(CN) — Rates of infant and neonatal mortality in Texas saw an unexpected increase after the state passed its early-term abortion ban in 2021, according to a study published Monday in the journal JAMA Pediatrics.
The Texas early-term abortion ban, known as Senate Bill 8 or the Texas Heartbeat Act, went into effect in September 2021, months before the U.S. Supreme Court reversed the constitutional right to an abortion in 2022's Dobbs v. Jackson Women's Health Organization ruling.
Prior research had found some evidence of an association between a state’s abortion restrictions and its level of infant mortality, but the study is the first to empirically link a state’s abortion restrictions with a subsequent rise in infant mortality in that state.
"The repercussions of potentially preventable increases in infant mortality are significant. Experiencing an infant death is associated with trauma and potential criminalization, particularly for racialized groups," the researchers wrote.
Researchers from Johns Hopkins University and Michigan State University conducted two different analyses, and found that empirical link in both. First, they collected the mortality statistics from 2018 to 2022, compiled by the National Center of Health Statistics and the CDC’s WONDER database, and compared the rates in Texas to those in 28 other states for infant mortality and 19 states for neonatal mortality.
“We selected those states because they had at least 10 deaths per month in every month-year of the study," Alison Gemmill of Johns Hopkins University's Department of Population, Family and Reproductive Health, Bloomberg School of Public Health and corresponding author of the study, told Courthouse News in an email. "We couldn’t use states that had fewer than 10 deaths per month because these are suppressed in the publicly available database we used due to confidentiality reasons.”
The states researchers investigated ranged from both Democratic-led states like California and New York that have robust abortion protections to red states like Florida and Alabama, where abortions are essentially completely banned.
Comparing the data in Texas to the other states, Gemmill and her colleagues found that infant mortality, or the number of deaths of children less than one year of age, increased in Texas by 12.9% from 2021 to 2022, well above the 1.8% increase seen in the rest of the U.S.
Neonatal mortality, or deaths of children less than 28 days of age, rose by 10.4% in Texas but just 1.6% nationally.
In both cases, the rates of mortality per 1000 live births increased in Texas by 5.8%; the national infant mortality rate rose just 2.2%, and the national neonatal mortality rate actually decreased by 2.0%.
In the second analysis, the team constructed a “synthetic control for Texas” from that data and used that to calculate what the mortality numbers would have been had the trend from prior years continued, or had the state’s abortion ban legislation not been enacted.
They then compared the expected numbers in this synthetic control to the observed monthly figures in Texas from March to December 2022. Their conservative estimate set March 2022 as the first month where infants born in Texas would have been exposed to the effects of SB 8.
The result of this statistical comparison found 216 excess infant deaths and 145 excess neonatal deaths between March and December 2022. Monthly infant mortality statistics were above the expected rate in all months except November, and neonatal mortality statistics were above expected in all but May and November.
They did not detect a similar pattern in any other state, even after more than a dozen placebo tests, finding only a few single-month values above expected in a few states.
"Our findings of excess infant deaths — and to a lesser extent greater-than-expected increases in mortality rates — suggest that additional live births occurring in Texas in 2022 disproportionately included pregnancies at increased risk of infant mortality, particularly those involving congenital anomalies, which appear to be the largest source of this increase," researchers wrote.
While deaths due to congenital anomalies fell in the rest of the U.S. by 2.9%, the number rose by 22.9% in Texas.
Texas does not provide an exception to its abortion ban for congenital anomalies, and in May 2024, the Texas Supreme Court rejected a call from several women to clarify what exceptions SB 8 and other Texas statutes did provide.
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