NEW YORK, February 22 (C-FAM) A new Guttmacher Institute report on Uganda recommends increased access to contraception and abortion as a way to improve women’s health and reduce unintended pregnancies. Yet the abortion advocacy group uses questionable data to push its priorities onto people who, it acknowledges, want children and reject abortion.
Guttmacher estimates that just over 54% of pregnancies in Uganda are unintended, and “[t]he high level of unintended pregnancy and the gap between actual and desired fertility in Uganda can be attributed largely to insufficient contraceptive use.” According to 2006 data from the UN Statistics Division, the unmet need for contraception in Uganda is 38%.
By Guttmacher’s reasoning, increased contraceptive access in Uganda would drive down the rate of unintended pregnancy. Yet the United States, which boasts an unmet need for contraception of only 6 - 7%, is also classified as having nearly half of its pregnancies as unintended (See Figure 1).
While experts call the concept of “unmet need” for contraception “baseless,” it remains the basis for the United Nations Population Fund’s call for $8.1 billion annually for family planning worldwide.
Unintended pregnancies are more likely to end in abortions in the United States than in Uganda: 47% as opposed to 30% in Uganda (See Figure 2). The Guttmacher report claims that a combination of confusing laws, lack of knowledge regarding one’s options, and stigma due to a pervasive negative attitude toward abortion makes abortion in Uganda unsafe.
While acknowledging that abortion is legal in some circumstances in Uganda, Guttmacher laments, “Although desired fertility is declining, many Ugandans still want large families and do not approve of abortion.”
Estimates of maternal mortality related to abortion in Uganda vary. Guttmacher cites unpublished sources estimating as many as 26% of maternal deaths are due to unsafe abortion, which is double the rates the Ugandan Ministry of Health claim in their 2011-2012 annual report. While the use of the higher figure does more to further Guttmacher’s argument for expanded abortion access, if incorrect, it underestimates and risks diverting attention away from other causes of maternal death, such as hemorrhage.
While Guttmacher calls for increased access to contraceptives and abortions, Uganda’s Ministry of Health has set out its own priorities for maternal health. Uganda’s Strategic Plan for 2010-2015 (PDF) attributes slow improvements in maternal mortality to “lack of [human resources], medicines and supplies and appropriate buildings and equipment including transport and communication equipment for referral.”
Improvements in overall healthcare would benefit more than just expectant mothers, they would likely reduce abortion-related mortality. World Health Organization researchers point out that good healthcare infrastructure “has kept the mortality relatively low in Latin America, and the unsafe abortion case fatality rate is just about equal to that in Europe,” despite the lack of liberal abortion laws in the region.
The Guttmacher Institute’s interest in Uganda may have more to do with population control than helping its citizens achieve the outcomes they want. As its report points out, “Uganda, a country of nearly 35 million (including 8 million women of reproductive age), has one of the highest rates of population growth in the world.”