Does Abortion Access Protect Women's Health?
Head, Jeanne E., Hussey, Laura, The World and I
Jeanne E. Head, a retired labor and delivery nurse, is vice president for international affairs and UN representative for the National Right to Life Committee. Laura Hussey is a Ph.D. student and research assistant for the National Right to Life Committee.
Just as abortion continues to stir a storm of acrimony in the United States, controversy rages around the world over the procedure's legalization in the many countries that still prohibit or sharply limit it. The chief justification for making abortion legal is reducing maternal mortality. Yet what's often overlooked in the debate is that the main factor that has dramatically diminished abortion-related fatalities since the 1930s and '40s until today is not legalizing the procedure so much as improving the overall quality of national health- care systems.
Organizations such as the UN's World Health Organization (WHO) report 40-50 million annual abortions worldwide with 70,000 abortion-related maternal deaths. Scanty data, however, make an accurate assessment of the status of abortion and abortion laws throughout the world a daunting, virtually impossible task. WHO's estimates are largely constructed by statistical estimation, based on meager data and poorly supported assumptions.
The group nonetheless frequently repeats these figures in the interest of expanding the legality of abortion, as do the United Nations Fund for Population Activities (UNFPA) and other UN bodies. So do their nongovernmental partners, whose ranks include such abortion advocates as the International Planned Parenthood Federation (IPPF), the International Women's Health Coalition (IWHC, which has published a manual for increasing access to abortion), and the Center for Reproductive Rights (CRR, formerly known as the Center for Reproductive Law and Policy).
Unfortunately, untrustworthy statistics lead to misidentifying the real causes of maternal mortality in the developing world. They also result in channeling valuable resources away from improving general and maternal health care and the overall health status of women, which, according to WHO's 1991 Maternal Mortality: A Global Fact Book, sharply decreased maternal mortality in the developed world from 1941 to 1951, long before legalization of abortion.
Although it was not a new idea, the move to make abortion a global, fundamental human right began in earnest with the 1994 International Conference on Population and Development (ICPD) in Cairo. After much controversy and compromise, participating countries ultimately stopped short of any outright call for a worldwide legal right to abortion but agreed on language involving calls to advance reproductive rights and reproductive health services, decrease the "need" for abortion, and eliminate "unsafe abortion." While these goals sound apolitical, abortion advocates in fact view them as synonyms for the broad legalization of abortion. IWHC, for example, recently challenged fellow abortion proponents to state their mission more boldly, "to move beyond the rhetoric of 'prevention and management of unsafe abortion' to argue that access to safe abortion is the most direct way to eliminate unsafe abortion."
STATUS OF WORLD ABORTION LAWS
In preparation for the Cairo ICPD, the UN Population Division in 1994 published Abortion Policies: A Global Review to catalog the world's abortion laws. It updated this in 1999, before the five-year review of the Cairo conference. In these volumes, the Population Division shared some of its difficulties in gathering this information. For starters, several countries had not codified their abortion laws, leaving decisions about its legality to common law or religious law. Researchers struggled to obtain legal documents from many developing countries.
Even where abortion law was codified, researchers found it difficult to know where in a country's code to look for the law. They found that abortion policies were not always uniform throughout a nation, especially if the state had a federal structure. …