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The Truth of Pre-Roe Abortion Mortality

Just about anybody that's paid attention has heard the claim that "thousands" -- or, more specifically, "5,000 to 10,000" maternal deaths a year in the United States from criminal abortions back in the bad old pre-Roe days. In fact, Planned Parenthood's amicus brief filed with PP v. Casey still cited this bogus "fact."

Let's start with the numbers. Where did they come from? Here's an interesting exercise: when you see the 5,000 - 10,000 claim, check and see who they cite. Odds are it will be Lawrence "Larry" Lader or some other late 1960's early 1970's abortion guru. This gives the impression that Lader (or whoever) looked at whatever the then-current situation was and wrote up his findings. Nothing could be further from the truth.

The 5,000 - 10,000 claim is one of the standard abortion promotion tricks: misleading citing. Often you'll see abortion advocates citing some recent (or relatively recent) "research." But when you check their source, you'll find that the source cites an even older source. And when you check that source, you'll find that it cites yet another, older source. You'll go round and round. (I've often joked that tracking down pro-choice original source material gives me motion sickness.) Eventually, you'll find the original source. If you're lucky.

In the case of the 5,000 - 10,000 claims, the original source was a book -- Abortion, Spontaneous and Induced -- published in 1936 by Dr. Frederick Taussig, a leading proponent of legalization of abortion. Taussig calculated an urban abortion rate based on records of a New York City birth control clinic, and a rural abortion rate based on some numbers given to him by some doctors in Iowa. He took a guess at a mortality rate, multiplied by his strangely generated estimate of how many criminal abortions were taking place, and presto! A myth is born!

Even if Taussig's calculations, by some mathematical miracle, had been correct, they still would have been out of date by the end of WWII. Antibiotics and blood transfusions changed the face of medicine. And you will notice that abortion proponents are all too aware of how dated Taussig's numbers are -- why else would they play Musical Cites instead of simply citing Taussig in the first place? But not only are the Taussig numbers dated, they were never accurate to begin with. At a conference in 1942, Taussig himself appologized for using "the wildest estimates" to generate a bogus number.

Although it took Taussig six years to reject his own faulty calculations, at least he did admit that he'd been wrong. Other abortion enthusiasts lacked Taussig's compunctions. Bernard Nathanson, co-founder of NARAL, admitted that he and his associates knew that the claims of 5,000 to 10,000 criminal abortion deaths were false. They bandied them about anyway, Nathanson confessed, because they were useful. This, too, is old news -- Nathanson came clean over twenty years ago.

How many criminal abortion deaths were there, then? An excellent question, and a tricky one to answer. Before the Centers for Disease Control began Abortion Surveillance Activities in 1968, and began looking at abortion mortality in earnest in 1972, all abortion deaths were typically counted together: legal (or "therapeutic"), illegal, and spontaneous (miscarriage). However, even without the CDC's intervention, public health officials were watching maternal mortality in general, and abortion mortality in particular, very carefully. After all, abortion itself was a crime, and an abortion in which the mother died could well result in a homicide investigation. This was not petty crime; the police, coroners, funeral directors, and hospital administrators were very attentive to possible criminal abortion deaths.

Peer-reviewed articles published in the decades before Roe gave varied estimates of the number of abortion deaths annually. One study determined that there were approximately 1.3 criminal abortion deaths per year in Minnesota from 1950 through 1965. Commentary on that study pointed out that if researchers combined known criminal abortion deaths with suspected criminal abortion deaths, 4.4 women were dying from criminal abortions per year in Tennessee from 1955 through 1965. A study in California reported 30 total abortion deaths per year during a period studied from 1957 through 1965, and as many as 87% of those abortion deaths were due to criminal abortions. This meant a maximum death rate in California of 26 women per year during that period.

But what can that tell us about mortality nationwide? In 1975 (the first year for which complete numbers are available), Minnesota reported roughly 1.6% of all legal abortions, Tennessee reported about 1.7%, and California about 22%. It is reasonable to assume that the proportion of illegal abortions in each state before legalization would be similar to the proportion of legal abortions in each state after Roe. If each of those states had been representative of the nation at large, that would put the national death rate at 78, 225, and 104, respectively. If we combine the totals, we find 31.7 criminal abortion deaths per year in three states, which represented roughly 26% of abortion deaths. This would mean approximately 123 criminal abortion deaths annually in the decades just before Roe.

Are these numbers realistic at all? Mary Calderone, who was then Medical Director of Planned Parenthood, reported on a conference studying abortion in America. She indicated that in 1957, there were 260 abortion deaths nationwide. That number included all abortions: legal, illegal, and spontaneous. The caluclations based on state maternal mortality investigations are fairly close to Calderone's numbers based on national data. These numbers were based on alerting doctors, law enforcement, coroners, and hospital administrators, along with public records officials, of their responsiblity to report these deaths. Taussig's estimates of 5,000 to 10,000 deaths would have meant that Minnesota authorities should have found 80 to 160 deaths per year when all their efforts could only find one or two. Tennessee should have been finding 85 to 170, rather than 4 or 5. And California should have been finding 1100 to 2200, rather than roughly 26.

Once more, with feeling:

  • In 1936, Frederick Taussig announced that there were 5,000 to 10,000 maternal deaths from criminal abortion annually in the United States.

  • In 1942, Taussig admitted that his calculations had been wrong, and that there was no way as many as 5,000 women were dying, much less 10,000.

  • From 1940 through 1970, abortion mortality fell from nearly 1,500 to a little over 100 (see table).

  • In 1972, according to the Centers for Disease Control, 39 women died from criminal abortions.

Are we supposed to believe that public health officials in Minnesota, Tennessee, and California, in cooperation with law enforcment, the medical community, coroners, and hospital administrators, were that far off? Are we supposed to believe that among abortion supporters, Planned Parenthood's Medical Director, the AMA, the Alan Guttmacher Institute, and the Centers for Disease Control were all that clueless? Are we to believe that only Taussig's numbers -- generated with admittedly faulty calculations over sixty years ago -- are the true measure of the cost of criminal abortion in the United States? This is what abortion promoters would have you believe when they cite Taussig's discredited numbers.

You would have to go back to before WWII to find as many as 1000 women dying from criminal abortions annually in the United States. By 1967, when the first states started allowing very limited elective abortions, the number had fallen almost 90%, to 110. Criminal abortion deaths clearly were diminishing dramatically without taking the radical step of legalization. Other strategies, such as liberalizing sterilization laws, providing competent counseling to frightened pregnant women to help them overcome their fears about having their babies, and teaching doctors better diagnostic and treatment strategies for addressing criminal abortion complications, were based on sound research and were likely to reduce criminal abortion deaths to an unavoidable minimum. (As long as some women insist on having abortions, some of them will die, no matter how diligently we try to protect them.) When current strategies are working, it's foolish to throw a monkey wrench into the works. The stragegy of improved medical care was solving the problem. Abortion advocates might have done well to listen to the old adage, "If it ain't broke, don't fix it."

1. Council on Scientific Affairs, American Medical Association, "Induced termination of Pregnancy Before and After Roe v. Wade: Trends in the Mortality and Morbidity of Women," Journal of the American Medical Association, December 9, 1992
2. Rachel Benson Gold, Abortion and Women's Health, Alan Guttmacher Institute, 1990
3. Cates, et al, "Legalized abortion: Effect on national trends of maternal and abortion-related mortality (1940 through 1976)", American Journal of Obstetrics and Gynecology 132:211, 1978
4. Alex Barno, "Criminal abortion deaths, illegitimate pregnancy deaths, and suicides in pregnancy: Minnesota, 1950-1965," American Journal of Obstetrics and Gynecology, June 1, 1967.
5. Mary Calderone, "Illegal abortion as a public health issue," American Journal of Public Health, July 1960
6. Leon Fox, "Abortion deaths in California," American Journal of Obstetrics and Gynecology, July 1, 1967
7. Frederick Taussig, Abortion, Spontaneous and Induced, 1936
8. "The Abortion Problem," Proceedings of the conference held under the auspices of the national Committee on Maternal Health, Inc., June 19-20, 1944.
9. Brief for Petitioners and Cross-Respondents, Planned Parenthood v. Casey (1992)

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 Illegal Abortion Deaths
   Year  Deaths
   1940   1,407
   1945     744
   1950     263
   1955     224
   1960     251
   1965     201
   1970     119
Source: "Induced termination of pregnancy before and after Roe v. Wade" JAMA, 12/9/92, vol. 208, no. 22, p. 3231-3239

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• "More on Illegal Abortion Myths"
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• The 1955 Planned Parenthood Conference on Induced Abortion
• The Bad Old Days of Abortion
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