The case to legalize abortion in Africa fails

By Jeanne Head, RN, and Paul Stark

Editor’s note. The following is a response to an International Herald Tribune blog that  the newspaper chose not to publish. The post appeared at http://latitude.blogs.nytimes.com/2011/12/15/africas-abortion-wars/.

Alexis Okeowo argues at the International Herald Tribune’s Latitude blog that African nations should legalize elective abortion in order to prevent the death of women from illegal abortions (“Africa’s Abortion Wars,” December 15). The argument fails on two levels.

First, only by assuming that abortion does not unjustly take the life of an innocent human being can Okeowo’s case hold any water. For if the human fetus killed by abortion is a rights-bearing member of the human family, like each of us, Okeowo’s argument is tantamount to saying that because some people will endanger themselves trying to kill other people, the government ought to legalize such killing. Mary Anne Warren, the distinguished American pro-choice philosopher, explains: “[T]he fact that restricting access to abortion has tragic side effects does not, in itself, show that the restrictions are unjustified, since murder is wrong regardless of the consequences of prohibiting it.”

Thus, in resolving the legal question of abortion, the decisive factor is whether abortion is unjust or not. Most Africans believe it is unjust—a position firmly supported by modern embryology together with sound moral reasoning about the dignity and rights of human beings at early developmental stages. African countries have good reasons to maintain laws against elective abortion.

Second, Okeowo is wrong to suggest that legalizing abortion can “solve” the problem of maternal mortality. She offers two statistical examples. “Just two years after abortion became legal in South Africa [in 1997],” she claims, “the number of deaths among pregnant women who underwent the procedure fell precipitously.”

But whatever the number of abortion-related deaths, the maternal mortality rate as a whole has not improved in South Africa. In fact, it has gotten much worse. According to the 2010 South African Health Review (SAHR), 625 mothers died per 100,000 live births in 2007. This is up from 369 in 2001, and it is double the 1990 rate. The SAHR explains, “South Africa … is actually in the small group of countries where the [maternal mortality ratio] has increased since 1990.”

Okeowo says efforts in Ghana (where abortion is broadly legal) to make abortion more accessible led to a “slow” drop in the maternal mortality rate between 1990 and 2008. But she offers no reason for attributing the supposed decline to abortion efforts (abortion accounts for only a small percentage of maternal deaths in Ghana), and the numbers she cites are themselves contradicted by other estimates, which tend to vary significantly.

The truth is that despite its long-time policy of legalized abortion and serious efforts in recent years to make abortion “safer” and more accessible, Ghana faces an enormous maternal health challenge. In 2003 the Ghana Health Service developed a strategic plan for the provision of abortion with the goal of reducing maternal deaths, and in 2006 that plan was fully implemented. More than four years later, DailyGuideGhana.com reported, “The country’s stringent efforts at reducing [the] maternal mortality rate seem to be failing miserably, as reports indicate that the rate is soaring across the country.”

Evidence from around the world shows that maternal mortality is determined mainly by the quality of maternal health care, independent of the legal status of abortion. For example, Chile prohibited abortion in 1989, and subsequently the maternal mortality rate continued to decline significantly; the rate of maternal deaths due specifically to abortion also dropped. Today Chile has the lowest maternal death rate in Latin America. In the developed world, the decline in maternal mortality rates coincided “with the development of obstetric techniques and improvement in the general health status of women” (from about 1935 to the 1950s), according to the World Health Organization. This took place well before the widespread legalization of abortion.

Legalizing abortion in African countries that lack adequate maternal health care would only increase the number of abortions and thereby increase the number of pregnant women exposed to the dangers of abortion. For the sake of both women and their unborn children, abortion should not be legalized and promoted throughout Africa.

Jeanne Head is National Right to Life’s Vice President for International Affairs and UN Representative for National Right to Life. Paul Stark is Communications Associate for Minnesota Citizens Concerned for Life GO (Global Outreach).