Chile: When abortion was banned the number of illegal abortions fell

One of the most common accusations levelled against abortion restriction is the claim that if abortion is prohibited, a market for illegal unsafe “back alley” abortions will inevitably emerge.  Therefore, abortion proponents argue, if women are going to get abortions anyway, it is better that they do so legally.  While this argument has numerous flaws, one critical point has recently been upset by new research emerging from Chile which demonstrates that the number of illegal abortions actually fell when abortion was banned.

This new report focuses specifically on Chile, where abortion was outlawed in 1989, and examines the numbers of abortion-related mortalities as well as hospital discharges due to abortion complications.  The results were surprising, as the idea of women forced to seek an illegal termination due to lack of abortion access has become very much part of public perception.

The findings released by the MELISA Institute (using data collected by Chile’s Ministry of Health) demonstrate that the number of women seeking illegal abortion has undergone a sharp decline since the ban on abortion came into force.  The Ministry of Health has been able to track this data by examining hospital records showing discharges of women experiencing complications due to abortion.  Women seeking to terminate their own pregnancies frequently use a drug called misoprostol which will end the life of the unborn child but can contribute to severe bleeding and pelvic pain in the mother, causing her to seek medical assistance.  According to the recent official data, Chile shows a continuous decreasing trend of hospital discharges due to complications of illegal abortions – recorded according to the recommended codes of the World Health Organisation classification – at a rate of 2% per year since 2001.

Furthermore maternal death related to induced abortion has decreased from 10.8 to 0.39 per 100,000 live births.  This marks a very substantial reduction

The report also found since the implementation of Chile’s abortion ban, the number of maternal mortalities has continued to fall. In fact, since 1989, the number of maternal deaths decreased from 41.3 per 100,000 women to 12.7 per 100,000 women, a reduction of almost 70%, making Chile’s one of the safest places in the Americas for a mother to have a baby – safer than the United States for example.

MELISA named this the abortion paradox precisely because the data contradicted the relentless claim that illegal abortions,  and deaths or complications from the same, would rise sharply following an abortion ban. Researchers then looked at a possible cause for the paradox: that better supports and better maternal healthcare was being made available to women, especially those who were vulnerable to abortion.

Previously unpublished data from an ongoing study of Chilean women experiencing unplanned pregnancies who are regarded as vulnerable to abortion was examined.  This study found that of these 3,134 at risk women, the majority display a vulnerability profile marked by fear and coercion which accounts for nearly 70% of the reasons given for electing to terminate a pregnancy.  The data suggested that support programs directed at vulnerable women can prevent most illegal abortions, with an outcome of live birth (with or without adoption) in between 69% and 94% of cases depending on the risk group.

Chile has seen significant success in this particular area of maternal health.  This success is ascribed to several factors including improved maternal health policy intervention, the increase in women’s educational levels, and the emergency of support programs to help vulnerable pregnant women.

Chile is a prime example of how abortion restriction is not adverse to proper medical care for women and, in fact, can lead to better maternal care.  Another example of this phenomenon would be Ireland.  A 2013 study entitled “Maternal and Neonatal Health and Abortion: 40 Year Trends in Great Britain and Ireland” was published in 2013 in the American Journal of Physicians and Surgeons.  The report compared 40 years of maternal and neonatal data from the United Kingdom, where elective abortion is legal, and Ireland, where abortion is restricted, and found that Irish mothers and babies are significantly better off than their British counterparts.   The rate of maternal mortality in Ireland is half that of the UK and Ireland has significantly lower rates of stillbirth and preterm birth.

The situation is even more dire in the United States, which has ultra-permissive abortion policies.  Research published this year in the Lancet medical journal found that 18.5 American mothers died giving birth per 100,000 births.  This is more than triple the rate of the United Kingdom.

The data from Chile and Ireland both challenge the assertion that abortion is a necessary component for women’s health.  What this research makes clear is that more restrictive abortion policies do not lead to higher morbidity associated with abortion and can, in fact, lead to a drop in illegal and unsafe abortions.  In the end, these policies produce a better outcome for both mother and baby.

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Nora Sullivan is a research analyst and student of policy

LINKS

• The epidemiology of abortion and its prevention in Chile
• Decrease in Maternal Deaths in Chile