Link found in Texas between rising infant mortality and state’s abortion restrictions

By Rob Kuznia and Isabelle Chapman, CNN

(CNN) — A new study has drawn a possible link between rising infant mortality in Texas and the state’s abortion restrictions, which, when they took effect in 2021, were the strictest in the nation.

The study, published today in JAMA Pediatrics – a publication of the Journal of the American Medical Association – cited an investigative report by CNN last year that revealed a sudden spike in infant deaths in the wake of the law’s passage.

“A report from the media found an increase in infant deaths in Texas between 2021 and 2022, suggesting that Texas’ abortion policy could be responsible,” according to the study by researchers at Johns Hopkins University and Michigan State University. “However, to our knowledge, no studies have conducted a systematic evaluation of infant mortality after the passage of Texas’ (law).”

The authors say their study is the first attempt to do so, and their conclusions echo the findings of CNN’s story.

In September 2021, Texas banned nearly all abortions beyond about six weeks of pregnancy. When the US Supreme Court overturned federal abortion rights the following summer, a trigger law in the state banned all abortions other than those intended to protect the life of the mother.

The study looks at the effects of the 2021 law, called Senate Bill 8, which made no exceptions for rape or incest, forcing women to carry a pregnancy to term even under traumatic circumstances. It also made no exceptions for congenital anomalies, also known as birth defects. The only exception that allowed for an abortion to be obtained after six weeks was “if a physician believes that a medical emergency exists,” according to the language of the bill.

The new JAMA Pediatrics study found that, between 2021 and 2022, infant deaths in Texas surged 12.9%, compared with a much smaller increase in the rest of the US of 1.8%. It also found a significant jump in the rate of infant mortality in Texas – or the number of deaths per thousand live births – relative to the rest of the country, suggesting that the increase in the number of infant deaths was not solely the byproduct of a rise in births. In that same time period, infant mortality rates rose 8.3% in Texas, compared with an increase of 2.2% in the rest of the nation.

The neonatal mortality rate – or the death rates of babies younger than 28 days – also increased in Texas by 5.8% but decreased in the rest of the US, the study found.

“This study provides some of the first empirical evidence on the association of restrictive abortion policies with infant deaths by using population-based data and a rigorous causal inference technique,” the authors wrote. “Although replication and further analyses are needed to understand the mechanisms behind these findings, our results indicate that restrictive abortion policies may have important unintended consequences in terms of trauma to families and medical cost.”

The study – whose lead author, Dr. Alison Gemmill, is a demographer and perinatal epidemiologist at Johns Hopkins University – was published alongside a critique of the Texas law by three unaffiliated medical experts in an editorial.

“In the coming years, as more people continue to be harmed by abortion bans across the country, we anticipate that more research will illuminate what Texans already know to be true: abortion bans harm everyone,” wrote Ghazaleh Moayedi and Aketch Osamba, both of the Pegasus Health Justice Center in Dallas, and Atsuko Koyama, of the University of Arizona, in the editorial.

“Future scholarship should focus on best practices and implementation strategies for collective action against and resistance to the increasing trend of extremist ideologies influencing the practice of medicine,” the authors wrote.

The study also found that the number of congenital anomalies increased in Texas from 2021 to 2022 but not in the rest of the US.

The authors based their study on publicly available death-certificate data and looked at infant and neonatal deaths across the country from January 2018 to December 2022.

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