In the first 18 months following the Supreme Court's Dobbs decision that overturned Roe v. Wade, states with abortion bans have experienced a significant rise in infant mortality rates, according to two new studies published in JAMA on February 13, 2025.
The research reveals that states enforcing complete or near-total abortion bans after six weeks of pregnancy saw a 6% overall increase in infant death rates, translating to 478 more infant deaths than expected based on previous trends. The impact was even more severe among non-Hispanic Black infants, who experienced an 11% increase in mortality rates.
"The groups that are most likely to have children as a result of abortion bans are also individuals who are most likely, for a number of different reasons, to have higher rates of infant mortality," said Alyssa Bilinski, a health policy professor at Brown University who reviewed the findings.
Regional Disparities and Texas Impact
The increase in infant mortality was concentrated primarily in Southern states, with Texas driving much of the overall trend. Texas, which had implemented strict abortion restrictions months before the Dobbs decision, saw a 9.4% rise in infant deaths—significantly higher than other states with bans.
"All but 94 of the additional 478 infant deaths were in Texas, which has a much larger population than any of the other states with bans," explained co-author Suzanne Bell, a professor at Johns Hopkins Bloomberg School of Public Health.
Other states with notable increases included:
- Kentucky: 8.6% increase
- Alabama: 6.9% increase
- Oklahoma: 5.1% increase
However, not all states with abortion bans saw rising infant death rates. Louisiana's rate remained unchanged, while Idaho, Missouri, West Virginia, and Wisconsin actually experienced decreases. Researchers attribute these exceptions to the availability of expanded abortion access in neighboring states like Illinois and Maryland.
Birth Rate Increases and Health Implications
The studies also found that states with abortion bans experienced a 1.7% higher-than-expected birth rate—equivalent to 22,180 more births than forecast by prior trends. This increase exceeds the 1.4% uptick in birth rates observed during the COVID-19 pandemic.
"It might seem like a 1.7 percent change in the fertility rate isn't a big deal, but it's actually a very big deal," noted Alison Gemmill of Johns Hopkins Bloomberg School of Public Health, who led one of the research teams.
Researchers observed an increase in babies born with fatal birth defects—cases where abortion was previously an option. This finding suggests that restrictions on abortion access may be preventing terminations in cases of severe fetal anomalies.
Socioeconomic and Racial Disparities
The studies highlight significant disparities in who is most affected by abortion bans. Women unable to access abortion care tend to come from low-income communities and communities of color, where maternal and infant health risks are already elevated.
"What happens when you ban abortion is that you create enormous inequality in access to abortion," explained Caitlin Myers of Middlebury College, who studies abortion data but was not involved in the new research.
Contrasting Perspectives
Anti-abortion groups have framed the higher birth rate as a positive outcome. "All of these 'excess' children who were born would have been killed in induced abortions," said Dr. Donna Harrison, director of research at American Association of Pro-Life Obstetricians and Gynecologists.
However, health policy experts emphasize that the findings highlight a critical need for stronger maternal and child health policies in states with abortion bans.
"If we are in a world where more people who perhaps didn't plan to and didn't feel prepared to become parents are becoming parents," Bilinski noted, "we should think about what it means to be supporting those families in a real and tangible way."
Broader Abortion Trends
These findings come amid a complex national landscape for abortion access. A separate report by the Society of Family Planning's #WeCount project found that overall abortion numbers have actually increased since the Dobbs decision, even in some states with bans.
Since March 2023, the #WeCount report identified a small but consistent increase in abortion rates nationwide. In the first six months of 2024, the monthly national abortion count averaged nearly 98,000—higher than both the 2023 monthly average of 88,000 and the 2022 monthly average of 81,400.
This unexpected trend is largely attributed to the expansion of telehealth services for medication abortion and the implementation of shield laws in some states, which protect providers who dispense abortion medication to women in states with bans.
Implications for Public Health Policy
The researchers behind the infant mortality studies emphasize that their findings should inform public health policies in states with abortion restrictions. They call for comprehensive maternal and infant health initiatives to address the concerning rise in preventable infant deaths.
"In many cases infant mortality is preventable," Bilinski stressed in an editorial accompanying the findings. She argued that preventing infant deaths should be a priority regardless of one's position on abortion access.
As the post-Dobbs landscape continues to evolve, these studies provide crucial data on the real-world health impacts of abortion restrictions, highlighting the need for evidence-based policies that protect maternal and infant health.
