Due to the controversial nature of abortion, it is very difficult to find reliable data in order to compare pregnancy outcomes of women in the United States. When most observers consider safety related to abortion, they only consider physical complications, but they should also consider psychological complications, which can also lead to a woman’s death. One comprehensive study analyzed 22 studies which considered mental health consequences of abortion. It found that there was an 81 percent overall increased risk of mental health problems after abortion. The safety of abortion is determined less by whether it is legal, and more by other factors such as available technology, gestational age in which it is committed, and the skill of the practitioner.
The frequency of complications increases as the pregnancy advances. Only half of U.S. states require abortionists to report their complications and no states require non-abortion doctors, coroners, or emergency rooms to report abortion-related deaths for investigation. Deaths are counted by the CDC only if they happen to come to their attention through death certificates, anecdotal reports, reports to state health agencies, quality committees, or Morbidity & Mortality committees.
For many reasons, the information about a preceding abortion may not make it onto a death certificate. The abortion may have initiated a cascade of events resulting in death, but only the most proximate events may be listed on the death certificate. The physician who completes the death certificate may be unaware of the abortion, which could happen if a sick woman presents to the emergency room, but leads the staff to believe that it was a miscarriage and not an abortion that led to her complication. If she is too sick to give a history, the family may be unaware of, or may be embarrassed about the abortion.
An ideologic commitment to legal abortion may lead a physician to leave this information off of the death certificate. A single investigative reporter was able to document 30 percent more abortion-related deaths nationwide than the CDC had listed, merely by correlating public documentation of malpractice cases with autopsy reports.
It is clear with the incomplete records available in the U.S., the political nature of abortion, and the ideological commitment of many academic researchers to legal abortion, that the question of comparative safety of abortion to childbirth is unlikely to be answered in our country.
A more complete, and less biased way to look at this question is to perform a records-linked study in a country with a more neutral view on legalized abortion, single payer health care so that records on all procedures are readily available, and more complete death certificate documentation.
Studies in other countries such as Finland have shown that women who have had abortions are 3.5 times more likely to die within a year than women who have carried their pregnancies to term. Researchers concluded that this may be due to the fact that carrying a baby to term has a protective effect on women’s bodies by reducing the risk of breast cancer as well as the risk of emotional stress.