Abortion bans not linked with significant increases in pregnancy-associated mortality

A retrospective population-based cohort study published April 3, 2026, in JAMA Network Open found that the implementation of complete or 6-week abortion bans in the United States was not associated with statistically significant increases in pregnancy-associated mortality. Although researchers observed heterogeneous mortality trends across different states and racial groups following the Dobbs v. Jackson Women’s Health Organization decision, the overall outcome of the analyses did not yield a statistically significant difference between ban and non-ban states during the study period.

The United States currently faces a maternal health crisis, with approximately 669 maternal deaths occurring each year, according to the study authors. These deaths are defined as those occurring during pregnancy or within 42 days of childbirth because of complications related to pregnancy management, excluding incidental causes.

Investigators found that significant racial disparities persist in these outcomes, such as non-Hispanic Black or African American individuals were 2-to-3 times more likely to die from pregnancy-related causes, with 50.3 deaths per 100,000 live births compared with 14.5 deaths per 100,000 live births among non-Hispanic White counterparts. The cost associated with maternal mortality is estimated at $30.8 million annually, whereas preterm birth costs reach $13.7 billion.

Researchers analyzed US National Center for Health Statistics birth and mortality data from 2018 to 2023, encompassing 22,011,131 live births and 12,993 pregnancy-associated deaths. The study included 14 states with abortion bans and 37 control states, including the District of Columbia, without such bans. The primary outcome measured was pregnancy-associated mortality, with secondary outcomes including pregnancy-related, maternal, and non-obstetric causes of death.

Data revealed that pregnancy-associated mortality declined by 9.8% in non-ban states, dropping from 54.5 to 49.2 deaths per 100,000 live births. In states with bans, smaller declines were observed. In ban states excluding Texas, mortality decreased by 2.4% (83.2 to 81.2 deaths per 100,000 live births), whereas Texas saw a 3.3% decline (54.2 to 52.4 deaths per 100,000 live births).

Racial disparities and maternal health outcomes

Despite the lack of overall statistical significance, specific racial groups in ban states (excluding Texas) saw descriptive increases in mortality. The largest increases were observed among non-Hispanic Asian individuals, rising 41.0% from 39.5 to 55.7 deaths per 100,000 live births. Mortality among non-Hispanic Black or African American individuals in these states rose 17.8%, from 140.2 to 165.2 deaths per 100,000 live births.

Synthetic control analyses yielded an estimated difference of 5.1 pregnancy-associated deaths per 100,000 live births between ban and non-ban states, but this result did not reach statistical significance. Similar non-significant results were found for pregnancy-related mortality (–2.0), maternal mortality (–3.0), and non-obstetric causes of death (1.2). State-specific estimates were heterogeneous across the 14 ban states, but none reached the threshold for statistical significance in the adjusted models.

The authors noted that the short post-ban observation period and wide confidence intervals highlight the necessity for continued surveillance. As more post-Dobbs data become available, further research is required to determine the long-term association between restrictive abortion laws and pregnancy outcomes, particularly regarding the exacerbation of existing maternal health resource gaps and racial disparities.

Reference:

Abraha HE, Buzas J, Bornstein M, Boghossian NS. US Abortion Bans and Pregnancy-Associated Mortality. JAMA Netw Open. 2026;9(4):e264801. doi:10.1001/jamanetworkopen.2026.4801