One question that I think often gets lost in the abortion debate is “What would happen if we criminalized all abortion?“

Well, here’s a brief answer in the context of Africa:

Worldwide, there are 19 million unsafe abortions a year, and they kill 70,000 women (accounting for 13 percent of maternal deaths), mostly in poor countries like Tanzania where abortion is illegal, according to the World Health Organization. More than two million women a year suffer serious complications. According to Unicef, unsafe abortions cause 4 percent of deaths among pregnant women in Africa, 6 percent in Asia and 12 percent in Latin America and the Caribbean…

The 120-bed hospital in Berega [Tanzania] depends on solar panels and a generator, which is run for only a few hours a day. Short on staff members, supplies and even water, the hospital puts a lot of its scarce resources into cleaning up after failed abortions…

On a Friday in January, 6 of 20 patients in the women’s ward were recovering from attempted abortions. One, a 25-year-old schoolteacher, lay in bed moaning and writhing. She had been treated at the hospital a week earlier for an incomplete abortion and now was back, bleeding and in severe pain. She was taken to the operating room once again and anesthetized, and Emmanuel Makanza, who had treated her the first time, discovered that he had failed to remove all the membranes formed during the pregnancy. Once again, he scraped the inside of her womb with a curet, a metal instrument. It was a vigorous, bloody procedure. This time, he said, it was complete…

Dr. Mdoe said he suspected that some of the other illegal abortionists were hospital workers with delusions of surgical skill.

“They just poke, poke, poke,” he said. “And then the woman has to come here.” Sometimes the doctors find fragments of sticks left inside the uterus, an invitation to sepsis…

“We as medical personnel think abortion should be legal so a qualified person can do it and you can have safe abortion.” There are no plans in Tanzania to change the law…

The steady stream of [botched illegal, amateur abortion] cases reflects widespread ignorance about contraception. Young people in the region do not seem to know much or care much about birth control or safe sex, Dr. Mdoe said…

In most countries the rates of abortion, whether legal or illegal — and abortion-related deaths — tend to decrease when the use of birth control increases. But only about a quarter of Tanzanians use contraception…

An assistant medical officer, Telesphory Kaneno, said: “Talking about sexuality and the sex organs is still a taboo in our community. For a woman, if it is known that she is taking contraceptives, there is a fear of being called promiscuous.”

In interviews, some young women from the area who had given birth as teenagers said they had not used birth control because they did not know about it or thought it was unsafe: they had heard that condoms were unsanitary and that birth control pills and other hormonal contraceptives could cause cancer.

Access to a safe and legal abortion is a moral good. The decision to terminate a pregnancy should be an entirely private one, and the right to make such a difficult decision in private is also a moral good.

The cultural war in this country over the right to a safe and legal abortion is, as it has been for past forty years, not really a religious struggle. It is, as Denise Grady’s brave article demonstrates, really about guaranteeing healthcare for poor women. Those opposed to keeping abortion safe and legal – ie, those who seek to deny professional medical care to poor women – wrap their repressive agenda in the robes of priests in order to hide the moral idiocy of their position. They spew false sanctity in the service of extremism and bigotry.

We stand on the moral high ground in the abortion debate, not those who use terrorism – the murder of Dr. Tiller – as an excuse to deplore access to safe and legal abortion.