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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Quebec groups launch court challenge to euthanasia bill

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By LifeSiteNews staff

As announced when the Quebec legislature adopted Bill 52, An Act respecting end-of-life care, the citizen movement Living with Dignity and the Physicians’ Alliance against Euthanasia, representing together over 650 physicians and 17,000 citizens, filed a lawsuit before the Superior Court of Quebec in the District of Montreal on Thursday.

The lawsuit requests that the Court declare invalid all the provisions of the Act that deal with “medical aid in dying”, a term the groups say is a euphemism for euthanasia. This Act not only allows certain patients to demand that a physician provoke their death, but also grants physicians the right to cause the death of these patients by the administration of a lethal substance.

The two organizations are challenging the constitutionality of those provisions in the Act which are aimed at decriminalizing euthanasia under the euphemism “medical aid in dying”. Euthanasia constitutes a culpable homicide under Canada’s Criminal Code, and the organizations maintain that it is at the core of the exclusive federal legislative power in relation to criminal law and Quebec therefore does not have the power to adopt these provisions.

The organizations also say the impugned provisions unjustifiably infringe the rights to life and to security of patients guaranteed by the Canadian Charter of Rights and Freedoms and the Quebec Charter of Human Rights and Freedoms. They further infringe the right to the safeguard of the dignity of the person, which is also protected by the Quebec Charter.

In view of the gravity of the situation and the urgent need to protect all vulnerable persons in Quebec, they are requesting an accelerated management of the case in order to obtain a judgment before the Act is expected to come into force on December 10, 2015.


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Colorado baker appeals gvmt ‘re-education’ order

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By LifeSiteNews staff

A Colorado cake artist who declined to use his creative talents to promote and endorse a same-sex ceremony appealed a May 30 order from the Colorado Civil Rights Commission to the Colorado Court of Appeals Wednesday.

The commission’s order requires cake artist Jack Phillips and his staff at Masterpiece Cakeshop to create cakes for same-sex celebrations, forces him to re-educate his staff that Colorado’s Anti-Discrimination Act means that artists must endorse all views, compels him to implement new policies to comply with the commission’s order, and requires him to file quarterly “compliance” reports for two years. The reports must include the number of patrons declined a wedding cake or any other product and state the reason for doing so to ensure he has fully eliminated his religious beliefs from his business.

“Americans should not be forced by the government – or by another citizen – to endorse or promote ideas with which they disagree,” said the cake artist’s lead counsel Nicolle Martin, an attorney allied with Alliance Defending Freedom. “This is not about the people who asked for a cake; it’s about the message the cake communicates. Just as Jack doesn’t create baked works of art for other events with which he disagrees, he doesn’t create cake art for same-sex ceremonies regardless of who walks in the door to place the order.”

“In America, we don’t force artists to create expression that is contrary to their convictions,” added Alliance Defending Freedom Senior Legal Counsel Jeremy Tedesco. “A paint artist who identifies as homosexual shouldn’t be intimidated into creating a painting that celebrates one-man, one-woman marriage. A pro-life photographer shouldn’t be forced to work a pro-abortion rally. And Christian cake artists shouldn’t be punished for declining to participate in a same-sex ceremony or promote its message.”

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In July 2012, Charlie Craig and David Mullins asked Jack Phillips, owner of Masterpiece Cakeshop, to make a wedding cake to celebrate their same-sex ceremony. In an exchange lasting about 30 seconds, Phillips politely declined, explaining that he would gladly make them any other type of baked item they wanted but that he could not make a cake promoting a same-sex ceremony because of his faith. Craig and Mullins, now represented by the American Civil Liberties Union, immediately left the shop and later filed a complaint with the Colorado Civil Rights Division. The case now goes to the Colorado Court of Appeals as Masterpiece Cakeshop v. Craig.

“Jack, and other cake artists like him – such as those seen on TV shows like ‘Ace of Cakes’ and ‘Cake Boss’ – prepare unique creations that are inherently expressive,” Tedesco explained. “Jack invests many hours in the wedding cake creative process, which includes meeting the clients, designing and sketching the cake, and then baking, sculpting, and decorating it. The ACLU calls Jack a mere ‘retail service provider,’ but, in fact, he is an artist who uses his talents and abilities to create expression that the First Amendment fully protects."

Celebrity cake artists have written publicly about their art and the significant expressive work that goes into the artistic design process for wedding cakes.


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Prisoner of conscience Mary Wagner appeals her conviction

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By Tony Gosgnach

TORONTO -- As promised, Mary Wagner has, through her counsel Dr. Charles Lugosi, filed a formal notice of appeal on numerous points regarding her recent, almost two-year-long court case that ended on June 12.

Justice Fergus O’Donnell of the Ontario Court of Justice rejected every application made by the defence – including for access to abortion center records, public funding, standing for a constitutional challenge and for expert witnesses to be heard – before he found Wagner guilty and sentenced her to five months in jail on a charge of mischief and four months on four counts of failing to comply with probation orders.

He further levied two years of probation, with terms that she stay at least 100 metres away from any abortion site. However, because Wagner had spent a greater time in jail than the sentence, she was freed immediately. She had been arrested at the “Women’s Care Clinic” abortion site on Lawrence Avenue West in Toronto on August 15, 2012 after attempting to speak to abortion-bound women there. She then spent the duration of the trial in prison for refusing to sign bail conditions requiring her to stay away from abortion sites.

Wagner is using the matter as a test case to challenge the current definition of a human being in Canadian law – that is, that a human being is legally recognized as such only after he or she has fully emerged from the birth canal in a breathing state.

Wagner’s notice states the appeal is regarding:

  • Her conviction and sentence on a single count of mischief (interference with property),
  • Her conviction and sentence on four counts of breach of probation,
  • The order denying public funding,
  • The order denying the disclosure of third-party records,
  • The order denying the admission of evidence from experts on the applicant’s constitutional challenge concerning the constitutional validity of Section 223 of the Criminal Code,
  • The order denying the admission of evidence from experts concerning the construction of Section 37 of the Criminal Code,
  • The probation order denying Wagner her constitutional rights to freedom of speech, freedom of expression, freedom of conscience and freedom of religion on all public sidewalks and public areas within 100 metres of places where abortions are committed,
  • And each conviction and sentence and all orders and rulings made by O’Donnell.

In the notice of appeal, Lugosi cites numerous points on which O’Donnell erred:

  • He denied Wagner her constitutional right to make full answer and defence.
  • He denied Wagner her right to rely on Section 37 of the Criminal Code, which permits “everyone” to come to the third-party defence and rescue of any human being (in this case, the preborn) facing imminent assault.
  • He decided the factual basis of Wagner’s constitutional arguments was a waste of the court’s time and that no purpose would have been served by having an evidentiary hearing on her Charter application because, in the current state of Canadian law, it had no possibility of success.
  • He misapplied case law and prejudged the case, “giving rise to a reasonable apprehension of bias and impeding the legal evolution of the law to adapt to new circumstances, knowledge and changed societal values and morals.”
  • He accepted the Crown’s submission that it is beyond the jurisdiction of the courts to question the jurisdiction of Parliament legally to define “human being” in any manner Parliament sees fit.
  • He ruled Section 223 of the Criminal Code is not beyond the powers of Section 52 of the Constitution Act, 1982.
  • He ruled Section 223 of the Criminal Code does not violate the Preamble to, as well as Sections 7, 11(d), 15 and 26, of the Charter of Rights and Freedoms.
  • He denied Wagner standing to raise a constitutional challenge to the validity of Section 223 of the Criminal Code.
  • He ruled that Section 223 of the Criminal Code applied generally throughout the entire Criminal Code and used it to deny unborn human beings the benefit of equal protection as born human beings under Section 37 of the Criminal Code.
  • He denied the production and disclosure of third-party records in the possession of the “Women’s Care Clinic” abortion site, although the records were required to prove Wagner was justified in using reasonable force in the form of oral and written words to try to persuade pregnant mothers from killing their unborn children by abortion.
  • He denied Wagner the defence of Section 37 of the Criminal Code by ruling unborn children did not come within the scope of human beings eligible to be protected by a third party.
  • He ruled Wagner did not come within the scope of Section 37 because she was found to be non-violent (in that she did not use physical force).
  • He ruled the unborn children Wagner was trying to rescue were not under her protection.
  • He denied Wagner the common-law defences of necessity and the rescue of third parties in need of protection.
  • He denied Wagner public funding to make full answer and defence for a constitutional test case of great public importance and national significance.
  • He imposed an unconstitutional sentence upon Wagner by, in effect, imposing an injunction as a condition of probation, contrary to her constitutional rights of free speech, freedom of expression, freedom of conscience and freedom of religion.

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Among the orders Lugosi is seeking are:

  • That an appeal be allowed against conviction on all counts and that a verdict of acquittal be entered on all counts,
  • That Section 223 of the Criminal Code be found unconstitutional  and contrary to Section 52 of the Constitution Act, 1982, as well as the unwritten constitution of Canada,
  • That the sentence be declared unconstitutional and contrary to Section 52 of the Constitution Act, 1982, and the unwritten constitution of Canada or that a new trial be conducted, with Wagner permitted to make full answer and defence, be given standing to make a constitutional attack on Section 223 of the Criminal Code, with the admission of expert witnesses,
  • That the Women’s Care Clinic abortion site be made to produce third-party records pertaining to patients seen on August 15, 2012 (when Wagner entered the site),
  • And that there be public funding for two defence counsels at any retrial and for any appeal related to the case.

No date has yet been established for a decision on the appeal or hearings.

A defence fund for Wagner’s case is still raising money. Details on how to contribute to it can be found here.


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