Texas’ Maternal Mortality and Morbidity Review Board We recently published a report of deaths occurring between conception and the first 12 months of pregnancy. In 2019, more than 50 Texans died of causes directly related to pregnancy, according to reports. This is an unacceptable number. Many others have experienced severe pregnancy complications that, while not fatal, can have long-term effects on maternal health.
The panel found that deaths during pregnancy often have multiple causes, but more than half of the contributing factors occurred at the provider, health facility, or health system level. This means that there is greater responsibility for the systems with which people interact than for individual choices. Ninety percent of these pregnancy-related deaths are considered preventable, higher than nationally reported, so state-level policy changes are needed to address these heartbreaking statistics.
Another important takeaway from the report: death and severe complications Texas’ Among black communities and those without private insurance.
As public policy and inequality researchers, we are not surprised by these findings. Research clearly shows how unequal access to quality care and systemic racism undermine people’s health and well-being before, during and after pregnancy.
texas It’s the state with the highest percentage of uninsured residents because state policymakers haven’t expanded Medicaid, but Medicaid expansion is supported by most Texans, and the maternal mortality rate has dropped. shown to decrease. Comprehensive Medicaid coverage helps manage health conditions that, if left untreated, can increase the risk of pregnancy complications. Coverage is also a common cause of pregnancy-related death. It may provide access to treatments for depression and substance use disorders.
Our research found that women of color without insurance or public insurance were more likely than white women to report health care barriers. found that they frequently reported serious and ongoing postnatal health conditions they were unable to manage because they were left uninsured 60 days after giving birth when their Medicaid or CHIP coverage ended.
Pregnancy-related mortality is over 1 in 4. texas performed between 2 and 12 months postpartum, texas All low-income Texas people should have their publicly funded insurance coverage extended for one year after giving birth. 27 states do this.why not texas?
texas And more could be done to address discrimination, which accounts for 12% of deaths. Efforts should be made to engage and listen to the calls of black women’s advocates to expand access to doulas that have been shown to improve pregnancy outcomes.
Here’s another reason these health metrics keep going in the wrong direction. Texas’ Laws that went into effect in 2021 and 2022 criminalize abortion, except in medical emergencies, but are not supported by a majority of Texans. Maternal deaths, such as those from ruptured ectopic pregnancies, were the leading cause of pregnancy-related deaths from bleeding in 2019 and are expected to rise as doctors fear providing needed medical care. . Texas’ Abortion bans also lead to more cases of severe pregnancy complications. Our research and other reports show that fear of legal repercussions has compelled physicians to delay treatment of pregnant women experiencing premature rupture of their membranes. Sepsis is a life-threatening infection that was already on the rise.
It shouldn’t be this dangerous to get pregnant texasState leaders must take bold action and adopt policies supported by evidence and a majority of Texans. They can start by extending Medicaid coverage for 12 months after pregnancy ends and passing legislation to fairly compensate everyone who wants a doula.a texas This makes the pregnancy and postpartum period safer for all residents, especially blacks and low-income Texans.
Vohra-Gupta is an assistant professor. Steve Hicks School of Social Work and University of Texas.
White is an associate professor Steve Hicks School of Social Work.
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