People, historically, are known to accept as factual that which is not.

If they hear something repeated often enough, and forcefully enough, many people tend to accept it at face value.

In fact, that was a frequent comment of Hitler.

Consequently, propaganda, prejudices, and old wives’ tales have far more impact than they should. Thus, medical wisdom should lead us to discover how & where so-called “facts” developed, before we accept them as truth.

In the summer of 1971, the American College of Obstetrics and Gynecology (ACOG) filed a brief before the U.S. Supreme Court asserting that “the medical procedure of induced abortion is potentially 23.3 times as safe as the process of going through ordinary childbirth.” 1

A couple of years later, in considering its Roe v. Wade decision, the Court “took as ‘established medical fact’ the contention that in the first 3 months of pregnancy ‘mortality in abortion is less than mortality in normal childbirth’.”2 Realizing that ‘safety’ in childbirth can be evaluated in terms of morbidity (complications) and/or mortality (death), we will direct our attention to evaluating ‘safety’ in terms of maternal mortality (maternal death) in this article.

The claim of the relative safety of abortion over pregnancy and childbirth has become one of the rallying cries for pro-abortion forces and is still supported by organizations such as the American Medical Association. In the April 5, 1989 edition of the Atlanta Journal and Constitution, the AMA continued to state, “The medical risks to a woman of childbirth are greater than the risks of abortion.” But how much truth is there to this claim?

To separate fact from fraud, one must first find out how comparisons are made between maternal mortality rates for childbirth and for abortion.

In 1983, the Maternal Mortality Collaborative, a special interest group of ACOG, began monitoring maternal deaths from 19 reporting areas between 1980-1985. It defines such mortality as: “the death of any woman that was caused or contributed by pregnancy, occurring during pregnancy or within one year of the termination of the pregnancy.”3

These deaths are sub-categorized as directly resulting from complications of childbirth, indirectly resulting from pre-existing health problems, and resulting from “non-maternal” causes which were accidental or incidental to the pregnancy.

Another major source of mortality figures for various studies is the National Center for Health Statistics. They define maternal mortality to include deaths up to 42 days after the termination of pregnancy. All state health departments forward information from death certificates to this national source where figures are analyzed, coded and computerized.

State regulations regarding the death certificates themselves vary. For example, according to the Georgia Vital Records Department, the funeral home receiving the body is responsible for the completion of such forms. A doctor (either M.D. or D.O.) or coroner fills out the medical portion, which includes three lines for direct or contributing causes of death. Unfortunately, these forms are often left incomplete.

It is clear that there is no consistent standard or definition by which these statistics are gathered and reported. Therefore, even at the basic level of these mortality statistics, there are inherent differences and potential problems.

Abortion-related mortality is defined as those deaths resulting directly or indirectly from abortion complications whether they be physical or emotional.

Statistics Flawed

When comparing overall maternal mortality rates with abortion-related death rates, researchers generally calculate the number of maternal deaths per 100,000 live births, versus abortion-related deaths per 100,000 abortions performed.4 This method of comparison has several inherent flaws:

**Though abortion deaths are measured per case, overall maternal mortality is measured per live births:

Abortion deaths                                   Maternal deaths

# of abortions                                     # of live births

The equation on the left only includes abortion deaths per number of abortion procedures.

The equation on the right includes all maternal deaths (including stillbirths, miscarriages, abortions, and ectopic pregnancies) in the numerator.

The denominator eliminates these “cases of pregnancy” since they do not result in a live birth, thus, “inflating” the number of maternal deaths. (Statistically, there would be about 120,000 “cases of pregnancy” for every 100,000 live births, resulting in a much lower mortality ratio.)

** Maternal death rates actually include all abortion-related deaths – the very data to which they are compared.

** Maternal mortality figures also include deaths from ectopic pregnancies. However, in 1979, ectopic pregnancy deaths were excluded from the abortion mortality ratio even though between 1972-1981, 21 deaths resulted from ectopic pregnancies that occurred soon after an attempted legal abortion.5

** Deaths from causes completely unrelated to the pregnancy, such as auto accidents, physical abuse, homicide, etc. are usually included in maternal mortality figures.

** Studies compare the isolated procedure of abortion with maternal deaths which include deaths over the entire 9 months of pregnancy and several months to a year post-partum. No attempt is made to compare “apples with apples”, i.e. deaths occurring from abortions performed within the first 20 weeks of pregnancy, compared to maternal deaths occurring during this same period.6