States with abortion bans had an even higher than expected infant death rate. Here's why.
The number of infants dying after states enact abortion bans is even higher than expected, a new study found.
At the same time, more babies are being born in states that implemented a complete or six-week ban after the Supreme Court overturned the constitutional right to abortion in 2022.
But the effects — sampled from more than a dozen states that had abortion bans — aren't felt evenly, according to studies published in JAMA Thursday.
'It is disproportionately impacting people who are already at the greatest risk of poor maternal and child health outcomes,' said Suzanne Bell, an assistant professor at Johns Hopkin's University's Bloomberg School of Public Health who co-authored both studies.
Evidence indicates many wealthier people have been able to travel to terminate pregnancies, contributing to increases in abortions despite bans. However, people who are poor, nonwhite and live in Southern states also now bear higher infant deaths and increased births because they lack access to abortion services.
'The data are reflecting some of these stories we have heard,' said Usha Ranji, associate director for women's health policy at KFF, a health policy nonprofit.
In news reports and research, she said, people who lost access to abortion 'were being forced to continue a pregnancy, even though they knew that it would not result in them being able to take a child home.'
Alison Gemmill, an associate professor at the Bloomberg School of Public Health who co-authored both studies with Bell, called infant deaths a 'bellwether.' There are warning signs for overall health outcomes.
'We have a very clear reason as to why it's trending in the wrong direction,' she said. 'It's because of policy choices.'
The studies, both funded by National Institutes of Health grants, built on existing research by the two researchers looking at infant deaths in Texas after the state enacted its 'heartbeat bill' banning abortion after six weeks' gestation in 2021, before the Supreme Court's June 2022 decision in Dobbs v. Jackson Women's Health Organization. That study found jumps in infant deaths, and even greater spikes from congenital anomalies or birth defects that cause infant mortality, compared to declines nationally.
Other research has found similar nationwide increases in infants dying after states enacted abortion bans.
In the new findings published in the American Medical Association's journal, researchers aimed to get a national picture of abortion bans across the U.S. In 14 states that enacted abortion bans, the two studies looked at infant deaths, before a child's first birthday, and birth rates among females ages 15 to 44, defined as of reproductive age. They drew from National Center for Health Statistics data from 2012 to December 2023.
Researchers estimated 478 additional infant deaths and 22,180 more live births than what would have occurred without the bans. Infant deaths had been declining in recent decades. However, in states that enacted bans, the study found infant deaths were 5.6% more than what they would have been without the bans. Meanwhile, deaths due to congenital anomalies, or birth defects, increased 10.9%. Those that didn't have defects but still died, such as from complications during birth, also rose 4.2%.
But there were stark differences, namely with non-Hispanic Black infants and mothers.
Black infants died at an 11% rate higher than expected, or about 265 infant deaths.
Birth rates were higher for Black, Latino and other nonwhite people, as well as people who received Medicaid, didn't have a college degree, and those who were unmarried or younger.
Deaths and births disproportionately occurred in the South, which has already tended to have worse infant and maternal health outcomes than the rest of the country. More specifically, researchers found Texas had an outsized influence. Texas overwhelmingly accounted for deaths and births.
In addition to being a large state by population, the state previously had large numbers of abortion providers forced to close operations. And being the largest state by geography, Texans also had to drive further distances or fly to get an abortion, which might not have been possible for others.
The studies only looked through the end of 2023, not afterward. Since then, Florida, also moved to limit abortion after six weeks of pregnancy, before most even know they're pregnant. More than half of all states — including nearly all of the South, have restricted abortion access, according to the Guttmacher Institute, a research and policy organization that supports abortion rights.
After the Dobbs' decision, organizations moved to donate to provide access to care for women in need of abortions. That funding is withering and could spell trouble for people who couldn't otherwise access an abortion, according to Rachel Jones, a principal research scientist at Guttmacher.
'It could be that these trends that we're seeing are going to become even more exacerbated,' she said.
Bell and Gemmill, the study authors, plan to also examine the effects of abortion bans on maternal health outcomes. Black women are disproportionately more likely to die than other mothers.
In 2024, reporting by the news organization ProPublica found at least two Georgia women, Amber Thurman, 28, and Candi Miller, 41, who died after not getting access to care under the state's abortion ban.
The studies published Thursday are significant in quantifying key public health indicators, Gemmill said.
'Of course, there are individual stories behind these numbers that we're not even conveying here.'
This article originally appeared on USA TODAY: Infant death rate is higher than expected after abortion bans
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