Yesterday in Texas, two Republican lawmakers presented two very different abortion-related bills, both of which deal with the reliability of mainstream medical and scientific research. One bill would bring Texas in line with the findings of the National Cancer Institute, removing language connecting breast cancer to abortion in the state-issued “Woman’s Right to Know” pre-abortion booklet. The other, the so-called Preborn Pain Act, would ban abortions performed after 20 weeks post-fertilization in the state, putting Texas in opposition to the Texas Hospital Association, the American Medical Association, and the American Congress of Obstetricians and Gynecologists.
State Rep. Sarah Davis (R-Houston) asked the Texas House State Affairs Committee to “vote to live in fact and not fiction” when considering her proposal to scratch the breast cancer claims out of the “Woman’s Right to Know” booklet. The language was first included in the booklet ten years ago. It reads, in part:
“If you have carried a pregnancy to term as a young woman, you may be less likely to get breast cancer in the future. However, you do not get the same protective effect if your pregnancy is ended by an abortion. The risk may be higher if your first pregnancy is aborted.”
Davis, a breast cancer survivor, called the language “patently offensive.” When she was diagnosed with cancer, she said, “Not one time did any of my medical advisors ask me, ‘Did you have an abortion, Ms Davis?’ Because that is simply not in the realm of science.”
Indeed, a review of research conducted by the National Cancer Institute found that the newest studies have “consistently showed no association between induced and spontaneous abortions and breast cancer risk.” And according to the American Cancer Society, “the scientific evidence does not support the notion that abortion of any kind raises the risk of breast cancer or any other type of cancer.”
But representatives from anti-choice groups such as the Texas Alliance for Life and Life Advocates said they do not trust the findings of these two organizations. One crisis pregnancy center director from Houston testified, “the people who want to remove [breast cancer’s link to abortion] are the very people who profit from abortion,” arguing that a national conspiracy on behalf of greedy abortion providers has skewed the country’s scientific research in their favor.
An obstetrician speaking on behalf of the Texas Alliance for Life also testified that science linking breast cancer to abortion has been “suppressed” since the passage of Roe v. Wade. Dr. Bevery Nuckolls said there exists “very strong evidence” linking breast cancer to abortion, citing a 1997 study led by Dr. Mads Melbye. The conclusion of that study: “Induced abortions have no overall effect on the risk of breast cancer.”
Just hours after Rep. Davis asked the committee members to consider her bill on the strengths of peer-reviewed medical science, Rep. Jodie Laubenberg (R-Parker) asked them to do precisely the opposite in considering a ban on abortion after 20 weeks post-fertilization. Laubenberg, who is the Texas state chair of the American Legislative Exchange Council (ALEC), a back-door lobbying group responsible for the rash of suspiciously similar conservative legislation proposed across the country over the last several years, said her bill deals with “the life issue.”
Laubenberg’s bill does not include any exceptions for rape, incest, or the mental health of the pregnant person—only an exception for life-threatening physical conditions.
“The technology that we have now, that we know more about the development of the feelings of that preborn child, allows us to make, I think, a better decision,” Laubenberg told the committee. Her bill asserts that “substantial medical evidence recognizes that an unborn child is capable of experiencing pain by not later than 20 weeks after fertilization.”
Whatever Laubenberg’s “substantial medical evidence” is, it is not accepted by the Texas Hospital Association, which sent a representative to Wednesday’s hearing to oppose the bill, nor by the Journal of the American Medical Association, which published a 2005 clinical review finding that “evidence regarding the capacity for fetal pain is limited but indicates that fetal perception of pain is unlikely before the third trimester.” Similarly, the American Congress of Obstetricians and Gynecologists holds the official position that “scientific evidence does not support the elimination of legal abortion at 20 weeks’ gestation based on concern for fetal pain.”
Rep. Laubenberg claimed that by 20 weeks post-fertilization, a woman has had “more than enough time to decide whether or not she will have, choose to have, that abortion.”
But the reality of second trimester abortions is much more complicated than a woman simply being too lazy or ignorant to bother to abort. Of the fewer than 0.5 percent of abortions that are performed after 20 weeks in Texas, many are due to fetal anomalies that cannot be identified prior to that time. Women of color in traumatic, abusive, or unstable living situations are more likely to seek abortions at 20 weeks, often because they lack access to medical care that would enable them to abort earlier, or because they must save up the hundreds or thousands of dollars for their procedures over the course of many weeks.
Amelia Long, president of the Lilith Fund, an organization that provides financial resources for Texans seeking abortion, told RH Reality Check in December that it’s “never the case” that the Texans who reach out to her fund are “just putting it off and just being lazy.”
Much of the testimony on the 20-week ban centered on fetuses, rather than pregnant Texans’ right to access safe, legal abortion before the third trimester. Abortion is already banned in Texas after 24 weeks.
Dr. Patrick Nunnelly, an anti-choice OB-GYN from Austin, testified that the bill was “a critical step in the protection of a group of vulnerable citizens who have no choice.”
But one woman’s tearful testimony put the focus back on pregnant Texans. She testified that her doctor discovered a terminal fetal anomaly in the second trimester of her pregnancy. The religious-affiliated hospital at which she was being treated would not allow her to terminate her pregnancy, even when her doctor appealed to the hospital’s board.
She said, through tears, “I should be allowed to make this very personal, very private decision,” and observed that had a 20-week ban been in place when she was faced with her decision, any choice about her medical options would have already been made for her, by the state.
The fundamental question proposed by both bills is this: Do Texas lawmakers trust peer-reviewed research produced by mainstream medical science? If the answer is no, then Laubenberg’s bill should pass. If the answer is yes, then Davis’ bill should pass. If both bills pass, Texas lawmakers are essentially contradicting themselves; either the best available peer-reviewed medical science is trustworthy, or it isn’t.