Infant mortality rates in Texas increased in the year after a law restricting abortion access was passed in 2021, according to a new study.
The study, published Monday in JAMA Pediatrics, compared Texas infant deaths to 28 comparison states from 2018 to 2022. It found that deaths of infants under 1 year old and newborn deaths under 28 days increased after the implementation of the abortion law, commonly referred to as SB8.
The law bans abortions after a fetal heartbeat can be detected, usually after six weeks. In Texas, access to abortion was further restricted after the repeal of Roe v. Wade, with the state only allowing the procedure with certain medical exemptions.
Suzanne Bell, a professor of public health at Johns Hopkins University and one of the study’s authors, said the study is one of the first to empirically examine the impact of abortion laws that restrict abortions before a fetus is viable. Because the 2021 law was one of the strictest in the country at the time, Bell said the study offers a unique preview of the impact other states with similar abortion bans may experience.
“These abortion bans have significant impacts in terms of trauma to families and the medical costs associated with treatment,” she said.
Amy O’Donnell, communications director for the Texas Alliance for Life, said the findings were not surprising because birth rates in Texas have risen since the passage of the abortion ban, with a corresponding rise in infant mortality rates.
“Losing a child is painful, but abortion does not erase that loss – it takes away time, no matter how brief, from an unborn baby and its family,” she said in a statement. “The lives of babies diagnosed with fatal or life-threatening disorders have value and deserve to be treated with dignity.”
Bell noted that the number of infant deaths has increased more than expected as births have increased. Previous research has found that SB8 will result in just under 10,000 additional births in 2022. Using the infant mortality rate before the law, Bell said, would predict 53 more infant deaths. Instead, his research shows that Texas saw an increase of 255 infant deaths.
The researchers also looked into the causes of the increase in deaths and found that some specific causes are more common.
The number of infant deaths increased by 12.9% from 2021 to 2022, while deaths from congenital malformations increased by 22.9%. The researchers noted that accidental deaths also increased over the same period, but this could not be clearly explained by the data.
“The additional births that occurred in Texas during 2022 included a disproportionate number of pregnancies at high risk for infant mortality, particularly pregnancies with congenital anomalies,” Bell said. “This is not just about forcing more people to continue with their pregnancies, but it is about certain types of pregnancies.”
Bell said many life-threatening congenital birth defects aren’t diagnosed until late in the first trimester, well after a fetal heartbeat can be detected, and SB8 would prohibit pregnant women from obtaining abortions in Texas.
This type of lawsuit made national news last winter when Kate Cox, a Dallas-area woman, unsuccessfully sued Texas for the right to access an abortion under the state’s medical exemption policy to end a nonviable pregnancy. She ended up leaving the state to get the abortion.
“I’m grateful to have had access to medical care and been able to make compassionate decisions for my family,” Cox told CNN when announcing her new pregnancy last week.
Dr. John Thoppil, past president of the Texas Society of Obstetricians and Gynecologists, said he wasn’t surprised by the results because he knew the state had eliminated options for people diagnosed with late-stage birth defects. He said he hopes the Legislature might be willing to consider changing the law to allow women in those situations access to treatment, just as they have in cases of prelabor rupture.
“Unfortunately, we still seem to be muzzled when it comes to health care, so we can’t necessarily put this information to use in concrete clinical situations,” he said. “I think the key is that we continue to fight the good fight and continue to educate the people who are passing these laws that we’re hurting Texans.”
Thoppil said she would also like to see more research examining which women are affected by rising infant mortality rates, given other data showing minorities and low-income families are the most likely to be unable to seek abortions out of state.
“We’re taking women who are already at highest risk for pregnancy. African-American mothers have a three-fold increase in maternal mortality. We’re forcing them into pregnancies that may not be viable.” [are] “I would still be taking a risk with my pregnancy,” he said. “And that breaks my heart.”
