A major new study presented this month at America’s foremost maternal medicine conference has put hard numbers to what reproductive health advocates have warned for years: banning or restricting abortion does not make pregnancy safer. It makes it deadlier.
The United States already holds a grim distinction among wealthy nations. It has the highest maternal mortality rate in the developed world, a statistic that sits alongside one of the most fractured and politically contested reproductive healthcare landscapes of any comparable democracy. Now, a peer-reviewed study from Columbia University has provided the most comprehensive population-level evidence to date that those two facts are not a coincidence.
Presented on 13 February at the Society for Maternal-Fetal Medicine’s 2026 Pregnancy Meeting in Las Vegas, the research analysed nearly two decades of data, tracking deaths among women aged 15 to 54 across all 50 states between 2005 and 2023, and arrived at a conclusion that is as damning as it is unambiguous: states with five or more abortion restrictions saw measurably higher rates of maternal death from all causes, including cardiovascular disease and violence.
Over the 18-year study period, 22,380 pregnant or postpartum women died in the United States. The three leading causes were violence, unintentional drug overdose, and cardiovascular disease. In states with the most restrictive abortion laws, each of those categories was elevated. Researchers estimate that the cumulative toll of increased restrictions amounts to approximately 16 additional deaths per year across the states that tightened their laws most severely.
“Abortion is a medically safe procedure, and restricting access to it has real consequences,” said Dr Marie C. Anderson, a resident physician in obstetrics and gynaecology at Columbia University Vagelos College of Physicians and Surgeons, who led the study. “When states adopt multiple abortion restrictions, we see measurable increases in deaths among pregnant and postpartum people. Reproductive health policy is inseparable from maternal health.”
How abortion bans are killing women who have no choice.
What makes this research particularly significant, and particularly uncomfortable for those who have framed abortion restrictions as a matter of moral rather than medical consequence, is how clearly it dismantles the idea that the procedure is primarily an elective choice. Abortion bans do not only affect people who have decided they do not want a child. They affect those whose waters break early. Those carrying pregnancies with life-limiting foetal anomalies. Those with pre-existing conditions that make continuing a pregnancy genuinely dangerous.
“This affects medical complications of pregnancy,” Dr Anderson told reporters following the presentation. “If there are medical conditions that are affecting the mother that make it unsafe for her to carry a pregnancy to term, these restrictions are affecting those people and causing these deaths. And I wish people understood that.”
The findings, published in the February 2026 issue of PREGNANCY, the official peer-reviewed journal of the SMFM, add significant weight to a growing body of evidence. In January, a separate study from Brown University found that the mortality risk associated with pregnancy is 44 to 70 times higher than that of abortion itself, which is three times higher than previously estimated. Researchers also noted that as abortion restrictions force more people to continue pregnancies, that gap in relative risk will likely widen further.
How two decades of restrictions built this crisis
The Columbia study covers a period that stretches well before the Supreme Court’s 2022 ruling in Dobbs v Jackson Women’s Health Organization, which overturned the federal constitutional right to abortion enshrined under Roe v Wade since 1973. It is precisely this longer time horizon that gives the research its power. State-level restrictions had been accumulating for two decades. In 2005, eight states already had at least five limitations on abortion access. By 2023, those restrictions had spread deep into the South, the Midwest, parts of the South-west, the Mid-Atlantic, and the West.
Today, 41 states limit abortion in some form, including 17 that have imposed total bans or prohibitions after six weeks of pregnancy, before many people even know they are pregnant. The post-Dobbs landscape means the study’s most alarming projections are not historical footnotes; they are the present reality.
Earlier research from the Gender Equity Policy Institute found that maternal mortality rose by 56% in Texas in the first full year following that state’s abortion ban, with the increase reaching 95% among white women. Black mothers in banned states were found to be 3.3 times as likely to die as white mothers in those same states, a racial disparity that the Columbia study’s findings do nothing to diminish. The Guttmacher Institute estimates that nearly 200 anti-abortion bills have already been introduced across 29 states in 2026 alone.
Restrictions are also linked to violent deaths, and researchers want to know why.
One of the most striking and underreported aspects of the Columbia findings is the association between abortion restrictions and deaths from violence. The researchers acknowledge they cannot pinpoint the mechanism for each individual death. But plausible pathways exist, and they are well-documented in existing literature. Pregnancy is a period of heightened vulnerability to intimate partner violence and homicide. Unwanted pregnancy is itself linked to coercive relationships. When people are forced to continue pregnancies they sought to end, some are doing so in circumstances that are not merely inconvenient but actively dangerous.
“Maternal mortality rates in the U.S. are just abhorrently high,” Dr Anderson said, “and restricting access to reproductive health exacerbates this problem.”
The researchers concluded with a warning that, given the current legislative trajectory, ought to be read as urgent: “Further restriction of abortion after Dobbs may result in higher rates of maternal deaths in coming years.”
Abortion is healthcare.
There is a phrase that has long been a rallying cry in reproductive rights movements and that this study, in the language of peer-reviewed science, validates entirely: abortion is healthcare. It is not a fringe position or a political slogan. It is a medical reality, confirmed by the data of 22,380 deaths, 18 years of evidence, and the expertise of researchers at one of the world’s leading medical institutions.
Dr Anderson put it plainly: “Abortion is health care. It’s a medical procedure or a medication that should be treated the same way as any other procedure or medication, and should not be subjected to increasing restrictions or regulations beyond what’s medically necessary.”
For the women counted in that dataset, for the mothers, daughters, and partners who did not survive their pregnancies in states that chose ideology over evidence, those words arrive too late. For the millions still living under those restrictions today, they cannot come soon enough.
The study, “State abortion restrictions and maternal deaths in the United States: 2005–2023,” was presented at the SMFM 2026 Pregnancy Meeting on 13 February 2026 and is published in the February 2026 issue of PREGNANCY. Lead author Dr Marie C. Anderson is a resident physician in the Department of Obstetrics and Gynaecology at Columbia University Vagelos College of Physicians and Surgeons, New York.
