Public Health  
 
A Legacy Beyond Controversy
Roger and Susan
Rochat reach out to students studying the lives of women broken apart by abortion

By Dana Goldman + photo by Bryan Meltz

   
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Abortion remains a hot-button topic, politically and culturally. For RSPH professor Roger Rochat, the larger issue is reducing the global epidemic of abortion-related deaths.
     For the past 40 years, Rochat has researched the 70,000 such occurrences that happen each year: death by coat hangers and infections in the United States, death by tree roots and hemorrhaging in Bangladesh, death by abdominal massage and home-brewed potions in Thailand. The numbers and the stories behind them led Rochat and his wife Susan to establish the Global Elimination of Maternal Mortality from Abortion (GEMMA) Fund.
     Starting this fall, the GEMMA Fund will support graduate students’ research on the topic and their collaborations with organizations such as WHO and the International Planned
Parenthood Federation. Through his funding and their work, Rochat hopes to create momentum to eliminate maternal abortion deaths.
     “If all women in the world who get unsafe abortions had access to services as we have in the United States, we could probably have fewer than 70 deaths a year worldwide,” he says. “That’s why I believe we could, at least in theory, eliminate maternal mortality from abortion.”
     And that’s the goal—along with honoring the public health concerns that draw students to a concentration in reproductive health. “We have students who come here every year who have a passion to make a difference in this area,” says Rochat, who also serves as medical adviser to the reproductive health nonprofit Pathfinder International. “It’s important to give recognition to this issue in part to support students who want to engage in the
issue.”
     First he must convince a public that often would rather not know about the 20 million unsafe abortions that happen around the world each year. “My sense is that as a society, we don’t want to hear the word and therefore don’t want to encourage good reporting,” Rochat says. “Because of the controversial nature of abortion, few people want to deal with it.”
     Rochat first became interested in abortion issues in the 1960s when his cholera research in Pakistan revealed a compelling and understudied public health problem: inattention to family planning that was resulting in unsafe, and often deadly, abortions.
     At the time, epidemiologists generally disregarded abortion as an important public health issue, but that was an incentive for him to get involved. “If I deal with HIV, I’m not the only one dealing with it. If I deal with infectious diseases, I’m one of many,” he says. “I would like in my life to engage in important things that other people have difficulty dealing with in the area of public health.”
     His own change of focus from cholera to abortion research is why the GEMMA Fund will help support practicums with nonprofits around the world. “Even now, each international project affects my understanding of the world and of public health,” he says. “All students rate international practicum experiences very highly. All mature. Nearly all apply lessons learned in the classroom.”
     Through these experiences, Rochat hopes students will seek answers to the questions he continues to pose to himself: “How can I, with my life, do something that others cannot, will not, or do not wish to do that’s important? How can I leverage my time here in a useful way?”

   
         
   
   
    "It's really hard for students after they graduate to come back and rework their theses into publication format. If I could use the fund to leverage some of them into publications, I would value that most because they would more likely be used by others to support programs and policies that address abortion-related deaths."    
   
- Roger Rochat
   
   
   
         
    Seeking answers
     Since the 1960s, that thread of usefulness has included service as an epidemiologist with the CDC, as an infant mortality researcher for the state of Georgia, and as an RSPH professor and director of graduate studies in the Hubert Department of Global Health.
     When he and his wife Susan decided a few years ago to create the GEMMA Fund, they posed a question similar to the one that had been the center of their lives: “What could we use this small amount of money for that would make a difference?”
     The answer was creating a mechanism to financially assist students studying abortion. Rochat hopes the endowment will help students connect to nonprofits focusing on the issue and then publish—and publicize—their research.
“It’s really hard for students after they graduate to come back and rework their theses into publication format,” he says. “If I could use the fund to leverage some of them into publications, I would value that the most because they would more likely be used by others to support programs and policies that address abortion-related deaths.”
     Student research is especially important because studies of abortion are so rare. Recent RSPH graduate Trisha Moslin’s thesis is the only U.S. study since Roe v. Wade— the 1973 Supreme Court decision upholding a woman’s right to abortion—to examine whether women use contraceptives after having abortions. (The field is so small, in fact, that Rochat co-authored the first study 35 years ago.)
     For her thesis, Moslin surveyed 75 women at Atlanta’s Feminist Women’s Health Center three weeks following their abortions to learn whether they were engaging in sexual intercourse and, if so, whether they were protecting against future pregnancies.
     She found that 76% of women were using contraception—even though only half of the respondents had become sexually active again. Of the women who were having sex, 92% were using birth control.
     By any measure, the finding offers significant information to the public health and medical communities. “The overall point of the study is that women understand they need to use contraception to prevent a future pregnancy,” says Moslin. “They do use contraception after abortions. They don’t want to have an abortion again.”
     Moslin has a potentially useful hypothesis about the other 8%. “Women may not understand that fertility returns within two weeks after an abortion,” she says. “Counselors could emphasize the importance of using contraception immediately if you’re going to resume sexual activity after an abortion.”
     The results were so persuasive that the Hubert Department of Global Health awarded Moslin an award for her thesis. But publication is a different matter—one she’s still working on after moving to Washington, D.C., and beginning a new position with the Population Reference Bureau.
     The GEMMA Fund may help students like Moslin as they work to make connections with such organizations, as well as give them time to prepare their theses for publication. But Rochat also hopes the endowment will impact more than just the student recipients.
     “It’s symbolic, but it’s a starting point,” he says. “It establishes a niche, a place to work, for faculty and for students. It says that Emory too is taking a stand to prevent maternal deaths from abortion.”
   
         
     
 

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