DOCTORS ' LOUNGE
I
appreciate the highlight about women in medicine and the attention on women ’ s health care in the Wonder Women edition of the Louisville Medicine magazine . The article Stories of the Two Kentuckys for Maternal Morbidity and Mortality by Dr . Tom James addresses an important issue for our state but is carelessly inaccurate regarding abortion care . I was alarmed that Dr . James listed abortion as the # 5 leading cause , which is a health care service , rather than a cause of death . Abortion has an enviable safety record with less medical risk than live birth by at least a factor of 10 , with 0.7 per 100,000 vs 8.8 per 100,000 for childbirth . The risk of death related to abortion is incredibly rare . In 2018 , the National Academy of Sciences Report on the Safety and Quality of abortion care in the US was published and provided comprehensive data to support that . The report also helps to put abortion care safety into perspective by comparing it to other common medical procedures .
This article paints a very dangerous and careless picture of abortion in the US . I went through the references Dr . James listed and I was unable to confirm the data directly related to the dangers of abortion care he quoted .
Simply putting abortion care on this list does so much harm to women ’ s full access to reproductive rights . Access to abortion care is already very limited in the US and this misinformation only reinforces the stigma and misconceptions that fellow physicians and the public have about abortion care . This has to be corrected and given the time and respect the maternal mortality conversation deserves .
26 LOUISVILLE MEDICINE
LETTER TO THE EDITOR AUTHOR Tanya Franklin , MD
As an OB-GYN in the community , I am intimately aware of the causes related to maternal mortality such as cardiovascular disease , infection and venous thromboembolism – and the systemic causes like racism in medicine . Also , as one of three providers of abortion care in the entire state , I intimately know the safety and quality of abortion care is highly scrutinized and a mortality rate of 7.9 % is inaccurate . Abortion care has been an essential service in some women ’ s course to preserve their lives and reduce maternal mortality , not contribute to it . We cannot allow the safety and necessity of abortion care be misinterpreted in a publication that is meant to educate our colleagues .
Sincerely , Dr . Tanya Franklin Dr . Franklin is a practicing OB-GYN in Louisville .
Editor ’ s Note : I apologize most deeply for carelessly assuming that the abortion death rate noted per Dr . James was related to self-induced or illegal abortions sought by desperate women . I should have , but failed to , look it up and thus failed to note clearly that that his statistic is from the World Health Organization global death rate , defined in the Lancet Global Health article ( 2014 2 : e323-33 ) as due to “ induced abortion , miscarriage and ectopic pregnancy ” - not the US death rate . Miscarriages and ectopic pregnancies carry separate , high risks of their own not related to standard surgical abortion . These statistics were drawn from all over the world , in health systems ranging from modern universal care to minimal , if any , care .
I am indebted to Dr . Franklin for her immediate correction , for reinforcing the historic safety of abortion procedures in the US , and for teaching us all .