There is no credible scientific opposition to the fact that a genetically distinct human life begins at conception and that an induced abortion is a death. Yet, abortion is not reported as a cause of death in the U.S. vital statistics system. Mortality patterns have profound implications for public policy. As a cause of death, we found abortion to be highly consequential, with large racial and ethnic disparities. Abortion represented 16.4% of non-Hispanic White deaths, but 61.1% and 64.0% of non-Hispanic Black and Hispanic deaths respectively. For Years of Potential Life Lost (YPLL), the ubiquitous measure of premature death, abortion accumulated 63.1% of non-Hispanic White YPLL and 86.5% and 87.4% of non-Hispanic Black and Hispanic YPLL respectively. Further, as measured by the availability of valid data and resources allocated for research, there is evidence that the science community is not appropriately engaged on this crucial public health problem.
There is no credible scientific opposition to the fact that a new genetically distinct human organism begins with fertilization and that, simply stated, human life begins at conception. Nor is there dispute that, in the absence of induced abortion and with the exception of natural fetal losses, conception usually results in a live birth. A very recent statement from the White House clearly affirms “… the critical importance of a child’s first 1000 days after conception in determining a healthy and productive life trajectory, …” [
Yet, despite the universal acknowledgement that the act of abortion results in a death, abortion is not reported as a cause of death in the vital statistics system in the United States. Nor is this exclusion limited to the United States. Although there are nearly 200 nations where the procedure is legal, and a conservatively estimated 45 - 50 million are performed annually worldwide, there is no country which considers induced abortion as a reportable death [
We employed a retrospective cross-sectional analysis which integrated data on pregnancy outcomes, including induced abortions, and deaths from all causes in the U.S. in 2009. We determined the relative magnitude of abortion as a cause of death compared to the other top ten ranked causes. We also calculated the years of potential life lost before the age 75 (YPLL 75) due to abortion and compared it to the other major causes of death. We considered induced abortion as the proximate cause of death and we subtracted the estimated number of natural fetal losses from the number of abortions to arrive at births averted by abortion. We used 2009 data because it was the most current year for which official group-specific fetal loss estimates were available from government sources. (Four Supplementary Data Tables follow the References and provide detail of the calculations and results, Tables S1-S4).
Counts of live births are provided by every state in the U.S. to the Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), through the Vital Statistics Cooperative Program of the National Vital Statistics System [
Death data is first reported on death certificates which are completed by funeral directors, attending physicians, medical examiners or coroners. Original records are filed in state registration offices and then compiled in a national database by the Vital Statistics Cooperative Program, CDC-NCHS. Causes of death are processed in accordance with the International Classification of Disease (ICD), Tenth Revision [
The statistical construct of YPLL accumulates all the years between age at death and an index year (75 in our application) and aggregates them by cause of death. While YPLL is the most widely applied method for characterizing the burden of premature death, and has been included in the standard reports of the CDC since 1982, it has never been used to measure the burden of premature death from abortion for the entire U.S. [
In the U.S. in 2009, there were 6,369,000 pregnancies among women of all racial and ethnic origins. Hispanics, NHB and NHW together accounted for 93.2% of all pregnancies. Abortions terminated 11.9% of NHW pregnancies, 17.1% of Hispanic pregnancies, and 35.5% of NHB pregnancies. The ratio of live births to a single abortion for each group was: 5.8 for NHW; 3.9 for Hispanics; and 1.4 for NHB.
For all racial and ethnic origins, there were 3,589,163 deaths (
For NHW abortion represents 63.1% of YPLL 75 and a rate of 11,369 YPLL 75 per 100,000 population. For Hispanics and NHB respectively, the values were 87.4% and 31,969/100,000 and 86.5% and 67,490/ 100,000 (
Abortion is undoubtedly the most demographically consequential cause of death for Hispanics and NHB. Yet, there is evidence that the scientific community is minimally engaged in informing effective public policy on the topic of abortion. Two important ways of gauging scientific engagement in any subject are the availability of consistently reported valid data and the allocation of sufficient resources for research. In the most recent CDC abortion surveillance report (2011 data published in 2014) three states (California, Maryland and New Hampshire) did not report, and the quality and timeliness of the reporting was uneven among states that did. The Guttmacher Institute, a private entity, has periodically surveyed all known abortion providers (16 times since 1973) and its abortion incidence data is widely considered the most reliable. For comparison purposes, the state reports compiled by the CDC capture only about 68% of the abortions reported by the Guttmacher surveys [
Requested by the US Congress, and implemented in 2008, the Research, Condition and Disease Categorization (RCDC) system was developed by the National Institutes of Health (NIH) to provide consistency and transparency in the reporting of its funded research. The system uses text data mining to cluster words or phrases, in conjunction with NIH expert definitions, to identify categories of funded research. A query of the system on November 6, 2015 returned a table with 244 Research/Disease Areas and their actual NIH funding for the fiscal years of 2011-2014, and estimated funding for years 2015 and 2016. Among these categories were all major diseases and causes of death and many others such as: Ataxia-Telangiectasia, Batten Disease, Charcot-Marie Tooth Disease, Climate Change, Human Fetal Tissue, Rural Heath, Stem Cell Research (Embryonic-Human), Vulvodynia, and Woman’s Health. Abortion is not one of the 244 categories. A second query specifically identifying abortion as the “Search Research/Disease Areas” term returned the following statement: “no estimates of funding information found which matched the criteria you specified.” In a related analysis utilizing data from the RCDC system, NIH researchers plotted the correlation between the number of deaths in 2010 attributed to a disease or condition category and the amount of NIH funding that it received. The objective of the analysis was to test the congruency between the societal burden of the disease/condition as measured by the number of deaths and the research resources allocated to it. As previously stated, abortion is not among the categories included in the analysis. However, the following categories were included: Malaria, Migraine, Depression, Autism, Infertility, Attention Deficit Disorder (ADD), Psoriasis, Macular Degeneration, Dental/Oral and Craniofacial Disease, and Headaches. For all US deaths in 2010, not a single death was attributed to any of these categories [
The exclusion of abortion as a cause of death, in spite of conclusive science to contrary, and the relative paucity of information and funded research on a topic of demonstrated consequence to the demographic composition of the society, may be the ultimate example of science denial. An abortion death is deemed necessary and performed by other humans in a purposeful and completely legal process. In these respects an abortion is similar to capital punishment and subject to the same clash of varying religious, political and ideological values. The appropriate role of science is to inform this societal dialogue with objective information. Labeling abortion as a preventable death is not an argument for restricting access to a legal abortion. However, refusing to acknowledge abortion as a death undermines the role of science and the value of transparency so fundamental to a free society.
James Studnicki,Sharon J. MacKinnon,John W. Fisher, (2016) Induced Abortion, Mortality, and the Conduct of Science. Open Journal of Preventive Medicine,06,170-177. doi: 10.4236/ojpm.2016.66016
Pregnancies | Live births | Abortions | Fetal losses | Fetal loss ratea | |
---|---|---|---|---|---|
All origins | 6,369,000 | 4,131,000 | 1,152,000 | 1,087,000 | 20.8% |
Hispanic | 1,474,000 | 1,000,000 | 252,000 | 222,000 | 18.1% |
Non-Hispanic Black | 1,253,000 | 615,000 | 445,000 | 192,000 | 23.8% |
Non-Hispanic White | 3,207,000 | 2,232,000 | 383,000 | 591,000 | 20.9% |
Other | 435,000 | 284,000 | 72,000 | 82,000 | 22.4% |
aFetal loss rate = fetal losses/(live births + fetal losses).
Abortions | Estimated fetal losses | Estimated births averted | YPLL 75 | |
---|---|---|---|---|
All origins | 1,152,000 | 239,616 | 912,384 | 68,428,800 |
Hispanic | 252,000 | 45,612 | 206,388 | 15,479,100 |
Non-Hispanic Black | 445,000 | 105,910 | 339,090 | 25,431,750 |
Non-Hispanic White | 383,000 | 80,047 | 302,953 | 22,721,475 |
Other | 72,000 | 16,128 | 55,872 | 4,190,400 |
Cause of death | All Origins | Hispanic | NH Black | NH White |
---|---|---|---|---|
All | 3,589,163 (100) | 393,576 (100) | 727,982 (100) | 2,327,606 (100) |
Induced abortion | 1,152,000 (32.1) | 252,000 (64.0) | 445,000 (61.1) | 383,000 (16.4) |
Diseases of the heart | 599,413 (16.7) | 29,611 (7.5) | 68,811 (9.4) | 485,779 (20.8) |
Malignant neoplasms | 567,628 (15.8) | 29,935 (7.6) | 63,967 (8.8) | 457,189 (19.6) |
Chronic lower respiratory disease | 137,353 (3.8) | 4,026 (1.0) | 8,444 (1.1) | 122,605 (5.3) |
Cerebrovascular diseases | 128,842 (3.6) | 7,065 (1.8) | 15,718 (2.1) | 101,703 (4.4) |
Unintentional injuries | 118,021 (3.3) | 10,654 (2.7) | 11,810 (1.6) | 91,416 (3.9) |
Alzheimer’s disease | 79,003 (2.2) | 69,695 (3.0) | ||
Diabetes mellitus | 68,705 (1.9) | 6,311 (1.6) | 11,833 (1.6) | 47,851 (2.0) |
Influenza and pneumonia | 53,692 (1.5) | 3,679 (0.9) | 42,752 (1.8) | |
Nephritis, nephrotic syndrome, and nephrosis | 48,935 (1.4) | 3,107 (0.8) | 8,727 (1.2) | 35,670 (1.5) |
Suicide | 36,909 (1.0) | 30,813 (1.3) | ||
Liver diseases | 4,303 (1.1) | |||
Homicide | 3,179 (0.8) | 7,733 (1.1) | ||
Septicemia | 6,131 (0.8) | |||
HIV | 5,307 (0.7) |
All origins | Hispanic | NH Black | NH White | |||||
---|---|---|---|---|---|---|---|---|
Cause of death | YPLL | Ratea | YPLL | Rate | YPLL | Rate | YPLL | Rate |
All | 88,690,205 (100) | 28,888 | 17,710,362 (100) | 36,577 | 29,405,708 (100) | 78,036 | 35,975,970 (100) | 18,001 |
Induced abortion | 68,428,800 (77.1) | 22,289 | 15,479,100 (87.4) | 31,969 | 25,431,750 (86.5) | 67,490 | 22,721,475 (63.1) | 11,369 |
Malignant neoplasms | 4,397,332 (4.9) | 1,432 | 343,017 (1.9) | 708 | 667,956 (2.3) | 1,772 | 3,223,417 (8.9) | 1,612 |
Diseases of the heart | 3,038,728 (3.4) | 664 | 219,814 (1.2) | 454 | 646,031 (2.2) | 1,714 | 2,069,806 (5.7) | 1,035 |
Unintentional injuries | 2,928,868 (3.3) | 954 | 382,274 (2.1) | 789 | 370,955 (1.2) | 984 | 2,056,507 (5.7) | 1,209 |
Suicide | 1,063,300 (1.2) | 346 | 94,971 (0.5) | 196 | 74,733 (0.2) | 198 | 843,198 (2.3) | 422 |
Perinatal period | 982,263 (1.1) | 320 | 196,197 (1.1) | 405 | 333,917 (1.1) | 886 | 401,240 (1.1) | 201 |
Homicide | 702,725 (0.8) | 229 | 144,928 (0.8) | 299 | 348,023 (1.2) | 923 | ||
Congenital anomalies | 548,362 (0.7) | 195 | 125,537 (0.7) | 259 | 102,287 (0.3) | 271 | 289,549 (0.8) | 145 |
Chronic lower respiratory diseases | 543,247 (0.6) | 177 | 440,717 (1.2) | 220 | ||||
Cerebrovascular diseases | 518,952 (0.6) | 169 | 56,278 (0.3) | 116 | 131,994 (0.4) | 350 | 303,933 (0.8) | 152 |
Diabetes mellitus | 494,484 (0.5) | 161 | 53,730 (0.3) | 111 | 114,546 (0.4) | 303 | 305,585 (0.8) | 153 |
Liver diseases | 75,370 (0.4) | 155 | 347,618 (1.0) | 174 | ||||
HIV | 146,262 (0.5) | 388 | ||||||
All others | 5,043,144 (5.7) | 1,642 | 539,146 (3.0) | 1,113 | 1,037,254 (3.5) | 2,752 | 2,972,925 (8.2) | 1,487 |
aPer 100,000.
*Corresponding author.
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