Risks of Abortion vs Childbirth

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It is commonly reported that abortion is safer than child-birth. A recent study from Finland raises questions about this claim.

The study was conducted by the National Research and Development Centre for Welfare and Health, or STAKES for short (from its acronym in Finnish). The goal of this study was to examine the accuracy of reported statistics on pregnancy-related deaths. Typically, statistics like this are computed by examining the cause of death listed on death certificates. But the researchers observed that it can be very difficult to determine whether a particular death was or was not related to pregnancy. For example, there are medical conditions that are dangerous in general, and that the extra stress of pregnancy might make worse.

So in this study, STAKES compared death records against birth, abortion, and hospitalization records. From this, they were able to identify virtually all women in Finland who had died within one year of pregnancy, and then examine medical information about each case.

Their conclusion was that statistics on pregnancy-related deaths occuring soon after the pregnancy were generally accurate -- within 13% -- but that longer-term problems were difficult to nail down and probably under-reported.

But along the way, they came up with another very interesting statistic: women who had an abortion were almost four times as likely to die within a year as women who gave birth. Specifically, they found the following death rates following pregnancy:

live birth: 27 per 100,000
miscarriage: 48 per 100,000
abortion: 101 per 100,000

Or graphically:

Maternal death rate
following live birth, miscarriage, or abortion

Deaths per 100,000 from all causes

(Your browser must support HTML5 and Javascript to display the grpah.)

Note this includes deaths from all causes, so many of these are not related to the pregnancy. If a woman is killed in an automobile accident 11 months after havig a miscarriage, this probably has nothing to do with the pregnancy, but it is still counted in the above totals. But the whole point of this study was that it's often hard to say. Like in the auto accident example, it's possible that she was physically weakened by the pregnancy or the trauma of miscarriage, and this made her less alert. By using the same, simple rule for all post-pregnancy deaths, they should all be equally inflated, and so comparison between them should be valid.

Source: Gissler, Mika 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.
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Posted 18 Sep 2000.

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