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Topic

The Determinants of Maternal Mortality Under Restrictive Abortion Laws in High-Income Democracies: A Comparative Analysis of Poland and the United States

Department of Political Science

Date & location

• Monday, August 25, 2025

• 10:00 A.M.

• Clearihue Building

• Room B007

Reviewers

Supervisory Committee

• Dr. Mara Marin, Department of Political Science, University of Victoria (Co-Supervisor)

• Dr. Laura Parisi, Department of Gender Studies, UVic (Co-Supervisor)

• Dr. Amy Verdun, Department of Political Science, UVic (Member) 

External Examiner

• Dr. Astrid Pérez Piñán, School of Public Administration, UVic 

Chair of Oral Examination

• Dr. Brian Starzomski, School of Environmental Studies, UVic

   

Abstract

This thesis examines abortion laws and maternal mortality ratios (MMRs) in Poland and the United States, which are the only two countries that have removed legal grounds for abortion since the establishment of the United Nations Sustainable Development Goals (SDGs) in 2015. Despite global trends toward abortion liberalization, both countries have implemented restrictive policies. Conventional theory suggests that restrictive abortion laws are associated with higher MMRs. However, Poland maintains one of the world's lowest MMRs at two deaths per 100,000 live births, while the US has one of the highest among high-income countries at 17.

This research addresses two questions: (1) What explains the abortion restrictions in Poland and the US? (2) What explains Poland's significantly lower MMR despite having more restrictive abortion laws historically? The conventional theory would suggest Poland’s MMR should be higher than that of the US, yet the opposite is true. Explaining Poland’s lower MMR allows for a separation of the legal impact on MMR from the effects of other factors, such as healthcare and education systems and broader socioeconomic factors.

The study identifies politically mobilized religion as a common variable that partially explains these abortion restrictions, despite significant differences in political systems, regional contexts, and demographics. Poland's lower MMR is attributable to its universal healthcare system, nationally standardized maternal care protocols, strong integration of midwives, and comprehensive parental leave policies. Through legal-historical analysis, SDG analysis, and intrinsic and comparative case studies analyses, the research demonstrates that while similar religious and conservative political forces have influenced the legal restrictions in both countries, they differ in healthcare system design, access to care, social support policies, and inequalities across peoples and regions.

This research contributes to understanding how countries can achieve low maternal mortality even with restrictive abortion laws, challenging oversimplified understandings between abortion legality and maternal health outcomes. While most research on maternal mortality focuses on the Global South, these findings provide valuable insights for policymakers seeking to improve maternal health in high-income contexts where abortion liberalization faces barriers.