It’s been a very busy week and I’ve mostly been working behind the scenes on the new web site, but I didn’t want to let these news items pass unremarked:

  • In Honduras, the president of the Congress declared on Wednesday that he has decided not to move forward on the bill that would have made use of the emergency contraceptive Plan B a crime subject to jail time. This bill was based on the mistaken belief that Plan B causes abortions.

  • The U. S. House of Representatives voted on H.R. 4970, a re-authorization of the Violence Against Women Act that contains none of the updated protections for LBGT people, Native Americans, or immigrants that were contained in the bill passed by the Senate. Advocates for victims of domestic violence considered H.R. 4970 a “fake VAWA” and promise to continue to work toward a final bill that contains the updated provisions.

  • Good news: New Report: Fewer Women Dying in Pregnancy, Childbirth

    The number of women dying in pregnancy and childbirth, worldwide, has decreased by almost half, over a twenty year period (from 1990 – 2010), according to a new report. It’s good news, says Dr. Babatunde Osotimehin, Executive Director of UNFPA. But there’s a lot more work to do. […]

    “We know exactly what to do to prevent maternal deaths: improve access to voluntary family planning, invest in health workers with midwifery skills, and ensure access to emergency obstetric care when complications arise. These interventions have proven to save lives and accelerate progress towards meeting the Millennium Development Goal 5,” said Dr. Osotimehin.

    Via Impatient Optimists, the blog of the Bill and Melinda Gates Foundation. I highly recommend the blog to anyone concerned about maternal and child health and family planning. You can subscribe directly to the Maternal, Newborn and Child Heath topic using this RSS feed.

  • More good news: Education, Not Abortion, Reduces Maternal Mortality, Study Suggests

    A scientific analysis of 50 years of maternal mortality data from Chile has found that the most important factor in reducing maternal mortality is the educational level of women. “Educating women enhances women’s ability to access existing health care resources, including skilled attendants for childbirth, and directly leads to a reduction in her risk of dying during pregnancy and childbirth,” according to Dr Elard Koch, epidemiologist and leading author of the study. […]

    One of the most significant findings is that, contrary to widely-held assumptions, making abortion illegal in Chile did not result in an increase in maternal mortality. In fact, after abortion was made illegal in 1989, the MMR continued to decrease from 41.3 to 12.7 per 100,000 live births (69.2% reduction). “Definitively, the legal status of abortion is unrelated to overall maternal mortality rates” emphasized Koch.

    For those of us who consider abortion violence against a human being, it is always encouraging to see recognition of nonviolent ways to solve the problems that abortion is meant to solve. Educating women is the key to women’s health, their ability to care for themselves and children, their economic security, and even their countries’ development. Holding women back from education and self-care — including family planning if they desire it — is unjust and wasteful. It’s a disservice to individual women and their families, and to the entire world.

H.R. 358, sponsored by Rep. Joseph Pitts (R-PA) and also known as the Protect Life Act, is being debated in the House today. The vote will be a symbolic one, because even if it passes the bill will be DOA in the Senate.  The provision that's getting most of the attention, and rightly so, is the one that says no hospital would be obligated to perform an abortion under the Emergency Medical Treatment and Active Labor Act (EMTALA), which requires hospitals to treat and stabilize people in medical emergencies.

When this bill first came up in the spring, I talked to Brian Bosak, a legislative aide in Rep. Pitts' office. There is no doubt in my mind that Mr. Bosak does not look at this as a question of valuing women less than their children. He believes that the conflict between the two is a manufactured one, and that pro-life doctors will treat both the mother and child as patients and act in the best interests of both of them as much as possible. That's a great ideal, and I have no doubt that many doctors do exactly that, but the fact is that this bill would permit doctors to do otherwise. It fails to safeguard women's lives — and for what? You can't protect the life of an unborn child whose mother is dead.

We talked about cases when, say, a woman comes in with a ruptured ectopic pregnancy and the embryo must be removed immediately. He said that the Catholic doctrine of double effect would allow for the treatment of ectopic pregnancy even though that would inevitably result in the death of a child. A lot of people don't even consider that an abortion. I replied that yes, that's the doctrine, but not everyone interprets it the same way. Oh yeah, and not everybody is Catholic. If a woman is experiencing a medical emergency, is she supposed to pick a hospital where she's sure the doctors believe in the doctrine of double effect and interpret it the same way Rep. Pitts and his staff do?

Bosak told me, "There has never been a case where a doctor refused an abortion and a woman died." As far as I've found, that's true — at least in the U.S. — but that's no guarantee of what people will do in the future. Also, I'm wondering about the converse: has a hospital ever been forced to perform an abortion (or a procedure that it may or may not consider an abortion, such as treatment of ectopic pregnancy) under EMTALA? If not, and if doctors really will perform abortions in those cases where they are medically necessary to save a woman's life, then what is the impetus for this provision? Just to say "you can't require doctors to do what they'll do anyway?" Doesn't sound right.

I felt that Bosak was not ill-intentioned, but that he was looking at the issue in a very abstract way. Arguments on paper are all well and good, but he didn't understand — and I couldn't get across to him — what it would be like to be a woman who knows how badly pregnancy can go, looking at this law and wondering if it might mean your death.

According to a 2006 paper from the British medical journal The Lancet, "Family Planning: The Unfinished Agenda", 13% of global maternal mortality is caused by abortions that are medically unsafe for women (as well as unborn children, for whom all abortions are unsafe). However, an estimated 90% of these maternal deaths (as well as the accompanying fetal deaths) could be prevented through access to effective family planning methods. 90%! That would represent an 11.7% drop in total maternal mortality worldwide (as well as prenatal mortality). This agenda remains unfinished, alas. But look how many lives it could save, whatever abortion's legal status in the countries where it becomes a reality.

Over the past twenty years, US maternal/fetal deaths from pregnancy & childbirth have *doubled.* The poor and women and children of color are the most affected. Lack of timely health care–or health care at all–is a major culprit. Please demand lifesaving action. http://takeaction.amnestyusa.org/siteapps/advocacy/index.aspx?c=jhKPIXPCIoE&b=2590179&template=x.ascx&action=13937