We're back with another edition of The Federalist or Radio Hour. I'm Emma Lajashinsky,
culture editor here at the Federalist. As always, you can email the
show at radio at the Federalist dot com, follow us on exit fdr LST,
make sure to subscribe wherever you download your podcasts, and of course the
premium version of the Federalist dot Com as well. I'm happy to be joined
today by Tessa Longbon. She's a senior research associate over at the Charlotte Loadsier
Institute and has a really interesting story about kind of a broad issue but also
in this case, a very particular case study. So Tessa, thank you
for joining the program. Thanks so much for having me on. I'm excited
to be here. Of course, this this case study that I just mentioned
is depressing, mind blowing, all of that in one. Before we get
into it, Tesla, could you tell us just a little bit about your
background and how you ended up working in research at the Charlotte Lovesier Institute.
Of course, yes, so I have been with the Charlotte Losure Institute for
almost seven years now. Like you said, I'm a senior research associate and
so I do a lot of research on abortion and in particular drug induced abortion
and its impact on women. And here at Charlotte Losure, we're a pro
life research organization and we're named after doctor Charlotte Losuer, who was one of
the first woman doctors in the US and she was known both for her advocacy
for women and her commitment to truth, and so we want to carry on
the spirit of her mission. And we believe in the dignity and value of
human life, and we also believe in truth and so we know that,
but research on the abortion issue has been extremely opaque, and it's also been
largely controlled by abortion advocates for decades, and so we want to be the
counter to that. And we're composed of a network of scholars who are experts
in different fields. We have scientists, public health researchers, medical doctors,
and we collaborate on research work together, and we want to do the research
that no one else is doing, you know, And this is where it
gets really interesting, because if you're gut mocker, you can do as much
research as you want and you're not going to face the pressures that Charlotte Lasuer
will face and U test will face in particular, so let's dive into this
recent case study regarding stage journals, which a lot of people will be sort
of familiar with as an academic paper. Academic I guess a publisher more broadly,
and you might have something to add to that, Tessa, But it
turned out that they were retracting Charlotte Laser studies. Once that you are listed
as an author on, can you tell us a little bit, just give
us the background on the sort of battle between between Sage and Charlotte Loasure and
probably a little bit about the timing would be helpful too, because that's very
very interesting. Yes, No, it's definitely, it's all very interesting.
The timing is striking, and even taking a step back further and looking at
the studies themselves, what it was that we researched, why we chose to
do what we did. This is all happening in an environment where we have
very little data. The data that's out there is flawed studying the topic of
abortion. We have states like California that don't report any abortion data at all,
and so we're missing huge chunks in the abortion data in the US,
and we have the FDA only counting debt as adverse events. No other complications
are required to be reported to FDA, and in this environment, the research
that is available on abortion very there's far less than meets the eye. There
are huge gaps, it's very piecemeal, and so we wanted our team here
at Loisure Institute wanted to get an idea of what was going on. We
wanted to know how abortion was impacting women's health, and specifically we wanted to
look at surgical versus drug induced abortion and how that was impacting women and how
often women were ending up in the emergency room, because surprisingly that's something that
we don't know a lot about. And the best data that's available to us
is Medicaid, because through Medicaid, we have deidentified all of the data on
women's interactions with the healthcare system. As long as you state tax dollars through
Medicaid paid for the abortion, paid for follow up care, paid for all
the healthcare, we can see all of that claims data, and so we
can see this trajectory of how it's impacting women's health. And so for this
particular study, we started with each drug induced and surgical abortion that was in
our Medicaid data set nineteen ninety nine or twenty fifteen. It was the most
recent year of data that we had when we published this study, and we
followed each woman out for thirty days after the abortion to see how many times,
how many women were ending up in the emergency room. And what we
found was that drug induced abortions were more likely to send women to the er
than were surgical abortions, and rates of er visits for both types of abortion
have been increasing dramatically. And so we published this study in a journal that
is owned by by Stage, like you mentioned, and published it almost three
years ago. It's been one of the top read articles in the journal.
It's been cited in court cases, and you know, prominently read until last
week when, like you mentioned, it was retracted by the journal for a
few different issues. But definitely interesting timing with all of this happening in the
midst of some ongoing court cases challenging FDA regulations of abortion drugs. Right,
I mean this is cited in a Supreme Court case that's set to go to
oral arguments fairly soon, is there, Tessa, What is your impression of
how this process usually goes about? Timing wise with Sage, you know,
retracting articles, It seemed you know, what could you maybe like a little
bit about the time between when the articles were published and when SAGE made this
decision. Basically, yes, well, it's hard to say what the normal
timing is because this is really unprecedented as far as anyone on our team is
concerned. We've never experienced anything like this before, although unfortunately it seems to
becoming more and more common with just the general environment that we're in and how
science has changed. But we certainly have been disappointed by how the process has
gone. After a couple of years after the study was published, a few
months ago, we heard from SAGE that they had received a complaint about the
study from one of their readers, who, at the time we didn't know
what was since been identified in the media as an openly pro abortion professor of
pharmaceutical sciences, and Stage raised a few issues about the study. They alleged
that we had undisclosed conflicts of interest because we work many of us are affiliated
with Charlotte Leasure Institute, which is a pro life research organization, and they
raised some questions about the methodology of the study, and so we responded to
both of those issues, you know, explained that we don't have any undeclared
conflict of interests. We were very open about our affiliation with Charlotte Leasure Institute,
that Charlotte Leasure Institute had funded the study, and that the really the
methodological issues were not really issues at all. There's always a million ways that
a study can be done, but certainly the issues that Stage had did not
affect our findings in any way. They weren't challenging our analyzes or our data,
or any of the findings of the study. So we sent all of
that to STAGE and then didn't hear back for a long time, and then
finally Stage let us know that they were moving forward to retract not just that
study but two other studies of ours that were also published in the same journal,
because they said that there had been a breakdown in the peer review process.
And so back when we had submitted these articles for publication, they had
been reviewed by anonymous reviewers who offered criticism and feedback that we incorporated into the
articles made them stronger, more robust, before they ultimately recommended to the editor
that the articles be published, and Stage let us know that one of the
reviewers was affiliated with Loisure Institute. Well, that was news to us,
because the entire peer review process is double an eye. We don't know who
the reviewers are. The reviewers don't know who we are, and so if
there was a problem with it, there's nothing that we could have done to
prevent that. That's, you know, all within the purview of Stage and
the journal. But because of that, Stage decided to re review all three
studies and then raised some of these pretty insubstantial challenges to the methodologies, but
again didn't challenge the findings or point to any errors that would that would render
the findings invalid, and so throughout the entire process, it was just kind
of disheartening and discouraging that we weren't able to have a true back and forth
as to the actual merits of the science, but were instead left largely in
the dark about how the investigation was proceeding and who was a valuating our work.
And as a researcher, can you talk to us maybe a bit about
the significance of SAGE, because it's my understanding that Stage is very powerful and
it's meaningful then that SAGE took the step and what appears to be a highly
politically charged decision, So what does it mean that this came from Sage,
you know, of all the different places it could come from. Well,
Sage is a publishing company that owns many, many different journals, and there
are several different publishing companies that own and operate these academic journals and publishing in
a peer reviewed journal that's opposed to safeguard the whole scientific publishing process. The
idea is that you're receiving feedback from your peers, people who with the expert
knowledge, who can offer substantial and useful criticism that will make your paper stronger,
that will prevent bad science from getting published, and we'll make sure that
everything is valid and reliable. And so to have a public publishing company that
owns so many of these journals taking this very dramatic step of retraction based on
some pretty insubstantial reasons is concerning because researchers need to be able to trust that
they're going to get a fair hearing, that they can trust the peer review
process and trust the impartiality of the journal that they're publishing in, and the
general public needs to know that too. They need to be able to know
that everything that's getting published, that's getting published as science, is trustworthy and
it's being evaluated based on its merits, not based on anyone's opinions, and
so to see this process breaking down is really concerning, especially when it's happening
in such a large and powerful organization. Doesn't bode well for science as a
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Now, can you tell us a little bit You've gone into this,
but could you tell us a little bit more about the findings themselves? You
know of these three studies because it's a lot of it's a lot of information
the media downplays or outright ignores or seeks to undermine in different ways, so
people actually might not be familiar with some of the information that your research presents.
So could you talk to us just about the findings of these three papers.
Yes, definitely. And so these three studies, two of them are
connected, and then one of them is a completely unrelated study that one looked
at abortion providers in Florida. We chose Florida because of the information that's available
from their medical board on provider details that allowed us to see some of these
characteristics of the abortion providers, and we looked at their use of well whether
they had hospital admitting privileges, were able to admit patients directly to the hospital,
and then of those that did, what their admissions looked like, how
many patients they were admitting for what reasons, and the general characteristics of the
providers, their age, their educational background, and details like had they ever
received and email practice claims, things like that. And it was designed to
be an exploratory study, kind of a jumping off point for future research because
there's very little research that's been done on abortion providers and whether they have hospital
admitting privileges, and so we were hoping that that would serve as a foundation
for subsequent research down the line, both from US and from other researchers.
And then the other two studies, The first one is the highest profile one
and the one that started all this looking at Medicaid data and focusing in on
emergency room visits after abortion. And we decided to look at er visits because
it's a really good comprehensive way to see how abortion is impacting women's health in
the short term. And so we took, I guess, kind of a
funnel approach to how we looked at these er visits. We would start with
an abortion. We knew the abortion had taken place, it was there in
the code, that Medicaid had been built for it, and then we would
follow that out for thirty days and capture all the emergency room visits that occurred.
And we found that over the course of the study period, and we
compared twenty two to twenty fifteen, because that's when abortion drugs really began to
be used in the US, and so we compared abortion drugs versus surgical abortion
and fower that abortion drugs were more likely to result in an emergency room visit
for any reason. And then well, these could have been visits for any
reason. You know, woman breaks her arm, goes to the emergency room.
So we decided to focus further in and we specifically looked at visits that
were related to the abortion itself, and we identified these by looking at the
code for the reason for the visit, how the visit was coded, and
we picked up all the codes for pregnancy related emergency room visits. It's happening
within thirty days of an abortion, that abortion is the pregnancy, and so
we looked at these visits and we found that among these abortion related er visits,
abortion drugs were over fifty percent more likely to result in an emergency room
visit than were surgical abortions. And over the course of the study, for
both types of visits or for both types of abortion increased dramatically, but the
increase was even greater for abortion drugs than it was for surgical abortion. And
something else that stuck out to us in this study was the number of women
who would go to the emergency room. We know they had had the abortion,
it was there in the data, but then when they went to the
er, it was coded as a miscarriage. Well, clearly, it's not
a miscarriage. Clearly it's an induced abortion, but it's getting coded as a
miscarriage. And by twenty fifteen, sixty percent of the abortion related er visits
after abortion drugs were getting miscoded as miscarriages. And so in the third study
that was affected by these retractions, we dug into that a little bit more
and we wanted to see if women were receiving different types of care if their
abortion was miscoded, and we found that women who had this miscoding as a
miscarriage had more hospitalizations and were more likely to be hospitalized for follow up surgery
to complete the abortion than women without the miscoding. So clearly it was having
an impact. Your doctor needs to know whether you had an abortion. It
can impact how you're treated. And so both of those studies related to abortion
drugs, the one looking at overall er visits and then the one looking at
miscoding, ended up getting cited in some of the briefs surrounding Alliance for Hippocratic
Medicine v. FDA, which is ongoing case challenging FDA regulations of abortion drugs.
I mean, that is absolutely fascinating research, and I can't I mean,
I can believe, but on the one hand, it seems so absurd
that the pro abortion left thinks that it can kind of keep up this facade
when so many women organically are having these bad experiences. It seems like it's
sort of from just a public relations standpoint, you know, let alone the
staggering human costs, it seems like it's a ticking time bomb for them.
Can you just tell us about how these drugs have proliferated across the country,
you pinpoint a twenty fifteen, how fast does this happen and how widespread is
it? Well, And that's the scariest part to me, because none of
the challenges to these studies have invalidated the findings. And women need to know
that they may end up in the emergency room after taking these drugs. That's
important information that women need to know, that women deserve to know. And
now because these studies have been retracted and made difficult to find, that information
is more were inaccessible to them than ever. So it's just it's scary to
think about the impact on women's health, and especially because abortion drugs have become
so widespread in the United States, and so this the the main drug that's
used in this method of abortion. Mifropristone was first approved in the US in
two thousand and When it was approved, FDA knew that it was a dangerous
drug and so put restrictions on it, on who could provide it, where
it could be dispensed, put a black box warning on it, which is
reserved for the drugs for drugs with the the highest risks, the highest that
we got most care needs to be taken with. And since then it's become
more and more widely used, and also the FDA has slowly walked back a
lot of the key regulations, the key protections on this drug that were put
in place to keep women safe. And the most recent changes that have been
made is to allow abortion drugs to go through the mail and to allow them
to be ordered online and it made available in pharmacies. And so as a
result of that, we've just seen the number of drug induced abortions skyrocketing in
the United States. Like I mentioned, our study goes up until twenty fifteen
because that's the most recent data that we had, But there's nothing to suggest
that these trends were slowing down, and in fact, you know, we've
only seen abortions continue to increase. Drug induced abortions continue to rise since then,
So just scary to think about how women have been affected. Is their
tension. I've seen some good stuff on us, but is there tension in
your view between so many people, especially in the kind of feminist left area,
their take on big pharma and myfi pristone, their METHI Priston's relationship with
the FDA, you know, the manufacturer, not the drug itself, obviously,
but the manufacturer's relationship with the FDA, how the drug was approved,
et cetera, et cetera. It seems to me that's in some ways a
case study of what a lot of people on the kind of feminist left,
the progressive left, claim to care so deeply about and be so opposed to.
I think, yes, absolutely, the fact that that mesh for Pristone,
that abortion drugs are that there really isn't a lot of good research out
there on their impact on women's health. And if you go back to the
very beginning, FDA rushed these through through an expedited process that's supposed to be
reserved for drugs that are used to create, used to treat serious or life
threatening illness for which there is no other alternative. I mean, clearly,
pregnancy is not a life threatening illness. There isn't there was an alternative surgical
abortion, and yet FDA followed this expedited process and brought these drugs to the
US without doing all of the studies that would normally be done. And that's
the same sort of pattern we've seen since then, which is why we were
inspired at Losure Institute to do this sort of study, taking this holistic view,
looking at emergency room visits and seeing well, what exactly is going on,
what are the rates, what are the trends, how have things been
changing, How does this compare to surgical abortion, Because certainly there have been
other studies published, But if you're only looking at a subset of the codes,
if you're not looking at all of the complicated that are resulting, or
if you're not looking at all of the abortions that are occurring, you're going
to miss You're going to have huge gaps in your study. And so that's
why we used the Medicaid data because we knew we could pick up all the
abortions that were funded by Medicaid and then all of the healthcare treatment following those.
But yes, definitely, there have just been this trend of largely the
science has been controlled by abortion advocates and with no comprehensive reporting requirement in the
US for abortion and the FDA not even requiring any complications from abortion drugs to
be reported except for death. The abortion industry controls the data, and we
think women deserve to know about complications short of death, and it's really sad
that this research is getting taken out of their hands. You know, is
there other research coming from you know what the media would deem falsely so called
the mainstream research groups or you know, people in different positions in the media
again will herald as whatever word they use to give credibility at any given moment.
But is there other research coming out? Again? I mean, you're
looking in some of these in some of this research just that you know,
state data. But are other people doing research in this space that tells the
true story at all? Or is it highly manipulated and being funded by the
abortion industry. What does the research look like in this space? Well,
some of the best research in this area actually comes from Scandinavia, where they
have much more comprehensive health data that allows them to do records linkage studies where
they're doing very similar to what we did here, linking each abortion, each
pregnancy outcome with the subsequent healthcare treatment that women receive. And through some of
those studies we've seen many of the same trends that we saw in this study,
which is abortion drugs resulting in higher rates of complications and surgical abortion,
those trends showing no sign of slowing down. And so those countries, those
Scandinavian researchers, those are that's a really good source of a good accurate view
of what's going on. But in the US, it's really hard to get
a good look at abortion and abortion safety because the data is so poor,
and when you have states like California not even collecting any data. California is
the highest abortion volume state in the country, and so at a time when
we should be knowing more and more about what's going on with the after dobs,
we actually know less and less, and so it's really hard to do
good research. And especially the abortion industry has no that there's no motivation for
them to be honest and open with their data. In fact the opposite.
How does it benefit them to make the data available and to be honest about
complications and so that's why we have such such poor research here for the most
part in the US. Again, that's fascinating because it reminds me of what
happened in Europe with trans hormones, so with medical transitions for children, they
had such a more concentrated data set in places like the UK with Tavistock,
but also in the Scandinavian countries that they have socialized medicine, it's just easier
to kind of track the trends. It's that almost it sounds like it's similar
here that it was, just it's sort of easier to track what's happening.
Well. I've talked a lot about this with our lead author, the lead
author of all three store udies, doctor Jim stid Niki, because he's been
doing he's been involved in research for his entire career, his fifty year career
involved in health services research. He's been faculty at several different universities, and
he's made the comment several times at how science has degraded from when he was
young and from what his mentors who were generation before him taught him about how
good science is supposed to be done. And he has reiterated many times that
good science is open science, and good science requires good data, and that's
the opposite of what we're seeing now. We don't have good data for the
most part, and we're not having an open discussion. We're not having an
open debate. Some things are simply not researched, or if they are,
we see advocacy wanting to keep these findings out of the conversation, like we've
seen recently with the retraction of our three studies. And it's really it's really
sad to see how how things have changed from the from what science could be
and should be to what we're seeing going on right now. You know,
it was interesting with the and this is obviously totally separate topics, so we
don't forget to deep into it, but it was interesting with the medical transition
research. How even still there are there's research in the United States that's being
suppressed and undermined through various ways on that as the conversation and as public opinion
has shifted, and you know, even the New York Times has come out
with some decent investigations into detransitioning and all of that. So, Tess,
I'm curious if because you know, even if there's not good data. This
is another thing that happened with medical transitions. There became this incredible deluge tragic
value of anecdotes, people with personal experiences, and that combined with some of
the research out of Tavistock and places in Scandinavia, for example, where in
Europe the medical community was reacting more rationally because some of this research wasn't overly
politicized and as charged and all of that. Is it possible that we could
see something happen similarly with mefipristone and abortion drugs, as so many people have
these personal experiences with them, and perhaps as some good research comes out of
countries in Scandinavia and in Europe and other parts of the world that is credible.
Well, I see that as an excellent point, because none of this
is happening in a vacuum, and certainly I see it most clearly researching the
abortion issue, but it's not just me, it's not just us, and
it's much broader than simply abortion. Coming across a whole host of issues,
we've seen this general attitude of suppression of opposing viewpoints, and sometimes it seems
as if it doesn't even matter the merits of the science or the merits of
the research if they're not if it's not fitting in with the general narrative that
the establishment would like to be telling. And I certainly already we've seen women
coming forward telling their stories, being open and honest about how they have been
harmed by abortion drugs. We've done research recently looking at women's experiences with abortion
pill reversal, so women who started that process and then immediately changed their minds,
immediately regretted it and decided to reverse it. And so there's already been
that those women who are being brave and coming forward and wanting to share their
experiences is but it doesn't it doesn't outweigh the need for large scale studies like
the one that was just retracted to come alongside and reinforce what these women's individual
experiences. And we need better data, and we need to be able to
share and debate these issues openly and have honest and open conversations about the research,
and that I think is one of the biggest challenges. People don't even
want to have the conversation other researchers. Academia doesn't want to have the conversation
we open where we invite challenges We want to have a debate with anyone who
would like to discuss the findings with us, who wants to offer their own
interpretation. But that's not what that's not what too many other researchers are interested
in. Instead of having a conversation, they would rather just shut it down
and pretend that the research doesn't exist. And I think that's been one of
the biggest challenges for us and all at the expense of women and unborn children.
Tessa long Bunds of the Charlotte Leasure Institute, where you guys just do
fantastic work. Thank you so much for joining the show. Thanks so much
for having me on. Absolutely recommend everybody check out the work that Charlotte LaSure
is doing and Tessa and all of her colleagues. I'm Emily Drashinsky called t
editor here at The Federalist. We'll be back soon with more. Until then,
be lovers of freedom and anxious for the friend, heard the fame by
the reason. Then it away.