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Abortion is linked to high maternity mortality

Dec 15, 2009 Editorial

The medical community is hard pressed to focus on the various ailments affecting people. It is fortunate that medical attention is free in Guyana because many people would not have been able to pay for their care.
There is, or was until Clico collapsed, some medical insurance in Guyana. The unfortunate thing is that people who sought such policies are now in limbo. Companies are not honouring their claims, choosing instead, to ask the people to pay the bill and make the claims from their insurance companies. In the past, the medical facility that provided the service simply claimed the charges from the insurance company.
But as fate would have it, mainly public servants sought medical insurance. The ordinary person simply presented himself or herself to doctors at the public institutions. The expenditure in health now means more doctors and more medical centres. But for all this the nation seems to be ignoring a serious problem.
The authorities, with assistance from the international community, including the United States through PEPFAR (President Bush’s Emergency Plan for AIDS Relief) have been spending millions of dollars on people living with HIV and AIDS. The sympathetic diseases that result—tuberculosis and the like—are also effectively being treated.
Diabetes and hypertension are other diseases that demand major expenditure.
Nearly fifty per cent of the population suffers from one or both of these ailments. Some only reach for medical help when it is almost too late.
But there is the single most preventable problem that is largely being ignored but which makes for depressing statistics. Guyana, despite all the talk by the Health Ministry, still has a high maternity mortality rate. A recent report placed Guyana’s maternal mortality as the highest in South America, certainly some thirty times higher that Chile which has the lowest such rate in the hemisphere.
The report blames the unlimited access to abortion. Many women, in this day and age of unlimited contraception and given the threat of HIV and AIDS from unprotected sex, still use abortion as a means of contraception.
Those who can afford the better doctors are more likely to survive but many are scarred and sometimes killed after seeking the services of less than professional abortionists. Each failed abortion is listed as a maternal death and the report, which is contained in these pages, blames the unregulated abortion practices allowed in Guyana.
Indeed, the Ministry of Health sought to regulate abortions because it recognised that if it maintained the pressure on abortions, then the bottom house quacks would have thrived and even more lives would have been lost.
The National Assembly mandated that there be counseling of people seeking abortions and that no abortion be conducted beyond twelve weeks. It also mandated that institutions performing abortions keep records of each abortion.
We are willing to bet that this is now observed more in the breach. The bottom line is the high maternity mortality. The report points to Chile where the laws on abortion are more stringent. It concludes that correspondingly, there are less maternal deaths.
The issue here, in Guyana, continues to be enforcement of regulations. In just about every area there are laws but little or no enforcement. If ever there is enforcement, this is temporary. There are so many things that expose this weakness in the society.
There was a committee to monitor the institutions that offer abortions. One must wonder whether these committees work, whether the members are still active.
There is a lot of information out there about HIV and AIDS but this information seems not to be transformed into the area of maternal health. Young women are still becoming pregnant to the extent that teenage pregnancy is another concern.
The state has set up services to deal with teenaged pregnant women who, in the first instance, should have

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