Maternal mortality has long been considered a third world problem, almost unthinkable in a society, like ours, that spends $3.3tn a year on healthcare. So it was shocking, in the late 2000s, when public health researchers began to see an uptick in US maternal mortality, and to some even more shocking that the excess deaths were concentrated in the states imposing the highest number of restrictions on access to abortion.

Texas, for example, saw its maternal mortality rate more than double between 2010 and 2014, as the state closed more than half of its abortion clinics and severely cut funding for Planned Parenthood. Thanks to Texas and a few other states with strong “pro-life” lobbies, mostly in the south, the US now bears the ghastly distinction of having the highest maternal mortality rate of all the world’s wealthy democracies.

What does the presence or absence of abortion services have to do with the chances of a woman’s surviving pregnancy and childbirth? No one knows exactly what’s going on, but most people seem to agree that the relationship is indirect: states that make abortions hard to get also tend to be stingy about health services like prenatal and postnatal care, hence less likely to catch the escalating blood pressure or anomalous bleeding that can presage a woman’s death.