Overturning Roe v. Wade could worsen the national maternal health crisis
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Being denied an abortion has been linked to a higher maternal death rate, poverty and physical pain.
Restrictions or bans on abortions also do not prevent them from occurring, with 7 percent of U.S. women projected to self-manage an abortion in their lifetime.
If Roe v. Wade is overturned, some health experts believe that could worsen the current U.S. maternal health crisis.
The U.S. could find itself in a worsening maternal health crisis if Roe v. Wade is overturned, with women being denied an abortion reporting higher rates of physical pain, poverty and death. That could soon become a reality for many more, as a draft opinion by the Supreme Court indicated it’s slated to overturn federal protections for abortions.
A draft opinion written by Justice Samuel Alito on the Dobbs vs. Jackson Women’s Health Organization case was leaked this week, and it shows that the Supreme Court is poised to overturn the 1973 decision on Roe v. Wade — the case that affirmed abortion access as a constitutional right.
Though the court’s final decision is expected in June, if Roe v. Wade is overturned the implications could be deadly.
The U.S. is already struggling with a maternal health crisis, and it could become even worse, as the Centers for Disease Control and Prevention (CDC) estimates about 700 women die from pregnancy-related complications annually. That rate is even higher for people of color, with Black and American Indian/Alaska Native women three times as likely to die from pregnancy as white women.
That’s the highest maternal mortality rate of any high-income nation in the world, according to the Aspen Institute.
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Lauren Ralph, an epidemiologist at the Bixby Center for Global Reproductive Health at the University of California San Francisco, told Changing America that if some variation of Alito’s opinion does become the Supreme Court’s official decision, “I do anticipate a rise in maternal deaths as a result, and I think that is something that we, as a public health community, have to prepare for.”
Ralph observed firsthand how being denied an abortion can affect women’s health, as a researcher for the Turnaway Study, a longitudinal study that examined the effects of unwanted pregnancies on women’s lives. After tracking nearly 1,000 pregnant women across the country, two women who were denied an abortion died due to maternal causes — while out of all the women who did receive an abortion, none died.
“At the very least we can say that those maternal deaths could have been avoided had those people had access to the abortion that they sought or that they went to the clinic to get,” said Ralph.
The CDC says 60 percent of pregnancy-related deaths are preventable. The causes of pregnancy-related deaths vary, with the agency saying cardiovascular, cerebrovascular accidents and other medical conditions have been increasing — like hypertension, diabetes and chronic heart disease.
Notably, in the Turnaway Study Ralph’s team found that women denied an abortion were more likely to experience serious complications from the end of pregnancy, like eclampsia and death. They also reported more chronic headaches or migraines, joint pain and gestational hypertension.
Using U.S. pregnancy statistics, Amanda Jean Stevenson, a researcher at the University of Colorado, estimated the impact of denying all wanted induced abortions. In the first year of an abortion ban, an estimated 49 maternal deaths would occur — a 7 percent increase. In subsequent years, there could be 140 additional deaths — a 21 percent increase.
Black people would experience the greatest increase in deaths — a 33 percent increase in subsequent years.
“Overall, denying all wanted induced abortions in the U.S. would increase pregnancy-related mortality substantially, even if the rate of unsafe abortion did not increase,” said Stevenson.
Even with the protections of Roe v. Wade in place, getting an abortion in the U.S. hasn’t been easy. Between 2011 and 2017 states have enacted 401 abortion restrictions, which is more than double the 189 that were enacted in the entire preceding decade, according to a working paper by the National Bureau of Economic Research (NBER).
The implications of being denied an abortion can stretch beyond health, as NBER also found those women also experienced an increase in household poverty lasting at least four years relative to those who did receive an abortion. They also ended up with lower employment and leaned more heavily on public assistance in both the short-term and long-term.
The Turnaway Study also found that women turned away from getting an abortion end up more likely to stay with an abusive partner longer, likely because they now have a child together.
That’s something Sen. Elizabeth Warren (D-Mass.) also alluded to, saying on Twitter that if the Supreme Court overturns Roe v. Wade, “women of color, those with lower-incomes and victims of abuse will suffer the most.”
Experts have reiterated that restricting or banning abortions won’t stop them from happening, as Ralph noted 7 percent of U.S. women will self-manage an abortion in their lifetime.
People resort to self-sourcing medication or drugs to try to terminate a pregnancy on their own, with some even trying physical methods like hitting themselves in the abdomen. Ralph anticipates incidents like these will rise if clinic-based abortions are no longer available or accessible.
One in 4 women in the U.S. will have an abortion at some point in their life, which is why Ralph believes abortion should be treated as part of the spectrum of health care that many people are going to need at some point during their lifetime.
“We need to make sure that we are supporting pregnant people, who now are probably more of them, be forced to continue their pregnancies and may suffer more adverse health outcomes as a result,” said Ralph.
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