Down syndrome birth rate post Dobbs decision: has it changed?

Area of Science:

• Reproductive Health Law
• Genetics and Public Health
• Maternal and Child Health

Background:

• The 2022 Dobbs v. Jackson Women's Health Organization Supreme Court decision significantly altered abortion access across the United States.
• Previous research suggested potential impacts of abortion access on the incidence of conditions like cyanotic congenital heart disease.

Purpose of the Study:

• To evaluate the impact of the Dobbs decision on Down syndrome (DS) live birth rates.
• To compare DS birth rates before and after the Dobbs decision in states with varying abortion access.
• To test the hypothesis that changes in abortion access might affect DS birth rates similarly to other congenital conditions.

Main Methods:

• A retrospective cohort study analyzed live birth data from the CDC birth certificate registry (2016-2025).
• Data were stratified by Down syndrome (DS) status and state abortion access categories (restrictive vs. protective) using Guttmacher Institute classifications.
• Segmented linear regression modeled and compared the incidence of DS and the difference in incidence between state cohorts pre- and post-Dobbs.

Main Results:

• The incidence of Down syndrome (DS) live births remained stable in both restrictive and protective states before and after the Dobbs decision.
• Segmented regression analysis indicated no significant national changes in the monthly incidence of DS in the post-Dobbs era compared to the pre-Dobbs period.

Conclusions:

• The mean monthly incidence of Down syndrome (DS) in live-born infants, based on CDC birth certificate data, did not show an increase following the Dobbs decision.
• These findings suggest that the alteration in abortion access following the Dobbs ruling did not lead to a measurable change in DS live birth rates.