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A recently published law review article suggests that a ban on abortion, even in the first trimester, may now be allowed under the legal standards established in the Supreme Court’s landmark Roe v Wade decision. The team of authors, including medical researchers, physicians, and an attorney, argue that this shift in practice, arising from new medical evidence of abortion’s risks, will not require a change in constitutional law.

The Supreme Court specifically grants that states have a “compelling interest” in regulating or banning abortion to protect women’s health when the risk of death associated with abortion exceeds the risk of death associated with childbirth. When Roe was decided in 1973, it was commonly believed that mortality rates associated with abortion in the first trimester were lower than the mortality rate associated with birth. States were therefore allowed to regulate abortion to protect women’s health only after the first trimester.

In the last seven years, however, four major epidemiological studies have shown that abortion is actually associated with higher rates of death compared to childbirth. The most recent study of pregnancy-related deaths was published earlier this year in the American Journal of Obstetrics and Gynecology. That study, linking birth, death, and abortion records for the entire country of Finland over a thirteen year period, found that women who had abortions were three times more likely to die than women who gave birth. Findings like these have completely reversed scientists’ conclusions regarding the relative risk of deaths associated with pregnancy outcome.

According to the lead author of the law review article, David Reardon, Ph.D., director of the Elliot Institute, “Prior to 1997, all the attempted comparisons of mortality rates employed relied on subjective reports, dissimilar measures, and even unequal time frames. These objective record-based studies, however, directly link death certificates to centralized records of abortion and childbirth. This methodology is far better than anything that was available before. In the seven years since the first of these record-based studies was published, no one has come forward with a single study contradicting these findings. Instead, the findings have been reaffirmed again and again.”

The article Reardon and his colleagues published in The Journal of Contemporary Health Law & Policy includes a detailed review of the literature on abortion related mortality pre- and post-dating the 1997 shift in research. It also examines how and why prior comparisons were inadequate or even misleading. In addition, the authors examine how the findings of these record-based mortality studies are supported by other recent research linking abortion to a decline in general health and an increase in psychological morbidity.

This body of new research, however, has mostly been ignored in the medical community. Reardon and his colleagues comment on this fact in their article, stating, “While some medical experts will certainly continue to defend the opinion that abortion is a safe alternative to childbirth, this opinion can no longer be characterized as an ‘established fact.’ It is at best an unsubstantiated opinion, most likely a hope, and at worst, an ideological mantra.”

The authors conclude their paper with the observation: “After thirty years of experience with legal abortion in the United States, it is now clear that mortality risks associated with abortion significantly exceed those associated with childbirth, both in the short term (under one year) and in the longer term. While statistical association is not proof of causation, it is clear that abortion is, at the very least, a marker for elevated mortality rates. In the context of the additional studies reviewed in this paper, it is also clear that the interpretation of a causal effect cannot be ruled out. It is therefore reasonable for legislators to conclude that abortion, at any stage of pregnancy, poses a significant risk to women’s health. Since Roe established comparative mortality rates as the standard for determining when states can regulate abortion to protect the health interests of women, this new medical evidence would appear to be sufficient to establish a compelling state interest in regulating abortion throughout all stages of pregnancy.”

     Reardon DC, Strahan TW, Thorp JM, Shuping MW. “Deaths associated with abortion compared to childbirth: a review of new and old data and the medical and legal implications.” The Journal of Contemporary Health Law & Policy 2004; 20(2):279-327.
     Gissler M, Berg C, Bouvier-Colle MH, Buekens P. “Pregnancy-associated mortality after birth, spontaneous abortion or induced abortion in Finland, 1987-2000.” Am J Ob Gyn, 2004; 190:422-427.
     Gissler M, Kauppila R, Merilainen J, et al. “Pregnancy associated deaths in Finland 1987-1994: definition problems and benefits of record linkage.” Acta Obstetricia et Gynecologica Scandinavica 1997; 76:-651-657.
     Reardon DC, Ney PG, Scheuren F, Cougle J, Coleman PK, Strahan TW. “Deaths associated with pregnancy outcome: a record linkage study of low income women.” South Med J 2002; 95(8):834-41.
     Gissler M, Hemminki E, Lonnqvist J. “Suicides after pregnancy in Finland: 1987-94: register linkage study.” British Medical Journal 1996; 313:1431-4.
[26Jul04, Elliot Institute (217) 525-8202,]