Pro-Life Laws Aren’t to Blame for Increased Infant Mortality

By: Ingrid Skop, originally published November 8, 2024, National Review

Demonizing pro-life protections isn’t the solution to the heartbreaking problem of infant mortality and diverts efforts from finding real solutions.

After a JAMA Pediatrics research letter identified notable national increases in infant mortality following the Dobbs decision, pro-abortion media were quick to blame pro-life laws. The reaction mirrored the response to a JAMA Pediatrics article from June reporting that infant deaths rose 12.7 percent above expectation in Texas following the implementation of its Heartbeat Act.

These knee-jerk reactions were rooted in uncritical analyses that serve only to push the pro-abortion lobby’s talking points.

Infant mortality, defined as death in the first year of birth, has been unacceptably high in the U.S. for many decades. The U.S. consistently ranks near the bottom of developed countries on this metric. The data provided in these studies, however, do nothing to justify laying blame on pro-life laws.

There are two reasons for this. First, although every infant death is a tragedy, focusing on changes in infant-mortality rates, rather than changes in absolute numbers, paints a far less dire picture than the media would have us believe — especially when comparing these rates with the sharp increases in infant mortality in other, pro-abortion states.

Second, much of the increase in infant mortality can be attributed to more infants being born with life-limiting conditions who otherwise would have been killed before birth by abortion. Killing these babies before they have a chance to be born and counted in the statistics is hardly a compelling, or moral, way to address the issue of infant mortality.

Attacking pro-life laws and promoting unlimited, all-trimester abortion won’t solve the tragedy of infant mortality.

Upon more closely examining the data in JAMA’s Texas article, my colleague Michael New observed that the infant-mortality rate in 2022 was 5.75 infant deaths per 1,000 births. This is very similar to previous rates in Texas from 2007 to 2020 (prior to an elevation related to Covid-19) and only about three percentage points higher than the U.S. average that year.

In part because of the Heartbeat Act, Texas experienced a baby boom in 2022 compared with the rest of the country. Sixteen thousand more children were born in the state that year than in 2021. This of course helps to explain the increase in the absolute number of infant deaths (as the study’s authors themselves admit). Examining the infant-mortality rate rather than the absolute number of deaths, however, takes these additional births into account and produces a more accurate measurement of “change” that puts these numbers in perspective. The Texas infant-mortality rate changed minimally, from 5.31 in 2021 to 5.75 in 2022, an 8.3 percent increase.

Two additional data points are notable in showing the likely political motivation of singling out Texas for criticism. First, the CDC reports that more than half of the states (28) had higher infant-mortality rates than Texas in 2022. Many of these states have permissive abortion laws. The same data show that a number of states with permissive abortion laws, such as Hawaii, New Mexico, and Wisconsin, also experienced increases in infant-mortality rates between 2021 and 2022. Hawaii experienced a 24 percent increase; New Mexico a 23 percent increase; and Wisconsin an 8.2 percent increase (roughly equivalent to Texas’s increase).

Both studies note that the increase in infant mortality was particularly high because of infant deaths from life-limiting conditions (birth defects and genetic disorders). But the presence of pro-life laws does not cause unborn children to develop life-limiting conditions, which account for about 20 percent of all infant mortality. Sadly, prior to the implementation of pro-life laws after Dobbs, obstetricians often promoted abortion as the preferred or only option to grieving families who received a severe prenatal diagnoses. Many families felt pressured to abort rather than patiently explore a full spectrum of options honoring the life and dignity of the child.

A reflexive recommendation of abortion in this circumstance fails to offer the option of perinatal palliative care, an approach that offers comfort and support to a family as they navigate the impending death of a beloved family member. Perinatal palliative care focuses on easing the suffering of the child and honoring the values of the family, allowing them to decide in advance the desired interventions for their child.

Continuing the pregnancy also allows more opportunities to find meaning in the child’s tragically shortened life and may improve the grieving process, even if the child does not survive birth. These opportunities include holding and showing love to the baby, creating mementos and photographs, and potentially allowing participation in research as well as in tissue or organ donation.

Physicians cannot predict the degree of impairment a child with a particular diagnosis will suffer. Nor do they know how a family will respond to caring for an affected child. In fact, it has been widely documented that antenatal screening tests for fetal malformations are often wrong. Advances in medical science also now offer in utero surgery to repair or ameliorate some serious conditions diagnosed prenatally.

Additionally, the survival of many children with diagnoses once thought “incompatible with life” has now been occasionally documented to span over a decade. Ninety-seven percent of parents of children with Trisomy 13 or 18 described their child as happy and felt that the child enriched the family.

Aborting an unborn child with a life-limiting condition merely kills him or her before birth, meaning these deaths would not be recorded as infant-mortality statistics. The sinister implication of articles that bemoan the missed opportunity to abruptly end life soon after a challenging diagnosis is that babies’ deaths only matter once they are born.

Demonizing pro-life protections isn’t the solution to the heartbreaking problem of infant mortality and diverts efforts from finding real solutions. Rather, to make progress on this issue, we should investigate the underlying causes of infant mortality.

Ingrid Skop is vice president and director of medical affairs for Charlotte Lozier Institute.