An abortion may play the role of a savior or threat in a mother’s life. What images flash inside your head when you hear these two words: Abortion and Maternal Death?
Certainly, a devastating image of a woman, mostly on the brink of a situation where she’s forcefully ready to sacrifice a part of their flesh, and in some severe cases, life.
Strictly speaking, the view of these two words isn’t that good.
Mind that, abortion and maternal death, both are physical conditions where women go through myriad conflicting experiences.
Let me remind you that the bodily experience is visible, but the mental experience is less spoken albeit it affects equally.
It’s mostly the process of abortion, which is responsible for maternal mortality. However, other factors as mental, physical, and social conditions also aggravate the matter.
Let’s discuss how the rules and regulations of developing and underdeveloped countries have an impact on this ever-challenging women issue.
With WomenMinds, let’s also shed light on various grounds that take a toll on women because of abortion leading to maternal mortality.
Statistical Scenario of Abortion in the Last 4 Decades
Death risks always walk on the heels of every single mother’s abortion procedure. We know how abortion or averting pregnancy could affect a mother physically and psychologically.
However, death toll due to abortion has decreased dramatically over the last forty years. An empirical report titled “Abortion Surveillance-United States, 2018,” conducted by the Centers for Disease Control and Prevention (CDCP) in November 2020, says that abortion caused just 2 deaths in 2017, whereas, the number was 47 in 1973.
The substantial reasons behind the decrease in abortion death are measures and campaigns on sexual health and education, promotion of contraceptives, and advanced surgical abortions in the US (curettage, vaccum aspiration, etc.). Nonetheless, there has been debates and controversies in public on the legality and mortality of abortion procedures recently.
Abortion Laws in Different Countries
As I have already mentioned that one of the most concerning reasons behind maternal death is abortion laws.
Throughout the world, there is a considerable variation in abortion laws.
For instance, in countries such as Sierra Leone, Afghanistan, Nigeria, Lao, and Myanmar, abortion is only legally permissible if a woman is in life-threatening situations.
Because of these countries’ least developed medical and health issues, they perform the abortion in the least safe ways, which mostly lead to maternal death.
According to the World Health Organization (WHO) report on September 25, 2020, abortion is the least safe abortion when it’s done by untrained people such as traditional healers and quacks who use harmful and inappropriate methods.
WHO further reports some scary events where inserting foreign objects like twigs and broken coke-bottles into the vagina also takes place in various underdeveloped countries in Africa and Latin America.
As a result, between 4.7% and 13.2% women die each year from complications of unsafe abortions in those countries, WHO reports.
Unfortunately, these statistics tell you the stories of only reported cases. Guess what happens to those women who don’t report anything and suffer silently!
However, abortion policies and ways are least restrictive in developed countries such as Australia, France, Germany, Italy, Canada, and the United States.
In these countries, a woman can request legal abortion for a range of reasons including physical or mental health, rape, fetal impairments, economic conditions, etc.
Although, lenient laws and systems for abortion in these countries haven’t been able to put an end to the maternal deaths.
WHO, in their same report, Preventing Unsafe Abortion, (as of September 25, 2020), suggests, 73.3 million annual abortions performed worldwide on average. One third of those abortion pose threats to women’s health and lives due to their procedure under least safe conditions.
The glitch of these developed countries persists even after following safe abortion procedures such as manual evacuation and prescribed drugs. Still, some places remain where risky methods are in practice.
Nonetheless, the disparity in abortion mortality is largely explained through advanced techniques to handle the situation. But the global challenges of abortion and maternal death still need to be dealt with in a robust manner.
Health Issues Impacting Abortion Related Maternal Mortality
A woman’s body may suffer from some long-term complications post-abortion.
Sometimes, if the abortion is done after the trimester window, many women have to risk their lives.
It’s essential to consider the long-term health effects while evaluating the safety of any medical intervention.
There have been various researches on abortion’s potential long-term health consequences on a woman’s body apart from killing it.
Here, we must understand two scenarios of an abortion.
Firstly, many women look forward to getting pregnant again after an abortion, but there remains a risk of secondary infertility.
According to WHO’s report, secondary infertility is defined as difficulty in conceiving or carrying a pregnancy to term after a previous abortion.
Note, the relation between abortion and the risk of secondary infertility is very high.
An article titled, “The Safety and Quality of Abortion Care in the United States,” opines that in Finland, between 2008 and 2010, the number of women who successfully conceived and gave birth for the first time was 57,406, out of which 5,167 had their prior cases of abortion.
The report also showcases that the infertility rate among women who have prior experiences of abortion is 5.14% higher than first-time mothers.
So, not only abortion can lead to maternal death, but there’s a high chance that a woman will experience secondary infertility even if she survives.
Secondly, it has been revealed through an investigation that after an abortion, a woman can experience an ectopic pregnancy.
What’s an ectopic pregnancy?
Google tells me that ectopic pregnancy occurs when a fertilized egg grows outside the uterus, most commonly in a fallopian tube.
In this case, the embryo doesn’t mature and as the pregnancy progresses, the fallopian tube may rupture causing major internal bleeding. The worst scenario could be death.
During 2006-2013, an estimated 12.3 per 1000 live births were diagonosed with ectopic pregnancy in the United States. were diagnosed and treated for ectopic pregnancy, reports “Trends in Ectopic Pregnancy Diagnosis in the United States Emergency Departments, 2006-2013.”
Thus, women with a history of abortion are at an increased risk of ectopic pregnancy. And if it’s left untreated, an abortion-related infection can increase the risk of maternal death.
The above article continues to suggest that apart from the above-mentioned serious illnesses, abortion can cause preterm birth, low birth weight, stillbirth, persisting bleeding causing Sepsis, risk of breast cancer, damage to the cervix, perforation of the uterus, damage to other organs, etc.
Psychological and Mental Issues Caused by Abortion
A wide array of research has been done to conclude that abortion increases the risk of several mental diseases in women.
Know this, women’s experiences of abortion differ from person to person depending on their phases of the life cycle.
For example, a teenager who obstructs her first pregnancy may experience psychological effects differently from an adult woman who’d terminated her pregnancy after giving birth to several children.
The journal titled “Abortion and mental health, 2018”, talks about several views that try to navigate abortion from diverse perspectives.
One of the perspectives argues that abortion severe mental disorders, including major depression, substance abuse, or suicidality. It’s obvious since a woman has to take the decision to murder her unborn child willingly and hence, she witnesses the cruel departing of her flesh and blood. Sadly, it kills a part inside her.
Abortion further creates a sense of severing maternal attachments and parental responsibility, which evokes unacknowledged grief leading to maternal death in some cases.
I think the indecision to be or not to be a mother creates a mixed feeling involving grief, guilt, remorse, and depression. Sometimes, the confusion affects so much that a woman’s body fails to cope with it, which can also contribute to death.
The journal “Abortion and mental health”, further suggests that abortion increases the risk of hypertension among women.
Hypertension regulates a woman’s mind whether to keep the baby or not. Thus, it increases the risk of maternal complications, such as placental abruption, gestational diabetes, poor birth outcomes, and in many cases, stillbirth.
However, positive cases are available too. A reproductive health journal named Contraceptive, published in January 2021, concluded that women who were diagnosed with preeclampsia (hypertensive syndrome of pregnancy) or eclampsia didn’t experience and complications during abortion.
PAS is a specific type of Post-Traumatic Stress Disorder (PTSD), comparable to the experiences of depression, grief, anger, shame, survivor guilt, and substance abuse.
A 2010-2016 study named, The Turnaway Study (comparing the contrast of receiving a desired abortion versus being denied the procedure and carrying the pregnancy to term) was conducted among 30 women in the United States.
The study advises that 15 women who went through abortion had experienced symptoms of depression, acute anxiety, suicidal ideation, and substance abuse compared to those whos’ aborting decisions were denied.
I think it’s safe to comment that abortion disrupts a woman’s mental health by causing psychiatric disorders such as psychoactive substance use disorder, mood disorder, neurotic, or stress-related disorders.
Social and Spiritual Grounds that Influence the Decision of An Abortion
I also believe that a woman’s decision to abort is influenced by many socio-cultural contexts. And that their experiences of abortion may vary based on the functions of their religious, spiritual, and moral beliefs.
Religious beliefs are very likely to shape a woman’s mindset of having an abortion as well as her responses to abortion.
There are women who belong to specific religious communities that oppose abortion on moral grounds. Evangelical Protestants or Catholics or Muslims may have different opinions about terminating a pregnancy through abortion.
This inner conflict to make a decision about keeping the child or not creates mental pressure and depression that might lead to various complications during the childbirth or abortion.
Also, the impact of socio-cultural conditions within which pregnancy and abortion occur, put a lot of psychological and physiological pressures on women.
For instance, it’s easier for a mature woman to opt for abortion compared to a teenage mother in a developed country.
Besides, the fear of being stigmatized of being raped, divorced, sexually active out of wedlock, and tortured by a close partner or their family members, make it difficult for women to process through abortion.
Another common social factor is the economic crisis. Women who live under the poverty line, struggling to cope with existing children, or married to men with below income, are prone to abortion mostly.
Hence, there are high chances that the women who’re aborting experience highly negative psychological issues from the religious, sociocultural, and socioeconomic stigmatization.
Suggestions and Thoughts of Abortion
The more social awareness is raised for issues like rape, divorce, cohabitation, and many more, the fewer the women around the world will face backlashes.
And it will lessen their inner struggle while minimizing psychological pressures during childbirth.
Both developed and developing countries should advocate the implementation of abortion laws properly to avoid the least safe abortion procedures.
The above discussions suggest that maternal mortality is lower when abortion laws are less restrictive.
In addition, to save women from illegal and unsafe abortion process, my suggestion will be several reformations of abortion laws.
For example, I think we should be following countries like Nepal and Ethiopia. Both of these countries have liberalized their laws to allow more abortions and support female choices.
Nepal and Ethiopia also assure that they provide thorough training to abortion providers and back them up with solid information on where women can get safe abortions.
Also, we must assure gender equity so that women get the right to choose without being influenced by any sociocultural factors. Thus, it will provide themselves safe abortion services and let live longer.
As a woman, I believe that a lot needs to be changed in order to tackle the abortion concept and its procedure.
If you ask me, whether abortion can cause maternal death or not, my answer would be, Yes. It’s vital that some of the factors be handled with utmost care.
Both men and women should receive education on when’s the most necessary time to seek an abortion.
Educating a woman from an early age about the biological factors could be a start. It additionally ensures a girl’s proactiveness and resolute to take the right decision in the future.
If we ascertain that women are getting proper education and are able to take effective decisions then maternal death caused by abortion can be under control.
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