Agree there have been fewer births, although the drop is in line with the trend that was playing out in Scotland since around 2010. In fact it looks like 2022 was a little better than what we would have expected against that trend.
But I think we're really early in the consequences of this - not only in terms of the healthcare and social consequences of COVID, but births are often also an economic factor, and the cost impact of COVID is still to properly land. When it does that is another huge bout of pressure on people, thinking of families. That's even if assuming zero adverse consequences from the gene therapies, which is far from proven to be the case.
yeah and if the spike stays in the body long term which looks to be the case and trasnfers from the breast-milk what will be the consequences of that ? Children of men.
Definitely intriguing how the first dramatic rise starts almost before the lockdown period in 2020. Perhaps there was a protocol in place prior to lockdown whereby the hospitals had started encouraging terminations. Alternatively, this may correlate with winter flu injections which I guess pregnant women are encouraged to take. Nevertheless this is a significant warning signal that has been ignored. In a caring system this should trigger a reasonable health system to step up their monitoring and report accordingly. But clearly they have failed in their duty as they have not reported, commented or acted on this matter.
Agree that first spike seems strange. Bearing in mind these are medical terminations, if anything should we not expect these to initially spike down, as hospitals were instructed to do nothing else except COVID treatment / preparation for COVID treatment. However PHS commentary makes clear that termination services continued throughout, and specifically noted "Over March and April 2020, around 500 more terminations than would have been expected based on pre-pandemic average levels were provided in Scotland. This is likely to reflect a higher proportion than usual of women who found they were pregnant at the start of the COVID-19 pandemic in Scotland choosing not to continue with their pregnancy"
So there was a 'rush' on terminations as a consequence of the propaganda surrounding the pandemic ('propaganda' is a pejorative term, but can't think of anything that fits better!).
I wondered about lack of or perceived lack of access to contraception in early 2020 accounting for more unwanted pregnancies, but that doesn't explain the later rise.
It is easier now to arrange a termination of pregnancy, through the Early Medical Abortion at Home legislation https://www.gov.scot/news/early-medical-abortion-at-home-1/ and as more people become aware of this option it might lead to a rise in requests, as self-referral now. Hopefully not being used as an alternative to contraception. Presumably someone somewhere will be analysing the reasons for this rise. I think economic uncertainty will be playing a part.
From discussing with those well-versed in the field we came to the same conclusion as you - it seems termination is rarely if ever declined these days. But that has been the situation for quite some time, it's not new post-covid. And we have an ongoing decline in births, which means terminations (as a percentage of all initial pregnancies) will be quite notably higher. For now the most likely hypothesis seems the one you mentioned, that economic uncertainty playing a part. The only thing which doesn't feel right about that hypothesis is that the biggest increase is happening in (i) the less deprived, and (ii) the older groups. If that were reversed it would seem to point more toward economic uncertainty, but those groups should in theory be the ones with highest economic stability. So do think that's the most likely explanation, but those two facets don't feel right.
Women in the Pfizer trials were told not to get pregnant although some did and the outcomes were not good. It entered my head that women who were recently vaccinated and then became pregnant may be concerned that the vaccination may have a negative affect on their pregnancy but I doubt this is a likely explanation. List young people I know who took it - often quite eagerly - seemed to hold no reservations about it at all.
Hadn't thought about the possibility of concern arising later. It's hard to be in touch with that, but it doesn't feel like that level of concern exists, do you think? Like you, it seemed that so many people just proceeded with no reservations or considerations at all.
I'd guess this is mostly driven by relationship stress and material insecurity in the category of professional women in their later 20's to later 30's: a group of women who will not proceed with a pregnancy unless they have a stable and secure relationship and a steady job.
Lots of evidence of mental health issues in the lockdown, with other stress indicators sky high.
So, this one is a head scratcher! Immediately, I was heading to the 'shots = problematic pregnancy = termination' but then the early terminations (pre any clinical diagnosis) seem to rule this out. Could the shots be interfering with contraceptives? Are more women falling pregnant unexpectedly, giving rise to an increase in early termination? That's my 'thinking out loud' thought, for what it's worth!
It's hard not to go there when so little (i.e. zero!) trials were done in pregnancy, and it's a cast-iron law that we never experiment with medical interventions in pregnancy. But better not go there, or we could write a book!
But the thinking does take you there, and were trying to be very careful in writing to be very fair (and these data - while the inflection comes post-vaccine - don't obviously suggest that as a cause). Interfering with contraception - had never considered that. Far from an expert on that, but oral contraception is essentially an ongoing feed of estrogen - so if something was to interfere with estrogen pathways in the body perhaps that could happen. But if it were the case would expect to see that in multiple countries (which we haven't checked if that's the case), and probably an increase in the number of births (there should be notably more pregnancies, of which a proportion would choose to terminate)?
May need to try and get data for other countries, see if they see anything similar.
There are already common drugs that interfere with the effectiveness of hormonal contraceptions. At a glance, the top offenders are antibiotics, seizure meds, antidepressants, antifungals, some meds for diabetes and high blood pressure, common-ish supplements such as soy isolates and St. John's Wort (which interferes with everything), and anti-nausea meds.
So... the idea that a totally experimental medical treatment might interfere with hormonal contraception is not even a little bit farfetched.
...also: "essentially an ongoing feed of estrogen" is not accurate. It's an ongoing feed of hormones, yes. Can be either progesterone-only ("minipill" varieties), or progesterone + estrogen (more effective, more side effects).
But IIRC the main thing is that it overrides natural hormonal cycles so that you're basically flatlined in something that resembles that last two weeks of a normal cycle-- where you're no longer fertile, but could be pregnant. Anything that tips the balance even a little may allow the natural program of ovulation to resume-- even changing from one birth control pill to a different one.
Thanks for the mention. A very interesting observation. Agreed it makes no sense that over 30's women would be the group that would be driving the excess terminations nor the most affluent. And there is something a bit odd about the weeks too... The orange bars are smaller than the equivalent bars before covid. I can't explain why this should be but it raises concerns about data integrity.
It is odd, and that's a very good spot on the orange bars, those are so small hadn't picked that up. Added a stacked line chart so that >12 weeks is on the bottom, and those trends can be more easily seen. >12 weeks (and 10-12 weeks) saw a trend up in early 2020, dropped thereafter, and was below normal until late 2021 when returning to 'normal'. <10 weeks is the one that has seen the ongoing and prolonged rise.
It's a strange set of data, and we'll try to dig into some more.
Thanks the line chart is a good visualisation. So there is a sustained drop in that 10-12 week band, which is strange. Did the deprivation data only go up to 2020? That's weird too.
If the data is correct (an assumption) - the increase in terminations in the under 10 week age group is not consistent with a teratogenicity increase (which would only ever be numerically small). In which case there would have to be an alternative explanation.
I would theorise then that an explanation could be that women couldn't get to their doctor for contraception, because the doctors were living in fear. However that should have dissipated over the time.
Do you think that first spike could have been caused by some indirect feature of lockdowns, such as people in the service industries being out of work? I'd love to see a breakdown by income on that.
It could potentially be. Ran the data on that and the extent of change does follow the SIMD. Most deprived was up 23%, least deprived by 12%, and the others falling in between. Updated the post to add that chart to the bottom.
Agree there have been fewer births, although the drop is in line with the trend that was playing out in Scotland since around 2010. In fact it looks like 2022 was a little better than what we would have expected against that trend.
But I think we're really early in the consequences of this - not only in terms of the healthcare and social consequences of COVID, but births are often also an economic factor, and the cost impact of COVID is still to properly land. When it does that is another huge bout of pressure on people, thinking of families. That's even if assuming zero adverse consequences from the gene therapies, which is far from proven to be the case.
There feels a long way to go on this yet.
yeah and if the spike stays in the body long term which looks to be the case and trasnfers from the breast-milk what will be the consequences of that ? Children of men.
https://odysee.com/@jeremypoole:b/2023-03-10-11-29-47:a
Definitely intriguing how the first dramatic rise starts almost before the lockdown period in 2020. Perhaps there was a protocol in place prior to lockdown whereby the hospitals had started encouraging terminations. Alternatively, this may correlate with winter flu injections which I guess pregnant women are encouraged to take. Nevertheless this is a significant warning signal that has been ignored. In a caring system this should trigger a reasonable health system to step up their monitoring and report accordingly. But clearly they have failed in their duty as they have not reported, commented or acted on this matter.
Agree that first spike seems strange. Bearing in mind these are medical terminations, if anything should we not expect these to initially spike down, as hospitals were instructed to do nothing else except COVID treatment / preparation for COVID treatment. However PHS commentary makes clear that termination services continued throughout, and specifically noted "Over March and April 2020, around 500 more terminations than would have been expected based on pre-pandemic average levels were provided in Scotland. This is likely to reflect a higher proportion than usual of women who found they were pregnant at the start of the COVID-19 pandemic in Scotland choosing not to continue with their pregnancy"
So there was a 'rush' on terminations as a consequence of the propaganda surrounding the pandemic ('propaganda' is a pejorative term, but can't think of anything that fits better!).
I wondered about lack of or perceived lack of access to contraception in early 2020 accounting for more unwanted pregnancies, but that doesn't explain the later rise.
It is easier now to arrange a termination of pregnancy, through the Early Medical Abortion at Home legislation https://www.gov.scot/news/early-medical-abortion-at-home-1/ and as more people become aware of this option it might lead to a rise in requests, as self-referral now. Hopefully not being used as an alternative to contraception. Presumably someone somewhere will be analysing the reasons for this rise. I think economic uncertainty will be playing a part.
From discussing with those well-versed in the field we came to the same conclusion as you - it seems termination is rarely if ever declined these days. But that has been the situation for quite some time, it's not new post-covid. And we have an ongoing decline in births, which means terminations (as a percentage of all initial pregnancies) will be quite notably higher. For now the most likely hypothesis seems the one you mentioned, that economic uncertainty playing a part. The only thing which doesn't feel right about that hypothesis is that the biggest increase is happening in (i) the less deprived, and (ii) the older groups. If that were reversed it would seem to point more toward economic uncertainty, but those groups should in theory be the ones with highest economic stability. So do think that's the most likely explanation, but those two facets don't feel right.
Women in the Pfizer trials were told not to get pregnant although some did and the outcomes were not good. It entered my head that women who were recently vaccinated and then became pregnant may be concerned that the vaccination may have a negative affect on their pregnancy but I doubt this is a likely explanation. List young people I know who took it - often quite eagerly - seemed to hold no reservations about it at all.
Hadn't thought about the possibility of concern arising later. It's hard to be in touch with that, but it doesn't feel like that level of concern exists, do you think? Like you, it seemed that so many people just proceeded with no reservations or considerations at all.
I'd guess this is mostly driven by relationship stress and material insecurity in the category of professional women in their later 20's to later 30's: a group of women who will not proceed with a pregnancy unless they have a stable and secure relationship and a steady job.
Lots of evidence of mental health issues in the lockdown, with other stress indicators sky high.
But its just a guess.
So, this one is a head scratcher! Immediately, I was heading to the 'shots = problematic pregnancy = termination' but then the early terminations (pre any clinical diagnosis) seem to rule this out. Could the shots be interfering with contraceptives? Are more women falling pregnant unexpectedly, giving rise to an increase in early termination? That's my 'thinking out loud' thought, for what it's worth!
It's hard not to go there when so little (i.e. zero!) trials were done in pregnancy, and it's a cast-iron law that we never experiment with medical interventions in pregnancy. But better not go there, or we could write a book!
But the thinking does take you there, and were trying to be very careful in writing to be very fair (and these data - while the inflection comes post-vaccine - don't obviously suggest that as a cause). Interfering with contraception - had never considered that. Far from an expert on that, but oral contraception is essentially an ongoing feed of estrogen - so if something was to interfere with estrogen pathways in the body perhaps that could happen. But if it were the case would expect to see that in multiple countries (which we haven't checked if that's the case), and probably an increase in the number of births (there should be notably more pregnancies, of which a proportion would choose to terminate)?
May need to try and get data for other countries, see if they see anything similar.
There are already common drugs that interfere with the effectiveness of hormonal contraceptions. At a glance, the top offenders are antibiotics, seizure meds, antidepressants, antifungals, some meds for diabetes and high blood pressure, common-ish supplements such as soy isolates and St. John's Wort (which interferes with everything), and anti-nausea meds.
So... the idea that a totally experimental medical treatment might interfere with hormonal contraception is not even a little bit farfetched.
...also: "essentially an ongoing feed of estrogen" is not accurate. It's an ongoing feed of hormones, yes. Can be either progesterone-only ("minipill" varieties), or progesterone + estrogen (more effective, more side effects).
But IIRC the main thing is that it overrides natural hormonal cycles so that you're basically flatlined in something that resembles that last two weeks of a normal cycle-- where you're no longer fertile, but could be pregnant. Anything that tips the balance even a little may allow the natural program of ovulation to resume-- even changing from one birth control pill to a different one.
Thanks for the mention. A very interesting observation. Agreed it makes no sense that over 30's women would be the group that would be driving the excess terminations nor the most affluent. And there is something a bit odd about the weeks too... The orange bars are smaller than the equivalent bars before covid. I can't explain why this should be but it raises concerns about data integrity.
It's a bit odd isn't it?
It is odd, and that's a very good spot on the orange bars, those are so small hadn't picked that up. Added a stacked line chart so that >12 weeks is on the bottom, and those trends can be more easily seen. >12 weeks (and 10-12 weeks) saw a trend up in early 2020, dropped thereafter, and was below normal until late 2021 when returning to 'normal'. <10 weeks is the one that has seen the ongoing and prolonged rise.
It's a strange set of data, and we'll try to dig into some more.
Thanks the line chart is a good visualisation. So there is a sustained drop in that 10-12 week band, which is strange. Did the deprivation data only go up to 2020? That's weird too.
If the data is correct (an assumption) - the increase in terminations in the under 10 week age group is not consistent with a teratogenicity increase (which would only ever be numerically small). In which case there would have to be an alternative explanation.
I would theorise then that an explanation could be that women couldn't get to their doctor for contraception, because the doctors were living in fear. However that should have dissipated over the time.
It's odd.
Do you think that first spike could have been caused by some indirect feature of lockdowns, such as people in the service industries being out of work? I'd love to see a breakdown by income on that.
It could potentially be. Ran the data on that and the extent of change does follow the SIMD. Most deprived was up 23%, least deprived by 12%, and the others falling in between. Updated the post to add that chart to the bottom.
Thanks! It's amazing that data's even available!