Deaths from abortions still happen, but they declined sharply after Roe v. Wade

Texas’ new far-reaching anti-abortion law has renewed calls from abortion-rights advocates to protect Roe v. Wade, the 1973 Supreme Court ruling that recognized a constitutional right to an abortion.

An Oct. 7 Facebook post joined those calls, advocating for Roe on the grounds of safety. The post featured a picture of what appeared to be a yard sign that read: "Roe wasn’t the beginning of women having abortions. Roe was the end of women dying from abortions."

The Facebook user posted a caption along with the photo that read: "Tens of thousands of American women died while having unsafe back alley abortions before Roe v. Wade. We CAN’T go back." 

The post was flagged as part of Facebook’s efforts to combat false news and misinformation on its News Feed. (Read more about our partnership with Facebook.)

Did Roe v. Wade put an end to abortion-related deaths in the U.S.?

The answer isn’t so simple. The number of women dying from causes related to abortion had been declining in the decades before Roe, thanks to medical advances and changes in state laws, and deaths still occur. But deaths from illegal abortions plummeted to a few, if any, in most years since the decision, and the mortality rate from legal abortions has fallen substantially.

Because of the historical stigma attached to getting abortions, there is limited data available about the number of women who died as a result of the procedure.

"Deaths for example were often coded as due to other causes to save families from shame, and we can only rely on estimates for illegal abortions," said Carole Joffe, a professor at the University of California, San Francisco, who specializes in reproductive health and has extensively researched access to abortion services. "No one was keeping careful track."

However, research suggests that even before the Roe decision, abortions were becoming less deadly than they had once been, with estimates of annual deaths dropping from the thousands in the 1930s to 260 in 1957.

The discovery and popularization of antibiotics helped improve the safety of abortions, according to a 1948 study published in the American Journal of Public Health. That study also mentioned that the increased use of contraceptives had reduced the need for illegal abortions, leading to fewer deaths.

A 1978 American Journal of Obstetrics and Gynecology study analyzed trends in abortion deaths in the U.S., and determined that from 1940 to 1950 and after 1965, "deaths from abortion declined more rapidly than deaths from other causes associated with pregnancy and childbirth." 

The Food and Drug Administration in 1960 approved the first commercially produced birth control pill and in the three years before Roe was decided, abortion had become legally available in a handful of states.

That study concluded that "the introduction of more effective contraception, and increased availability of legal abortion" were the two most likely explanations for the "accelerated decline in abortion-related deaths."

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By the early 1970s, abortion-related deaths had become relatively rare.

In 1972 — the year before Roe was decided and the first year for which data for abortion-related deaths was available — 24 women died from legal abortions, and 39 died from illegal abortions, according to the U.S. Centers for Disease Control and Prevention. (The CDC categorizes an abortion as legal when it is performed by a licensed clinician within the limits of state law.)

The number of deaths related to illegal abortions decreased to 19 in 1973 and dropped further, to six, by 1974, CDC data shows. From 1979 to 2017, the number of women who died in a year was never higher than two.

Meanwhile, as deaths from legal abortions fluctuated in subsequent years, mortality rates declined.

A study by the Guttmacher Institute, a global research group that supports women’s access to abortions, determined that as legal abortion access increased after Roe, "mortality due to abortion dropped sharply."

"The trend was caused mainly by a decline in the absolute number of deaths from illegal abortion — especially after Roe v. Wade — from 39 in 1972 to two in 1976," the study concluded based on CDC data. "After 1975, mortality due to legally induced abortion also fell — from more than three deaths per 100,000 abortions in 1975 to about one in 1976 and even fewer thereafter."

Studies show that abortion rates are similar, regardless of whether or not a country has legalized the procedure.

Along with legal changes, medical advances play a role in reducing deaths. 

In countries where abortions are illegal, they are less deadly today than they once were. One factor is the changing methods used to induce abortions. A relatively common and inexpensive drug, misoprostol, is commonly used to end pregnancies, for example.

"The same safe pills that one can get in an abortion clinic, one can order online," Diana Greene Foster, another UCSF professor specializing in reproductive health, told PolitiFact in an email. "So the relationship between safety and illegality is likely less clear-cut now as long as pregnant people get the right pills."

A Facebook post claimed, "Roe was the end of women dying from abortions." A caption on the post alludes to deaths from illegal abortions in non-clinical settings.

Deaths from abortions were already becoming relatively rare by the time Roe v. Wade was decided in 1973, as a result of medical advances and legal changes at the state level. But studies and experts say increased access to legal abortion after Roe v. Wade sharply reduced the number of pregnant women who died because of illegal abortions. 

CDC data shows that the number of women who died from causes related to illegal abortions was zero or close to zero for most years from 1979 to 2017. Mortality rates for legal abortions have declined over the same period.

Roe was an important factor in reducing deaths from abortions, but not the only one. We rate this claim Half True.