Here’s why maternal mortality rates will rise



Abortions are statistically safer than childbirth. 2012 research shows that the risk of death during childbirth is 14 times higher than a safe and legal abortion.

Still research from 2022 indicates that even self-managed abortions, when performed under the direction of a doctor, can be safe and effective. In 2021, the Food and Drug Administration issued a standing approval for prescription abortion pills by mail, allowing physicians to meet out-of-state patients via telemedicine and prescribe the drug.

dr. Sarah PragerMAS, a UW professor of medicine in the department of obstetrics and gynecology, told Healthline that the primary way people will likely try to self-manage an abortion will always be with medication regimens using mifepristone and misoprostol. But these drugs are only approved up to 10 weeks gestation, which means self-administered abortions beyond 10 weeks are not safe.

Prager warned that the safety of managing an abortion outside of a medical system will diminish as the pregnancy continues. “People who do not have access to abortion [may] quickly become desperate and will resort to any means possible to not to be pregnant.”

Maternal mortality can affect anyone who becomes pregnant.

Experts have warned that people from all walks of life are dying from untreated pregnancy complications, such as an incomplete miscarriage. Others expressed concern for pregnant women experiencing domestic violence, which could increase the number of maternal homicides.

But restricted access to abortion is more likely to increase maternal mortality rates among people of color, especially black women. The CDC reports that Black, Native American, and Alaska Native (AI/AN) women are 2-3 times more likely to die from pregnancy-related causes than white women.

According to the CDCFactors contributing to the increase in pregnancy-related deaths among people of color may include:

  • structural racism and implicit bias
  • lack of access to quality health care
  • underlying chronic conditions
  • social determinants of health that prevent people from having equitable opportunities for economic, physical, and emotional health (i.e., rural location, transportation issues, lack of insurance)

Here are some reasons why being denied access to a safe abortion could be deadly.

Limitations of care in case of miscarriage

Research from 2022 estimates that 26% of pregnancies end in miscarriage, more than a quarter of all pregnancies.

Miscarriage care, including medications or medical procedures, is similar to abortion care.

Limitations of medical care in the event of a miscarriage due to pregnancy complications can be fatal, placing medical professionals in a complicated ethical position in the emergency room.

“Doctors are ethically bound to treat patients, and this can [also] be a violation of state anti-abortion laws,” Prager said. “Even if it’s not in violation, there will be confusion for many clinicians about what is allowed and what isn’t, which will also potentially create confusion about how they can legally proceed.”

The media have already quoted stories of people who have encountered barriers to obtaining care for a miscarriage.

Ruptured ectopic pregnancy

Ectopic pregnancies – when a fertilized egg implants outside the uterus – affect approximately 1–2% of all pregnancies. These pregnancies are not viable and may result in Medical emergency. Delaying treatment due to the ban on abortion can lead to further complications or even death.

“A [person] with an incomplete miscarriage can bleed to death if the uterine contents are not evacuated, an ectopic pregnancy can rupture and the [person] can bleed to death,” said Kecia Gaiter, MD, MPH, FACOG, Director of Perinatal Services at NYC Health + Hospitals/Lincoln in New York City. “In both cases, intervention is necessary.”

Maternal sepsis

Maternal sepsis, or “septic uterus”, affects 11% of maternal deaths worldwide. Indeed, the World Health Organization (WHO) reports that maternal sepsis is the third most common cause of maternal death.

For example, if a pregnant person’s waters break before 20 weeks of gestation, it could cause serious bacterial infection and sepsis (or blood poisoning) if left untreated. Sepsis can also occur during a incomplete miscarriage.

In these cases, doctors may have to wait until the patient becomes seriously ill before performing an abortion or until the fetal heartbeat stops.

Delay in care for cancer patients

In some cases, cancer care during pregnancy may be delayed as it may harm the fetus.

“A variety of cancer treatments compromise the immune system and suppress bone marrow, which increases the risk of bleeding,” explained Mitzi Krockover, MDWomen’s Health Podcast Host, Beyond the Paper Dress. “Denial of [abortion] care can cause a patient to lose too much blood or become septic.

Krockover added that delaying cancer treatment that could harm the fetus, such as chemotherapy or radiation therapy, could decrease a person’s chances of remission, thereby decreasing their overall chances of survival.

In some scenarios, Krockover explained, doctors may choose to use a suboptimal therapy that is less harmful to the fetus but not as effective for successful cancer treatment.

Other Complications

Pregnant people with significant comorbidities are at additional risk if they cannot terminate a pregnancy, which can lead to death.

A cohort study Californian mothers who gave birth between 1997 and 2014 published in 2020 shows that severe maternal mortality (SMM) increased by 160% during this period. The study noted that medical comorbidities accounted for a substantial number of maternal mortality rates, increasing by 111% over the study period. Obstetrical comorbidities increased by 30% to 40%.

According to Gaither, comorbidities that increase the risk of maternal mortality can include:

Suicidal thoughts and attempts

According to American Psychological Association (APA)restricting access to abortion can increase the risk of mental health problems.

Being denied an abortion can lead to increased anxiety, depression, post-traumatic stress disorder (PTSD) and even suicidal ideation, according to the APA.

suicide is a leading cause of maternal death in the USA. In fact, a study 2021 Examination of data from 2006 to 2017 shows that suicidal ideation and self-harm increased significantly among pregnant women in the year before and after childbirth.

“According to Disclaimer Studypeople who were denied access to abortion experienced higher levels of depression and anxiety and overall worse mental health outcomes than people who were allowed to have abortions,” said the Dr. Mary Jacobson, Chief Medical Officer of Alpha Medical.

In contrast, Jacobson cited another studywhich showed that levels of suicidal ideation were equally low between people who had abortions and people who were denied abortions.

The researchers concluded that there was not enough evidence to suggest that abortion increases a person’s risk of suicide. They noted that some studies had shown a higher risk of deliberate self-harm in women who were denied abortions, but concluded that more rigorous research was still needed.

“Based on these facts, one can hypothesize that maternal mortality due to suicidality may increase, but this hypothesis is debatable,” Jacobson said.

Domestic violence and maternal homicide

Research from 2021 shows that homicide is another major cause of maternal death in the United States, with marginalized groups and people of color more likely to be affected, especially younger people.

The data shows that there were approximately 4 homicides per 100,000 live births among people who were pregnant or within a year of giving birth, which was 16% higher than the prevalence of homicides among people of to procreate non-pregnant and non-postpartum.

Domestic violence is associated with maternal mortality. Domestic Violence Survivor Advocates said that pregnant women are particularly at risk of increase in domestic violence in a post-Roe world if they are denied an abortion.

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