Refuting Elard Koch’s errors and distortions
by Joyce Arthur
Illegal abortions still common in Mexico
Increases in abortion after legalization to be expected
Koch complains that legalization causes an increase in abortions, but this reflects an anti-choice belief that denies the positive and obvious reasons for such increases. It also stems from Koch’s stubborn refusal to acknowledge the prevalence of illegal abortion. Common sense dictates that after legalization, reported legal abortions will begin to replace the previous non-reported illegal abortions. Since it takes time to ramp up services after legalization, of course numbers will increase for a few years as access improves. But if all goes smoothly and especially if contraception also becomes increasingly accessible, legal abortion numbers will eventually stabilize and start to go down. That pattern is now well-documented for most western countries.
Overreliance on official statistics and unwarranted dismissal of evidence that doesn’t fit anti-choice ideology
Koch’s trust in the accuracy of Chile’s maternal death registry is based on faith, not evidence. In a criminalized regime like Chile, there is good reason to believe that many healthcare workers misreport the cause of death when women die in hospital from complications of illegal abortion, since women themselves (or a family member) would be highly motivated to lie to medical personnel about what happened when they arrive at the hospital, to protect themselves from prosecution. Healthcare workers are required to report women who have illegal abortions. While many would likely not ask too many questions and record the complication or death as a result of spontaneous abortion (going along with the woman's story in other words), some women are still being turned in by health workers to face arrest and a possible jail sentence, at least they were as recently as 2007. A 2010 article on abortion in Chile by researchers Shepard & Becerra notes: “More than 99% of abortions are not reported at all, disguised as a different procedure, or reported as spontaneous abortions in public hospitals.” They state the reason for the latter: “To protect both women and hospital staff from prosecution, hospital patient data reported to the Ministry of Health do not differentiate between spontaneous and induced abortion.”
Koch has not explained why alternative methods of collecting data (besides his preferred statistical sources) on maternal deaths from illegal abortion should be considered entirely worthless. He has no grounds for totally dismissing them, since other ways must necessarily be found to measure the incidence of illegal abortion and resulting deaths and complications (which include for example, surveys of women, surveys of specific healthcare facilities, and interviews with healthcare workers). His dismissal of the data these methods produce amounts to a gratuitous slur against the hundreds of reputable scientists and researchers who spend large amounts of time carefully gathering, comparing, and adjusting such data under challenging circumstances.
Small numbers of pre-1989 legal abortions in Chile.
It's also worth noting that since the pre-1989 law allowed abortions only to save the woman’s life and required the approval of two doctors, it’s highly unlikely that large numbers of Chilean women would have even attempted the process, let alone succeeded at it – especially poor, indigenous, uneducated, rural, and other marginalized women with few resources. Such common-sense considerations seem to be beyond Koch, because of his insistence on considering hard data and nothing else.
(* I call this the central claim because we hardly need a study to determine that declines in maternal mortality would be associated with higher education for women, improved access to health facilities and doctors, nutrition programs, clean water, skilled birth attendants, and similar factors. Such findings are already well-documented elsewhere and are pretty much self-evident. Therefore, I believe the authors' focus on those factors serves as a smokescreen to help conceal the study's true agenda, which is political and ideological - part of an anti-choice campaign to ensure that abortion stays criminalized throughout Latin America.)
In my opinion, based on the above analysis and my published rebuttal, Koch's anti-choice advocacy as a privileged male academic in Chile is an irresponsible abuse of power that puts women's lives and health at risk – not just in Chile, but throughout Latin America wherever abortion is mostly illegal.