Infant mortality increased by 12.9% from 2021 to 2022 in Texas after Texas' near-total ban on abortion was enacted, according to a new study published today in JAMA Pediatrics. A total of 2243 Texas infants, or children under 1 year, died in 2022 compared to 1985 Texas infant deaths in 2021.
This study, "basically confirms what we've suspected for a long time," said Dr. Richard Ivey, a practicing OB/GYN in Houston. "We knew that infant mortality would go up, particularly with congenital anomalies," after the passage of the ban, he said.
The Texas Heartbeat Act, Texas' near-total abortion ban, was implemented in September 2021. The infant mortality rate, or deaths per 1000 live births, increased by 8.3% from 2021 to 2022. The increase in death rates of infants in 2022 erase gains made in Texas since 2017. This data is from before Roe vs. Wade was overturned two years ago.
While deaths from birth defects decreased by 2.9% in all other states, researchers found a 22.9% increase in deaths from birth defects in Texas. According to the CDC, birth defects are one of the leading causes of infant deaths.
"This is really an atypical trend specifically in Texas," said Dr. Suzanne Bell, an assistant professor at the Johns Hopkins Bloomberg School of Public Health and co-lead on the study, about the increase in birth defects. She clarified that all other states that Texas was compared to also experienced COVID, and COVID alone cannot account for the increase in birth defects or infant mortality. In all other states, excluding Texas, infant mortality only increased by 1.8% -- a far smaller increase than the jump in death rates in Texas.
The study showed an increase in the number of infants who died from a dangerous intestinal complication called necrotizing enterocolitis, which is often associated with prematurity. However, the individual-level data, such as prematurity and race/ethnicity, is not yet publicly available for 2022. Researchers used data from CDC Wonder, or Wide-ranging Online Data for Epidemiologic Research, to conduct their analysis.
Provisional data from the CDC showed infant mortality continued to increase in 2023. Provisional data can be adjusted up or down after the final numbers are analyzed by the CDC.
As more data becomes available from the CDC, Dr. Bell plans to continue this research. She and her team will look next at specific characteristics associated with infant death, including prematurity and low birth weight.
Studying the health consequences of restrictive abortion bans "is the first step for people to understand" the gravity of the situation, said Dr. Ivey.
"Women don't talk about their miscarriages. Women don't talk about chromosome abnormalities in their children. Women don't talk about birth defects. So, the general public often doesn't understand" the consequences of abortion bans, he said.
Dr. Bell concurred, saying, "I think drawing attention to perhaps the unintended consequences, although perhaps foreseeable consequences, of abortion bans, is really important public health work."
When asked what brings him hope, Dr. Ivey said Texas House Bill 3058, which was passed in late 2023. This bill adds protections for pregnant people seeking abortions in cases of non-viable and potentially lethal pregnancies located outside of the womb or a pregnant person’s water breaks far too early.
Sejal Parekh, MD is a practicing pediatrician and a member of the ABC News Medical Unit.
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