Prop 5 Article 22 Maternal Health

Rep. George Till of Jericho is a board-certified obstetrician-gynecologist who has served in the Vermont State Legislature since 2008. Dr. Till is also an Associate Professor of Obstetrics and Gynecology at the UVM School of Medicine.  

Article 22: Protecting Women’s Health

I serve as the Division Chief of General OB/GYN at the UVM Medical Center, the Division that provides termination of pregnancy services. I’m outraged by the reckless and dangerous misinformation about Article 22 — the Reproductive Liberty Amendment — that’s being propagated by its opponents.

One irresponsible opposition talking point concerns the safety and health implications of pregnancy termination. Abortion is an extremely safe medical procedure and less than 0.3 percent of abortion patients in the United States experience a complication that requires hospitalization.

The risk of dying from a legal abortion in the first trimester—when more than 90 percent of abortions in Vermont are performed—is less than four in a million, making pregnancy termination one of the safest of all medical procedures. According to the Centers for Disease Control — the nation’s leading science-based, data-driven public health organization — carrying a pregnancy to term is 33 times more likely to result in maternal death than having an abortion.

I’ve also seen misinformation about the long-term health effects of abortion on women. An expert panel convened by the National Academies of Sciences, Engineering and Medicine in 2018 concluded that having an abortion does not increase a person’s risk of mental health conditions such as depression, anxiety, and post-traumatic stress disorder. The National Cancer Institute published a report categorically dismissing any causal link between abortion and breast cancer. Abortions performed in the first trimester pose virtually no long-term risk of problems such as infertility, ectopic pregnancy, miscarriage, congenital malformation, or future preterm or low-birth-weight delivery.  

Currently, no UVM medical staff member is required to participate in pregnancy terminations. Despite information to the contrary being fed to Vermonters, nothing about Article 22 changes this at all. Participation in termination by hospital and medical staff will continue to be completely voluntary.

Research shows that those most likely to seek abortion care, including women of color, poor women, and those with chronic health conditions, are also more likely to encounter serious complications during pregnancy.   

It is no surprise that the states with the highest maternal mortality in the country are the states with the most non-evidence-based restrictions on contraception and pregnancy terminations. The result of legislatures restricting access to reproductive rights is an overall increase in maternal morbidity and mortality

A recent publication showed the maternal mortality rate increased most significantly in states that enacted the most restrictive abortion laws. In 2017, states that restricted abortion had a maternal death rate that was nearly double those that had passed laws protecting access to abortion. In 2019, researchers looked at maternal mortality data from 38 states and Washington, D.C. and found that gestational limits on abortion significantly increased maternal mortality. They found that laws restricting abortion based on gestational age ​​increased maternal mortality by 38 percent.

Banning abortion nationwide would lead to an astounding 21 percent increase in the number of pregnancy-related deaths overall and an appalling 33 percent increase among Black women, according to research from the University of Colorado at Boulder.

One only needs to look at the state of Indiana as an example. In 2010, Indiana had a maternal mortality rate below the national average. In 2011, Indiana began its war on women, and on Planned Parenthood in particular, causing 16 of 28 clinics to close. The state has placed multiple non-science-based restrictions on clinics, abortion providers, and on women seeking an abortion. The result is a maternal mortality rate which nearly tripled. It now stands at about double the national average, commensurate with the rates in many developing countries. The current maternal mortality rate in Indiana is 43.6/100,000.

Meanwhile, in California, rated as the most abortion tolerant state, we see the lowest overall maternal mortality in the country, less than 1/10 of the rate of maternal mortality in Indiana at 4/100,000.

This is the main point: Pregnancy terminations are very safe procedures, and the earlier in pregnancy they are done, the safer they are. The result of legislatures restricting access to reproductive healthcare, including abortion, is a large overall increase in maternal morbidity and mortality. This is why passage of Article 22 is so important.

In November, Vermont voters will have the opportunity to protect reproductive liberty by voting “yes” for Article 22. The does not expand or change —in any way — the reproductive care that has been available to Vermonters since the early 1970s. By enshrining these rights in our constitution, we’ll ensure that individuals and their doctors remain free to make evidence-based decisions that work for their health, for their lives and for their futures.