Pregnancy-related deaths could rise 20% or more in states that outlaw abortion, experts say

In the 26 states poised to either restrict or outlaw abortions if Roe v. Wade is overturned this summer, the number of pregnancy-related maternal deaths could rise 20% or more, according to some calculations.

Currently in the United States, about 700 women die each year either during pregnancy, during delivery or soon afterward, according to the Centers for Disease Control and Prevention.

“Denying people abortions increases deaths because staying pregnant is more dangerous than having an abortion,” said Amanda Stevenson, a sociology professor at the University of Colorado, Boulder.

In a paper published last year,  Stevenson analyzed the risk of dying from an abortion versus the risk of dying from pregnancy, delivery or post-partum issues such as preeclampsia.

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She then compared what death rates would look like if the U.S. were to enact a total abortion ban and found that 140 more deaths could result because of more pregnancies being carried to term. 

The death rates for women who want an abortion but are unable to access one are likely to be even higher than for wanted pregnancies, Stevenson said. 

"People with resources are more likely to make it out of state or find out about medication abortions," she said. "People who can't are more likely to have health issues, to live in poverty and have less access to resources."

That will especially impact people of color, she said. 

There also likely will be an additional increase in deaths due to unsafe abortions or attempted abortions, said Dr. Ana Langer, a reproductive health expert and coordinator of the Women and Health Initiative at Harvard T.H. Chan School of Public Health.

"If the current trend in the U.S. persists, 'back alley' abortions will be the last resource for women with no access to safe and legal services," she said. "And the horrific consequences of such abortions will become a major cause of death and severe health complications for some of the most vulnerable women in this country."

Dangers of pregnancy

Pregnancy is a potentially dangerous health event. According to the CDC, for every 100,000 live births in the United States, 20 mothers die. 

"There's a wide perception that abortion is more dangerous than giving birth, but that probably comes from pre-Roe v. Wade times, when many women died because of unsafe abortions," said Dr. Lisa Harris, a professor of obstetrics and gynecology at the University of Michigan, Ann Arbor. 

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Today, surgical and medication abortions with prescription drugs are much safer, she said. CDC data shows the death rate for abortions is less than 1 per 100,000. 

Pregnancy makes tremendous demands on the body and can exacerbate a wide range of underlying health issues, Harris said. "It brings a whole new set of health complications that no other time of life does."

Some of the most common complications in pregnancy include nausea and vomiting, high blood pressure, heart issues, gestational diabetes, infections and anemia. 

The most common causes of pregnancy-related deaths in the United States include:

• Cardiovascular issues. 
• Infection or sepsis.
• Hemorrhage. 
• Blood clots in the lungs.
• Stroke.
• High blood pressure (includes preeclampsia).

While some states with strict anti-abortion laws on the books include exceptions when the life of the mother is endangered by the pregnancy it is rarely a realistic option, Stevenson said. 

“There are a great deal of additional barriers to getting an abortion even if you quality under these very restrictive standards, related to providers and medical institutions’ fear of retaliation,” she said.

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The risks are even greater for women of color, experts say. 

Dr. Cynthia Gyamfi-Bannerman, a specialist in maternal-fetal medicine and high-risk pregnancies, said restrictions to reproductive rights make racial disparities in pregnancy outcomes worse.

"Restricting access to abortion care for cases where there's danger to the mom could really worsen our maternal mortality outcomes rather than do anything to help them,” she said.

Contributing: Nada Hassanein, USA TODAY