For more than a year, since the US Supreme Court’s decision to overturn Roe v. Wade, pregnant women have faced a radically changing landscape of challenges and choices as the number of abortion providers has been reduced to zero in more than a dozen states.
But the exact impact of the decision has been difficult for researchers to measure directly, particularly when it comes to a central question: How many children are born as a result of the abortion ban?
Researchers from Johns Hopkins University’s Bloomberg School of Public Health on Thursday published one of the first serious attempts at an answer. They focused on Texas, where a law that went into effect in September 2021, nine months before the Dobbs court decision, effectively banned abortions within six weeks. The analysis found that the state saw nearly 10,000 more births between April and December last year than would have been expected without the law, or 3 percent more.
The result, emboldened by abortion opponents, could indicate a staggering number of pregnancies carried out at term that would otherwise not have been possible, absent the law known as Senate Bill 8.
Researchers monitoring new abortion bans across the country had expected a rise in the number of births, but perhaps not much.
“They seem to show that births increased more in Texas than we would have expected,” said Caitlin Myers, a professor of economics at Middlebury College who studies abortion but was not involved in the study. “The conclusion I’m not comfortable with at this point is that all of these overbirths are caused by SB 8. Some of them may be, but I don’t think all of them will be. It’s just so high.”
The authors of the study, which was published on behalf of A two-page research letter in the Journal of the American Medical Association, stopping short of attributing the estimated increase in births solely to the unusual law, which allows civil lawsuits to be brought against those who assist in abortions after the fetus begins cardiac activity, usually around six weeks. At least, they wrote, the findings suggest that “not everyone who had an abortion in the absence of SB 8 was able to obtain it.”
However, the authors were confident in their methods and results.
“This pattern was unique to Texas,” said Alison Gemmell, a professor at the Johns Hopkins Bloomberg School of Public Health and one of the researchers on the study. She said the team looked at each of the other 49 states and Washington, D.C., but found no evidence of differences from expected birth numbers. She added that if there are other explanations for the increase, it must be unique to Texas and the period after the eighth abortion law took effect.
Determining the impact of the abortion ban was difficult for researchers because of delays in obtaining detailed data on births.
In other states where abortion bans went into effect after the Dobbs decision in June 2022, researchers are still collecting vital statistics in order to study the impact of the new ban on births. Projections were that this ban would have a greater impact on those seeking abortions than SB 8 did in Texas, because many of them ban all abortions and have been adopted in a large number of contiguous states, making it difficult for women to travel to the states other procedures.
The study published Thursday, which looked at data going back to 2016, relied on provisional birth data for 2022 because full data was not available. It did not include demographic information such as maternal age or ethnicity that could be compared to previous years and used to understand other factors that may have played a role.
The researchers then created a statistical model of what Texas would have looked like without the abortion law. Thus, they were able to estimate the number of births that would have occurred in this case.
“This is an indirect way of measuring what we cannot measure,” said Ms. Gemmell. “We don’t know the decisions behind whether people seek an abortion, or whether they are unable to.”
Broader changes in birth rates have complicated the researchers’ efforts. The number of births has decreased in recent years in TexasAnd and across the United States, a trend exacerbated at the height of the Covid emergency. But there has been a spike in births since the pandemic in Texas: There were about 389,000 births last year, down from 398,000 in 2016 but larger than the number recorded in 2020.
Ms. Myers said other factors may have led to higher birth rates during that time period, including a higher number of foreign-born mothers giving birth, many of them in Texas. Ms Gemmell said this factor was difficult to measure without detailed demographic data on births in 2022.
Despite the new restrictions under SB 8, many women in Texas still obtain an abortion, either by having them done before the six-week end, by traveling out of state for their procedures, or by taking the abortion medication themselves. Texas saw an influx of mail-order pills, and some Texans were able to get abortions in Mexico.
Still, anti-abortion activists viewed the Johns Hopkins study as evidence that their success in severely limiting abortions in Texas had the desired effect: more pregnancies carrying to term.
“Every baby saved from elective abortion should be celebrated!” John Sego, Texas president of the right to life, said in a statement. “This new study highlights the great success our movement has had in the past two years, and we look forward to helping mothers and families in our state take care of their children.”