The Guttmacher Institute, a staunch advocate of legalized abortion, has criticized a recent peer-reviewed study of maternal mortality in Chile. The study shows that the prohibition of abortion in Chile did not increase maternal deaths, as abortion advocates frequently claim would be the case; rather, maternal mortality continued to decline significantly after abortion was made illegal. Maternal mortality in Chile, the researchers explain, is "not related to the legal status of abortion."
Guttmacher, of course, disagrees. But its attempt to "debunk" the Chilean study is extraordinarily weak. The authors of the study have issued a response that thoroughly refutes Guttmacher point by point.
What is Guttmacher's evidence that legalizing abortion improves women's health? First, it observes that many countries with strong abortion restrictions have high maternal mortality ratios (maternal deaths per 100,000 live births), and many countries with legal abortion on demand have low MMRs. But correlation, as they say, is not causation. The abortion-restricting countries in question are precisely those countries (particularly in Africa) where health conditions are worst -- so they are precisely where we would expect to see high rates of maternal death, regardless of the status of abortion. And the countries that permit abortion on demand and have low MMRs are developed nations with quality health care -- so we should expect to see very low death rates.
There is no actual empirical evidence -- no rigorous scientific research -- causally linking abortion restrictions to increased maternal mortality. And Guttmacher's view simply cannot explain why MMRs dramatically declined in the developed world as a result of advancements in modern medicine before the widespread legalization of abortion; why countries like Ireland, Poland, Malta and Chile ban abortions and yet have very low MMRs (among the lowest in the world) because they have good maternal health care; why some countries with abortion on demand, like Guyana, have not decreased their MMRs after legalizing abortion (Guyana's MMR only increased). The worldwide evidence indicates that maternal mortality is a function of maternal health care, sanitation, women's education and related factors, but not the legal status of abortion.
Guttmacher's second argument is that certain countries that legalized abortion over the last two decades are "beginning" to see "improved health outcomes for women." But much of the world has been seeing "improved health outcomes for women" as health conditions and education level improve; why think it has to do with the legality of abortion? Of the four countries that decreased their MMRs the most between 1990 and 2008 (according to the World Health Organization, et al., Trends in Maternal Mortality: 1990-2008), three of them did so while maintaining bans on abortion.
Guttmacher specifically cites Ethiopa in Africa, but its MMR is still much higher than that of Mauritius, which prohibits abortion; Guttmacher cites Nepal in Asia, but its MMR is still much higher than that of Sri Lanka, which prohibits abortion; and, as Guttmacher's only other example, it cites South Africa, whose MMR has actually increased significantly in the last two decades.
In short, Guttmacher doesn't have a leg to stand on. Legalizing abortion, the Chilean researchers conclude, "is unnecessary to improve maternal health: it is a matter of scientific fact in our study. We think this should be recognized by a scientific community guided by principles of honesty and objectivity in science, no matter how controversial the finding might be."
(In their response, the Chilean team refutes Guttmacher's other criticisms and exposes the deeply flawed methodology used by Guttmacher researchers -- which, for example, led Guttmacher to make what we now know to be "at least a 30-fold overestimation in the number of induced abortions conducted before abortion legalization" in Mexico.)
