A new study which demonstrates that abortion restrictions in Chile have improved maternal mortality outcomes has received a lot of attention from pro-life blogs and websites. Quality research that highlights the positive public-health impact of pro-life laws is always welcome. However, this study which appeared in the peer-reviewed journal PLoS ONE is more important than many people realize. It is the most rigorous study of its kind, and it could have a significant impact on future public-health research.
Countless public-health professionals and researchers reflexively assume that expanded access to abortion improves public-health outcomes for reproductive-age women. However, there is relatively little quality academic research that supports this assertion. For instance, the literature review of the Chilean maternal mortality study only cites five studies that have analyzed the impact of abortion policy on maternal-mortality rates. Only two of these five studies have appeared in peer-reviewed journals and both have methodological shortcomings.
A 1998 study, which appeared in the International Journal of Gynecology and Obstetrics, identified several countries where maternal-mortality rates decreased after abortion was legalized. However, it failed to analyze the trends in maternal mortality prior to abortion legalization. It also failed to consider that maternal health-care facilities, sanitation, and educational opportunities for women were all likely improving in these countries. This study also cites the decline in maternal mortality after abortion was legalized in Romania in 1989. However, the authors fail to consider that access to quality health care doubtless improved after the fall of Communism.
Similarly, a 2006 study, which appeared in The Lancet, simply compared maternal-mortality rates in countries where abortion is legal to maternal-mortality rates in countries were abortion is restricted. However, the researchers fail to consider the fact that most of the countries where abortion is illegal are in Africa and the Middle East. These countries have much higher poverty rates and offer lower quality health care. These factors doubtless contribute to high maternal mortality rates.
The Chilean study improves on this research for a couple reasons. First, Chile has reliable data on maternal mortality dating back until the 1950s. Second, Chile is one of the few countries that placed legal restrictions on abortion after a period of legalization. In many other countries, both improvements in maternal health-care facilities and better educational opportunities for women occurred during an era of greater access to abortion. As such, it was difficult for researchers to determine whether falling maternal-mortality rates in these countries were due to the increased availability of legal abortion or to these other trends.
The evidence from Chile, however, clearly indicates that maternal mortality continued to fall even when abortion became more restricted. This provides very solid evidence that increases in the educational level of women and improvements in maternal-health facilities are responsible for the decline in the maternal mortality rate. Furthermore, Poland, Malta, and Ireland, where abortion is restricted, have among the lowest maternal-mortality rates in Europe. All in all, this research provides very good evidence that access to abortion has had little to do with improved public-health outcomes for women.
— Michael J. New is an assistant professor of political science at the University of Michigan –Dearborn, a fellow at the Witherspoon Institute, and an adjunct scholar at the Charlotte Lozier Institute in Washington, D.C. Follow him on Twitter at @Michael_J_New