This conventional ‘wisdom’ is demonstrably false.
This conventional ‘wisdom’ is demonstrably false.
‘C hildbirth is fourteen times more dangerous than abortion!” This assertion has been repeated, in person and in the media, by highly credentialed physicians and scientists, by lawyers appearing before the Supreme Court and at least one Supreme Court Justice herself, by a galaxy of popular entertainers, and by a horde of media reporters and pundits. Despite its continuous, widespread dissemination for more than a decade, this conventional wisdom is demonstrably false.
The delusion of abortion safety compared to childbirth originated in a 2012 paper by E. G. Raymond and D. A. Grimes, who concluded that “the risk of death associated with childbirth is approximately 14 times higher than that with abortion.” They came to this conclusion by dividing the number of pregnancy-related deaths in the United States between 1998 and 2005 (8.8 deaths per 100,000 live births) by the “mortality rate related to legal induced abortion” during the same time period (0.6 deaths per 100,000 abortions). The result of this calculation is 14.66, thus the origin of the notorious 14-to-1 stat.
However, a calculation is only as good as the data used, and the data necessary to produce valid comparisons of pregnancy outcomes (e.g., birth versus induced abortion) is not routinely collected in most nations, including the United States.
The World Health Organization (WHO) has cautioned that a valid death rate tied to specific pregnancy outcomes requires three important pieces of information that must be formally and comprehensively collected and linked to the same woman: 1) the certification of the death of a woman at a reproductive age, 2) her pregnancy status at or near the time of death, and 3) the actual medical cause of death. In the United States, national abortion reporting is not required by law. California, Maryland, and New Hampshire don’t report any official data. Other states report their data inconsistently. Therefore, reliable data on abortions and related adverse events, including hospitalizations and deaths, are underreported.
Raymond and Grimes knew this, of course, and lamely acknowledged it as a weakness in their paper, stating that “weaknesses include the likely underreporting of deaths, possibly differential by pregnancy outcome (abortion or childbirth).” This is an admission that abortion-related deaths are significantly underreported compared to childbirth-related deaths and, therefore, should have rendered the paper’s conclusions invalid.
What about countries that do consistently collect the pregnancy-outcome data recommended by the WHO? Larger population-based studies that have access to complete reproductive histories linked to death and health-services utilization invariably show that mortality associated with abortion is higher than mortality associated with childbirth. In a 1997 study from Finland, post-pregnancy death rates within one year were reported to be nearly four times higher after abortion than after childbirth (100.5 versus 26.7 per 100,000). In a 2004 study from Finland, researchers again found that mortality after abortion was over three times higher than after childbirth. In a 2002 U.S. study that linked Medicaid treatment records and death certificates, Dr. David Reardon found significantly higher rates of death associated with abortion than with childbirth.
It is astounding that these rigorous analyses (1997, 2002, 2004) utilizing superior linked data sets for large populations were not mentioned, especially considering that Raymond and Grimes (2012) claimed that they had “searched for relevant population-based studies on mortality and morbidity of abortion and childbirth.”
From a public-health and statistics perspective, the events represented by the two fractions used by Raymond and Grimes are conceptually different and the use of the ratio based upon these two fractions is statistically and clinically inappropriate. Back in 2004, Dr. Julie Gerberding, who was then head of the Centers for Disease Control and Prevention, wrote that maternal mortality rates and abortion mortality rates “are conceptually different and are used by the CDC for different public health purposes,” essentially discouraging the juxtaposition of these two rates. For example, “deaths per 100,000 live births” includes women whose death could be associated with any pregnancy outcome, including birth, abortion, natural loss, or no outcome at all. The “14 to 1” talking point reinforces the mistaken notion that all maternal deaths are consequent to a live birth.
The most egregious assault on science represented by Raymond and Grimes, hiding in plain sight, is what they chose not to consider. Their methodology considered only the risk to the woman and not the risk to the unborn child. The death of an unborn child is the explicit purpose of, and the very definition of, induced abortion.
Once the paradigm shifts to a two-life metric (mother and baby), it becomes unquestionably clear that abortion will always be orders of magnitude more deadly than carrying a baby to term. Data on maternal deaths and abortions in the period of 2011–15 show that there were 1,320 abortion deaths for every one maternal death.
What does the Raymond and Grimes ratio look like when we consider both mother and baby? Depending on the assumptions in estimating and accounting for miscarriages and the simple recognition that abortion is a death, abortion could be as much as 4,500 times more likely to result in a human death than giving birth. Perhaps abortion advocates continue to tirelessly propagate a discredited, never-replicated study to distract from the startling carnage that is abortion.
James Studnicki, Sc.D., M.P.H., is vice president of Data Analytics for Charlotte Lozier Institute. He was the first director of the Master of Health Science Program in Health Finance and Management at the Johns Hopkins School of Hygiene and Public Health, where he served as a faculty member for 13 years. Tessa Longbons is senior research associate at Charlotte Lozier Institute.