The politics of maternal health and child mortality

Prime Minister Stephen Harper wants to reduce maternal and infant deaths, but Michael Ignatieff insists that program must include abortion.

The numbers are staggering. A half-million women die during pregnancy every year. Nine million children in the developing world will die before their fifth birthday. That’s one pregnant mother and 18 children every minute of every day of the year will die prematurely, unnecessarily. Their dire circumstances cry out for redress, but thus far, the plight of the world’s poorest and most vulnerable has been met merely with rhetoric.

In 2000, more than 100 countries signed up to the Millennium Development Goals, a set of eight goals to improve the lives of people in the developing world by 2015. For the most part, they are not even near to being achieved. Maternal deaths have dropped about 1.1 per cent year, about one-fifth the reduction necessary to reach the 15-year goal.

In January, Prime Minister Stephen Harper announced he would use Canada’s leadership as host of the G8 and G20 meetings this June to highlight the issues of maternal health and child mortality. In columns in the Toronto Star and Montreal’s La Presse newspapers, and in a speech to the World Economic Forum in Davos, Switzerland, he outlined his plan challenging the G8 – the group of eight large, developed economies that include the United States, Japan, Italy, France, Germany, the United Kingdom and Russia – to invest in clean water, inoculations, nutrition programs and the training of health workers to care for women and deliver babies. As Harper wrote, “The lack of the most basic services can lead to dire consequences, especially for the world’s most vulnerable populations … This is simply not acceptable.”

Campaign Life Coalition “applauded” the prime minister for “prioritizing the health of mothers and children in foreign aid.” CLC national president Jim Hughes told The Interim the pro-life community has long argued for authentic maternal and infant care at the international level, whereas groups such as UNICEF, the United Nations Population Fund, most foreign aid programs and various non-governmental organizations prioritize for abortion and reproductive health measures.

Don Hutchinson, vice-president and general legal counsel with the Evangelical Fellowship of Canada, observed in a webitorial that several “Canadian charities already active in this area have noted they have been declined for (Canadian International Development Agency) funding because their religious orientation encourages a focus on maternal health, not including the option of abortion – which when you think of it, is the antithesis of maternity care.”

CIDA

There was some initial concern that the federal government was partnering with, or sought the advice of the pro-abortion, pro-population control Action Canada for Population and Development (ACPD). Brian Lilley, the Canadian politics columnist for Examiner.com, reported that Jennifer Kitts of the ACPD is an advisor to Bev Oda, minister of international co-operation. Lilley reported that Oda indicated the government had not yet decided whether “family planning” was going to be part of the government initiative when he inquired about it, but that Kitts told him it is the key to reducing maternal and infant mortality.

Kitts claims abortion and contraception will reduce maternal deaths by 30 per cent and infant mortality by 20 per cent, but when asked to explain how the number of children dying before their fifth birthdays could be reduced by their mother’s access to condoms, contraceptive pills and abortion, Kitts “asked (Lilley) to turn off my recorder” and even then said she would have to continue the interview another time.

ACPD policy preferences are clear and it appears they are influencing the Canadian International Development Agency (CIDA). In its fact sheet on reducing maternal mortality, ACPD notes the Guttmacher Institute’s “4 Pillars” for saving women’s lives, which are (in order): “family planning and other reproductive services,” “skilled care during and immediately following pregnancy and childbirth,” “emergency obstetric care” and “immediate post-natal care for mothers and newborns.”

ACPD makes special note that “other reproductive services” include “the provision of safe abortion services.” Last May, Oda announced priority themes to guide CIDA as pertaining to children’s issues and one of those priorities included promoting and delivering sexual and reproductive health services, although the minister did not explicitly state whether that included abortion. (It should also be noted that the Millennium Development Goal of reducing maternal deaths includes the provision of abortion and contraception.

To be clear, initially we did not know what the final policy was going to look like and, in all likelihood, neither did the prime minister, his office or the government. The policy was probably going to be drafted by the Canadian International Development Agency after receiving directions from the government. CIDA, after all, will be responsible for implementing it.

The Conservatives

But on Feb. 18, Oda’s spokesman told the Canadian Press that abortion and contraception are not part of the maternal and infant health initiative. According to CP: “A spokesman in Oda’s office said the prime minister has set out several specific areas that will be the focus of funding, but that family planning measures were never part of that group. Instead, they include immunization, access to clean water, better nutrition and improved training for health-care workers on the ground who are delivering babies and treating children.”

Oda herself said, “Canada is not currently going to be changing its approach to improving maternal and infant health … The prime minister has been clear since we became government that there’s no intention on regenerating any debate on abortion.”

That still leave some wiggle room; the current policy for CIDA does include support for a broadly defined “reproductive health” component of maternal health. Also, the CP report merely re-asserts that the “focus” of the initiative is the priorities Harper spelled out in January, but that does not mean that other measures cannot be introduced. If abortion is not part of the plan, it is incumbent upon the prime minister and his staff to ensure that the government’s priorities are represented in the program CIDA comes up with and carries out.

As Jim Hughes says in the March CLC National News, “Abortion is the antithesis of helping mothers and their children. You don’t promote infant health care by killing babies before they are born.” Hughes notes that the precise words Harper used in making his announcement – “Far too many lives and unexplored futures have already been lost for want of relatively simple healthcare solutions” – is rhetoric that should rule out abortion.

Thus far, the Conservatives are sticking tightly to the script, quoting what Harper has said the initiative should include and thus implying that there is no room for abortion within that agenda without explicitly ruling it out – just as Oda’s spokesman did to the Canadian Press.

In a press release, Harper spokesman Dimitri Soudas said his boss had “one clear objective and that is saving lives of vulnerable children and mothers.” He accused Ignatieff of “fear-mongering” and raising “red-herrings” by “stirring up old debates” and “playing cheap politics.” He said the initiative “has nothing to do with abortion,” as he chastised the Liberal leader for playing domestic politics with the health of women and children.

Conservative MP Shelly Glover (Saint Boniface) was more emphatic in her CBC interview: “First and foremost, this has absolutely nothing to do with abortion. That topic is not part and parcel of this initiative.” She reiterated that Harper specifically called for medical and nutritional help. “Abortion is not a part of this,” she reiterated.

Lilley says, “Harper owes it to all of us to say whether his solution” to the problem of infant mortality, “will see more kids reach their fifth birthday or fewer kids reach birth.”

Michael Ignatieff

While Harper’s comments imply no room for abortion, there is no ambiguity on the part of the Liberals. Both Soudas and Glover were responding to Liberal leader Michael Ignatieff’s call for a guarantee that the new maternal health initiative include “reproductive health rights.” In a press release and a pair of press conferences, Ignatieff insisted that, “Women are entitled to the full gamut of reproductive health services and that includes termination of pregnancy and contraception.” For good measure, he used the phrase “full gamut of reproductive health services twice” and threw in a demand for the government to continue funding the International Planned Parenthood Federation.

Ignatieff’s call to arms on behalf of international abortion was seen by many as crass politics. While calling upon the prime minister to eschew politics and ideology, he invoked George W. Bush, who cut off funding for international groups that promoted or committed abortions and urged the government not to follow the former president’s example.

CLC national organizer Mary Ellen Douglas condemned Ignatieff for playing to his left-wing base and letting the party’s women’s caucus call the tunes. She said, “The women’s caucus of the Liberal party pulling Ignatieff’s strings shows that they are determined to include the killing of the unborn in developing countries.”

Paul Szabo, a Liberal MP, went on the record complaining that his party leader was not speaking on behalf of the caucus, which includes several pro-life Liberals. Szabo noted that abortion never came up during a caucus meeting on the topic of international development, which occurred just before Ignatieff’s bombshell. Indeed, another Liberal MP, John McKay, seemed surprised that Ignatieff mentioned abortion at the roundtable discussion on international development that he, McKay, was co-chairing on Jan. 26, where Ignatieff first announced that the party’s support for the initiative was dependent on the government’s guarantee for abortion “rights.”

The EFC’s Hutchinson was in attendance at that meeting and reported that of the 200 people at the roundtable, about a third gave only polite applause – “the kind you hear when others have started and the uncertain join in” – while “half the room sat in shocked silence.”

Ignatieff said, “We want women to care for themselves better and then look after their kids better.” He said that without contraception and “safe” abortions, women will continue to die. Ignatieff said, “We want women to care for themselves better and then look after their kids better.” He said that Liberal party support for Harper’s initiative is contingent upon access to abortion and contraception, describing the requirement as “laying down a marker” for the government. All this, Ignatieff explained, was because he does not want to play politics with this issue.

Reaction

Religious leaders were quick to respond. Toronto Catholic Archbishop Thomas Collins publicly rebuked Ignatieff. In a statement, he said that “in light of the many positive contributions that Canada can make to the improvement of maternal and child health, it is astonishing that the leader of the opposition, Mr. Michael Ignatieff, has issued a statement advocating contraception and abortion as fundamental elements addressing” maternal and infant health.

He continued: “There are many fruitful ways to improve maternal and child health and the discussion should centre on the most effective strategies for doing this.” Collins noted that even abortion supporters do not “propose it as a positive contribution to society.” Pastor Joe Boot of the Westminster Chapel in downtown Toronto was more blunt, calling Ignatieff’s position “pure evil” on The Michael Coren Show.

Lawyer and blogger Ezra Levant suggested that Ignatieff’s placement of abortion beside food, clean water and vaccinations was troubling enough, but that there was something deeply disturbing that the Liberal leader’s foray into abortion politics was in relation to exporting it to the developing world. In his post on the topic, Levant reminded readers of the eugenic and racist views of Planned Parenthood foundress Margaret Sanger.

University of Calgary political science professor, and former Harper adviser, Tom Flanagan told the National Post: “Of all the issues that you could possibly raise about women’s health, why would you start with abortion?” Flanagan, who has since had a falling out with the prime minister and cannot be considered a mouthpiece for the government, wondered: “What kind of mindset is it that you have to start killing unborn babies in order to help people?”

Curiously, Ignatieff repeatedly referred to the “gamut of reproductive rights” and to “terminations,” but could not bring himself to say abortion. Indeed, his spokesman, Michael O’Shaughnessy, told the National Post that the Liberal leader is “not actively promoting abortion,” but merely “seeking assurances that all contraception health options will be available.”

Keith Martin, a pro-abortion Liberal MP, has offered a “compromise.” He suggests that each country in the G8 take up a different aspect of the initiative, whether it be the provision of clean water, training health workers or providing access to family planning. He said that countries could focus on an area of expertise. While Martin said this is a typically Canadian “pragmatic” solution to the quandary of a country that might not want to pony up for abortion and contraception, it misses the point: abortion and contraception should not even be considered part of maternal health.

The bottom line

Harper’s initiative seeks to address the issue of 500,000 maternal deaths and nine million infant deaths. You do not help these vulnerable people by having women kill their unborn. Liberal leader Michael Ignatieff wants to provide more abortion and contraception at the expense of less clean water and fewer inoculations; every dollar spent on condoms and abortion-performing midwives is a dollar not spent fighting malnutrition and unsafe deliveries.

This needs to be repeated: every dollar spent on abortion and contraception is a dollar not being spent on providing the necessities of life: food, clean water, medicine and safe deliveries.

Jim Hughes, who also serves as vice-president of the International Right to Life Federation, says, “Canada must not allow abortion and depopulation activists to gain control of this program and use it to promote their own agendas at the expense of the health and lives of millions of women and children in the developing world.”

For all the hoopla over abortion as part of maternal health, what has been ignored is that Canada funds abortion through its grants to groups such the United Nations Population Fund. CIDA will likely continue supporting pro-abortion groups abroad, just not as part of this new effort.

Still, this whole ordeal tells us a lot about Michael Ignatieff: either he is willing to hold the health and lives of women and children in the developing world hostage for domestic political reasons or he genuinely thinks abortion is a central component of maternal and infant health. Which is worse will be left for readers to decide, now and during the next federal election..