ABC-Link.jpg

The Abortion-Breast Cancer Myth: A Cloaked Science Case Study

By
Irene Pasquetto and Jennifer Nilsen
Published on
May 17, 2021
Media Manipulation Tactics Used
Cloaked science
Misinfographics
Viral sloganeering
Date Range
1993 - Ongoing
Region
USA
Network Terrain
Blogs
Facebook
Instagram
Twitter
Websites
Attribution
Activists (attribution)
Partisans
Target
Scientific and medical community
Strategy
Distributed amplification
Vulnerabilities
Data void
Wedge issue
Observable Outcomes
Media exposure
Muddy the waters
Political adoption
Mitigation
Civil/private lawsuit
Critical press
Debunking
Research and investigation
Campaign Adaptation
Unclear or no observable adaptation

Overview

Since the 1970s, before there was an internet to spread , activists in the anti-abortion movement have promoted the falsehood that there is a link between abortion and breast cancer (which abbreviates to the viral slogan “ABC Link”). 

Anti-choice marketers have promoted this campaign for decades through the use of pamphlets, on social media, and in crisis pregnancy centers. Most recently and prominently, the ABC Link was adopted by members of the Trump administration.

This scare tactic has had enormous staying power, muddying the waters about the non-existent association while undermining the medical and scientific community’s consensus on the lack of link between abortion and breast cancer. In the internet era, this disinformation campaign is increasing in scale and finding new audiences.

Background

There is no causal link between abortion and breast cancer. Yet, the anti-abortion movement has campaigned on a false connection between the two since the 1970s. 

This decades-long campaign is formally based on a study connecting breast cancer and abortion conducted in Japan in 1957 by researchers Segi, Fukushima, Fujisaku, Kurihara, Saito, Asano, and Kamoi. The authors were hesitant about drawing strong conclusions since they recognized flaws in their methodology.1 It wasn’t until the 1980s that research focused specifically on this relationship.

Before the US Supreme Court legalized abortion in 1973, state laws regarding access to—and, in some cases, sharing information about—abortion differed throughout the United States. Abortion rights groups began drawing national support in the 1960s, formalizing the movement as NARAL in 1969.2 This growing social movement prompted a conservative backlash (and a decade later the reactionary “pro-life” anti-abortion movement).

The abortion debate did not fall along party lines until well after Richard Nixon’s 1968 presidential campaign. Prior to that, elected Republicans and Democrats voted against abortion in roughly the same numbers. In 1973, restrictions on abortion were standardized nationwide through Roe v. Wade. Abortion became a highly politicized wedge issue in the 1970s when Nixon signalled his opposition of abortion to win the votes of Catholics and social conservatives in his run for a second term.3 Polarization began as Republicans tried to portray themselves as “pro-family.”4 The arc of Ronald Reagan’s political career demonstrated this shift: he voted for expanded abortion access in 1967 as governor of California, but campaigned on appointing anti-abortion judges during his presidency from 1981-1989.5 It wasn’t until the end of his presidency that Gallup polls began to show consistently that more Democrats than Republicans were supportive of abortion access.6

In the 1970s and 1980s, breast cancer was reported to be on the rise, especially among two groups: liberal white women and young Black women. Both these groups were more politically supportive of abortions than other groups of women.7 In messaging to white and Black women specifically, the anti-abortion movement used the “ABC Link” (an abbreviation of “abortion-breast cancer link” that had become its popular nickname) as a rhetorical tool to explain what was often termed an “epidemic” of cancer among these two groups.8

This rise, however, was due in part to increased medical recording, media reporting, and mammography technologies for early detection.9

During the same period, evangelical Christianity and the anti-abortion movement rose in parallel. The Catholic church opposed abortion before Roe; after Roe, its members were “joined by increasingly militant, and increasingly numerous, Protestant fundamentalists dedicated to the anti-abortion cause”—showing the partisan positioning of the and increasing the number of anti-abortion messengers.10  

As the anti-abortion movement carried into the early-1990s, its tactics were violent, including clinic break-ins, bombings, and murders of physicians and clinic workers.12 In response, media attention and public support turned away from the movement.13 One narrative that seemed to push people away from the anti-choice movement was its apparent indifference to the health of mothers when discussing abortion.

During this period, the anti-abortion organization Life Dynamics took an active role in trying to rebrand the movement. It produced monthly videos, advocated for anti-abortion litigation, and put out a 1992 tactical manual (“Firestorm: A Guerrilla Strategy for a Pro-life America” by founder Mark Crutcher)14 that advised anti-abortion activists on how to appear “to work on behalf of women while opposing abortion.”15 The manual claimed that abortion activists “are evidently so accustomed to our arguments being focused only on the unborn baby, for us to voluntarily talk about the woman catches them totally off-guard.”16 The author of the manual, Crutcher, advises that “legislation should be sold as ‘pro-women’ and/or ‘consumer protection’ legislation.”17 This style of rhetoric would soon be adopted by a subset of the anti-abortion movement deploying the ABC Link campaign.

STAGE 1: Manipulation Campaign Planning and Origins

In 1993, anti-abortion activist and lawyer Scott Sommerville created, self-published, and sold a pamphlet titled “The Link Between Abortion and Breast Cancer.”18 The pamphlet was published by the Abortion Industry Monitor, an anti-abortion organization of which Sommerville was president.19 In it, he delineates between “our studies” and “the abortion industry’s studies.”20 The studies he claims as his own all employ either cloaked science (the use of scientific jargon and community norms to cloak or hide a political, ideological, or financial agenda within the appearance of legitimate scientific research) or methodologically flawed approaches to assert the ABC Link, which date back to the 1957 Segi et al. study. This pamphlet is still available for purchase and is circulated online.21

Sommerville’s main collaborator was Dr. Joel Brind, who has a PhD in Basic Medical Sciences, with a specialization in biochemistry, physiology and immunology, but no MD to practice medicine. He is a professor at Baruch College (a constituent college of the City University of New York system).22 Brind’s involvement with highlights that it is not a tactic employed by science deniers alone—scientists and academics sometimes push cloaked science, as well. When this kind of misinformation is given the imprimatur of legitimacy by a doctor or academic, it becomes even more influential. Throughout the 1990s, Brind and Sommerville spread medical misinformation on Christian radio, wrote for churches and anti-abortion publications, and sold Sommerville’s pamphlet.23 Of note, Brind’s name has become synonymous with the ABC Link disinformation campaign. Sommerville’s name is no longer associated with the movement, but the strategies he advised in his pamphlet have been implemented by anti-choice organizations.24

In 1993, the same year Sommerville’s pamphlet came out, there was early political adoption of the ABC Link. Michael Farris, a Republican candidate running to be Virginia’s lieutenant governor, “stated in interviews that part of his opposition to abortion was that it increased a woman’s risk of breast cancer.”25

As a result of the early ‘90s violence and  against abortion practitioners referenced in the background section of this case study, the Freedom of Access to Clinic Entrances Act was passed in 1994 and signed by President Bill Clinton.26 It prohibited obstruction, violence, and threats, but the law didn’t affect the “public education” practices of the movement, such as handing out pamphlets or putting up billboards. 

In 1996, Brind led a biased meta-analysis of 23 studies across 11 countries.27 In these studies, he found “a 30-percent increase in the risk of breast cancer attributable to” abortion.28 He continued his research at the Breast Cancer Prevention Institute, a private research institution that he founded in 1999 with Drs. Angela Lanfranchi (a surgeon), John T. Bruchalski (an OBGYN), and William L. Toffler (a physician and a professor). Since its establishment, the New Jersey-based Institute has been pushing the ABC Link.29 This team uses preprint servers, such as ResearchGate, to give legitimacy to their misleading studies.30

By 2001, 18 states introduced legislative measures to require breast cancer risk warnings when gathering informed consent from patients seeking an abortion.31 In tandem, public education campaigns across billboards, bus sideboards, and mall kiosks—all sponsored by anti-abortion organizations—warned about the risks of breast cancer “caused by” abortion.32
 
As early as 1996, abortion advocates and medical professionals attempted to mitigate the false claims by the ABC Link proponents. The first came in the form of a lawsuit filed by the Southeastern Pennsylvania Transportation Authority against anti-abortion activists who had advertised the ABC Link across billboards and subway posters. A federal judge condemned a subway poster for being “misleading” and “unduly alarming.”33

In 2002, a North Dakota abortion clinic attempted to counter the ABC Link campaign by distributing pamphlets that shared the accurate scientific conclusion that there was no link between breast cancer and abortion. Anti-abortion activists sued the clinic for “false ,” but lost. The judge ruled in favor of the clinic. The case was appealed, and the ruling was again in favor of the clinic. After the appeal, the clinic updated their pamphlets to include:34  

Some anti-abortion activists claim that having an abortion increases the risk of developing breast cancer. A substantial body of medical research indicates that there is no established link between abortion and breast cancer. In fact, the National Cancer Institute has stated, ‘[t]here is no evidence of a direct relationship between breast cancer and either induced or spontaneous abortion.’

Linda Rosenthal, a staff attorney with the Center for Reproductive Rights and lead counsel in the North Dakota case, stated: “This ruling should put to rest the unethical anti-abortion tactic of using pseudo-science to harass abortion clinics and scare women.”

But the court case did not end the cloaked science approaches that the anti-abortion movement used to spread medical disinformation. 

As cloaked science was used to justify the promotion of the link, scientists conducted major research studies repeatedly confirming that there was no link between breast cancer and abortion. A 1997 study published in The New England Journal of Medicine found “no association.”35 In 2003, the National Institutes of Health (NIH) criticized the flawed methodology used to claim the ABC Link. The NIH pointed to methodologically reliable studies, concluding that they “consistently showed no association between induced and spontaneous abortions and breast cancer risk.”36 A 2004 study reanalyzed 53 studies across 16 countries—studying a patient pool consisting of 83,000 women—and concluded that abortions “do not increase a woman's risk of developing breast cancer.”37 The study also criticized the methodology of “the studies of breast cancer with retrospective recording of induced abortion,” which the researchers wrote “yielded misleading results, possibly because women who had developed breast cancer were, on average, more likely than other women to disclose previous induced abortions.”38  

Nevertheless, in 2004, doctors were still regularly warning patients about the so-called risks of the ABC Link in many clinics across the US. Doctor-to-patient notification was law in Texas and Mississippi, and reportedly done voluntarily by health officials in Kansas and Louisiana.39 Rules about requiring the warning were debated and considered by state legislators in Georgia, Hawaii, Illinois, Iowa, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, North Carolina, Oklahoma, Vermont, Washington, and West Virginia.40

STAGE 2: Seeding Campaign Across Social Platforms and Web

These early 2000s legislative considerations coincided with the rising popularity of blogs, personal websites, and early social media. The anti-choice movement adopted the new technology of the internet to spread the movement’s messages—without friction—across the web. Its large web presence experienced little friction, was not illegal, and broadly represented the opinions of about half the population.41 The internet allowed and continues to allow for reinforcement of the movement’s history and offline activity.

As the internet became more accessible in the 2000s, the anti-abortion movement used it as additional terrain to spread medical misinformation. Like its offline presence, the anti-abortion movement online both advocates and deceives. It developed evangelical tools meant to reach people who are not looking for anti-abortion content. 

The ABC Link is seeded online by “pro-life” activists mainly via three specific mediums: social media accounts and webpages, crisis pregnancy centers, and private research institutes.

First, the ABC Link is seeded online via social media, , and news sites. “Pro-life” accounts, such as Colorado Campaign for Life (figure 1)42 and Pro-life America,43 use their social media platforms to perpetuate the ABC Link rumor. At the time of writing in May 2021, the online presences of major anti-abortion organizations were significant. The top pages include Students for Life of America (57.8K Twitter; 456K Facebook), Susan B. Anthony List (61.9K , 121K FB), National Right to Life (65.7K , 281K FB), Americans United for Life (22.3K Twitter; 55K FB), Pro-Life Action League (12.9K Twitter; 76.7K FB), LifeNews.com (218K Twitter; 987K FB), and Live Action (137K Twitter; 2.9M FB). Live Action was founded by anti-abortion influencer, Lila Rose, who has 217K Twitter followers and 889K Facebook followers. 

Figure 1: A Facebook post from Colorado Campaign for Life claiming the ABC link. Credit: TaSC.

Figure 1: A Facebook post from Colorado Campaign for Life claiming the ABC link. Credit: TaSC.

The Polycarp Research Institute,44 The Coalition on Abortion-Breast Cancer,45 Students for Life,46 Americans United for Life,47 Life Dynamics,48 and Susan B. Anthony List49 all include warnings about the ABC Link on their . Pro-Life Action League’s earliest blog promoting the disinformation campaign was posted in January 2003.50 A search on its site for “abortion breast cancer link” yields 26 posts on the rumor.51

LifeNews.com, which bills itself as “The Pro-Life News Source,” returns 336 links for a search of “abortion breast cancer link.”52 LifeNews headlines warn readers “Bombshell Study Finds 44% Increased Breast Cancer Risk for Women Having Abortions”53 and “Study Shows Highest-Ever Abortion-Breast Cancer Risk for Women.”54

Other sites are less direct. One such example is Teen Breaks, a website that obscures its mission, funder, and author in order to counsel its users away from abortion.55 As Jessie Daniels writes in “From Crisis Pregnancy Centers to Teenbreaks.com: Anti-Abortion Activism’s Use of Cloaked Sites,” “[t]he danger in a cloaked site of this type is that young girls or women might stumble upon the site through an Internet search for reliable reproductive health information.”56

Secondly, the ABC Link is seeded online by crisis pregnancy centers (CPCs). After Hawaii legalized abortion in 1967, the first crisis pregnancy center was established. These centers are often built near abortion clinics and designed to look deceptively like them.57 CPCs are usually affiliated with religious organizations, and they typically offer services (such as pregnancy tests), resources (diapers or baby clothes), and information or counseling with anti-abortion messages. By 2017, there were nearly three times as many CPCs as abortion clinics in the US.58

Some crisis pregnancy center websites list breast cancer as a health risk.60 A key aspect of most CPCs’ web presence is their online stores, with one prominent example being Care Source. Care Source is the retail and resource provider of Care Net, a CPC network that has been around since 1980. Its online shops have booklets and pamphlets—misinfographics, or graphics with misleading information—that misinform readers about false risks of abortion. In addition to selling resources to online shoppers, Care Net distributes these resources at its 1,100 CPC locations.61 These products promote the ABC Link through cloaked science—including referencing studies on the ABC Link that have been debunked.

Lastly, private research institutes, such as the Breast Cancer Prevention Institute (described above),62 seed the ABC Link online when they produce, organize, and curate “research material” that supposedly provides evidence of the validity of the link. Like Care Source, the Breast Cancer Prevention Institute also sells pamphlets that warn against the ABC Link. 

Private research institutes work in partnership with the pregnancy crisis centers, and their research is used by anti-abortion groups and the pregnancy crisis centers to “prove” the link. Their doctors and scientists organize public lectures, publish brochures and fact sheets, produce audio and video tapes, and disseminate educational and research material about the ABC Link. Their work continues to be foundational to the cloaked science efforts used to spread the ABC Link.

Like Care Source (figure 2) and the Breast Cancer Prevention Institute (figure 3), Life Dynamics (figure 4)63 —the anti-abortion organization that was at the forefront of the women-centered approach to anti-abortion messaging—sells pamphlets on its website espousing the ABC Link, often using outdated citations to support the link. All three sell their pamphlets in bulk, implying that their target market is organizations seeking to distribute their literature widely. 

Figure 2: A sample page of Care Net’s “Before You Decide” brochure linking abortion and breast cancer. Credit: TaSC.

Figure 2: A sample page of Care Net’s “Before You Decide” brochure linking abortion and breast cancer. Credit: TaSC.

Figure 3: References from a Breast Cancer Prevention Institute pamphlet. Note the early 1990s references, the studies where BCPI cites itself, and multiple citations from Brind. Credit: TaSC.

Figure 3: References from a Breast Cancer Prevention Institute pamphlet. Note the early 1990s references, the studies where BCPI cites itself, and multiple citations from Brind. Credit: TaSC.

Figure 4: The product description for Life Dynamic’s Lime 5. The description shows the book’s contents as well as its attempt to distribute the pamphlets widely by offering them in bulk and for free. Credit: TaSC.

Figure 4: The product description for Life Dynamic’s Lime 5. The description shows the book’s contents as well as its attempt to distribute the pamphlets widely by offering them in bulk and for free. Credit: TaSC.

STAGE 3: Responses by Industry, Activists, Politicians, and Journalists

Over the years, the ABC Link has been amplified through the healthcare industry, media exposure, celebrity promotion, , and the continued research attention it receives.

The Association of American Physicians and Surgeons—once referred to by the press as “the Tea Party’s favorite doctors”64 —has promoted the ABC Link.65 Their endorsement of it—along with that of Dr. Brind, who published the original pamphlet on the ABC Link and Dr. Lanfranchi, co-founder of the Breast Cancer Prevention Institute—again demonstrates that members of the push the link, despite scientific evidence against it. 

With the release of each new study about the ABC Link comes articles about it, amplifying the research to a broader audience. For example, in 2013, a study conducted in China reasserted the ABC Link. Conservative press gave the study—and the link itself— by covering the research uncritically.66

The ABC Link has also been boosted by conservative, anti-abortion , such as Fox News host Tucker Carlson, radio firebrand Rush Limbaugh, and activist Lila Rose. Carlson endorsed it on The Daily Caller after a 2011 study again claimed a connection.67 Limbaugh warned his listeners in 2012 about a 2007 study supporting the ABC Link.68 Of note, as anti-choice advocates continued to search for evidence of the ABC Link, studies the link continued. For example, a 2007 study of over 100,000 patients found no association.69 Rose, whom The Atlantic calls “the face of the millennial anti-abortion movement,”70 has used her social media platforms to promote the ABC Link to her 217.1K Twitter followers and 889K Facebook followers.

When John Oliver debunked the ABC Link on his show Last Week Tonight in 2018 (the episode has 5.5M+ views on ),71 Rose tweeted at him that “misleading [his] viewers about these potential and undisputed abortion risks is dishonest and wrong” (figure 5).72

Figure 5: Influencer Lila Rose tweeting at John Oliver after he discussed abortion misinformation on his show. Credit: TaSC.

Figure 5: Influencer Lila Rose tweeting at John Oliver after he discussed abortion misinformation on his show. Credit: TaSC.

In addition to the coverage that the ABC Link receives through influencers and news coverage, it has become state law five times over, was mentioned in response to various proposed laws, and remains a belief of political appointees. 

The Women's Health Protection Act of 2013,73 introduced by Senator Blumenthal (D-Connecticut), argued that state legislatures did not have the power to restrict abortion access. At a hearing in the Senate Judiciary Committee considering the act, Representative Diana Black (R-Tennessee) used the ABC Link to criticize the bill.74

By 2015, Alaska, Kansas, Louisiana, Oklahoma, and Texas formalized political adoption of the pseudoscience in requiring by law that doctors must warn women who want to get an abortion about the ABC Link and requiring women to sign a consent form about the risk. As of March 1, 2021, all five states still require this biased counselling.75

In 2016, an official State of Texas booklet (pamphlet) titled “A Woman’s Right to Know” pushed the ABC Link (figure 6). It has been widely debunked, but it is still in circulation by the Texas Department of State Health Services.76

Figure 6: The cover of “A woman’s right to know,” the pamphlet actively available online and distributed by Texas’ Health and Human Services department. Credit: TaSC.

Figure 6: The cover of “A woman’s right to know,” the pamphlet actively available online and distributed by Texas’ Health and Human Services department. Credit: TaSC.

The next year, President Donald Trump appointed vocal ABC Link proponent Charmaine Yoest as the assistant secretary for public affairs in the Department of Health and Human Services in May 2017.77 Marjorie Dannenfelser, president of the anti-abortion Susan B. Anthony List, has called Yoest “one of the pro-life movement’s most articulate and powerful communicators.”78

Indicating even more political adoption, on May 29, 2019, ABC Link promoter Wendy Vitter began her lifetime appointment in the United States District Court for the Eastern District of Louisiana. At the 2013 Louisiana Needs Peace Conference, she spoke on a panel titled “Abortion Hurts Women,” and she encouraged distributed amplification of the ABC Link theory. As Vanity Fair and NPR reported, she told the audience:79  

Go to Dr. Angela [Lanfranchi]'s website, Breast Cancer Prevention Institute, download it, and at your next physical, you walk into your pro-life doctor and say, 'Have you thought about putting these facts or this brochure in your waiting room?' Each one of you can be the pro-life advocate to take that next step. That's what you do with it.

The Breast Cancer Prevention Institute is the private research institute founded in 1999 by Brind and “Dr. Angela,” as Vitter calls her. Vitter’s comments as a panelist resurfaced in her confirmation hearing.80 Dr. Lanfranchi was questioned by then-Senator Kamala Harris during Vitter’s confirmation hearings.81 Susan Collins was the only Senate Republican who did not support her nomination,82 and Vitter was confirmed. 

STAGE 4:  

The ABC Link has been repeatedly debunked and fact-checked. The American College of Obstetrics and Gynecology,83 the American Cancer Society,84 WebMD,85 the National Cancer Institute,86 and the Susan G. Komen Foundation87 have all issued statements refuting the ABC Link disinformation. 

In the style of the anti-abortion pamphlets, Planned Parenthood offers a fact sheet on why the ABC Link is a myth.88

Activists and organizations have worked to repeatedly demonstrate the falsehood of the link over the decades through reports, public education campaigns, and social media posts. For example, reproductive justice organizations, such as NARAL,89 the National Abortion Federation,90 and the Guttmacher Institute,91 have regularly tweeted that there is no evidence that abortion and breast cancer are connected. 

Figure 7: A NARAL tweet with an American Cancer Society link debunking medical misinformation about abortion. Credit: TaSC.

Figure 7: A NARAL tweet with an American Cancer Society link debunking medical misinformation about abortion. Credit: TaSC.

Critical press has also emphasized that there is no connection between breast cancer and abortion. The New York Times,92 NPR,93 The Atlantic,94 Slate,95 and The Washington Post96 all have articles repudiating the link. 

In addition to national publications, this claim has been debunked via local news. The Colorado Times Recorder debunked the medical misinformation spread on Facebook by the Colorado Campaign for Life,97 the Jackson Free Press explained that there is no ABC Link—despite what the local CPC was telling people,98 and the Reno Gazette Journal wrote a fact-check article after an email from Nevada Right for Life led to an AM radio appearance by Dr. Brind.99

Snopes has a general fact-check, and PolitFact published an article after Ohio State Rep. Ron Hood included a reference to the ABC Link in legislation.100 PolitiFact also published an article on the falsehoods in Texas’ 2016 pamphlet.101 The Washington Post’s Fact Checker published an article on the same pamphlet.102

Media Matters has a special project on abortion rights and reproductive health. Within this project, they have published articles on the ABC Link debunking Limbaugh’s promotion of it,103 adding the context that The Washington Post omitted when fact-checking statements by Yoest (context that would have given evidence to why the link is false),104 and debunking Carlson’s promotion of the ABC Link.105

According to January 2020 Boston Globe reporting, NewsGuard and NewsWhip, partner organizations that measure social media engagement and news site reliability, gave a red check—an indicator of unreliability—to LifeNews.com, an aforementioned anti-abortion website. Despite its lack of credibility, it had a higher engagement rate (measured by shares on Facebook, Twitter, and Pinterest) in December 2019 in the US than the Chicago Tribune, the Detroit Free Press, or the Dallas Morning News.106

Despite all these fact-checks, social media platforms have taken no actions to mitigate the spread of the ABC Link disinformation campaign, as far as we can find. Anti-abortion organizations continue to promote the link on their social media accounts. Twitter, Pinterest, Instagram, and Facebook all host posts about the link. Searching these social media platforms for information on the ABC Link returns tweets, pins, and posts that have not been moderated. 

Facebook has blocked some anti-abortion ads,107 but the content of those advertisements was unrelated to the ABC Link. The ABC Link remains unmitigated on Facebook. Ahead of Ireland’s referendum of its Eighth Amendment (which legalized abortion in 2018), ads promoting the ABC Link were not removed (for clarity: Facebook gets paid to host such ads).108

During the coronavirus pandemic, major social media platforms have all updated their policies on health disinformation. While Twitter, Facebook, and have tailored their rules to specifically attempt to slow the spread of COVID-19 disinformation, Pinterest’s medical misinformation policy is more broad, including any medical misinformation that could pose a threat to a person’s health or public safety, which would appear to apply to posts about the ABC Link.109 However, pins about the link on the site remain unmitigated. Amazon has not mitigated the campaign to promote the link either, and the retailer continues to profit from the medical misinformation by selling books such as Breast Cancer: Its Link to Abortion and the Birth Control Pill.110

Activists have tried to use hashtags on social media to mitigate the spread of medical misinformation around the ABC Link, with campaigns like #ExposeFakeClinics.111 This campaign involved investigations of CPCs across the country. An investigation in New York City conducted112 and another in California113 (both conducted by NARAL) have reported malpractices and misinformation at CPCs—including their promotion of the ABC Link.

Two states, Minnesota and Mississippi, correctly counsel those seeking abortions that there is no link between abortion and breast cancer.114 Both states used to misinform patients about the ABC Link,115 but corrected their approach as the research evolved.116

STAGE 5: Adjustments by Manipulators to New Environment 

This disinformation campaign to use cloaked science to claim that abortion causes breast cancer has has largely not adapted over the decades. It has not needed to, since it has been largely unmitigated. The claim was again in the news last September when former Vice President Mike Pence visited a CPC in North Carolina that promotes the ABC Link, as part of his “pro-life” campaign tour. This tour was an attempt to galvanize anti-abortion votes in swing states. On the campaign trail, Pence repeated his belief that Trump is “the most pro-life President in American history.”117 His tour represented the first time a sitting vice president visited a CPC.118 This—along with his frequent, vocal, and consistent support of anti-abortion policies—was seen as a victory for and by the movement.

The CPC he visited, Gateway Women's Care, is among the most vocal centers in seeding and promoting the ABC Link online and offline, and its website directly warns about the ABC Link. Gateway attempts to directly influence college students in particular. It has two locations in North Carolina, both of which are in college towns: Raleigh and Durham. In a section of its website called “Our Uniqueness,” Gateway describes itself as being “strategically located” and lists 11 universities that it targets.119

On this “tour,” Pence also participated in a round table co-organized by the Gateway Women’s Center and an anti-abortion group in a local church in which he mainly talked about the anti-choice agenda in Congress.

President Biden signed a memorandum on January 28, 2021 that reversed Trump/Pence abortion restrictions in the US and internationally.120

Conclusion

The ABC Link offered the anti-choice movement a “women-centered,” nonviolent strategy that put the health of women—not of the fetus—at the center of the debate. In “Breast Cancer and the Politics of Abortion in the United States,” Patricia Jasen writes that “[t]he initial focus on fetal rights appeared to disregard the needs and rights of women and lost support as a result. But the focus on the ABC Link presents itself as protective, sympathetic, forgiving, and ready to help the women suffering psychological or physical hardship resulting from abortion.”121

This focus fit within public health conversations in the 1990s, which was awash with “[h]ighly visible public and medical concern about the prevention and cure of breast cancer. This provided a context within which anti-abortion advocates’ warnings could gain significant attentions. Anti-abortion advocates have worked to identify abortion as a dangerous medical procedure that women should both fear and blame in relation to breast cancer.”122 Further, physicians could not guarantee that any action—beyond reproductive choice and extending to exercise or specific diets—would or wouldn’t cause breast cancer. As such, physicians could not 100% rule out any correlational connections, despite having reason to believe personal choices were not causal. This uncertainty created a data void filled by the ABC Link.123

The ABC Link is supported by cloaked science. The proponents of the ABC Link often point at scientific literature and data that according to them show that the ABC Link is valid or at least possible. The table below breaks down the tactics of cloaked science and how they were used to strengthen the argument that the ABC Link is real.

Further, ABC Link advocates take the few studies that suggest a link, remove them from their context, do not mention the biases in them, and present them as definitive. By using this pseudo-conclusion, the anti-abortion movement muddied the waters around the risk of abortion. This shows the power that “ABC Link” has had as a viral slogan. It has made the connection between abortion and breast cancer part of a conversation common within the public and medical spheres.

TACTICS OF CLOAKED SCIENCE

Action 

Example

Referencing an outdated study

Pamphlets that include citations before 1997 (in that year, The New England Journal of Medicine published research concluding “no association”)124

Referring scientific data/evidence in a misleading way

“Our studies” vs. “Their studies”

Avoiding to report on methodological flaws

Retrospective case-control studies

Publishing original research via biased meta-analysis

Dr. Brind’s 1996 study

 

This table breaks down the tactics of cloaked science and how they were used to strengthen their argument that the ABC Link is real. Although a few studies found some evidence of the link, these studies all have significant methodological flaws—and the studies’ authors themselves are cautious in presenting the link as real. For example, 99% of pro-link studies are case-control, retrospective studies which suffer from “recall bias:” women were asked to report about an abortion after they were diagnosed with cancer, and their answers were then compared to women who did not have cancer. Women who had cancer were more likely to admit that they had an abortion, though it is not clear why. In contrast, cohort studies and studies that used records to determine the history of abortions have not found an increased risk.

  • 121Jasen, “Breast Cancer and the Politics of Abortion in the United States.”
  • 122Harthorn and Oaks, Risk, Culture, and Health Inequality: Shifting Perceptions of Danger and Blame.
  • 123Harthorn and Oaks.
  • 124Mads Melbye et al., “Induced Abortion and the Risk of Breast Cancer,” New England Journal of Medicine 336, no. 2 (January 9, 1997): 81–85, https://doi.org/10.1056/NEJM199701093360201.

Cite this case study

Irene Pasquetto and Jennifer Nilsen, "The Abortion-Breast Cancer Myth: A Cloaked Science Case Study," The Media Manipulation Case Book, August 12, 2021, https://casebook-static.pages.dev/case-studies/abortion-breast-cancer-myth-cloaked-science-case-study.