A comprehensive study published in the Journal of the American Medical Association (JAMA) has found that U.S. states implementing complete or six-week abortion bans experienced a 5.6% increase in infant mortality rates, resulting in an estimated 478 excess infant deaths across 14 states during the study period. The research, led by Johns Hopkins Bloomberg School of Public Health and UC Berkeley scientists, represents the most extensive analysis to date of how abortion restrictions affect infant survival rates.
The study analyzed vital statistics data from all 50 states and the District of Columbia between 2012 and 2023, using advanced Bayesian modeling to compare actual infant mortality rates with expected rates based on pre-ban trends. States with abortion bans saw infant mortality rise to 6.26 deaths per 1,000 live births compared to an expected 5.93 per 1,000 births, an increase of 0.33 deaths per 1,000 births.
The most alarming finding concerned racial disparities in outcomes. Non-Hispanic Black infants experienced the steepest increases, with mortality rates rising to 11.81 per 1,000 live births compared to an expected 10.66 per 1,000, representing an 11% relative increase. This translated to an increase of 1.15 deaths per 1,000 births among Black infants, more than triple the overall average increase.
The research revealed that deaths from congenital anomalies surged by 10.87%, while deaths from non-congenital causes increased by 4.23%. The infant mortality rate linked to congenital anomalies was observed at 1.37 deaths per 1,000 live births, compared to the anticipated rate of 1.24 deaths per 1,000 births.This pattern suggests that abortion bans may be forcing higher-risk pregnancies to term, particularly those involving fetal abnormalities that would previously have been terminated.
Previous research has shown that congenital heart defects, which are often diagnosed around 20 weeks of pregnancy, present particular challenges under abortion restrictions. A Stanford Medicine study projected that complete abortion bans could result in 541 additional births annually of infants with severe single-ventricle cardiac defects, requiring extensive medical resources and resulting in higher mortality rates.
Texas had a dominant influence on the overall results, with the state’s restrictive abortion law (known as SB 8) contributing significantly to the national trends. A separate JAMA Pediatrics study focusing specifically on Texas found that infant deaths increased by nearly 13% after the state’s abortion ban went into effect, compared to less than 2% nationwide during the same period.
Southern states showed larger increases compared to non-southern states, reflecting both the concentration of restrictive abortion laws in the region and existing healthcare disparities. The researchers noted that 14 states had implemented complete or six-week abortion bans by the study period, with these policies taking effect primarily between September 2021 and August 2022.
The findings align with growing evidence that abortion restrictions create cascading effects throughout healthcare systems. Healthcare professionals in states with abortion restrictions say they are often prevented from delivering standard medical treatment, which results in care delays, refusals, and poorer health outcomes for patients.
A University of California San Francisco report documented 50 cases of poor-quality care following the Dobbs decision, showing how abortion bans obstruct medical decision-making even in emergency situations.
Medical organizations, including the Society for Maternal-Fetal Medicine and the American College of Obstetricians and Gynecologists, have consistently affirmed the safety and necessity of abortion care in certain medical circumstances.
Recent policy changes at the federal level have further complicated the landscape. The Trump administration recently rescinded Biden-era guidance requiring hospitals to provide emergency abortions regardless of state bans, potentially affecting care for women facing life-threatening pregnancy complications.
