You could hear the groans from coast to coast. "Welcome to the Middle Ages — or earlier," said one email in my inbox. You've surely heard it all by now: Rep. Todd Akin’s unspeakably (except it wasn't unspeakable for him) offensive remark about how woman who are the victims of "legitimate rape” can purportedly "shut down" somehow to prevent pregnancy.
Akin has been appropriately bashed and battered all over the media. The Planned Parenthood League of Massachusetts just sent over a statement from its president, Dianne Luby: “Congressman Todd Akin’s misinformed statements on women’s health are astonishing and downright offensive. For an elected U.S. Representative and Senate candidate to be so ill-informed about 51% of the country’s population is alarming and perfectly illustrates why politicians should not be allowed to decide what kind of health care a woman can and can’t have." There are now calls for him to be removed from the House Science, Space and Technology Committee. (Yes, he was really on a science committee.)
[module align="right" width="half" type="pull-quote"]'There's no biologic plausibility to that theory.'[/module]
But I wanted to hear it from a primary source: Is Akin's bizarre statement as utterly lacking in factual foundation as it certainly seems to be? I spoke with Dr. Erin Tracy, an obstetrician and gynecologist at Massachusetts General Hospital and an assistant professor at Harvard Medical School. Our conversation, lightly edited, follows, but the short answer to my question is: Yes. Utterly lacking.
Dr. Tracy: I saw that The New York Times quotes a physician who tried to lend some credibility to the theory that there is impaired fertility in the case of extreme stress which is rape, but that is absolutely not the case. There's no biologic plausibility to that theory and there’s no evidence that there are decreased fertility rates in that setting.
Yes, I saw that your Mass. General colleague, Dr. Michael Greene, said in The Times, "It is just nuts."
I actually posted that on Facebook. The reality is that if someone has ovulated and the egg is sitting there and the sperm can get to it, then pregnancy is possible. So whether that sperm has arrived via a criminal assault such as a rape or from consensual sex, that woman has a possibility of getting pregnant. There’s no difference.
My one question is: We do hear a lot about how when women are trying to get pregnant, they're told that they should try to relax and that will help their chances. Wouldn't the corollary be that high stress hurts fertility?
The theory behind that advice is that high levels of stress can potentially impair ovulation, but in the setting of a rape, that is irrelevant. If someone has sex they could possibly get pregnant within 72 hours, and if they've already ovulated they can get pregnant. With prolonged periods of stress you can be affected because of the response to stress hormones over time, but that is not applicable in the setting of a rape.
Should we mention the emergency contraception Plan B here? The way of shutting down a woman's fertility that is actually known to work?
There are ways to prevent pregnancy after sex and Plan B is one of those ways. But I think the comments made about the physiology of pregnancy happening is sort of a secondary issue. We know that works. The media coverage has been so profound because the comments were so offensive. There is no such thing as 'legitimate' vs. 'illegitimate' rape, there are no degrees of correctness for rape, it’s all horrendous. Rape is forcible by definition.
The comments seemed to highlight some amazing ignorance about the body. Apparently there's a whole school of thought behind Akin's theory.
There's no debate about this in the scientific community that I've ever seen. I've never seen any credible data arguing for this theory. There are many political ideologies that influence people's interpretation of scientific principles and there are certain things one could challenge. But when pregnancy occurs is very clearly understood and should not be subject to political interpretation. We know when pregnancies happen. People try to spin things to support their own political positions, but that's not a reasonable thing to do in the context of understanding physiology.
This program aired on August 21, 2012. The audio for this program is not available.