CNN
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In the year and a half after the Dobbs Supreme Court decision repealing federal abortion rights, hundreds more babies died in the United States than expected, new research shows. The vast majority of these babies had congenital anomalies or birth defects.

Previous research — spurred by a CNN investigative report — found that infant mortality in Texas spiked after a six-week abortion ban went into effect in 2021. Dobbs have been big enough to influence broader trends.

“This is evidence of a national ripple effect, regardless of state-level status,” said Dr. Parvati Singh, assistant professor of epidemiology at the Ohio State University College of Public Health and lead author of the new study.

In the new paper, published Monday in JAMA Pediatrics, Singh and co-author Dr. Maria Gallo, professor of epidemiology and associate professor of research at the Ohio State University College of Public Health, the infant mortality rates for the 18 months after the disease. Dobbs concludes against historical trends.

They found that infant mortality in the US was higher than usual for several months after the Dobbs decision and was never lower than expected.

In the months when child deaths were higher than expected – October 2022, March 2023 and April 2023 – the rates were about 7% higher than normal, leading to an average of 247 additional child deaths in each of those months.

About 80% of these excess infant deaths can be attributed to birth defects, which were higher than expected in six of the 18 months following the Dobbs decision, according to the new research. Birth defects can range from mild to severe cases, and some of the most common types can affect a baby’s heart or spine. In some cases, babies with birth defects survive only a few months.

“This is the tip of the iceberg,” Singh said. “Mortality is the ultimate consequence of any health condition. This is a very, very acute indicator. It could be representative of the underlying morbidity and the underlying hardship.”

Other research has found that births have increased in states that ban abortions, and experts say some of that increase is linked to a disproportionate increase in the number of women carrying fetuses to term with fatal birth defects.

“Whether the pregnancy was wanted or unwanted, we know that many of these pregnancies would have ended in abortion if people had access to these services,” said Dr. Ushma Upadhyay, associate professor in the department of obstetrics, gynecology and reproduction. science at the University of California, San Francisco. She was not involved in the new research, but does research abortion trends in the US.

Experts say abortion bans could also affect access to broader health care, leading to increased risk for both babies and mothers.

“The well-being of a pregnant person is inextricably linked to the well-being of the pregnancy,” Upadhyay said. Abortion bans can impact access to and willingness to seek prenatal care and broader support systems, she said, and the barriers are growing.

“People who face the most structural barriers of poverty, lower educational attainment, food insecurity and other life stressors do not have access to abortion care, and these factors also increase their risk for poor pregnancy and birth outcomes,” said them.

Infant mortality includes deaths that occur before a baby is one year old, so it’s difficult to parse exactly what happened in the months when the numbers were higher than expected, Singh said. But the timing – four, nine and 10 months after the Dobbs decision – corresponds to approximately the time at which congenital abnormalities can be diagnosed in the fetus and at full gestational age.

“These studies send a message that people are not getting the care they need, and therefore there are spillover effects,” says Dr. Alison Gemmill, a demographer and perinatal epidemiologist at Johns Hopkins University who led the study identifying the link between rising infant mortality and abortion restrictions in Texas. “It will never be the case that everyone will be able to overcome the barriers of these bans.”