Infants died from birth defects at higher rates after abortion ban was imposed in Florida

FORT LAUDERDALE, Fla. – Like most pregnant women, Deborah Dorbert of Lakeland went for a routine anatomy scan of her unborn baby at 23 weeks.

The results spiraled into a nightmare scenario and the eventual death of Dorbert’s son, Milo, only 94 minutes after he was born.

The anatomy scan in late 2022 showed Milo’s kidneys and lungs had failed to develop from a lack of amniotic fluid in the uterus. A doctor told Deborah her baby would not survive more than a few hours outside the womb. Initially, a specialist advised Deborah and her husband, Lee, that the safest option would be to induce Deborah and end the pregnancy as soon as possible. “We all agreed getting induced was the best option for my health and because it was less likely my son would suffer as much,” she told the South Florida Sun Sentinel.

However, Florida had enacted a 15-week abortion ban six months earlier in July 2022 after the U.S. Supreme Court overturned Roe v. Wade. The hospital’s legal team determined inducing Deborah at the hospital early at 24 weeks, rather than waiting full term, would break the state law. “They said until my life was on the line, they couldn’t do anything,” she said.

Milo, born in March 2023, now serves as an example of the ripple effect of changes to Florida abortion laws after the end of Roe v. Wade, the federal law that protected the right to have an abortion.

In 2023, the year that followed Florida’s initial 15-week abortion ban, the state saw an increase in the number of infants like Milo, who died from lethal congenital anomalies or fatal birth defects before celebrating a first birthday. Indeed, infant mortality attributed to congenital anomalies in Florida jumped to its highest level in at least six years in October 2023, a little over a year after the state’s initial abortion ban went into effect, according to data from the Centers for Disease Control and Prevention. Congenital anomalies can be mild or severe and often have no known cause. The more serious issues involve the heart, kidneys, and spine.

That escalation in infant mortality happened just as both sides were arguing before the Florida Supreme Court over whether the abortion ban signed into law by Gov. Ron DeSantis should be upheld. Eventually, Florida’s highest court ruled Florida could restrict abortion, and a six-week ban signed by DeSantis went into effect on May 1. With this newer, more restrictive ban in place, it appears the increase in the number of infants dying from birth defects continues in 2024. For now, the 2024 infant mortality numbers are partial, and the full impact of the six-week ban won’t be clear until more data becomes available.

Florida’s trends parallel national research that found in the year and a half following the Supreme Court Dobbs decision overturning Roe v. Wade’s federal right to an abortion, hundreds more U.S. infants died than expected overall and in particular among those with fatal birth defects.

“The trend in infant mortality from cognitive anomalies had been declining in the U.S., but after Dobbs, it picked up,” said Dr. Parvati Singh, an assistant professor of epidemiology with The Ohio State University College of Public Health and lead author of National Trends in Infant Mortality in the US After Dobbs.

Singh and researcher Maria Gallo compared infant mortality rates for the 18 months following Dobbs to historical trends and found deaths attributed to congenital abnormalities were higher than expected in six of the 18 months following the Dobbs decision. A similar pattern occurred in Florida. “The increase takes into account births and trends in the past,” Singh said. At the time of her research, 14 states had total abortion bans and eight states had bans at various times before the first 18 weeks of gestation.

Dr. David Berger, Dorbert’s primary care physician and pediatrician in Tampa, said he is not surprised to see an increase in the number of women in Florida carrying fetuses with lethal congenital anomalies to term. “Many of these are pregnancies that would have ended in abortion if people had access to those services,” he said.

When Florida enacted a 15-week ban, pregnant women in the state began traveling for abortion care. The Dorberts said they were discouraged because of the financial and potential legal implications of traveling for care. “We also had a four-year-old son who still needed us,” Deborah Dorbert said.

So, for 13 more weeks, Deborah carried baby Milo in her uterus, knowing he would die soon after birth. She avoided going out into public, fearing seeing people in the grocery store who might see her pregnant and congratulate her or ask, “Is this your first child? Are you excited?”

“I just went into a really dark place, you know, essentially planning my son’s birth and funeral at the same time,” she said.

Under Florida’s six-week ban, effective May 1, more defined exceptions exist than under the 15-week ban: Two physicians can certify in writing that ending the pregnancy is necessary to save the pregnant woman’s life or avert a serious risk of significant physical impairment. Or, two physicians can certify in writing before the third trimester that the fetus has a fatal fetal abnormality.

Berger said confusion over these exceptions still makes it difficult for pregnant women to get care when they encounter pregnancy complications.

“There are still mothers and doctors and patients who aren’t clear on what laws are and will not think to act on it because they are scared of repercussions,” he said.

Dr. Ushma Upadhyay, an associate professor in the Department of Obstetrics, Gynecology, and Reproductive Science at the University of California, San Francisco, said abortion bans also can affect access to broader maternal care, especially in marginalized populations, and that, too, has a ripple effect.

“Whether a pregnancy is wanted or unwanted, the lack of access to abortion care is having an impact on childbirth outcomes,” she said. “Abortion care is essential to prevent maternal mortality and infant mortality and that is what the data is showing us.”

Dorbert, who now campaigns for Amendment 4 to enshrine abortion access in the state constitution, said her recent pregnancy experience had a life-changing impact: “I will never have children again. I know I would not survive another pregnancy like that. I can’t endure it.”