Across the world, the amount of money that a nation spends on health care is directly correlated with its maternal mortality rates. The United States, however, is an exception. And one social scientist asks how a country that spends more on health care per capita than any other country in the Organisation for Economic Co-operation and Development has such high rates. Her conclusion: Restrictive laws governing abortion and reproductive health lead to an increase in maternal mortality.

Summer Sherburne Hawkins, an associate professor at Boston College’s School of Social Work, published "Maternal Mortality Is Worse in Washington, D.C. Than Syria. Abortion Access Is One Reason Why," on NBC News on February 18. The piece opens with a comparison of U.S. maternal mortality rates with those of countries either experiencing war or working with smaller national budgets:

From 2007 to 2015, Syria‘s maternal mortality rate rose from 26 deaths per 100,000 live births to 31 deaths per 100,000 live births, a result of the country’s war and a crumbling health care system.

In Washington, D.C., where politicians make decisions about both what the United States will do about the war in Syria and American women’s access to reproductive health care, the average maternal mortality rate across the same eight-year period was 33 deaths per 100,000 live births.

And that is for woman of all races: The rate of maternal mortality for African American women living in our nation’s capital is 59.7 deaths per 100,000 live births—worse than Panama (52) or Ecuador (59).

Hawkins stresses that the issue goes beyond economics—it is also significantly impacted by sociopolitical realities:

Over the past decade, the U.S. has witnessed a changing political, economic and social climate related to women’s reproductive health. Many states have restricted women’s access to abortion, and funding cuts to Planned Parenthood have resulted in clinic closures. Nine states passed bills in 2019 to reduce the window of opportunity for when women are allowed to have an abortion, including Georgia, Kentucky, Louisiana, Mississippi and Ohio which prohibited abortions after a fetal heartbeat could be detected—effectively banning the procedure for many women who do not realize they are pregnant until later than that. As of February 1, 2020, the Guttmacher Institute found bills in another 17 states that would effectively ban all abortions based on various criteria and 16 states has bills to ban abortions after 12 weeks.

Hawkins led a 2019 study, "The Impact of State-Level Changes on Maternal Mortality: A Population-based, Quasi-Experimental Study," that further explored the consequences of state laws and policies on reproductive health. It reads:

We found that both a state’s enactment of gestational limits for abortion and the Planned Parenthood clinic closures in a state increased its maternal mortality rates. Legislation that restricted abortions based on gestational age—often, in the time period we studied, by prohibiting abortions later than 20 weeks, though more recent bans are proposed to start earlier—increased mortality by 38 percent, primarily among White women, although rates were higher across all racial/ethnic groups.

While she sees legislative hope with the passage of the Preventing Maternal Deaths Act of 2018 by Congress, Hawkins also points to the danger in the passage of state bills to prohibit abortion after eight weeks of pregnancy or earlier. She writes, "We need politicians to move beyond short-term political decisions and consider the longer-term impact of policies on women’s health.”

Read the entire article here.