By Lauren Caruba, The Dallas Morning News
DALLAS — In the more than four years since the state of Texas significantly restricted access to abortion, medical researchers have been studying the health effects of that policy change.
A growing body of research indicates that the state’s abortion bans — which are among the country’s most restrictive, with no exceptions for rape, incest or fetal anomalies — have negatively impacted the health and lives of Texas women and babies in multiple ways.
Here’s what they have found:
Outcomes worsened for women who experienced pregnancy loss and other serious complications in their pregnancies.
In October, a team of researchers published a study of more than 320,000 pregnancy losses in Texas health care facilities from January 2017 through September 2023. After Texas’ near-total abortion ban went into effect in 2022, blood transfusions for women who lost their pregnancies were 15% higher than expected, based on historical trends.
In January 2025, researchers with UTHealth Houston presented research on previable premature rupture of membranes, when a woman’s water breaks far too early in pregnancy. In such cases, the fetus rarely survives, while the mother is at risk of infection, bleeding and other serious complications. The researchers studied outcomes in these patients before and after implementation of the Texas Heartbeat Act, which in September 2021 banned abortion in all but the earliest stages of pregnancy.
Under national standards of care, treatment options for previable rupture of membranes include abortion or expectant management, where the mother is monitored without intervention. After the law went into effect, termination was only an option in Texas if the mother’s life was endangered. Risk of serious adverse outcomes overall increased from 24% to 38.5%, while rates of sepsis jumped from 9.4% to 29.2%.
Similarly, women whose babies were diagnosed with severe birth defects also experienced higher rates of adverse outcomes in their pregnancies. Like with previable rupture of membranes, national standards of care include pregnancy termination as an option in cases where serious fetal anomalies are identified.
When abortion was no longer an option for these patients, rates of serious complications increased significantly, researchers found in a study published in July 2025. Researchers with UT Southwestern Medical Center and Parkland Health studied outcomes in dozens of pregnancies in which the fetuses were diagnosed with genetic conditions such as Trisomy 18 or structural abnormalities such as anencephaly, where the skull and brain fail to fully form. Rates of preeclampsia, which can cause dangerously high blood pressure in pregnancy, increased. Delivery via cesarean section doubled for those who did not travel out of the state to terminate. None of the babies survived.
More babies are being born with congenital defects, and neonatal and infant mortality rates have increased.
Researchers with Johns Hopkins University and Michigan State University studied nearly 95,000 infant deaths in Texas and 28 other states for comparison. After Texas banned abortion in cases where embryonic cardiac activity could be detected, Texas saw a 12.9% increase in infant deaths, compared with 1.8% for the rest of the country. Further analysis found that infant deaths attributed to congenital anomalies in 2022 jumped by almost 23% in Texas, suggesting that more pregnancies that previously would have ended in termination were being carried to term.
In a follow-up study, the same lead author conducted a national examination of infant mortality rates in states with complete or six-week abortion bans, using vital statistics data from 2012 through 2023. That analysis also found higher-than-expected rates of infant mortality, including hundreds of excess deaths, in 14 states with abortion bans. Texas, which was analyzed separately due to the fact that it banned abortion earlier than most states, had a greater increase in infant mortality than those other states. Deaths were higher among babies born with congenital anomalies or in southern states, as well as Black infants.
Other researchers who studied national data from 2018 to 2023 identified a 7% increase in overall infant mortality and a 10% increase in infant mortality attributed to birth defects in the months after the U.S. Supreme Court overturned the constitutional right to abortion in its Dobbs vs. Jackson Women’s Health Organization decision.
In some cases, medical providers have delayed or denied care to patients in an effort to comply with the laws.
A Texas-based research team interviewed 50 health care professionals — including specialists in OB-GYN, maternal-fetal medicine, genetic counseling and abortion care — before and after enactment of the Texas Heartbeat Act. One specialist disclosed that the chief medical officer of their hospital denied an abortion to a patient with severe heart disease after operating room staff expressed discomfort with the procedure. Others described having to obtain additional permissions, sometimes through “cumbersome approval processes” that delayed patient care. Multiple clinicians shared accounts of watching patients develop sepsis before being able to offer an induction of labor when they developed complications.
In a case study published in the New England Journal of Medicine Evidence, doctors with Baylor College of Medicine in Houston described a 43-year-old patient who began leaking amniotic fluid 15 weeks into her pregnancy — about two months before the fetus would be considered viable. When she went to the hospital, an evaluation found that her membranes had ruptured and that her white blood cell count was elevated, raising concerns that she was developing an infection. She was admitted to the hospital for three days but was discharged home with instructions to monitor her temperature and other symptoms. It wasn’t until she came back to the hospital two more times and developed a fever that hospital staff performed a dilation and evacuation, a procedure used for second-trimester abortions.
In September 2025, a report published by Physicians for Human Rights found that abortion laws have impacted medical care across different specialties, not just those focused on maternal care. Based on interviews with 33 physicians across 20 states, including several from Texas, the research team identified delays in care for patients with acute or chronic medical conditions such as kidney disease, cancer or pulmonary hypertension. Some clinicians reported changes in how they prescribed teratogenic medications, which pose a risk to a developing embryo or fetus.
Abortions dropped drastically in Texas as residents began ordering abortion pills by mail and traveling to other states to terminate their pregnancies. Live births also rose.
After Texas instituted its six-week abortion ban, the number of monthly abortions fell precipitously, according to a 2022 study in JAMA. In the year before the ban, there were more than 4,000 abortions each month, on average. In the six months after the ban, that monthly average fell to about 2,300. Later, under Texas’ near-total abortion ban, the state averaged about five abortions a month, an analysis of state data by the Texas Tribune found.
Instead, many Texans continued their pregnancies. Those who still sought to terminate them either traveled across state lines or self-managed their abortions.
In interviews with Texas researchers, 65 Texans who left the state for their abortions described how they weighed numerous factors as they planned their trips: appointment availability, distance, cost and state-level restrictions. They often had to account for time off work and care for their existing children, and the fact that most insurance providers would not cover the cost of their abortions. Texans described the burden of traveling for their abortions as not only frustrating and stressful, but as “an ordeal” and “a nightmare.”
In a different study focused on pregnancies with fatal and other serious fetal diagnoses, researchers interviewed 16 women who traveled to Colorado, New Mexico and Washington to obtain abortions. They described fear, confusion and inability to rely on their medical providers for assistance in navigating their options, as well as steep out-of-pocket costs that could range from $10,000 to $20,000.
Increasingly, Texans and other residents of states where abortion was banned began to rely on medications to end their pregnancies themselves, at home. In the six months after the Dobbs decision, a national survey of telemedicine providers, community networks and online retailers identified about 28,000 excess instances where abortion medications were dispensed.
At the same time, researchers estimated there were almost 10,000 more live births in Texas than expected from April to December 2022, according to an article published in JAMA — suggesting that reduced abortion access contributed to more pregnancies being carried to term.
More Texans have undergone tubal ligation and salpingectomy, or surgical sterilization. The mental health of younger residents has also suffered.
After the Dobbs decision, tubal sterilizations rose in states across the country, with greater increases in states where abortion was banned or limited. In Texas and 14 other states where abortion was almost or completely banned, sterilizations increased by 3% each month from July to December 2022.
A study using information from a population-based behavioral health survey that included more than 30,000 Texans found that symptoms of poor mental health — including depression, stress and difficulty regulating emotions — increased among younger residents after implementation of the six-week abortion ban, particularly among women of childbearing age.
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