The Pro-Life Paradox: Can A State’s Views on Abortion Predict The Health Of Its Citizens?

When does a human life begin? At first glance it would seem like, given the myriad advances in science’s understanding of human reproductive biology in modern times, a simple question that should have a concrete answer. However, ask a dozen developmental biologists, obstetricians, politicians, theologians and laypersons when human life begins and you’re likely to get a wide range of responses, none of which can be considered a definitive answer to the question. An advocate for an anti-abortion lobbying group like National Right To Life or presidential candidates who get their seal of approval, like Ted Cruz, would argue that life begins at conception or when the woman’s egg is fertilized by the man’s sperm, a seemingly clear cut delineation that’s murkied up by the fact that 20-50% of fertilized eggs never manage to implant themselves in the woman’s uterus. At the same time, someone who has spent their life working as a neonatal neurologist might think that life begins when brain activity can first be detected while a lawyer might define personhood along the lines set by Roe v Wade and contend life begins at the point the fetus is able to survive out of the womb. For a mother, personhood might be recognized when certain points of maternal-fetal connection are reached, like when a fetus is first seen on an ultrasound or the first time he or she kicks.

This issue over when personhood begins has been central to the debate over abortion in America and, while there is no indication that a clear-cut answer will arise anytime soon—if anything, the more science discovers, the more is uncertain—it’s beyond doubt that anti-abortion and pro-abortion groups will try to frame the discussion in ways that benefit their side. I say anti-abortion and pro-abortion instead of pro-life and pro-choice because the euphemistic labels we’ve put on the two movements allow for distortions and unjust associations to crop up around them.

Long before the introduction of Roe v Wade, American women aborted pregnancies in lieu of carrying them to term, but they did so using a variety of methods that were unnecessarily painful and potentially fatal. Before the legalization of abortion, every large municipal hospital in the US had what were known as Septic Abortion Wards, where doctors would treat women who had attempted to self-abort their pregnancies by penetrating themselves with sharp objects like coat hangers and knitting needles or swallowing chemicals like bleach and turpentine. Those women—and countless other women in other nations who have yet to legalize abortion—did make a choice to abort their pregnancies, but it was a choice in much the same way a Civil War soldier made the choice to have his leg amputated to avoid a gangrenous death. Theirs was a choice born out of desperation, guided by unnecessarily draconian laws and one which frequently wound up costing them their lives. It is not the mere existence of a choice that is the primary issue for many who advocate for the right to easily accessible, medical abortion services in America so much as it is the quality and safety that comes with that choice and the recognition that every woman, and not the state or anyone else, has ownership or control over her own body.


A woman protests at a 2012 anti-abortion rally in Portland (Randy L. Rasmussen/The Oregonian)

With all that being said, the semantic quibbles that can be drawn from the public persona of the pro-choice movement are a pittance compared to the duplicitousness inherent in anti-abortion advocates calling themselves the “pro-life” crowd. As can be inferred by their vehement opposition to a law that saves the lives of thousands of women each year through the provision of medical abortion services and the refusal of many to allow for exceptions in cases where a woman’s pregnancy places her in mortal danger, the life of the mother isn’t much of a consideration to many pro-lifers. But, what would happen if we tried to quantify the value placed on life by anti-abortion supporters and took the dichotomy between the pro-life movement’s desire to protect the fetus and extended it to the overall health of all Americans? Would that disregard for the health of the mother be reflected in the well being of all in areas dominated by pro-life sentiment?

To answer these questions, I came up with a formula to try and elucidate the ways in which a particular state’s views on abortion correlated to the health and welfare of its citizens, especially its mothers. The idea came to me a couple weeks ago when I was walking through a parking lot and saw one of those Smile, Your Mom Chose Life stickers on the back of an SUV. Living at the confluence of the south and the midwest in Cincinnati, I had seen stickers like that one hundreds of times, but it was only then that it occurred to me to wonder how someone whose mother had committed suicide would react to seeing it. Considering the fact that over 9,000 women commit suicide each year, the chances of someone who had lost their mother to suicide seeing one of the hundreds of thousands of Smile, Your Mom Chose Life bumper stickers at some point in their life is probably pretty high. It was this disconnect between the consideration for fetal life and human life that got me thinking: do anti-abortion states value life less than states that are pro-abortion?

In an attempt to find an answer to this question, I have used the most recent rankings from the United Healthcare Foundation’s America’s Health Rankings and the congressional scorecards from The National Right To Life Committee to determine if there is any correlation between a state’s attitudes towards abortion and the value it places on maintaining the health of its already-born population. To measure this I combined each state’s rankings for infant mortality, teen birth rate, preterm birth percentage, rate of suicide, community & environment health (which combines measures for percent of children in poverty, infectious disease rate, violent crime, occupational fatalities, and air pollution) and overall health to calculate how much each state values the lives of its residents and compared it with each states ranking on abortion issues according to The National Right to Life Committee’s congressional scorecard from 2014-15. The results were shocking with regards to the severity of the correlation, but not necessarily its direction.

Screen Shot 2016-04-11 at 12.40.53 AM

On the graph, a 1 represents the highest composite life rank & National Right To Life rank, while 50 is the lowest. For example, Massachusetts had the highest composite life rank & tied for the lowest NRTL rank, so it is at the very top left of the graph. Arkansas, which got the lowest composite life rank and tied for the highest NRTL rank is at the bottom right.

Among the top 10 healthiest states in the country according to this formula, not one of them had a passing grade on their National Right To Life scorecard, with the congressional delegation from New Hampshire having the highest marks, voting along with the anti-abortion group 50% of the time. Meanwhile, at the other end of the spectrum, only 1 of the 10 states with the worst health outcomes (New Mexico) had a failing NRTL grade, with none of the other 9 getting a grade lower than a B+. With the exception of a handful of mountain and plains states like Utah, Nebraska, Idaho and Wyoming, which all had decent health rankings along with good National Right To Life scores and a couple of outliers with bad NRTL scores and poorer health outcomes (the aforementioned New Mexico & Delaware), the degree to which a state’s elected representatives in Congress supported or opposed abortion was a good indicator of how healthy its residents would be.

Of course, correlation isn’t causation and there are certainly other measurables like median household income or geography that line up well with the health rankings that were used for this comparison. But, to be fair, the purpose of this exercise was never to prove any causal relationship between the anti-abortion movement and poor health outcomes, but to illustrate the inherent hypocrisy in a social movement that is patently obsessed with the life of the theoretical child in utero, but unconcerned with that child’s health and wellbeing after it leaves the womb. Looking over that graph, it strikes me that all those anti-abortion bumper stickers might need a little tweak. Maybe something along the lines of:

Smile, your mom chose life…too bad your elected officials have no interest in protecting it.


If you would like to look at the raw numbers that were used in constructing the chart above, you can check out this Google Doc.

Categories: Public Health, Uncategorized, US Politics

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1 reply

  1. You should look into the new and most horrible anti abortion law Mike Pence just passed. It’s so disgusting and set us back about 100 years in women’s equality. Plus, Indiana had a “Choose Life” license plate that I think it’s the most offensive thing over the “On God We Trust” one here in Indiana. As a woman that chose to have an abortion in my early 20s it was not an easy decision to make. I knew if I had carried to term (if I had even been able too) I would have died. And i would have left 2 babies without their mother. All of it is ridiculous as alot of it is born from ignorance and fear (just like the trump campaign)

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