National Analysis Covers 2018‑2021 Births and Abortions The researchers examined 14,902,571 births and 3,662,580 abortions recorded between 2018 and 2021, using the National Vital Statistics System for pregnancy deaths and the Pregnancy Mortality Surveillance System for abortion deaths[1]. They identified 3,065 pregnancy‑related deaths and 17 abortion‑related deaths, providing the largest dataset of its kind to date[1]. The analysis included live births, stillbirths, and all gestational ages, ensuring comprehensive coverage[1].

Pregnancy‑to‑Abortion Mortality Ratio Exceeds Prior Estimates The mean ratio of pregnancy‑related to abortion‑related deaths was 69.6, far above the previously cited figure of 14.7[1]. After removing non‑specific pregnancy deaths the ratio fell to 52.9, and excluding COVID‑19 deaths reduced it further to 44.3, still markedly higher than earlier estimates[1]. These numbers indicate that pregnancy carries a substantially greater mortality risk than abortion in the current environment[1].

Dobbs Ruling Increases Pregnancy‑Related Death Exposure Researchers attribute the rising ratio to the 2022 Dobbs v. Jackson Women’s Health Organization decision, which halted federal abortion protections[1]. The ruling forced many women to continue pregnancies they would have terminated, exposing them to medical complications that contribute to higher mortality[1]. The study suggests that improved safety of abortion procedures combined with reduced access amplifies the relative danger of pregnancy[1].

Thirteen States Enforce Total Bans, Many Impose Gestational Limits The legal landscape is fragmented: thirteen states have enacted outright abortion bans, while twenty‑eight impose gestational restrictions, including seven that prohibit abortions at or before 18 weeks and twenty‑one that ban after 18 weeks[1]. This patchwork of laws creates uneven access to safe abortion services across the country[1]. The authors argue that such restrictions compound health risks for pregnant people in restrictive states[1].

Researchers Combine Vital Statistics and Surveillance Systems Mortality data were drawn from the National Vital Statistics System, abortion counts from the Guttmacher Institute, and abortion‑related deaths from the Pregnancy Mortality Surveillance System[1]. The study was conducted between February and October 2025, employing ICD‑10 codes A34, O10‑O95, O96, and O98‑O99 to classify pregnancy deaths[1]. This multi‑source approach strengthens the reliability of the findings[1].