FOR IMMEDIATE RELEASE: Sept. 7, 2021
Contact: Clare Fauke, Physicians for a National Health Program communications specialist: clare@pnhp.org
Last week, the U.S. Supreme Court upheld SB8, a Texas law that prohibits abortions after about six weeks of pregnancy, resulting in a near-total ban on abortions in the state. Reproductive health experts estimate that the law could cause a spike in maternal mortality of up to 15% overall, and up to 33% for people of color.
“Recent research shows a strong correlation between abortion restrictions and increased maternal mortality,” said David Eisenberg, M.D., M.P.H., associate professor in obstetrics and gynecology at the Washington University in St. Louis School of Medicine. “With a near-total abortion ban in effect now, we can expect to see an increase in Texas’ overal maternal mortality rate in 2022.”
Two studies published in the last year show a link between abortion restrictions and increased maternal mortality. A study published in the American Journal of Preventive Medicine found states that enacted abortion restrictions based on gestational age saw an increase in their maternal mortality rate by 38%, and those that reduced the proportion of Planned Parenthood clinics by 20% increased their maternal mortality rate by 8%.
A second study, published in the journal Contraception and co-authored by Dr. Eisenberg, found that between 1995 and 2017, the maternal mortality rate increased significantly in states that enacted the most restrictive abortion laws; by 2017 the most restrcitve states’ maternal mortality rates were nearly double (28.5 maternal deaths per 100,000 live births) the rates in states that protected abortion access (15.7 maternal deaths/100,000).
Dr. Eisenberg notes that many abortion clinics that will be forced to close due to SB8. He cites Texas’ experience after the passage of House Bill 2 in 2013, when more than half of the state’s abortion clinics shut down, causing “collateral damage” to sexual and reproductive health care services previously provided by those clinics. “While it is difficult to account for all the variables involved, it is not unreasonable to anticipate a 15% increase in Texas’s maternal mortality rate in 2022 to over 21 per 100,000 live births. Based on the number of births in prior years, we could see over 10 additional deaths per year,” he noted.
Dr. Eisenberg added that it’s especially important to look at the law’s impact on people of color, who received about 70% percent of abortions in Texas in 2019. “Our analyses of trends in maternal mortality rates broken down by race/ethnicity showed that a disproportionate amount of the increase in maternal death was due to the increase in deaths among Black and Native American women. Since the rate of maternal mortality for Black women is about 2.5 times higher than the national average, it is not unreasonable to expect the maternal mortality rate among Black Texans to be about 11% to 33% higher starting in 2022, with maternal mortality rate for Indigenous Texans to be about 8% to 25% higher.”
Any increase in maternal mortality is especially concerning given the growing maternal mortality crisis in the U.S. After decades of improvement, maternal mortality rates started going up around the same time that many states began restricting access to abortion. The rate of pregnancy-related deaths in the U.S. has nearly tripled in the past 30 years, from 7.2 deaths per 100,000 live births in 1987, to 20.1 deaths per 100,000 in 2019; the rate jumped 15% just between 2018 and 2019. The only other nations with increasing maternal mortality rates are Afghanistan and Sudan.
“America’s rising maternal mortality rate should be considered a public health emergency,” said Dr. Eisenberg. “Restricting access to safe and legal abortion — which disproportionately affects those with low incomes and people of color — will only add to the death count. If state and national leaders are serious about protecting health, we need universal access and coverage for the full spectrum of reproductive health care, including primary care, contraceptive care, and abortion care.”
Physicians for a National Health Program (pnhp.org) is a nonprofit research and education organization whose more than 24,000 members support single-payer Medicare-for-All reform.