Saturday, January 18, 2014

Are unsafe abortions the cause of high maternal mortality rate?

Soviet poster circa 1925, warning against midwives performing abortions. Title translation: "Abortions performed by either trained or self-taught midwives not only maim the woman, they also often lead to death."(Wikipedia: Abortion)

The question of whether unsafe abortions are the cause of high maternal mortality rate is a hypothesis and not an established fact. When we say "the cause", we assume that there are no other dominant causes.  The organizers of the coming 7th Asia Pacific Conference on Reproductive Sexual Health and Rights that will be held Jan 21 at PICC thinks only in terms of safe and unsafe abortions, because their sponsors have the agenda of controlling population either by contraception or abortion. There are other factors that determine the maternal mortality rate and abortion is just one of them:
Maternal and Child Health: Global Challenges, Programs, and Policies
Maternal and Child Health: Global Challenges, Programs, and Policies

  • Hospital cleanliness.  The hospital does not properly disinfect its surroundings, equipment, and personnel.
  • Medical competence.  Doctors, nurses, and midwives are not following standard procedures in child delivery or the mother was administered wrong medicines.
  • Maternal hygiene. The mother does not wash herself properly, e.g. wash hands with soap and water
  • Maternal sickness.  The mother may already be suffering from another sickness, e.g. leukemia, before delivering her child.
  • Maternal nutrition.  The mother may not be eating or drinking well, e.g. she starved to death.  
  • Maternal surgery.  The mother may have had several caesarean operations before or underwent heart bypass surgery 
  • Maternal psychological health. The woman committed suicide because she was depressed or insane.
  • Contraceptives.  The mother may have taken contraceptives that have fatal side effects, e.g. blood clots
  • Abortion. The mother attempted to abort her child or asked somebody to help her do it. Abortion is a surgical or chemical operation and women's lives are always in danger whenever they undergo abortion procedure.
  • Others
The scientific way to find the cause of high maternal mortality rate is to assume all possible causes, test them one by one, find the leading causes, and make recommendations to address these leading causes.  Even if you restrict your study only to one hospital, this is already a research paper--a research which requires careful methodology design in order to isolate one possible cause of maternal mortality in question, while keeping the other variables constant.  Different hospitals may have different causes of maternal mortality.  The results of this study would be very important, because Philippines don't have accurate statistics on maternal mortality rate and their causes.  Lawmakers like Lagman just blurt out the statistic of 11 mothers dying per day, based on Guttmacher's estimates, which in turn are not based on actual hospital records, as I shall show in another post.

Thus, it is presumptuous to conclude that high maternal mortality rate is due to unsafe abortions, unless, of course, you wish to push the abortion agenda, such as in the coming The 7th Asia Pacific Conference on Reproductive Sexual Health and Rights at PICC.