A new study has found that in the year and a half since the Supreme Court's decision in Dobbs, which struck down the federal right to abortion, hundreds of infants have died in the United States, more than expected. The majority of these infants had birth defects or congenital anomalies. Previous research, sparked by CNN investigative reporting, has found that infant mortality in Texas spiked after a six-week abortion ban went into effect in 2021, and experts say the new data suggests the impact of bans and restrictions imposed in some states after the Dobbs case became large enough to affect broader trends. "This is evidence of a nationwide ripple effect, regardless of state-level status," said Dr. Parvati Singh, assistant professor of epidemiology at the Ohio State University School of Public Health and lead author of the new study. In a new paper published Monday in JAMA Pediatrics, Singh and co-author Dr. John said. Maria Gallo, professor of epidemiology and associate dean at the Ohio State University College of Public Health, compared infant mortality rates in the 18 months following the Dobbs ruling with historical trends. They found that in the months following the Dobbs decision, infant mortality rates in the United States were higher than normal and did not fall to lower levels than expected. In the months when infant mortality rates were higher than expected, namely October 2022, March 2023, and April 2023, mortality rates were about 7% higher than normal, resulting in an average of 247 additional infant deaths each month. About 80% of these additional infant deaths could be attributed to birth defects, which were higher than expected in 6 of the 18 months following the Dobbs decision, the new study found. Birth defects can range from mild to severe, and some of the most common types can affect an infant's heart or spine. In some cases, babies with birth defects may only live a few months. "This is just the tip of the iceberg," Singh said. "Death is the end result of any illness. This is a very serious indicator. It could represent underlying illness or underlying distress." Other studies have found that births increase in states where abortion is banned, and experts say part of that increase is related to a disproportionate increase in the number of women carrying fetuses with fatal birth defects. "We know that if people had access to these services, whether the pregnancy was wanted or unwanted, many of these pregnancies would have ended in abortion," said Dr. Ushma Upadhyay, associate professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at the University of California, San Francisco. She is not involved in the new study but has studied abortion trends in the United States. Experts say abortion bans limit access to more comprehensive health care and could lead to increased risks for babies and mothers. "The health of a pregnant person is inextricably linked to their health during pregnancy," Upadhyay said. Barriers are compounded by the fact that abortion bans can affect access to and willingness to receive prenatal care and broader support systems, she said. "People who face the greatest structural barriers -- poverty, low education, food insecurity and other life stressors -- are less likely to have access to abortion care, and these factors also increase their risk of poor pregnancy and birth outcomes," she said. Infant mortality rates include those that died before the baby turned one year old. So it's hard to analyze exactly what happened in the months when rates were higher than expected, Singh said. But the timing -- 4, 9 and 10 months after the Dobbs ruling -- roughly coincides with when fetal birth defects are detected and pregnancies are completed. "These studies show that people aren't getting the care they need, and that's why there's a ripple effect," said Dr. Alison Gemmill, a demographer and perinatal epidemiologist at Johns Hopkins University who led a study showing the link between rising infant mortality rates and abortion restrictions in Texas. "No one is ever going to be able to get over these ban hurdles."
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