Despite new lower numbers, Texas must still address maternal mortality

A study released in 2016 ignited a flurry of concern about the rate of maternal death occurring in Texas.  This study indicated that the maternal mortality rate had doubled over a two-year period, from 18.6 in 2010 to 38.7 in 2012.  However, a report released this month in the journal Obstetrics & Gynecology determined that the actual number of maternal deaths that occurred in 2012 was 56, bringing the maternal mortality rate down dramatically to 14.6.   As the Washington Post reported, “For the past few years, Texas’s maternal mortality rate was so high it seemed unbelievable.  As it turns out, according to a study released this week it was, indeed, not to be believed.”

Even though these numbers are better than what were initially thought, Texans, and Pro-Lifers particularly, should still pay close attention to the issue of maternal mortality and morbidity and what we can do to protect more Texas mothers.

Maternal mortality is defined in Texas law as “the death of a woman while pregnant or within one year of delivery or end of pregnancy, regardless of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.”  This is used in figuring out the maternal mortality ratio, which is calculated as the number of these pregnancy-related deaths per 100,000 live births every year.

The 2016 study reported that there were 147 maternal deaths in 2012, producing a high rate of 38.7.  However, concerns have been raised on the accuracy and reliability of data, as well as the lack of confirmation of these coded maternal deaths through other sources of data matching.   In the newest study released this month, researchers did more thorough analysis of maternal death data by not only trusting the coding used on death certificates to determine if a woman had been or was pregnant, but also verifying the coding through data matching.  This resulted in the lower rate of 56 maternal deaths in 2012, producing a ratio of 14.6.  

Last year, Pro-Abortion organizations and politicians used the flawed data to blame Pro-Life policies and compared Texas’ mortality rates to other countries.  However, globally, there are other confounding factors, including that maternal mortality is not uniformly defined.  In Texas, the definition and rate encompasses pregnancy-related deaths that occur within a year of a woman’s pregnancy.  The World Health Organization (WHO) only includes maternal deaths that occur while a woman is pregnant or within 42 days of the end of the pregnancy.  This leads to issues when attempting to compare maternal mortality ratios for various countries.  Maternal morbidity, which is a pregnancy-related health condition that occurs during or within one year of the delivery or end of a pregnancy, is another grave concern that needs to be addressed.  

Texas has taken significant steps to prevent maternal mortality and morbidity, such as the creation of the Maternal Mortality and Morbidity Task Force in 2013, which was reauthorized during the Special Session of the 85th Legislature in 2017 for another five years.  The purpose of this task force is to analyze cases of maternal death and morbidity and recommend specific legislative and medical solutions.  

The lower numbers in 2012 for maternal mortality are certainly encouraging; however, there is still much work to be done in solving this crucial public health problem for women. Texans, including Pro-Life Texans, must still take this problem seriously.  Hypertension, one of the main causes of maternal death in Texas, is preventable.  Other top causes, including drug overdoses, are in line with the national opioid crisis and must be addressed. There is also a clear racial disparity at play here, as black women have the greatest risk for maternal mortality.  Maternal health is a sentinel indicator of healthcare quality, and feasible reliable and accurate data collection are vital to solving the problem.  Texas mothers deserve no less than a safe and life-affirming environment within which to give birth and raise their children. The Pro-Life movement should be part of the effort to achieve that public health goal in Texas.