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Monday, September 12, 2005

Women three times more likely to die after an abortion.

Off the top of your head, do you think that women are more likely to die from the complications of childbirth or the complications of abortion?

If you're like most people, your immediate thought would be, "Women are far more likely to die from the complications of childbirth." Somewhere along the line, you've probably heard it said that women are six times more likely to die from childbirth than from abortion.

A study published in late 2004 in the international medical journal Paediatric and Perinatal Epidemiology has called this assumption into question.

Researchers Mika Gissler, Cynthia Berg, Marie-Helene Bouvier-Colle and Pierre Lukens investigated whether our methods for identifying deaths associated with abortion are accurate. In Methods for
identifying pregnancy-associated deaths: population-based data from Finland 1987-2000
, this team of researchers provides evidence that current international methods for collecting information about abortion-related deaths are quite faulty.

In a press release today from The Elliot Institute, post-abortion research specialist David Reardon describes the Gissler/Finnish results this way:

International health experts have published a new study disclosing that 94 percent of maternal deaths associated with abortion are not identifiable from death certificates alone. Proper tracking of pregnancy associated deaths, they report, requires the linking of death certificates to the deceased women's medical records. Only in this way, they conclude, can accurate information about recent pregnancies be determined--information that is frequently missing from death certificates and autopsies.

The study, completed by researchers from the National Research and Development Center for Welfare and Health in Finland, shows that the long held presumption that abortion is associated with fewer deaths than childbirth does not hold up once the pregnancy history of women is actually investigated using record linkage. Previously, it has been widely assumed that the mortality rate associated with
abortion was only one-sixth that of childbirth. But those estimates were based primarily on information gathered only from death certificates or other public records. Proper identification of pregnancy history, the researchers found,
reveals that the death rate associated with abortion is actually three times higher than that of childbirth.
Reardon goes on to suggest that these findings might impact the abortion debate in the United States, quoting Walter Weber, an attorney with the American Center for Law and Justice who specializes in abortion law. Weber says:

"The claim that abortion was safer than childbirth, at least early in pregnancy, was accepted as a crucial fact in Roe v Wade. In fact, the Court concluded that the states had authority to regulate abortion to protect women's health only at the point at which death rates associated with abortion exceeded those associated with childbirth -- which at that time was assumed to be around 12 weeks of gestation."
Reardon provides additional analysis of these new results in articles here (a PDF file) and here.

As Reardon notes:

Planned Parenthood and the closely allied Alan Guttmacher Institute (AGI) continue to promote the message that abortion is safer than childbirth. Their argument is based on comparing the nationally reported rates of death for childbirth to the rate of death associated with abortion that is reported by the National Institutes of Health's Centers for Disease Control (CDC). But both sets of numbers are drawn principally from death certificates.
And as the new study in Paediatric and Perinatal Epidemiology shows, just looking at the death certificates turns out to be quite inadequate. To get the true figures, general medical records (which disclose pregnancies and dispositions of pregnancies) have to be linked to death certificates in order to accurately assess the rates of death associated with pregnancy.

In the United States, the Centers for Disease Control has been a major player in providing what are probably inaccurate figures about abortion-related deaths. Reardon writes:

Even before this latest study discrediting the accuracy of accessing pregnancy associated deaths from death certificates alone, the CDC's reports on abortion associated deaths had been severely criticized by abortion opponents.
One of the chief complaints was that the top physician's in the CDC's abortion surveillance unit had clear conflicts of interest since they were not only outspoken advocates for expanding abortion services but also practicing abortion providers.
That's not good.

The CDC has proven resistant to adopting the new record linkage techniques for assessing the rate of deaths associated with pregnancy outcomes. David Reardon writes:

"The CDC abortion surveillance team has yet to apologize for and repudiate a
blatantly misleading study its team authored in 1982 which asserted they were successfully identifying at least 90 percent of deaths associated with abortion. This report was particularly dishonest in that they misappropriated a little known statistical comparison test, and violated each of the test's three preconditions for validity, simply to dismiss calls for better investigations."

"The work of Kevin Sherlock, a writer and reporter who specializes in public record research, proves that the CDC's abortion mortality statistics are essentially
meaningless. Sherlock's independent review of death certificates, with cause of death verified by autopsies and court records regarding malpractice claims, confirmed at least 140 abortion related deaths for the decade of the 1980s, which is thirty percent more than the total reported by the CDC. "That a single investigator could fully document thirty percent more deaths than the entire CDC abortion
surveillance unit should give everyone pause."

This long-standing stalemate between the CDC and its critics, when it comes to assessing abortion death rates, has the potential to be broken by the new methods advocated by Mika Gissler and her colleagues. The record-linkage studies she advocates create for the first time a neutral, objective, way to compare deaths associated with abortion and childbirth using a consistent and uniform standard.

Everyone interested in women's health should cheer these new techniques and advocate their adoption.

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