The Nation
Click here for article
[from the November 5, 2007 issue]
For years feminists and prochoicers have pointed out that women have abortions whether or not the procedure is legal.
That was true here before Roe v. Wade, and it is true today in countries where abortion is restricted or banned. The difference is that when abortion is legal it is a remarkably safe procedure; when it is illegal, women are injured, women die, children are left motherless. (True, these are already-existing, sinful children, not embryos or fetuses, but still.) This simple public health argument has gotten lost in a thicket of theology, sexual morality, "family values," politics, spin and outright disinformation. The coat hanger has become a political cliché, a relic of the '60s, like the peace sign. Oh, that old thing.
Now comes an article in The Lancet that shows in cold hard data how right we've been all along. "Induced Abortion: Estimated Rates and Trends Worldwide," a study conducted by the World Health Organization and the Guttmacher Institute, is the first global analysis of abortion incidence since 1995. It finds that rates of abortion (the number of abortions per 1,000 women) are relatively unaffected by whether it is legal. Thus, in South America, where abortion is largely illegal, the rate is 33; in northern America, where it is legal, the rate is 21. "The legal status of abortion doesn't predict whether abortions occur," study co-author Gilda Sedgh told me by phone. "It predicts whether they are safe. South Africa liberalized its abortion laws in l997, and maternal deaths from unsafe abortion have plummeted by 90 percent." Around the world 48 percent of abortions are unsafe--that's more than 20 million. Some 67,000 women die from unsafe abortions--13 percent of maternal deaths, almost all of them in the developing world, where abortion is mostly restricted or banned. Many times that number are injured or maimed.
The good news is that the global trend is toward legalization: as Susan Cohen reports in the upcoming Guttmacher Policy Review, since the Beijing conference on women seventeen countries have liberalized their abortion laws, while three have tightened restrictions (including, most recently, Nicaragua, where abortion is now illegal even to save the woman's life--thank you, Daniel Ortega). The bad news is that, due to population growth, the percentage of abortions that are unsafe has increased since 1995.
The big takeaway from the Lancet article is this: there is basically only one thing that lowers the rate of abortion for more than the minute and a half it takes women to figure out how to evade a new legal restriction: contraception. The countries with the lowest abortion rates, like the Netherlands, have few abortion restrictions and lots of birth control. Consider Eastern Europe. Under communism, abortion was virtually the only family planning method. As contraception has become more available, the abortion rate has plummeted--from 90 in 1995 to 44 in 2003. Indeed, Eastern Europe accounts for almost the entire worldwide decline in abortion in the period covered by the study. Meanwhile, for all our Sturm und Drang, with women in many states having to jump through more hoops than a circus tiger, the decline in the US abortion rate has been small.
I was curious to know how antichoicers would respond to what certainly seems like a devastating refutation of their position. "Anybody can look at data and pick and choose whatever they want," Jim Sedlak, vice president of the American Life League, told me. "The real fact is that abortion is ending life in the womb and should never be legal." I asked him if he accepted the finding that abortion was more dangerous where it was illegal. No, he said. "When something is illegal, people are more careful." So legal abortion is more unsafe? According to Sedlak, it is indeed.
As for contraception lowering the rate of abortion, that's an illusion: contraception is abortion. "Most methods of birth control kill babies in the womb by preventing implantation," said Sedlak, who'd like to see the pill, the IUD and most other methods outlawed. The American Life League, although not an official Catholic organization, explicitly follows Catholic teaching--unlike most Catholics, as Sedlak admitted. But so far as I know (and Sedlak agreed with me here) there is no antichoice organization that endorses contraception. Not one. Even Democrats for Life of America has refused to support Congressional legislation expanding funding for contraception. "Between Title X and Medicaid, the government has made a tremendous investment in contraception," DLA executive director Kristen Day told me. Actually, the government has done the opposite. Title X, which funds contraception for low-income women, has 61 percent less money in real terms than it had in 1980, to serve a much larger population. Had funding merely kept pace with inflation, it would be more than $725 million, instead of $283 million. As for Medicaid, skewed eligibility rules actually deny contraceptive benefits to many poor women who qualify for pregnancy care.
In the past few months, due to a technicality in the 2005 Deficit Reduction Act, the price of contraception in campus clinics has skyrocketed, from around $15 for a pack of pills to more than $50. Some college health centers have simply stopped offering the pill. When you consider that 3 million college women take the pill--38 percent of female students--you can see the disaster in the making. That won't bother the new head of the HHS Office of Family Planning, Susan Orr, a longtime opponent of birth control formerly with the Family Research Council. "We're quite pleased, because fertility is not a disease," Orr told the Washington Post in 2001, praising a Bush proposal to stop mandating contraceptive coverage in federal employees' health plans.
Between facts and theology, antichoicers choose the latter every time.
* * *
Showing posts with label legal abortion. Show all posts
Showing posts with label legal abortion. Show all posts
Wednesday, October 24, 2007
Tuesday, October 23, 2007
Legal or Not, Abortion Rates Compare
Legal or Not, Abortion Rates Compare
By ELISABETH ROSENTHAL
Click here for NYT Article
ROME, Oct. 11 — A comprehensive global study of abortion has concluded that abortion rates are similar in countries where it is legal and those where it is not, suggesting that outlawing the procedure does little to deter women seeking it.
Moreover, the researchers found that abortion was safe in countries where it was legal, but dangerous in countries where it was outlawed and performed clandestinely. Globally, abortion accounts for 13 percent of women’s deaths during pregnancy and childbirth, and there are 31 abortions for every 100 live births, the study said.
The results of the study, a collaboration between scientists from the World Health Organization in Geneva and the Guttmacher Institute in New York, a reproductive rights group, are being published Friday in the journal Lancet.
“We now have a global picture of induced abortion in the world, covering both countries where it is legal and countries where laws are very restrictive,” Dr. Paul Van Look, director of the W.H.O. Department of Reproductive Health and Research, said in a telephone interview. “What we see is that the law does not influence a woman’s decision to have an abortion. If there’s an unplanned pregnancy, it does not matter if the law is restrictive or liberal.”
But the legal status of abortion did greatly affect the dangers involved, the researchers said. “Generally, where abortion is legal it will be provided in a safe manner,” Dr. Van Look said. “And the opposite is also true: where it is illegal, it is likely to be unsafe, performed under unsafe conditions by poorly trained providers.”
The data also suggested that the best way to reduce abortion rates was not to make abortion illegal but to make contraception more widely available, said Sharon Camp, chief executive of the Guttmacher Institute.
In Eastern Europe, where contraceptive choices have broadened since the fall of Communism, the study found that abortion rates have decreased by 50 percent, although they are still relatively high compared with those in Western Europe. “In the past we didn’t have this kind of data to draw on,” Ms. Camp said. “Contraception is often the missing element” where abortion rates are high, she said.
Anti-abortion groups criticized the research, saying that the scientists had jumped to conclusions from imperfect tallies, often estimates of abortion rates in countries where the procedure was illegal. “These numbers are not definitive and very susceptible to interpretation according to the agenda of the people who are organizing the data,” said Randall K. O’Bannon, director of education and research at the National Right to Life Educational Trust Fund in Washington.
He said that the major reason women die in the developing world is that hospitals and health systems lack good doctors and medicines. “They have equated the word ‘safe’ with ‘legal’ and ‘unsafe’ with ‘illegal,’ which gives you the illusion that to deal with serious medical system problems you just make abortion legal,” he said.
The study indicated that about 20 million abortions that would be considered unsafe are performed each year and that 67,000 women die as a result of complications from those abortions, most in countries where abortion is illegal.
The researchers used national data for 2003 from countries where abortion was legal and therefore tallied. W.H.O. scientists estimated abortion rates from countries where it was outlawed, using data on hospital admissions for abortion complications, interviews with local family planning experts and surveys of women in those countries.
The wealth of information that comes out of the study provides some striking lessons, the researchers said. In Uganda, where abortion is illegal and sex education programs focus only on abstinence, the estimated abortion rate was 54 per 1,000 women in 2003, more than twice the rate in the United States, 21 per 1,000 in that year. The lowest rate, 12 per 1,000, was in Western Europe, with legal abortion and widely available contraception.
The Bush administration’s multibillion-dollar campaign against H.I.V./AIDS in Africa has directed money to programs that promote abstinence before marriage, and to condoms only as a last resort. It has prohibited the use of American money to support overseas family planning groups that provide abortions or promote abortion as a method of family planning.
Worldwide, the annual number of abortions appeared to have declined between 1995, the last year such a broad study was conducted, and 2003, from an estimated 46 million to 42 million, the study concluded. The 1995 study, by the Guttmacher Institute, had far less data on countries where abortion was illegal.
Some countries, like South Africa, have undergone substantial transitions in abortion laws in that time. The procedure was made legal in South Africa in 1996, leading to a 90 percent decrease in mortality among women who had abortions, some studies have found.
Abortion is illegal in most of Africa, though. It is the second-leading cause of death among women admitted to hospitals in Ethiopia, its Health Ministry has said. It is the cause of 13 percent of maternal deaths at hospitals in Nigeria, recent studies have found.
By ELISABETH ROSENTHAL
Click here for NYT Article
ROME, Oct. 11 — A comprehensive global study of abortion has concluded that abortion rates are similar in countries where it is legal and those where it is not, suggesting that outlawing the procedure does little to deter women seeking it.
Moreover, the researchers found that abortion was safe in countries where it was legal, but dangerous in countries where it was outlawed and performed clandestinely. Globally, abortion accounts for 13 percent of women’s deaths during pregnancy and childbirth, and there are 31 abortions for every 100 live births, the study said.
The results of the study, a collaboration between scientists from the World Health Organization in Geneva and the Guttmacher Institute in New York, a reproductive rights group, are being published Friday in the journal Lancet.
“We now have a global picture of induced abortion in the world, covering both countries where it is legal and countries where laws are very restrictive,” Dr. Paul Van Look, director of the W.H.O. Department of Reproductive Health and Research, said in a telephone interview. “What we see is that the law does not influence a woman’s decision to have an abortion. If there’s an unplanned pregnancy, it does not matter if the law is restrictive or liberal.”
But the legal status of abortion did greatly affect the dangers involved, the researchers said. “Generally, where abortion is legal it will be provided in a safe manner,” Dr. Van Look said. “And the opposite is also true: where it is illegal, it is likely to be unsafe, performed under unsafe conditions by poorly trained providers.”
The data also suggested that the best way to reduce abortion rates was not to make abortion illegal but to make contraception more widely available, said Sharon Camp, chief executive of the Guttmacher Institute.
In Eastern Europe, where contraceptive choices have broadened since the fall of Communism, the study found that abortion rates have decreased by 50 percent, although they are still relatively high compared with those in Western Europe. “In the past we didn’t have this kind of data to draw on,” Ms. Camp said. “Contraception is often the missing element” where abortion rates are high, she said.
Anti-abortion groups criticized the research, saying that the scientists had jumped to conclusions from imperfect tallies, often estimates of abortion rates in countries where the procedure was illegal. “These numbers are not definitive and very susceptible to interpretation according to the agenda of the people who are organizing the data,” said Randall K. O’Bannon, director of education and research at the National Right to Life Educational Trust Fund in Washington.
He said that the major reason women die in the developing world is that hospitals and health systems lack good doctors and medicines. “They have equated the word ‘safe’ with ‘legal’ and ‘unsafe’ with ‘illegal,’ which gives you the illusion that to deal with serious medical system problems you just make abortion legal,” he said.
The study indicated that about 20 million abortions that would be considered unsafe are performed each year and that 67,000 women die as a result of complications from those abortions, most in countries where abortion is illegal.
The researchers used national data for 2003 from countries where abortion was legal and therefore tallied. W.H.O. scientists estimated abortion rates from countries where it was outlawed, using data on hospital admissions for abortion complications, interviews with local family planning experts and surveys of women in those countries.
The wealth of information that comes out of the study provides some striking lessons, the researchers said. In Uganda, where abortion is illegal and sex education programs focus only on abstinence, the estimated abortion rate was 54 per 1,000 women in 2003, more than twice the rate in the United States, 21 per 1,000 in that year. The lowest rate, 12 per 1,000, was in Western Europe, with legal abortion and widely available contraception.
The Bush administration’s multibillion-dollar campaign against H.I.V./AIDS in Africa has directed money to programs that promote abstinence before marriage, and to condoms only as a last resort. It has prohibited the use of American money to support overseas family planning groups that provide abortions or promote abortion as a method of family planning.
Worldwide, the annual number of abortions appeared to have declined between 1995, the last year such a broad study was conducted, and 2003, from an estimated 46 million to 42 million, the study concluded. The 1995 study, by the Guttmacher Institute, had far less data on countries where abortion was illegal.
Some countries, like South Africa, have undergone substantial transitions in abortion laws in that time. The procedure was made legal in South Africa in 1996, leading to a 90 percent decrease in mortality among women who had abortions, some studies have found.
Abortion is illegal in most of Africa, though. It is the second-leading cause of death among women admitted to hospitals in Ethiopia, its Health Ministry has said. It is the cause of 13 percent of maternal deaths at hospitals in Nigeria, recent studies have found.
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