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August 21, 2024

Abortion and health care

Does legal abortion reduce maternal mortality?

Tyler Smith

Activists protest the overturning of Roe v. Wade by Supreme Court.

Source: LyonStock

In 2022, the US Supreme Court overturned Roe v. Wade, revoking the constitutional right to abortion. The landmark Dobbs decision has reignited debates about legal abortion and in particular its status as an essential health care service.

In a paper in the American Economic Journal: Economic Policy, authors Sherajum Monira Farin, Lauren Hoehn-Velasco, and Michael F. Pesko analyzed maternal mortality between 1959 and 1980, as abortions became legal first at the state level and then at the federal level with Roe v. Wade in 1973. Using an event study that compared maternal mortality rates at the state level before and after abortion decriminalization, they found that state-level legalization over the period 1969–73 substantially lowered non-White maternal mortality.

Panel C of Figure 3 shows the estimates from that analysis for non-White females between the ages of 15 and 44.

Panel C of Figure 3 from Farin et al. (2024)

The solid lines in the left graph indicate maternal mortality overall, and the solid lines in the right graph indicate abortion-related mortality. The gray diamonds represent the results for all US states in the sample; the colored circles represent estimates that control for state policies, such as access to contraception; and the colored squares are estimates for states that legalized abortion voluntarily prior to Roe v. Wade. The dashed lines show the 95 percent confidence intervals. The red vertical lines indicate the year before legalization. 

In both graphs, mortality rates begin flat in the years leading up to legalization. But soon after abortion becomes legal, mortality declines across each type of estimate. Overall, non-White maternal mortality fell by 30 to 50 percent one year after legalization, averting approximately 134 non-White maternal deaths nationally. For non-White abortion-related mortality, the reduction was between 30 and 80 percent. Most of the mortality decline was concentrated around early state-level legalizations rather than Roe v. Wade.

The findings suggest that restricted access to legal abortion is likely to affect the health of non-White women the most, a group that already suffers from maternal mortality rates that are much higher than they are for their White counterparts.