Wednesday, May 30, 2012

Why Guttmacher is wrong about maternal mortality and abortion

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.)

Tuesday, May 29, 2012

Video: Beginning of fetal period

Friday, May 25, 2012

Evidence presented at World Health Assembly that health care, not abortion, will solve maternal mortality

(Left to right) Patrick Buckley (SPUC), Jeanne Head (NRLC), Mary Langlois (HLI) and Scott Fischbach (MCCL GO) 

Note: The following was published yesterday at NRL News Today.

By Paul Stark

Evidence that legalizing abortion does not reduce maternal mortality was presented this week at the World Health Assembly in Geneva, Switzerland.

Scott Fischbach, executive director of Minnesota Citizens Concerned for Life Global Outreach (MCCL GO), and Jeanne Head, R.N., U.N. representative and vice-president for international affairs at the National Right to Life Committee, launched an updated analysis published by both organizations.

Despite a worldwide decline in recent years, maternal mortality remains a serious problem in developing nations. "We have known for decades that most maternal deaths can be prevented with adequate nutrition, basic health care, and good obstetric care throughout pregnancy, at delivery, and postpartum," says Head. "Yet some in the international community have focused their resources primarily on legalizing abortion at the expense of women's lives."

The new analysis, "Women's Health & Abortion," explains that maternal mortality fell dramatically in developed nations as a result of mid-20th century improvements in health care—well before the widespread legalization of abortion. Today Ireland and Poland, which prohibit most abortions, boast among the world's lowest rates of maternal death.

"Maternal mortality is determined by the quality of maternal health care, not the legal status of abortion," notes Fischbach. "Pushing for legal abortion in developing countries does nothing to solve the problem. It only leads to more abortions."

The analysis highlights a peer-reviewed study of maternal mortality in Chile published on May 4. The researchers, led by Dr. Elard Koch of the University of Chile, show that maternal mortality declined significantly even after Chile prohibited abortion in 1989. Maternal deaths due specifically to abortion also dropped after abortion was made illegal.

Koch, et al., cite various factors to explain the decrease, including a significant increase in education level, utilization of maternal health facilities, and improvements in the sanitary system. The researchers conclude that "making abortion illegal is not necessarily equivalent to promoting unsafe abortion, especially in terms of maternal morbidity and mortality. ... Our study indicates that improvements in maternal health and a dramatic decrease in the [maternal mortality ratio] occurred without legalization of abortion."

Chile's success contrasts with the recent record of the United States, which permits abortion on demand and has seen its maternal mortality rate climb upward over the last two decades. The U.S. maternal mortality ratio (the number of deaths per 100,000 live births) increased from 10.3 in 1999 to 23.2 in 2009. Over the same period, Chile's ratio decreased from 23.6 to 16.9.

A report issued this month by the World Health Organization and other U.N. agencies estimates that maternal deaths worldwide dropped 47 percent from 1990 to 2010. The report offers further proof that women’s lives can be saved through improved health conditions.

"We urge the World Health Assembly to adopt measures to significantly reduce maternal mortality in the developing world by improving women's health care," Fischbach adds. "We call upon the WHA to save lives, not expend endless energy and resources advocating the legalization of abortion in countries that protect their unborn children."

Monday, May 21, 2012

New analysis of maternal mortality confirms health care, not abortion, key to saving lives

The following was released today, May 21.

GENEVA, Switzerland — Improved medical care, not abortion, is the solution to the problem of maternal deaths in the developing world, according to a new analysis of research from Chile and other sources. The analysis was released today at the World Health Assembly (WHA) in Geneva by Minnesota Citizens Concerned for Life Global Outreach (MCCL GO) and National Right to Life Educational Trust Fund (NRLC), an NGO based in Washington, D.C. Leaders of both organizations called for a renewed emphasis on improving health care for women as the only sure means of reducing maternal mortality.

"We have known for decades that most maternal deaths can be prevented with adequate nutrition, basic health care, and good obstetric care throughout pregnancy, at delivery, and postpartum," said Jeanne Head, R.N., National Right to Life vice-president for international affairs and U.N. representative. "Yet some in the international community have focused their resources primarily on legalizing abortion at the expense of women's lives."

"Our analysis presents clear, factual evidence to repudiate the claim that legalized abortion reduces maternal mortality," said MCCL GO Executive Director Scott Fischbach.

The analysis, "Women's Health & Abortion," compares the impact of improved medical care and legalized abortion on maternal mortality rates in several countries. Maternal deaths declined sharply in the United States through the 1930s and 1940s, for example, coinciding with advancements in maternal health care, obstetric techniques, antibiotics and in the general health status of women. This occurred long before the widespread legalization of abortion.

Chile offers the most striking proof that maternal mortality is unrelated to the legal status of abortion. Chile sharply reduced its maternal mortality rate even after its prohibition of abortion in 1989, and now has the lowest maternal mortality rate in Latin America. Even maternal deaths due specifically to abortion declined—from 10.78 abortion deaths per 100,000 live births in 1989 to 0.83 in 2007, a reduction of 92.3 percent after abortion was made illegal.

In the developing world, the danger of legalized abortion is profound, the analysis found. Ms. Head explains: "Women generally at risk because they lack access to a doctor, hospital, or antibiotics before abortion's legalization will face those same circumstances after legalization. And if legalization triggers a higher demand for abortion, as it has in most countries, more injured women will compete for those scarce medical resources. The number of abortion-related maternal deaths may actually increase."

MCCL GO and National Right to Life called upon the WHA to focus its resources on the improvement of women's health care in the developing world.

"We urge the World Health Assembly to adopt measures to significantly reduce maternal mortality in the developing world by improving women's health care," Mr. Fischbach added. "We call upon the WHA to save lives, not expend endless energy and resources in areas where there is profound disagreement, such as the legalization of abortion."

MCCL GO is a pro-life global outreach program of the Minnesota Citizens Concerned for Life Education Fund with one goal: to save as many innocent lives as possible from the destruction of abortion. Learn more at www.mccl-go.org.

Tuesday, May 15, 2012

Organ donor awareness: Know your risks

The following was released today, May 15.

A shocking article in this month's Discover magazine has renewed concern over end-of-life treatment for those willing to donate their organs after death. Minnesota Citizens Concerned for Life is calling attention to the issue on behalf of donors and recipients.

"One of the pro-life movement's guiding principles is that every human being, regardless of their strong or weak physical state, has an inalienable right to life and that right cannot be infringed upon by others," said MCCL Executive Director Scott Fischbach.

The Discover article explains how, in 1968, a group of doctors established an entirely new definition of death: the loss of "personhood." This subjective, philosophical determination of "brain death" is now the standard which enables physicians to declare a person to be dead, and then keep the "beating-heart cadaver" warm, pink and breathing until transplant procedures can be performed. Dr. Michael DeVita of the University of Pittsburgh's Medical Center describes this new category of humanity as only "pretty dead."

In 1971, a Minnesota team observed reflexes in moribund patients that looked like signs of life, and pregnant women declared brain-dead have gestated their babies for weeks—in one case, for 107 days. Transplant physicians are reluctant to discuss the possibility that a "brain-dead" organ donor can feel pain.

The cover of this month's Discover offers an ire-and-dire quote: "The organ harvest proceeded over the objections of the anesthesiologist, who saw the brain-dead donor react to the scalpel ..."

"Being a 'donor' means different things to different people. Caution is advised and education is the key for any donor," Fischbach added. "A donor's compassion and generosity represent pro-life ideals—donating blood, plasma, bone marrow and even a kidney can result in little to no impact on the donor's health. We just want them to be well informed when they give their consent."

Knowledge of current health care directive laws is crucial. In Minnesota, health care providers are required to follow a patient's advance care directive (living will, etc.). A patient cannot be denied nutrition and hydration, even at the end of life.

"Nobody knows what, if anything, brain-dead patients experience, and none of them could plausibly return to consciousness to tell us," wrote Discover Editor-in-Chief Corey Powell. "All we can do is read on and take one more step toward an information-based ethics—one that respects death while giving primacy to life."

Thursday, May 10, 2012

New Chilean study shows banning abortion does not increase maternal mortality

A new study analyzes the incidence of maternal mortality in Chile and demonstrates that it is "not related to the legal status of abortion," contrary to the claims of international abortion advocates who use maternal deaths as an argument for the legalization of abortion. The study, led by Dr. Elard Koch of the University of Chile, was published May 4 in the peer-reviewed scholarly journal PLoS ONE.

Over a span of 50 years (1957 to 2007), the researchers note, the maternal mortality ratio (MMR) in Chile declined dramatically -- from 293.7 to 18.2 deaths per 100,000 live births, a decrease of 93.8 percent. (It dropped to 16.5 in 2008.) Abortion was banned in Chile in 1989, and the MMR continued to decline significantly and at the same pace. "After abortion was prohibited, the MMR decreased from 41.3 to 12.7 per 100,000 live births (−69.2%)," explain the authors. "The slope of the MMR did not appear to be altered by the change in abortion law." Even maternal deaths due specifically to abortion declined -- from 10.78 abortion deaths per 100,000 live births in 1989 to 0.83 in 2007, a reduction of 92.3 percent after abortion was banned. The abortion mortality ratio plummeted 99.1 percent from 1961 to 2007.

Thus Chile, which prohibits abortion, now has the lowest MMR in Latin America and the second lowest in all of North and South America. And maternal death due specifically to (illegal) abortion is now "practically null."

Yet many in the international community, and groups like the International Planned Parenthood Federation, contend that prohibiting abortion leads to increased maternal mortality, and legalizing abortion leads to decreased maternal mortality. That was not true in Chile, and there is no reason to think it is true anywhere else. Koch, et al., write (notes omitted):
The validity of this assumption depends on whether the legal status of abortion is causally associated with the prevalence of illegal abortion, the safety of the abortive procedure, and maternal morbidity and mortality exhibited in general. Nevertheless, no direct evidence testing this causal assumption in developing countries currently exists. Furthermore, the lowest MMRs observed in European countries such as Ireland, Malta and Poland, where abortion is severely restricted by law, suggest that this assumption may be untrue.

After 1989, Chile is recognised as one of the countries with the most restrictive abortion laws in the world and has been criticised because of the purported possible deleterious consequences on maternal health. Nevertheless, the present study provides counterintuitive evidence showing that making abortion illegal is not necessarily equivalent to promoting unsafe abortion, especially in terms of maternal morbidity and mortality. Chile's abortion prohibition in 1989 did not cause an increase in the MMR in this country. On the contrary, after abortion prohibition, the MMR decreased from 41.3 to 12.7 per 100,000 live births -- a decrease of 69.2% in fourteen years. Excluding ectopic pregnancy, the absolute risk of death due to unspecified abortion is one in two million women at fertile age. Our study indicates that improvements in maternal health and a dramatic decrease in the MMR occurred without legalization of abortion. This does not imply that there are no illegal or clandestine abortions in Chile. Rather, current abortion mortality ratio and recent epidemiologic studies of abortion rates in this country suggest that clandestine abortion may have been reduced in parallel with maternal mortality and may have currently reached a steady state based on stable ratios between live births and hospitalizations by abortion.
What does affect maternal mortality? The Koch study cites various factors in Chile, such as a significant increase in education level, "access and utilization of maternal health facilities" (including "early prenatal care, delivery by skilled birth attendants, postnatal care, availability of emergency obstetric units and specialized obstetric care") and "improvements of the sanitary system." We should work in the developing world to improve basic maternal health care. Deaths can be dramatically reduced just as they were in Chile and in the developed world, including the United States (where maternal mortality rates dropped well before abortion was legalized). Abortion has nothing to do with it.

Nations that prohibit abortion should not be bullied into legalizing the practice on the grounds that doing so is necessary for women's health. As the Chilean example shows, that's simply not true.

Tuesday, May 8, 2012

U of M pursuing ethical stem cell research with hopeful results

The following was released today, May 8.

MINNEAPOLIS — Stem cell research by the University of Minnesota has shown promise in treating muscular dystrophy without the destruction of human embryos. Published May 3 in Cell Stem Cell, the ethical research is being praised by Minnesota Citizens Concerned for Life (MCCL), the state's oldest and largest pro-life organization.

"It is encouraging to see the U of M explore the amazing potential of non-embryonic stem cells in developing a treatment for muscular dystrophy," said MCCL Executive Director Scott Fischbach. "We look forward to further ethical stem cell discoveries from U of M researchers."

The research involves the use of iPS (induced pluripotent stem) cells derived from human skin cells. The skin cells are reprogrammed to become pluripotent, or able to express the properties of embryonic stem cells. The U of M admits in its press release that "iPS cells have all of the potential of embryonic stem (ES) cells." These iPS cells have the added advantage of guarding against rejection, because the patient’s own cells are used rather than cells derived from a human embryo.

Other researchers have used ethical adult stem cells to develop treatments for more than 70 diseases and conditions, including cerebral palsy, Parkinson's disease, leukemia, multiple sclerosis, cancers, anemias and autoimmune disorders. Thousands of people are alive today because of treatments developed from adult stem cells.

"Adult stem cell research offers great promise for those suffering from debilitating diseases and conditions," Fischbach added. "The U of M is smart to draw from this rich source in its development of cell-based therapies."

Wednesday, May 2, 2012

MN taxpayers forced to pay for 3,700 abortions in 2010

The following was released today, May 2.

ST. PAUL — After 15 years of taxpayer-funded abortions, Minnesotans have funded more than 58,000 abortions at a cost of $18 million, according to a just-released report from the Minnesota Department of Human Services (DHS). Nearly all of these abortions have been elective.

Since its successful 1995 challenge to Minnesota's law which prohibited funding of most abortions, the state's abortion industry has steadily increased its taxpayer-funded procedure numbers and revenue by marketing taxpayer-funded abortions to low-income women. Taxpayers now pay for 32.7 percent of all abortions performed in the state — the highest percentage ever.

"Economically vulnerable women represent guaranteed revenue for the state's abortion centers," said Scott Fischbach, Executive Director of Minnesota Citizens Concerned for Life (MCCL). "It is time to end abortionists' money grab at the expense of poor women and their unborn children."

Minnesota taxpayers have been required to fund elective abortions since the Minnesota Supreme Court’s 1995 Doe v. Gomez ruling. In that decision, the Court created a state "right" to abortion on demand and obligated all taxpayers to fund abortions.

Since the Doe v. Gomez ruling, taxpayers have paid $18,692,827 for a total of 58,552 abortion procedure claims. The 2010 numbers are $1,405,741 paid for 3,757 abortions. Prior to the court decision, taxpayers were charged about $7,000 per year for about 23 abortions in cases of rape, incest and to save the life of the mother.

Planned Parenthood posted big gains once again. Its abortion center in St. Paul increased its taxpayer funded abortions by 3.2 percent in 2010, the largest increase of any provider. Planned Parenthood's abortion marketing efforts to low-income and minority women have yielded a staggering 163 percent increase in its publicly funded abortions since 2000.

"Polls continue to show that most Minnesotans and most Americans are opposed to taxpayer funded abortions, yet they continue to be forced to pay for them," Fischbach said.

The state also pays for the cost of "treatment of incomplete induced abortions"; the 2010 total was $11,970. This amount is expected to continue to increase, according to DHS, due in part to the increased promotion of RU486 chemical abortions, which have a failure rate of up to 5 percent. Planned Parenthood began offering RU486 "webcam abortions" in Rochester in 2010, in which a doctor in St. Paul administers the drugs remotely via video teleconference. The doctor never examines the woman prior to prescribing the drugs, increasing the risks to the woman.

MCCL helped to pass a ban on taxpayer funded abortion during the 2011 legislative session; it was vetoed by Gov. Mark Dayton. The measure would have ended the forced funding by taxpayers of this mistreatment of poor women and the killing of unborn children.

Tuesday, May 1, 2012

Video: Squinting, grasping 8 weeks after conception