Abortion Restrictions and Infant Mortality in the United States, 2018-2023.

Abstract

<b>Objectives.</b> To evaluate the impact of state-level abortion restrictions enacted between 2018 and 2023 on infant mortality in the United States, comparing mortality trends across restricting and nonrestricting states. <b>Methods.</b> Using a difference-in-differences approach, we drew infant mortality data from the Centers for Disease Control and Prevention's WONDER (Wide-ranging Online Data for Epidemiologic Research) database and categorized deaths by age and cause, incorporating information on abortion restrictions and legal exceptions from the Center for Reproductive Rights and the Kaiser Family Foundation. We calculated estimates at the state-year level. <b>Results.</b> Infant mortality increased by 7.2% in restricting states. The increase is predominantly attributable to early (aged < 1 day) and late (aged 1 month to 1 year) infant deaths. Effects were largest for perinatal and noncongenital causes of death. Health exceptions did not significantly moderate the effects. <b>Conclusions.</b> Curtailing abortion access increases infant deaths. Fetal and maternal health exceptions do not moderate this effect. Excess deaths are not exclusively attributable to congenital abnormalities. Further work is needed to understand how restrictions contribute to late deaths and the long-term effects of infant deaths on families and communities. (<i>Am J Public Health</i>. 2025;115(11):1895-1902. https://doi.org/10.2105/AJPH.2025.308228).