When the Supreme Court abruptly ended the constitutional protection of access to abortion care with its 2022 decision in Dobbs v. Jackson Women’s Health Organization, experts predicted that restrictive laws would have negatively impact reproductive care access and practice, and maternal and infant health outcomes. Paula Lantz, the James B. Hudak Professor of Health Policy at the Ford School of Public Policy, examines current research on these impacts in a recent opinion piece for Milbank Quarterly.
“The signals from the limited yet high-quality research to date reveal that restrictive abortion policy is having negative effects on medical practice and on maternal and infant health, while having only a small impact on abortion prevention,” writes Lantz.
Nearly one-third of the U.S. population now lives in one of 18 states with restrictive abortion policies. Despite these changes, the overall number of abortions nationwide has not declined significantly, Lantz notes. However, procedures have dropped sharply in states that enacted restrictions, with some states reporting zero abortions. One study cited by Lantz found that birth rates in states with the most restrictive policies rose about 2% above expected trends, with increases particularly among groups already experiencing higher rates of negative birth outcomes, such as racial and ethnic minorities and Medicaid beneficiaries.
Lantz also highlights the negative effects these policies have on access to and quality of obstetrical care. OB/GYN practitioners across the U.S. report new constraints on their ability to treat pregnancy-related emergencies, such as miscarriages. The current legal landscape, including the reversal of emergency abortion guidance by the Trump Administration, has complicated practice, education, and training for OB/GYNs. In addition, the departure of clinicians and medical residents from states with restrictive laws is intensifying existing disparities in reproductive health care access.
Emerging research indicates further adverse maternal and infant health outcomes connected to restrictive abortion policies. Lantz points to findings that suggest states with abortion bans have experienced approximately 22,000 additional births, 59 excess pregnancy-associated maternal deaths, and 478 excess infant deaths since Roe v. Wade was overturned.
Finally, Lantz draws attention to diminished data capacity at organizations such as the CDC’s Division of Reproductive Health, following recent staff and resource cuts.
“Everyone who cares about the health and well-being of children and families should agree that additional objective research based on high-quality data is essential to fully understand the reproductive health care experiences of women and public health realities in the post-Dobbs policy landscape,” Lantz concludes.
