US Abortion Bans and Pregnancy-Associated Mortality.

Area of Science:

• Public Health
• Reproductive Health
• Mortality Studies

Background:

• Previous studies projected increased maternal mortality in states with restrictive abortion laws before the Dobbs decision.
• The impact of post-Dobbs abortion bans on pregnancy-associated mortality remains unclear.

Purpose of the Study:

• To examine the association between complete and 6-week abortion bans and pregnancy-associated mortality in the US.

Main Methods:

• Retrospective, population-based cohort study using US National Center for Health Statistics data (2018-2023).
• Included 14 states with abortion bans and 37 control states.
• Synthetic control methods with staggered adoption were used to compare ban states to their synthetic controls.

Main Results:

• Pregnancy-associated mortality declined in both non-ban and ban states, with smaller declines in ban states.
• No statistically significant increase in overall or state-specific pregnancy-associated mortality was observed following abortion bans.
• Increases in mortality were noted among non-Hispanic Asian and non-Hispanic Black individuals in ban states excluding Texas, but did not reach statistical significance.

Conclusions:

• Abortion bans were not associated with statistically significant increases in pregnancy-associated mortality in this cohort study.
• The short post-Dobbs observation period and wide confidence intervals necessitate ongoing surveillance.
• Further research with longer follow-up periods is required to fully assess the long-term effects of abortion bans on maternal mortality.