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Guttmacher Fails to Debunk Chilean Maternal-Mortality Study



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A recent study which demonstrates that abortion restrictions in Chile have not hurt maternal-mortality outcomes has received a considerable amount of attention. As I wrote previously, this study is very important for several reasons. It is methodologically rigorous, it analyzes reliable public-health data, and it looks at one of the few countries to place restrictions on abortion after a period of legalization. As such, it should come as no surprise that the Guttmacher Institute has revved up its spin machine in the hopes of discrediting the study. Unfortunately, Guttmacher’s response leaves much to be desired.

In their response to the study, Guttmacher makes several points. First they claim that abortion was restricted in Chile prior to the passage of a restrictive 1989 law. However, while there were some legal restrictions on abortion in Chile prior to 1989, abortions were still allowed for “therapeutic” purposes. The authors of the Chilean maternal-mortality study identify a hospital in Santiago that performed thousands of abortions in the months preceding the coup in 1973. Even taking Guttmacher’s claim at face value, the sharp decline in the Chilean maternal-mortality rate clearly shows that it is possible for developing countries to lower their maternal-mortality rates without legalizing abortion.

Second, Guttmacher questions the reliability of the public-health data utilized by the researchers. However, the researchers were diligent in using Chile’s public-health registry to combine a range of maternal death causes. Furthermore both the World Health Organization and the United Nations have deemed public-health data from Chile reliable. This charge from Guttmacher is especially ironic because in previous research on abortion in developing countries, Guttmacher has used surveys which greatly overestimate the incidence of abortion. For instance, a 2006 analysis by Guttmacher claimed that anywhere from 700,000 to 1,000,000 abortions were taking place every year in Mexico. After abortion laws were liberalized in Mexico, health data indicates that only between 10,000 and 20,000 abortions were performed there annually.

#more#Third, Guttmacher argues that the researchers fail to account for other factors which may have decreased the Chilean maternal-mortality rates. Not surprisingly, they argue that increases in contraception use played a role. The authors of the Chilean study acknowledge that this may be a possibility. However, only about one-third of reproductive-age women in Chile use hormonal birth control. As such, it is unlikely that contraception use played a substantial role in the decline in Chile’s maternal-mortality rate. Similarly Guttmacher also argues that the availability of the abortifacient misoprostol played a role as well. However, misoprostol became available during the 1990s, well after Chile’s maternal-mortality rate started falling.

Finally, Guttmacher claims that there is no body of evidence suggesting that restricting abortion improves women’s health. Guttmacher does acknowledge that some countries where abortion is restricted including Ireland, Poland, and Malta all have low maternal-mortality rates. However, they discount this, stating that women in these countries simply obtain abortions in neighboring countries. While this may be true, there is data which suggests that even taking inter-country travel in to account, women in these countries obtain abortion less often than their counterparts elsewhere.

What Guttmacher must find frustrating is that this research is significantly better than most of the other studies which analyze the impact of abortion policy on maternal mortality. The other studies simply compare mortality rates in countries where abortion is restricted to mortality rates in countries with permissive abortion policies. These studies fail to consider that many countries where abortion is illegal are located in Africa, the Middle East, and Latin America. These countries tend to have higher poverty rates, worse sanitation, and other problems which contribute to high maternal-mortality rates. It is no surprise this new research has Guttmacher analysts worried.

— Michael J. New is an Assistant Professor at The University of Michigan — Dearborn, a Fellow at the Witherspoon Institute, and an Adjunct Scholar at the Charlotte Lozier Institute.



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