SALON

Thursday, Dec 13, 2012 6:36 PM UTC

Abortion deaths wildly underestimated

It was worldwide news when a woman died in Ireland after being denied an abortion. She was hardly the only tragedy

By

Topics: Savita Halapannavar, Abortion, Maternal Mortality, Health, Editor's Picks, ,

Abortion deaths wildly underestimatedSavita Praveen Halappanavar (Credit: The Irish Times)

By now, many have heard the name of Savita Halappanavar, whose death in a Galway hospital this fall was a chilling reminder of how abortion bans can be deadly.

That case had the benefit of a vocal and angry person to speak on the dead woman’s behalf — her husband, Praveen. He has said she requested a termination that may have saved her life — but was told, “This is a Catholic country.” (An official inquiry by the hospital has yet to be released, and Praveen Halapannavar is appealing to the European Court of Human Rights.) But for every Savita, there are thousands of women whose names we don’t know, women who aren’t even counted.

The most commonly cited statistic suggests that complications from unsafe abortions led to approximately 13 percent of maternal deaths worldwide. That’s a World Health Organization figure first arrived at in 2000, which hasn’t been re-evaluated. Every year, when WHO says how many women have died from unsafe abortions, they’re simply taking the same percentage of the global maternal mortality figure — 56,000 in 2003, or 47,000 in 2008. But one epidemiologist, Caitlin Gerdts, wondered if that number wasn’t a potentially vast understatement.

A few years ago, Gerdts was planning to write her dissertation about maternal mortality at a hospital in Zanzibar, Tanzania. “From the data we were able to gather I was sure that we had missed a number of women who had died likely from unsafe abortion,” she told Salon. Even in the original WHO report, she said, the authors “talk about how unsure they are about that estimate, and how they have the aggregate data, and how the data that they did have from countries where abortion-related mortality is the highest were of the poorest quality. They say directly, this is the best number we can come up with –  but we think it’s an under estimate.”

And a lot has changed since 2000, in both directions: Some countries, including in sub-Saharan Africa, have liberalized their laws; others, notably in Central America, have toughened their bans. Meanwhile, misoprostol, a pill which can induce a miscarriage identical to a spontaneous one, has become more widely distributed across the developing world. “There has been so much happening in the last decade,” said Gerdts, who is now affiliated with Advancing New Standards in Reproductive Health at University of California, San Francisco. “It’s impossible that the number has stayed the same.”

She eventually proposed a statistical model that would take into account what the researchers were getting at but not naming: Stigma. Specifically, women who were coming into hospitals seeking post-abortion care and would be reluctant to attribute the bleeding to a self-induced abortion because they feared social and criminal consequences. And, said Gerdts, “Doctors aren’t going to record it because they’re afraid of repercussions. Or maybe the woman hasn’t even told her family she was pregnant or that she had induced abortion.”

Gerdts and her colleagues canvassed 300 women treated for post-abortion or miscarriage care in that Tanzanian hospital, and found that only seven of them admitted they had induced abortion. But over 85 percent of these women said they were “unsure or unhappy” about their pregnancies, suggesting that not all of them had spontaneous miscarriages. And that’s not even counting women like Halappanavar, who may have been eligible for what life-saving exceptions sometimes do exist on the books but who died out of physician reluctance to test the boundaries of the law.

If these women hemorrhaged to death or died of sepsis because they couldn’t access a safe termination, few, if anyone, would have known that it was no ordinary miscarriage — or that it could have been prevented.

Irin Carmon

Irin Carmon is a staff writer for Salon. Follow her on Twitter at @irincarmon or email her at icarmon@salon.com. More Irin Carmon.

Next Article

Related Stories

More Related Stories

Featured Slide Shows

The week in 10 pics

close X
  • Share on Twitter
  • Share on Facebook
  • Thumbnails
  • Fullscreen
  • 1 of 11
  • Lisa Montgomery embraces her nephew Thursday after a tornado tore apart her home in Cleburne, Texas. The twister killed six people and destroyed entire swaths of the North Texas town.
    Credit: AP/LM Otero

  • Jack McMahon, the defense attorney for abortion doctor Kermit Gosnell, speaks outside the Criminal Justice Center in Philadelphia Tuesday. His client was convicted of killing three babies in his clinic, and will serve multiple life sentences.
    Credit: AP/Matt Rourke

  • A photo taken Monday captures Vice President Joe Biden's response to a Milwaukee second-grader's innovative proposal to end America's epidemic of gun violence. This guy!
    Credit: AP/Jenny Aicher

  • Sen. Rand Paul, R-Ky., flanked by a grouper-eyed Michele Bachmann, addresses the IRS' admission that it targeted Tea Party groups in advance of the 2012 election. In an op-ed for CNN Thursday, the Kentucky senator slammed the president for his faux outrage.
    Credit: AP/Molly Riley

  • Ousted IRS chief Steven Miller is sworn in on Capitol Hill Friday. Miller testified before the House Ways and Means Committee on the extra scrutiny the agency gave conservative groups applying for tax-exempt status.
    Credit: AP/J. Scott Applewhite

  • Attorney General Eric Holder pauses as he testifies on Capitol Hill before the House Judiciary Committee Wednesday. Holder is under fire, among other things, for the Justice Department's gathering of phone records at the Associated Press.
    Credit: AP/Carolyn Kaster

  • O.J. Simpson sits during an evidentiary hearing at Clark County District Court in Las Vegas, Nev., Thursday. Simpson, who is currently serving a nine-to-33-year sentence in state prison for armed robbery and kidnapping, is using a writ of habeas corpus to seek a new trial.
    Credit: AP/Las Vegas Review-Journal/Jeff Scheid

  • Major Tom to ground control: On Sunday astronaut Chris Hadfield recorded the first music video from space, a cover of David Bowie's "Space Oddity."
    Credit: AP/NASA/Chris Hadfield

  • When it rains it pours. President Barack Obama speaks during a news conference Thursday with Turkish Prime Minister Recep Tayyip Erdogan, inexplicably inspiring an #umbrellagate Twitter meme.
    Credit: AP/Jacquelyn Martin

  • A smoke plume rises high above a road block at the intersection of County A and Ross Road east of Solon Springs, Wis., Tuesday. No injuries were reported, but the the wildfire caused evacuations across northwestern Wisconsin.
    Credit: AP/The Duluth News-Tribune/Clint Austin

  • Recent Slide Shows

  • Share on Twitter
  • Share on Facebook
  • Thumbnails
  • Fullscreen
  • 1 of 11

Related Videos

Comments

 5 Comments

Comment Preview

Your name will appear as username

You may use these HTML tags and attributes: <a href=""> <b> <em> <strong> <i> <blockquote>

follow salon

Most Read

Popular on Reddit

links from salon.com

vote
Journalists file suit against Manning's trial secrecy: Plaintiffs including Glenn Greenwald and Julian Assange demand press, public access to trial and documents
159 points160 points | comment
vote
Kaitlyn Hunt refuses plea offer, will go to court over high school relationship - The 18-year-old rejected a deal that would have labeled her a sex offender and placed her under house arrest
142 points143 points | 96 comments
vote
Report: Nearly a quarter of Americans struggle to afford food
137 points138 points | 12 comments
vote
Kaitlyn Hunt refuses plea offer, will go to court over high school relationship - The 18-year-old rejected a deal that would have labeled her a sex offender and placed her under house arrest
142 points143 points | 59 comments
vote
Ted Cruz against the world - How the Junior Senator is igniting the GOP civil war
80 points81 points | 21 comments

From Around the Web

Presented by Scribol
listener_new_rect The Listener: Chekhov's story mirrors Russia's own

Recommendations