NRL News
Page 13
Summer 2012
Volume 39
Issue 3

Evidence Presented at World Health Assembly That
Health Care, Not Abortion, Will Solve Maternal
Mortality; Pro-Abortion Rebuttal Fails Abysmally

By Dave Andrusko

In the month of May two important studies came out which rebutted the pro-abortion orthodoxy that abortion is the solution to the problem of maternal deaths in the developing world. The real solution has been known for decades but denied: “That most maternal deaths can be prevented with adequate nutrition, basic health care, and good obstetric care throughout pregnancy, at delivery, and postpartum,” as Jeanne Head, R.N., UN representative and vice president for international affairs at the National Right to Life Committee, has explained.

But the guardian of the pro-abortion orthodoxy, the Guttmacher Institute, quickly tried to counter the evidence. As we’ll see, Guttmacher failed abysmally.

Miss Head and Scott Fischbach, executive director of Minnesota Citizens Concerned for Life Global Outreach (MCCL GO), presented their evidence at the World Health Assembly in Geneva, Switzerland. The new analysis, “Women’s Health & Abortion,” explains that maternal mortality fell dramatically in developed nations as a result of mid-20th century improvements in health care—well before the widespread legalization of abortion. Today Ireland and Poland, which prohibit most abortions, boast among the world’s lowest rates of maternal death.

“Maternal mortality is determined by the quality of maternal health care, not the legal status of abortion,” notes Fischbach. “Pushing for legal abortion in developing countries does nothing to solve the problem. It only leads to more abortions.”

The analysis highlights a peer-reviewed study of maternal mortality in Chile published on May 4. The researchers, led by Dr. Elard Koch of the University of Chile, show that maternal mortality declined significantly even after Chile prohibited abortion in 1989. Maternal deaths due specifically to abortion also dropped after abortion was made illegal. (See www.nationalrighttolifenews.org/news/2012/05/chilean-study-shows-better-health-care-other-factors-reduce-maternal-mortality-not-legal-abortion)

Koch et al. cite various factors to explain the decrease, including a significant increase in education level, utilization of maternal health facilities, and improvements in the sanitary system. The researchers conclude that “making abortion illegal is not necessarily equivalent to promoting unsafe abortion, especially in terms of maternal morbidity and mortality. … Our study indicates that improvements in maternal health and a dramatic decrease in the [maternal mortality ratio] occurred without legalization of abortion.”

Chile’s success contrasts with the recent record of the United States, which permits abortion on demand and has seen its maternal mortality rate climb upward over the last two decades. The U.S. maternal mortality ratio (the number of deaths per 100,000 live births) increased from 10.3 in 1999 to 23.2 in 2009. Over the same period, Chile’s ratio decreased from 23.6 to 16.9.

A report issued in May by the World Health Organization and other UN agencies estimates that maternal deaths worldwide dropped 47% from 1990 to 2010. The report offers further proof that women’s lives can be saved through improved health conditions.

Though Guttmacher’s claims were not the focus of Koch’s article, Guttmacher recognized the threat posed by the Chilean study and responded aggressively, defending its own claims and its methods. In an advisory published on its website, Guttmacher claims that the Chilean study “has several serious conceptual and methodological flaws that render some of its conclusions pertaining to abortion and maternal mortality invalid.”

Paul Stark, communications associate for MCCL, offered a thorough critique of Guttmacher’s counter-claims on the MCCL Blog. He graciously allowed me to include much of his fine analysis.

What is Guttmacher’s evidence that legalizing abortion improves women’s health? First, it observes that many countries with strong abortion restrictions have high maternal mortality ratios (maternal deaths per 100,000 live births), and many countries with legal abortion on demand have low MMRs. But correlation, as they say, is not causation. The abortion-restricting countries in question are precisely those countries (particularly in Africa) where health conditions are worst—so they are precisely where we would expect to see high rates of maternal death, regardless of the status of abortion. And the countries that permit abortion on demand and have low MMRs are developed nations with quality health care—so we should expect to see very low death rates.

There is no actual empirical evidence—no rigorous scientific research—causally linking abortion restrictions to increased maternal mortality. And Guttmacher’s view simply cannot explain why MMRs dramatically declined in the developed world as a result of advancements in modern medicine before the widespread legalization of abortion; why countries like Ireland, Poland, Malta and Chile ban abortions and yet have very low MMRs (among the lowest in the world) because they have good maternal health care; why some countries with abortion on demand, like Guyana, have not decreased their MMRs after legalizing abortion (Guyana’s MMR only increased). The worldwide evidence indicates that maternal mortality is a function of maternal health care, sanitation, women’s education and related factors, but not the legal status of abortion.

Guttmacher’s second argument is that certain countries that legalized abortion over the last two decades are “beginning” to see “improved health outcomes for women.” But much of the world has been seeing “improved health outcomes for women” as health conditions and education level improve; why think it has to do with the legality of abortion? Of the four countries that decreased their MMRs the most between 1990 and 2008 (according to the World Health Organization, et al., Trends in Maternal Mortality: 1990–2008), three of them did so while maintaining bans on abortion.

Guttmacher specifically cites Ethiopia in Africa, but its MMR is still much higher than that of Mauritius, which prohibits abortion; Guttmacher cites Nepal in Asia, but its MMR is still much higher than that of Sri Lanka, which prohibits abortion; and, as Guttmacher’s only other example, it cites South Africa (which has a very liberal abortion law) whose MMR has actually increased significantly in the last two decades.

In short, Guttmacher doesn’t have a leg to stand on. Legalizing abortion, the Chilean researchers conclude, “is unnecessary to improve maternal health: it is a matter of scientific fact in our study. We think this should be recognized by a scientific community guided by principles of honesty and objectivity in science, no matter how controversial the finding might be.”