New study finds increasing infant deaths in Texas after implementation of SB 8

Infant deaths in Texas increased in the year following the passage of a 2021 law restricting abortion access, a new study shows.

The study, published Monday in JAMA Pediatrics, compared infant deaths in Texas between 2018-22 with 28 comparison states. It found both infant deaths, described as children under 1 year, and neonatal deaths, children under 28 days, increased following the implementation of the abortion law, commonly referred to as SB 8.

The law bans abortions after a fetal heartbeat can be detected, usually around six weeks. Abortion access in Texas was further restricted after the fall of Roe v. Wade, with the state only allowing the procedure in the case of certain medical exemptions.

Suzanne Bell, a public health professor at Johns Hopkins and one of the study authors, said this research is some of the first to empirically examine the effect of abortion laws that restrict the procedure before the fetus is viable. Since the 2021 law was among the most stringent in the country at the time, Bell said this research provides a unique preview of the impacts other states with similar abortion bans may experience.

“There are significant consequences that these abortion bans have in terms of trauma to families and medical costs associated with care,” she said.

Amy O’Donnell, communications director for the Texas Alliance for Life, said the results of the study are not surprising, as birth rates in Texas have increased after the passage of abortion bans and infant deaths would therefore increase as well.

“Losing a child is difficult, but aborting that child doesn’t take away the loss, and it robs the unborn child and family of time together, however short that may be,” she said in a statement. “The lives of babies diagnosed with fatal or life-limiting disabilities have value and worth and are worthy of being treated with dignity.”

Bell pointed out that infant deaths have increased even more than expected with an increase in live births. In prior research, she found just under an additional 10,000 live births in 2022 associated with SB 8. Applying the infant mortality rate before the law, an additional 53 infant deaths would be expected, she said. Instead, Texas saw an additional 255 infant deaths, according to their findings.

The researchers also examined the cause of death for the increasing fatalities, finding that some specific causes were more common.

While infant deaths rose 12.9% from 2021 to 2022, deaths caused by congenital malformations increased 22.9%. The researchers also noted an increase in accidental deaths during the same period, which they said could not clearly be explained by the data.

“Additional live births in Texas occurring during the 2022 period disproportionately included pregnancies at increased risk of infant mortality, and particularly those involving congenital anomalies,” Bell said. “It’s not just about forcing more people to continue pregnancies, it’s involving certain types of pregnancies.”

Bell said that many life-threatening congenital malformations are not diagnosed until the end of the first trimester, well after when a fetal heartbeat is detectable, and SB 8 would have prohibited a pregnant person from receiving an abortion in Texas.

This type of case made national news last winter when Kate Cox, a Dallas-area woman, unsuccessfully sued the state of Texas to access an abortion under the state’s medical exemption policy to end her non-viable pregnancy. She ultimately left the state to have the procedure.

“I’m grateful that I was able to access health care and that we got to make the decision that felt compassionate for our family,” Cox told CNN last week when announcing her new pregnancy.

Dr. John Thoppil, past president of the Texas Association of Obstetricians and Gynecologists, said he was not surprised by the results, as it was known that the state had eliminated options for people diagnosed with terminal malformations. He said he is hopeful the Legislature may be willing to consider revising the law to allow women in these situations to receive care, as they have done with pre-labor ruptures.

“In terms of our medical care, unfortunately, we’re sort of still muzzled, so we can’t necessarily use this information in any tangible clinical way,” he said. “I think what’s important is that we continue to fight the good fight and continue to educate the people that have passed these laws that we are hurting Texans.”

Thoppil said he would also like to see more research examining which women are affected by these rising infant deaths, as other data has shown that minority and low-income people are the ones most likely to be unable to seek an abortion out of state.

“We’re taking women that already have the highest risk for pregnancy — increased maternal mortality in our African American moms is 3x — these women that we’re forcing to carry pregnancies that may not be viable [are] still incurring that pregnancy risk,” he said. “That’s what breaks my heart.”