A Forensic Investigation and Critique of Suicidal Ideation Reported in a Turnaway Study

In a published report of suicidal ideation rates drawn from the Turnaway Study, the abortion advocacy group Advancing New Standards in Reproductive Health (ANSIRH) asserted that their findings proved that abortion has no effect on suicidal ideation. Therefore, laws requiring notification of abortion's link to higher suicide rates were not based on good science. But how good is the science ANSIRH offers to displace the evidence of an abortion-suicide connection? The Turnaway Study upon which they rely is drawn from a non-random, non-representative convenience sample that suffered from a 68% refusal rate and a 50% attrition rate. No conclusions applicable to the general population of aborting women can be drawn from such a sample. Moreover, on closer examination, ANSIRH's suicidal ideation trajectory analysis is severely flawed and violates Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines. Basic and critical information is withheld, specifically the mean scores and number of women identified as having suicidal thoughts. Instead, readers are provided with only highly massaged results from a mixed-effects logistic regression employing thirteen covariates that appear to have been chosen precisely to water down the confidence intervals to such a high degree that virtually nothing was statistically significant. In addition, ANSIRH suggested that an attrition analysis of three of the covariates used strengthened the reliability of their finding. However, the fact that they chose not to report on attrition rates associated with the other ten covariates, much less the two outcome variables related to suicidal ideation, actually exposes the falsity of this reliability claim. Rather than proving that abortion has no effect on suicidal behaviors, ANSRIH's published analysis provides evidence of deliberate obfuscation and disinformation by a group funded and dedicated to the expansion of abortion rates around the world.