Limiting access to abortions has neither eliminated the need for them nor reduced their number. Instead, it has been associated with increased maternal and infant mortality.
Abortion and access to reproductive healthcare more broadly are major deciding factors in the upcoming election. To make informed decisions, it is critical that we take stock of what has happened in this country after abortion bans were implemented across the country.
Bans Are Handcuffing Doctors—and Killing Women
Just this week, we learned of at least two pregnant Texas women who died after doctors delayed emergency care. And last month, we learned that at least two women died after they were unable to access legal abortion care in their home state of Georgia. All four of these woman leave behind their children and families. In both states, a committee of state experts deemed their deaths preventable.
All because of state-level abortion bans.
Even still, legislators across the country are willing to continue denying care to the people who need it, prioritizing political extremism over medical realities.
In Louisiana, beginning this month, both medications commonly used in medication abortions (mifepristone and misoprostol) are officially on the controlled substances list. This change will force hospitals to remove misoprostol from crash carts that are used in cases of emergency postpartum hemorrhage. That means when people are experiencing life-threatening hemorrhage after delivery, it will now be harder for them to access this life-saving medication. This is the latest demonstration of the fact that abortion bans have outsized harms, not just for those wanting or needing an abortion, but for anyone who is pregnant.
Take, for example, the case of Texas radio show host Ryan Hamilton who has spoken at length about his family’s experience while his wife, Jess, has been focusing on her recovery. Jess had an incomplete miscarriage and was unable to obtain adequate treatment despite multiple healthcare visits; she ultimately collapsed in their home. One hospital kept her in the emergency department for hours, apparently debating whether they could offer her definitive care even though the fetus had no cardiac activity.
Obstetricians, gynecologists and reproductive justice advocates have long warned that separating abortion from the rest of reproductive healthcare leads to significant casualties. As gender equity scholars, a physician, and an epidemiologist who studies abortion safety, we are concerned about rising maternal and neonatal mortality rates in states with abortion bans.
Prior to Dobbs, data indicated states with stricter abortion policies had worse overall maternal mortality rates compared to others. In 2021, people who lived in states that would later enact abortion bans were 2.4 times more likely to die from pregnancy-related complications than those in states without bans. This maternal mortality disparity will almost certainly be exacerbated as updated state-level data reflecting other abortion bans become available.
Worsening maternal mortality due to difficulty accessing life-saving abortion care is heightened by the maternal health deserts that result from healthcare workers leaving states such as Idaho and Texas and fewer medical trainees wanting to work in these states.
Whether pregnant people seek to obtain an abortion, or other pregnancy-related care, they experience worse outcomes if they live in a state with a ban.
Infant Mortality Is on the Rise
Another predictable outcome of abortion bans is rising infant mortality.
Despite a nationwide decline in infant mortality since 1995, from 2021 to 2022, the infant mortality rate rose from 544 to 560 deaths per 100,000 live births—an increase of 3 percent. As one recent study from Texas showed, this is in part due to more infants being born with fatal congenital anomalies in 2022 compared to 2021.
These infants may have been spared suffering if abortion had been available.
Samantha Casiano—a plaintiff in a lawsuit filed by the Center for Reproductive Rights on behalf of Texas women denied abortions despite serious pregnancy complications—described to a packed courtroom last summer what it was like to give birth to her daughter, Halo, who lived for only four hours: “She was gasping for air. I just kept telling myself and my baby that I’m so sorry that this has happened to you. I felt so bad. She had no mercy. There was no mercy there for her.”
Despite Bans, Women Are Still Getting Abortions
If abortion bans are associated with higher maternal and infant mortality rates, do they at least limit the number of abortions that take place? No; there were actually more abortions in the United States in 2023 than in previous years. According to #WeCount, a project that tracks monthly abortion rates by state following the Dobbs decision, abortions increased from about 85,000 in April 2022 to nearly 100,000 abortions in March 2024—a growth of 18 percent. Restricting access to abortion does not reduce the number of abortions.
Despite all this, legislators in states such as Alabama are moving to further restrict reproductive rights with fetal personhood bills. The Alabama state Supreme Court upheld a bill that essentially makes in vitro fertilization (IVF) illegal because every embryo is considered a “child.” In the immediate aftermath of the court’s decision, reproductive endocrinology clinics virtually shut down in Alabama.
Today, IVF is available in Alabama, after state lawmakers provided a fast fix: legislation to provide civil and criminal immunity to IVF providers and patients. But if fetal personhood were upheld at the federal level, anyone pursuing IVF could be affected.
Limiting access to abortions has neither eliminated the need for them nor reduced their number. Instead, it has been associated with increased maternal and infant mortality. Pregnant individuals are being turned away from hospitals, and healthcare workers fear providing care.
The Supreme Court had the opportunity to rule that the federal Emergency Medical Treatment and Labor Act (EMTALA) supersedes state law, allowing healthcare workers to provide stabilizing abortion care and reducing the devastating impact of abortion bans. However, rather than doing so, the court punted the issue back to lower courts, leaving healthcare workers in states with abortion bans uncertain about whether EMTALA pre-empts state law in such cases. This is putting pregnant people in danger, as we saw in Georgia.
Like all patients, pregnant people deserve privacy, dignity and respect when consulting with their physicians, and their decisions should be honored rather than influenced by political ideology. Abortion is an essential component in the spectrum of reproductive healthcare and should be treated as such.
A federal ban could be implemented via multiple different pathways, not all of which require congressional action. Over-zealous policy changes aimed at restricting abortion are likely to worsen maternal and infant mortality rates in states such as Louisiana and Georgia, which are already among the worst in the country.
Now is the time for everyone who wants to ensure pregnant people have access to healthcare to speak up, vote and advocate for legal access to abortion in every state and at the federal level.
At Ms. magazine, our mission is to deliver facts about the feminist movement (and those who stand in its way) and foster informed discussions—not to tell you who to vote for or what to think. We believe in empowering our readers to form their own opinions based on reliable reporting. To continue providing you with independent feminist journalism, we rely on the generous support of our readers. Please consider making a tax-deductible donation today if you value the work we do and want to see it continue. Thank you for supporting women’s voices and rights.
