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Sen. Lindsey Graham (R-S.C.) attends the third day of Supreme Court nominee Amy Coney Barrett's confirmation hearing before the Senate Judiciary Committee on Capitol Hill on October 14, 2020 in Washington, DC. (Photo: Erin Schaff-Pool/Getty Images)

Sen. Graham's Proposed Abortion Ban Could Kill Thousands of Women and Children in the Next Decade

Not only then would Sen. Graham’s proposed abortion force millions to carry pregnancies to term against their will, but it could very well be associated with the deaths of thousands of women and children in the following decade.

Kenneth Antonio Colón

Earlier this week, Senator Lindsey Graham introduced a bill to ban abortions nationwide after 15 weeks. Such a bill, if passed, could prove disastrous for the health of our nation's women and children, resulting in thousands of avoidable deaths.

Such a clearly disastrous, lethal, and freedom-restricting policy must be vigorously opposed by elected officials and the American people—Democrat and Republican alike—at every possible turn.

According to CDC data, there were 491,901 abortions in 2019 in the U.S. for which the gestational age was known, with 21,527 of these abortions occurring in weeks 16 or later (roughly 4% of total abortions).

Recent analyses have estimated that a nationwide abortion ban would result in 49 additional maternal deaths in the first year, and 140 additional maternal deaths every subsequent year. This figure, however, is related to a ban on all abortions. What would the impact be of only banning abortions after a certain gestational age, as in Sen. Graham's bill?

One potential estimate comes from the UCSF Turnaway Study—a longitudinal study of the effects of unwanted pregnancies on women's lives. Of the 231 study subjects who were turned away from abortion providers due to advanced gestational age, one subject subsequently died within 10 days of delivery from an infection associated with higher mortality risk for pregnant women, relative to nonpregnant women.

Applying this rate of 1 maternal death per 231 abortions denied due to advanced gestational age to the 21,527 abortions occuring in Weeks 16 or later—those which would be denied under Sen. Graham's bill—suggests 93 excess maternal deaths. Granted, the Turnaway Study deals with a relatively smaller number of participants, so these results should be treated with a degree of caution.

However, one analysis of state-level abortion policies by Vilda et al. found that, controlling for other correlates, states with gestational age limits on abortion had 10% greater total maternal mortality. If we were to apply these findings to the 935 pregnancy-related deaths in the U.S. in 2018, this would imply as many as 94 additional pregnancy-related deaths could be associated with a national gestational age law—nearly the exact same number as the Turnaway Study might suggest.

Increased mortality rates due to denied abortions applies not only to maternal mortality, however. In fact, Karlestos et al. found that gestational age limit laws were associated with 0.23 excess infant deaths per 1,000 live births. Applying these results to the 3.6 million live births at the national level would suggest roughly 831 excess infant deaths with a national gestational age limit. 

Pabayo et al. found an even greater impact on infant mortality, with an 8% increase in infant mortality risk in states with 1-2 laws restricting access to abortion, and a 10% increase in states with 3 or more laws restricting access. Given 19,582 infant deaths at the national level, an 8% increase in infant mortality would suggest 1,567 excess infant deaths attributable to the passage of a single restrictive abortion law at the national level.

It's likely, however, that basing national-level death toll estimates on state-level analyses would result in under-estimation of deaths, given the majority of these state-level gestational age limits are at 22 weeks—a full seven weeks later than Sen. Graham's proposed ban. Notably, only 1% of abortions in the U.S. occured at weeks 21 or later, as opposed to roughly 4% in weeks 16 or later.

On the other-hand, extrapolating from state-level analyses to the national level could be equally problematic in the other direction, given the differing population sizes and characteristics, potentially causing us to overestimate the expected death toll.

So what then does this research, caveats and all, say about Sen. Graham's proposed abortion ban? Based on what we've outlined thus far, we might cautiously estimate an additional 93 maternal deaths per year and an additional 831 excess infant deaths per year associated with the passage of Sen. Graham's proposed ban—or 9,240 excess maternal and infant deaths over the subsequent decade.

Not only then would Sen. Graham's proposed abortion force millions to carry pregnancies to term against their will, but it could very well be associated with the deaths of thousands of women and children in the following decade.

Even if these estimates overshoot the death toll by a full factor of 10, well over 900 otherwise-avoidable deaths of women and children should not be something we as a nation are willing to accept.

Such a clearly disastrous, lethal, and freedom-restricting policy must be vigorously opposed by elected officials and the American people—Democrat and Republican alike—at every possible turn. 


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Kenneth Colon

Kenneth Antonio Colón

Kenneth A. Colón, MPA is a Research Affiliate at the Yale University School of Public Health.

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