The United States has the highest maternal mortality rate in the wealthy world. And unlike almost every other nation in the world, including deeply impoverished ones, our maternal mortality rate has risen over the last decade. It is more dangerous to give birth in the state of Georgia than in 100 other countries, including Iran, Iraq, and the West Bank. Almost all of these deaths are preventable, and we have excellent data telling us how to prevent them. Yet Republican “pro-life” lawmakers have remained silent about the lives of women, and instead moved to enact more and more draconian anti-abortion laws. In states such as Georgia and Ohio, lawmakers have even supported the death penalty for women who seek abortions—apparently unaware that when the mother dies, so too does the fetus.
In an attempt to prove that they care about pregnant people and their families, anti-choice lawmakers almost always write an exception for the life of the mother into abortion bans. But this is a ruse. These exceptions will not save anyone’s life because no condition that can be diagnosed in pregnancy will kill a pregnant person with certainty.
The Ruse of ‘Life of the Mother’ Exceptions
Pregnancy is getting progressively more dangerous in the United States, even as countries such as Sweden and Finland have rendered maternal death virtually nonexistent. While preventative care and responsive providers can and do save lives, most life-threatening conditions are diagnosed late in pregnancy (when women are unlikely to be seeking abortions) or during delivery.
The leading causes of maternal mortality in the U.S. are:
- cardiovascular health conditions
- pulmonary embolisms
- high blood pressure
Even when these conditions can be diagnosed early in pregnancy, none of them carries a 100% chance that the woman will die. This puts doctors in a difficult position: where does one draw the line and recommend an abortion? How can any doctor be confident they’ve drawn the line correctly when states penalize abortion with imprisonment or even death? Is a 50% chance of death sufficient? What about a 10% probability? What if the chances of dying are 0.04%, as they are for every pregnant person in Georgia?
In a nation with skyrocketing maternal mortality, every pregnancy is a threat to the life of the woman, and there is no way to accurately predict who will die and who will be permanently disabled.
Placenta accreta, one of the deadliest pregnancy conditions provides a perfect study of the problem. Placenta accreta is often misdiagnosed, thanks to a maternal health system that fails to properly care for birthing people. It almost inevitably causes hemorrhages, and 90% of birthing people with this condition require a blood transfusion. The mortality rate is among the highest of any pregnancy-related condition, at 7%. Is that high enough to justify an abortion?
In the United States, Every Pregnancy Threatens the Life of the Mother
Republicans consistently allow exceptions to save the life of the mother because they know they can’t condemn pregnant people to die. Choice activists need to push back more on this. No pregnancy-related condition guarantees a woman’s death, or even drives the odds to greater than 50%. This means any doctor who certifies that a woman could die of her pregnancy will be entering uncharted legal territory. Abortion clinics in Georgia, Alabama, and other states proposing restrictive abortion laws must use their own judgment—knowing on one hand that women’s lives hang in the balance, but on the other, that doctors could lose their freedom.
If abortion bans go into effect, doctors must grapple with questions like:
- If there is a high risk that a woman will kill herself if forced to carry a pregnancy to term, is that a credible threat to her life? Suicide is a leading cause of postpartum death, and the U.S. has done nothing to slow the epidemic of postpartum depression. When El Salvador banned abortion, suicide became the leading cause of maternal death.
- If a woman’s partner is abusive, does she get to have an abortion? Women are more likely to be abused during pregnancy than at any other time in their lives. Homicide is the leading cause of death among pregnant women, accounting for 20% of all pregnancy deaths, according to a 2001 study.
- If a pregnancy will force a woman to live in such extreme poverty that it endangers her health and life, or the life and health of her unborn baby, does this count? Women who are forced to carry their pregnancies to term are more likely to live in poverty.
- If a woman cannot afford medical care that could save her life, does her pregnancy count as life-threatening?
- If there is a compelling risk that racism will cause doctors to ignore a woman’s life-threatening condition, does this count? Numerous black women have died while begging for life-saving care. Kira Johnson was told she was “not a priority” as she slowly bled to death. Research consistently shows that large numbers of doctors believe racist myths about black people, and that these racist beliefs cause black people to get lower quality care. Black women are three to four times more likely to die giving birth than white women. Research shows that racism, not race or individual choices, is the culprit.
- How likely does a woman have to be to die to get care? If her fetus won’t survive, does this change this calculation?
Misogyny created a healthcare system in which women do not get the care they need. That’s why women are dying more in the U.S. than they are in any other wealthy country. And now, misogynist lawmakers get to decide which pregnancy risks are too significant for women to bear. In a country that has done nothing to stop maternal deaths, it seems obvious that lawmakers will not err on the side of caution and respect for pregnant women.
Choice means that women and their doctors get to decide which risks are too great. Remove that choice and people who know nothing about women’s bodies are left to make the decision instead. Deaths are inevitable. When abortion is illegal, women don’t stop having abortions. In Latin America, where abortion is banned, abortion rates are higher than in the United States. Abortion bans only make abortion more dangerous. Worldwide, unsafe abortion is a leading cause of maternal death.
Republican lawmakers seem determined to join the most impoverished nations, driving the maternal mortality rate up and ensuring that unsafe abortions kill women.
This has never been, will never be, about the life of the mother or protection of babies. This is about punishing women for seeking abortions—including with death. It’s about forcing children into poverty because their mothers had sex (or were raped).
Exceptions to save the life of the mother are mere words. They allow anti-choice lawmakers to claim that, technically speaking, they’re not condemning women to die, even when they know they are. Every pregnancy potentially threatens the life of a mother.