Opinion | The End of Roe Doesn’t Need to Bring an Increase in Maternal Mortality

The evidence from Europe demonstrates that it is not necessary or inevitable that restricting abortion will lead to adverse health outcomes for women.

Still, in the United States the uncomfortable truth for Republicans is that, according to a 2019 analysis by America’s Health Rankings, eight out of the 10 states with the lowest maternal mortality are blue states, whereas eight out of the 10 states with the highest are red states. Mississippi, whose proposed law was at the center of the Dobbs case, is in the bottom half of the table for maternal mortality. It was also given the lowest ranking of any state for overall health of women and children. The dissenting minority in Dobbs notes that Mississippi “neither bans pregnancy discrimination nor requires provision of paid parental leave,” has “strict eligibility requirements for Medicaid and nutrition assistance” and has “rejected federal funding to provide a year’s worth of Medicaid coverage to women after giving birth.”

If Mississippi and other red states wish to demonstrate that they are truly “pro-life,” then they must address their shameful levels of maternal mortality. The first priority is to address “concentrated disadvantage” among their poorest citizens, and especially among women of color. This measure has been shown to be an important determinant of maternal health. Second, it is essential to ensure that women have access to health care not only before and during but also in the weeks after giving birth. Third, according to the World Health Organization, midwife-led maternity services provide an evidence-based approach to reducing maternal mortality. Currently there are only four midwives per 1,000 births in the United States, in comparison with 43 per 1,000 births in the United Kingdom. There is much that could be done, but it is not being done and maternal mortality in the United States is not falling but rising.

The right to abortion granted by Roe v. Wade did not prevent this ongoing scandal, and restricting access to abortion will not inevitably make things any worse. The situation is perpetuated, in part, by a national debate that remains hyper-focused on abortion access (whether against or in favor) rather than on the causes and remedies of maternal mortality. While this remains the case, hundreds of women and disproportionately women of color will continue to die needlessly every year in the richest country in the world.

David Albert Jones is the director of the Anscombe Bioethics Centre in Oxford, England, a fellow of Blackfriars Hall, Oxford University, and a professor of bioethics at St. Mary’s University, Twickenham.

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