Abortion Restrictiveness and Infant Mortality: An Ecologic Study, 2014-2018.

Area of Science:

• Public Health
• Reproductive Health
• Societal Impact of Healthcare Policy

Background:

• The United States exhibits the highest infant mortality rate among comparable nations.
• Restrictive abortion laws are a potential contributing factor to adverse infant health outcomes.

Purpose of the Study:

• To investigate the association between county-level infant mortality and state-level abortion access legislation in the U.S. from 2014 to 2018.

Main Methods:

• Ecological study utilizing multivariable regression analysis.
• Examined county-level infant mortality rates, controlling for state abortion laws, county demographics, proximity to abortion facilities, and Medicaid expansion.
• Analyses were conducted between 2022 and 2023.

Main Results:

• States with 8 or more restrictive abortion laws showed increased infant mortality rates, with the most restrictive states (11-12 laws) exhibiting a 16% rise.
• Black infant mortality rates were more than double White infant mortality rates.
• Factors associated with increased infant mortality included higher proportions of Black individuals, lower educational attainment, maternal smoking, and inadequate prenatal care.

Conclusions:

• State-level abortion law restrictiveness is significantly associated with elevated county-level infant mortality rates.
• Future infant mortality trends may be influenced by the Supreme Court's Dobbs decision and subsequent changes in state abortion laws.