Wednesday, July 30, 2008

1987: Reagan orders the "Koop Report"

On July 30, 1987, then-President Ronald Reagan directed his Surgeon General, C. Everett Koop, to prepare a report on the effects of abortion on women. Prolife and prochoice groups disagree about what the results of that request were. Prolife activists say that Koop never wrote a report, but instead sent a letter to Reagan saying that there were no "unassailable" studies. Prochoice activists say that there was a Koop report that said abortion is perfectly safe. Which side is telling the truth? Both are -- if you know the inside story.

How can that be? The story is complex, and getting to the bottom of it took many hours in Library of Congress, digging through Congressional record. Follow this carefully.

Koop didn't want to write the report, for an assortment of personal and professional reasons. He tried repeatedly to beg off, but Reagan kept pestering him. Koop foisted the task off on his staff. The research and preparations for the planned report evidently became largely the task of one George Walter.

Walter listed a lot of folks he "consulted" about research into the effects of abortion women. Superficially, it looks as though Walter had a crew of mostly prochoice researchers, with token prolife researchers, bring forth their evidence. But what really happened is that Walter contacted the prochoice researchers at the Centers for Disease Control, and they forwarded a list of 250 research articles to him.

These staffers were not neutral public servants without an agenda. They were abortion's cheerleaders, people for whom abortion was the answer to a multitude of sociological and public health problems -- if only practitioners could work the bugs out. Carl Tyler, for example, had agitated during the pre-Roe period for a federal law legalizing abortion on demand, with the full expectation that the surge in the number of abortions would mean a surge in maternal deaths. Tyler felt that these deaths would be worthwhile in the long run, because he believed that legalized abortion on demand would "eliminate child abuse in a single generation." Tyler and his colleagues were people with an agenda. Therefore the articles they selected were the 250 articles that CDC staff had written or that their friends had written, that painted abortion in the best possible light.

After the meetings and the literature review, Koop felt satisfied that his staff had gone through sufficient motions to satisfy Reagan. Koop then drafted and sent a letter to the President, concluding that there had been no unassailable studies of the long-term impact of abortion.

Koop directed his staff to drop the project on January 10, 1989, hoping Reagan would be content with the letter and would drop the subject. Nevertheless, George Walter proceeded to re-write the report, submitting it to Koop on January 17. Walter's cover letter said, "This document was reviewed and concurred with by our unofficial consulting group. It represents a balanced, well-written document which is directed to the general public. Its underpinning is scientifically sound and presents a solid, common sense approach to this important public health problem."

However, the report was not concurred with by many scientists studying abortion, such as Thomas Hilgers, Wanda Franz, Matthew Bulfin, Leonard Aaro, and Thomas McDonald. How then could it be a balanced report? It would seem so only to those who already had a strong pro-abortion bias. For example, the report says that problems such as infertility, miscarriage, and ectopic pregnancy "are no more frequent among women who experienced abortion than they are among the general population of women."

Koop instructed Walter to shelve the draft, and not to release any report about abortion from his office. Instead, Walter released the draft under Koop's name. Koop didn't even read the final report until he was brought before a Congressional committee. During his testimony, he repeatedly tried to distance himself from the report with vague statements about not having read it.

Walter said that the bulk of the consulting was with Carol Hogue at the CDC and with Jackie Forrest of the Alan Guttmacher Institute, which is the research arm of Planned Parenthood Federation of America. (To give you some perspective, Carol Hogue tries to claim that abortion enhances fertility by pre-stretching the uterus, like you'd stretch a balloon before you blow it up.) Walter admits that he elected to not study the impact of abortion on rape or incest victims, or those aborting for fetal abnormalities. In other words, he deliberately excluded from their study the women already known to be at highest risk for both physical and emotional sequelae.

Jackie Forrest told Congress, "I met with Dr. Koop and his staff members twice during the course of his review of research on the health effects of abortion. The first meeting was the initial group meeting held by Dr. Koop, in fall of 1987. The second was with other representatives of the Alan Guttmacher Institute in the summer of 1988. In addition, I was asked to meet and consult with Dr. Koop's staff to provide more detailed information about pertinent research by AGI and to present findings from studies that were in process in 1987 and 1988." She said that she wished "that Dr. Koop and his staff had issued a full report on their research review," and that she wanted "to commend them for undertaking the project in a very professional manner." This is akin to getting a glowing review of a report of the health effects of smoking from R.J. Reynolds. Notice also that Ms. Forrest said lamented that Koop and his staff had not issued "a full report." In speaking to Congress, Ms. Forrest recognized that there was no officially released Koop report, merely the draft she had helped to prepare.

When noted abortionist/abortion promoter Jaroslav Hulka was "asked to present the complications of legal abortion to the Surgeon General," he instead "organized a literature review around the following question: Why did the United States legalize abortions?" Hulka evidently never presented to Koop any evidence of legal abortion complications, despite the existence of such evidence in research performed by abortion advocates such as William Brenner and Philip Stubblefield. Clearly, Hulka treated the proposed report as an opportunity to propagandize in favor of legalized abortion rather than as an opportunity to have existing research reviewed by the Surgeon General.

Touting his "over 9 years" in the Abortion Surveillance Branch of the CDC, abortionist David Grimes claimed, "The medical evidence concerning the safety of induced abortion in the United States is clear and incontrovertible." As proof of legal abortion's safety, he points to the Joint Programs for the Study of Abortion (JPSA, pronounced "GYP-sah"), which got all of its information from abortionists' records. One of the participating facilities was later discovered to have charted a dead patient as "pink, alert, responsive", which gives you an idea how accurate their data must be.

Grimes had met with Koop to convince him that the data was indeed conclusive -- that abortion is quite safe. He claimed that the risk of death from legal abortion is "less than the risk of death from an injection of penicillin," and cites as his source the 1982-83 CDC Abortion Surveillance Summary, which never mentions penicillin. He also asserted, "Legal abortion has not been found to impair a woman's ability to have children in the future," citing Willard Cates, Carol Hogue, and Christopher Tietze.

First, this constitutes incestuous citing, basing his conclusions on the biased research of some of the most avid proponents of abortion. Second, this assertion is patently false, since many acknowledged abortion complications impede future childbearing capability. Third, even Hogue, et al., admit the effects of multiple abortions are not even remotely known -- and nearly half of all abortions are repeat abortions.(Family Planning Perpsectives J/A 1996, p. 143) Fourth, second-trimester abortions have been shown to at least potentially affect future childbearing unfavorably even if no complications are noted at the time. So Grimes is lying on at least 4 counts with this single statement.

Grimes also makes the obviously false blanket statement that "the risk from pregnancy and childbirth is about seven times higher than that from induced abortion." At that time, it was known that by 16 weeks, abortion was at least as dangerous as childbirth, and that the risks increased exponentially after 16 weeks. No blanket statements can be made comparing the risks of abortion to the risks of childbirth, even if one assumes that current data are reliable, because there is no single "abortion" risk to compare to a single "childbirth" risk. Abortion risks vary widely depending upon the woman's health, the stage of pregnancy, the skill of the practitioner, and the method chosen. Childbirth risks vary according to many factors as well, including how much prenatal care is provided.

Others that Koop met with included the American Public Health Association, the American College of Obestetricians and Gynecologists, and Planned Parenthood Federation of America -- notoriously pro-abortion groups. (This is akin to asking tobacco growers and cigarette companies to prepare a report on the health effects of smoking.) Koop and Walter met with no pro-life medical groups, despite the number of respected and notable professionals in these groups. The few pro-life professionals consulted were treated as individuals speaking for themselves rather than as representative of a large number of their colleagues. His input from those opposed to abortion was almost exclusively limited to religious groups. Is it any wonder his data were skewed?

Koop made the ridiculous statement that "...obstetricians and gynecologists have long since concluded that the physical sequelae of abortion were no different than those found in women who carried pregnancy to term or who had never been pregnant." First of all, only a few obstetricians and gynecologists have concluded any such thing -- most notably Jaroslav Hulka and David Grimes. Second of all, it is absurd on its face. Is Koop claiming that a woman who has never been pregnant -- some nun in a convent -- is going to develop a utero-colonic fistula (a hole between her uterus and colon) spontaneously? That her cervix will just spontaneously drop off? That her empty uterus will rupture all by itself? This assertion is straight from George Walter's unauthorized report, which we have already established was written and approved by people who make absurdly broad and insupportable statements about abortion's safety. Clearly, Koop's mind had been muddled by his contact with these people, both on his staff and in consultation.

The "Surgeon General's Report" or "Koop Report" on abortion is non-existent. There exist only the Koop letter and the unauthorized report prepared by George Walter in consultation with some of the most avid and enthusiastic promoters of legal abortion. Many scientists and physicians would vehemently disagree with the tone and content of the report. Therefore, any presentations of the report as reflecting Koop's independent conclusions, or accepted scientific knowledge, are at best based on colossal ignorance, and at worst are a deliberate attempt to deceive. Any statements by Koop on the safety of abortion are based on what appear to be a concerted effort by abortion advocates to turn the Surgeon General into an abortion industry spokesman.

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