Culture of Data 2025

Background: Texas’ 2021 SB8 was passed in September 2021, which effectively banned abortion after six weeks. We sought to investigate the association of this change in legal access with infant mortality.
Methods: Utilizing CDC Wonder mortality data from January 2018 to June 2024, an interrupted time series analysis assessed the association between changes in the law and monthly counts of deaths under the age of one year in Texas, adjusting for both long term time trends and seasonality, using abortion-rights protective jurisdictions including Colorado for comparison. The interruption point was set at 3 months after legal access changed. Aggregate mortality was assessed along with mortality disaggregated by race, ethnicity, and two groups of specific causes.
Results: Overall mortality was 18% higher after SB8 when compared to before. Rate Ratio (RR): 18%, (95% Confidence Interval (CI): 10%, 26%). In disaggregated race and ethnicity data, non-Hispanic Black mortality was 21% higher (95%CI: 6%, 39%), where non-Hispanic white mortality was 15% (95% CI: 2%, 30%). Cause-specific mortality was also higher after SB8. Grouped comparison states showed a 6% increase in the same timeframe, while separately analyzed Colorado infant mortality showed no evidence of change.
Discussion: Higher mortality after SB8 was identified both overall and in disaggregated racial and ethnic groups, with non-Hispanic Black infants having the highest increase. Increases in some cause-specific mortality associated with changes in abortion access were even more pronounced.
Conclusion: This study contributes evidence that infant mortality in Texas rose significantly after the implementation of a six-week abortion ban, and that impacts were differential by race and ethnicity, as well as among specific causes of death. Changes to population health in association with abortion bans may extend beyond pregnancy, providing further motivation for ensuring abortion access in states like Colorado.