By Dr Ryan Corbin
With the US Supreme Court reversing Roe v Wade, the media has quickly published several opinions on this major change, many deeming it a step made in the negative direction.
What is even more worrying is the proposal by many ‘experts’ that we will see a spike in maternal death rates due to the restriction in this “essential medical service” as worded by the World Health Organization (WHO).
Is there truly cause for concern? Is abortion, that is, the intentional killing of preborn human beings necessary for the sake of development and ‘progress’ in lowering maternal mortality?
To define the concepts:
Maternal mortality: The annual number of female deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy.1
Maternal mortality ratio (MMR): The number of maternal deaths during a given time period per 100,000 live births during the same time period.2
The existing frame is that limiting abortion access will have detrimental effects on maternal mortality leading to many more women dying unnecessarily.
Various research articles are cited 3,4 to “confirm” this fear and it is a leading argument by many medical colleagues to emphasise how critical abortion access is to women’s health.
A common study used5 concluded; “maternal mortality is lower when abortion laws are less restrictive. Our results suggest that there is a need to reform abortion laws in the countries with the most restrictive abortion laws, and to provide safe abortion services to protect women from unsafe and illegal abortions.”
This understanding of the relationship has led the WHO to conclude; “Lack of access to safe, timely, affordable and respectful abortion care is a critical public health and human rights issue.”
“Access to safe abortion improves women’s health… Access to safe, legal abortion is a fundamental right of women, irrespective of where they live.”6
Therefore it is implied that with easier abortion access, the maternal mortality will be lower.
At the foundation of this is the agreed understanding that one maternal death is one too many. According to the WHO, “No issue is more central to global well-being than maternal and perinatal health. Every individual, every family and every community is at some point intimately involved in pregnancy and the success of childbirth.”7
We must do all we can, within morally just reason, to protect and care for those who quite literally carry our future within them.
However, is unrestricted abortion access one of, if not the main tool(s) to achieve this?
For developed countries, prior to reversing of opinion on Roe v Wade, the United States had one of the most liberal laws (similar to China and North Korea) in place regarding abortion access with most states having unrestricted abortion on demand up to birth.
With this in mind and using the proposed relationship in the above frame, it should therefore be expected that maternal mortality in the US will be very low. Surprisingly the data shows that the opposite is true with the US having the highest maternal mortality ratio at 23.8 (latest data – 2020).8
Further to this, some of the lowest maternal mortality ratios (MMR) in the world can be found in countries with the most restrictive abortion laws such as Poland (MMR = 2)9 and Malta (MMR = 6)9.
If we dive deeper into the data, we will also observe that while the US was “enjoying” abortion on demand, the MMR continued to climb. We also notice that global maternal mortality has declined not with the introduction of abortion but with antibiotics and improved medical management of the pregnant patient. Therefore, is legal abortion access so ‘critical’ to lowering maternal mortality? If restricted abortion access forces women to have more “back alley” abortions, why isn’t the MMR much higher in those countries with such restrictions? Is the answer to improving women’s health abortion on demand?
As mentioned before, society has popularised abortion as the ‘quick fix’ to women’s problems, but this comes at a great price.10 Can we challenge our society to reframe, to move from a throwaway culture to one which looks to journey with pregnant women from conception to birth and beyond, tending to her needs in the best way possible while maintaining the optimal care for both mother and child? Contrary to popular belief, there is no such thing as a ‘safe’ abortion; one human lives, one human dies.
Let us elevate our goals in the care of our future and not allow ourselves to have a restrictive mindset; let us be prudent.
What is prudence, one might ask? In the Christian tradition, prudence is classically understood as a practical wisdom that empowers one to be good and to act well in daily affairs, both ordinary and extraordinary. Or, as the Catechism of the Catholic Church (CCC) quotes St Thomas, “right reason in action”. 11
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5 – Latt, S.M., Milner, A. & Kavanagh, A. Abortion laws reform may reduce maternal mortality: an ecological study in 162 countries. BMC Women’s Health 19, 1 (2019). https://doi.org/10.1186/s12905-018-0705-y
6 – Grimes DA, Benson J, Singh S, et al. Unsafe abortion: the preventable pandemic. Lancet. 2006;368:1908–1919.