New article on EC and the trouble with WHO data

By Susan Yoshihara, Ph.D. | March 1, 2011

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This afternoon at UN headquarters, senior UN delegates will discuss how best to reduce the number of women who die in childbirth worldwide.

It is doubtful that any of the short but lofty speeches will address the dangers of emergency contraception or the way the UN’s own health experts use faulty data to promote dangerous medical abortions around the world.

So here is a recent article from Annals of Pharmacotherapy that delegates serious about reducing maternal deaths should consider. (It calls for Risk Evaluation and Mitigation Strategy (REMS) to assess the dangers of medical abortion in the US). A pertinent excerpt:

Currently, development funding is linked to compliance with World Health Organization (WHO) indicators, among which is the reduction in unsafe abortion. But WHO uses legal, not medical, definitions of safe and unsafe abortion.

Safe abortion is defined as “(a) abortions in countries where abortion law is not restrictive and (b) that meet legal requirements in countries where the law is restrictive.” Unsafe abortions are defined as including “(a) abortions in countries where the law is restrictive and (b) abortions that do not meet legal requirements in countries where the law is not restrictive.” So, if a REMS identifies that 90% of pregnancies that occur after ulipristal failure end in fetal death, these deaths would be counted as unsafe abortions in a country where abortions are illegal. However, the very same fetal deaths under the very same circumstances would not be counted as unsafe abortions in a country where abortions are legal, because the abortions meet legal requirements in that country.

So, the effect on reproductive health policy of introducing ulipristal as an emergency contraceptive will differ, depending on the legal status of abortion in a country. For this reason, opposition to an evidence-based medicine REMS is likely to come primarily from abortion proponents, for whom accurate information about the number and causality of fetal losses may threaten funding for programs based on an erroneous estimation of “unsafe abortions.”

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