Texas abortion ban linked to increase in infant and newborn deaths
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Texas abortion ban linked to increase in infant and newborn deaths

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Abortion ban in Texas linked to increase in infant and newborn deaths | Photo credit: © Meeko Media – © Meeko Media – stock.adobe.com.

Texas’ 2021 ban on early pregnancy abortions is associated with higher rates of infant and newborn deaths in Texas in 2021–2022, according to a recent study published in JAMA Pediatrics.1

Conclusions

  1. Texas’ 2021 abortion ban is associated with a 12.9% increase in infant mortality, which is significantly higher than the 1.8% increase observed in other states.
  2. From 2021 to 2022, Texas saw a 10.4% increase in newborn deaths, contrasting with a decline in newborn mortality across the rest of the United States.
  3. The ban led to more pregnancies being carried to term with birth defects, which contributed to higher infant and neonatal mortality rates.
  4. From March to December 2022, Texas saw an infant death rate that was 12.7% higher than expected, with significant increases in neonatal deaths, particularly in April and October.
  5. The study suggests restrictive abortion policies may result in increased infant and neonatal deaths, traumatizing families and raising medical costs.

Overall, infant mortality has been declining in the United States since 1995. However, it has been hypothesized that infant mortality will increase following the U.S. Supreme Court ruling Dobbs vs. Jackson Women’s Health Organization decision.

Restrictions on abortion lead to the forced continuation of pregnancies with anomalies, potentially increasing the number of deaths from birth defects. The risks associated with carrying a pregnancy to term may also be greater due to restrictions on abortion.

One study showed a 53.7% increase in the incidence of single-ventricular heart defects, an increase of 9 cases per 100,000 live births.2 Researchers found that the increase would lead to 531 additional neonatal heart surgeries, 16 heart transplants and 102 neonatal deaths per year.

Current research on the relationship between abortion bans and infant deaths is limited by the fundamental differences between restrictions and bans, and most analyses are correlational in nature.1 These gaps can be filled by using data from Texas, which has the most restrictive abortion laws in the United States.

Researchers conducted a cohort study to determine the effect of Texas abortion bans on infant and neonatal deaths. Death certificate data were obtained from the Provisional Causes of Multiple Deaths Database, which contains data compiled by the National Center for Health Statistics.1

Information on cause of death, up to 20 additional causes, and demographic data were included in death certificates. Infant deaths were defined as deaths less than 1 year of birth, and neonatal deaths were defined as deaths less than 28 days of birth. Deaths from January 2018 to December 2022 were included in the analysis.

States with fewer than 10 infant deaths in any month during the study period were excluded from the analysis, leaving 28 comparator states for the infant mortality analysis and 19 for the neonatal mortality analysis. The primary exposure was Texas Senate Bill 8, which banned abortion after fetal cardiac activity.

Infant and neonatal deaths in Texas during the postexposure period were reported as the primary outcome. Secondary outcomes included changes in monthly infant and neonatal deaths and infant deaths from specific causes from 2021 to 2022.1

From 2018 to 2022, there were 102,391 infant deaths in the United States, of which 65.2% were neonatal deaths, and 10,351 in Texas. Texas infant mortality rates have been observed to increase by 255 deaths in 2021-2022, from 1,985 to 2,240 deaths.1

The increase in infant mortality in Texas was 12.9%, significantly higher than the 1.8% increase seen in other states overall. In terms of infant mortality, the increase was 8.3% in Texas compared to 2.2% in other states.1

Similar patterns were observed in neonatal deaths, with increases of 10.4% in Texas and 1.6% in the rest of the United States. From 2021 to 2022, the infant mortality rate in Texas increased by 5.8%, but decreased in the rest of the United States.

From March to December 2022, infant deaths in Texas were 12.7% higher than expected, at 1,913 compared to 1,697. Infant deaths were much higher than expected in April, July, September, and October. Similarly, 145 additional infant deaths were reported, with much higher than expected increases in April and October.

These results indicate a link between restrictive abortion policies and infant deaths. Investigators concluded that restrictive abortion policies could lead to trauma for families and increased medical costs.1

Bibliography

  1. Gemmill A, Margerison CE, Stuart EA, Bell SO. Infant deaths after Texas bans early-stage abortion in 2021 JAMA Pediatrician. 2024. doi:10.1001/jamapediatrics.2024.0885
  2. Miller HE, Fraz F, Zhang J et al. Abortion bans and resource utilization for congenital heart disease. Obstetrics and Gynecology. 2023;142(3):652-659. doi:10.1097/AOG.0000000000005291
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