Abortion is not healthcare in Africa
Africa has the highest maternal mortality rates in the world. The problem is not uniform across the continent, of course, but most of the countries that register the worst figures are in Africa. In some of them, like South Sudan, over a thousand mothers die for every 100,000 live births.
The American Centers for Disease Control and Prevention (CDC) defines maternal mortality as the “death of a woman during pregnancy or within one year of the end of pregnancy from a pregnancy complication.” This is irrelevant to the present topic, but man am I glad I got that before they erased the word “woman” from it!
In any case, the fact that African countries lose so many women to pregnancy-related complications is one of the biggest scandals of modern medicine. The major causes of, and solutions to, maternal mortality have been figured out for a century, and many countries in the developed world now have maternal mortality rates within the single digits. Still a tragedy, yes, but not nearly as scandalous.
Unfortunately, most of the attention paid to African mothers has been focused a lot more on reducing the number of children they bear, rather than on stemming the loss of our women, hence the frenzy of activity and funding for the promotion of abortion and contraception.
Some commentators even have the temerity to opine that abortion and contraception are necessary healthcare for African women, a potent set of tools even, in the fight against maternal mortality. In the deluded eyes of this crowd, access to so-called “safe” abortion and modern contraceptives should be the highest priority of sexual and reproductive health in Africa.
However, this is utter and inexcusable hogwash. There is no proof that access to abortion and contraception has any salutary effect on maternal mortality. The most drastic decline in maternal mortality in history took place in the developed world over around 15 years, from the late 1930s to the early 1950s, long before legal abortion and the pill were widespread.
According to a review paper published in The American Journal of Clinical Nutrition in 2000, maternal mortality rates for the developed world in 1930 ranged from 250 deaths per 100,000 births in the Netherlands (the lowest) to around 700 deaths per 100,000 births in the United States (the highest). By the 1960s, these had declined to under 60 deaths per 100,000 births in each developed country.
Tragically, the country that thereafter legalised abortion most dramatically, the United States, now has the developed world’s worst maternal mortality figures. In fact, it is getting worse, especially in the African-American community, which, incidentally, also happens to have the highest abortion rates of all the major racial groups there.
On the other hand, Poland, one of the few developed countries that refuses to kowtow to the pro-abortion lobby, has the lowest maternal mortality rate in the developed world. It loses two women for every 100,000 births. The same was true of Ireland before it, too, succumbed to the hysteria of abortion activists.
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In short, the attempt to link limited access to abortion and contraception to high maternal mortality rates is a red herring. If anything, it is much more likely that they exacerbate, rather than improve, the situation. Prioritising them is an insult to the thousands of mothers that die in Africa each year.
The main cause of maternal mortality is really quite simple. The drastic decline in the developed world in the first half of the 20th century has been linked primarily, and that quite conclusively, to a dramatic expansion of high-quality maternal care, that is, giving mothers timely medical attention throughout their pregnancies.
This is in no way a controversial point. It is well known that unmanaged medical complications are the leading cause of maternal deaths. A 2021 review published in the Journal of Global Health pinned the greatest blame on obstetric haemorrhage, hypertensive disorders in pregnancy, non-obstetric complications, and pregnancy-related infections, for the majority of maternal deaths in Africa.
Incidentally, these are all well-understood complications, with well-developed therapies and standards of care. All that is needed now is for this care to be availed to African women, especially in the rural areas where most of the maternal deaths occur because facilities and trained personnel are few and far between.
This is not an impossible problem to solve. It’s not even that complicated. The only reason it persists is that not enough priority is being placed on it. And those with the ability to help cannot extricate themselves from their population-control-dominated tunnel vision. Medical facilities in rural Africa are much more likely to be awash in contraceptives than to have skilled midwives.
And that’s why it’s a scandal.
Mathew Otieno is a Kenyan writer, blogger and dilettante farmer. Until 2022, he was a research communications coordinator at a university in Nairobi, Kenya. He now lives in rural western Kenya, near the shores of Lake Victoria, from where he's pursuing a career as a full-time writer while concluding his dissertation for a master's degree. His first novel is due out this year.
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