Friday, April 06, 2007

Are late-term abortions coded as stillbirths?


In a recent post on late-term abortion, I speculated that some late-term abortions are counted as stillbirths.

I finally found proof that this is sometimes the case.

The answer can be found on page 55 of the Nova Scotia Atlee Perinatal's Database's annual report of the year 2000, version 2.0.9 (issued 2005):

In the comment to Table 5.2.1, it is written:

Prenatal diagnosis and pregnancy termination tends to increase rates of early fetal death and to decrease rates of late fetal death and infant death due to congenital anomalies. Canadian data are from the Canadian Perinatal Health Report 2003. Some provincial components of the Canadian rate may include stillbirths following pregnancy terminations.


Now it remains to be seen which provinces code their terminations as stillbirths, and which do not, and how that affects the calculation of the number of abortions in Canada.


There is another interesting tidbit in this report about the way Nova Scotia codes perinatal deaths.

I did a screen capture of the criteria:


It says that the death will be coded as a congenital anomaly if it's the product of any medical or surgical complications that are secondary to the malformation. So if the baby dies of a surgery to correct spina bifida, the cause of death will be attributed to congenital anomaly.

Also included:

all lethal malformations, even if there exists another specific cause of death, for example, respiratory distress syndrome in an infant with a lethal congenital malformation.


If you ask me, that sounds really dumb.

So if the real cause of death is the termination of pregnancy, but you happen to have a congenital anomaly, the congenital anomaly is considered to be the cause of death.

That coding hides reality.

But there you go.



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