In the wake of seismic policy shifts on both sides of the globe, two recent reports have cast a harsh light on the unintended—and sometimes tragic—consequences of abortion restrictions and cuts to health aid. In the United States, a new study published in the American Journal of Public Health finds that infant mortality has risen in states that enacted tighter abortion restrictions following the June 2022 Dobbs v. Jackson Women’s Health decision. Meanwhile, across the Atlantic, a report from Physicians for Human Rights (PHR), highlighted by The Guardian, reveals that U.S. aid cuts under the Trump administration have led to a rise in unwanted abortions and babies being born with HIV in East Africa.
Both reports, published in early September 2025, underscore a sobering reality: decisions made in legislative halls and government offices can ripple far beyond their intended targets, impacting the most vulnerable populations—often in ways policymakers never anticipated.
Let’s start with the U.S., where the post-Dobbs landscape has become a patchwork of abortion laws. According to the study team, which drew on data from the Centers for Disease Control and Prevention (CDC) spanning 2018 to 2023, states that enacted abortion restrictions after Dobbs saw a 7.2% increase in infant deaths. That translates to roughly 30 additional deaths per year among children up to age one. Strikingly, the increase was not limited to newborns less than a day old; much of the disparity was concentrated among infants between one month and one year old, who suffered a 9.3% uptick in excess deaths.
What’s more, the study found no meaningful difference in infant mortality rates between states whose abortion restrictions included health exceptions—such as provisions allowing abortions to save the life of the mother or in the case of life-limiting fetal abnormalities—and those that did not. As the researchers put it, “despite such exceptions, infant deaths increased at the same rate as states without the exceptions.”
This finding raises tough questions about how such exceptions are interpreted and applied in real-world clinical settings. “Medical professionals may be unsure when they can lean on such exceptions when treating patients,” the study authors noted, suggesting that clearer definitions of terms like “serious risk” and “irreversible impairment” are urgently needed if these exceptions are to have any real effect.
The study’s methodology, known as a “difference in differences” approach, compared changes in infant deaths before and after new abortion restrictions were introduced, contrasting those changes with states that had not implemented new laws. This rigorous analysis builds on earlier research, including a 2021 study showing that infant deaths in Texas rose nearly 13% following the passage of Texas Senate Bill 8. The new findings suggest that what happened in Texas was not an outlier; rather, it’s part of a troubling national trend.
But while the numbers are clear, the underlying causes remain murky. The researchers acknowledge that the rise in mortality wasn’t solely due to perinatal or congenital issues, nor was it confined to the timing of birth. Increases also occurred in a catch-all category of “other causes” that may affect infants up to their second year of life. “This murkiness deepens the mystery around how, exactly, abortion restrictions are putting infants at risk,” the authors wrote. They also point out that, due to data limitations, little is known about how these laws are affecting different racial and socioeconomic groups, though it is likely that economic and public-health approaches will be needed to address what they call “a problem that is reaching tragic proportions.”
Meanwhile, the effects of U.S. policy decisions are being felt thousands of miles away in East Africa. According to The Guardian, a new report by Physicians for Human Rights paints a grim picture of the fallout from aid cuts implemented during the Trump administration. The cuts, which disrupted the U.S. President’s Emergency Plan for AIDS Relief (Pepfar), led to widespread drug shortages in Tanzania and Uganda. Medical staff and patients interviewed for the report described how people living with HIV were forced to skip doses, raising the risk of drug resistance. Pregnant women, unable to access necessary medication, could not prevent mother-to-child transmission of HIV, resulting in some babies being born with the virus.
“The disruption to Pepfar caused widespread drug shortages. This forced people with HIV to skip doses, increasing the risk of drug resistance,” the PHR report states. Vulnerable groups—already at a disadvantage—were hit hardest, as specialized health services bore the brunt of the cuts. The authors of the report didn’t mince words about the broader impact: “The cuts have eroded trust in both U.S. foreign aid and domestic governments, creating fears of a ‘dark’ future marked by rising costs and the spread of fake cures.”
Perhaps most alarmingly, the report documented a rise in unwanted abortions as a direct consequence of diminished access to health services. Without adequate funding, clinics were unable to provide contraception and reproductive health counseling, leaving women with few options. The result: more unplanned pregnancies and, paradoxically, more abortions—often under unsafe conditions.
The PHR report urges the U.S. government to “immediately restore and protect global health funding to stabilize these vital services and prevent the loss of decades of progress in the fight against HIV/AIDS.” The call is a stark reminder that global health gains can be fragile, and that political decisions made in Washington can have life-or-death consequences half a world away.
Both the U.S. and East African stories share a common thread: when access to reproductive health care is restricted—whether by law or by lack of resources—the consequences can be devastating and far-reaching. In the U.S., the debate over abortion rights remains deeply polarized, with some states moving to protect access and others doubling down on restrictions. In East Africa, the legacy of aid cuts serves as a cautionary tale about the dangers of neglecting global health commitments.
As policymakers, advocates, and voters wrestle with these complex issues, the evidence continues to mount: public health outcomes are shaped not just by medical advances, but by the policies and priorities set by those in power. For the infants and families affected by these decisions, the stakes could hardly be higher.
