“Abortion is safer than childbirth.” This statement is ubiquitous. A mantra for abortion advocates, it is repeated in popular culture and by educational and legal elites. It is common wisdom within the medical profession. For several decades now, it has shaped medical practice and public policy. Among its progeny are newer slogans, most recently, “abortion is healthcare.”
The influence of elites in the medical profession should not be underestimated. Their positions can abide even where contrary evidence reveals them to be fundamentally weak, out-of-date, incomplete, and inaccurate. Few seriously question the conclusions of prestigious medical professionals and organizations, particularly when medical studies are cited as proof. Their reports on abortion gain added importance in the vacuum created by a recast field of “medical ethics” that avoids evaluating the moral legitimacy of abortion under the Hippocratic Oath.
Such is the case for “abortion is safer than childbirth.” Its supporters claim that mortality rates for women having abortions are lower than mortality rates for women giving birth. An increasing body of evidence contradicts this. Abortion harms women by exposing them to a wide range of serious risks, both immediate and long-term. Abortion is not safer than childbirth.
Medical knowledge of its era played a key role in the United States Supreme Court’s 1973 decision to legalize abortion in Roe v. Wade. To balance the state’s two legitimate interests, the health of the pregnant woman and the protection of “the potentiality of human life,” the Court created a structure of trimesters of pregnancy to evaluate medical risks to the mother against “viability” of the fetus within each trimester.
It used comparative maternal mortality rates of abortion and childbirth as the standard for prohibiting state restrictions on abortion in the first trimester; allowing state regulation of abortion in the second trimester “in ways that are reasonably related to maternal health”; and permitting further state restrictions or prohibitions on abortion in the third trimester when the fetus is viable unless “appropriate medical judgment” concludes abortion is necessary to preserve the life or health of the mother.
The Court cited, but did not analyze in its opinion, seven articles related to maternal mortality in favor of the view that abortion is safer than childbirth. Contrary data was presented to the Court, but not used. No information on any other medical risks of abortion was considered.
Thirty-seven years later, through advancing medical knowledge and capabilities, we have a fuller and changed picture of maternal health, fetal viability, the impact of legalization of abortion on maternal health, and both short-term and long-term consequences of abortion. As a result, we now know more about the harm to women (and children) that abortion inflicts.
We also have better methods of determining comparative mortality risks of abortion and childbirth. Recent analyses of large medical databases that link to death certificates (“record linkage studies”) show that pregnancy-associated deaths are between two and four times higher for women who abort than for women who deliver. These studies represent, according to one researcher, “the best available medical evidence on the issue,” in contrast to “prior comparisons of mortality rates, crudely constructed on the basis of an incomplete and inaccurate reporting system.” For example, deaths from abortion often go unreported to cover up the abortion or, perhaps, the abortionist. Substitute terms, such as “uncontrolled hemorrhage,” might be listed as the cause of death.
In late 2009, the World Economic Forum issued its annual Gender Gap Report. According to its data, maternal mortality is lower in nations with pro-life laws restricting abortions. Countries with permissive abortion law have higher maternal death rates. Ireland, which has constitutional protection for the unborn, has the lowest maternal mortality rate in Europe: 1 maternal death per 100,000 live births. Poland, another country with restrictive laws on abortion, has 8 maternal deaths per 100,000 live births. In contrast, the United States, with permissive laws on abortion, has 11 maternal deaths per 100,000 live births. Figures for other areas in the world confirmed the pattern: countries with the most restrictive abortion laws had the lowest maternal morality rates.
In early 2010, a study in Chile shows that bans on abortion do not increase maternal deaths. Their research found that maternal mortality peaked in Chile in 1961, at a time when abortion was legal. Abortions caused 34 percent of maternal deaths that year. In contrast, in 2007, after Chile banned abortion, maternal mortality rates had been lowered 97.9 percent.
Hence, greater access to abortion does not result in lower maternal mortality. The “reproductive justice movement” fails to realize this in its demand for cheaper and more convenient abortion service.
Real reproductive justice calls for full disclosure. In addition to comparative mortality figures, other risks of abortion must be made known: increased risks of pre-term births and placenta previa; increased incidence of depression, suicide, substance abuse, and psychiatric admission; loss of the protective effect of a first full term pregnancy against breast cancer; and increased risk of death and injury from violent assault. Real reproductive justice relies on accurate, up-to-date, and complete information about all the risks of abortion and childbirth.
Other posts from AUL’s Reproductive Justice Series:
- Introduction to AUL’s Reproductive Justice Series
- Real Reproductive Justice Encourages Complete Information and Facilitates Life-Affirming Options
- Reproductive Justice for All Moms
- Prenatal Diagnosis and Reproductive Justice
- When Choice Becomes Discrimination
- Real Reproductive Justice Places Women’s Health Above Profit
- Real Reproductive Justice Relies on Medical Reality