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January 25, 2026
A comprehensive analysis of nearly 15 million births and 3.7 million abortions in the United States has revealed a stark and widening disparity in maternal health outcomes. According to a new study, the risk of death associated with carrying a pregnancy to term is now between 45 and 70 times higher than the risk associated with legal induced abortion—a ratio that has at least tripled since the early 2000s.
The findings, published in JAMA Network Open, come at a pivotal moment for U.S. public health, providing a data-driven look at the relative safety of reproductive healthcare outcomes just prior to major shifts in national abortion access.
Quantifying the Risk: A Threefold Increase
The study, led by Maria W. Steenland, SD, of the University of Maryland’s School of Public Health, analyzed data from 2018 through 2021. Researchers utilized the National Vital Statistics System and the Pregnancy Mortality Surveillance System to track outcomes for 14,902,571 births and 3,662,580 abortions.
The core metric used in the study is the “mortality ratio”—the number of deaths per 100,000 events. The results were striking:
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The Baseline Gap: The mean ratio between pregnancy-related and abortion-related mortality was 69.6.
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Adjusted Figures: Even after excluding non-specific causes of death, the ratio remained at 52.9.
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The COVID-19 Factor: Recognizing that the pandemic skewed maternal health data, researchers removed COVID-related deaths from the equation. The resulting ratio was 44.3.
For historical context, this represents a massive surge from previous data. A similar study using data from 1998–2005 found a mortality ratio of 14.7. Essentially, the safety gap between childbirth and abortion has at least tripled in the last two decades.
Why is the Gap Widening?
To understand these numbers, it is essential to define what “pregnancy-related death” means. In this study, it refers to a death occurring during pregnancy or within one year of the end of pregnancy from any cause related to or aggravated by the pregnancy.
“We found that the risk of mortality from ongoing pregnancy was far greater than the risk associated with induced abortion,” the authors noted.
Several factors contribute to the rising risks of childbirth in the U.S. compared to the relative stability of abortion safety:
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Maternal Health Crisis: The U.S. continues to face a rising maternal mortality rate, driven by cardiovascular conditions, hemorrhage, and sepsis, often exacerbated by underlying chronic conditions like hypertension and diabetes.
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Safety of Abortion Care: Modern abortion care, particularly medication abortion and early procedural intervention, has a highly established safety profile with extremely low complication rates.
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Systemic Barriers: Disparities in access to prenatal and postpartum care continue to disproportionately affect marginalized communities, driving up the national average for pregnancy-related deaths.
Expert Perspectives
Independent experts suggest these findings have significant implications for informed consent and public policy.
“This data provides a sobering reality check on the biological and systemic toll of pregnancy in the United States,” says Dr. Elena Rossi, an OB-GYN and maternal-fetal medicine specialist not involved in the study. “While childbirth is a joyful event for many, it is medically complex. When we discuss reproductive health, we must be honest about the comparative risks involved.”
The study authors also addressed the legislative landscape. “Some policy and academic experts have argued that abortion bans themselves will increase pregnancy-related mortality by denying some people abortion care, therefore exposing them to increased health risks from ongoing pregnancy,” they wrote.
Understanding the Limitations
While the study is massive in scale, researchers pointed to several caveats:
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The “Checkbox” Effect: Data was limited to 2018–2021 because the “pregnancy checkbox” on death certificates—a tool to help identify maternal deaths—was not universally implemented in all states until 2018.
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Rare Events: Abortion-related deaths are extremely rare, occurring only two to six times per year nationally. Because the denominator is so small, even a single additional death can cause significant statistical fluctuations.
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Pre-Dobbs Data: The study period ended in 2021, meaning it does not reflect the impact of the 2022 Dobbs v. Jackson Supreme Court decision, which ended the federal right to abortion and led to bans in multiple states.
What This Means for Patients
For the average reader, these statistics are not meant to cause alarm but to provide a clear picture of the importance of high-quality maternal care.
“The takeaway isn’t that pregnancy is ‘unsafe’ in a vacuum, but that it is a significant medical undertaking that requires robust support,” says Dr. Rossi. “It also highlights that abortion is, statistically speaking, one of the safest medical interventions available.”
As the U.S. continues to grapple with a maternal health crisis, this data underscores the need for policies that support pregnant people through every stage of their journey—whether that journey leads to parenthood or the termination of a pregnancy.
References
- https://www.medscape.com/viewarticle/us-data-reveal-increases-pregnancy-mortality-compared-2026a10002a6
Medical Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making any health-related decisions or changes to your treatment plan. The information presented here is based on current research and expert opinions, which may evolve as new evidence emerges.
