“How can we reduce abortions while also preventing an increase in maternal mortality?”

Aug 27, 2025

I recently received the following email (edited for length):

Since the Roe reversal, I’ve noticed that states with stricter abortion laws have seen an increase in maternal deaths. Do you know why this is happening, and what can be done to reverse it? I support reducing abortions, but not if it leads to more mothers dying. Are these deaths due to unclear laws, hospitals lacking knowledge, or political interference in care? How can we reduce abortions while also preventing an increase in maternal mortality?

I appreciate this question. I appreciate people willing to squarely face potential problems with our own advocacy and grapple with complexity. I expect the person who emailed me is nowhere near the only pro-lifer with this concern, so I decided to publish my response here for others.

First, it’s not clear to me that abortion bans are increasing maternal deaths. I did a detailed analysis of a report from the Gender Equity Policy Institute suggesting states have higher maternal mortality rates (MMRs) because of abortion bans. If you’d like to read it (or watch the video version), I explain how this report is, at best, a gross oversimplification, and at worse, just false. The same can be said for the widely cited stat that Texas MMR “skyrocketed” after their heartbeat ban went into effect; that conclusion isn’t from the actual data.

There is a lot of manipulation of data and deception in reporting. But that doesn’t mean that there are zero reasons for concern. I think there have been at least some credible reports of medical providers concerned about whether they can take appropriate steps when women are experiencing emergencies. I think usually these concerns are about more factors than the actual language of the laws.

For example, in the case of Josseli Barnica the Texas hospital made her wait 40 hours until there was no fetal heartbeat before inducing her labor, and some of her medical team said Texas law requires that, even though the law doesn’t. Barnica died, days later, when the medical providers dismissed her calls saying she was concerned about ongoing symptoms. An autopsy report revealed she actually had “retained products of conception,” meaning even when they did finally induce labor, they didn’t properly verify a complete expulsion of fetal remains and other pregnancy tissue, and they didn’t sufficiently monitor her afterward or take her concerns of ongoing symptoms seriously. This was clear malpractice.

Abortion rights proponents cite cases like this to say abortion bans are causing harm, but blaming the law isn’t very straightforward. The doctors seemed unaware of what the law actually says, and provided substandard care even after inducing her labor. Clarifying the language of laws wouldn’t fix either of those issues.

I don’t think there are many (or maybe any) doctors purposefully putting patients in harm’s way to make political points. I think most of the harm is grossly exaggerated, but to the extent it is real it’s from ignorance, not malice.

Best we can do is keep speaking up about what the laws actually say, and what the goals of abortion legislation actually are. Several states have already gone out of their way to offer such clarifications. Here are a few examples:

For people who are genuinely confused or nervous, these reassurances should help. For people who have political reasons to claim—no matter what we say—that abortion laws will always be too confusing and so we must not have any, these clarifications will probably make little difference.

The healthcare industry is heavily regulated. Doctors and nurses are trained to navigate legal landscapes all the time. I don’t believe abortion is a unique exception that simply can’t be subject to laws.

Meanwhile, there are ways to decrease maternal mortality that have nothing to do with abortion laws, and I think it’s good practice to invite people on all sides of the abortion issue to work together where there should be easy common ground. So for example, we can advocate for better training and standard protocols in healthcare facilities regarding hemorrhage, hypertension, sepsis, and heart failure (all leading causes of maternal death). We can advocate for insurance reimbursements, educational grants, and other financial supports for midwifery in rural and maternity care deserts. We can call for expansion of postpartum Medicaid, because a lot of maternal deaths happen well after birth without sufficient healthcare interaction. These could all be common ground.

Similarly there are ways to decrease abortion regardless of abortion laws, including changing hearts and minds on the ethics of the issue so people are less likely to personally choose abortion or expect their loved ones to get one, and including decreasing the pressure to abort from financial and cultural constraints. There’s always plenty of work to be done, which is intimidating but also means there are places for all types to fit in and help.

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This article was originally published on August 27, 2025 at secularprolife.org.

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