Women with high-risk pregnancies could die if Roe knocked down


June 1, 2022 – Kendra Joseph of San Antonio, TX had given up on the idea of ​​having a second child. At 40, and with a daughter pleading for a sibling, she and her husband were worried about the risk of trying for another child due to her advanced maternal age. Joseph had terminated an earlier pregnancy at 15 weeks after discovering his son had Edwards Syndrome, a genetic trait that is fatal in most cases.

Now a new Texas law that bans abortion beyond 6 weeks would mean that if she or her baby were at risk of dying, she might still have to carry the baby to term. For Joseph, it wasn’t worth the risk at first. Then in February, just when they had decided not to have another baby, the couple found out they were pregnant. She is thrilled with her pregnancy, but the past few months have also been nerve-wracking.

“It’s scary to be pregnant anyway,” she says, “but these new restrictions add a layer of stress.”

Twenty-eight states could ban or severely restrict abortion if the Supreme Court overturns the landmark Roe v. Wade. A leaked version of the court’s opinion was widely interpreted as signaling that the court would overturn the law. This means that women who are at higher risk of complications during pregnancy or those who suffer from chronic conditions before becoming pregnant are at risk of dying if they cannot have an abortion.

According to the CDC, the maternal mortality rate in the United States in 2020 was 23.8 deaths per 100,000 live births – among the highest in the developed world. The rate is eight times higher than in countries like the Netherlands, Norway and New Zealand.

“Many of the women I care for have pregnancies that present a real and present danger to their health, and this often goes hand in hand with the fact that they are highly unlikely to have a healthy baby,” says Chavi Karkowsky, MD, specialist in maternal-fetal medicine at Montefiore Medical Center in New York.

Maternal mortality, she says, can be caused by health issues that some women may not experience until they become pregnant. (For example, finding out she had cervical cancer during a prenatal visit and then having to choose between chemotherapy and her baby.) And there are also life-threatening conditions caused by pregnancy, such as preeclampsia, which can cause high blood pressure and kidney damage. , as well as gestational diabetes. Research has also shown that the risk of maternal death increases with age.

Researchers from the University of Colorado, in a study published in the journal Demography, found that banning abortion nationwide would lead to a 20% increase in maternal deaths. For black women, the increase in mortality could be as high as 33%, due to higher poverty rates and reduced access to health care, says Amanda Stevenson, PhD, a sociologist at the University of Colorado and l one of the authors of the study. According to the CDC, black women in the United States are more than three times more likely to die from pregnancy complications due to poor health care exposure, structural racism, and chronic health conditions.

If Roe v. Wade is canceled, more women are likely to die because staying pregnant poses a much higher mortality risk to them than the risk associated with having an abortion, Stevenson says.

For women with high-risk pregnancies who need an abortion, traveling out of state puts them at health risk, says Jamila Perritt, MD, OB/GYN in Washington, DC, and president of Physicians for Reproductive Health. In places where abortion is restricted, this can lead to significant delays in accessing medical care. “Abortion is an urgent procedure, and as the pregnancy progresses, it can become increasingly difficult to find a clinic that will provide care,” she says.

She remembers one of her patients who had a heart problem requiring the termination of a pregnancy. The patient first had to travel to find a doctor who could assess her unique condition, then travel out of state to have an abortion. All the while, time was passing and his health was in danger. In this case, the patient had the money to travel out of state, find daycare, and pay for the procedure.

“She was a resourceful person, and while it was difficult for her, it wasn’t impossible,” Perritt says.

Many states with the highest maternal mortality rates, including Louisiana, Texas, Arkansas, Alabama, South Carolina and Georgia, also plan to strictly limit abortions or ban them altogether. Some opponents of abortion insist that it will not harm mothers.

“The pro-life movement loves both babies and moms,” says Sarah Zagorski, spokesperson for Louisiana Right to Life. “It is a tragedy that Louisiana has high death rates among pregnant women. However, legal abortion does not improve those rates.

But for many women who need an abortion, statewide bans can make abortion difficult. This worries Kendra Joseph, who is now 18 weeks pregnant.

“I try to forget the bad things that could happen, but it’s really hard when you’re dealing with these totally unnecessary and cruel restrictions. As women, we lose so much,” she says.


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