PSYCHIATRIC ANNALS/2.9 SEPTEMBER 1972 ABORTION CRITIQUE on unwantedness in pregnancy, on the real underlying problems such as population hysteria and nonpaternal attitudes of fathers and on pregnancy being a normal developmental crisis, it should be obvious that the alternative to abortion is the practice of scientifically sound medicine applied to the whole patient. In order to practice medicine ethically (which means on a scientific basis), the physician will have to learn to say no to an abortion request and to offer psychosocial help to both the mother and father to be. Age THE DECLARATION OF RIGHTS AND RESPONSIBILITIES DEFINING THE PERSONNESS OF CHILDREN 1 14 to 18.. 5 to 14.. Birth to 5... To adequate food and appropriate health care... Conception to birth. Responsibility Of peaceful nondestructiveness in assembly. Of honesty, fairness, and carefulness in the ac- Of privacy in what offends or upsets others. Of learning without animosity. Of using the scientific method in a pro-life direction. Of growing as well as biologically capable. 1 By Samuel A. Nigro, M.D., Copyright © The Mankind First Co., 1974, from the book entitled "The Death of America." Senator BAYH. Thank you, Doctor. Our final witness this afternoon is Dr. James W. Prescott, health scientist, Administrator, and developmental neuropsychologist, National Institute of Child Health and Human Development, at the National Institute of Health. STATEMENT OF JAMES W. PRESCOTT, PH. D., HEALTH SCIENTIST ADMINISTRATOR AND DEVELOPMENTAL NEUROPSYCHOLOGIST, NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT, NATIONAL INSTITUTES OF HEALTH Dr. PRESCOTT. Thank you, Mr. Chairman. Let me state my appreciation for your giving me this opportunity to testify before your subcommittee and to share with you some of the data that I have that I believe is related to the issue of abortion. As a matter of introduction, my name is Dr. James W. Prescott, a developmental neuropsychologist and health scientist administrator with the National Institute of Child Health and Human Development. I am a past president of the Maryland Psychological Association and served as a member of the Maryland House of Delegates Judiciary Committee's Subcommittee on Abortion Reform, 1967-68. I am currently a member of the Day Care Licensing Advisory and Study Committee, Department of Health and Mental Hygiene, State of Maryland. Additionally, I am a member of the American Ethical Union and the American Humanist Association where I am currently a member of the board of directors. I am testifying as an independent professional and as a private citizen. This statement does not necessarily reflect the viewpoints of the National Institutes of Health or the Department of Health, Education, and Welfare. I have prepared a longer, more detailed report, "Abortion or the Unwanted Child: Issues in Child Abuse and Neglect," of which this statement is a summary. With the chairman's permission, I would like to have this made a part of the record. And a shorter article "Before Ethics and Morality," which deals with the same issues from a somewhat different perspective. Senator BAYH. We would be glad to include that in the record. [The report and article referred to follow:] ABORTION OR THE UNWANTED CHILD: ISSUES IN CHILD ABUSE AND NEGLECT (By James W. Prescott, Ph.D., National Institute of Child Health and Human Development My name is Dr. James W. Prescott, a developmental neuropsychologist and health scientist administrator with the National Institute of Child Health and Human Development. I am a past president of the Maryland Psychological Association and served as a member of the Maryland House of Delegates Judiciary Committee's Subcommittee on Abortion Reform (1967-68). I am currently a member of the Day Care Licensing Advisory and Study Committee, Department of Health and Mental Hygiene, State of Maryland. Additionally, I am a member of the American Ethical Union and the American Humanist Association where I am currently a member of the Board of Directors. I am submitting this material as an independent professional and as a private citizen. This statement does not necessarily reflect the viewpoints of the National Institutes of Health or the Department of Health, Education and Welfare. It is recognized that the issue of abortion is characterized by constitutional, religious, philosophical, medical, psychological and social controversy. It is the intent of this testimony to address itelf to the social and psychological implication of abortion for the individual and society. From a social-psychological perspective abortion can be viewed as an issue of the unwanted child. Women who seek to terminate a pregnancy and are denied an opportunity to do so by society are forced to give birth to a child they do not want. Consequently. it is important to know what the consequences of being "unwanted" are for the development of the unwanted child" and for society in general. This becomes particularly crucial when a society considers establishing laws to prohibit abortion and to provide criminal sanctions for its violation. The integrity and excellence of development of each individual and the achievement of a stable, compassionate and humane social order should be the objectives of any society. It is within these objectives of society that abortion will be examined and questions raised and answered as to whether abortions serves or does not serve these objectives of society. My testimony will review studies that examine: (a) the consequences of being an unwanted child as reflected by abortion requests being denied and by acts of filiacide and neonatacide; (b) the relationship of high infant mortality and child mortality rates to the abortion issue and their relationship to a variety of measures reflecting social unrest and disorder; (c) cross-cultural studies of societies which permit and do not permit abortion and how these social customs relate to other, social behaviors of these societies; (d) an assessment of the abortion and anti-abortion personality and its implications for social legislation in this country; (e) an evaluaton of the expected consequences of repressive abortion legislation for the future of this country. A. CONSEQUENCES OF ABORTION DENIED 1. The Scandinavian Study One of the most important studies in evaluating the consequences of being an unwanted child upon the development of the child was conducted by Forssman and Thuwe (1966) from the Department of Psychiatry, Goteborg University, Sweden. Therapeutic abortion was first officially legalized in Sweden in 1939 and liberalized in 1946 to include mental health criteria. These Swedish investigators examined the development of children from birth to age 21 who were born to mothers during the years 1939-1941 who had applied for abortion but were denied. The sample included 120 children who were compared to a control group of children whose mothers had not applied for abortion. There were 66 boys and 54 girls in the abortion-denied group, 32 (27 percent) of the unwanted children were born out of wedlock whereas only 9 (8 percent) of the control children were born out of wedlock. 57-676 - 76 - 27 The differences between the unwanted and control children can be summarized as follows: (a) According to the criteria for an insecure childhood, 72 (60 percent) of the unwanted children had an insecure childhood in contrast to only 34 (28 percent) of the control children. (b) 34 (28 percent) of the unwanted children had received some form of psychiatric care compared to 18 (15 percent) of the control children; (c) 22 (18 percent) of the unwanted children were registered with child welfare boards for delinquency compared to 10 (8 percent) of the control children; (d) 19 (16 percent) of the unwanted children were registered for drunken misconduct compared to 13 (11 percent) of the control children; (e) 17 (14 percent) of the unwanted children had some form of higher education compared to 40 (33 percent) of the control children; (f) 17 (14 percent) of the unwanted children received some form of welfare between the ages of 16-21 in contrast to 3 (2.5 percent) of the control children; (g) 10 (15 percent) of the unwanted male children were found unfit for military service in contrast to 4 (7 percent) of the control children; (h) 13 (11 percent) of the unwanted children were educationally subnormal in contrast to 6 (5 percent) of the control subjects. Unwanted children got a significantly smaller amount of education than the control children : (i) and finally, while 68 percent of the control children showed none of these social disabilities discussed, only 48 percent of the unwanted children were free of such characteristics. In summary, unwanted children suffer over, twice the social, emotional and mental disabilities than do wanted children on a variety of measures. The costs to society in increased crimes; welfare recipient; poorly educated citizenry and drunkenness constitute a clear and present danger to a well-functioning society. 2. The Czechoslovakia Study In a more recent study, Dytrych, Matejcek, David and Friedman (1974) reported upon a preliminary analysis of 220 children born to women denied abortion in Prague, Czechoslovakia during 1961-1963. A control group of 220 children were matched with respect to age, grade in school, sex, birth order, number of siblings, mothers' marital status and father's occupation. In summary, the following difference between wanted and unwanted children were found. Unwanted children had— (a) More childhood diseases and hospitalizations; (b) Were more "naughty"; (c) Were worse in all school subjects; (d) Were more demanding, more intent on getting attention and more egotistical; and (e) In general, experienced quite varied and usually unfavorable consequences in their subsequent lives than wanted children. The above study is still in progress and evaluation of adolescent and adult functions will be assessed in future reports. The preliminary results, however, are consistent with the findings of the Swedish study which, taken together, provide substantial documentation that denial of abortion leads to undesirable consequences for both the unwanted child and society. 3. Filicide and Neonaticide The number of children killed by their parents is an extreme outcome of being unwanted and is the final act of child abuse. Roman civil law recognized the right of the father to maim and kill his offspring (patria potestas) and a number of cultures have practiced the killing of female infants because they were less valuable than male infants. The ceremonial sacrifices of infants and children have been documented in a number of cultures and Abraham's willingness to kill his son for religious purposes is a Biblical case in point. The killing of one's own children in modern civilizations, however, is uniformly met with revulsion and horror, although child abuse which is the precursor to filicide and neoaticide has much broader acceptance and practice in many societies. The central issue for us is the role of abortion in preventing unwanted children and reducing the incidence of child abuse and infanticide. Phillip J. Resnick (1969, 1970) has published two papers on filicide and neonatacide. In his study of 131 filicides (the killing of one's own child), he found that 49 percent were associated with "altruistic" motives, e.g., to relieve suffering; 21 percent were attributed to psychoses; 26 percent were attributed to being unwanted" which includes the child abuse syndrome and 4 percent were attributed to spouse revenge. Statistics, however, fail to convey the personal horror and tragedy of parents killing their own children, particularly, when it could be prevented. Several case histories are presented by Dr. Resnick of parents killing their children which necessarily raise the question whether it is more desirable to permit human life which results in a cruel and painful death than to prevent that life in the beginning. This is even more forcibly brought to our attention by Dr. Resnick's discussion of the several means by which infants and children are killed. He states: "Head trauma, strangulation, and drowning were the most frequent methods of filicide (table 3). Fathers tended to use more active methods such as striking, squeezing, or stabbing, where mothers more often drowned, suffocated, or gassed their victims. Unusual methods included putting sulfuric acid in a nursing bottle and biting to death. One father put his son on a drill press and drilled a hole through his heart." It is unnecessary to further catalogue the atrocities that are inflicted upon unwanted children and the compelling conclusion that life should be prevented if the outcome of life is an early violent and painful death. This is highlighted by Dr. Resnick's study of 37 neonaticides (infants killed within first 24 hours) where he found that 83 percent of infant killings were attributed to being “unwanted' by the mother; 11 percent to psychoses; 3 percent to "accidental" murder (child abuse); and 3 percent to "altruism." These infanticide statistics and the child abuse statistics mus the seriously considered in any discussion of abortion since these are often the alternative to compulsory pregnancies. The excellent review of Schwartz (1972) "Abortion on Request: The Psychiatric Implications" should be consulted in this context. 4. Child Abuse & Child Neglect: Consequences of Being Unwanted There is little time to discuss the growing literature on child abuse and neglect and its relationship to being unwanted. Gil (1970, 1971), Helfer & Ken (1969), Schwartz (1972), and a number of other investigators have discussed the outcome of illegitimate births and unwantedness as to related child abuse and neglect. Schwartz (1972) cites statistics that indicate that illegitimate births rose from 3.5 to 9.7 percent during 1940-1968; that 90 percent of these illegitimate births were unwanted; and that 40 percent of all children born into poor families are unwanted. Schwartz cites additional studies that found a 19 percent incidence of unwanted children in a sample of 5,600 married women during the period of 1960-65. The implications of these statistics for society is substantial. For example, in 1967 the total of unwanted legitimate births (19 percent of 3,203,000 or 608,500) and unwanted illegitimate births (90 percent of 318.000 or 286,000) was 894,000 unwanted births. In other words, 25 percent of all births were unwanted in that year. The above statistics are not unrelated to child abuse statistics which report that between 30,000 and 37,000 children are badly beaten each year (Schwartz, 1974), and that the maximum incidence of physical abuse during 1965 ranged from 2.53 to 4.07 million cases (Gil, 1971). This figure includes all kinds of injuries from minimal through serious to fatal Gil (1971) estimates a larger figure if incidents of abuse which did not result in physical injury were added. Gil (1971) cited nationwide reporting rate of child abuse at 6.7 percent per 100,000 for whites and 21 percent per 100,000 for non-whites where this latter statistic reflects over representation in the sample and reporting bias. The 1965 survey on child abuse by the National Opinion Research Center estimates 3.7 percent of 110 million adults knew personally families involved in incidents of child abuse or approximately 4 million abused children. It was further estmated that 6 percent of the abused children are fatally injured and 8 percent suffer permanent brain damage. Children who are unwanted and unloved are subjected to a life of suffering and agony-if they survive-and it is this issue of survival which I would like to discuss as it is reflected in our own infant and child mortality rates. |