U.S. infant mortality increased 7 percent in months following Dobbs, researchers find

The findings mirror previous research analyzing the experience in Texas after a ban on abortions in early pregnancy and illuminate the consequences of restricting access to abortion care, said Maria Gallo and Parvati Singh, researchers from The Ohio State University who conducted the national analysis appearing online today (Oct. 21) in JAMA Pediatrics.

"In the seven to 14 months after Roe v. Wade was overturned, we saw a 7% increase in infant mortality, and a 10% increase in those babies born with congenital anomalies," said Singh, an assistant professor of epidemiology.

From 2018 through 2023, monthly infant mortality averaged 5.6 deaths per 1,000 live births and mortality with congenital anomalies averaged 1.3 deaths per 1,000 live births. When the researchers compared the months after Dobbs with the months before, they found 247 more total infant deaths per month than expected and 204 more deaths per month than expected due to chromosomal and genetic conditions.

"I'm not sure that people expected infant mortality rates to increase following Dobbs. It's not necessarily what people were thinking about. But when you restrict access to health care it can cause a broader impact on public health than can be foreseen," said Gallo, a professor of epidemiology.

This study doesn't reflect variations from state to state, but the researchers said they would expect the impact to be more pronounced in states with more restrictive abortion laws.

To determine the effect of the Dobbs decision on infant mortality, and on infant mortality due to congenital problems in particular, the researchers used a national birth outcomes database to look for patterns from 2018 to 2023.

"Birth outcomes are usually pretty stable in any population, and in a large population like the entire U.S., infant mortality is typically quite consistent except for some predictable seasonal peaks and valleys," Singh said. The researchers accounted for those routine changes when analyzing the data.

"Babies born to people who became pregnant in the first part of 2022 are where we see these additional deaths," Singh said.

The researchers did not see an elevated rate of infant death beyond 14 months after the decision, Gallo said.

"Will this continue past this time period? That's an open question," she said. "It could be that, yes, it will because (abortion care) access is shut down in some states. But it also could be that eventually more state policymakers are seeing that this isn't what people in the state want and more will pass constitutional amendments to protect access."

Going forward, the researchers would like to look at the impact based on different populations, including those who typically struggle more when care is limited, and to examine maternal mortality rates.

"There's a broader human toll to consider, including mental health consequences of being denied abortion care or being forced to carry a fetus with a fatal genetic abnormality to term," Singh said.