Abortion bans aren’t protecting lives, they’re jeopardizing them

On Dec. 1 the Supreme Court heard oral arguments centering on a Mississippi law that bans abortion after 15 weeks of pregnancy. Today, the conversation has turned to what the court will decide and how far it might go. The majority of justices seem prepared to uphold the Mississippi law. If that happens, 21 other states are poised to enact similar laws.

Beyond the clear violation of individual rights that these laws impose, the public health consequences will be catastrophic.

Our decades of experience practicing medicine and public health are why we joined more than 500 of our colleagues from around the country in signing an amicus brief urging the court to strike down Mississippi’s law. Far from “protecting life,” draconian abortion bans such as Mississippi’s are detrimental to the health and lives of mothers and the babies they are forced to carry to term, as well as to their families and communities.

Maternal and child health are closely linked to a woman’s ability to plan her pregnancy. Safe and legal abortion, like contraception, is an essential component of reproductive health. Abortion rates have declined in recent years, largely due to the increased availability of contraception. But contraception isn’t foolproof. More than half of women who have an abortion are actually using some form of birth control.

Moreover, many women — especially younger women and teens — might not recognize they are pregnant by the 15-week mark. In addition, the Mississippi law makes no exceptions in cases of rape or incest. For women and girls who have been assaulted and become pregnant, these traumatic events can hinder their ability to process what has happened to them, let alone to understand they are now pregnant. 

Even if recognized early, unwanted pregnancies can lead to a range of health issues.

We cite an extensive body of research in the amicus brief that documents the harmful health impacts of restricting access to abortion. This includes maternal and infant mortality, premature birth, developmental difficulties and the increased likelihood of exposure to significant traumas that can trigger intergenerational harm.

Planning a birth means being able to enter pregnancy in the best health possible. Women with unintended, and particularly unwanted, pregnancies are far less likely to receive adequate and timely prenatal care, placing them and their babies at greater risk for poor health outcomes. Plus, unintended pregnancy is strongly associated with preterm birth and low birthweight — together, leading causes of higher rates of infant death, lifelong chronic illness and developmental disabilities.

Restrictive abortion policies also increase the risk of maternal death. Research shows that women living in states with the most restrictive abortion policies are more likely to die while pregnant or shortly thereafter than women living in states with less restrictive abortion policies. In Mississippi, it is 75 times more dangerous for women to carry a pregnancy to term than to have an abortion. (Nationally, the health risks associated with childbirth are 14 times greater than risks associated with abortion.)

There is also a risk of additional violence and trauma for some women and their children. Studies have revealed higher rates of physical violence against women with unintended pregnancies, and that children born of unintended pregnancies (and their siblings) are more likely to suffer neglect, violence and abuse. The consequences of these toxic home environments reverberate throughout the lives of these women and children. 

Finally, any ban on abortion will disproportionately affect young women, women of color and low-income women who live in families and communities already vulnerable to elevated health and social risks and reduced access to health care. In fact, pregnancy-related mortality rates for Black women are more than three times higher than those for white women, and rates for Native American and Alaska Native women are over two times higher compared to rates for white women. Women who are denied abortions are also subsequently more likely to live in poverty, to lack financial support critical to better health outcomes, such as housing and nutrition and to raise their children alone. 

Ironically, 14 states with the nation’s most restrictive abortion laws, including Mississippi, invest the least in policies and programs aimed at improving the health of women and children. In a Commonwealth Fund study, Mississippi ranks last in the nation on a score that measures infant mortality, preventable death and other benchmarks of child health. Perhaps rather than restricting abortion access (or banning it outright), these states should focus their energies on policies and programs that make the decision to bear children less difficult rather than consigning thousands of women and children to unnecessary health risks.

The evidence overwhelmingly points to abortion access as a necessary tool in promoting health and mitigating health threats to women and their families. Mississippi’s law — and the legion of similar laws poised to be enacted across the country — not only threatens a woman’s constitutional rights but poses a direct threat to human life. The Supreme Court must strike it down to prevent unnecessary human tragedies.  

Lynn R. Goldman is the Michael and Lori Milken Dean of the Milken Institute School of Public Health at the George Washington University. Georges C. Benjamin is the Executive Director of the American Public Health Association.