New research published , in JAMA Network Open reveals that commonly cited statistics regarding the relative risks of pregnancy versus abortion are a significant underestimate. The study, conducted by researchers at the University of Maryland and Brown University, demonstrates that pregnancy is considerably more dangerous than abortion, and the disparity in risk is even greater than previously understood.
The impetus for the study stemmed from a need for updated data to accurately inform patients, clinicians, and policymakers navigating complex reproductive health decisions. “It’s widely understood by scientists that continuing a pregnancy carries a much higher risk of death than having an abortion,” explains Dr. Maria Steenland, assistant professor at the University of Maryland’s School of Public Health and lead author of the study. “Our new analysis shows that it is far more dangerous to be pregnant than to have an abortion, and this gap in mortality risk is even larger than previously recognized.”
The findings carry significant implications, particularly in light of increasing restrictions on abortion access across the United States. Researchers emphasize that abortion bans effectively compel individuals who would otherwise choose abortion to carry pregnancies to term, thereby exposing them to substantially elevated health risks. These risks include complications such as hemorrhage and high blood pressure.
“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,” states Dr. Benjamin Brown, an assistant professor of obstetrics and gynecology at Brown University’s Warren Alpert Medical School and a study author. He further highlights the urgent need to address and reduce overall mortality rates for individuals during pregnancy, childbirth, and the postpartum period.
The study’s core finding is a striking comparison of mortality risks. The analysis determined that the risk of death associated with pregnancy (including up to one year postpartum) is 44 to 70 times higher than the risk of death from abortion. This represents a threefold increase compared to previous estimates. Prior to this research, a frequently cited statistic indicated that childbirth carried a risk of death approximately 14 times higher than abortion. However, that figure was based on data collected between and , when maternal mortality rates were lower.
The current study, utilizing data from to , revealed an average of 32.3 maternal deaths per 100,000 live births, peaking at 43.9 deaths per 100,000 in .
Researchers defined pregnancy-related deaths as those occurring during pregnancy or within one year following the end of pregnancy. These deaths were identified based on hundreds of specific underlying causes related to pregnancy, including hypertensive disorders, obstetric hemorrhage, and complications stemming from pre-existing heart and kidney conditions, as well as infections contracted during pregnancy.
A key factor contributing to the revised estimates was the improved availability of data. The addition of a pregnancy checkbox to death certificates in , and its full implementation in , addressed previous underreporting of maternal deaths. However, this also introduced a potential for overcounting due to misclassification of the cause of death.
To mitigate this potential overcounting, the research team employed a conservative approach. They analyzed data on deaths and births (both live and stillbirths) from the US National Vital Statistics System, alongside abortion-related deaths from the Pregnancy Mortality Surveillance System. Abortion statistics were sourced from the Guttmacher Institute, a nonpartisan research organization that monitors abortion surveillance data nationally and globally. The team removed nonspecific causes of pregnancy-related mortality, which prior research suggested were prone to misclassification, and excluded deaths related to COVID-19 and those resulting from miscarriage or self-induced abortion.
“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,” explains Dr. Marie Thoma, a reproductive and perinatal epidemiologist and an associate professor at the University of Maryland. “People deserve access to updated information about these comparative risks and policies that reflect these realities.”
The study also notes that the risk of death associated with abortion has decreased in recent years, likely due to the increasing trend of individuals obtaining abortions earlier in pregnancy, which is generally safer. Researchers anticipate that further restrictions on abortion access will likely have a detrimental impact on maternal health outcomes. The study underscores the importance of comprehensive reproductive healthcare and informed decision-making for all individuals.
