With Brown University
Amid national debates about the importance of abortion access to maternal health, the aim of the study was to estimate risks using updated data to provide accurate information that could aid decision-making by patients, clinicians and policy makers.
“It’s widely understood by scientists that continuing a pregnancy carries a much higher risk of death than abortion,” says study lead author Maria Steenland, an assistant professor at the University of Maryland School of Public Health.
“Our new analysis shows that it is much riskier to be pregnant than to have an abortion, and this gap in mortality risk is even wider than previously recognized.”
The findings suggest that abortion bans force pregnant women who would otherwise have sought abortion care to take on significantly increased health risks associated with continuing the pregnancy, the researchers noted, including bleeding and high blood pressure.
“Our findings underscore just how dangerous abortion bans are for pregnant women: forcing someone to continue a pregnancy puts them at dramatically higher risk of death—along with so many other harms,” says study author Benjamin Brown, assistant professor of obstetrics and gynecology at Brown University’s Warren Alpert School of Medicine.
“The data also highlight the urgent need to reduce mortality rates for all pregnant, labor and postpartum women.”
Steenland, whose research goal is to identify policy options to increase equity and quality of women’s health services, and Brown, an OB-GYN with a subspecialty in complex family planning (including complex abortion and contraception), connected while Steenland was an assistant professor of health services, policy and practice (research) at Brown University’s School of Public Health.
The new analysis found that the risk of mortality from pregnancy (including one year postpartum) is 44 to 70 times higher than the risk of mortality from abortion — three times higher than previously estimated. Before this study, a commonly reported statistic was that the risk of death associated with childbirth is about 14 times higher than that of abortion. This statistic was based on data from 1998 to 2005, and during that time frame, mortality rates for people with ongoing pregnancies have been estimated to be between 8.8 and 14.5 per 100,000 live births. The current study, using data from 2018 to 2021, found an annual average of 32.3 maternal deaths per 100,000 live births, with the highest rate of 43.9 occurring in 2021.
The study defined pregnancy-related deaths as occurring during pregnancy or within one year of the end of pregnancy. They were further identified by hundreds of specific underlying causes related to pregnancy, such as hypertensive disorders, obstetric hemorrhage, complications from chronic heart and kidney disease, and various infections that occur during pregnancy.
An important factor involved in the new estimates was the availability of new data. In 2003, a pregnancy check box option was added to death certificates to indicate whether the deceased was pregnant. When the framework was fully implemented in 2018, it addressed the previous undercounting of maternal deaths, but it also led to a potential overcounting problem, where the deceased’s cause of death may have been misclassified as pregnancy-related.
To estimate pregnancy-related mortality rates, the research team analyzed data on deaths and births (live and stillbirths) from the US National System of Vital Statistics, as well as abortion-related deaths from the Pregnancy Mortality Surveillance System between 2018 and 2021. Follow-up data in the US and worldwide.
To account for potential overcounting of maternal deaths, the study removed non-specific pregnancy-related causes of death, such as “other specified pregnancy-related conditions,” which previous research has shown were likely to be misclassified. The study also excluded deaths from COVID-19 and deaths of people whose pregnancies ended due to miscarriage or self-induced abortion.
“Even with this conservative approach to calculating maternal mortality, we found that the risk of death from pregnancy and childbirth greatly exceeded the risk of death from abortion,” says study author Marie Thoma, a reproductive and perinatal epidemiologist and associate professor at the University of Maryland.
“People deserve access to up-to-date information about these comparative risks and policies that reflect these realities.”
The risk of death from an abortion has decreased since previous studies were conducted, likely because more people having abortions are having them earlier in pregnancy, which is generally safer, the researchers say. They note that it increased restrictions on access to abortion it will likely affect the mother’s health in the future.
The survey appears at JAMA Network Open.
Source: Brown University
Original Study DOI: 10.1001/jamanetworkopen.2025.54793
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Previously Posted at future.org with Creative Commons license
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