States with greater restriction on abortion show a higher maternal mortality rate

Bowerbird · Nov 9, 2021

There are more than one research paper showing the correlation between maternal mortality rates and abortion restriction but this is a recent paper looking at this issue

Maternal mortality in the United States has remained unacceptably high over the past few decades compared with other high-income countries.1,2 In 2020, the National Center for Health Statistics (NCHS) reported a national maternal mortality ratio (MMR, defined as deaths of women while pregnant or within 42 days of being pregnant, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes) at 17.4 per 100 000 live births for 2018.3 In addition, wide racial disparities in maternal death persist, with non-Hispanic Black women being more than 2 to 3 times more likely to die from a pregnancy-related complication than non-Hispanic White women.3,4 Furthermore, research shows that more than 60% of maternal deaths are preventable.4

Emerging evidence suggests that broader societal and policy factors may contribute to adverse maternal health outcomes and inequities.5‒7 Along with elevated maternal mortality rates, the past decade has witnessed an increasing passage of laws restricting access to abortion care.8 Although the United Nations and the World Health Organization recognize abortion as a key component of reproductive health services and an important aspect of maternal and child health,9,10 and despite Roe v. Wade(1973) guaranteeing the right to abortion in the United States, many states continue to undermine access to safe abortion care by imposing numerous policies and regulations. In 2015, nearly 400 abortion-restricting provisions were considered in 46 states, with 17 states enacting a total of 57 new abortion restrictions.11 Such restrictions range from gestational age limits, ultrasound requirements, mandatory counseling, and waiting periods to insurance coverage limitations and targeted regulations on abortion providers.8 As a result, access to abortion care varies greatly across the United States, with 6 states having only 1 abortion clinic in operation.12

While the link between restricted access to abortion care and maternal mortality is well established in low- and medium-income countries,13,14 the evidence base on the impact of abortion restrictions on maternal death in the United States is limited. Using 2007–2015 National Vital Statistics System data files from 38 states and the District of Columbia, a recent study found that the enactment of gestational age limits for abortion was associated with a 38% increase in maternal mortality, and a 20% reduction in Planned Parenthood clinics was associated with an 8% increase in maternal mortality.5In addition, growing evidence has linked abortion restrictions to other maternal and child health outcomes, including infant mortality,15,16 child homicide deaths,17 negative mental health outcomes among women who were denied abortion,18,19 and adverse birth outcomes.20,21
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https://ajph.aphapublications.org/doi/10.2105/AJPH.2021.306396

Now let us do a comparison

Getting away from the emotive aspect of pro/anti choice and look at why there is this correlate. It is easy to assume in those countries across the globe that the increase in maternal mortality seen with abortion restriction is mostly related to back alley illegal abortions but this does not seem to be the case within the USA.
https://www.statista.com/chart/23541/maternal-mortality-developed-countries/

Comparing the USA to other OECD countries there is a stark inequality.

“You have to ask “is the focus on abortion shifting attention away from other interventions that would reduce maternal and infant mortality?” What brought me to this question was this news report

According to Safer Care Victoria, 20 stillbirths were prevented over an 18-month period after the initiative was introduced to 15 maternity services across the state.

"This is a remarkable achievement and a life-changing outcome for 20 Victorian families," a summary of the program said.

Experts believe the dramatic drop in deaths was driven by:

A 200 per cent increase in the number of women who quit smoking during pregnancy

Improved screening for poorly growing babies

More expectant mothers being informed about changed baby movements

Better education around the importance of side-sleeping for women in their third trimester

And shared decision-making with women around the timing of birth

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https://www.abc.net.au/news/2021-11...oria-s-stillbirth-rate-decline-for-/100603472

simple interventions that actually do not cost a lot but with a massive positive outcome. This is a true “pro-life” initiative an improvement in survival.

So - where should society invest their limited resources - into programs stopping early abortion or into improving survival of women and infants?

https://www.cdc.gov/reproductivehealth/maternalinfanthealth/infantmortality.htm

kazenatsu · Nov 9, 2021

I say this again and again and again, correlation does not necessarily imply causation.

Please adjust for other factors. Adjusting for racial factors alone would probably make 60% of this correlation disappear.

Maybe there is some other third factor (or factors) that cause certain states to be both Republican and end up with higher mortality rates. I know many of those rural areas are poorer. The rates also would be expected to be a little higher in the Rust Belt. It seems to be surprising that the rates are relatively low in Texas, being both a conservative state and having a lot of illegal immigration.

Bowerbird · Nov 9, 2021

kazenatsu said: ↑

I say this again and again and again, correlation does not necessarily imply causation.
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of course it doesn’t but when you see the same correlation replicated in study after study then the probability of causation becomes greater

Please adjust for other factors. Adjusting for racial factors alone would probably make 60% of this correlation disappear.

They did - read the research, in fact read the OP please

Maybe there is some other third factor (or factors) that cause certain states to be both Republican and end up with higher mortality rates. I know many of those rural areas are poorer. The rates also would be expected to be a little higher in the Rust Belt. It seems to be surprising that the rates are relatively low in Texas, being both a conservative state and having a lot of illegal immigration.
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And the correlate globally?

One of the best measures is to look at mortality pre legislation and post legislation

Total vs. Abortion-related Maternal Deaths per 100,000 Live Births in Romania, 1970-2005: This figure compares the number of abortion-related maternal deaths against total number of maternal deaths per 100,000 live births in Romania prior to and following legalization of abortion in 1989. Source for this figure is reference [24].

https://www.researchgate.net/figure...ive-Births-in-Romania-1970-2005_fig2_51919144

Meanwhile one has to ask - what is California doing right?

That’s led researchers like Boston University maternal health expert Eugene Declercq to conclude that a key driver of America’s maternal mortality problem is that America doesn’t value women.

“The argument we make internationally is that [a high maternal death rate] is often a reflection of how the society views women,” he says. “In other countries, we worry about the culture — women are not particularly valued, so they don’t set up systems to care for them at all. I think we have a similar problem in the US.”

Policies and funding dollars tend to focus on babies, not the women who bring them into the world. For example, Medicaid, the government health insurance program for low-income Americans, will only cover women during and shortly after pregnancy. “Nothing has captured it better for me than that: Get on when you’re pregnant, but get off when you’re not,” Declercq said. Only 6 percent of block grants for "maternal and child health" under the Title V Maternal and Child Health Services Block Grant Program goes to moms.
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https://www.vox.com/science-and-health/2017/6/29/15830970/women-health-care-maternal-mortality-rate
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States with greater restriction on abortion show a higher maternal mortality rate

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States with greater restriction on abortion show a higher maternal mortality rate

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