NEW YORK — Is legalizing abortion a way to reduce the incidence of maternal deaths around the world?
For years, the World Health Organization, Planned Parenthood and the Guttmacher Institute have claimed between 68,000 and 78,000 women die annually as a result of the abortion procedure. They’ve based their figures on a rule of thumb that 13% of illegal and unsafe abortions end in death.
This year, two reports have revised the estimates of maternal deaths radically downward by a third. One of the reports was released just last month by WHO itself.
But so far, no pro-abortion groups have re-estimated abortion deaths to match.
That doesn’t surprise Donna Harrison, president of the American Association of Pro-Life Obstetricians and Gynecologists, who says she has never been able to find “any solid, peer-reviewed evidence connecting maternal mortality with illegal abortion.”
Harrison isn’t the only one. The authors of the first and wholly independent report on maternal deaths earlier this year also reported no link between maternal deaths and abortion.
Dr. Christopher Murray, director of a study team at the Institute for Health Metrics and Evaluation at the University of Washington, told the Register, “With maternal mortality, we actually have more information than many other major causes of death. We don’t, unfortunately, have information in all cases about the specifics of the maternal death.”
Murray said the institute has now embarked on research into the causes of maternal death. His report, which counted 526,300 maternal deaths worldwide in 1980, found just 342,000 in 2008. It attributes the decline to a matching fall in the fertility rate, improved health care, rising incomes (that translate into better access to health care, better nutrition and better education) and, possibly, better trained birth attendants.
The report contained no mention of abortion as a cause of maternal death or of legalization of abortion as a way to reduce it.
In its report, however, the World Health Organization, which has maintained for decades that annual maternal deaths exceed 500,000, did advocate improving the safety of abortions to reduce maternal mortality — without citing any evidence.
As recently as 2005, it participated with UNICEF and the World Bank in a research report putting the number of maternal deaths at 535,000 and abortion deaths at 68,000. Pro-abortion organizations were happy to use both numbers and continue to assume that 13% of illegal abortions result in maternal death.
Now, in the wake of the Washington University study, WHO has produced its own report revising downward maternal deaths from 542,000 in 1990 to 358,000 in 2008. The report attempted no estimate of abortion deaths, though it does call for an expansion of “safe abortion services.”
The American Association of Pro-Life Obstetricians and Gynecologists’ Harrison says the new WHO report’s actual research findings do not support more abortion services: “They show a need for skilled birth attendants, greater access to antibiotics and more female literacy.”
Harrison said that the U.N.‘s numbers for both maternal mortality and deaths from unsafe abortions have always been suspect. She says she knows of several instances where U.N. officials have admitted they adjusted their numbers on maternal deaths and abortions when the data they had gathered from a particular country didn’t match expectations.
What’s more, Harrison contradicted the fundamental argument of groups such as Guttmacher and Amnesty International: that legalizing abortion will reduce maternal mortality due to abortion. She says the evidence from the U.S., as well as countries such as Chile that legalized and then recriminalized abortion, is that abortion deaths go down when it’s illegal. The reason: “When it’s legal, there are more abortions and so there are more complications.”
Chemical abortions via the RU-486 pill — mifepristone — are particularly prone to cause complications such as hemorrhaging, Harrison told the Register.
Brian Clowes of Human Life International said estimates of the death toll from illegal abortions are wild exaggerations and wildly various. In his book Facts of Life, he lists numbers for yearly illegal abortion deaths ranging from 70,000 to 1 million globally, and in specific countries to numbers exceeding official totals for all maternal deaths. His own calculations led him to suggest the total for the world is under 3,000, but this is based on an assumption that illegal abortions result in death 20 times as often as legal abortions.
But Gilda Sedgh, chief researcher at Guttmacher, cites contrary cases, such as in South Africa, where, after restrictions were removed, “the number of maternal deaths declined by more than half.”
Pro-abortion groups took the WHO revision in stride. Mary-Jane Wagle, Planned Parenthood Federation of America vice president for international programs, stated in a news release that “358,000 women dying every year from treatable and preventable causes is still 358,000 too many. … Governments, NGOs [non-governmental organizations] and donors need to redouble their efforts to ensure that getting pregnant is not a death sentence.”
Wagle’s conclusion: “Complications from unsafe abortion are a leading cause of maternal death; we will never reach the MDG targets without addressing the problem of unsafe abortions head on.”
She referred to the United Nations’ Millennium Development Goals, eight development objectives including eradication of extreme poverty, advanciing gender equality and reducing maternal mortality. The Vatican recently hailed the efforts to eliminate poverty but voiced concern at paragraphs of the MDGs on population control. The maternal health goal includes increasing use of contraceptives, and some NGOs have argued that reducing maternal mortality requires access to abortion.
As for reducing the estimate of abortion deaths, WHO communications staff did not return the Register’s call, while the Guttmacher Institute did respond, saying it was too busy “working on updating our estimates of maternal mortality based on the WHO report … and cannot comment at this time.”
Register correspondent Steve Weatherbe writes from Victoria, British Columbia.