Let’s Get Clinical

Nobody is going to tell the world that it needs more abortions. As much as we argue about “right to life” vs. a “right to choose,” and notwithstanding China’s acceptance of abortion as a mechanism to implement its “one child” per couple mandate, induced abortion is never pretty, never free from emotional struggle and never pleasant. The moral and religious overtones can complicate an extraordinarily difficult decision, and abstinence appears to be a huge fraud on our youth. Young innocents, caught up in passion, conceive without preparation or understanding… and moreover, step into their parents’ and peers’ moral quandaries as they seek the correct answer. Those who conceive, give birth and are emotionally or economically unprepared for the magnitude of parenting often raise succeeding generations of socioeconomically impaired children, foment rising crime rates and people unable to cope with mainstream society and normal employment tracks.

Let me step away from the moral debate and focus on what seems to be effective in reducing abortions and saving lives. If we could introduce policies and legislation that effectively lower the number of such abortions, to many that would be a good thing, right? You are going to be reading a lot of facts (and a few quotes) and figures in this edition of my blog. They have all been generated by a long-term set of studies, beginning in 1995, of abortion patterns and risks globally by the prestigious and statistically rigorous World Health Organization (the public health arm of the United Nations) reported this January. I won’t cite each fact separately, but you can find this information in their “Facts on Induced Abortion Worldwide” presentation, available online and reported in the British medical publication, the Lancet.

First, 13% of all women’s deaths during child-bearing years occur in connection with induced abortions (half of all abortions are technically labeled as “unsafe”). The vast majority of such fatalities are in countries where such abortions are illegal and are conducted by untrained amateurs, are self-inflicted or are performed, ad hoc, by locals who don’t even know anything at all about the procedure. When the law permits abortions, and hence medically competent people are charged with implementing an induced abortion, associated death-rates drop like a stone. Case in point: “In South Africa, the annual number of abortion-related deaths fell by 91 % after the liberalization of the abortion law.” Or this: “In the United States, legal induced abortion results in 0.6 deaths per 100,000 procedures. Worldwide, unsafe abortion accounts for a death rate that is 350 times higher (220 per 100,000), and, in Sub-Saharan Africa, the rate is 800 times higher, at 460 per 100,000.”

But clearly, banning or restricting the right to abortion saves the lives of vastly more unborn lives than in nations where such procedures are legal, right? Strangely, the abortion rates begin to fall in countries where such medical choices are still available and remain high where they are not allowed or are severely restricted: “Highly restrictive abortion laws are not associated with lower abortion rates. For example, the abortion rate is 29 per 1,000 women of childbearing age in Africa and 32 per 1,000 in Latin America—regions in which abortion is illegal under most circumstances in the majority of countries. The rate is 12 per 1,000 in Western Europe, where abortion is generally permitted on broad grounds.” Perhaps a more “liberal” society, where abortions are permitted, is also one where contraception and sex education clearly communicate how to limit childbirth before conception. Looking at these numbers, it seems that every year, almost 3% of all women in childbearing years experience an abortion. Every year!

Yet the overall number of abortions has dropped: “Between 1995 and 2003, the abortion rate (the number of abortions per 1,000 women of childbearing age—i.e., those aged 15–44) for the world overall dropped from 35 to 29. It remained virtually unchanged, at 28, in 2008.” Some attribute this statistical change to alteration in legal restrictions worldwide: “Between 1997 and 2008, the grounds on which abortion may be legally performed were broadened in 17 countries: Benin, Bhutan, Cambodia, Chad, Colombia, Ethiopia, Guinea, Iran, Mali, Nepal, Niger, Portugal, Saint Lucia, Swaziland, Switzerland, Thailand and Togo. Mexico City and parts of Australia (Capital Territory, Victoria, Tasmania and Western Australia) also liberalized their abortion laws. In contrast, El Salvador and Nicaragua changed their already restrictive laws to prohibit abortion entirely, while Poland withdrew socioeconomic reasons as a legal ground for abortion.” Notwithstanding these changes, however, the number of abortions “carried out without trained clinical help rose from 44% in 1995 to 49% in 2008.”

The BBC (January 18^th) drilled down into this report with some additional information: “Professor Beverly Winikoff, from Gynuity, a New York organisation which pushes for access to safer abortion, wrote in the Lancet: ‘Unsafe abortion is one of the five major contributors to maternal mortality, causing one in every seven or eight maternal deaths in 2008…Yet, when abortion is provided with proper medical techniques and care, the risk of death is negligible and nearly 14 times lower than that of childbirth… The data continue to confirm what we have known for decades - that women who wish to terminate unwanted pregnancies will seek abortion at any cost, even if it is illegal or involves risk to their own lives… Dr Richard Horton, the Lancet's editor [noted that ‘c]ondemning, stigmatising and criminalising abortion are cruel and failed strategies.’”

So let me think… fewer abortions take place in countries where it is legal, fewer mothers die or are injured during abortions performed where the procedure is legal, and women absolutely everywhere (there are measurable abortions in every country on earth) are completely willing to take any risk, ignore any law to get an abortion… hmmmm. So if you want fewer abortions and fewer lost lives… hmmmm. If you really, really want fewer abortions… make abortion… er… legal?

I’m Peter Dekom, and why do I think that facts will most certainly not get in the way of anyone’s preexisting views on Roe vs. Wade?