Infant deaths in the United States have increased since the Supreme Court overturned Roe v. Wade and allowed states to make abortion illegal, researchers reported Monday.
The researchers found that the change became evident three months after a June 2022 ruling that increased infant mortality rates, involving babies born with severe congenital anomalies, were found.
There was a six-month period to the end of 2023 when the death rate for babies with serious anatomical problems was significantly higher than in the years before the High Court ruling. The researchers also identified three months when infant mortality rates increased overall across the country.
However, in the year and a half since the Dobbs v. Jackson Women’s Health Organization decision, neither rate has fallen below historical ranges.
The findings, reported Monday in the journal JAMA Pediatrics, are seen as a clear sign that Dobbs’ decision prevents some women from terminating pregnancies that might otherwise end in abortions.
“There’s a very simple mechanism here,” says Alison Gemmill, a demographer and perinatal epidemiologist at the Johns Hopkins Bloomberg School of Public Health who doesn’t participate in this study.
“Before these abortion bans, people had the option of terminating a pregnancy if the fetus was found to have serious congenital anomalies – we mean organs outside the body and other conditions that were very serious and incompatible with life,” Gemmel said. However, if women in this situation have no choice but to continue the pregnancy, “these babies will die shortly after birth,” she said.
Gemmill said the new findings are consistent with her own research, including one published in June that documented the state’s 2021 state ban on abortions after six weeks of pregnancy. Infant mortality increased by nearly 13%. The study found that deaths from congenital anomalies rose by 23%, while deaths were falling in other parts of the country.
Parvati Singh, an epidemiologist at Ohio State University who studies the impact of sudden changes in health policy, wondered whether Dobbs’ decision would have similar consequences for the entire country.
To find out, she and Maria Gallo, a sexual and reproductive health epidemiologist at Ohio State University, dug into live birth and infant death data collected by the Centers for Disease Control and Prevention. These figures allowed them to calculate monthly infant mortality rates.
In a country with a large population like the United States, the number of babies born and killed each month tends to remain stable, Singer said. What she and Gallo were looking for were significant deviations from a stable mean.
Singer said the pair started with data from January 2018 to May 2022, a month before the Dobbs ruling, to identify a “core signal” and “the natural ebb and flow around that core signal.”
They then used this information to estimate how much the country’s monthly infant mortality rate would rise by December 2023 if the Supreme Court did not allow states to restrict or ban abortion. (According to the Guttmacher Institute, 13 states ban abortion entirely, and another eight ban it at some point in the first 18 weeks of pregnancy.)
The next step is to compare their monthly estimates of infant mortality with actual numbers based on CDC data. They found that nine times the observed infant mortality rate was higher than expected, and the differences were too large to be explained by natural variation or random chance.
Singer said that because researchers don’t know the details of each death, they can’t determine whether there are any specific cases involving pregnant women who were denied abortions. But the patterns suggest that many of them are.
For example, the first increase in deaths of babies with congenital anomalies occurred in September and October 2022.
this Ultrasound examination The tests doctors use to make sure the fetus’ organs are developing normally occur between 18 and 22 weeks into pregnancy. If the test is done immediately after Dobbs’ decision, but the patient is unable to obtain an abortion, she will be at risk of premature labor three to four months later.
Dobbs decided that interest rates would not rise again until eight months later. Singer said this may reflect what happened to women who got pregnant around the time of the Dobbs ruling — before they had a chance to reconsider getting pregnant and before they could figure out a way around the ruling.
One year after the ruling, infant mortality rates returned to normal ranges, which may indicate a shift in the population willing to conceive due to the new restrictive circumstances.
Singh said a similar situation occurred early in the COVID-19 pandemic.
“Fertility rates are falling very fast,” she said. People who choose to become pregnant despite the threat of a new disease are less likely to give birth prematurely, and their newborns are less likely to have low birth weight.
“In other words, their pregnancies are healthier,” Singer said. “Maybe that’s what’s happening here.”
In total, Singer and Gallo counted an increase of 247 infant deaths in the 1.5 years after Dobbs, a 7 percent increase. The vast majority of these deaths (204) were due to congenital anomalies, a 10% increase, the study showed.
The fact that infant mortality never fell below expected levels is strong evidence that the abortion ruling was the root cause of the excess deaths, Singh said.
“If our theory is correct, there is no reason why infant mortality rates should be lower than expected,” she said.
Gemmel said the rise in infant mortality might have been more pronounced if researchers had focused on changes in states with abortion restrictions rather than looking at the country as a whole.
The increases are likely to be highest in places where pregnant women must travel long distances to another state to get an abortion, she added.