Abortion and mortality rates

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Abortion Mortality, or abortion-related death, is defined by the Centers for Disease Control as, "death resulting from a) a direct complication of an abortion, b) an indirect complication caused by the chain of events initiated by abortion, or c) aggravation of a preexisting condition by the physiologic or psychologic effects of the abortion."


Contents

Historical Trends

Illegal Abortion Mortality

Claims that tens of thousands of women lost their lives annually from illegal abortion persist to this day.[1]

The original source of the claim that 5,000 - 10,000 women died from criminal abortions annually in the US was a book -- Abortion, Spontaneous and Induced -- published in 1936 by Dr. Frederick Taussig, a leading proponent of legalization of abortion. Taussig himself, at a conference in 1942, apologized for using "the wildest estimates" to generate a bogus number.[2]

Peer-reviewed articles published in the decades before Roe gave varied estimates of the number of abortion deaths annually, but all tended to confirm the numbers cited by Mary Calderone, who was then Medical Director of Planned Parenthood. Calderone reported on a conference studying abortion in America. She indicated that in 1957, there were 260 abortion deaths nationwide. That number included all abortions: legal, illegal, and spontaneous.[3] These numbers were based on alerting doctors, law enforcement, coroners, and hospital administrators, along with public records officials, of their responsibility to report these deaths.

The Impact of Legalization

Abortion advocates, including those at the U.S. Centers for Disease Control, credit the legalization of abortion with a sharp decline in abortion deaths, as in this example:[4]

The legalization of induced abortion beginning in the 1960s contributed to an 89% decline in deaths from septic illegal abortions during 1950-1973.

What the authors fail to note is that abortion mortality had been falling since at least since 1940, when public health officials started tabulating abortion mortality separately from other causes of maternal mortality. This graph illustrates when sulfa drugs and penicillin were introduced, as well as two major landmarks in abortion legalization: the legalization of abortion on demand in New York and California (1970) and the Roe vs. Wade decision striking down abortion laws nationwide (1973).

The authors also fail to note that abortion mortality did not improve overall during the 1950s. The decline in abortion deaths slowed, then reversed, before resuming the downward trend in 1960 -- a full decade before the first states legalized on-demand abortion.

Current Data on Mortality Rates

Centers for Disease Control

The U.S. Centers for Disease Control first began specifically tracking abortion mortality data in 1972.[5] "Data were collected through the cooperation of personnel in charge of vital statistics in the state health departments. Reports were received from all 50 states, New York City, and the District of Columbia." They investigated and tallied 19 legal abortion deaths and 35 illegal abortion deaths, but did not explain how they distinguished between legal and illegal abortions.

In the 1973 Abortion Surveillance Summary, CDC notes the addition of "state medical or hospital associations, CDC investigation, published case histories, and records from other federal agencies." They also noted, "The delay in reporting abortion deaths to CDC has ranged from 1 to 33 months." This resulted in the discovery of an additional two legal abortion deaths, and five additional illegal abortion deaths. For 1973, they noted 24 legal abortion deaths and 19 illegal abortion deaths. And now, for the first time, they indicate how they distinguish between the two: Legal abortion deaths are deaths from abortions performed by licensed physicians; all other induced abortion deaths (including those for whom the perpetrator or his license status is unavailable) are counted as illegal. Thus, if a woman keeps a legal abortion secret from her family and then dies, her death is counted as an illegal abortion death, since the CDC would be unable to verify that it was indeed performed by a licensed physician.

In the combined 1979 - 1980 Abortion Surveillance Summary, CDC noted, "Of the subsequently confirmed abortion-related deaths for 1972 - 1980, 65% were reported through State health departments. We also obtained reports from medical and hospital associations, maternal mortality committees, NCHS, the Commission on Professional and Hospital Activities, case histories published in professional journals, and private sources." But they also indicate that beginning in 1979, ectopic pregnancy deaths would no longer be counted among abortion deaths unless the abortion attempt directly caused the woman's death. This is mightily convenient for abortion cheerleaders, since women often fail to seek health care for ectopic pregnancies immediately after abortion procedures because they assume that they can't possibly be pregnant, and abortion facilities have often been caught advising women to avoid seeking care they might have otherwise sought. So though the abortion led to the death by preventing timely intervention, the CDC doesn't count these deaths as abortion-related.

The CDC, without fanfare, changed their mortality data collection methods at some point. By the 1992 Abortion Surveillance Summary, they say "Sources for obtaining such data include national and state vital records, maternal mortality review committees, surveys, private citizens, the media, health-care providers, and medical examiner reports. Clinical records and autopsy reports are requested and reviewed by medical epidemiologists to determine the cause of death and to verify that the death was abortion-related." Note that the aggressive search for abortion deaths is no longer mentioned. The CDC is now, more by omission than commission, admitting to their passive system described to Life Dynamics Inc. (LCI) researcher by Clarise Green (a research fellow at the CDC) during research for Lime 5 (1996). As Ms. Green indicated, the primary source of abortion deaths for the CDC was death certificates provided by the NCHS. According to Lime 5, LDI contacts at state vital records offices indicated that NCHS gets only a sample of death certificates from each state.

The inadequacy of CDC's efforts to collect data on maternal deaths from abortion is best exemplified in the case of a 17-year-old Black girl who bled to death after a 1991 abortion performed by National Abortion Federation member Robert Crist. Crist discussed his patient's death at the 1992 National Abortion Federation Risk Management Seminar in Dallas. Present at that seminar were two CDC Abortion Surveillance employees, Lisa Koonin and Stanley Henshaw. The case was also highly publicized in both print and broadcast media in Texas, where the girl died, and in Missouri, where Crist had earlier allowed a mentally disabled teenage rape victim to die of abortion complications under his care. In spite of all the publicity, and in spite of Crist discussing the death at a seminar where Koonin and Henshaw were present, the CDC never counted any abortion death that year for any Black teenager.

Strangely, in the 1992 Abortion Surveillance Summary, the CDC suddenly tallied 12 additional abortion deaths they'd failed to count in previous years, with no explanation as to how they'd suddenly uncovered these deaths. There are similar additions of five previously uncounted deaths from prior years added to the 2000 Abortion Surveillance Summary, again with no explanation of how these deaths had previously escaped the notice of a data collection system that the CDC claims is noting 94% of all abortion deaths nationwide.[6] The 4 abortion deaths of 9 that they missed the first time they released mortality data for 1990 means that their initial efforts found only 44% of abortion deaths.

Criticism of CDC Numbers

In 2000, researcher David Reardon published The Cover-Up: Why U.S. Abortion Mortality Statistics Are Meaningless. Reardon noted that the public health officials the CDC looks to for abortion mortality data are not doing a very thorough job:

On March 1, 1989, Erica Richardson, a 16-year-old Maryland resident, bled to death from a punctured uterus only hours after undergoing an abortion. During the next five months, two adult women, Gladys Estanislao and Debra Gray, also died from abortion complications. They too were residents of Maryland.
Shockingly, none of these three women was even granted that smallest of recognitions--becoming a statistic. The official statistics issued by Maryland public health officials showed that there were no deaths from abortion in 1989. Indeed, Maryland only reported a single abortion-related death for the entire decade of 1980 to 1989

Reardon notes that a lone researcher, working out-of-pocket, was able to find more deaths than the Centers for Disease Control, with all their contacts in vital records offices, health departments, etc.:

In the late 1980's, Kevin Sherlock, an investigative reporter who specializes in public document searches, undertook an extensive review of death certificates for women of reproductive age in Los Angeles County. Looking for indications of "therapeutic misadventure," he pulled autopsy reports and was able to find 29 abortion-related deaths in L.A. County alone between 1970 and 1987. Four of these deaths occurred during a one-year period for which the CDC reported zero abortion-related deaths for the entire state of California and only 12 deaths for the whole country.

Reardon further noted that even when city and state health officials did a thorough job, the CDC did not make much use of the information. For example, New York City health officials noted 30 abortion deaths in New York City alone from 1981-1984, while the CDC noted only 42 abortion deaths during that period for the entire United States. In the CDC's 1981 Abortion Surveillance Summary, they note that 101,880 of the nation's 1,300,760 reported abortions were performed in New York City. That means that if the CDC really was counting all abortion deaths, 71% of the entire nation's abortion deaths happened in New York City, where only 7.8% of abortions took place. Are we to believe that abortion is 10 times more likely to be fatal in New York City than elsewhere in the country?

Reardon also cites a memo from the Commissioner of Health "identifying another 146 abortion-related deaths for that same time period outside of New York. Combined with the 30 deaths in New York City, that is 176 abortion-related deaths in all--419 percent higher than was reported in the official CDC numbers."

What Are The Real Numbers?

If we trust New York City data -- that there really were 30 abortion deaths during 1981 - 1984 -- and the New York City abortion mortality rate was the same as the mortality rate in the rest of the country, that would mean that there were 385 abortion deaths in the US during 1981 - 1984, rather than the 42 the CDC counted. That would mean the CDC is counting only about 11% of abortion deaths -- roughly the number we'd expect them to find if Clarisse Green and the state vital records offices are to be believed, and the CDC is getting abortion mortality data from a sampling of 10% of the nation's death certificates, then assuming that this sample represents all abortion deaths and that all abortion deaths are coded on death certificates in such a way that the NCHS computers notice them and forward them to the CDC.

If we look at the total deaths noted by New York city and state health officials -- 176 deaths out of the 12% of US abortions that take place in New York -- New York deaths ought to be about 12% of US abortion deaths. In that case, there would have been 1,467 abortion deaths in the US during 1981 - 1984, in which case the CDC would be counting only 3% of abortion deaths. This would be the accuracy we'd expect if Clarisse Green and the state vital records offices are to be believed, and also only about 30% of abortion deaths are coded on death certificates in such a way that the NCHS computers notice them.

Reardon also noted that the World Health Organization's coding rule number 12 "requires that deaths due to medical and surgical treatment must be reported under the complication of the procedure (embolism, for example) and not under the condition for treatment (elective abortion)." Reardon quotes researcher Isabelle Bégin:

In effect, this makes the "abortion" category a "ghost" category under which it is simply impossible to code a death due to abortion. Medical coders have in fact relayed that any attempt to code a death due to abortion under abortion yields a "reject message" from the computer programs provided by the National Center for Health Statistics of Washington D.C., a division of the U.S. Centers for Disease Control in Atlanta, Georgia. Only a minute number of abortion-related deaths actually qualify to be declared under abortion, i.e. those for which the medical certificate of death categorically and unequivocally gives abortion as the underlying cause of death.[7]

This lends credence to the theory that the combined efforts of the New York City and New York State health officials were much more accurately measuring abortion mortality rates than is the CDC.

References

  1. "The Impact of Illegal Abortion" from Abortion Access Project
  2. "A Primer on 'Abortion Distortion'", National Right to Life Committee
  3. Mary Calderone, "Illegal abortion as a public health issue," American Journal of Public Health, July 1960
  4. "Achievements in Public Health, 1900-1999: Healthier Mothers and Babies" Morbidity and Mortality Weekly Report, October 01, 1999
  5. Centers for Disease Control Abortion Surveillance Annual Summary 1972
  6. [http://aje.oxfordjournals.org/content/108/3/200.abstract Cates, W., et. al., Assessment of Surveillance and Vital Statistics Data for Monitoring Abortion Mortality, United States, 1972–1975", Centers for Disease Control
  7. Isabelle Bégin, "World-wide Abortion Statistics Scam Exposed," Reality, Oct. 1999.

See also

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