The Association Between State-Level Safe Haven Laws and Rates of Infant Mortality in the United States: A Legal Epidemiology Study

Abstract

AbstractObjectiveAlthough the United States has safe haven laws, which allow mothers to safely relinquish their babies to designated safety points, rates of infant mortality remain significantly higher in the United States than other similarly developed countries. The current study is seeking to explore the association between state-level safe haven laws and infant mortality in the United States utilizing a legal epidemiological approach.MethodsSeveral sources of publicly available data were combined to examine the association between state-level safe haven laws and rates of infant mortality. A backward stepwise regression was used to determine whether certain safe haven laws significantly predicted rates of infant mortality, while controlling for demographic variables.ResultsAfter controlling for demographic variables including race, poverty, and education, safe haven laws regarding who is permitted to relinquish a child significantly predicted rates of infant mortality, with the total model accounting for 74.4% of variance in infant mortality.ConclusionSafe haven laws pertaining to who may relinquish infants significantly predicted infant mortality, specifically laws stating only the mother may relinquish the child and laws which do not specify who may relinquish the child. These results have important implications for policymakers considering the reform of the safe haven laws. It is especially important to evaluate the effectiveness and origins of safe haven laws in the wake of the overturn ofRoe v. Wade. Future studies should longitudinally examine how changes in safe haven laws lead to changes in rates of infant mortality.Three-Question Summary Box1)What is the current understanding of this subject?Although a goal of safe haven laws is to ensure the safety of infants and reduce infant mortality, few studies have analyzed the relationship between safe haven laws and infant mortality. Prior research revealed a reduction in infant homicide rates after the enactment of safe haven laws, but no studies have studied the association between specific elements of safe haven laws, including who may relinquish the infant, where the infant may be relinquished, and how old the infant is at the time of relinquishment, and state-level rates of infant mortality.2)What does this report add to the literature?This is the first study to use a legal epidemiological approach to examine the association between specific elements of safe haven laws and state-level rates of infant mortality in the United States, including who may relinquish the infant, where the infant may be relinquished, and how old the infant is at the time of relinquishment. After controlling for demographic variables including race, poverty, and education, safe haven laws regarding who is permitted to relinquish a child significantly predicted rates of infant mortality, with the total model accounting for 74.4% of variance in infant mortality.3)What are the implications for public health practice?Safe haven laws pertaining to who may relinquish infants significantly predicted infant mortality, specifically laws stating only the mother may relinquish the child and laws which do not specify who may relinquish the child. These results have important implications for policymakers considering the reform of the safe haven laws, which is especially important in the wake of the overturn ofRoe v. Wade.