It’s going to be a challenge tracking changes in the maternal mortality rate

We expect maternal deaths to rise post-Dobbs, especially in states that have effectively banned abortions. But collecting the data to document what’s happening will not be easy.

Since the Supreme Court overturned Roe v. Wade last year, doctors have warned that limiting abortion care will make pregnancy more dangerous in a country that already has the highest maternal mortality rate among industrialized nations.

The case of Mylissa Farmer, a Missouri woman, is one example. Last August, her water broke less than 18 weeks into her pregnancy, when her fetus was not viable. She was at risk for developing a life-threatening infection if she continued the pregnancy. Yet during three separate visits to emergency rooms, she was denied abortion care because her fetus still had a heartbeat. Doctors specifically cited the state’s new abortion law in her medical records and said they could not intervene until her condition worsened. She eventually traveled to Illinois for care.

Even for people who don’t develop sudden life-threatening complications, doctors note that carrying a pregnancy to term is inherently risky because rapid physical and hormonal changes can exacerbate chronic health conditions and trigger new complications. If more people are forced to continue unwanted pregnancies, there are bound to be more pregnancy-related deaths: A study by the University of Colorado estimates a 24% increase in maternal deaths if the United States bans abortion federally. They predicted the increase would be even higher for Black patients, at 39%. Currently, 14 states have total abortion bans.

Additionally, when abortion is illegal, it makes the procedure more dangerous for those who still try to terminate their pregnancies. The World Health Organization found that unsafe or illegal abortions account for up to 10% of maternal deaths worldwide.

As the United States enters its second post-Roe year, advocates say it’s important to gather data on the impact abortion bans are having on the health of pregnant people to help both policy makers and voters understand the life-or-death consequences of the restrictions. Without such accounting, they say, the public may remain ignorant of the toll. Maternal mortality rates would be a crucial gauge of impact.

Despite the stakes, experts say, at least in the short term, it may be difficult or impossible to track the number of lives lost due to limits on abortion access.

ProPublica spoke to four members of state maternal mortality review committees. Here are some of the challenges they see to drawing any clear conclusions from maternal mortality data in the near future.

The challenges include inconsistent data, which may not include any indication of whether an abortion was available, interference from anti-abortion states, small sample sizes, and the fact that some women in anti-abortion states can still access abortion care. I think the story is going to be told more by anecdote, at least at the beginning. Any individual story about a woman dying after being denied an abortion will have an effect. There are already tons of stories of horrific near misses, some of which resulted in permanent damage to the woman in question; the plaintiffs in the lawsuit against Texas have told some of those stories, and they’re far from alone. The data will be there, but it will take time and effort to fully understand it.

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