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Thursday, August 23, 2007

Romanian Roulette

Abortion is often cast as a matter of life and death. But this idea of life beginning at the point of conception -- a purely philosophical view -- brings us to impasses over other issues like stem cell research. In his first veto of stem cell legislation -- at that point, his only veto -- President Bush said, "...we must also remember that embryonic stem cells come from human embryos that are destroyed for their cells. Each of these human embryos is a unique human life with inherent dignity and matchless value."

People like myself wondered how Bush could get all bent out of shape over human life that was entirely theoretical, while blowing the crap out of real, non-theoretical human life in Iraq. Consistency has never been his strong point. But this was just one example of how the hypothesis that life begins at conception could be taken to absurd extremes.

When we talk about abortion as a matter of life and death, somehow we've become convinced that there's only one life involved -- the hypothetical unborn one. But there's another, actual life involved -- one that no one argues doesn't actually exist -- that of the woman.

Unfortunately, we have a real world example of what happens when abortion is illegalized. It's one that's so well documented that we can actually call it a clinical experiment, with countries with liberal abortion laws as the control.

CeaucescuIn 1965, Romania had the highest rate of legal abortion in the world -- one in four pregnancies in women between the ages of fifteen and forty-four ended in abortion. Communist dictator Nicolae Ceaucescu came to power and, in an attempt to increase the population, banned abortion in 1966.

As a result, the legal abortion rate fell, but maternal mortality rates (MMR) went through the roof. Complications due to illegal abortion became by far the most common cause of death in pregnant women, accounting for 85 percent of all maternal deaths. The reason that we know the cause was unsafe abortion was that the romanian ban may have been the most restrictive in the world. Women were under police surveillance with mandatory pelvic exams and routine pregnancy testing. Pregnancies were monitored closely. In the US, it's impossible to say how many women actually died because of unsafe abortions before Roe v. Wade, since family embarrassment and shame would often cause people to claim another cause of death. In Romania, every dead pregant woman and every miscarriage was investigated as a possible crime. Logic would dictate that in a society where abortion was illegal, but easier to get away with, the MMR would be even higher.

MMR rose throughout Ceaucescu's reign, beginning at 86 per 100,000 live births in 1966 to 170 per 100,00 in the eighties. Romania had the highest rate of maternal mortality in Europe.

Then came the fall of the Soviet Union and the end of Ceaucescu, executed by firing squad after he refused to step down. Abortion was legal again and, within one year, maternal mortality had dropped 50 percent and continued to fall. According to the World Health Organization, "Between 1990 and 2002, Romania's MMR (three-year moving average) fell by almost 73%..."

So what we see is that when abortion is illegal women -- who are indisputably alive -- die. And, since these women are pregnant, that hypothetical unborn life would logically be dead too. The math doesn't really work. As a lifesaving measure, banning abortion sucks.

You can make unsupported -- and unsupportable -- arguments that a blastocyst becomes 'ensouled' with conception, that abortion should be illegal in order to save lives. But the best evidence we have shows that illegalizing abortion creates a public health crisis. Women don't abort because pregnancy is merely inconvenient -- the fact that abortion continues even after it becomes a game of russian roulette proves that. Women abort because they feel they have no choice. When abortion is illegal, that lack of choice can be disastrous.

If you've got a problem with abortion, making it illegal is demonstrably the exact wrong thing to do. The thing to do is to make abortion unnecessary. As long as the term "crisis pregnancy" means something in our world, women will abort -- legally or illegally.


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Cynos said...

While the correlation is obvious, I do think you do your point a disservice by not mentioning that Ceau┼čescu is did everything in his power to increase the incidences of pregnancy - contraceptive imports were ended, and no contraceptives were manufactured with Romania. Further, childless couples were taxed at a higher rate.

All of this will significantly distort the correlation and should be mentioned for the sake of completeness.

Cynos said...

Oops, forgot to give a relevant source.

Wisco said...

First off, what difference would taxation make to the incidence of maternal mortality? Let's keep this within reality here.

Now, are you saying that if abortion is outlawed in the US, no illegal abortions will occur, that only safe illegal abortions will occur, or that there's an acceptable MMR from illegal abortion?

If you could clarify that, it'd really be helpful.

Cynos said...

The simplest I can put it is this - the US banning abortion is not the same as Romania banning abortion unless the US also bans all contraceptives concurrently.

It's not like you had any method of avoiding an unwanted pregnancy in Romania beyond celibacy, (illegal) abortion or adoption. If the US banned abortion tomorrow, those who wished to remain childless would have a variety of methods at their disposal.

Just a note on where I'm coming from - I support usage of abortion in cases of medical necessity, I don't support it as a form of birth control when alternatives are available. The Romanian experience shows that birth control is a necessity in any modern society - if you've ever seen the harrowing footage from a Romanian orphanage, you'll understand what I mean.

Ian Danforth said...

Brilliant Post.

To Cynos - I hate it when people say they support the usage of abortion. No one supports abortion. It's a terrible terrible thing, especially when it's done just to save the life of the mother. She probably wanted that child!

The reality is that it is a *necessary* evil in that the alternatives are worse.

So there is no pro or anti abortion stance. We're all against it, but some of us recognize that hampering a woman's decision to have an abortion is at best counter productive and at worst, criminal.

So being against it "as a form of birth control" is ludicrous and begs the question exactly what you'd do to a woman to stop her? Throw her in jail? Forced sterilization? Tie her down until she has the baby?

Maybe you support education and alternative contraception, but you damn well better be shouting from the rooftops to protect a woman's right to chose even though you disagree with it, even though we all know abortion to be abhorant, because as Ceausescu and pre-Roe v. Wade America proved; The Alternative is Worse.

Anonymous said...

People like me are born, adopted and get a chance at life with a loving family.

Wisco said...


The romanian ban included exceptions for health, rape, and incest -- as well as fetal defect.

Nothing you've posted negates the obvious fact that if the US bans abortion, MMR will rise. I think only the most ideologically blinded would argue with that.

Which brings us again back to the question, what is an acceptable MMR related to unsafe abortion?

ankur said...
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