The Relative Risk of Dying Due to Remaining Pregnant Compared with Having an Abortion

Amanda Stevenson, University of Colorado at Boulder

Because remaining pregnant is the alternative to having an abortion, the relative mortality risk associated with staying pregnant compared to having an abortion is the salient relative risk for discussions of abortion laws and in clinical settings. However, competing risks due to miscarriage and the multiple decrement nature of pregnancy have prevented the calculation of this relative risk. To address these challenges, I demonstrate how to use vital statistics and published estimates to construct decrement national pregnancy life tables. Then constructing cause-deleted national pregnancy life tables in which abortion is deleted as a cause of exit allows one to estimate the conditional probability and relative risk of dying due to staying pregnant for each week of gestational duration in the condition where no pregnancies end in abortion. Comparing a weighted average of this quantity with the published or estimated abortion case fatality rates yields the average relative risk of continuing pregnancy compared to abortion. I illustrate for the case of the United States 2013-2019, finding that remaining pregnant is 33.3 times deadlier than having an abortion. A wide variety of sensitivity analyses vary necessary assumptions. Even extreme alternative assumptions change the relative risk by less than 10%.

Keywords: Population Policies, Mortality and Longevity, Mathematical demography

See extended abstract.