dc.description | In countries where induced abortion is legally restricted, as in most of Latin America,
evaluation of statistics related to induced abortions and abortion-related mortality is challenging.
The present article reexamines recent reports estimating the number of induced abortions and
abortion-related mortality in Mexico, with special reference to the International Classification
of Diseases (ICD). We found significant overestimations of abortion figures in the Federal District
of Mexico (up to 10-fold), where elective abortion has been legal since 2007. Significant
overestimation of maternal and abortion-related mortality during the last 20 years in the entire
Mexican country (up to 35%) was also found. Such overestimations are most likely due to the
use of incomplete in-hospital records as well as subjective opinion surveys regarding induced
abortion figures, and due to the consideration of causes of death that are unrelated to induced abortion,
including flawed denominators of live births. Contrary to previous publications, we found
important progress in maternal health, reflected by the decrease in overall maternal mortality
(30.6%) from 1990 to 2010. The use of specific ICD codes revealed that the mortality ratio associated
with induced abortion decreased 22.9% between 2002 and 2008 (from 1.48 to 1.14 deaths
per 100,000 live births). Currently, approximately 98% of maternal deaths in Mexico are related
to causes other than induced abortion, such as hemorrhage, hypertension and eclampsia, indirect
causes, and other pathological conditions. Therefore, only marginal or null effects would
be expected from changes in the legal status of abortion on overall maternal mortality rates.
Rather, maternal health in Mexico would greatly benefit from increasing access to emergency
and specialized obstetric care. Finally, more reliable methodologies to assess abortion-related
deaths are clearly required. | |