Infant Mortality Increase in States with Abortion Bans: An In-Depth Analysis
HQ Team
February 15, 2025:Two recent studies published in the Journal of the American Medical Association (JAMA) reveal a concerning trend: an increase in infant mortality rates in U.S. states that have implemented abortion bans. This rise follows the Supreme Court’s decision in 2022 to overturn Roe v. Wade, which had previously guaranteed a woman’s constitutional right to abortion up to the point of fetal viability, typically around the 24th week of pregnancy.
The two studies compared data from January 2012 through December 2023, analyzing birth and death certificates and U.S. Census Bureau data across all 50 states and Washington, D.C.
One study estimated a 5.6% higher-than-expected infant mortality rate in states with near-total abortion bans or bans after six weeks of pregnancy. This translates to approximately 478 additional infant deaths in these states.
The other study estimated a 1.7% increase in birth rates in states with abortion bans, equating to about 22,000 more births than expected.
The studies indicated that the increases in infant mortality were more pronounced among already vulnerable groups, such as Black infants and those in southern states. Specifically, mortality among Black infants in states with abortion bans was approximately 11% higher than expected.
There was a notable increase in deaths from congenital anomalies, rising from an anticipated 1.24 per 1,000 to 1.37 per 1,000, marking a relative increase of 10.87%. This increase aligns with cases where women were unable to access abortions for non-viable pregnancies.
State-specific variations
The impact of abortion bans varied across states. For example, Texas had a significant influence on the overall findings, with the majority of the additional infant deaths occurring in the state. This is partly attributed to Texas’s large population and the implementation of a six-week abortion ban in September 2021, before the Dobbs ruling. Some states, like Louisiana, Idaho, Missouri, West Virginia, and Wisconsin, did not experience an increase in infant mortality, potentially due to expanded abortion access in neighboring states like Illinois and Washington.
Factors influencing increase in infant mortality
Abortion restrictions have curtailed access to services, compelling many women to either carry pregnancies to term or travel long distances to access abortion services.
The demographics most likely to give birth due to abortion bans are often those who experience higher rates of infant mortality for various reasons.
Abortion bans may disproportionately affect marginalized groups already at greater risk for infant mortality and who may face delays in accessing medical care
Global abortion rights overview
Abortion laws vary widely across the globe, reflecting diverse cultural, religious, and social perspectives. According to the Center for Reproductive Rights:
Many countries, primarily in Europe and North America, permit abortion on request or for a broad range of reasons. For over sixty years, Europe has generally led the global trend toward more liberal abortion laws
In several regions, including parts of Africa, Latin America, and the Middle East, abortion is highly restricted or completely prohibited, often with exceptions only to save a woman’s life.
Impact of abortions on infants and maternal mortalities
Almost 90% of abortions in countries with liberal abortion laws are considered safe, compared to only 25% in countries with restrictive laws. Globally, unsafe abortions account for approximately 68,000 maternal deaths each year, representing about 13% of all maternal deaths
While some studies suggest that increased abortion access may correlate with lower infant mortality rates, these outcomes are also affected by a nation’s overall health care system, economic status, and access to prenatal and postnatal care.
In the United States, states with more restrictive abortion policies have been shown to have higher maternal mortality rates. A study from Tulane University found that states with a higher abortion policy composite index experienced a 7% increase in total maternal mortality compared to states with fewer restrictions. Specifically, states requiring licensed physicians for abortions had a 51% higher total maternal mortality rate.
The legal status of abortion continues to evolve worldwide, with ongoing debates and legal challenges seeking to either expand or restrict access to abortion services.
The recent studies underscore the potential consequences of abortion bans on public health, particularly for infants and vulnerable populations. Experts emphasize the need for ongoing research to fully understand the effects of abortion restrictions and to identify strategies to support pregnant individuals and infants. Potential solutions include improving access to Medicaid, parental leave, and affordable child care. As Alyssa Bilinski, a professor at Brown University School of Public Health, notes, “ensuring every child has the opportunity to thrive should be a shared objective that transcends partisan lines”.
