Carolyn Moynihan

New Chile study challenges the ‘safe abortion’ myth

Carolyn Moynihan
By Carolyn Moynihan
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May 8, 2012 (Mercatornet.com) - One of the great scandals of today’s global village is the deaths of hundreds of thousands of mothers each year simply because they are carrying or giving birth to a child. The last reliable estimate, from 2008, indicated nearly 343,000 of these maternal deaths. The scandal lies in the fact that most of them are easily preventible with basic health care, as the West discovered more than a century ago.

The West, as we know from many statements from the World Health Organisation and reproductive health groups, is anxious to reduce this awful statistic, which is an important aim of the Millennium Development Goals. Unfortunately, this altogether worthy goal is entangled with another: the reduction of fertility in the developing countries, by the quickest means possible. This means that, often before other basic medical and social improvements are in place, there must be universal access to birth control technology—not only contraception but abortion.

Abortion, however, must be safe for the woman—that is, provided by medically qualified people or by medically certified means—and to be safe it must be legal. Where it is illegal it will happen anyway but it will be unsafe, and often lethal. States which persist in keeping abortion illegal or severely restricted (and not the agents who are pushing this form of birth control) are thus contributing to the dire maternal mortality statistics. And states which ban abortion after it has been legal are similarly putting women’s lives at risk. That, as they say, is the narrative.

There’s just one problem with the drift of this story: there is no proof that it is true. The only hard evidence that we have on the subject of restrictive abortion laws and maternal mortality rates (MMR) is very new and it points in the opposite direction.

Research from Chile published a few days ago shows that, when therapeutic abortion was banned in 1989 after a long period when it had been legal in that country, there was no increase in maternal mortality. None at all. On the contrary, maternal deaths continued to decline. Chile today has one of the lowest maternal mortality rates in the world (16 per 100,000 live births), outstripping the United States (18) and, within the Americas, second only to Canada (9). Rather than the rogue violator of women’s reproductive health that the UN makes it out to be, Chile is looking this week like a model for countries that really want to save the lives of mothers.

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It’s important to note here what the study, Women’s Education Level, Maternal Health Facilities, Abortion Legislation and Maternal Deaths: A Natural Experiment in Chile from 1957 to 2007, does not claim. It does not say that making abortion illegal caused a decline in maternal deaths. But it shows, importantly, that the 1989 law did not increase mortality. It continued to decline substantially, although other factors were at work in the decline—notably, the education of women and their ability to shape their own reproductive behaviour. (The latter does not mean quite what birth control fundamentalists mean, as we shall see.)

The study, published in the open access online journal PLoS One, is the work of Chilean and American researchers led by Dr Elard Koch, epidemiologist and a professor at the University of Chile and Universidad Católica de la Santísima Concepción (UCSC). The group, who formed the Chilean Maternal Mortality Research Initiative (CMMRI) for the purpose of the study, had access to exceptionally good data: 50 years of official records from Chile’s National Institute of Statistics, 1957 to 2007. These provide the basis of what the authors call a “natural experiment” in fertility and abortion policy.

What these records show is a dramatic decline in MMR from 1965, when abortions were numerous and abortion was the main cause of mortality, through to 1981; a continuing but slower reduction from 1981 to 2003; and a steady state from 2003 to 2007. To explain this pattern the researchers analysed social policies and trends likely to influence maternal mortality. Here are the key ones, especially for the first phase:

* Delivery by skilled birth attendants. For each 1 per cent increase in the number of deliveries performed by skilled attendants there was an estimated decrease of 4.58 maternal deaths per 100,000 live births. Clean water and other sanitary improvements also played a part.

* Access to maternal healthcare services. Nutrition programmes for mother and child, coupled with the distribution of fortified milk at primary care clinics created new opportunities for pregnancy and birth care for both mother and child. This strategy practically eradicated malnutrition, increased birth weight and contributed to the noteworthy reduction in infant mortality observed in Chile, 3.1/1000 live births for infants 28 days to 1 year of age.

* Women’s educational level. This, says Koch, is the most important factor, and the one which increased the effect of all other factors. Educating women enhances a woman’s ability to access existing health care resources and directly leads to a reduction in her risk of dying during pregnancy and childbirth. Data showed that for every additional year of maternal education in Chile there was a corresponding decrease in the MMR of 29.3/100,000 live births.

Boosting female education did something else: it brought down the fertility rate (currently the TFR is 1.87). To return to a point mentioned earlier, the authors point out that “education promotes higher autonomy in women, allowing them to take control of their own fertility” using the method they prefer. Interestingly, a majority of Chilean women do not prefer artificial contraceptives. The authors note:

“Although the primary care system currently provides universal access to a variety of contraceptives methods, actual use of hormonal contraceptives and intrauterine devices in Chile reaches approximately 36% of women of reproductive age. Therefore, as in developed nations, other factors not limited to the use of artificial contraceptives seem to be contributing to the reduction in TFR in Chile. One such factor could be women’s increasing level of education.”

And here the news stops being good. At this point Chilean woman meets North American and European and Antipodean woman in a pattern of delayed motherhood—and pathologies associated with that delay. Koch and colleagues describe this “fertility paradox” as follows:

Although a strong correlation did exist between the decline on the MMR and the reduction on total fertility rate (i.e. the average number of children that would have been born to a woman over her reproductive lifetime), the increase in the number of first pregnancies at advanced ages was directly associated with an increase on maternal deaths. For every 1% increment in primiparous women giving birth older than 30 years of age, an increase of 30 maternal deaths per 100,000 live births was estimated. Thus, when the total fertility decreases and produces a delayed motherhood it can also provoke a deleterious effect on maternal health via an increase of the obstetric risk associated with childbearing at advanced ages.

Before 1980 the causes of MMR in Chile were on the whole directly related to pregnancy and birth. From then on the underlying health problems of “aging pregnancy” began to take over in the mortality stakes: hypertension, diabetes and obesity among others. The problem now, there and here in the developed world, “is not a matter of how many children a mother has, but a matter of when.”

Did the reproductive health brigade get that? Delayed motherhood can be literally deadly. At a certain point, the gains of education and good health and social services are taken too far and recoil upon the modern woman. With the greater part of the world, including many developing countries, now below replacement TFR, maternal mortality from social progress is set to climb before deaths from deprivation have been thoroughly, and one could say properly, addressed.

Koch’s study shows that the custodians of reproductive health profoundly misunderstand the remedy for maternal mortality in developing countries. Will they do any better when they try to come to grips with the fertility paradox?

Carolyn Moynihan is deputy editor of MercatorNet. This article is reprinted under a Creative Commons License.


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Although it is widely believed that people with Down syndrome are doomed to a life of suffering, in one large survey 99% of respondents with Down syndrome described themselves as "happy." Shutterstock
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‘Sick and twisted’: Down’s advocates, pro-life leaders slam Richard Dawkins’ abortion remarks

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By Dustin Siggins

Advocates on behalf of individuals with Down syndrome, as well as pro-life leaders, are slamming famed atheist Richard Dawkin’s statements made on Twitter earlier today that parents have a moral responsibility to abort babies diagnosed in utero with Down’s.

During a shocking Twitter rant, Dawkins responded to questioners saying that it was "civilised" to abort Down Syndrome babies, and that it would be "immoral" to choose not to abort babies diagnosed with the condition.

He said that his goal is to "reduce suffering wherever you can," indicating that unborn children cannot suffer, and that unborn children don't "have human feelings."

In addition to being scientifically challenged - unborn children can feel both pain and emotions - Dawkins' comments drew criticism for his callousness towards children with disabilities.  

"A true civilization – a civilization of love – does not engage in such cold and ultimately suicidal calculus"

“It's sick and twisted for anyone to advocate for the killing of children with disabilities,” Live Action President Lila Rose told LifeSiteNews. “Dawkins's ignorant comments serve only to further stigmatize people with Down syndrome.

“While many people with Down syndrome, their families, and advocacy groups are fighting discrimination on a daily basis, Dawkins calls for their murder before they are even born,” she said. “Those with Down syndrome are human beings, with innate human dignity, and they, along with the whole human family, deserve our respect and protection.”

Carol Boys, chief executive of the Down's Syndrome Association, told MailOnline that, contrary to Dawkins’ assertion, “People with Down’s syndrome can and do live full and rewarding lives, they also make a valuable contribution to our society.”

A spokesperson for the UK disabilities charity Scope lamented that during the “difficult and confusing time” when parents find out they are expecting a child with disabilities, they often experience “negative attitudes.”

“What parents really need at this time is sensitive and thorough advice and information,” the spokesperson said.

Charlotte Lozier Institute president Chuck Donovan agreed with Rose’s assessment. "Advocates of abortion for those 'weaker' than others, or of less physical or intellectual dexterity, should remember that each of us is 'lesser' in some or most respects," he said.

According to Donovan, "we deliver a death sentence on all of humanity by such cruel logic."

"A true civilization – a civilization of love – does not engage in such cold and ultimately suicidal calculus" he said.

One family who has a child with Down syndrome said Dawkins was far from the mark when he suggested that aborting babies with Down syndrome is a good way to eliminate suffering.

Jan Lucas, whose son Kevin has Down syndrome, said that far from suffering, Kevin has brought enormous joy to the family, and "is so loving. He just has a million hugs."

She described how Kevin was asked to be an honorary deacon at the hurch they attend in New Jersey, “because he is so encouraging to everyone. At church, he asks people how their families are, says he'll pray for them, and follows up to let them know that he has been praying for them."

It's not just strangers for whom Kevin prays. "My husband and I were separated for a time, and Kevin kept asking people to pray for his dad," said Jan. "They didn't believe that Kevin's prayers would be answered. Kevin didn't lose hope, and asking people, and our marriage now is better than ever before. We attribute it to Kevin's prayers, and how he drew on the prayers of everyone."

"I don't know what we'd do without him," said Jan.

Speaking with LifeSiteNews, Kevin said that his favorite things to do are "spending time with my family, and keeping God in prayer." He said that he "always knows God," which helps him to "always keep praying for my friends."

"I love my church," said Kevin.

Although it is widely believed that people with Down syndrome are doomed to a life of suffering, in one large survey 99% of respondents with Down syndrome described themselves as "happy." At the same time, 99% percent of parents said they loved their child with Down syndrome, and 97 percent said they were proud of them.

Only 4 percent of parents who responded said they regretted having their child.

Despite this, it is estimated that in many Western countries the abortion rate of children diagnosed in utero with Down syndrome is 90%, or even higher. The development of new and more accurate tests for the condition has raised concerns among Down syndrome advocates that that number could rise even higher. 


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Asked about Iraq on his return flight from South Korea, Francis replied that 'it is legitimate to halt the unjust aggressor.' Shutterstock
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Pope Francis: steps must be taken to halt ‘unjust aggressor’ in Iraq

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Pope Francis and his emissary to Iraq’s persecuted non-Muslim minorities, Cardinal Fernando Filoni, have both called on the United Nations to act in concert to protect Iraqis Christian and Yazidi minorities from the radical Islamic forces of ISIS.

Asked about Iraq on his return flight from South Korea, Francis replied that “it is legitimate to halt the unjust aggressor.”

He added, however, that “halt” does not mean to “bomb” and lamented “how many times with the excuse of halting the unjust aggressor…have powerful nations taken possession of peoples and waged a war of conquest!”

He also cautioned that no single nation could determine the right measures. Any intervention must be multilateral and preferably by the United Nations, he said.

Meanwhile, Cardinal Foloni, who is visiting Iraq on behalf of Pope Francis, issued a joint statement this week with Chaldean Catholic Patriarch Louis Raphael I Sako and the Iraqi bishops that urged the international community to “liberate the villages and other places that have been occupied as soon as possible and with a permanent result.”

The statement also urged efforts to “assure that there is international protection for these villages and so to encourage these families to go back to their homes and to continue to live a normal life in security and peace.”

Archbishop Giorgio Lingua, the Vatican nuncio to Iraq, was also asked by Vatican Radio earlier this month about the U.S. airstrikes in Iraq.

“This is something that had to be done, otherwise [the Islamic State] could not be stopped,” the archbishop said. 

Although Pope Francis’ own remarks about an intervention in the war-torn country were carefully guarded, Catholic commentator Robert Spencer, author of such bestselling exposes of Islam as “The Truth About Muhammad: Founder of the World's Most Intolerant Religion,” told LifeSiteNews he believes the pope was clearly calling for an “armed intervention, though a very limited one.”  

“Only a fool would think there is another way to stop an ‘unjust aggressor,’” he said.

Spencer expressed concerns that both Francis and Pope John Paul II before him have both referred to Islam a “religion of peace,” which Spencer says is “completely false.” However, he suggested that Francis’ remarks calling for action in Iraq are a sign of a more realistic attitude towards Islam.   

On this, Spencer would likely have the support of Amel Nona, the Chaldean Catholic archbishop of Mosul, who issued a letter last week warning the West in stark terms about the encroaching threat of Islam.

“Our sufferings today are the prelude of those you, Europeans and Western Christians, will also suffer,” Nona warned. “Your liberal and democratic principles are worth nothing here.

“You must consider again our reality in the Middle East, because you are welcoming in your countries an ever growing number of Muslims. Also you are in danger. You must take strong and courageous decisions, even at the cost of contradicting your principles,” he said

“You think all men are equal, but that is not true: Islam does not say that all men are equal. Your values are not their values. If you do not understand this soon enough, you will become the victims of the enemy you have welcomed in your home.”


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'Apparently I'm a horrid monster for recommending WHAT ACTUALLY HAPPENS to the great majority of Down Syndrome fetuses,' said Dawkins. 'They are aborted.' Shutterstock
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Richard Dawkins: it’s ‘immoral’ NOT to abort babies with Down syndrome

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By Dustin Siggins

In a bizarre rant on Twitter earlier today, atheist Richard Dawkins wrote that choosing not to abort a child with Down Syndrome would be "immoral."

The conversation started when Dawkins tweeted that "Ireland is a civilised country except in this 1 area." The area was abortion, which until last year was illegal in all cases.

A Twitter user then asked Dawkins if "994 human beings with Down's Syndrome [having been] deliberately killed before birth in England and Wales in 2012" was "civilised."

Dawkins replied "yes, it is very civilised. These are fetuses, diagnosed before they have human feelings."

Later, Dawkins said that "the question is not ‘is it 'human'?’ but ‘can it SUFFER?’"

In perhaps the most shocking moment, one Twitter user wrote that he or she "honestly [doesn't] know what I would do if I were pregnant with a kid with Down Syndrome. Real ethical dilemma."

Dawkins advised the writer to "abort it and try again. It would be immoral to bring it into the world if you have the choice."

According to Dawkins, the issue of who should be born comes down to a calculation based upon possible suffering. "Yes. Suffering should be avoided. [The abortion] cause[s] no suffering. Reduce suffering wherever you can."

Later, however, he said that people on the autism spectrum "have a great deal to contribute, Maybe even an enhanced ability in some respects. [Down Syndrome] not enhanced."

When Dawkins received some blowback from Twitter followers, he replied: "Apparently I'm a horrid monster for recommending WHAT ACTUALLY HAPPENS to the great majority of Down Syndrome fetuses. They are aborted."

It is estimated that in many Western countries the abortion rate of children diagnosed in utero with Down syndrome is 90%, or even higher. The development of new and more accurate tests for the condition has raised concerns among Down syndrome advocates that that number could rise even higher. 

Although it is widely believed that people with Down syndrome are doomed to a life of suffering, in one large survey 99% of respondents with Down syndrome said they were "happy." At the same time, 99% percent of parents said they loved their child with Down syndrome, and 97 percent said they were proud of them.

Only 4 percent of parents who responded said they regretted having their child. 

A number of Dawkins' statements in the Twitter thread about fetal development are at odds with scientific realities. For example, it is well-established that 20 weeks into a pregnancy, unborn children can feel pain. Likewise, unborn children have emotional reactions to external stimuli -- such as a mother's stress levels -- months before being born. 

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