Opinion | The math is clear: Forced-birth laws will kill more women

The Texas Tribune recently reported that “[because] of high chronic stress and race-based trauma and fear, the majority of Black women produce about 15% more cortisol, a stress hormone, than white women, which in turn raises the risk of pregnancy complications, according to the National Library of Medicine.” Among the Black women who want an abortion but are forced to give birth, the Tribune reports, many “will be left permanently disabled or sick long enough that they will lose their jobs, which will make caring for their families much more difficult.” For Black families in which a woman is the only source of income, the “ripple” effect of a forced birth, both on her family and the greater community, can be profound.

Amanda Stevenson, an assistant sociology professor at the University of Colorado at Boulder and a leading researcher on abortion bans, projected in a study published last year, based on 2017 data, that if the United States had a nationwide abortion ban, there would be a 21 percent increase in pregnancy-related deaths. Deaths among non-Hispanic Black people would increase 33 percent. In fact, Stevenson shared with me a pre-print version of an update to that study with 2020 data, which shows even worse numbers: A national ban would result in a 24 percent increase in deaths for all women and a 39 percent for non-Hispanic Black women.

The reasons for the increases in death arise primarily from two factors. First, with more births, we will get more maternal deaths. Second, the composition of the population of women giving birth will include more Black women, who are disproportionately represented in the population of patients seeking an abortion and who are more likely to die from pregnancy.

Moreover, the states that seek to ban abortion are the same that rank among the worst in a slew of health indicators — overall health, infant mortality, rates of insurance among low income women and disparity in health between Blacks and Whites. Many of these states have not expanded Medicaid. In other words, states looking to force women to have birth have the sickest women and worst health outcomes.

The bans will also contribute to more deaths in other ways. If doctors feel compelled to wait until a woman is at immediate risk of death before performing an abortion (e.g., in cases of ectopic pregnancies or a membrane rupture), there will be more “near misses.” Accordingly, there will more deaths, Stevenson tells me.

Even among women not seeking abortions, the risk of death will increase. The Texas Tribune reports: “Abortion-inducing medication is the most common method used by Texans to terminate pregnancies, according to Texas Health and Human Services. But it also has a broad range of other uses in obstetrics and gynecology, according to the U.S. National Institutes of Health, including medical management of miscarriage, induction of labor, cervical dilation before surgical procedures, and treatment of postpartum hemorrhage.” To the extent doctors worried about criminal liability hesitate to use these drugs, women’s health and lives will be at risk.

In sum, when courts decide that women cannot make critical decisions for themselves and that the impact of abortion on their lives doesn’t matter, they become not only second-class citizens but are also at greater risk of death. Call it anti-woman or pro-maternal death, but please don’t call the forced-birth movement “pro-life.”