Study: Heartbeat law against abortion in Texas leads to more infant deaths

June 24, 2024

Texas lawmakers touted their Heartbeat Law as a crusade to save lives, but the reality of the state’s near-total abortion ban was deadly.

According to a new study published on Monday, hundreds of babies have died since the law came into force.

The findings in JAMA Pediatrics show that infant mortality increased after Texas Senate Bill 8, which banned all abortions about six weeks after conception. SB 8 became law in Texas in September 2021, and the U.S. Supreme Court struck down the constitutional right to abortion just over nine months later, on June 24, 2022. The Supreme Court’s ruling in the Dobbs case prompted more than a dozen states to ban abortion entirely. Observers speculate that the evidence will show an increase in infant mortality in those states as well, similar to what happened in Texas, the study said.

“It just shows some of the devastating consequences of abortion bans that people may not have thought about when they passed these laws,” Alison Gemmill, an assistant professor at the Johns Hopkins University Bloomberg School of Public Health and an author of the study, told USA TODAY. She called the deaths resulting from Texas’ heartbeat law “spillover effects on mothers and babies.”

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After the Texas law passed, more babies died before their first birthday, likely due to birth defects or genetic problems that would have made it impossible for them to survive, the study found. These pregnancies would normally have been terminated by abortion, researchers said. Texas’ heartbeat law makes no exceptions for pregnancies with such conditions. Mothers are legally required by state law to carry these babies to term.

Writing in the peer-reviewed Journal of the American Medical Association, Gemmill and researchers from Johns Hopkins University and Michigan State University said the Texas law was linked to an “unexpected increase in infant and newborn mortality” between 2021 and 2022. Previous research had found a link between the rise in infant mortality and the enactment of anti-abortion laws, but no study to date has directly linked the deaths to the restrictive laws that force women to carry these pregnancies to term.

“Abortion care is an essential part of comprehensive health care, and when it is restricted, the human impact is devastating,” Wendy Davis, a senior adviser to Planned Parenthood Texas Votes, said in a statement. Davis, who fought for abortion rights as a Democratic state senator, pointed out that the study only covered 2022, not results from 2023 and 2024 in the wake of a more restrictive abortion ban that came with the Dobbs decision. This “likely means the situation on the ground is even worse today,” Davis said.

Texas Gov. Greg Abbott’s office did not dispute the study’s findings but defended the Republican-controlled state’s anti-abortion record. Those efforts included the Heartbeat Act of 2021 “to save the innocent unborn, and now thousands of children have been given a chance at life,” Andrew Mahaleris, a spokesman for Abbott, said in a statement to USA TODAY. He said the governor has taken “significant actions to protect the sanctity of life” and offered resources to expectant mothers “so they can choose their child’s life.”

Abortion opponents also did not dispute the increase in infant mortality cited in the study. Supporters of the Heartbeat Law and other laws restricting abortion say such bans protect life. They say aborting a fetus with a fatal disease is “a conscious decision to kill the child.” But the vast majority of these abortions occur before the fetus is viable.

Amy O’Donnell, a spokeswoman for the Texas Alliance for Life, said the study’s findings were no surprise. She said babies born with disabilities or even fatal abnormalities deserve a chance at life, even if that means the newborn dies after birth from a disease that doctors predicted would be fatal. The death of a child is not easy, she acknowledged. She noted that her nonprofit offers resources for families grieving such losses.

“In Texas, we celebrate every unborn child’s life saved. We value the fact that our laws protect women’s lives,” she said. “We make no apologies for not supporting discrimination against children who face disabilities or terminal diagnoses in or out of the womb. And that is a line we believe must not be crossed.”

Gemmill of Johns Hopkins University said babies who died from birth defects shortly after birth “probably caused a lot of unnecessary trauma for families.”

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Researchers examined death data from the time the Heartbeat Law took effect. The study created a “synthetic Texas” that simulated the outcomes that would have occurred had the law not been in place and compared the numbers to national trends during that time period. In 2021, 1,985 infants died before their first birthday in Texas. The following year, when SB 8 took effect, the number of deaths rose to 2,240, a 12.9% increase, while the U.S. overall saw an increase of less than 2%. Deaths due to congenital anomalies or birth defects rose nearly 23% in Texas, while they fell 3% nationwide.

“This suggests that this policy was indeed responsible for the increase in infant mortality in Texas,” Gemmill said.

The study is significant because Texas is a conservative state whose urban and rural areas may reflect what is happening in the rest of the U.S., says Dr. Tracey Wilkinson, associate professor of pediatrics and obstetrics and gynecology at Indiana University School of Medicine. Texas has had the restrictions in place longer than other states that passed abortion bans after the Dobbs ruling.

“When people ask me why this is happening, it’s very simple,” said Wilkinson, who was not involved in the new study. “If you take away people’s ability to make decisions about whether and when to become pregnant, there will be consequences such as rising infant and maternal mortality.”

The study did not examine the impact of infant deaths on the health of mothers who were legally required to carry dead babies to term, nor the psychological impact of mothers carrying and delivering infants only to watch them die. The study also raises questions about, but does not address, the financial costs to families carrying and delivering terminally ill newborns.

Gemmill is currently working to understand the impact of abortion restrictions on parents of different races and ethnicities. Previous research has shown that black mothers and babies have higher death rates than other groups.

The study reflects what Molly Duane, a senior attorney at the abortion rights nonprofit Center for Reproductive Rights, has experienced in the courtroom while arguing against Texas laws. She recently represented women who sued the state after being denied a medication abortion. One of her clients, Samatha Casiano, was legally required to carry a child that developed without a brain. In late May, the Texas Supreme Court ruled that pregnant patients must suffer from a “life-threatening condition” to be eligible to terminate a pregnancy.

Duane questioned anti-abortion activists’ claims that Texas is a “pro-life” state in light of the study’s findings. “Women are suffering, families are suffering, babies are dying, and no one in the state is taking responsibility for that real human suffering,” she said.

In late 2023, a report from the U.S. Centers for Disease Control and Prevention found an increase in infant mortality for the first time in more than 20 years. The states cited in the report with increased deaths were states that had restricted access to abortion. However, experts cautioned at the time that they could not say what caused the increase in deaths.

The Texas study went a step further and found a state where abortion restrictions led to more deaths.

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