There has been a lot of outrage given the recent reversal of Roe vs Wade by the U.S Supreme Court. If you have been living under a rock and haven’t heard about it, basically in a nutshell: this ruling protected a woman’s reproductive right to have an abortion. This has now been overturned.
This has lead to the public outcry (or celebration) of people who have long associated with one of two groups: Pro-Life and Pro-Choice. These two groups will never see eye to eye. And I write this post on neutral territory in support of neither. There is no point engaging in emotive debates about whether abortion is murder, or at what gestation a fetus is considered a sentient being. Whatever your view, I hear you and I’m not going to argue with you about it. I don’t know where you’ve come from or what your beliefs are and I’m not here to judge you, and I’m not interested in changing your mind.
As a doctor deciding where I stand on this topic- let me be clear: I respect people’s religious beliefs, and I also respect upholding basic human rights. But I belong to neither of these groups. I am not Pro-Life or Pro-Choice. I am Pro-Harm Reduction. And I am interested in facts. So I think the real question we should be asking ourselves is this:
What does banning abortion or making it illegal actually achieve?
To answer this question I have looked at data from the paper Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990–2019 by J. Bearak, A. Popinchalk, A. Moller, O. Tuncalp, C. Beavin, L. Kwok and L. Alkema, published in The Lancet Global Health Journal – July 20, 2022
The key fact that I took away from this paper is: In countries where abortion is illegal, the rates of abortion is similar to that of countries where it is legal. In summary, a country’s abortion rate in recent history (per 1000 women aged between 15-49 years) is 40 regardless of whether abortion is illegal or not. See graph below which I have circled and underlined for your reference.
And now we have to consider some limitations in this paper. The rates of abortion in countries where it is illegal may not be accurate. It reports only known abortions. Therefore it is likely to be underreported given the stigma, and sheer illegality of it. So I think it’s safe to assume that the rates could actually be higher in these countries.
What this paper also doesn’t mention is the method of abortion. In countries where it is illegal- you can’t readily access abortion. Therefore you can assume that the methods of these illegal abortions are much more dangerous and not sterile, which can inevitably lead to life threatening infections/sepsis, infertility, severe bleeding and death. The paper also doesn’t mention the rates of death that result from women being denied access to abortion procedures for life threatening conditions such as ectopic pregnancies.
Okay. So if the rates of abortion are similar regardless of the legality. Then what is the point of making it illegal???
Well, there isn’t much point. The key point is that making abortion illegal doesn’t achieve anything positive. It does not reduce the rates of abortion. It remains the same (or probably increases in countries where it is illegal). What making abortion illegal does achieve is this: it results in more harm to women– whether that be mental and emotional harm through stigma, isolation or judgment. And physical harm through unsafe practices and inability to access care for life-threatening conditions related to pregnancy (to name a few). So regardless of what you believe in, I hope that you will consider the facts. I hope that we can live in a world where facts takes precedence above all else in decision making at an individual and political level.
The Weekday Notes 