Outlawing any and all terminations of pregnancies across the entirety of the United States could result in a 21 percent jump in pregnancy-related deaths, estimates a recent study. Among Black communities, the figure is an even more shocking 33 percent.
The research doesn't even take into account the potential risks of illicit abortions, which, although safer today than in the past, aren't 100 percent risk-free, so they could push the mortality rate even higher.
While the scenario is purely hypothetical, not to mention extreme, the prediction highlights the potential costs of broad-sweeping legislation that seeks to simplify what is a complex and very personal issue.
"The takeaway here is that if you deny people abortion, pregnancy-related deaths will increase because staying pregnant is more dangerous to a woman than having an abortion," says the study's author Amanda Stevenson, a sociologist from the University of Colorado Boulder.
Though accessibility and restrictions vary from one jurisdiction to the next, most people in the US can seek a termination of their pregnancy for reasons that are between them and their physician.
In 2017, some 862,000 abortions were legally practiced across the nation – a figure that reflects a long-term downward trend resulting from a mix of factors, including a general decline in overall pregnancies.
While an increasing number of people are opting out of building bigger families, those who do happen to fall pregnant still face a significant risk of complications that put their health in jeopardy.
For every 100,000 live births reported in 2017, some 17 birthing parents lost their lives. The statistic adds up to around 675 deaths in all, a total that's no less tragic but thankfully relatively limited thanks to advances in medical intervention.
Termination of a potentially life-threatening pregnancy remains one medically sanctioned option across the US. Even the controversial 'Senate Bill 8' legislation passed in Texas early this year – which outlaws the majority of abortions after 6 weeks – leaves some (albeit ill-defined) room for 'medical emergencies'.
Yet, by constructing a civil law that threatens any individual who "aids or abets" an abortion, Texas's attempt to ban terminations could have far broader implications, forcing health specialists to gamble over lives in the face of potential litigation.
To estimate the health impact similar laws might have in the event that no medical emergency-based abortions were carried out across any US state, Stevenson took the published annual figures on births and abortions for 2014 to 2017 and then deduced the number of gestations that would have continued to birth had a termination not occurred.
Given the risk of death from abortion is just 0.6 for every 100,000 procedures, compared with a number closer to 20 for every live birth, it's not hard to predict mortality rates would climb.
According to Stevenson's estimates, the 675 deaths in 2017 would look more like 724 throughout the first 12 months following the hypothetical bill, representing a 7 percent increase. This would flatten out to 815 each year after – around 21 percent more deaths than occur currently.
To get a sense of how this would break down across demographics, Stevenson had to go back to 2014 reports, the last year minority categories for abortion statistics were available. Among Black populations, the number could rise by around 33 percent.
The figures aren't precise predictions given the wide range of assumptions at work. For example, the CDC's figures on pregnancy-related mortality seem to have risen over the years, and we're not sure why. Increased reporting is one possibility, but so are errors leading to an overestimation.
The numbers also don't take into account the subtleties of human behavior, such as the impact of disobeying the law. Illicit abortions, whether medically informed or through desperate use of 'home remedies' or other forms of misinformation, come with their own risks.
But to Stevenson, speculating over the consequences of such civil disobedience misses the point: A law that interferes with a person's right to govern their own health and wellbeing puts those lives at risk.
"We need to stop talking about coat hangers and start talking in an honest way about how these laws will actually impact women's lives and mortality," says Stevenson.
"This study provides one piece of the evidence we need to begin that hard conversation."
This research was published in Demography.