Pregnancy Risk Far Higher Than Abortion, New Study Finds

New research indicates that commonly held statistics regarding the risks of pregnancy versus abortion in the United States significantly underestimate the dangers associated with carrying a pregnancy to term. The study, released amid ongoing national debate about abortion access and maternal health, aimed to provide updated and accurate risk assessments for patients, clinicians, and policymakers.

Understanding the Increased Risks

Researchers found that continuing a pregnancy is considerably more dangerous than having an abortion. Lead study author Maria Steenland, an assistant professor at the University of Maryland’s School of Public Health, stated, “It is widely understood by scientists that continuing a pregnancy carries a much higher risk of death than having an abortion.” The new analysis reveals this risk gap is even larger than previously understood.

Did You Know? In 2003, a pregnancy checkbox was added to death certificates, but full implementation wasn’t achieved until 2018, addressing prior undercounting of maternal deaths.

Study author Benjamin Brown, an assistant professor of obstetrics and gynecology at Brown University’s Warren Alpert Medical School, emphasized the implications of abortion restrictions. “Our findings underscore how dangerous abortion bans are for pregnant people: forcing someone to continue a pregnancy puts them at a dramatically higher risk of death—along with so many other harms.” The research also highlights the critical need to reduce mortality rates for all individuals during pregnancy, childbirth, and the postpartum period.

Quantifying the Risk

The analysis determined that the mortality risk from pregnancy, including up to one year postpartum, is 44 to 70 times higher than the risk associated with abortion. This is three times higher than previous estimates. Earlier data, from 1998 to 2005, suggested childbirth was approximately 14 times riskier than abortion, with mortality rates ranging from 8.8 to 14.5 deaths per 100,000 live births. However, data from 2018 to 2021 revealed an average of 32.3 maternal deaths per 100,000 live births, peaking at 43.9 in 2021.

Expert Insight: The substantial increase in estimated maternal mortality rates underscores the importance of continually updating risk assessments with the most current data available, particularly as healthcare practices and data collection methods evolve.

Pregnancy-related deaths were defined as those occurring during pregnancy or within one year following the end of pregnancy. These deaths were identified through hundreds of specific causes, including hypertension disorders, obstetric hemorrhage, complications from chronic heart and kidney disease, and infections contracted during pregnancy.

Data Collection and Considerations

The research team analyzed data from the US National Vital Statistics System on deaths and births (live and stillbirths), alongside abortion-related deaths from the Pregnancy Mortality Surveillance System, covering the period from 2018 to 2021. Abortion data was sourced from the Guttmacher Institute, a nonpartisan research organization that tracks abortion surveillance data both domestically and internationally.

To address potential overcounting of maternal deaths—a possible consequence of the 2018 implementation of the pregnancy checkbox on death certificates—the study excluded nonspecific causes of pregnancy-related mortality, such as “other specified pregnancy-related conditions.” Deaths attributed to COVID-19 and those resulting from miscarriage or self-induced abortion were also excluded from the calculations.

Marie Thoma, a reproductive and perinatal epidemiologist and an associate professor at the University of Maryland, stated, “Even with this conservative approach to calculating maternal mortality, we found the risk of dying from pregnancy and childbirth far exceeded the risk of dying from abortion.” She added, “People deserve access to updated information about these comparative risks and policies that reflect these realities.”

Researchers also noted that the risk of death associated with abortion has decreased, likely due to more abortions being performed earlier in pregnancy, which is generally safer. They suggest that increased restrictions on abortion access could negatively impact maternal health in the future.

Frequently Asked Questions

What time period did this study focus on?

The study analyzed data from 2018 to 2021, using information on deaths and births from the US National Vital Statistics System and abortion-related deaths from the Pregnancy Mortality Surveillance System.

What factors contributed to the updated risk estimates?

The availability of new data, specifically the full implementation of the pregnancy checkbox on death certificates in 2018, was a major factor. Researchers also accounted for potential overcounting by excluding nonspecific causes of pregnancy-related mortality.

What is the significance of this research?

The findings demonstrate that the risk of death from pregnancy and childbirth is substantially higher than the risk of death from abortion, and this difference is greater than previously estimated. This information is intended to inform decisions made by patients, clinicians, and policymakers.

Considering these findings, how might access to comprehensive reproductive healthcare impact maternal mortality rates?