and two renewals. According to the agreements, Rue was hired to assist the DOJ in the “development of case strategy, procurement of expert witnesses” and in “discovery and trial preparation.” He is also a “liaison between the Office and the experts.” The contract states that Rue “possesses a high degree of professional expertise in litigation consulting and abortion practice and research.”

There is evidence that Rue is managing and recruiting witnesses in some of these state cases. Emails between Rue and and the Alaska Department of Law show that Rue coordinated payments between the state and at least one of its witnesses, John Thorp, in a case for which Rue was hired as a consultant.

In Wisconsin, where Rue was hired as an independent consultant to help the state defend its admitting privileges abortion statute in Planned Parenthood of Wisconsin v. Van Hollen, the state categorized him as a “liaison between the Office and the experts,” according to documents obtained by Rewire from a public records request.

Rue’s initial contract with the state, dated August 12, 2013, reads: “Dr. Rue will assist the Department in the development of case strategy, procurement of expert witnesses and be a liaison between the Office and the experts, as well as assist in discovery and trial preparation. Dr. Rue possesses a high degree of professional expertise in litigation consulting and abortion practice and research.”

But Rue has come under fire in recent months for his role coordinating expert witnesses in lawsuits involving anti-choice legislation in several states. Rue has been accused—most recently in Texas—of manipulating expert witnesses’ testimonies to reflect his vehement abortion opposition in the state’s defense of HB 2.

HB 2 is an omnibus anti-choice law that requires legal abortion facilities to meet the standards of ambulatory surgical centers, requires abortion providers to have admitting privileges at local hospitals, bans abortion at 20 weeks’ gestation, and severely restricts the provision of medication abortion. In late August, U.S. District Judge Lee Yeakel blocked part of HB 2, ruling that some of the law’s provisions place “an unconstitutional undue burden on women throughout Texas.” (Immediately after Yeakel’s ruling, the state appealed the case to to the Fifth Circuit Court of Appeals, which ruled on October 2 that Texas could begin enforcing the law. As a result, currently only 16 abortion clinics remain open in Texas.)

In a 21-page memorandum, Yeakel dismissed the credibility of many of the state’s expert witnesses upon discovering that Rue was involved in shaping their testimonies. Yeakel argued that “the level of input exerted by Rue undermines the appearance of objectivity and reliability of the experts’ opinions.”

“The credibility and weight the court affords the expert testimony of the State’s witnesses Drs. Thompson, Anderson, Kitz, and Uhlenberg is informed by ample evidence that, at a very minimum, Vincent Rue, Ph.D., a non-physician consultant for the State, had considerable editorial and discretionary control over the contents of the experts’ reports and declarations,” Yeakel said. “The court finds that, although the experts each testified that they personally held the opinions presented to the court, the level of input exerted by Rue undermines the appearance of objectivity and reliability of the experts’ opinions.”

Yeakel also took issue with the state’s apparent attempt to cover up Rue’s involvement.

“Further, the court is dismayed by the considerable efforts the State took to obscure Rue’s level of involvement with the experts’ contributions.”

Indeed, the Texas Attorney General’s Office has gone to great lengths to conceal Rue’s involvement. Plaintiffs in the Texas case learned of Rue’s involvement with expert witness testimony because of news reports. In July 2014, the plaintiffs, including Texas abortion provider Whole Woman’s Health, filed a motion (which has been partly redacted by the state) to compel the disclosure of written communications between Rue and the state’s expert witnesses.

“During the course of depositions of these Testifying Experts, it came to light that some of them have had extensive communications with Mr. Vincent Rue, a consulting expert retained by the State Defendants,” the motion reads. “When the Plaintiffs’ counsel questioned the Testifying Experts regarding their communications with Mr. Rue, counsel for the State Defendants instructed them not to answer.”

By way of example, plaintiffs pointed to testimony from the state’s expert witness Dr. Geoffrey Keyes, who admitted that Rue had helped draft his report in the pending admitting privileges case in Wisconsin:

Plaintiffs’ Attorney Stephanie Toti (with the Center for Reproductive Rights): Did Mr. Rue play any role in helping you draft that expert report?

Keyes: Am I obligated to answer any of these questions?

Defendants’ Attorney Philip Lionberger: You may answer the questions regarding the Wisconsin case and any contact that you had with Mr. Rue with regard to that case but to the extent any of your conversations with him had anything to do with your work also on the Texas case, I instruct you not to answer that.

Keyes: So the Wisconsin case I can tell, answer questions but not with respect to Texas. Well, essentially what happened was he interviewed me, credentials, experience, thoughts about accreditation and the whole management and method that [American Association for Accreditation of Ambulatory Surgery Facilities] AAAASF uses to promulgate its standards and from there he drafted up a history from what I gave him of what I said to him basically.

Toti: So he actually drafted your expert report in the Wisconsin case based on information that you provided him?

Keyes: He assisted me with it, yes.

James Anderson, another of the expert witnesses, also testified that Rue wrote one of his reports in the Alabama admitting privileges case.

The court granted the plaintiffs’ motion to compel disclosure of communications between Rue and the defendants’ experts, with some exceptions. In his order, Judge Andrew W. Austin concurred with the plaintiffs that to the extent that Rue influenced the testimony of the state’s expert witnesses, his communications with them were relevant “in order for Plaintiffs to adequately assess the reliability of those opinions.” Austin also addressed the confusing nature of Rue’s role in this case.

“The evidence before the Court demonstrates that State Defendants have attempted to characterize Rue as a consulting expert, agent, and consultant,” Austin wrote. “When the Court inquired precisely what duties Rue had in this case, State Defendants responded with a variety of tasks, including facilitating communication between the testifying experts and the State’s counsel, ‘polishing’ the testifying experts’ reports, and identifying the experts themselves. … While it was clear that Rue had been retained by State Defendants, it was not obvious how Rue was contributing to the litigation.”

Among the illuminating communications between Rue and one of the state’s experts that the plaintiffs were able to obtain were email exchanges between Rue and Dr. Mayra Jimenez Thompson, a Dallas-based obstetrician-gynecologist.

The Austin Chronicle reported in August 2014 that email exchanges indicated that Rue had helped to draft and had modified Thompson’s expert report.

The Chronicle reported: “Correspondence from Rue included: ‘I’m still drafting, will keep you posted’; ‘Tried to use as much of your material as I could, but time ran out’; ‘Just want you to review, I’ll keep working on the draft.’ Thompson defended the assistance, saying she was a medical doctor, not trained in legalese and the proper ‘wordage’ of court testimony.”

Rewire obtained copies of Rue’s payment vouchers and signed contracts with the state, which deal with two different lawsuits over the same Texas law, HB 2. One contract covers September 1, 2013, through August 31, 2015; the other April 2, 2014, through August 31, 2015. Both contracts—which identify the expert as Rue’s firm Rue & Stanford-Rue PA—cap the OAG’s “total liability” to Rue at $40,000 and at a rate of $500 per hour. The included vouchers showed Rue was paid for certain services at a rate of $225 per hour.

According to the documents, the OAG contracted Rue to “perform consulting expert and/or testifying expert services as requested by the OAG.” He was contracted to “furnish expert examinations, observations, opinions, consultations, analyses, reports, testimony, and other services upon the request of the OAG.”

Specifically he has billed for services such as “review[ing] plaintiffs’ filings” and “continued assistance in preparation of experts’ declarations.”

As of September 18, 2014, the OAG had paid Rue & Stanford-Rue PA $59,217, according to the Texas Comptroller of Public Accounts, for work performed in 2014 and assigned work for 2015.

What’s significant about Rue’s influential role in these legal cases and his seemingly cozy relationship with several state AG’s offices is that he is not a credible source when it comes to abortion policy.

In the HB 2 trial in Texas, U.S. District Judge Lee Yeakel in Texas chastised the state for failing to show how much influence Rue had in preparing the state’s witnesses. The state “effectively tried to hide Rue’s involvement,” said Yeakel, calling the obfuscation of evidence “very disturbing,” as the Austin Chronicle reported.

Correction: An earlier version of this story stated that Rue has coordinated expert witnesses to testify in abortion-related legal cases in at least six states in recent years. In fact, we identified evidence that he has worked in five states in recent years. He worked in additional states in the 1980s and 1990s. We regret the error.

This page has also been updated to reflect that while Rue was a member of the American Academy of Experts in Traumatic Stress, according to that organization’s director, he never obtained Fellow status as Rue’s online resume indicates.

Background

Shuping has served on several boards of anti-choice medical organizations that peddle controversial viewpoints, such as the Association of American Physicians and Surgeons, which promotes unscientifically supported positions on vaccinations, HIV/AIDS, and abortion.

In state houses and in court, she has testified that she has treated scores of women who have suffered psychologically as a direct result of their abortions.

Shuping has worked with several advocacy groups that offer what they call “abortion recovery services,” such as Abortion Recovery InterNational, Inc.; the Rachel Network; and Rachel’s Vineyard Ministries, a project of Priests for Life, which hosts retreats around the world for women who claim to regret their abortions. These organizations, in particular Abortion Recovery InterNational, solicit declarations from women (many of them anonymous) who claim to have suffered from abortion, which are later used in court cases to argue in favor of abortion bans or restrictions.

Controversy

There are myriad risk factors for depression and mental illness that include genetic, biological, environmental, and psychological factors.

But in the scientific world that Shuping and some of her ideologically driven colleagues inhabit, if a woman has an abortion at some point in her life and then, say ten years later, is hospitalized for clinical depression or has a drug overdose, the suspected culprit is always that abortion. This logic applies even if the women had been diagnosed with depression before the abortion.

These are the sorts of inferences Shuping made with co-authors Priscilla Coleman, Catherine Coyle, and Vincent Rue in a study published in 2009 in the Journal of Psychiatric Research. Their study analyzed the relationship between induced abortion and various mental health disorders, using data from the National Comorbidity Survey.

Shuping and her co-authors compared women who reported having at least one abortion with women who report having never had an abortion (regardless of whether they had ever been pregnant). They concluded that the women in the study who had reported having an abortion were likelier to be at a significantly increased risk for 12 out of 15 anxiety, mood, and substance-abuse disorders.

As Rewire has reported, soon after Shuping’s study came out, other researchers tried but failed to replicate her team’s findings. At that point, Shuping’s team first lied about the measures they used to crunch their numbers but then eventually admitted to using a measure that the editors of the very magazine that published this research said was fundamentally flawed. Shuping and her colleagues had looked at all of the women who had ever been diagnosed with a mental illness at any point in their lives, and if any of those women reported ever having an abortion (even after the mental illness had been diagnosed), the researchers determined that the relationship was causal.

Journal of Psychiatric Research Editor-in-Chief Alan F. Schatzberg and Ronald C. Kessler, the principal investigator of the survey Shuping’ team used, responded to the criticism of Shuping’s paper, stating it “does not support their assertions that abortion led to psychopathology in the NCS data.” Still, the journal has never retracted the study.

Shuping continues to publish papers and give speeches asserting the direct causal link between abortion and mental health.

In court testimony and in speeches, Shuping describes abortion as a form of post-traumatic stress disorder and argues that some women might only experience the psychological effects of an abortion years or even decades down the road.

But emerging evidence—such as a Journal of the American Medical Association study published in December 2016—underscores the American Psychological Association’s findings of no causal link between abortion and mental illness.

Researchers at the Advancing New Standards in Reproductive Health program at the University of California, San Francisco published a large-scale, longitudinal study in February 2017, concluding that the women in this study who had abortions did not suffer more psychologically than the women in the study who initially wanted to but could not get an abortion.

Influence

Shuping has co-authored papers claiming that most women who have abortions are forced or pressured to have them and that abortion in the United States is more fatal than childbirth. Attorneys and lawmakers in Wisconsin and North Dakota have made these claims citing Shuping’s work, despite evidence to the contrary.

In the last two decades, Shuping has testified before Congress and in state houses in Maryland, North Dakota, and South Dakota in favor of laws that either restrict abortion or force doctors to tell patients that abortion can lead to depression and suicidal ideation.

In 2013, Shuping testified in the federal lawsuit MKB Management Corp, et al., v. Birch Burdick, et al. For her expert testimony, the North Dakota Attorney General’s Office paid Shuping $21,000, according to records Rewire obtained through a public records request.

The Center for Reproductive Rights and the American Civil Liberties Union filed that lawsuit in 2013 on behalf of the Red River Women’s Clinic, North Dakota’s sole abortion clinic. The lawsuit took aim at two newly passed state laws, HB 1456, which banned abortion at the point that a fetal heartbeat is detectable (often as early as six weeks’ gestation) and HB 1305, which banned abortions for reasons of sex-selection or for genetic abnormalities. (In the end, the district court found HB 1456 unconstitutional, and the plaintiffs withdrew their challenge to HB 1305.)

Shuping submitted a declaration and expert report in January 2014 in defense of HB 1456, arguing that if abortion is criminalized early in pregnancy, women will be saved from psychological trauma, drug abuse, and suicide. She cited a discredited Journal of Psychiatric Research study among other research papers authored by fellow anti-abortion ideologues, as well as her professional experience counseling women with various pregnancy outcomes, to support this assertion.

“In my opinion, within reasonable medical and scientific certainty, the provisions of HB 1456 are necessary to protect women from the well-substantiated increased risk of mental health, emotional and psychological problems and disorders associated with and caused by abortion, and in particular the adverse and profound adverse effects abortion has on the mental, emotional, and psychological health and well-being of women,” Shuping wrote.

Background

John Thorp has served as an expert witness in anti-abortion cases in Alabama, Alaska, Arizona, Indiana, Mississippi, North Carolina, North Dakota, Texas, and Wisconsin. In large part, his testimony has been used to defend laws that require abortion providers to obtain admitting privileges at nearby hospitals.

Thorp declined to speak to Rewire or to answer questions regarding some of his recent court testimonies in support of challenged state abortion restrictions. In an email, he said he was “asked to not comment on these cases while they are under appeal.” He did not specify who asked him not to comment.

Controversy

In the Wisconsin lawsuit related to the state’s admitting privileges law in 2014, Thorp and other legal experts hired by plaintiffs and defendants in the case were asked by the judge if abortion was a “relatively safe procedure.” Thorp agreed, despite the fact that he had essentially argued in his writings and court testimonies that abortion is not a relatively safe procedure.

Under cross-examination, Thorp admitted that his written testimony submitted to the court had included an error, stating complications included in 2 to 10 percent of abortions. Thorp explained he had misplaced a decimal; the actual range was 0.2 to 10 percent. He submitted the erroneous “2 to 10 percent” range in expert witness reports in multiple state cases.

Upon questioning, Thorp admitted that he inflated the 10 percent figure. He said he came to this range by adding up the highest rates of complications of abortions reported in various studies, which totaled to 7 percent. But he rounded it up to 10 percent, he explained, because he believes abortion providers under-report complications.

In a declaration submitted in 2013 in the Wisconsin admitting privileges case Planned Parenthood of Wisconsin Inc. v. Van Hollen, he claimed breast cancer is among the potential long-term health consequences of abortion, writing:

While there have been numerous claims that TOP [termination of pregnancy] has no long-term health consequences beyond the immediate complications identified above, these assertions are based upon the data limitations previously discussed, particularly lack of completeness and the sole use of observational data generated by self-report of TOP exposure. Methodologically sound research has, however, indicated significant associations between TOP and placenta previa, preterm birth, breast cancer, mental health problems, i.e., mood disorders, substance abuse and suicide.

However, in his deposition given in November 2013 in the Alabama case Planned Parenthood Southeast Inc. v. Strange, Thorp admitted having doubts about many of the alleged health impacts of abortion, and said he is “not particularly convinced about the abortion-breast cancer reputed link.”

In terms of long term complications, I think the strongest case can be made for subsequent preterm birth. To my mind the mental health consequences are difficult to ferret out between the things that lead somebody to make that difficult decision versus the actual procedure itself, but some suggestion of harm. And then I’m not particularly convinced about the abortion-breast cancer reputed link, although there might be a loss of protection phenomenon that could occur and very difficult to study or measure.

The staff attorney for Planned Parenthood Federation of America pressed Thorp on the alleged link between abortion and breast cancer, to which he replied: “The epidemiologic studies are mixed with different conclusions. I think it is a well-known fact that an early term pregnancy and/or lactation are protective against subsequent breast cancer.”

In a supplemental opinion from October 2014 in Planned Parenthood Southeast Inc. v. Strange, Judge Myron H. Thompson detailed how the court determined whether or not to throw out parts of expert witness testimony. In the opinion, Thompson wrote that Thorp “displayed a disturbing apathy toward the accuracy of his testimony.”

As an example, Thompson addressed Thorp’s “2 to 10 percent” error, which Thorp has made in other state lawsuits, such as the aforementioned example in Wisconsin.

“Although he was confronted with the error during his November 2013 deposition, he submitted a declaration to the court in April 2014 that again claimed the two percent figure,” Thompson wrote. “In addition, other choices that he made in developing his estimates seemed to be driven more by a bias against abortion and a desire to inflate complication rates than by a true desire to reach an accurate estimate of the dangerousness of abortion procedures. The court therefore discredited Thorp’s testimony on complication rates from abortion.”

Thompson also pointed out hypocrisy within Thorp’s testimony that doctors who perform abortions should provide “continuity of care” to their patients.

“However, even though the procedures he performs at his own office may, like abortion, in extremely rare cases cause complications that require post-procedure hysterectomy or laparatomy, he himself does not maintain staff privileges at a local hospital that would allow him to perform gynecological surgery for his patients,” Thompson wrote of Thorp. “This inconsistency between what he says and what he does led the court to give his opinions extremely limited weight.”

Influence

Thorp has testified in favor of anti-abortion restrictions in many cases at the state and federal level.

In the 2005 Supreme Court Case Ayotte v. Planned Parenthood of Northern New England, Thorp signed an amicus brief in support of New Hampshire’s parental notification abortion law. (The New Hampshire law was repealed in 2007.) This brief was adapted into a Bioethics Defense Fund briefing in 2013.

In Arizona, Thorp provided a declaration in 2009 in defense of a law restricting the administration of abortion-inducing drugs in the lawsuit Planned Parenthood of Arizona v. Goddard.

In North Carolina in 2011, Thorp attempted to intervene as an expert in the lawsuit Stuart v. Huff, in defense of a law that mandated women seeking abortions be first shown a sonogram. The court denied his request and struck his testimony from the record.

In Mississippi in 2012, Thorp served as an expert witness defending the state’s admitting privileges requirement.

In Alaska, Thorp testified as an expert witness in 2012 in defense of a law requiring that the parent of a minor seeking an abortion be notified, in the lawsuit Planned Parenthood of the Great Northwest v. State of Alaska.

In Alabama, Thorp was deposed in 2013 to defend the admitting privileges law in the lawsuit Planned Parenthood Southeast v. Strange.

In Massachusetts in 2013, Thorp signed on to an amicus brief co-authored by the anti-choice Bioethics Defense Fund and neuroscientist Maureen L. Condic in support of petitioners in McCullen v. Coakley, which successfully challenged the state’s law mandating 35-foot buffer zones around abortion clinics. (The Supreme Court eventually ruled in favor of plaintiffs in June 2014.) As the brief stated, “Amici … each have an interest in free speech that allows the disciplines of medicine and science to inform the moral questions faced by individuals and society, especially when it is relevant to aiding women in making thoughtful and informed decisions about their pregnancies.”

In North Dakota, Thorp provided a declaration in December 2013 to defend a law that criminalizes abortions at the point when a fetal heartbeat can be detected (about six weeks) in the lawsuit MKB Management Corp v. Burdick.

In Wisconsin, Thorp testified in support of the state’s admitting privileges requirement.

In South Dakota, Thorp’s 2005 paper “Long-Term Physical and Psychological Health Consequences of Induced Abortion: A Review of the Evidence” was cited in support of a statute requiring doctors to warn women considering abortion of the medical risk of suicide or suicidal ideation.

Thorp’s work is referenced in Clarke D. Forsythe (of Americans United for Life) and Stephen B. Presser’s 2006 article “The Tragic Failure of Roe v. Wade: Why Abortion Should Be Returned to the States.”

Thorp’s studies on the alleged long-term consequences of abortion and the public health impact of abortion are cited in a 2013 report published by Americans United for Life.