The Chilean experience challenges standard notions that access to legal
abortion-on-demand is necessary for high-quality maternal health.
by John
Tyburski
Copyright © Daily
Digest News, KPR Media, LLC. All rights reserved.
Popular
opinion says that restricting access to abortion-on-demand will result in
increases in illegal abortions, increases in complications resulting from
unsafe illegal abortions, and overall reductions in maternal health indicators.
The back alley coat hanger image is easily conjured up in the collective public
imagination whenever abortion is debated.
In fact,
however, these adverse outcomes have not been observed in several countries
where abortion is limited or prohibited by law. Chile, for example, prohibited
abortion with legislation ratified in 1989 and yet has shown a dramatic,
steady decrease in maternal mortality ratio, or MMR, a maternal health
indicator. In the context of the United Nations’ Millennium Development Goals,
Chile has become a “paragon” of maternal health in the entire American
continent, as determined by the MELISA Institute, Concepcion, Chile.
According
to a new report published on Friday in the Journal
of the Chilean Society of Obstetrics and Gynecology, the number of hospital
visits for complications from illegal abortions continues to decline at a rate
of about two percent each year since 2001, along with abortion-related
mortality. Hospitalizations for other kinds of abortion, including spontaneous
and ectopic pregnancies, have remained constant over the same period.
The
Chilean experience shows, argues report author Elard Koch, director of research
at MELISA, that maternal health indicators can be significantly improved
without allowing access to abortion. What is more, the evidence presented by
Koch suggests that reducing morbidity and mortality associated with abortion
plays a role in Chile’s successful maternal health program.
According
to a MELISA Institute statement,
Estimates for the annual number of illegal abortions performed in Chile range from
13,000 to 18,000. The risk of death from illegal abortion is estimated to be
one in four million women of reproductive age. Approximately 16 percent of
hospital discharges for all abortion types are attributed to illegal abortion
complications. The most common method of illegal abortion is self-medication
with misoprostol.
The
progress in maternal health in Chile since 1989 is generally attributed to
successes in maternal health policy, improved access to birth control,
increases in women’s education, and the recent emergence of support programs
for women with unplanned pregnancies who are at elevated risk of seeking
abortion.
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