Chilean study shows better health care, other factors reduce maternal mortality — not legal abortion

Randall K. O'Bannon, Ph.D.

By Randall K. O’Bannon, Ph.D., NRL-ETF Director of Education & Research

A common refrain among those pushing to legalize abortion worldwide is that this will somehow help reduce sky-high maternal mortality rates. The assertion is as simple as it is unfounded in research.

The narrative says that women are going to have abortions. If they are illegal, they will be unsafe and women will die as a result. Solution? Legalize abortion and the scandalously high rates of maternal mortality will decline.

These are the sorts of things one often hears whenever there is some move to legalize abortion in a given country. Claims of high maternal mortality are put out, based on the “estimates” of “experts” (who may have a vested interest in the outcome), anecdotal accounts of deadly botched abortions are published, government health ministers come forward, and editorials clamoring for legalization appear. It often snowballs from there.

Lost in the shuffle is the fact that often there is little hard evidence for any of these “statistics.” In many of these developing countries where high abortion-related maternal mortality rates are reported, there is little in the way of infrastructure, medical system, modern communication, much less any organized government data gathering process, making any sort broad statistical claims about national births, deaths, abortions, or even population problematic.

All this makes a recent study that looked at fifty years of solid data on abortion and maternal mortality from Chile all the more valuable and remarkable. And the conclusion there is something quite different than what the advocates of worldwide abortion have been telling us for years.

The study, “Women’s Education Level, Maternal Health Facilities, Abortion Legalisation and Maternal Deaths: A Natural Experiment in Chile from 1957 to 2007,” by six Chilean authors and one American, appeared in the May 2012 edition on-line peer reviewed journal PloS ONE (access at The lead author is Elard S. Koch, an epidemiologist from the Department of Family Medicine, Faculty of Medicine, University of Chile.

The researchers got their data, not from advocates in the field, but from official government data from the Chilean National Institute of Statistics on maternal deaths and live births for the years 1957 up to 2007.

With no pro-abortion axe to grind, they looked at many variables, such as education, income, access to clean water and sanitary sewer facilities, birth rate, birth order, whether the deliveries were by skilled medical attendants, etc. All were likewise based either on data from governmental agencies, the national bank, or on private research institutes.

Koch et al. noted when laws were passed mandating compulsory education (1965) and when an extensive prenatal care program with a family planning component was implemented (between 1964 and 1967). Another critical historical factor that was taken into account was Chile’s legislation prohibiting “therapeutic” abortion passed in 1989.

The results of the study are unambiguous.  Counter to the usual claims that placing limits of abortion is associated with higher maternal mortality, the authors found that in the 14 years following Chile’s abortion prohibition, the maternal mortality rate went from 41.3 to 12.7 per 100,000 live births, a 69.2% decrease.

This is what hard data shows. Not the estimates of abortion advocates or the speeches of abortion activists or sensational anecdotes in the newspapers.

The authors are not naive enough to think that this means that no abortions are performed in Chile. They grant that there are, though data indicates that there have been both fewer abortions and abortion-related complications since abortion’s prohibition. The claim that there would be more maternal deaths due to abortion’s going underground does not seem to have been borne out by the data at all.

Koch and his co-authors are not claiming that the law limiting abortions is the cause behind the lower maternal mortality rates, readily granting and demonstrating that other factors were involved in the reductions. For example, they found that every additional year of maternal education was associated with a decline in the maternal mortality rate of 29.3 deaths per 100,000. Other factors like better sanitation and increased access and utilization of maternal health facilities also improved those rates.

The take-away isn’t that the way to lower maternal mortality rates is to limit abortion, but that there are many positive ways to reduce those rates. Claims of abortion’s international advocates that legalization of abortion is essential to women’s health and safety are shown to be false. Against all their constant contentions, maternal mortality rates continued their downward trend after Chile banned abortion.

So, if those advocates really want to reduce maternal mortality, they will focus on things such as better education, better sanitation, and improved maternal health care rather than waste their time peddling abortion. Better yet, switch sides and do something that will save the lives of both mothers and their children.

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