A new analysis by public health researchers led by Maria Steenland re-evaluates death risks from pregnancy and abortion using more recent US data. The authors estimate that the mortality risk associated with pregnancy — counted from pregnancy through one year postpartum — is 44 to 70 times higher than the mortality risk from abortion. That figure is roughly three times larger than a widely cited earlier comparison, which relied on data from 1998 to 2005.
The study used deaths and births from national vital statistics, abortion-related deaths from a pregnancy mortality surveillance system, and abortion counts from the Guttmacher Institute. To keep estimates conservative, the team removed nonspecific causes such as “other specified pregnancy-related conditions” and excluded deaths attributed to COVID-19 and deaths after miscarriage or self-induced abortion. Researchers also note that a pregnancy checkbox on death certificates, fully implemented in 2018, improved identification of pregnancy-related deaths but can introduce misclassification when causes are recorded incorrectly.
The authors list hundreds of specific pregnancy-related causes, including hypertensive disorders, obstetric haemorrhage, complications of chronic heart and kidney disease, and various infections. They argue that forcing people to continue pregnancies can increase the risk of death and other harms, and they call for efforts to lower mortality for pregnant, birthing, and postpartum people. The research appears in JAMA Network Open.
Difficult words
- re-evaluate — examine or judge again with new informationre-evaluates
- mortality — number of deaths in a group or time
- postpartum — period after childbirth when recovery occurs
- surveillance — systematic monitoring of events or data
- conservative — intended to avoid overstating or exaggerating
- misclassification — incorrect assignment of category or cause
- hypertensive — relating to conditions of high blood pressure
- haemorrhage — heavy bleeding from inside the body
- complication — additional medical problem that makes care hardercomplications
- nonspecific — not clearly linked to a single cause
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Discussion questions
- How might excluding nonspecific causes and some deaths change public perception of pregnancy risks?
- Given the specific causes listed (e.g., hypertensive disorders, haemorrhage, chronic disease), what health system measures could reduce pregnancy and postpartum deaths?
- How can improvements in death records both help researchers and create new challenges for data accuracy?
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