Health literacy linked with safe and successful self-induced abortions in Lagos state, Nigeria

Recently, we published a blog post about our paper “Sexual and Reproductive Health Literacy, Misoprostol Knowledge and Use of Medication Abortion in Lagos State, Nigeria: A Mixed Methods Study” in the FemQuant blog.

Please click here to read the post, which summarises some of the main results of our study.


How to define top journals in social science? The example of demography.

Inspired by a blog post by Patrick Dunleavy about citation practices in different disciplines I wanted to update my understanding of which journals belong to the top of my discipline, demography.

Traditionally I have checked this using the impact factor scores listed in ISI Web of Social Science’s Journal Citation Reports under group “Demography”. I knew that impact factor is in fact quite a bad indicator of a journal’s prestige, but I kept focusing on that anyway. I simply assumed that everyone else was doing that as well and thus the socially constructed understanding of which journals are the best ones would be based on impact factor rankings despite its problems. As a young researcher I have to be constantly thinking about my CV and I thought submitting to journals that rank high on this indicator would impress a potential employer reading my list of publications.

However, Professor Dunleavy wrote that anyone still looking at impact factors is “mathematically ignorant”, whereas h-indices listed in Google Scholar’s Metrics are “robust and meaningful average indicators”. In addition, he said that coverage of social science journals is much better in Google’s than ISI Web’s database. Consequently, I decided to see what Google Metrics had to say about demography.

Unfortunately Google Metrics does not have a subcategory for demography, so I was only left guessing whether the coverage actually is any better in my discipline. Instead, I decided to search for the top 20 journals listed by ISI Web and see what happens to the rankings when h-index is used instead of impact factor.

The table below shows that regardless of the metric the top two journals in demography are Demography and Population and Development Review. There is more variation in the raking of other journals, for instance the open source Demographic Research’s rankings vary from 5 to 11 and the London based Population Studies’ from 8 to 17.


So, what did we learn from all this? Where should I submit my next article? I guess we are still in search of the perfect metric and journal database, but the results seem to be fairly robust at least when it comes to the few journals at the very top of the rankings.

If one wants to maximise the h-index/impact factor of their publications, and happens to work in an interdisciplinary field like demography, they’re probably better of publishing in journals listed under other disciplines, such as sociology (e.g. American Sociological Review has H5 index of 47) or epidemiology (e.g. H5 of American Journal of Epidemiology is 73).

I guess in the end it all comes down to varying citation traditions discussed in Dunleavy’s blog post. Perhaps we all should just start vigorously citing research published in our field?

How research becomes populism – Abortion debate in the Finnish Parliament

Liberal abortion legislation was introduced in Finland in 1970. Every now and then, there is discussion regarding, whether the law should be changed in any way. Some would like to see a day, when abortion is available on request (as in Sweden for instance) and others wish to make it more difficult to obtain abortions.

Recently, a few members of parliament from the Christian party, the Centre party and the True Finns party suggested that the legislation should be changed  so that medical doctors and other hospital personnel should be given a right to refuse performing abortions, if that’s against their conviction.

Last Thursday, the parliament discussed the suggestion. Quite rapidly the discussion shifted from the rights of hospital staff into whether abortions are morally justified. An MP from the True Finns party, Mika Niikko, referred to a study showing that more than 50 percent of the women, who went through a termination of pregnancy were depressed a year after the termination and that two percent suffered from severe depression. Later he tells that the study was conducted by “a researcher called Söderberg” and also mentions that there is a Finnish study by Gissler, Hemminki and Lönnqvist that found the risk of suicide being three times higher for women, who had had an abortion, compared to the women, who had a childbirth.

Given that I have worked on abortion-related topics for a while, the results of the studies seemed somewhat surprising to me and I decided to track down these papers. Since the citations are not more specific than what I’ve described above, I cannot be sure I found the right papers, but I managed to identify two, which fit the criteria (Söderberg et al.; Gissler et al.). After having looked at the results of these studies, I have to say I’m quite concerned about the relationship between academic research and policy making.

The paper by Söderberg and colleagues is a study of 854 women, who had had an abortion in Malmö, Sweden in 1989. The researchers identified a case group of 139 women that had experienced emotional distress and doubts regarding abortion decision and compared them to a control group of 114 women not having these feelings. Given that I only have access to an not-so-clearly-written abstract rather than a full text, I cannot say much about the study design, but the conclusions of the study are clear: the researchers identified risk factors of experiencing emotional distress (such as poor support from family and friends and underlying ambivalent attitude to abortion) and state “[t]he risk factors identified suggest that it may be possible to ameliorate or even prevent such distress”.

The other study compared suicides after pregnancy in Finland between 1987 and 1994. The researchers were able to identify 73 suicides within one year after the end of the 667,572 pregnancies observed during the study period. Women, whose pregnancy had ended in abortion, were six times more likely to commit a suicide than women, who had a childbirth. The researchers state clearly at the end of the paper that the study was not able to study causality between these two events, because they had no information of pre-pregnancy mental health conditions of the women. Thus, the causal relationship could go either way: suicides and abortions are caused by similar things or abortions cause mental health problems to some women. In addition, I’d bear in mind the small number of suicides observed, which adds uncertainty to any conclusions.

Had Niikko read a more recent paper from Gissler and colleagues, he would have discovered that having mental health problems is associated with a higher risk of abortion. Therefore it seems like experiencing difficult life events is associated with higher risk of abortion rather than the other way around. Also this paper ends with caution: more research is needed, before claiming causality in this complex relationship. Many previous studies have suffered from severe problems in research design and thus cannot be trusted.

So, the studies Niikko referred to were from late 1980s and early 1990s. It goes without saying that they are old and that there are more recent studies he could have referred to. Moreover, the results of the studies were clearly misinterpreted. The really sad part is that in the discussion Niikko was the only MP, who even tried to refer to academic studies to justify his point of view.

Where are the policy implications of policy relevant academic studies hiding?