Reproductive & Maternal Health Resource Center

Reproductive & Maternal Health Resource Center

Source:

Healio Interview

Disclosures: Stevenson reports no relevant financial disclosures.
November 17, 2021
3 min read
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Q&A: Total abortion ban in US could increase pregnancy-related deaths by 21%

Source:

Healio Interview

Disclosures: Stevenson reports no relevant financial disclosures.
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The U.S. Supreme Court recently heard arguments over S.B. 8, the controversial Texas law banning abortions after 6 weeks of pregnancy, and will take up the Mississippi case, which bans abortions after 15 weeks, on Dec. 1.

The Supreme Court is unlikely to rule on the Texas case until the summer of 2022, according to Amanda Jean Stevenson, PhD, an assistant professor of sociology at the University of Colorado Boulder. Meanwhile, at least 12 other states have recently passed laws attempting to ban abortion at 6 weeks of gestation or earlier, Stevenson wrote in a recent paper in Demography. These laws highlight the need to estimate the “mortality consequence of totally banning induced abortion,” she wrote.

Graphical depiction of data included in article.
Stevenson AJ. Demography. 2021;doi:10.1215/00703370-9585908. 

Stevenson conducted an analysis on the impact of reproductive health policies and found that, if implemented, a total abortion ban in the U.S. could increase pregnancy-related deaths among women by 21%, and Black women specifically by an estimated 33%. These estimates do not take into account deaths that may arise from unsafe or attempted abortions, according to Stevenson.

In addition, Stevenson found that a total ban could result in an additional 140 deaths per year, for an estimated 815 annual deaths due to pregnancy-related causes. Black women and women of lower socioeconomic status face a higher mortality risk since these populations are more likely to seek abortion care or encounter serious pregnancy complications, according to Stevenson. She reported that if all wanted induced abortions were banned, it could increase the lifetime risk for a pregnancy-related death from 1 in 3,300 women to 1 in 2,800 women. For Black women, the risk would increase from 1 in 1,300 to 1 in 1,000 women.

Amanda Jean Stevenson

Healio Primary Care spoke with Stevenson to learn more about the association between maternal mortality and abortion restrictions.

Healio Primary Care: What is the key takeaway of your analysis?

Stevenson: Forcing people to remain pregnant by banning abortion will increase pregnancy-related deaths because staying pregnant is deadlier than having an abortion.

Healio Primary Care: Can you discuss the disparities in maternal mortality if a nationwide abortion ban were instituted?

Stevenson: We currently have a maternal health crisis in this country. Our maternal mortality rates have been increasing for decades, while our peer countries’ rates have been declining. The increases in maternal mortality have been felt across racial and ethnic groups, but the largest increases have been among Black pregnant people, who are about three times more likely to die from pregnancy-related causes. These tragically high and unequal rates of pregnancy-related deaths in this country would be exacerbated, both in terms of level and in terms of unequalness if abortion were banned. This is because Black people are more likely to need abortion care because of systematic inequalities in health care access, economic opportunity and for other reasons associated with systematic racial oppression. Because Black people are more likely to seek abortion care under the current abortion access conditions, Black people are more likely to be denied the abortion care they need under an abortion ban. Therefore, they are more likely to be forced to remain pregnant when they don’t want to be and the increase in pregnancy-related deaths would disproportionately fall on them. Banning abortion would worsen the existing Black maternal health crisis, deepen already unjust racial disparities in pregnancy-related death, and increase pregnancy-related death for everyone.

Healio Primary Care: Why is an abortion ban harmful for women’s health?

Stevenson: Abortion bans harm women’s health in many ways. They immediately block access to lifesaving pregnancy care, which is what abortion is. But they also force people to remain pregnant when they do not want to be. Some people choose abortion for health reasons, so staying pregnant can have immediate adverse health consequences or increases in risk of adverse health outcomes for them. But more broadly, from the Turnaway Study, we know that being denied a wanted abortion has broad negative causal effects on health in the long term after abortion denial.

Healio Primary Care: Could you comment on the Texas case before the Supreme Court?

Stevenson: Banning abortion forces people to remain pregnant when they do not want to be. The consequences of forcing people to remain pregnant include negative psychological, economic and health impacts, up to and including death. The federal judiciary has allowed this law to hurt Texans, and now that will continue. The Texans who have been and will be forced to remain pregnant when they did not want to be will forever have different lives (or tragically, not continue) because of this law. Even more states will now likely follow Texas’ example.

We can limit the number of pregnant people who will die because of laws like this by addressing the maternal mortality crisis, which will require that we address racism in our society and in medicine, helping pregnant people who want abortion to get the care they need, and working to overturn abortion bans like S.B. 8.

Now is the time for non-governmental organizations and other states to step up to support Texans and residents of other states who cannot access the health care they need in their home states. Individuals can support abortion funds in Texas, which will continue supporting pregnant Texans. And they can hold their own states accountable for shoring up their abortion care infrastructure and abortion funding.

References:

Ralph LJ, et al. Ann Intern Med. 2019;doi:10.7326/M18-1666.

Stevenson AJ, et al. Demography. 2021;doi:10.1215/00703370-9585908.

What to know about the Mississippi abortion law challenging Roe v. Wade. https://www.nytimes.com/article/mississippi-abortion-law.html. Published Oct. 28, 2021. Accessed Nov. 17, 2021.