In the late spring of 1995, Rebekah Mitchell went into the hospital at 27 weeks pregnant with her second child. Mitchell had a kidney disease that was affecting her own health and the health of the baby. She made it to seven months, and then the baby, whom she and her husband had already named Jonathan, became entangled in the kinked umbilical cord, and died suddenly. Stunned and recovering from the cesarean section required to deliver Jonathan, she kept his body with her in the hospital room for three days.
The grief seemed overwhelming, insurmountable even, Mitchell told Sojourners.
“When a mom loses a baby, whether a miscarriage, a stillbirth, or an early infant death, our lives are forever and ever changed.”
Stories like Mitchell’s are rare tragedies, but a new study suggests they are becoming more common in Texas — and it likely has to do with the state’s abortion bans.
A study published in JAMA Pediatrics found that between 2018 and 2022, Texas saw 10,351 of the 102,391 infant deaths in the U.S. The study found a 12.9 percent increase in infant deaths in Texas from 2021 to 2022 compared to a 1.8 percent increase nationwide. Neonatal deaths and deaths due to congenital anomalies also rose significantly more in Texas than in the rest of the country during this period. The study concluded that Texas’ 2021 early pregnancy abortion ban was “associated with unexpected increases in infant and neonatal mortality in 2022.”
‘A chilling effect’
The ban, which was passed before the Supreme Court overturned Roe v. Wade, blocked abortion after about six weeks and was upheld by the court. The law bans abortion after fetal cardiac activity can be detected, typically around two weeks after a person’s missed period. Because pregnancy is counted from a person’s most recent period, at that stage a person is considered six weeks pregnant.
Explicitly invoking Christian faith, Texas Gov. Greg Abbott said when he signed the bill that “Our creator endowed us with the right to life and yet millions of children lose their right to life every year because of abortion.”
From the moment the law was passed, abortion-rights advocates have said that most people do not know they are pregnant within six weeks and criticized the law as creating a chilling effect, where abortion providers were too afraid of being sued to provide appropriate care.
Sparing parents the pain of waiting
The law does not include exceptions to allow for compassionate induction, a procedure that allows doctors to induce labor when a fetus is found to have a fatal condition, usually in the second trimester. The parent delivers the baby alive (though some die in labor) and is able to be with them until their child dies, usually in hours. Sometimes, doctors will stop the baby’s heartbeat before induction to prevent pain or trauma to the baby in delivery.
Mitchell said she is devoutly pro-life and praised the Court’s overturning of Roe, but she feels that certain procedures were inappropriately swept up in Texas’s six-week abortion ban. While Mitchell does not support stopping the baby’s heart before delivery, other pro-life parents have found themselves coming to understand the term compassionate induction to potentially encompass those injections.
For Mitchell, compassionate induction of a living baby represented a life-affirming way to spare families the pain of waiting, sometimes for months, for their baby to inevitably die. She said it gives parents their best chance at holding their child for the short time they are alive.
Texas law on abortions for lethal abnormalities is murky. A judge ruled in 2023 that a woman could receive an abortion for a lethal abnormality, but Texas Attorney General Ken Paxton threatened that the ruling did “not insulate hospitals, doctors, or anyone else, from civil and criminal liability for violating Texas’ abortion laws.”
For people who do continue to carry a pregnancy with life-limiting diagnosis to term, there is a concern of compounding trauma, Mitchell said. That’s a concern she shares with doctors who, before the ban, would have referred their patients for an abortion.
“Behind these numbers are people,” Dr. Erika Werner, chair of obstetrics and gynecology at Tufts Medical Center, told NBC News when the JAMA Pediatrics article was published (Werner was not involved in the research). “For each of these pregnancies, that’s a pregnant person who had to stay pregnant for an additional 20 weeks, carrying a pregnancy that they knew likely wouldn’t result in a live newborn baby.”
The extra weeks and months layer trauma on top of a situation that is already, as Mitchell describes it, complex and lonely.
Support amid loss
Compounding Mitchell’s grief was the fact that friends and family didn’t seem to understand that she had lost a child. They would refer to the death as a miscarriage, which, in addition to being medically inaccurate because the baby died after 20 weeks gestation, made Mitchell feel like they were unwilling to acknowledge Jonathan and his role in her life. It wasn’t that miscarriages are not painful and traumatic — Mitchell firmly believes that they are — but she could feel a resistance to her desire to make Jonathan, their named, loved baby, a permanent part of her family.
“[Parents who have lost babies] always know when the baby would have started kindergarten, turned 16, graduated,” she said. “Not that we live in the pit of grief and sorrow — but those emotions are forever.”
She vowed to find other mothers who wouldn’t need her to explain, mothers who had been through what she’d been through. A year later, she started what would become “Mommies Enduring Neonatal Death, known as M.E.N.D. — a ministry to parents experiencing miscarriage, stillbirth, and infant loss. Now operating in eight states with three national online support groups, M.E.N.D. convenes support groups, remembrance events, and offers training to OB-GYNs and nurses on how to best serve families going through neonatal loss. The peer-to-peer model is important, Mitchell said.
“We’ve all experienced loss, and we all get it.”
It was her pastor, who had lost a 7-year-old, who advised her to speak openly to her older child about the loss of his baby brother. The pastor told her to be clear and explicit with the 3-year-old, who would need to process the loss in his own way. Mitchell also advises M.E.N.D. moms on how to relate to newly pregnant friends and family members, setting up boundaries around what kind of news and pregnancy milestones they want to partake in. She encourages them to keep whatever photos and memorabilia they have on display in their house if they want to. It will make some visitors uncomfortable, Mitchell said, but it’s critical not to feel as though the grief is somehow inappropriate or shameful.
Limited options
Rev. Cheryl Kimble, a Baptist pastor from Texas, said that for many families, abortion bans may present another complicating factor: loss of agency. Some families experiencing lethal abnormalities may have chosen an abortion if it had been an option for them, allowing them to process the grief of infant loss rather than continue carrying a pregnancy unlikely to be viable.
“It’s inhumane,” she said.
It compounds a grief that is already, in her view, on par with any other infant loss. Whether or not an abortion procedure is involved, she said, grieving parents need spiritual support and the opportunity to memorialize the child as one would any child who had died.
In her time as pastor of The Church @ Highland Park in Austin, Kimble has offered spiritual support to congregants who, when faced with devastating news of a fatal condition in their first pregnancy, chose to travel out of state to have an abortion. This was before Texas’s near-total ban, she said, when abortions were legal in the first trimester. The problem for this couple and many others is that the scans and tests that reveal many life-limiting conditions aren’t found until 20-22 weeks, limiting their options for where and how the abortion can take place.
When the couple came back, Kimble said, the church held a commemorative service for the baby, similar to a funeral.
“That’s what they needed,” she said. “They needed the chance to say goodbye.”
The thought that their grief was any less just because they had ended the pregnancy through intervention rather than waiting four or five more months while the baby suffered seemed absurd to Kimble.
“They weren’t just willy-nilly getting rid of a baby; they had lost a child,”