A Doctor's Commentary: Akin is Right

By Dr. Dominic Pedulla, MD, FACC, CNFPMC, ABVM, ACPh
8/27/2012
Catholic Online (www.catholic.org)

To punish the unborn child through abortion, he said, is to create a second victim.

Not only did Akin attempt to sensitively answer the delicate question about allowing abortion in cases of rape or incest, and not only did he thoroughly answer the question, but above all he probably had the science right.If we can't bring ourselves to condemn all acts of violence against innocents -- I mean all, everywhere, without exception -- then we are saying that some victims just don't count, and that we care more about our own political agendas than about real victimization.

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EDMOND, OKLAHOMA (Catholic Online) - When the Congressman Todd Akin story first surfaced, I regret to admit that I jumped on the growing bandwagon criticizing his statement from both the feminist and scientific perspectives. I said that he was wrong to say that pregnancy from rape is rare, or that it does not really happen.

As the controversy exploded, I began to realize that I was probably wrong on this.

He didn't exactly mean that pregnancy from rape is rare, or that is does not really happen.

What he did attempt to say was that pregnancy resulting from rape was not the pressing issue that abortion promoters tendentiously pretend it is (so that they can press their case for the deceptive "rape and incest" exemption). He meant to say that these pregnancies are comparatively rare, and this due to the fact that there actually were physiological factors that diminish the chance of pregnancy during rape, so that pregnancy is less likely in these cases than with consensual acts.

He didn't mean that it never happens.

And even though he used the unfortunate phrase "legitimate rape," he seemed by this to mean "actual rape," "forcible rape"; i.e., truly non-consensual acts -- a distinction of physiological and scientific significance -- rather than denying that rape is something atrocious and heinous in itself, which of course it is. He was characterizing as "legitimate" not rape itself, but rather an act's classification as rape. This seems, well, legitimate, and should not have been shamelessly exploited to mean something otherwise.

Not only did Akin attempt to sensitively answer the delicate question about allowing abortion in cases of rape or incest, and not only did he thoroughly answer the question, but above all he probably had the science right.

As Tara Brelinsky correctly points out this week on a Catholic Online article, it is well known among professional fertility awareness educators that stress will interfere with ovulation, making pregnancy difficult if not impossible.

The science of this is established both in human and mammalian non-human reproductive biology. Cortisol is released at times of acute stress, as for example violent acts, and is acutely inhibitory of ovulation at the level of the pituitary gland so that luteinizing hormone -- the ovulation hormone -- is suppressed. (Reprod Biomed Online. 2012 Aug;25(2):180-9. Epub 2012 Apr 3, and Gynecol Endocrinol. 2012 Mar;28 Suppl 1:9-13.)

And then there is the growing body of scientific evidence among specialists in so-called "assisted reproductive techniques," to the effect that stress can uniquely handicap the achievement and maintenance of pregnancy during IVF cycles. (Fertil Steril. 2011 Aug;96(2):404-8. Epub 2011 Jun 30; Arch Womens Ment Health. 2012 Jul 6.

It is more than clear that an acute act of violence would easily seem to be just the kind of stressor uniquely capable of interfering with ovulation or even implantation, in the event conception occurred.

Anthropologically and teleologically speaking and apart from empirical data, a mechanism selecting against pregnancies from rape would also be of unique value to species, woman, and child, as a survival advantage is conferred on pregnancies free of this type of violence.

Perhaps most importantly, although the 1996 paper often cited by proponents of the abortion for rape and incest "exemption" did report a 5% incidence of pregnancy from acts of rape (Am J Obstet Gynecol. 1996 Aug;175(2):320-4; discussion 324-5.), this is very likely a gross overestimate, as the authors themselves imply that they might well have significantly underestimated the number of individual rapes because of the common problem of rape under-reporting, thereby overestimating the pregnancy rates.

Moreover, the authors may have conflated some statutory, volitionally consensual rapes (presumably lower stress instances) with strictly nonconsensual ones (violent or higher stress instances; i.e., Akin's "legitimate rapes"), again leading to pregnancy overestimates.

A staggeringly high percentage of the reported pregnancies from rape and incest occur in adolescent women, where predation and victimization are often chronic and repetitive, and the perpetrators are often familiar to the victim (involving dysfunctional and violence-prone broken homes), so that for every reported pregnancy there often already has been a repetitive pattern of predatory acts.

Finally, more recent and updated data suggest a much lower incidence of pregnancy after rape, on the order of 1 to 2% (J Med Assoc Thai. 2009 Jul;92(7):885-90).

I also didn't properly give Akin credit for exposing the major flaw behind the deceptive "abortion in cases of rape or incest" ...

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1 - 10 of 19 Comments

Dr. Dom
8 months ago
OK, and very thought-provoking stuff Mike from Juneau! I wish all intellectual discussions were this interesting. An anthropology can be "open to" creation (possibly this would have been a more felicitous turn of phrase than saying as I did creation "based", so thanks for correcting me on that), as for example the anthropology of Thomas Aquinas, which while not having Divine revelation as its starting point -- precisely because it is philosophy not theology -- nonetheless recognizes from reason alone a discernible pattern of orderly means oriented around a specific end, and thereby recognizes an intelligent planner and designer as the author of the particular thing one is observing. It is in this sense that my anthropology is "open to creation" simply in that I refuse to close my eyes to the obvious, and I have no inherent bias that force me to close my mind that way.

But this does have further implications, and they apply directly to the idea of the real effect of mutations because of what we call an "authentic anthropology" or "adequate anthropology of nature"; let me explain what I mean. Teleologically speaking we say with Aquinas that nature is a serious of means designed around specific ends or goals ("telos" meaning "end"), and therefore often a substantive revision of the thing in question is more often deleterious rather than beneficial, for the simple reasons that the thing in its complexity is already directionally oriented with a certain finality, to that end. A change often therefore deters and hinders the thing in question, making it harder to achieve that end. That is why I say one can speak in a certain limited fashion of "entropy" borrowed from the law of thermodynamics but here applied to biological systems. It may or may not be provably true, but seems at this point a not altogether unreasonable idea because it is just one more thing making the "dogma" I learned in the university without ever hearing from any competing voices a little -- even f just a very little -- shaky.

Having said all that, it is nonetheless not for me a passionate quest to disprove mechanistic evolution biologically, granted a guiding intelligence, as it is for some. As long as we don't make matter alone the Designer this matters little to me. And I don't quibble with you about the level of influence of the mutation being at the level of the gene only. You might well be right on that particular and the more I think about it the more I believe you are.

A more important theme for me though is that nature is designed as a serious of means around ends, and for the physician, it is elementary knowledge, even if often lacking today! So it is with the subject at hand; i.e., a helpful arrangement whereby the female organism can thwart ovulation at times disadvantageous to human thriving. Reproductive biology 101 -- you might call it when applied to motherhood -- and then it becomes imperative to understand the plan in nature to be able to only choose those interventions assisting nature in achieving the goals (as in wellness), and in avoiding those interventions abrogating those goals, diverting away from those goals, or replacing them with false ones of merely human capricious or whimsical choosing.

As examples of the ones to avoid, we think readily of several: contraception, sterilization, abortion, IVF. No one thinking this way, for example, is ever surprised to find out (and this is why I say the Church's wisdom offers us a certain advantage in dealing with people that would almost be a bit "unfair" were it not strictly for the benefit of patients and not our own selfish interests) that, for instance, women end up with psychological difficulties that are only too well documented in the scientific and medical literature. It may be that the creative intellect thinks contraception to be a brilliant contrivance, but it is as if someone forgot to tel the souls of our female patients, their unconscious minds, which are very definitely not designed to work that way. Add to this the Church's respect for the individual conscience -- we are bound by our own teachings never to proselytize -- and the unconditional respect for every human being's dignity, and you have in the approach something powerful and inherently beautiful.

But I digress.
Juneau Alaska
8 months ago
Dr. Pedulla,

Thanks for the reply. Your first paragraph is impossible for me to respond as I have no idea what creation-based anthropology means. Let's just leave that one aside! I also can't agree with your "increasing entropy" analogy. For starters, mutations are not always or mostly harmful. So right there, we have a problem with your entropy hypothesis. And supremely deleterious mutations will kill the organism outright so those mutations wouldn't get passed on. Considering evolution has been rolling along now for billions of years (weeding out large-scale mutations) it shouldn't seem unlikely that organisms can survive with some mutations. And then of course, some mutations are of no consequence to evolution as they don't affect reproductive cells (somatic cells). Selection does not operate at the species level. The term "species" is a human-needed term and is not important for evolution, only human taxonomists. Natural selection operates at the level of the gene (a quantum of information essentially). This is not a controversial fact for 99.9% of biologists. I do hope you enjoy the book, thank you for accepting. -Cheers! ~Mike
Stephanie
8 months ago
@Jay, the problem with that argument is that studies have shown that abortion after a rape just creates another trauma... it's almost as if the woman is being raped all over again, psychologically.

Rape victims should be encouraged to seek counseling. There are a lot of emotions that need to be worked through, maybe even unjust anger toward her unborn baby, but killing the baby is not the answer. Remember, it is also HER baby, not just the rapist's baby.

Many women who have given birth to and chosen to keep their babies conceived through rape have said that they see the child as a reflection of themselves. This shocks many people because I guess for some reason they like to label babies conceived through rape as "rape babies" rather than seeing them as individuals created in God's image. A person is a person... no more labeling, please.

If a woman doesn't want to take care of her newborn baby for *any* reason, she should place the child for adoption. Using that as an excuse to promote abortion is silly. There are thousands of couples on waiting lists to adopt babies, even babies born with disabilities. This "if I can't have it, no one can" mentality is very juvenile.
Fredi D'Alessio
8 months ago
Thank you doctor.
Dr. Pedulla
8 months ago
To all in general: thanks for the positive comments.

Mike you're right in part, but I didn't intend here to offer a kind of proof for evolution. In fact I say nothing about evolution at all actually. If you re-read my quoted statement as if "selecting" in this context had nothing to do with evolution, you'll see I'm making an anthropological point, where the designed process (a strictly creation-based anthropology) provides the mechanism. In fact the body is already designed to "select" against all kinds of defects and dangers to survival at the level of thee individual.

But even here I think you're making an argument that would be better stated this way: "selection has at the genetic level strictly unfavorable -- as far as species survival is concerned -- effects, so that at the species level it could actually select against survival, like a kind of law of increasing entropy but applied to genetic theory. Mutations are almost always and uniformly negative (think for example of the sickle cell gene), so we can hardly build a theory for enhanced species survival based on positive or favorable selection. Selection might indeed operate at the species level (this can neither at the moment be proved nor disproved empirically), but it would be uniformly negative, and so it is disadvantageous selection, not advantageous selection".

Fair enough?

I appreciate the book-gift too. Thank you.

Email me at pedullad@aol.com if you have any other ideas.
abey
8 months ago
It is wise to say " look before you leap, to the Judging". In this context it is even wise to state & does show, that the desires of the flesh are contrary to the truth of the Spirit
Alex
8 months ago
Good article. Aside from the pointed out fact that with rape comes many hormonal factors that may reduce the risk of pregnancy, why don't people realize the scientific fact that pregnancy as a whole is rare? It truly is a miracle. There are so many things that have to be exactly right in order for pregnancy from any sexual act to occur. The majority of sexual health consolers agree, when a person says they got pregnant "just from having sex once," often times that person is lying. As many married couples know, pregnancy is usually something you have to work at, and when I say "work at" I mean exactly what you think I mean. This is something I myself know from experience. That doesn't mean it DOESN'T happen from a 1 time encounter, but the odds are not in it's favor. Even a 25% chance of pregnancy from a 1 time encounter is a relatively "rare" statistic, because the VAST majority of the time (75%), pregnancy does not even result from a consensual encounter. These people running around asking for their contraceptives are entirely sick people that do not just experience 1 one-night stand, they make a habit, a lifestyle out of it. Few people are willing to own up to their promiscuity. It's as simple and disgusting as that. And of course, the problem is that we're promiscuous in the first place.
Theresa H
8 months ago
I understand/agree with Akin and Dr. Pedulla.... Even if a child is conceived via true "rape," it is always wrong to kill the child. (Ultimately, the child can be put up for adoption after birth if the mother is unable to live with an "illigitimate" child. There are generous persons willing to welcome these children.) Every child is precious in God's eyes--it is He who gives the "breath of life!"
terry
8 months ago
While I appreciate this physicians effort at clarifying what the politician said, he doesn't address what happens after ovulation has already occurred. As far as the Thai study goes, the 1-2% pregnancy rate for rape corresponds to oral contraceptive failure. My point is that trying to defend public gaffs such as the one in question is a loser. It places one in the position of needing to say, "rape is just awful",as if that needs to be articulated, in order to validate what follows: Innocent life must not be attacked. It just takes away from the real issue. Emphasizing as he did the violence on top of violence is the correct path of defending the second victim of rape, the unborn child. Defending an undisciplined, careless comment is not necessary.
Kasoy
8 months ago
You're right. The uproar over Akin's 'politically incorrect' statement is simply that, political. It is simply immoral to try to mitigate the effects of rape by murdering the innocent unborn child. What the Christian community should do is to provide emotional as well as financial support to the rape victim during her pregnancy and provide alternatives (eg, adoption) to support and raise the child after it is born. Abortion, euthanasia, and capital punishment are all immoral. Only the Giver of life has the absolute right to take back life. Let us make use of the tragic events of life as means to draw down God's grace by choosing to do right (His will) rather than to do another wrong (man's will).

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