Assessing the Relationship between Policy and Abortion-Related Maternal Mortality in the United States

Following the U.S. Supreme Court’s 2022 Dobbs v. Jackson Women’s Health Organization decision, the current legal and political landscape surrounding abortion access in the United States has undergone significant transformations, underscoring the urgent need to address factors influencing maternal health outcomes, including restricted abortion access. As a result, this review seeks to illuminate the connections between restrictive abortion policies and maternal health disparities while emphasizing the importance of intersectional factors such as race, gender identity, and socioeconomic status. Our findings identify legal restrictions, healthcare provider bias, and stigma coupled with patient distrust in the healthcare system as three crucial determinants of maternal mortality among individuals seeking abortion care. To structurally visualize the complex interactions of these determinants and other auxiliary variables, we developed a causal loop diagram (CLD), consisting of three reinforcing loops and a central balancing loop suggesting mitigation strategies through comprehensive sexual health education. Another intervention we have proposed involves comprehensive reproductive healthcare provider training, which aims to improve abortion care access through bias-reduction programs and standardized protocols. Given the influence of policy decisions on state-level maternal mortality reporting standards and recent shifts in federal and state leadership, we highlight the urgent need for community-led initiatives to establish data collection strategies. These grassroots efforts, which operate independently of government funding, are crucial for documenting reliable, timely data on maternal mortality and driving other necessary actions. Future improvements to the CLD could include findings from a broader array of qualitative studies to better understand the unique challenges minority groups face and how they navigate the healthcare system. Through detailing these distinct pathways of access to care in the CLD, we can better meet the specific needs of those overlooked and most affected by restrictive abortion policies.