Time Series Analysis of Infant Mortality Disaggregated by Race, Ethnicity and Specific Causes After 6-Week Abortion Ban.

Introduction: In 2021, Texas Senate Bill 8 banned abortion after six weeks gestation. Prior research has shown persistent differences in infant mortality by race/ethnicity and an overall increase in infant mortality in association with SB8. It is unclear whether recent changes may be differential by race, ethnicity, and causes of death.

Methods: Using a population-based cohort of all infants under the age of one-year in Texas and 26 abortion rights protective states, a controlled interrupted time series analysis used Poisson regression to assess the association between changes in the law and monthly counts of infant deaths, adjusting for both long-term trends and seasonality. Monthly data was obtained from the Centers for Disease Control and Prevention Wonder dataset from January 2018 through December 2024.

Results: Overall mortality in Texas was 17% higher after the six-week ban when compared to before (95% Confidence Interval (CI): 9%, 25%) and 10% higher than in comparison states. In disaggregated race and ethnicity data, Non-Hispanic Black mortality in Texas was 21% higher (95%CI: 5%, 38%) and 17% higher than in comparison states. Cause-specific mortality in Texas was also found to be 21% higher for congenital anomalies (95% CI: 6%, 39%), 19% higher than in comparison states.

Conclusions: This study found evidence of increased infant mortality in Texas after the implementation of a six-week abortion ban with differential impact identified for Non-Hispanic Black infants in a comparison analysis. These results build on growing evidence and should guide and inform policy and public health interventions addressing increased infant mortality.