Questionable Motives

February 1, 2010

What is Survivor Bias?

Focus on the Family (a right wing christian fundamentalist and biblical literalist organization)  has purchased an advertising slot during the Super Bowl featuring Tim Tebow – a star college quarterback and Heisman Trophy winner, and his mother, Pam. According to the group’s press release, the Tebows “will share a personal story” about Tim’s birth in 1987, when his parents were missionaries in the Philippines. According to Pam’s account in the Gainesville Sun, she contracted amoebic dysentery and went in a coma shortly before the pregnancy. To facilitate her recovery, she was given heavy-duty drugs. Afterward, doctors told her the fetus was damaged. They diagnosed her with placental abruption, a premature separation of the placenta from the uterine wall. They predicted a stillbirth and recommended abortion. Yet here is Tim.

The message from Focus on the Family is intended to support the anti-choice movement in the US – what anti-abortionists like to inappropriately term ‘pro-life.’ But its not pro-life at all, and this ad reveals exactly this bias against maternal life in favour of foetal life at all cost, which is much closer to the truth than these anti-abortionists will honestly admit.

Let’s look at the mortality rates for women who have an abruption and see if we can better understand the recommendation to abort made by Pam’s doctors.

In normal pregnancies, the perinatal mortality rate—death of the fetus after 20 weeks gestation, or death of the baby in its four weeks after birth—is less than 1 percent (from a 2001 US study published in the American Journal of Epidemiology). In abrupted pregnancies, the rate is roughly 12 percent. If the total number of abrupted pregnancies in the United States in those two years studies (1995-96) was 46,731, then the number of fetuses and babies killed by placental abruption was 5,570.

And that’s just the U.S. number. In less developed countries, studies have found higher rates of perinatal death. In Thailand, a 2006 review of 103 abrupted pregnancies showed a rate of 16 percent. In Sudan, an analysis of more than 1,000 cases from 1997-2003 yielded a rate of 20 percent. In Tunisia, a 2005 review of 45 cases indicated a rate of 38 percent.

So because Pam was an older expectant mom (37 years old and in a higher risk category) and in the Philippeans where presumably the death rate would be higher than the US for this condition, these doctors recommended abortion not on any kind of pro-abortion medical opinion as the anti-choice supporters like Focus on the Family’s founder Jimmy Dobson and his crusading ilk like to paint anyone involved in medical abortions, but on the  probabilities of mortality for the mother, which is not the only problem connected to allowing a dangerous pregnancy to come to term. Losing the mother in a dangerous pregnancy – a perfectly natural and acceptable occurrence according to anti-choice supporters – has consequences beyond losing the foetus.

Being dead is just the first problem with dying in pregnancy. Another problem is that the fetus you were trying to save dies with you. A third problem is that your existing kids lose their mother. A fourth problem is that if you had aborted the pregnancy, you might have gotten pregnant again and brought a new baby into the world, but now you can’t. And now the Tebows have exposed a fifth problem: You can’t make a TV ad. Hence, this ad is a good example of survivor bias. Pam and Tim Tebow are talking because they can talk. They’re not dead.

If Pam Tebow’s abruption had taken a different turn, her son would be just another perinatal mortality statistic, and she might be just another maternal mortality statistic. And you would know nothing of her story, just as you know nothing of the women who have died carrying pregnancies like hers. Focus on the Family certainly wouldn’t pay for a spot to bring you that story, now would they? But the better doctors know and that’s why they are in an educated position to make medical recommendations. Before we trust those who wish to legalize anti-choice in the matter of abortion on theological grounds, we should remember that abortion is a medical procedure which properly belongs between a woman and her doctor and not in a courtroom nor a procedure that sends people to live behind bars.

Let’s leave the priests and religious tyrants out of any medical decision-making process altogether and, like Pam Tebow, allow these women to make whatever difficult and courageous choices they feel they must make.

Excerpts from Slate’s article here.

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