Latest news with #maternaldeaths
News24
28-07-2025
- Health
- News24
This professor's life's work is to save mothers and babies from death during childbirth
Over a long and distinguished career, Professor Susan Fawcus has become known for her work trying to reduce the deaths of mothers and babies in South Africa. In her home in Cape Town, the soft-spoken champion for health equity chats to Spotlight about her journey as a researcher, doctor, and obstetrician, and shares her fears of rising maternal mortality in an age of austerity. From Cape Town maternity wards to rural obstetric interventions and policy task rooms at the national Department of Health, Professor Susan Fawcus has played a key role in shaping South Africa's response to the preventable tragedy of mothers dying while giving birth. Seated at a table in her Plumstead home, the former head of obstetric services at Cape Town's Mowbray Maternity Hospital from 1996 to 2018, reveals the harsh reality of maternal deaths in the country, using figures from Saving Mothers reports. The reports, which Fawcus edited as a member of the National Committee on Confidential Enquiries into Maternal Deaths (NCCEMD), note that in 2019, maternal deaths fell below 100 per 100 000 live births for the first time, reaching 98.8, but in 2021 it spiked to 148 as Covid-19 disrupted services. Fawcus offers two reasons for the rise in maternal deaths during the Covid-19 pandemic. 'One, there were a lot of women who died from Covid pneumonia, usually in the later stages of pregnancy. So, that was probably the biggest reason,' she says. 'And then the second reason was the effect on health services: emergency ambulances were being used for COVID, staff were off because they had Covid, or they were in quarantine.' Behind each data point is a family ruptured by tragedy, Fawcus stresses. During the interview, her speech is matter-of-fact as she cites figures, her tone soft-spoken and measured. But it is apparent that this stoic facade belies a deep passion for the plight of mothers suffering and dying preventable deaths during childbirth. The latest Saving Mothers report recorded 987 deaths, putting South Africa's maternal mortality ratio at 111.7 per 100 000 in 2023 – in other words, not yet back to pre-Covid-19 levels. While there has clearly been some recovery after Covid-19, Fawcus is concerned that the numbers may be 'flat-lining' at current levels. There is substantial differences between provinces. Compared to 2022, the maternal mortality ratio in 2023 increased by more than 10 maternal deaths per 100 000 live births in the Eastern Cape, Free State, North West, and Northern Cape. The ratio stayed about the same in KwaZulu-Natal, Limpopo, Mpumalanga and Western Cape, and dropped in Gauteng. The latest report also states that non-pregnancy-related infections and medical and surgical conditions remain the most common causes of maternal death. This is closely followed by hypertension and obstetric haemorrhage (excessive bleeding). And there are other concerning signs. According to the latest District Health Barometer, fewer women in South Africa are accessing care during their pregnancies. At a national level, the percentage of women attending antenatal visits was at 69.4% in 2023/2024, a seven-percentage-point decrease from the 76.4% the previous year. Fifty out of 52 districts showed a decline in the last year. The authors of the relevant chapter in the District Health Barometer write that the decline 'may in part be due to budget constraints in more recent years that may have negatively impacted on the accessibility of services'. Global picture: 700 childbirth deaths a day In April, the World Health Organisation (WHO) reported that most maternal deaths are preventable given that healthcare solutions to prevent or manage complications are well known. For example, it states that excessive bleeding after childbirth can kill a healthy woman within hours if she is unattended, and that injecting oxytocics (medication that stimulate uterine contractions) immediately after childbirth could effectively reduce such risk of bleeding. The WHO report adds that a maternal death occurred almost every 2 minutes in 2023, meaning that every day over 700 women died from preventable causes related to pregnancy and childbirth, with 70% of these deaths having occurred in Sub-Saharan Africa. Maternal lives threatened following budget cuts and Pepfar collapse Fawcus says she doubts South Africa will reach the Sustainable Development Goal (SDG) to reduce the global maternal mortality ratio to less than 70 per 100 000 live births by 2030. The global maternal mortality ratio was 197 per 100 000 live births in 2023, substantially higher than the most recent number of 111.7 in South Africa. To reach the SDG goal, countries would require an annual rate of reduction of almost 15% - a rate that has rarely been achieved at the national level, according to the WHO. According to our back-of-the-envelope calculations, the rate in South Africa would have to decline by well over 6% per year to meet the target. But whether such reductions will be possible in the current context is questionable. Fawcus says she is concerned about South Africa's health budget cuts, compounded by the collapse of the United States President's Emergency Plan for AIDS Relief (Pepfar). Among others, Pepfar funded several large NGOs that provided services to people in South Africa, including some programmes that focused on young women. She says: I think the worry at the moment with everything actually is austerity; these budget cuts and just not being able to replace staff. Not being able to do any outreach work, not having enough staff to visit your referring facilities. And now Pepfar… The withdrawal of funding from the United States is curbing some primary healthcare programmes, which Fawcus says successfully helped reduce childbirth deaths. 'It will be important to see what happens over the next few years with maternal mortality, because it did drop due to very effective antiretroviral therapy for pregnant women living with HIV, and lots of other initiatives, including around high blood pressure and postpartum haemorrhage,' she says. Early roots: Kenya, England and Zimbabwe Following her early childhood in Kenya, Fawcus grew up in England where she completed a Master of Arts degree in physiological sciences at Oxford University followed by medical school at the University of London. Thinking back to her formative years in England's Midlands, becoming a healthcare professional always seemed an obvious career choice. 'I remember once walking to school and the guy sweeping the road stopped me because he had a thorn in his finger and it was all sort of infected. And I spent quite a lot of time helping him with his finger. And somehow it made me feel that I liked helping people with health problems,' Fawcus recalls. An awareness of women's unique health challenges would soon follow. 'It was during my study years that I began to see that there was a real need in women's health, that women's health has been quite neglected,' she says. In 1980, she moved to Zimbabwe with her now-deceased, Professor David Sanders – a well-known academic and healthcare activist who founded the School of Public Health at the University of the Western Cape. Fawcus was training as a junior doctor at Harare Central Hospital at a time when established thinking about maternal health was being challenged. An article published in the Lancet medical journal in 1985 highlighted systemic failures that allowed healthy women to die during pregnancy and birth, particularly in low- and middle-income countries. The authors wrote: It is difficult to understand why maternal mortality receives so little serious attention from health professionals, policy makers, and politicians. The world's obstetricians are particularly neglectful of their duty in this regard. Correcting this would come to drive Fawcus' working life. She recalls her formative years in Harare: 'It was a very busy hospital and so I became a very competent hands-on clinical doctor, surgery and all that.' She says partaking in a pioneering study run by the Swedish Agency for Research and Collaboration along with the University of Zimbabwe opened her eyes. 'It was the first time anyone had really done a community-based survey of maternal mortality, because up to then, all the statistics had been based in facilities,' she says. 'So we identified all these women in rural areas who died in childbirth, many of whom never got to a hospital. And for each one, field workers went to interview the family about what had happened. 'It was one of my biggest learning experiences because I saw that while obviously what you do in a hospital makes a huge difference, a lot of it is about what happens before you even get to a hospital and relates to poverty and a lack of transport. It inspired me to work better as a doctor for women and as an obstetrician. I just saw the bigger picture.' Democratic South Africa's maternal health transformation A decade later, Fawcus moved to Durban, then to Cape Town, where she was 'invited' to participate in South Africa's maternal health transformation led by the country's first democratically elected health minister, Nkosazana Dlamini-Zuma. Fawcus recalls contributing to the Choice on Termination of Pregnancy Act promulgated in 1997 - critical legislation that allow women access to abortion services. In 1998, Dlamini-Zuma set up the NCCEMD as an audit system, which, to this day, reviews every reported maternal death in South Africa. Fawcus has served on the NCCEMD investigating deaths and drafting national protocol recommendations on issues like haemorrhage management and caesarean section care. She has served as the committee's deputy chairperson and as editor of its annual and three-yearly Saving Mothers reports. 'I still serve [on the NCCEMD], but now I'm sort of handing over to other people … and mentoring them,' she says. About her time leading at Mowbray Maternity Hospital, which sees some 1 000 births a month, she says: 'It made me really passionate about working in the public sector. You know, so many people get very impatient about the public sector – and it's true, things take a while. But what if we could devote our energy into making it function better?' (Spotlight previously featured Mowbray Maternity in its Hospital Histories ' series.) She highlights the success of Cape Town's public healthcare referral system. 'The Cape Metro has a very good system of maternity care, which I think is why it's results are quite a lot better than some other places. The approach here, really from about the 1970s, has been to develop these midwife obstetric units near where people live, for example in Gugulethu, Mitchells Plain and Retreat, run by midwives. Many women give birth at these units. If they develop complications or have medical problems, they will come through to Mowbray Maternity, and the very, very sick women would end up at the emergency wards at Groote Schuur Hospital'. A mother of three babies delivered by midwives In her sitting room, family portraits are displayed on a wooden cabinet. Fawcus herself is a mother of two sons and a daughter delivered by midwives. 'I think caesarean section is a lifesaving procedure; it can be for the mother and the baby. But there are far too many unnecessary ones in the private sector,' she says. At 72, Fawcus is still involved with the University of Cape Town's Department of Obstetrics and Gynaecology where she is a senior scholar and professor emeritus. She continues to do research, now on pre-eclampsia, a pregnancy complication marked by the sudden onset of high blood pressure. Fawcus also serves on the steering committee of the South African Obstetric Justice Coalition, which is linked to Embrace - a civil society group focused on listening to women and addressing any experiences of disrespect and unkindness during childbirth. As we wrap up our interview, Fawcus reflects on her career in her typical understated manner: 'It's been quite a long journey looking at maternal mortality in South Africa and all the trends. And I'm still continuing. I'm still involved. I am definitely not ready to 'not do anything' yet.'
The Guardian
20-07-2025
- Health
- The Guardian
Maternal deaths rising in UK despite fewer births, official figures show
Growing numbers of women in the UK are dying during pregnancy or soon after giving birth, even though fewer babies are being born, official figures show. While 209 maternal deaths occurred in England, Scotland, Wales and Northern Ireland during 2015-17, that rose to 254 during 2021-23, data compiled by the House of Commons library shows. The upward trend underlines a recent acknowledgment by the heath secretary, Wes Streeting, that poor care in NHS maternity services is so widespread that it has led to 'the normalisation of deaths of women and babies'. A maternal death is defined as one that occurs while the woman is pregnant or within 42 days of the pregnancy ending, either in the delivery of a child or other event, such as a stillbirth. 'It is appalling that maternity deaths are rising even after the years of concern over the state of services that has led to so many scandals with deadly consequences,' said Jess Brown-Fuller, the Liberal Democrat health spokesperson who commissioned the library's research. 'Families are being torn apart and unimaginable pain is being caused after years of shocking neglect so that now, even with the number of births declining, the number of deaths are rising,' added Brown-Fuller, who speaks for the party on primary care and hospitals. The rate at which such deaths occur is also rising. The 209 deaths during 2015-17 meant that there were 9.16 deathsfor every 100,000 women giving birth. However, the 254 deaths during 2021-23 meant the death rate had by then climbed to 12.67 for every 100,000 births. However, the 2021-23 figures were slightly down on the 275 deaths and 13.56 deaths per 100,000 maternities seen in 2020-22. The two were the highest figures in the eight years the library analysed. Its staff collated the figures from reports by MBRRACE-UK, a longstanding official audit of maternity care quality and outcomes, which is led by the National Perinatal Epidemiology Unit at Oxford University and involves senior doctors and the Royal College of Nursing. Each of the seven reports they analysed covered a three-year period, with the figures for 2021-23 the most recent available. Streeting last month announced the setting up of an England-wide 'rapid national investigation' into what he called the 'crisis' in maternity and neonatal services. It would 'provide truth and accountability for impacted families and drive urgent improvements to care and safety, addressing systemic problems dating back over 15 years'. The investigation will look into maternity care in up to 10 areas that have prompted particular concern, such as in Leeds – where a scandal is unfolding – and Sussex. It will be undertaken in conjunction with families who have suffered as a result of substandard care of mothers and newborns. Streeting is also chairing a newly created taskforce to ensure that progress is made in tackling what he described in his speech last month as 'the biggest patient safety challenge facing our country'. Sign up to First Edition Our morning email breaks down the key stories of the day, telling you what's happening and why it matters after newsletter promotion Women aged 35 or over are three times more likely to die than those aged 20-24 and black women are at more than double the risk of white women of dying in pregnancy or soon after, MBRRACE-UK has found. In recent years there have been official inquiries into maternity scandals at the Morecambe Bay, East Kent and Shrewsbury and Telford NHS trusts, and another is continuing into one in Nottingham. In addition, ministers and the NHS have published major strategies in 2016 and 2023 to overhaul care. 'We cannot allow a situation to persist where people are needlessly dying and their loved ones are left to pick up the pieces,' added Brown-Fuller. She blamed the Conservatives for letting maternity services 'decay' while they were in power and challenged Streeting to take immediate 'concrete steps', including ensuring that recommendations from previous reports were acted on. The Commons library research also found that progress on implementation in 11 of the 31 areas in which NHS England promised action in its three-year delivery plan for maternity and neonatal services in 2023 has gone backwards. They include staff responding to the woman's concerns during her labour and birth, women receiving kind and compassionate treatment during labour and birth and receiving adequate explanations during their postnatal care. The Department of Health and Social Care did not comment on the rise in maternal deaths. It instead highlighted Streeting's decision to launch the investigation and promise to overhaul the quality and safety of care provided.
The Guardian
17-07-2025
- Health
- The Guardian
Republicans wanted fewer abortions and more births. They are getting the opposite
Dobbs v Jackson Women's Health Organization, the US supreme court case that rescinded the constitutional right to abortion, is failing on its own terms. Since the ruling, in June 2022, the number of abortions in the US has risen. Support for reproductive rights is on the upswing. And the rate of voluntary sterilization among young women – a repudiation of Trumpian pronatalism, if a desperate one – jumped abruptly after Dobbs, and there's no reason to believe it will drop off. Also rising at an alarming clip are preventable maternal deaths and criminal prosecutions of pregnant people. Yet the 21 state legislatures that have imposed total or near-total bans are doing little or nothing to give doctors legal leeway to save the health and lives of pregnant women in medical distress, even if that means inducing abortion. In fact, rather than trying to save lives, they are prosecuting pregnant people who handle those emergencies on their own. The first three – more abortions, more pro-abortion sentiment, more contraception –have frustrated the anti-abortion crowd no end. They know they need stronger disincentives to abortion. Which brings us to the latter two: more punishment and more death. Was punishment the aim all along? And has the anti-abortion movement accepted pregnant people's deaths as an unfortunate consequence of saving the pre-born? According to the Guttmacher Institute, abortions rose 1.5% in 2024 from 2023, on top of a 11.1% leap in the first year after Dobbs, compared with 2020, before the near-bans enacted in several states that presaged the ruling. It's also probably an undercount. The statistics include only 'clinician-provided abortions', either surgical or medical (using abortion pills), performed in healthcare facilities or via telemedicine. Guttmacher does not estimate how many abortions are happening outside the formal healthcare system, with drugs obtained directly from suppliers or through feminist underground networks. Indeed, Plan C, the country's biggest clearinghouse for pill access, reports 2m visits to its website and 500,000 click-throughs to resources and care in 2024, a 25% increase from the year before. How many of those people ended their pregnancies at home, with only a friend or lover in attendance? Anecdotal evidence gleaned from activists suggests they number in the tens of thousands. At the same time, rather than making abortion 'unthinkable', as the anti-abortion activists pledge, the bans may be having the opposite effect. An analysis of two restrictive states, Arizona and Wisconsin, and one with broad access, New Jersey, found that negative attitudes toward abortion are down and positive ones up, in both red and blue states. And if the goal of banning abortion is to produce more children, that's not working either. Public health researchers saw 'an abrupt increase in permanent contraception procedures' – sterilization – following Dobbs among adults in their prime reproductive years, ages 18 to 30. Unsurprisingly, the increase in procedures for women (tubal ligations) was twice that for men (vasectomies). The Trump administration is cheerleading for procreation. 'I want more babies in the United States of America,' declared JD Vance in his first public appearance as vice-president, at the March for Life in Washington. He blamed the declining birth rate on 'a culture of abortion on demand' and the failure 'to help young parents achieve the ingredients they need to lead a happy and meaningful life'. The federal budget extends some of that help. It raises the annual child tax credit (CTC) from $2,000 to $2,200. It also creates 'Trump accounts', $1,000 per child, which parents or employers can add to. But only those with social security numbers are eligible for either program; the tax credit is available only to people who earn enough to pay taxes; and as with any investment, those able to sow more in the savings accounts reap more. It's clear what sort of baby the administration wishes to be born: white babies with 'American' parents, and not the poorest. The carrots are not appetizing enough. The stick is not effective enough. So red-state legislators and prosecutors are bringing out the AR-15s. This year, Republican lawmakers in at least 10 states introduced bills defining abortion as homicide, and, for the first time, criminalizing both the provider and the patient. No such bill has passed – yet – and anti-abortion organizations are usually quick to renounce them publicly, nervous about widespread opposition. But their passage might not be far off. The bills are based on fetal personhood – the concept of conferring full legal rights to a fetus from conception forward. The idea was introduced in 1884 and finally written into one state's law in 1986. By 2024, 39 states had fetal homicide laws. Last year, there were three bills criminalizing the person who has an abortion; now there are 10. And though the federal courts rejected fetal personhood for a century, it is the bedrock of anti-abortion politics, and this US supreme court is looking much more friendly toward it. While they work toward straightforward criminalization of ending one's own pregnancy, anti-abortion lawmakers and prosecutors are making creative use of existing law to punish miscarriage, an event indistinguishable from elective abortion, just in case the pregnant person induced the miscarriage. The most ghoulish is the prohibition on abusing corpses. For instance: last week a 31-year-old South Carolina woman who miscarried and disposed of the tissue in the trash was arrested for 'desecration of human remains', a crime carrying a 10-year sentence. In March, a woman found bleeding outside her Georgia apartment after a miscarriage was jailed for 'concealing the death of another person' and 'abandonment of a dead body' for placing the remains in the bin. A week before that, a Pennsylvania teenager was under investigation for corpse abuse after a self-managed pill abortion and burial of the fetus in her yard. In a grim sense, these are the lucky ones: they survived. Because Dobbs has indisputably been deadly. 'Mothers living in states that banned abortion were nearly twice as likely to die during pregnancy, childbirth, or soon after giving birth' as mothers living in states where abortion was legal and accessible, reports the Gender Equity Policy Institute. Maternal mortality rose 56% in Texas after it enacted a six-week ban; a Texan's risk was one and a half times that of a Californian's. The future isn't sunny. A study of 14 total-ban states predicts that in the four years beginning a year after Dobbs, up to 42 mothers will die and as many as 2,700 will be afflicted with 'severe maternal morbidity', defined by the CDC as 'unexpected outcomes of labor and delivery that result in significant short-term or long-term [health] consequences'. In one analysis Black women represented 63% of the deaths. The anti-abortion movement is indefatigable. 'We abolishioners will not rest until we have effected the abolishment of human abortion,' one leader told Oklahoma Voice. But this is an unattainable grail. Where abortion is illegal, people still have abortions. They just take more risks. Globally, more than 39,000 women die yearly from unsafe abortions. As they run out of options, red-state lawmakers will harden criminal penalties against people who refuse to give up their reproductive self-determination. It may grow less outré to endorse Trump's opinion, expressed in an unguarded moment, that women who get illegal abortions 'deserve some form of punishment'. Whether intentional or not, the sentence for some of those women will be death. Judith Levine is a Brooklyn journalist and essayist, a contributing writer to the Intercept and the author of five books
The Guardian
17-07-2025
- Health
- The Guardian
Republicans wanted fewer abortions and more births. They are getting the opposite
Dobbs v Jackson Women's Health Organization, the US supreme court case that rescinded the constitutional right to abortion, is failing on its own terms. Since the ruling, in June 2022, the number of abortions in the US has risen. Support for reproductive rights is on the upswing. And the rate of voluntary sterilization among young women – a repudiation of Trumpian pronatalism, if a desperate one – jumped abruptly after Dobbs, and there's no reason to believe it will drop off. Also rising at an alarming clip are preventable maternal deaths and criminal prosecutions of pregnant people. Yet the 21 state legislatures that have imposed total or near-total bans are doing little or nothing to give doctors legal leeway to save the health and lives of pregnant women in medical distress, even if that means inducing abortion. In fact, rather than trying to save lives, they are prosecuting pregnant people who handle those emergencies on their own. The first three – more abortions, more pro-abortion sentiment, more contraception –have frustrated the anti-abortion crowd no end. They know they need stronger disincentives to abortion. Which brings us to the latter two: more punishment and more death. Was punishment the aim all along? And has the anti-abortion movement accepted pregnant people's deaths as an unfortunate consequence of saving the pre-born? According to the Guttmacher Institute, abortions rose 1.5% in 2024 from 2023, on top of a 11.1% leap in the first year after Dobbs, compared with 2020, before the near-bans enacted in several states that presaged the ruling. It's also probably an undercount. The statistics include only 'clinician-provided abortions', either surgical or medical (using abortion pills), performed in healthcare facilities or via telemedicine. Guttmacher does not estimate how many abortions are happening outside the formal healthcare system, with drugs obtained directly from suppliers or through feminist underground networks. Indeed, Plan C, the country's biggest clearinghouse for pill access, reports 2m visits to its website and 500,000 click-throughs to resources and care in 2024, a 25% increase from the year before. How many of those people ended their pregnancies at home, with only a friend or lover in attendance? Anecdotal evidence gleaned from activists suggests they number in the tens of thousands. At the same time, rather than making abortion 'unthinkable', as the anti-abortion activists pledge, the bans may be having the opposite effect. An analysis of two restrictive states, Arizona and Wisconsin, and one with broad access, New Jersey, found that negative attitudes toward abortion are down and positive ones up, in both red and blue states. And if the goal of banning abortion is to produce more children, that's not working either. Public health researchers saw 'an abrupt increase in permanent contraception procedures' – sterilization – following Dobbs among adults in their prime reproductive years, ages 18 to 30. Unsurprisingly, the increase in procedures for women (tubal ligations) was twice that for men (vasectomies). The Trump administration is cheerleading for procreation. 'I want more babies in the United States of America,' declared JD Vance in his first public appearance as vice-president, at the March for Life in Washington. He blamed the declining birth rate on 'a culture of abortion on demand' and the failure 'to help young parents achieve the ingredients they need to lead a happy and meaningful life'. The federal budget extends some of that help. It raises the annual child tax credit (CTC) from $2,000 to $2,200. It also creates 'Trump accounts', $1,000 per child, which parents or employers can add to. But only those with social security numbers are eligible for either program; the tax credit is available only to people who earn enough to pay taxes; and as with any investment, those able to sow more in the savings accounts reap more. It's clear what sort of baby the administration wishes to be born: white babies with 'American' parents, and not the poorest. The carrots are not appetizing enough. The stick is not effective enough. So red-state legislators and prosecutors are bringing out the AR-15s. This year, Republican lawmakers in at least 10 states introduced bills defining abortion as homicide, and, for the first time, criminalizing both the provider and the patient. No such bill has passed – yet – and anti-abortion organizations are usually quick to renounce them publicly, nervous about widespread opposition. But their passage might not be far off. The bills are based on fetal personhood – the concept of conferring full legal rights to a fetus from conception forward. The idea was introduced in 1884 and finally written into one state's law in 1986. By 2024, 39 states had fetal homicide laws. Last year, there were three bills criminalizing the person who has an abortion; now there are 10. And though the federal courts rejected fetal personhood for a century, it is the bedrock of anti-abortion politics, and this US supreme court is looking much more friendly toward it. While they work toward straightforward criminalization of ending one's own pregnancy, anti-abortion lawmakers and prosecutors are making creative use of existing law to punish miscarriage, an event indistinguishable from elective abortion, just in case the pregnant person induced the miscarriage. The most ghoulish is the prohibition on abusing corpses. For instance: last week a 31-year-old South Carolina woman who miscarried and disposed of the tissue in the trash was arrested for 'desecration of human remains', a crime carrying a 10-year sentence. In March, a woman found bleeding outside her Georgia apartment after a miscarriage was jailed for 'concealing the death of another person' and 'abandonment of a dead body' for placing the remains in the bin. A week before that, a Pennsylvania teenager was under investigation for corpse abuse after a self-managed pill abortion and burial of the fetus in her yard. In a grim sense, these are the lucky ones: they survived. Because Dobbs has indisputably been deadly. 'Mothers living in states that banned abortion were nearly twice as likely to die during pregnancy, childbirth, or soon after giving birth' as mothers living in states where abortion was legal and accessible, reports the Gender Equity Policy Institute. Maternal mortality rose 56% in Texas after it enacted a six-week ban; a Texan's risk was one and a half times that of a Californian's. The future isn't sunny. A study of 14 total-ban states predicts that in the four years beginning a year after Dobbs, up to 42 mothers will die and as many as 2,700 will be afflicted with 'severe maternal morbidity', defined by the CDC as 'unexpected outcomes of labor and delivery that result in significant short-term or long-term [health] consequences'. In one analysis Black women represented 63% of the deaths. The anti-abortion movement is indefatigable. 'We abolishioners will not rest until we have effected the abolishment of human abortion,' one leader told Oklahoma Voice. But this is an unattainable grail. Where abortion is illegal, people still have abortions. They just take more risks. Globally, more than 39,000 women die yearly from unsafe abortions. As they run out of options, red-state lawmakers will harden criminal penalties against people who refuse to give up their reproductive self-determination. It may grow less outré to endorse Trump's opinion, expressed in an unguarded moment, that women who get illegal abortions 'deserve some form of punishment'. Whether intentional or not, the sentence for some of those women will be death. Judith Levine is a Brooklyn journalist and essayist, a contributing writer to the Intercept and the author of five books
