Study shows more people could die under extreme abortion restrictions

When the U.S. Supreme Court allowed a Texas law banning most abortions in the state to go into effect on Sept. 1, the reaction from abortion rights groups was dire.

“This is a travesty for the nearly seven million women of reproductive age, and everyone who supports access to safe, legal abortion,” Planned Parenthood Federation of America CEO Alexis McGill Johnson said in a statement.

“This should send chills down the spine of everyone in this country who cares about the Constitution,” echoed Nancy Northrup, president and CEO of the Center for Reproductive Rights.

Abortion rights proponents have warned that the Texas law could serve as a blueprint for other states to impose similarly restrictive abortion measures, and indeed GOP officials in at least seven states have suggested that they may amend their abortion policies with the law in mind, according to the Washington Post.

But beyond the potential political and legal implications, there’s another alarming potential outcome of the enactment of SB 8: More Texans could die.

That’s the takeaway from a new study published in the American Journal of Public Health by researchers at the Mary Amelia Center for Women’s Health Equity Research at Tulane University.

“It is likely that we’ll see the numbers of maternal death growing as a result of the extremely restrictive abortion climate,” Dr. Dovile Vilda, a research assistant professor at the center and the lead author of the study, said in an email.

Vilda’s and her colleagues’ study explored the impact of state abortion policies on rates of maternal mortality from 2015-2018. Using data from the National Center for Health Statistics, the authors investigated associations between states’ abortion policies in effect in 2015 and maternal death rates over the following years, considering eight different types of abortion restrictions: state-mandated counseling before abortion; mandatory waiting periods; ultrasound requirements; parental involvement for minors seeking abortions; gestational age limits; licensed physician requirements; insurance coverage limitations; and restrictions on public funding for abortions.

States with a higher score in the abortion policy composite index, which combined those eight policies into one measurement, had on average a 7% increase in total maternal mortality, defined as death while pregnant or within one year following the end of a pregnancy.

But the data was even more stark when specific abortion policies were looked at individually. States that had imposed a requirement that abortions be performed by clinicians who comply with special licensing requirements and have admitting privileges or other arrangements with hospitals had 51% higher total maternal mortality, the study found, while states with restrictions on how Medicaid funding could be used to cover abortions saw a 29% increase in their total maternal mortality rate.

“In many cases, maternal death results from health-related complications developed or exacerbated during pregnancy, and thus women with chronic health conditions, who are not able to access abortion care, will be forced to carry unwanted pregnancy to term even if their health and lives are in danger,” Vilda told the American Independent Foundation.

The United States has the highest maternal death rate of any developed nation, owing in part to an undersupply of maternity care providers such as midwives and OB-GYNs and the lack of universal paid parental leave post-pregnancy. Even before the new law took effect, Texas had a maternal death rate higher than the U.S. average, and the highest rate of uninsured women of childbearing age in the country.

Maternal death also disproportionately impacts communities of color, both in Texas and across the country. In the United States, Black women have a pregnancy-related death rate over three times that of white women; in Texas, Black women account for 11% of live births but 31% of maternal deaths.

“Given the historically entrenched systemic racism, discrimination, a lack of institutional power and access to resources, women of color will continue to be disproportionately affected by the new abortion ban,” Vilda said.

Anti-abortion policies also do not exist in a vacuum, Vilda noted: States that implement abortion restrictions also tend to support restrictions on things like publicly supported contraceptive supplies and sex education, both of which are associated with lower maternal mortality rates.

But the study demonstrates a significant link between restrictive abortion policies and maternal death, counter to proponents‘ claims that the Texas law is “saving lives.”

“Our study provides evidence that decreasing the number of abortion restrictions across the states may reduce incidence of death during pregnancy and postpartum among all women in the U.S.,” Vilda said.

Published with permission of The American Independent Foundation.