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

Stephanie L Santoro1, Chance Alvarado2,3,4,5, Stephanie Y Tseng2

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The Dobbs decision did not impact Down syndrome (DS) birth rates. Live birth rates for DS remained stable nationally and in states with differing abortion access laws post-Dobbs.

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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.