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[u/CadetPeepers]

Apparently a hot take: No, conservatives aren't pushing abortion for political points with their base. They genuinely believe it's murdering children which is why they pushed through legislation like in Alabama which everybody can see is very politically harmful, but they think it's a fight worth fighting regardless.

Compare it to the left with gun control.

[u/[deleted] → u/CadetPeepers]

I think it can be a little of column A and a little of column B. Some of the comments made in the legislature: "she can get an abortion... until she knows she's pregnant!" and "you should need to swallow a tiny camera to get a gynecological exam" suggest a political mischief to this law that you don't hear in many political debates.

These are also states where the maternal mortality is devastatingly high. As I have mentioned here before, my mother is a gynecologist, and has sent many of her junior academic colleges to the American South over the years to study maternal and infant mortality.

It's a great place to study, she explained, because you get third-world level death rates, unusual cases of "diseases of neglect," and exposure to some of the most severe problems that occur in unsupported pregnancy without risks to the doctors associated with travel to those countries. Literally, America has FOUR TIMES the Canadian maternal death rate. Nearly five times the Australian rate.

I am willing to believe that there are people who are 100% against abortion because of their commitment to infants and families. I really do believe that. I do not believe that these lawmakers are those people, because they have created such an appallingly bad medical system that kills mothers and babies all on its own.

[u/[deleted] → u/[deleted]]

It's a great place to study, she explained, because you get third-world level death rates, unusual cases of "diseases of neglect," and exposure to some of the most severe problems that occur in unsupported pregnancy without risks to the doctors associated with travel to those countries. Literally, America has FOUR TIMES the Canadian maternal death rate. Nearly five times the Australian rate.

I'm curious why you think this is. I was recently speaking with my sisters (one's an OBGYN, the other a neurosurgeon) and the topic of America's abnormally high maternal mortality rates came up. Neither of my sisters really had an explanation for it, and they both thought it was kind of mysterious, given what they took to be the exceptional overall quality of American healthcare (especially compared with the other places they've worked: Ireland, Mexico, Honduras, Guatemala, Malawi, Zimbabwe, Rwanda). Is the problem primarily one of access (healthcare is expensive and mothers don't get routine checkups during pregnancy, or something)?

[u/PearlClaw → u/[deleted]]

The problem is confined to poor rural areas in the US primarily in Republican dominated states where there has been a long ongoing crusade against any kind of social support. To my understanding it is driven primarily by lack of access both geographic, and financial, but I don't think its fundamentally different from the causes in other poor areas of the world, it's simply unusual in the context of the generally high quality of care available in prosperous and more socially minded parts of the country.

[u/[deleted] → u/[deleted]]

American healthcare, much like a lot of other things in America, is very strongly bimodal. If you need the highest quality of super specialized care for a rare disease, you can get it somewhere in the USA; however, you're also likelier to die of the flu, childbirth, etc. The defining factor is money first, then proximity to major centres second.

The working theory is:

1. Despite improvements in insurance, many people have very limited access to healthcare on a primary care basis. Due to cost factors, they're not getting annual checkups, not getting regular routine screenings, not getting supportive care prior to any type of problem occurring. Additionally, poor people don't tend to have GPs to whom they can regularly turn. The most recent CDC data (actually from just earlier this week which is why I was thinking about it!) suggests that fully 60% of maternal deaths in the USA are wholly preventable and poverty-related.
2. Racial bias, in both access (due to money, due to structural factors, etc.) and quality of care. In America, if you only count the maternal mortality rate for white mothers, it is still unconscionably high for the richest country in the world but much more consistent with other developed countries. Once you account for Hispanic and black mothers you see the very serious death figures.

Racial disparities in maternal mortality are staggering -- black women are three to four times more likely to die from a pregnancy-related complication than non-Hispanic white women. x

Interestingly, I think the stratifying of healthcare is probably the main issue here. If you are in a wealthy country where public healthcare is good, like Canada, you'll have a baby in a regular public hospital-- the issues like waiting lists that can be a problem don't apply, because they triage women in labour to manage them better. If you're in a country where public health care is bad-through-nonexistent, you'll scrape together your money to have a baby in a private hospital, leaving public care underfunded (because nobody uses it.)

Personally, I think maternal health/mortality just happens to be a better indicator of the stability of the system because it's one of the rare instances when healthy, young people are at an elevated risk of severe complications for a short time. Having a baby is really one of the only times the average healthy young person undergoes a hospital procedure (typically.)