Startling research reveals staggering hidden cost of red state abortion bans

Black women living in states with abortion bans were more likely to have preterm babies, compared with what would be expected in the absence of those bans, according to a study published in this month’s issue of the American Journal of Public Health.

A lack of timely prenatal care can increase the risk of preterm births. Because important development still occurs later in pregnancy, babies born too early, especially before 32 weeks, have higher rates of death and disability. Preterm birth can also contribute to breathing, hearing and vision problems, and other developmental delays.

The researchers looked at birth rates through December 2023 across a dozen states (Alabama, Arkansas, Idaho, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, South Dakota, Tennessee, Texas, and West Virginia) with total abortion bans implemented immediately after the Dobbs decision struck down the federal right to an abortion. These states imposed bans between June 24, 2022 (the date of the Dobbs ruling) and August 25, 2022.

Across those states, the rate of preterm births among Black women was 2.1% higher than what would be expected without a ban. The authors defined preterm births as babies born before 37 weeks. Black, American Indian and Alaska Native, and Native Hawaiian women already have higher rates of preterm labor, according to the U.S. Centers for Disease Control and Prevention.

For all women, the change in the preterm birth rate was not statistically significant.

“These findings suggest that at least some of these births may have been to women who were unable to access a wanted abortion and had no choice but to continue the pregnancy to birth,” wrote lead author Maeve Wallace and her colleagues. Wallace is an epidemiologist and associate professor of public health at the University of Arizona.

“The factors related to their inability to overcome an abortion ban — limited institutional power, financial and social resources — may subsequently increase their likelihood of experiencing a preterm birth.”

Total monthly birth rates increased 2% in the 18 months post-Dobbs, compared to estimates of what would be expected without an abortion ban. Among Black women, birth rates increased 3.5%.

Women enrolled in Medicaid also saw an increase in birth rates — up 3% overall and 4.2% among Black women enrolled in the program.

The American Journal of Public Health study adds to a growing body of research on the impact of abortion bans.

In the first half of 2023, states with abortion bans saw 2.3% more births, compared to the number of births if no bans had been enforced, according to a 2024 study by health economists. The same group also estimated that a total abortion ban would increase births between 2.1% and 2.2% within counties in ban states where the nearest abortion facility was 50 miles away before Dobbs and 300 miles away afterward, “the changes in distance experienced by the average resident of a ban state.”

Indiana was excluded from this month’s study because it implemented an abortion ban later in 2023, four months before the end of the study period. North Dakota and Wisconsin were also excluded, the authors noted, due to the confusion around legality surrounding the bans in those states following the Dobbs decision.