New research from the University of Colorado in Boulder shows that banning abortion in the U.S. could lead to a huge increase in maternal deaths, particularly for Black women who already face a high maternal mortality rate.

Forthcoming in the journal Demography, the study, which is currently available as a preprint, finds that if all abortions in the U.S. are banned, pregnancy-related deaths would increase by 21 percent. Among Black women, maternal deaths would increase by a third.

Compared with other high-income countries, the U.S. ranks as one of the worst in maternal mortality, particularly for women of color who already face disparities in care. Black women are three times as likely to die of pregnancy-related causes than white women.

According to the Commonwealth Fund, it’s more dangerous to have a baby in the U.S. in 2021 than it was in 2000, despite the medical advancements of the last 20 years.

Researchers point to a variety of causes for these disparities, including racial bias in the health care system, higher rates of chronic disease, and lack of access to quality health care.

Policymakers have recently begun to pay more attention to the maternal mortality crisis. In Colorado, lawmakers recently passed legislation aimed at improving maternal health care, including for people who are incarcerated. Along with these advancements, however, comes a torrent of abortion restrictions and attacks on reproductive rights that threaten to exacerbate the crisis.

“Increasing Black women’s exposure to the risk of pregnancy-related mortality by denying them access to abortion would exacerbate an existing public health crisis,” said study author Amanda Stevenson, an assistant professor of sociology, in an interview with CU Boulder Today.

The study comes in the midst of a devastating year for abortion rights and access, particularly in Texas, where abortion is mostly banned due to a law that took effect on September 1. In allowing Texas’ SB8, which bans abortions at 6 weeks, to take effect, the U.S. Supreme Court signaled a lack of interest in upholding the constitutional right to abortion established in Roe v. Wade and gave conservative state governments a green light to pass abortion restrictions.

Since then, Florida has already introduced a copycat version of the Texas law and several Republican governors have promised to do the same.

In December, the court plans to hear a case that presents a direct challenge to Roe v. Wade, threatening to further unravel abortion rights and access nationwide.

At the core of the new CU Boulder study is the reality that continuing a pregnancy in the U.S. carries a much higher risk of death than having a legal abortion – 14 times more likely, according to a 2012 study. In fact, having an abortion is safer than getting your wisdom teeth removed or having a colonoscopy.

While unsafe abortion killed hundreds of people per year prior to the Roe v. Wade ruling in 1973, advances in medication abortion, which uses pills rather than a procedure, have made it increasingly common and safe for people to manage their own abortions outside of a clinical setting.

For example, organizations like Plan C and Aid Access help people get abortion pills via mail and manage their abortion at home, and Planned Parenthood is increasingly relying on telehealth for abortion services. But bans on telemedicine for abortion in some states and other financial, logistical, and legal barriers will continue to push care out of reach for some despite these advancements.

While some people will resort to unsafe measures for ending a pregnancy when legal abortion is inaccessible, Stevenson explains that the existing medical dangers associated with carrying a pregnancy to term in the U.S. are the likely driver of pregnancy-related death in the absence of legal abortion.

“We need to stop talking about coat hangers and start talking in an honest way about how these laws will actually impact women’s lives and mortality,” said Stevenson. “This study provides one piece of the evidence we need to begin that hard conversation.”