In August 2025, the Mississippi State Department of Health (MSDH) declared rising infant mortality in the state a public health emergency. According to the MSDH, “2024 data shows the overall infant mortality rate has increased to 9.7 deaths per 1,000 live births, which is the highest in more than a decade. In Mississippi, 3,527 babies have died before the age of 1 since 2014.”

Mississippi currently has the highest infant mortality rate in the United States, and double the average of the countries that comprise the Organization for Economic Co-operation and Development. The MSDH said that it declared a public health emergency because it “recognized the urgency of this crisis and could not wait to take action.” A public health emergency allows MSDH to mobilize additional resources and garner the attention and collaboration of more partners. It is a cry in the wilderness, speaking the truth about the fate of children not only in Mississippi but in many other states around the country with high infant mortality rates, like Arkansas, Alabama, Alaska, South Carolina, Louisiana, Oklahoma, and Ohio.

But the public health professionals in Mississippi and elsewhere are facing an uphill battle, because state and federal policies are making their work almost impossible. For instance, Medicaid expansion is a powerful tool in improving infant mortality, but Mississippi Governor Tate Reeves has refused to expand Medicaid, which covers 60 percent of births in the state. Even with an extension of postpartum care under Medicaid in Mississippi to up to a year, many poor women will remain uninsured between pregnancies.

Furthermore, cuts to Medicaid in Trump’s Big Beautiful Bill will also leave up to 40,000 more Mississippians without coverage. And the Trump administration has all but destroyed the Pregnancy Risk Assessment Monitoring System (PRAMS) by decimating staff at the Centers for Disease Control and Prevention’s Division of Reproductive Health. PRAMS is vital to gathering data on maternal and infant health before, during, and after pregnancy. It also shapes policies and interventions for states across the nation, including Mississippi, which has had to suspend its own data collection efforts in the midst of its public health emergency.

Though the GOP likes to consider itself pro-family, the maternal and infant mortality data across the United States tells a different tale. The policies enacted by Republican state legislatures strongly contribute to the poor maternal and infant health outcomes in these jurisdictions.

This has been true for a very long time. But Trump’s war on public health is making things a whole lot worse, a whole lot more quickly. Many in public health have been reeling over the attacks on vaccination by RFK Jr. and his cronies, as evidenced by their refusal to recommend Covid vaccination for pregnant people and infants this summer. Last week, RFK Jr.’s handpicked Advisory Committee on Immunization Practices (ACIP) sowed misinformation and doubts about the combined measles, mumps, rubella, and varicella (chickenpox) vaccine, and was poised to meddle with infant vaccination for hepatitis B as well, leading many medical societies to break with ACIP once again.

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December 2025 Issue

But no one was prepared for the double whammy of this week’s gonzo press conference at the White House, where President Trump made false claims about vaccines and acetaminophen causing autism. As the eminent bioethicist Arthur Caplan has said:

The announcement on autism was the saddest display of a lack of evidence, rumors, recycled old myths, lousy advice, outright lies, and dangerous recommendations by anyone in authority in the world claiming to know anything about science that I have ever witnessed. And that’s saying something, since I’m 76 years old. Among other things, I watched Trump gurgle on about taking bleach during Covid.

Vaccines don’t cause autism. While the case on acetaminophen is more complicated, the most convincing data suggests there is no association. In particular, while some studies have shown an association, genetics or other confounding factors could bias these results. To address this potential skew, a large Swedish study of close to 2.5 million children used sibling controls to address the role of genetics and parental health, and found that the relationship between prenatal acetaminophen use and autism disappeared.

Thus, the statements by President Trump and the actions he will take to discourage acetaminophen use in pregnancy are irresponsible at best, and dangerous at worst. Why? Because “untreated fever, especially in the first three months of pregnancy, increases the risk of miscarriage, birth defects and premature birth” and nonsteroidal anti-inflammatory drugs (e.g., aspirin, ibuprofen, and naproxen) in pregnancy present well-documented risks to the developing fetus. Thus, acetaminophen is the safest option for pregnant people in the context of fever and pain, as medical societies were quick to point out in their corrections of the president’s rash statements.

While previous GOP policies have endangered maternal and child health, RFK Jr. and President Trump will surely out-Herod Herod in their contributions to infant mortality in the United States. These two men—from their attacks on vaccination, now their attacks on a key drug used in pregnancy, to their dismantling of key programs that help us understand the risks and complications of pregnancy in America to the programs that serve expectant mothers and their health and the health of their children—are presiding over a modern-day massacre of the innocents that should disgust and enrage us all.