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States with tightest abortion restrictions have higher infant death rates

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States with the tightest abortion laws had a 16% increased infant mortality rate from 2014 to 2018, compared to the states with the least restrictions on abortion, researchers said. Photo by Adobe Stock/HealthDay News

Abortion bans are intended to preserve the lives of children, proponents say, but a new study has found infants are more likely to die in the states with the most restrictive laws.

States with the tightest abortion laws had a 16% increased infant mortality rate from 2014 to 2018, compared to the states with the least restrictions on abortion, researchers said.

"Given the current changing legal landscape in the U.S. regarding reproductive health policy, it is essential that we consider the larger impacts of restricting access to abortion, not just to birthing individuals, but also on infant births," said lead researcher Dr. Lois Lee, an associate professor of pediatrics and emergency medicine at Harvard Medical School in Boston.

For the study, Lee and her colleagues assessed states regarding 12 types of laws that restrict abortion access.

Six of the laws set requirements for how abortions can be conducted. For example, the law might require that they happen in a hospital, with a second physician present or with a required waiting period.

Other laws restrict abortion, allowing the procedure only under certain circumstances such as rape, incest or to save the woman's life.

The researchers categorized the 48 contiguous U.S. states by the number of restrictive abortion laws, also factoring in variables like driving distance to an abortion facility, state Medicaid expansion status and key demographics.

In those states, there were more than 19.5 million live births and more than 113,000 infant deaths between 2014 and 2018.

Researchers found that states that had enacted 11 to 12 of the abortion restrictions had a 16% increased infant mortality rate, compared to those that had adopted one to five of the laws.

Other factors also were associated with increased infant mortality rate, including Black ethnicity, lower education, smoking during pregnancy and inadequate prenatal care, researchers said.

The new study was published recently in the American Journal of Preventive Medicine.

Abortion laws could be having unintended consequences by also restricting access to reproductive healthcare for women with limited financial means, the researchers explained.

"Maternal health directly influences infant and child health -- and ultimately population health," Lee said in a journal news release. "From our study findings, it is important to understand that limiting access to abortion as part of comprehensive reproductive care not only affects birthing individuals, but also their infants. Without the implementation of more equitable access to comprehensive reproductive care, there will be continued disparities in access to care and health outcomes, varying especially by geography in the U.S."

It will likely take years for the Supreme Court's reversal of Roe v. Wade to fully reverberate through America's reproductive healthcare services, Lee said.

"Given the well-established disparities in maternal and infant mortality by race and geography, we are concerned more restrictions on comprehensive reproductive care will exacerbate these disparities, especially among lower-income individuals," she noted.

More information

The U.S. Department of Health and Human Services has more about reproductive healthcare.

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