Opinion surveys used by researchers from the Guttmacher Institute show overestimated figures of abortion in the Federal District of Mexico (Mexico DF) by as much as 10-fold, according to a paper in the International Journal of Women's Health, which highlights that the actual figure of induced abortion in Mexico DF has not surpassed 15,000 per year according to the official registry.
The research group directly compared the estimations of induced abortion reported by the Guttmacher Institute and the actual figures reported by the GIRE (from the Spanish acronym Grupo de Información en Reproducción Electiva), institution that maintains epidemiological surveillance of abortion in Mexico DF since its decriminalization in 2007.
The researchers detected that discrepancies found between estimated and actual figures are likely due to the subjective and potentially biased nature of opinion surveys, which have estimated figures as large as 1,024,424 abortions per year for the entire Mexican country.
Meanwhile, they say abortion mortality in Mexico has decreased to the point that approximately 98% of total maternal deaths are conclusively related to hemorrhage during childbirth, hypertension and eclampsia, indirect causes and other pathological conditions, data they use to note that legal abortion has reduced deaths. They say that out of the 1,207 total maternal deaths registered in Mexico during 2009, only 25 could be directly attributable to abortion, resulting in a mortality rate of 0.97 per 100,000 live births.
Direct attribution is the difficulty in cultural hot-button issues. Almost no deaths can be directly attributable to smoking, for example, but a lot of correlations are made to such an extent that lung cancer patients are bothered that everyone thinks lung cancer patients did it to themselves, even though 50% of lung cancer patients never smoked. Abortion proponents do just the opposite and use a very stringent metric for a death related to abortion. They note that in the case of Chile, out of a total 43 maternal deaths observed during 2009, only 1 could be attributable to induced abortion, with a mortality rate of 0.39 per 100,000 live births.
"This is a perfect example demonstrating that methodologies used for estimating figures of induced abortion and related indicators, such as abortion mortality rates, need constant re-evaluation and scrutiny by the scientific community in order to provide the best epidemiological data to be used for public policies of any region" explained Byron Calhoun, specialist in Obstetrics and Gynecology from the West Virginia University-Charleston and co-author of the study.
"During 2009, the number of induced abortions in Mexico DF was 12,221, which directly contradicts the figure of 122,355 induced abortions estimated by opinion surveys for the same year, resulting in a 1000% overestimation" said Elard Koch, the Chilean epidemiologist leading the research.
To make the abortion case, they even say some of the maternal abortion deaths could instead be violence against women during pregnancy. Surveys of violence against women (Encuesta Nacional sobre Violencia contra las Mujeres, ENVIM) conducted in 2003 and 2006 show an increase in the prevalence of intimate partner violence from 9.8% to 33.3% and of physical violence during pregnancy from 5.3% to 9.4%. "In addition to some deaths due to spontaneous miscarriages rapidly complicated by sepsis, membrane rupture and subsequent abortion are often observed in pregnant women suffering episodes of excessive physical violence, falls or accidents. If these women do not receive prompt medical attention, they may die from clinical complications. It is important to remark, that any of these deaths cannot be avoided by promoting changes in abortion legislations simply because they are the result of other causes, especially septic shock resistant to antibiotic treatment," said Koch.
The researchers stated that implementation of emergency obstetric units and timely access to specialized medical care for high-risk pregnancies, especially in the most vulnerable regions, are key to further reduce maternal mortality in Mexico. "Hundreds of Mexican women continue to die due to hemorrhage, eclampsia and indirect causes; this suggests very concrete strategies that clearly are unrelated to the legal status of abortion," Koch and Calhoun concluded.