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Mortality From Abortion and Childbirth

1983; American Medical Association; Volume: 250; Issue: 3 Linguagem: Inglês

10.1001/jama.1983.03340030023018

1538-3598

Mary Jo Lanska,

Healthcare Policy and Management

This response to an earlier article on maternal mortality by LeBolt and others argues that mortality rates of women having an abortion should be separately compared to women having vaginal delivery and women having cesarean delivery, the latter being subject to higher mortality rates partly because of the ocmplications that lead to the cesarean and partly because of increased risks inherent in the abdominal route. Maternal mortality following a cesarean is approximately 100/100,000 live births, roughly 10-20 times higher than mortality following vaginal delivery. The incidence of cesarean section generally ranges from 10-20% of deliveries; assuming the national figure to be 10%, some 90% of the 22,257 live births reported by LeBolt, or 2,253, were due to cesarean deliveries. Using these figures, the maternal mortality rate for vaginal deliveries would be 1.1/100,000 live births, less than the death-to-case rate of 1.9/100,000 legal abortions reported by LeBolt. The maternal mortality rate for cesarean deliveries would then be approximately 53 times greater than that for legal abortion, but the mortality rate for legal abortion would be almost twice as high as that for vaginal deliveries. Even if the effect of artificially lowering the mortality rate for vaginal deliveries because high-risk mothers are more likely to have cesarean deliveries were eliminated by adjusting for preexisting medical conditions between the vaginal and cesarean delivery groups, the increased rate of mortality associated with childbirth would still be accounted for by cesarean deliveries.