Sunday, March 13, 2011

Government must listen to calls for improved abortion statistics

It seems everyone is calling for better information on abortion statistics. Yet we continue to have numbers that are contradictory, unreported, or unknown.

Anastasia Bowles of LifeCanada recently reported a discrepancy between CIHI's figures, and a recent study done by an Ontario group, Project for an Ontario Women’s Health Evidence-Based Report (POWER).

Bowles states:

"By comparison, the new POWER study uses OHIP billing records and several different databases, making it more reliable than other recent data. This may account for a large discrepancy between the study’s and CIHI’s figures. The study does not give absolute numbers for abortions but it does provide the abortion to live birth ratio. Since Statistics Canada reports the number of Ontario live births as 138,000, this would suggest the number of Ontario abortions in 2007 may actually be around 51,000, much higher than CIHI’s figure of about 32,000."

If we extrapolate the discrepancy for these numbers from Ontario, and assume that this discrepancy is the same for all provinces, we may not be looking at 94,010 abortions per year in Canada (as per CIHI), but rather a staggering 150,000 abortions in Canada each year.

Of course all of this is simply best-guess numbers because our Government refuses to make the collection of abortion statistics mandatory. And it isn't just pro-life groups that want accurate statistics.

In an Access to Information request I made to Statistics Canada (to learn how Statistics Canada decided to change participation in the Therapeutic Abortion Survey from mandatory to voluntary), I learned many others also want accurate statistics including pro-choice groups.

In a document entitled A note on Slipping Timelines and Declining Data Quality of Therapeutic Abortion Statistics Program Canada, written in 1998 by Surinder Wadhera, the Program Manager of the Therapeutic Abortion statistics, Wadhera stated:

"Phase I - Sept. 1964 - July 1986...Abortion reports for the 16 year period (1970-1986) were timely, comprehensive and met the increasing data needs of the users. The satisfaction element of users is reflected in positive feed back: (a) in the form of a letter from Justice Minister to the Chief Statistician at that time; (b) appreciation from Canadian Medical Association, Media, Pro-life and Pro-choice abortions groups and international agencies like World Health Organisation, Population Council.

Phase 11- August 1986- July 1998 Statistics Canada cancelled the therapeutic abortion program in August 1986 and the reason assigned was budgetary constraints. The activity of data collection and analysis was suspended for the next 15 months till November 1987. At that time the Minister in charge of Statistics Canada announced the re-instatement of the program, which was as a result of pressure from users across Canada, comprising of members of provincial legislatures, Members of Parliament and other interested parties like Pro-life and Pro-choice groups."

(I need to digress here for a moment. It is tragic that the preceding information is only available to me because Statistics Canada is ATIPPable. Now that CIHI produces and collects the abortion statistics, other abortion related information like the information above, will no longer be available to Canadians. It will remain permanently hidden from our purview.)

Here is an example of abortion analysis Statistics Canada used to produce in this document called Pregnancy Outcomes. The author states is his introduction:
"Data on pregnancy rates and outcomes are important for planning, implementing, and evaluating maternal and child health and family planning programs. Such information also has implications for the provision of facilities and treatment now and in the future."

This is just as true today as it was in 1996 when this was written. But we don't get this kind of analysis anymore from Statistics Canada since the responsibility for abortion collection and publication was transferred to CIHI.

In a counterpoint article to Ms. Bowles article, Ruth Croxford, Sheila Dunn, and Lorraine E. Ferris of the POWER project, also advocated for improved data collection. (Ms. Dunn conducts clinical trials of hormonal contraceptives and means of medical abortion.):

"We were pleased to see Ms. Bowles make the point for improved data collection. Health services researchers have long advocated for better data about all health care services. The provision of effective and efficient evidence-based health care can only thrive in an environment rich in data."

Abortion reporting is not mandatory for clinics, so numbers will only get worse, especially as more and more abortions are performed at clinics. The few statistics we do have are poor. Pro-life, pro-choice, and many other groups want better statistics.

So what's to be done?

The Conservatives need to honour their promise that:

"Government will become more transparent and more open. It will provide Canadians with access to more information from Crown corporations, Agents of Parliament, and government-funded foundations".

This can be accomplished by the government mandating reporting of abortions performed by all abortion clinics, along with a law to disclose the statistics to the public.

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