Executive Summary: Decriminalizing and including abortion care as integral to health care reduces maternal and infant mortality. Criminalizing abortion increases pregnancy-related deaths and rates of admission for sepsis because women cannot access lifesaving medicines or uterine evacuation procedures. Women who miscarry, a common occurrence (up to 1 in 5 pregnancies), often need medical intervention, including medicines and procedures used for abortion. Women diagnosed with life threatening cancers cannot get treatment without full spectrum reproductive care. Abortion bans are creating maternal care deserts, worsening access to care, and eliminating training in states that criminalize abortion care, exacerbating health disparities across state lines. Women who are the most vulnerable are disproportionately affected by laws that criminalize and ban abortion. Lifesaving legislation is needed to prevent unnecessary deaths, life-long trauma, and loss of fertility.
Background: Since the United States Supreme Court overturned Roe v. Wade in 2022 in Dobbs v. Jackson Women’s Health, disparities in access to reproductive care across states have widened dramatically. Today, 2 in 5 (25 million) women of childbearing age in the US live in a state with an abortion ban. Abortion bans threaten pregnant people’s safety and autonomy with cascading impacts on providers and health systems. Due to legal uncertainty in many states, people experiencing obstetric emergencies cannot access necessary care, putting them at risk of death, lifelong complications, or infertility.1 Maternal mortality rates vary dramatically from state to state, exacerbated by abortion bans and criminalization of abortion.2 Pregnant women living in states that banned abortion are nearly 2x as likely to die during pregnancy or postpartum when compared to people living in states where abortion was legal and accessible.3 We should all agree that families should not suffer preventable death or face lifelong consequences. Access to reproductive health care is essential, and abortion is one of the critical interventions that must be taught and practiced to save lives. Protecting the lives and health of pregnant people is a truly pro-life position.
We can learn from statistics in the US after the Roe v, Wade decision, where maternal mortality decreased and admission for sepsis plummeted. In other countries, advocacy and awareness has reshaped the landscape of reproductive care. In Argentina, decades of grassroots activism—known as the “Marea Verde” or “Green Wave”—brought the facts to the public and the legislators: over 4,500 hospital admissions and nearly 1,500 deaths had resulted from banning and criminalizing abortion, particularly impacting those with the fewest resources. In 2022, the legislature legalized abortion, making it part of reproductive care. In Ireland, public outrage over the death of a young woman denied care during miscarriage galvanized reform and led to legalized abortion to protect pregnant people’s lives. In the US, abortion bans have already caused preventable fatalities, largely because of the inability to access routine procedures such as a D&C,4,5 soaring sepsis rates, especially in the case of miscarriage in the second trimester,6 and higher rates of blood transfusions during miscarriages, indicating the consequences of delays in care due to these bans.7 These bans are already having devastating consequences. We need to intervene now to prevent additional suffering and deaths of women in the United States – the futures of our sisters, mothers and daughters depend on it.
The repercussions of state abortion bans extend well beyond the infringement on reproductive autonomy and access to abortion. A new law is needed.
1. Access to timely abortion saves lives: The people who are the most impacted are those who face barriers to healthcare. The data from the US and countries all over the world clearly demonstrate that decriminalization and legalization of abortion reduce admissions for sepsis and decreases maternal & infant mortality. See factsheet in Appendix 1.
2. Current laws do not protect women in the case of emergency: While all states with abortion bans include exceptions for the life or health of the pregnant person, these provisions are often vague or so restrictive that they are functionally unworkable in a medical setting.8 This leads to arbitrary standards regarding viability and when and whether a woman's life is threatened. For example, most allow abortion if there is a “serious risk of substantial and irreversible impairment of a major bodily function,” yet only one state defines what qualifies as a “major bodily function” or a “substantial impairment.”8 This legal ambiguity forces providers to seek legal counsel before providing care—even in urgent situations—delaying treatment and increasing patient risk. A summary of prior attempts for legislation is included in Appendix 2.
3. Medical decisions are too complex to legislate, and current laws are undermining evidence-based medicine: Laws that exist today directly contradict medical standard of care. Especially in the cases of obstetrical emergencies, states may only specify a small number of obstetrical emergencies that may fall under an exception (e.g. ectopic and molar pregnancies). Conditions such as cancer, or other potentially life-threatening illnesses where life-saving treatments are lethal to a fetus are not understood to be included under these exceptions. Legislation should not be used as a tool to substitute for the practice of medicine by providers trained to address the myriad complexities they encounter.
Current bills that could address these challenges: The Women’s Health Protection Act (WHPA) was first introduced in 2013, and has been reintroduced several times since, most recently in the House in 2025. The WHPA seeks to establish a statutory right for health care professionals to provide abortion care, and for patients to receive that care, free from bans and medically unnecessary restrictions that single out abortion. It passed the House of Representatives in both 2021 and 2022 but failed in the Senate due to the filibuster.
Now is the time to act. The proposal this November from Senator John Thune’s proposal to condition the extension of ACA premium subsidies on strengthening Hyde Amendment abortion restrictions 9—shows that he and many other do not understand that access to abortion saves lives. It is an essential part of pregnancy care and a woman’s right to life. It is critical that we correct the notion that abortion is an optional choice rather than an essential part of lifesaving reproductive care.
Solution - National, lifesaving legislation is urgently needed to restore access to abortion as an essential healthcare. This law should empower patients and their healthcare providers to make safe, informed and timely decisions together. All physicians are impacted by anti-abortion legislation, which undermines not only patient autonomy, but professional judgment guided by medical expertise and humanitarian ethics. Universal training licenses enable providers to get training in procedures where expertise is lacking in their state. Legal abortion care saves lives; it should be accessible in all states. By codifying these protections at the federal level, the bill would guarantee equitable, lifesaving access to reproductive care across the United States.
“We all know that pregnancies can come out beautifully or horribly. Instead of putting laws in place to make pregnancy safer, we created laws that put them back in dangers.” Hope Ngumezi, husband of a young mother of 2 who bled to death in an emergency room in Texas after her miscarriage
Let’s put laws in place that provide the healthcare that pregnant women need.