Editor's note: This article first appeared on May 14, 2014 in Chileno magazine and is reprinted with permission.
[caption id="attachment_12828" align="aligncenter" width="600"] Maternal deaths per 100,000 live births.
Photo Credit: The MELISA Institute[/caption]
In a recent article by Liz Ford published in The Guardian on the 25th of April (2014), Chile is portrayed as one of the six countries in the world that bans abortion even when the mother’s life is in danger, and where deaths due to illegal abortion account for as many as 40% of all maternal deaths in the country. These assertions are in direct contrast to the internationally recognised image of Chile as a country that safeguards motherhood and childhood, and currently boasts the lowest maternal mortality in Latin America, second only to Canada in the American continent.
In this regard, maternal deaths due to abortion complications decreased 99% between 1957 and 2009 in Chile, and the downward mortality trend was continuous before and after abortion ban in 1989. Currently, less than 3% of all maternal deaths are related to an abortive outcome (mainly secondary to ectopic pregnancy and/or other pathologic conditions), additionally decreasing from 10.8 to 0.39 per 100,000 live births between 1989 and 2009. In other words, the current absolute risk of dying from abortion in Chile is about one in four million for women between 15 and 49 years old.
Fortunately, after an active correspondence exchange between the Readers’ Editor of The Guardian and the MELISA Institute, a non-profit private biomedical research institution with headquarters in the city of Concepción, Chile, The Guardian acknowledged that one of the United Nations (UN) documents quoted in the article was outdated. A thorough reading of the document revealed a series of errors both in the statistics of deaths due to abortion, and the contribution of abortion-related deaths to overall maternal deaths. For instance, it states that “deaths from illegal abortion declined from 118 to 24 per 100,000 live births between 1964 and 1979”. First, it is very difficult to quantify illegal abortions in countries with less permissive legislation. Second, recent peer-reviewed studies using official data indicate that abortion-related deaths (deaths due to all types of abortion, including ectopic pregnancy, spontaneous abortion or unspecified abortion) were 89.0 and 23.4 deaths per 100,000 live births between those years.
In an amendment of the article on the 9th of May, The Guardian removed the paragraph regarding the 40% contribution of abortion-related deaths to total maternal death in the country. Such an amendment is not only a demonstration of the journalism ethics in The Guardian but also is a clear acknowledgement of the actual statistics and the progress made in maternal health in Chile.
The other UN document quoted by the writer regarding abortion policies around the world indeed lists Chile as one of the six countries in the world banning abortion even in cases where the mother’s life is at risk. The Guardian stands by such assertion in their article (see correspondence). Close inspection of the UN document, however, specifically in its methodological notes, revealed that for the cases of Chile, El Salvador, Malta, and Nicaragua, “it is not clear whether a defence of necessity might be allowed to justify an abortion performed to save the life of the woman”. Accordingly, the UN recognizes that Chile does not display an explicit law allowing abortion in cases where the mother's life is at risk but under such law, abortion is a medical ethics decision rather than a legal issue, as long as its practice is not the final goal. In fact, this interpretation is supported by the Chilean College of Physicians. Therefore, such nuances of the Chilean law make a big difference when making judgements over misleading information, especially when misinformation may damage the international image of a country.
Why is this correction important? The answer is very simple. In order to preclude any kind of misinformation to the general public, it is important to provide actual and accurate statistics of maternal mortality when dealing with delicate and controversial subjects such as abortion, especially if the international prestige of a country is at stake. Erroneous statistics lead to erroneous conclusions and therefore, we celebrate the amendment made by The Guardian.
Finally, after reading The Guardian’s article, a subtle question remains to be addressed on this issue: How can a law of therapeutic abortion decrease maternal deaths in Chile if virtually no women are dying from abortion nowadays? At least, it is hard to understand the logic behind this argument.