Hemorrhage, maternal health conditions, and blood clots were the leading causes of death during pregnancy and the year following.
By Allie Morris
AUSTIN – According to a long-awaited state report released on Thursday, most pregnancy-related deaths in 2019 were preventable and disproportionately affected Black Texans.
Hemorrhage, mental health issues, and blood clots were the leading causes of death during pregnancy and the year after. Mental health issues, discrimination, and violence all played a role.
According to advocates, the Texas Maternal and Morbidity Review Committee‘s report highlights how the state must do more to assist pregnant Texans and address disparities.
The report “reflects every mother who didn’t make it, every kid and family who lost her too soon,” said committee member Nakeenya Wilson, an Austin-based advocate for maternal health. And now we must all accept it as true and put forth the effort to alter the story.
The report was released after a months-long delay, which irritated members of the committee, Democratic lawmakers, and maternal health advocates.
The final review of all 147 deaths will not be completed until next year, but the major conclusions are expected to remain unchanged. The analysis comes as the Legislature prepares to convene on January 10.
The committee’s top recommendation, as in previous years, is to extend Medicaid coverage to a full year after pregnancy. The GOP-controlled Legislature approved a six-month postpartum policy last session, but the report emphasized that 12 months are required to “help identify and properly manage health conditions before they become life-threatening.”
The study discovered that 14 women died during pregnancy, while 45 died in the days and months following childbirth. The committee also emphasised a key theme that runs throughout the report: “the persistence of maternal health disparities.” According to the report, the rate of serious pregnancy complications increased for all women between 2016 and 2020, but most dramatically for Black Texans. In 2020, Black women were twice as likely as white women to have critical health issues during childbirth, such as sepsis and preeclampsia.
While the rates of severe haemorrhage among white and Hispanic Texans have decreased in recent years, the rate among Black women has increased. “The report clearly shows that state leaders must do more to prevent maternal deaths and promote healthy pregnancies among Texas women of all backgrounds, but especially among Black women,” said Diana Forester, Director of Health Policy for the advocacy group Texans Care for Children. The report advocated for involving Black communities in program development, diversifying the maternal health workforce, and mandating bias training.
It also looked at the function of medical professionals. The research discovered that treatment delays, poor care quality, and insufficient risk assessment all contributed to the maternal deaths. State Representative Shawn Thierry, a Democrat from Houston, claimed that mothers frequently receive blame and humiliation. The report “does demonstrate that there is discrimination that exists and that there is occasionally subpar clinical care given.”
It remains to be seen how the report will impact the upcoming legislative session. House Speaker Dade Phelan, R-Beaumont, has made a full year of postpartum Medicaid coverage a priority. The issue was not on Lt. Gov. Dan Patrick’s list.
Committee members have expressed a desire for legislative changes to expedite their work. Much of the information reviewed by the committee when investigating maternal deaths must be redacted, a time-consuming process that takes an average of 45 hours per case, according to the report.
The state initially missed the report’s required September 1 release date and delayed publication until mid-2023.
Former Department of State Health Services Commissioner John Hellerstedt stated at the time that more time was required to complete an investigation into each death.
Some activists accused the state of attempting to play politics ahead of the midterm elections.