The health sector and legislature must revisit the issue of abortion given the dangers associated with unsafe abortion practices by those who need it, says Dr Bernadette Theodore-Gandi of the Pan American Health Organisation (PAHO).
She said so at the national consultation on Improving maternal, infant, child and adolescent health through quality interventions in T&T, hosted by the office of the representative of the Pan American Health Organisation/World Health Organisation (PAHO/WHO).
It was held at the Hilton Trinidad and Conference Centre, Port-of-Spain, yesterday.
Theodore-Gandi said abortion remained a leading cause of maternal deaths in Latin America and the Caribbean, owing to multiple complications owing to safety issues.
“In T&T the extent of this situation is difficult to assess due to the lack of reporting and under-reporting, due to its illegality under certain circumstances.
“What we do know is that unplanned and unwanted pregnancies lead to unsafe abortions and unfortunately to the death of many mothers, including very young mothers,” Theodore-Gandi said.
The Family Planning Association, she added, conducted a situational analysis of abortions in 2004 which found that 96 per cent of the pregnancies were unplanned and that almost one-third of the women attempted to terminate their pregnancy through self-selected methods, such as tablets, hormones, misoprostols, herbs, backyard visits and other self-administered means.
“Surely this is a telling sign of a woman’s physical and mental capacity to care for herself and baby if she is willing to risk death. “As well, the need for clarity on and equitable access to lawful terminations is highlighted by such scenarios,” Theodore-Gandi added.
Regarding child mortality, she said in 2013 the global figure had fallen by 49 per cent and maternal mortality by 45 per cent.
But achieving healthy outcomes for mothers and children, Theodore-Gandi added, required urgent political commitment and action and investment in proven interventions and programmes that would save mother and child.
In presenting some global statistics, she said every day approximately 800 women died from preventable causes related to pregnancy and childbirth, adding that in 2013 some 289,000 women had died.
Theodore-Gandi said 99 per cent of all maternal deaths had occurred in developing countries and maternal mortality was higher among women living in rural areas and among poorer communities.
“Young adolescents face a higher risk of complications and death as a result of pregnancy than older women. Skilled care before, during and after childbirth can save the lives of women and new-born babies,” Theodore-Gandi urged.
In examining why pregnant women continued to die, she said globally major complications that accounted for maternal deaths included pre-existing medical conditions exacerbated by pregnancy, such as diabetes, obesity, HIV and malaria, severe bleeding, pregnancy-induced high blood pressure, infections, obstructed labour, abortion complications and blood clots.
“In T&T we note that this situation obtains as well. While women are attended by skilled health professionals at delivery, reportedly 95 per cent of women attend antenatal clinics at least once during their pregnancy. This figure needs to be increased to at least eight visits during pregnancy,” Theodore-Gandi said.
Saying that more lives can be saved through the implementation of very simple measures, she said those included that pregnant women access quality health care before, during and after birth, the availability of safe blood supplies, the availability of essential medicines, such as antibiotics and oxytocin, and women having the knowledge to plan their families safely
When asked about the Government’s position regarding abortion, especially in light of reducing maternal deaths, Health Minister Dr Terrence Deyalsingh said abortion was “currently on the books” in that if a mother or child was in stress, “they can do it.”