Blood Transfusions for Pregnancy Loss in Texas Before and After Abortion Bans, 2017‒2023

Objectives. To measure changes in blood transfusion related to pregnancy loss in Texas after the 2021 Senate Bill 8 (SB8), which banned abortion after the detection of fetal cardiac activity (6-week ban), and the ban that was enforced after the 2022 Dobbs v Jackson Supreme Court decision, which banned abortion at all gestational durations (total ban). Methods. We used administrative data from all Texas hospital, emergency, and ambulatory surgical facilities from January 2017 through September 2023. Using time series analysis, we assessed if the number of pregnancy loss encounters that received blood transfusions, an indicator of severe morbidity, was different than expected after the 6-week and total bans. Results. We identified 320 696 pregnancy loss encounters and 7408 related blood transfusions. During the 6-week ban, transfusion numbers were similar to expected. During the total ban, the quarterly mean number of pregnancy loss encounters that received blood transfusions was 385.8, which was 50.7 more transfusions (15.1%) than the 335.1 expected based on historical data (2-sample t test P = .03). Conclusions. Texas's total abortion ban was associated with an increase in severe morbidity among people experiencing pregnancy loss. (Am J Public Health. 2025;115(11):1887-1894. https://doi.org/10.2105/AJPH.2025.308224).