Three Years After Roe—What We Feared Is Confirmed

Infant and maternal mortality rates continue to spike, with Black and brown women and babies suffering the most

Today, June 24, is the three year anniversary that U.S. Supreme Court made the unconscionable decision to overturn Roe v. Wade. In doing so, SCOTUS stripped crucial precedent and life saving healthcare access that women relied on for nearly 50 years. At the time, physicians across the country—particularly OBGYNs—sounded the alarm: this wasn’t just about ideology or politics. It was about lives. About health. About whether doctors could do their jobs without interference from politicians who have never stepped foot in an exam room. And now, three years later, the data is in. Those doctors were right, the repeal of Roe has enabled widespread, mass, and preventable death of women and babies. Let’s Address This.

Credit: Anna Moneymaker/Getty Images

What Was Predicted

For states that have banned abortion access, or severely restricted it, the predictable results have been a spike in maternal mortality and infant mortality. This, again, is no surprise. A study by Colorado University in 2021 warned of this, concluding:

Banning abortion nationwide would lead to a 21% increase in the number of pregnancy-related deaths overall and a 33% increase among Black women, according to new CU Boulder research.

Another study by Tulane University, prior to Roe’s repeal, found the same results in 2018, concluding:

States with more restrictive abortion policy climate have higher total maternal mortality, measured as a death during pregnancy or within one year following the end of a pregnancy.

What Has Happened

Post-Roe, these trends have only exacerbated, costing the lives of babies and mothers. A comprehensive post-Roe study conducted by JAMA found that:

Published on Oct. 21 (2024) in the journal JAMA Pediatrics, the data concludes that infant mortality rates were up by 7% in three of the first 18 months examined after the Dobbs decision — an average of 247 more infant deaths. Eighty percent of those deaths can be attributed to congenital anomalies, the report says.

And then there’s the deeply racial element. Another study published in early 2025 concluded that, “The findings showed the highest mortality occurred among infants who were Black, lived in Southern states or had fetal birth defects.”

Unsurprisingly, therefore, according to recent surveys of practicing OBGYNs, more than 64% report that the fall of Roe has made America’s maternal mortality crisis even worse. And that’s saying something—because the United States already had the highest maternal mortality rate in the developed world. For example, consider the horrifying story out of Georgia in which a Black mother named Adriana Smith was denied the healthcare she needed and suffered a terminal illness causing her to become braindead. But, because she was six weeks pregnant at the time, the State of Georgia forced her to remain ‘alive’ on life without her consent to support to serve as an incubator for the next six months, until the child (who also will suffer from congenital anomalies) could be cut from her corpse.

Likewise, more than 68% of OBGYNs say that treating pregnancy-related medical emergencies has become more difficult—often requiring legal consultations before life-saving care can even begin. For example, Republican Congresswoman Kat Cammack recently blamed “the left” for medical staff hesitating to treat her ectopic pregnancy due to a Republican law that effectively banned abortion, even in life threatening cases like hers. Rep Cammack is fortunate to have the privilege and power to demand care—but what of the millions of women who don’t due to the extremist Republican push to repeal Roe?

And finally, more than 70% of OBGYNs report that racial disparities in reproductive health care have gotten worse, further endangering Black and brown women who already face higher rates of complications and death (300% higher to be exact). This is not just a rollback of rights—it’s a public health disaster. And it was preventable.

It is no surprise, therefore, that when it comes to infant mortality, the CDC data arrives at the same conclusion—banning reproductive health access is killing babies. For example, CDC data reports that 15 of the top 16 states with the highest rates of infant mortality are red states that restrict or deny reproductive healthcare access.

Meanwhile, the CDC data also shows that 12 of the top 13 states with the lowest rates of infant mortality are blue states that protect reproductive healthcare and access.

Put another way, a child is three times more likely to die in Mississippi where reproductive health access is restricted or banned, than in Massachusetts where access is protected and ensured. We might as well be discussing two entirely different countries at this point. So much for red states being “pro life,” right?

Where Do We Go From Here?

If you know me, you know my answer is to take action, not sit idle. Here are three things I encourage you to do.

One, Congress must pass the Women's Health Protection Act of 2023. More than 70% of Americans across political parties support the right of women to make healthcare decisions without a politician in the doctor's office with them. The WHPA passed the House, but failed in the Senate due to the Jim Crow filibuster. When Biden was President, I called on Democrats to abolish the filibuster and pass this critical piece of legislation. Unfortunately, establishment Dems were more aligned with “norms” than they were with recognizing that failing to pass this legislation will cost untold pain, death, and suffering. This is not complicated, folks. This is basic common sense and basic healthcare. It is critical we continue to publicly advocate for this critical piece of legislation.

Two, I encourage you to continue to support public health experts and organizations dedicated towards advancing better reproductive health policy. This can include Planned Parenthood, NARAL, or my friends at

Repro Ready

, who write regularly on public health and reproductive health right here on Substack. (They’re an excellent platform to subscribe to as well).

Finally, know that raising your voice matters. Continue to contact your members of Congress to demand they protect reproductive health—it is literally a matter of life and death. Find your member of Congress here.

Conclusion

Ultimately, this isn’t just about law or policy—it’s about trust. Do we trust women to make decisions about their own bodies? Do we trust doctors to use their training and expertise to save lives without fear of prosecution? Or do we believe politicians—who most notably are not healthcare professionals—should be in the exam room with us?

Trusting women and healthcare professionals led to healthier women and babies. Trusting unqualified politicians has led to mass death and suffering. Why is this even a debate? Every restriction, every delay, every political stunt dressed up as policy is rooted in the belief that women can’t be trusted. It’s legislative medical malpractice, and it is an abomination to human intellect and human decency.

We must do and demand better. And if we truly respect women—if we truly want to lower maternal mortality, improve infant health, and close racial disparities—then we need to get politicians out of the doctor’s office, period. That is what reproductive freedom means. That is what justice demands. And that is what our future must reclaim.