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Maternal Mortality: Childbirth vs Abortion
By Valerie Jane | April 18, 2008
We on the pro-life side hear it all the time. That abortion is ten times safer than childbirth based on maternal mortality statistics. Somehow, in
their minds, this means abortion is the better choice if the pregnancy is unwanted. (Pregnancy can be unwanted, children cannot. Someone would want the child even if the biological mother doesn’t. - but I digress.) On Jill’s blog there was a discussion on this and based on statistics it was proven that both childbirth and abortion have less than a 1% chance of maternal death in the United States. I wanted to provide this information on this website so I decided to dig a bit further rather than just accept the results of a study a Pro-choicer linked to. What I found was very interesting.
Here is FAQ -type explaination for the maternal mortality statistics for easier reading:
How does the CDC get the final numbers for Maternal Mortality from the states at the end of the year?
Basically by Death Certificates that have been added to the National Vital Statistics system. Physicians, medical examiners and coroners are responsible for completing the medical portion of the certificate.
Are states consistent on how they report?
No.
In 1979, the ICD–9 (International Classification of Diseases ninth revision) had two main changes related to maternal deaths. The impact of implementing this revision resulted in a 10 percent increase in maternal deaths. This was the result of additional causes considered to be maternal….
The ICD–10, which provides cause-of-death titles and codes, coding rules and procedures, and definitions, was implemented in the United States in 1999.
By 2003, 21 states had a separate question related to the pregnancy status of female decedents around the time of their death and two states had a prompt encouraging certifiers to report recent pregnancies on the death certificate; however, there were at least six different questions being used. In 2003, only four states could capture information consistent with the standard.
Are abortion related deaths included in the Maternal Mortality rates and What defines a Maternal Death from pregnancy?
Yes, abortion is included.
‘‘Maternal deaths’’ are defined by the World Health Organization as ‘‘the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.’’
‘‘Late maternal deaths’’ are defined as ‘‘the deaths of a woman from direct or indirect obstetric causes more than 42 days but less than one year after termination of pregnancy.’’
‘‘Pregnancy-related deaths’’ are defined as ‘‘the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the cause of death.’’
‘‘Direct obstetric deaths: those resulting from obstetric complications of the pregnant state (pregnancy, labour and puerperium), from interventions, omissions, incorrect treatment, or from a chain of events resulting from any of the above.’’
‘‘Indirect obstetric deaths: those resulting from previous existing disease or disease that developed during pregnancy and which was not due to direct obstetric causes, but which was aggravated by physiologic effects of pregnancy.’’
Are the Maternal deaths related from abortion removed from the statistics of Maternal deaths related from Pregnancy/Childbirth before comparing the two?
No. The rates are taken from the reports as is, and no consideration is taken that abortion deaths are counted in both topics.
How do the states provide information for abortion statistics to the CDC?
States voluntarily give information to the CDC on their abortion numbers. There are 52 reporting area’s - all 50 states, DC and NYC.
In 1998 and 1999, CDC compiled abortion data from 48 reporting areas. Alaska, California, New Hampshire, and Oklahoma did not report, and data for these states were not estimated. During 2000–2002, Oklahoma again reported these data, increasing the number of reporting areas to 49; for 2003 and 2004, Alaska again reported and West Virginia did not, maintaining the number of reporting areas at 49.
Before California stopped reporting they were responsible for 17 - 20% of all US abortions.
How accurate is the information?
It isn’t. In recent years some states have decided not to release all their abortion numbers. An example is NJ; they did not include any abortions from private physician procedures. Another example:
(T)hree states (Delaware, Maryland, and Wisconsin) reported characteristics only for residents who obtained abortions in the state but not for women from out-of-state. Three states (Florida, Kentucky, and Louisiana) did not report abortion totals by resident status, and four states (Alaska, Arizona, Iowa, and Massachusetts) provided only the total number of abortions for out-of-state residents without specifying individual states or areas of residence.
The 7 states reporting inaccurate resident status means that the states the people came from were not counted correctly on their homestates statistics. It also means that they may not have reported the out-of-state people coming for abortions which would mean that 2 states statistics would be affected.
How does the CDC get their maternal mortality on abortion?
Sources of data for abortion-related deaths included national and state vital records, maternal mortality review committees, surveys, private citizens and groups, media reports, health-care providers, medical examiners’ reports, public health agencies, and computerized searches of fulltext newspaper/print media databases. For each death possibly related to an induced abortion or an abortion of unknown type, clinical records and autopsy reports were requested and reviewed by two clinically experienced medical epidemiologists to determine the cause of death andwhether the death was abortion related.
Is there a way to correctly calculate the rate of abortion related maternal deaths?
No.
National case-fatality rates were calculated as the number of known legal induced abortion-related deaths per 100,000 reported legal induced abortions…. Case fatality rates for 1998–2003 cannot be calculated because a substantial number of abortions occur in the nonreporting states; as a result, the total number of abortions (the denominator) is unknown.
So, can anyone really compare these deaths and accurately say that one has more maternal related deaths than the other?
No. The statistics are inaccurate and incomplete. The two cannot be compared because one is based on the number of live births which is accuratley reported (birth certificates are not as difficult as death certificates) and the other is compared to the number of reported legal abortions which is inaccurately reported.
The only way to accurately compare the two would be to remove the abortion related maternal deaths from the overall maternal deaths and then compare the precentages of maternal deaths based on the definitions listed above. Abortion related deaths must be compared to live births and not reported legal abortions in order to get an accurate comparrison. This is because an abortion related death is a result of the pregnancy, and pregnancy related death does not have to be a result of the abortion. You have to compare what they have in common and not what is different.
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