Is abortion more life-threatening than giving birth?

In the comments of an earlier post, arguing that abortion may be more dangerous than childbirth, “Alas” reader Joe M. has pointed to the abstract of “Pregnancy-associated mortality after birth, spontaneous abortion, or induced abortion,” from The American Journal of Obstetrics and Gynecology (Feb 2004).

The abstract, based on medical records from Finland (due to socialized medicine, Finland has exceptionally accurate medical statistics), reports that “mortality was lower after a birth (28.2/100,000) than after a spontaneous (51.9/100,000) or induced abortion (83.1/100,000).”

Joe’s not alone; many pro-life organizations have cited this article, pretty much to make the same point Joe does.

I’m neutral in the “which causes more deaths – legal abortion or childbirth?” debate. I don’t know which is safer; it seems clear that both procedures are pretty safe for the average American. And the abortion question is, in the end, about civil rights, not about safety.

Nonetheless, since Joe brought it up – and since it’s been argued about endlessly in comments – I looked up the study. Joe’s point – which is, if I understand him, that abortion is more dangerous than childbirth – isn’t really supported by the Finland study. From the study’s text (no link available, sorry):

Women who underwent an induced abortion had a pregnancy-associated mortality rate from natural causes that was one third higher than that of women who had given birth. These deaths included both terminations in early pregnancy (indicating most often an unwanted pregnancy) and in late pregnancy (included practically all cases for medical reasons). After excluding all terminations for medical reasons, the pregnancy-associated mortality rate from all natural causes declined from 22.3 to 15.9 per 100,000 induced abortions, a rate lower than the mortality rate after a birth.

Having a late-term abortion for medical reasons is relatively dangerous – but it seems unjustified to assume that carrying these particular pregnancies to term would have been any less dangerous. You could just as easily use this study to argue that, for an ordinary pregnancy, it’s safer to abort than to give birth.

However, I’m sure other studies could be (and will be) cited to show just the opposite. In the end, the studies seem to show that both childbirth and legal abortion, at least in the first world, are fairly safe. A more substantial debate about abortion would concentrate on different issues.

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21 Responses to Is abortion more life-threatening than giving birth?

  1. 1
    Deep River Appartments says:

    Amp makes an interesting point in the topic above this one (“Is the Federal Goverment systematically undercounting abortion deaths?”) that I think should have been made here as well. If abortion is really so much more lethal than childbirth, why hasn’t the current, very much anti-choice administration made proving this the top priority of its abortion agenda!? Such a charge would be WAY more effective in cutting back on abortion that the nebulous PBA issue they’ve invested so much energy and political capital on, as it would pierce through the partisan philosophical wall seperating the two camps.

    But the choice-hostile white house remains silent on this front. I think that says a lot about the credibility of these charges.

    And in the end, even if this charge were true (which I sincerely doubt), it would only buy the anti-choicers time, not victory. Medical science would inevitably advance to the point where abortion would be totally safe, and the debate would once again center on issues of philosophy and freedom, where the anti-choice crowd can only “win” through tyranny and duplicity.

    Of course medical science also brings us closer and closer to a time when fertilized eggs can be kept in uterus-simulating tanks to grow for the whole nine months, a prospect the anti-choicers supposedly look forward to as the end of the debate in their favor. Won’t they be surprised when they discover it wasn’t just about a woman’s right to control her body, but also the parents’ right to decide wether or not a new life should be created by accident and against their will.

    Of course medical science could also eventually grant us the fabled 100% effective contraception, finally making 99% of this fighting go away.

  2. 2
    Jake Squid says:

    If the CDC is to be believed, the mortality rate for abortion ranged from 0.3 to 1.2 per 100k from 1987 to 1996 while the maternal mortality rate from live births was 7.7 per 100k for that same period.

    Of course, if you don’t trust the CDC this is meaningless.

  3. 3
    Raznor says:

    Or, DRA, medical science will advance to the point of creating extremely advanced cyborgs that will then turn on their human creators. It will be then that the abortion debate is completely eliminated as all humanity must join to rebel against our cybernetic opressors.

    Ahhhh, science.

  4. 4
    Jake Squid says:

    I plan on turning informant to the cyborgs in an attempt to live years longer than my fellow inferior bags of meat.

  5. 5
    Raznor says:

    At the risk of completely losing this young comments thread to a tangent:

    Damn you Jake Squid!!! You would sell out your own kind to the gathering mechanical menace?! Damn YOUUUUUUUUUUU!!!!!!!

  6. 6
    Erika says:

    DRA — I am currently rabidly prochoice. And yet, I don’t know that I would continue supporting fetus-terminating abortion in the event that reliable fetus incubators were introduced and that even very young feti could be extracted safely from their carriers. I do sincerely happen to believe that abortion is part of a larger a right to control the uses of one’s body, and not necessarily a right to kill the fetus.

    However, I really think that this is such a long way off that arguing what stance I or any other prochoice individual should/would take in such an event is somewhat silly.

  7. 7
    Deep River Appartments says:

    Erkia — Yeah, I’m not too keen on pondering distant “what ifs” at this stage, especially since such technology won’t be available to poor women anyway. It’s just that I sincerly doubt society will be willing to foot the incredible bill our overpacked adoption system will demand if every single fertilized egg became a person! You do realize how massive a surge of unwanted kids that would mean right?

    Then again, since we are talking about what ifs, maybe the government will eagerly find a use for these kids as say…cannon fodder raised from birth to be killing machines, or something equally ghastly.

  8. 8
    Erika says:

    DRA — or maybe by that time we’ll have free birth control available to everyone who wants it, better forms of birth control designed to be used by men, and no stigma against wanting sterilization. In that event, there would be far fewer unwanted pregnancies in the first place.

    I agree it would be totally disasterous to the adoption system, and yet another reason for being prochoice, to me, is that prolifers haven’t even begun to think, as far as I can tell, about how they would handle the ramifications of criminalizing abortion. (Then again, I’ve talked to at least one prolifer who seemed to think that criminalizing abortion was a great idea because them it would force society to deal with the fucked up adoption system, with health care, and with inadequate birth control availability, etc. Idealistic but weird admirable.)

  9. 9
    Joe M says:

    Interesting. I haven’t read the entire study, but I’d be curious to see how the portion you quote can be squared with the portion from the abstract.

    Namely, the abstract says this: “The mortality was lower after a birth (28.2/100,000) than after a spontaneous (51.9/100,000) or induced abortion (83.1/100,000).”

    This plainly says that the mortality rate after an inducted abortion was 83.1, compared to 28.2 after a birth. This is a difference of nearly three times.

    But the new portion that Amp quotes says: “Women who underwent an induced abortion had a pregnancy-associated mortality rate from natural causes that was one third higher than that of women who had given birth. . . . After excluding all terminations for medical reasons, the pregnancy-associated mortality rate from all natural causes declined from 22.3 to 15.9 per 100,000 induced abortions, a rate lower than the mortality rate after a birth.”

    Actually, I just figured out the answer: This paragraph is talking about natural causes only, whereas the sentence I quoted was talking about deaths from all causes. So I was probably right that women who have abortions are also more likely to lead dangerous lives or to make the sort of bad choices that lead to death.

  10. 10
    Raznor says:

    So I was probably right that women who have abortions are also more likely to lead dangerous lives or to make the sort of bad choices that lead to death.

    This is just mean, Joe. Do you think that complications in pregnancy can only result from bad choices? This just shows a complete lack of respect for women in general.

  11. 11
    Ampersand says:

    No, he’s saying that the deaths he’s talking aren’t related to complications in pregnancy.

    Although Joe was wrong to think that this study contradicts the general claim that “abortion is safer than childbirth,” he may be right about his current claim. Women who decide to go through with childbirth probably are, on the whole, more likely to have stable lives, steady incomes, a support network, etc. For most of the women whose abortion decisions I’ve read about or spoken to about, these are major factors they considered when deciding to terminate a pregnancy or not.

    So women without stable lives, steady incomes, support networks, etc, are also less likely to die, other factors held equal. If that’s true, is that really surprising?

    However, you can’t look at that fact (if it is a fact) and say that tells us anything about if abortion is safer or less safe than childbirth. All it tells us is that feeling able to raise a child may be correlated with factors like stable lives, steady income, support networks, etc; and that these factors are also correlated with a lower mortality rate. Since correlation is not causation, it would be incorrect to look at that and conclude that abortion is more dangerious than childbirth.

  12. 12
    lucia says:

    Joe M
    I haven’t read the article yet. I can comment on something pertaining to women who terminate pregnancies for medical reasons.

    The women who terminate abortions for medical reasons are different in an important way from both other groups or pregnant women. These women have serious health problems! In fact, they are sufficiently severe to warrant an abortion for the sake of her health, she is too unhealthy to carry the fetus to term.

    Many, if not most, of these women don’t want abortions. If they had wanted them, they would have had them before the medical need arose.

    It is quite likely that, if you identified these women and refused abortions, and, they would die at a higher rate than the healthy preganant women who don’t have abortions! The same diseases that required the abortion may very well kill them!

    What are these diseases? Well, I don’t know all even a fraction of them. But, they can include severe complications of diabetes or cancer.

  13. 13
    Joe M. says:

    What Amp said sounds intuitively true. Women who have abortions have worse circumstances overall.

    But — the opposite could sound intuitively true as well. Who is more likely to have an abortion, the poor inner-city 20-year-old who has nothing other than a baby to occupy her time, or the rich college girl who sees a baby as an enormous intrusion into her life’s plans?

    Basically, I wonder if women who have abortions are really worse off on average. Are there any reliable statistics on this?

  14. 14
    Deep River Appartments says:

    Joe sez:
    “Who is more likely to have an abortion, the poor inner-city 20-year-old who has nothing other than a baby to occupy her time…”

    Hmm, I dunno Joe, from my experience the vast average of poor inner-city 20-year-olds have more than enough to keep them busy without a baby in the equation. They generally fall into three categories from what I’ve seen (which can be combined in various configurations to a limited extent):

    She might be trying to pursue an education, which is a pretty intense goal for someone who must work double hard in and outside the classes to compensate for the lack of a family fortune to pay for it.

    She might be trying to scratch out her own life, usually married to someone as poor as her, meaning that she has to hold her own job (and perhaps several) just to make ends meet. For her this is the best equation to add a child in, but it will strain their limited resources enormously, and neither parent will be able to spend as much time with the child as they should, which is a major contributing factor to future delinquence.

    (I’ll be polite and assume Joe didn’t think married poor women had nothing to do other than settle into domestic bliss while father earned a healthy living for both of them)

    Lastly she might still be single and living at home, where she will be expected to contribute to the family’s financial and domestic solvency. Once again she’ll be trying to hold down a job, as well as helping with numerous chores. If she has a child at this point she becomes something of a liability, as in the traditional “rules” of coupling, poor potential husbands are less likely to consider her. Besides, this won’t do for conservatives at all, as they theoretically dissaprove of single parenthood.

  15. 15
    Floyd Flanders says:

    According to Alan Guttmacher (http://www.guttmacher.org/pubs/abslides/abort_slides.pdf) inadequate finances is the number one reason given (tied with not ready for responsibility) for why a woman gets an abortion. According to the report I linked to above, 57% of women seeking abortions were poor or low income.

    From the report:
    “Nearly half (48%) of women who had late abortions attributed their delay to “difficulty making arrangements for the procedure” because they needed time to raise mony or get a medicaid card, they had to arrange transportation, there was no local provider, they were minors subject to state laws requiring parental involvement, or they had difficulty securing childcare.”

  16. 16
    Deep River Appartments says:

    Floyd sez:
    “Nearly half (48%) of women who had late abortions attributed their delay to “difficulty making arrangements for the procedure” because they needed time to raise mony or get a medicaid card, they had to arrange transportation, there was no local provider, they were minors subject to state laws requiring parental involvement, or they had difficulty securing childcare.”

    Priceless. The anti-choicers hate late term abortions most of all (that’s where they get most of their fetus porn images), yet their policies and tactics might actually increase the number of late term abortions needed.

    This is in the same vein as the contraceptives issue, where better sex ed and promotion of contraceptives would drastically reduce the number of abortions, but most anti-choicers have a puritan midset as well so they oppose such things.

  17. 17
    lucia says:

    “Nearly half (48%) of women who had late abortions attributed their delay to “difficulty making arrangements for the procedure” because they needed time to raise mony or get a medicaid card, they had to arrange transportation, there was no local provider, they were minors subject to state laws requiring parental involvement, or they had difficulty securing childcare.”

    And the other half? Might we assume they didn’t have the these problems and requires the late term abortions due to ill health?

    But.. in any case what is your point vis-a-vis the statistics in the article and anything that’s been posted.

    The statistics provide a clear indication that women who have abortions as because of a medical need die at a higher rate than those who weren’t pregnant, got pregnant and give birth or had abortions for other reasons.

    It is generally the case that people with serious medical needs die at a greater rate than people who have no serious medical needs. One need look no further than that to explain why the sick pregnant women were more likely to die than the healthy pregnant ones.

  18. 18
    Floyd Flanders says:

    Lucia asks:
    “And the other half? Might we assume they didn’t have the these problems and requires the late term abortions due to ill health?”

    Well, if you go to page 13 of the report I linked to you will see a list or reasons that women gave as to why they got their abortion after 16 weeks. Most women gave more than one reason. The most moftern cited reason (71%) was that the woman did not realize she was pregnant. Health seems to have been a factor in 2% of the time for late diagnosis of fetal abnormality and possibly 6% for something changed during pregnancy.

    “But.. in any case what is your point vis-a-vis the statistics in the article and anything that’s been posted.”

    They were a response to Joe’s question about whether there were stats describing who gets abortions by economic status. As I pointed out, 57% of women who get abortions are poor or low income and when they do seek abortions they often have to wait to save money, find transportation, attain childcare etc before they can get the procedure–thus nearly half of women getting a later abortion do so for reasons that seem to be tied into their economic status.

  19. 19
    lucia says:

    The most moftern cited reason (71%) was that the woman did not realize she was pregnant.

    Really? Wow. In highschool, I knew a girl who found out she was pregnant when she gave birth. We always assumed this was extremely unusual!

  20. 20
    Amanda says:

    I find it hard to believe that women don’t know if they are pregnant, but what do I know? I guess if your periods were irregular to begin with…. I am certain though that a large amount of the “didn’t know”‘s are “couldn’t admit it”‘s. One more example of how heaping shame on women’s sexuality is exactly the WRONG strategy for reducing abortions.

  21. 21
    Amber McDermott says:

    yes if abortion is murder wouldnt birth be murder too? because abortion only kills 5,000-10,000 women a year when giving birth kills 529,000 women a year. sooo yeah you might want to think about that. It also isnt anyones right to tell a women what she can and can not to with her body. If she wants to have a baby then you should let her and if she wants to get an abortion you should let her. No man or women has the right to say what any women can or can not do with her body. And if anyone has a problem with what i just said you can E-mail me at tinkerbell12677@yahoo.com