Abortion bans in the United States have led to a rise in births among high-risk populations and a corresponding increase in infant mortality, particularly affecting vulnerable groups. New research indicates that in 14 states where abortion bans or severe restrictions were implemented following the Supreme Court’s Dobbs decision, the fertility rate increased by 1.7%, resulting in about one additional birth per 1,000 women of reproductive age. Alongside this, infant mortality in these states surged by nearly 6%.
Among the 22,000 additional births attributed to abortion bans, approximately 500 more infant deaths occurred than expected, bringing the infant mortality rate for these births to 24 deaths per 1,000 four times higher than anticipated. The findings suggest that these additional births are happening disproportionately among populations already at a higher risk for infant mortality and other negative pregnancy outcomes.
The research further highlights that Black and other minority women, as well as individuals with lower socioeconomic status, experienced the largest increases in fertility rates. Medicaid beneficiaries and those with lower levels of education were among the groups most affected. Infant mortality also increased at an alarming rate in these populations, particularly among Black infants, where deaths rose by nearly 11% almost double the overall average increase.
These findings reinforce longstanding concerns that restricting access to abortion can have serious consequences for both maternal and infant health. When abortion access is removed, more pregnancies are carried to term under circumstances that may pose greater health risks. One particularly concerning trend identified in the study was the significant increase in infant deaths due to congenital anomalies. In states with abortion bans, there was an 11% rise in mortality from congenital conditions, equating to more than one additional death for every 10,000 births. This suggests that a growing number of women are being forced to carry pregnancies with severe or fatal fetal conditions to term.
However, congenital anomalies were not the only cause of rising infant mortality. Deaths from other causes also increased by approximately 4% in states that imposed abortion restrictions. This suggests that even in cases where legal exceptions exist for fetal anomalies, they do not fully mitigate the broader negative effects of abortion bans on infant health. Many pregnant individuals were unable to access abortion services and were instead forced to continue pregnancies they may not have been physically, emotionally, or financially prepared for.
The impact of these policies has been particularly pronounced in states that already had some of the worst maternal and child health outcomes before bans were put in place. Existing racial and socioeconomic disparities in healthcare have only been exacerbated, as demonstrated by other recent research showing that maternal mortality among Black women increased between 2022 and 2023. The maternal mortality rate for Black women remains nearly three times higher than for other groups.
One state played an outsized role in the overall findings. Texas accounted for approximately three-quarters of the additional births and 80% of the additional infant deaths linked to abortion bans. Various factors may contribute to this, including long travel distances to out-of-state clinics and the early adoption of strict abortion laws before the Dobbs decision.
The research underscores the need for stronger support systems for pregnant individuals and infants, particularly in states with restrictive abortion policies. Ensuring access to healthcare, financial assistance, and family support programs is critical in mitigating the adverse effects of these laws. Without significant intervention, the trend of rising infant mortality and worsening health disparities is likely to continue.
