Analysis

Report: 90% of Texas pregnancy-related deaths preventable, Black women impacted most

A long-awaited and delayed report by the Texas Maternal Mortality and Morbidity Review Committee was released to the public in the last days of 2022. The study detailed statewide trends related to pregnancy deaths from 2019 and reveals damning information about the treatment of pregnant people, especially Black women.

The Texas MMMRC was established in 2013 and reviews pregnancy-associated deaths: any fatalities that occurred during or in the year following the end of a pregnancy. Once a death is determined to be pregnancy-related, the MMMRC investigates potential preventability and contributing factors, then gives recommendations based on these findings. The study also tracks overall trends and disparities in maternal morbidity and mortality rates.

Of 118 pregnancy-associated deaths reviewed by the MMMRC, 52 were determined to be pregnancy-related, meaning the deaths were explicitly tied to complications arising from the pregnancy itself.

The report ultimately found that 90% of pregnancy-related deaths in the 2019 cohort were preventable, and just six underlying causes accounted for 79% of those deaths. Obstetric hemorrhages (excessive bleeding) were the leading cause of death, making up 25% of cohort fatalities, with ectopic pregnancies (in which a fertilized egg grows outside the uterus) being the leading cause of pregnancy-related hemorrhage deaths.

The overall rate of obstetric hemorrhages has fallen slightly in recent years, but not for everyone: obstetric hemorrhages among Black women actually increased by almost 10%. Even worse, complications related to in-hospital deliveries involving Black women increased by 28%. Black women are disproportionately impacted in every severe maternal morbidity rate and are three times more likely to die from pregnancy-related causes than white women.

These disparities persist regardless of socioeconomic status, meaning that racism plays a major factor in the increased risk that Black women face. Other studies have shown that conscious and unconscious racist biases pervade the medical system. A 2016 study found that nearly half of all white medical students held false beliefs about biological differences of Black patients, including believing that Black people have thicker skin and less sensitive nerve endings.

Other factors causing increased risks for Black women include inadequate health care, underlying conditions and socioeconomic status. All of these are problems relating to capitalism, which continues to profit immensely from racism and treats its most vulnerable populations — Black and Brown people, especially women and LGBTQ people — as disposable.

This report is especially damning in light of the state of Texas’ full frontal assault on abortion rights. The legislature is preparing countless bills attacking not just abortion rights, but the right to birth control, to access websites with information about abortion, and to travel out of state for abortion procedures. Texas’ abortion bans have led to doctors refusing to treat ectopic pregnancies until the very last minute, which will greatly increase the maternal mortality rate by the time the next report is released two years from now.

The legislators will likely plead ignorance, as this report was released months after its due date and after many heinous anti-abortion bills were filed. Critics have accused the delays of being politically motivated for this purpose.

One Texas legislator has filed a bill to make “Celebration of Life Day” (June 24, the date Roe was overturned in 2022) a state holiday. In light of the maternal deaths that Texas’ abortion bans will cause, such a “holiday” can only be recognized as a far-right celebration of death — especially the deaths of Black women.

Texas activists are coming together on January 22 for a statewide day of action across five cities to continue the fight for abortion rights.

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