New research indicates that continuing a pregnancy in the United States carries a death risk at least 44 times higher than having an abortion. This updated figure, published in JAMA Network Open, dramatically revises the previously cited 14-to-1 ratio and underscores the stark reality of maternal health in the U.S.
Outdated Statistics and Rising Maternal Mortality
The original 14-to-1 statistic was based on data nearly two decades old (2005), with a single study looking at CDC records from 1998 to 2005. Researchers now find this ratio critically outdated. The new analysis, using data from 2018 to 2021, reveals a significantly higher risk due to both improved tracking of maternal deaths and an actual increase in those deaths.
Between 2018 and 2021, the U.S. saw approximately 32.3 maternal deaths per 100,000 births, totaling at least 3,662 deaths from over 15 million births. This is more than double the rate reported in the older 2012 study. Meanwhile, abortion-related deaths remain exceptionally rare, with only 17 documented out of over 3.5 million abortions during the same period.
Why This Matters
This disparity isn’t just an academic exercise. Accurate risk assessment is critical for informed healthcare decisions. The outdated statistic has likely shaped public perception and policy, potentially downplaying the dangers of pregnancy. The U.S. is an outlier among developed nations in maternal mortality, with preventable deaths rising since the 2000s.
The 2003 revision of U.S. death certificates, which added a “pregnancy” checkbox fully implemented in 2018, may have contributed to more accurate tracking of pregnancy-related deaths. The updated data confirms that pregnancy is far more dangerous than abortion, and that the old statistics were likely undercounting the risks.
Systemic Factors and Policy Impacts
The increased risk of pregnancy-related death isn’t solely biological; it’s tied to systemic issues. Socioeconomic status, age, and access to healthcare all play a major role. The 2022 Dobbs v. Jackson Women’s Health Organization ruling, overturning Roe v. Wade, has further complicated the landscape. State-level abortion bans are already linked to rising infant deaths and disproportionately affect Black mothers, who are 3.3 times more likely to die in restrictive states.
Data Limitations and Future Challenges
The study acknowledges limitations: It includes live births but excludes early pregnancy losses (ectopic pregnancies, miscarriages), and relies on estimated abortion numbers due to gaps in reporting (the Guttmacher Institute did not report numbers in 2021, so 2020 numbers were duplicated). The CDC’s future ability to track abortion-related mortality is also uncertain due to recent staff cuts in the Division of Reproductive Health.
The latest findings provide a clearer picture of maternal mortality in the U.S., but ongoing data collection and policy changes will be essential to further improve outcomes.
In conclusion, the new analysis provides stark evidence that pregnancy in the U.S. carries a significantly higher risk of death than abortion, and that systemic issues and political decisions directly impact maternal health outcomes.
