Studies - General Research

Epidemiolgy of Abortion and its Prevention in Chile (In Press 2015)

This recent review article is a publication, ahead of printing, in Issues in Law & Medicine, Volume 30, Number 1 (Spring), 2015. Elard Koch, Director of Research MELISA Institute, Concepcion, Chile. Fifty References.

ABSTRACT: Mortality by abortion has continuously decreased over the past fifty years in Chile.

In fact, maternal death as a result of an induced abortion has become an exceptionally rare phenomenon in epidemiological terms (a risk of 1 in 4 million pregnant women of fertile age or 0.4 per 100,000 life births for abortion of any type, excluding ectopic pregnancy).

After abortion became illegal in 1989, deaths related to abortion continued to decrease from 10.8 to 0.39 per 100,000 live births.
This scientific fact challenges the common notion that less permissive [stricter] abortion laws lead to greater mortality associated with abortion.

…[A] more recent second line of prevention has been the emergence of support programs for vulnerable women with unplanned pregnancies at risk for abortion, which are conducted by the community or by local obstetric teams in the case of serious congenital diseases.

Expanding the coverage of these preventive programs, as well as monitoring their effectiveness, is necessary to prevent clandestine abortions and to continue to decrease their incidence in the Chilean female population…

A third factor to consider as a major determinant in the decrease in abortion-related morbidity, has been the emergence and gradual expansion of community preventive programs in Chile (e.g., Fundación Chile Unido, Fundación San José, Proyecto Esperanza, Fundación Maternitas, ISFEM, etc.).

These programs identify the specific situation leading to vulnerability in unplanned pregnancies at risk for abortion and offer immediate support to the mother to find a solution.

Recently, the preliminary results from one of the most extensive programs in terms of coverage (i.e., a cohort of 3,134 Chilean women with unplanned, vulnerable pregnancies) were presented in parallel discussion sessions of the United Nations’ Millennium goals. [28]

As observed in Figure 5, based on the mother’s declared intentions regarding abortion, the program achieved a live birth rate (with or without adoption) ranging between 69% and 85% depending on the risk group and whether the mother abandons or continues the program.

Research to identify specific situations associated with increased vulnerability appears to be key in the design of preventative strategies.

In a sub-cohort of the previously mentioned study[28] (the 486 women who initially declared an intention to abort), the following six factors explained more than 92% of the motivation to abort (Table II): coercion from their parents, a partner or from a third party with or without domestic violence (44.4%); interference with life expectations (22.8%); the desire to hide the pregnancy from parents or partner due to fear of their reaction (20.4%); repeated sexual abuse, rape and incest (2.1%); partner abandonment (1.9%); and psychological or emotional problems (1.9%)…

…Lastly, it should be highlighted that changes in the legal status of abortion are not focused on preventing this procedure occur, but rather only on facilitating its access depending on the permissiveness of the type of legislation.[6,7,9]

Legislative changes also do not solve the problems that lead to the specific vulnerability that motivate the intent of abortion, such as coercion or fear…

Related: The Chilean Abortion Paradox: Even When Prohibited by Law, Abortion Rates Decrease (MELISA Institute) (7 Nov 2014)
[In Press, June 2015,]