Chile, Ireland

March 22, 2013 Dear ProLife Colleague, The international prochoice mantra is: “Legalize abortion in order to decrease maternal mortality!!” Sounds reasonable. Unless you look at the facts. The article below is by Elard Koch, a Chilean Epidimologist . THE FACTS: Chile and Ireland have among the best (lowest) maternal mortality rates in the Americas and in Europe. Chile and Ireland have among the most restrictive abortion laws in their respective continents. The prochoice mantra is very deceptive propaganda. See below. What makes Chile and Ireland similar countries in matters of maternal health and abortion? I had the invaluable opportunity to participate as a member of the Committee on Excellence in Maternal Healthcare, convened in Dublin to analyze the experience of Ireland, Chile, and other countries with a high standard in maternal health around the world. Such meeting was crowned with the Declaration of Dublin. Both Chile and Ireland are placed among the world safest nations for motherhood in their respective continents. In the case of Chile, excluding deaths due to non-obstetric causes (also called indirect causes), 30 maternal deaths were registered during 2010, with a mortality ratio of 11.9 per 100,000 live births. This places Chile only second to Canada in the American continent, with better maternal health than the United States of America. In Ireland, only 3 maternal deaths were registered out of 74,976 live births, i.e. a mortality ratio of four per 100,000 live births, placing this country among the five nations with the lowest maternal mortality in Europe. Interestingly, both countries have the least permissive abortion laws in the world, while still displaying negligible abortion-related mortality. This challenges the myth according to which the restriction of abortion leads to hundreds -even thousands- deaths due to abortion: that’s untrue. Deaths related to abortion in Chile decreased 99% in 50 years. Moreover, this decrease continued even after the ban of “therapeutic abortion” in 1989, confirming that this law was completely futile in reducing maternal mortality or to address exceptional cases where life of the pregnant mother is in risk. This is not a minor issue, since it is a recurrent argument used to promote abortion legalization in Ireland, Chile, and Latin America in general. During the 1960’s, almost 45% of hospitalizations due to abortion were associated with induced abortion. The continuous decrease in hospitalization rates due to any kind of abortion, whether spontaneous or induced, in Chile since 1967 suggests that the practice of induced abortion also decreased in parallel with the decrease in abortion-related mortality. In fact, estimations performed a few months ago show only 10% to 19% of all hospitalizations due to abortion in Chile can be attributed to induced abortion over the last decade. Most of induced abortions in Chile would be taking place nowadays by resorting to illegally acquiring of misoprostol in the black market, an apparently lucrative business without proper control even though it is illegal -a fact that undoubtedly demands the attention of sanitary and judicial authorities, especially due to the associated health risks to the mother. In statistical terms, abortion rates in Chile and Ireland are, in average, 10- to 12-fold lower to those in countries with legal abortion, such as Spain, whose abortion rate has increased 10-fold since its decriminalization in 1985. In absolute numbers, abortions increased from 16,700 in 1985 to almost 115,000 per year at the present. Repeated abortions by the same women increased from 20% to over 35%, suggesting that legal abortion is being used as a sort of contraceptive method by young Spanish women. In the case of Chile, the confidence interval falls between 8,270 and 20,675 induced abortions per year over the last decade, with repeated abortions less likely due to obvious reasons. The explanation is logical: while legal permission facilitates the access and increases the incidence of elective abortion, its legal restriction hinders access and decreases its incidence. Obviously, the dissuasive effect of a less permissive law cannot completely eliminate the problem, but it can decrease it. In fact, their purpose is similar to that of legislation restricting the consumption of illicit substances, alcohol or tobacco. In addition, moral concerns or social stigmatization towards induced abortion are stronger in countries such as Chile and Ireland. Thus, it is reasonable to think that a significant proportion of women considering abortion as an alternative to unplanned pregnancy choose to continue with it rather than taking a chance in the clandestine abortion world. Surprisingly, anachronisms are stressed over and over again to reinstate a useless “therapeutic abortion” legislation that lends itself for interpretative abuse. For instance, a complete article published by The Clinic on 2003, entitled “La vía chilena hacia el aborto” [fusion_builder_container hundred_percent=”yes” overflow=”visible”][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][“The Chilean way for abortion”], documents the case of the Chilean physician Aníbal Faúndes and his team at the Barros Luco Trudeau Hospital during 1973. “Therapeutic abortion” was loosely interpreted, with reasons ranging from socioeconomic to simple choice. Thousands of elective abortions were hypocritically performed under that law. Loose interpretation of grounds for abortion, leading to abuse of more permissive laws appears to be more general issue. In fact, most of abortions carried out in England and Spain are performed due to “reasons of mental health” even though there is no scientific evidence supporting abortion as a therapeutic indication for any mental related problems. The valuable Chilean experience shows that medical ethics is sufficient to deal with every case of apparent conflict between the life of the mother and that of the gestating child. Moreover, a straight ethical reasoning operating within the current law allows the dynamic adaptation to the advance of technology and scientific knowledge, promoting a healthy, reflective, and responsible medical praxis, while preventing bad medical praxis. Finally, if the goal of nations such as Chile and Ireland is to maintain their high standard in maternal healthcare, simultaneously protecting women’s health and the human life in gestation, while still displaying a low rate of induced abortion, the way certainly does not involve modifying their current abortion legislations. Elard Koch – @ElardKoch Epidemiologist Institute of Molecular Epidemiology (MELISA) Concepción, Chile www.melisainstitute.com[/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]