A closer look at the maternal mortality report

I take no joy in predicting that the Legislature will take no action on this.

Nakeenya Wilson was at a meeting of Texas’ maternal mortality review committee when she got the call: Her sister, who had recently had a baby, was having a stroke.

Wilson raced to the hospital, leaving behind a stack of files documenting the stories of women who had died from pregnancy and childbirth complications. Many of the women in those files were Black, just like Wilson, who experienced a traumatic delivery herself.

“The whole thing just reminded me, if you change the name on those files, it could be me. It could be my sister,” said Wilson, who serves as the committee’s community representative.

A decade ago, when Texas first formed the Maternal Mortality and Morbidity Review Committee, Black women were twice as likely as white women, and four times as likely as Hispanic women, to die from pregnancy and childbirth.

Those disparities haven’t improved, according to the committee’s latest report, published Thursday.

In 2020, pregnant Black women were twice as likely to experience critical health issues like hemorrhage, preeclampsia and sepsis. While complications from obstetric hemorrhage declined overall in Texas in recent years, Black women saw an increase of nearly 10%.

Wilson said these statistics show the impact of a health care system that is biased against Black women.

“We’re still dying and being disproportionately impacted by hemorrhage when everybody else is getting better,” Wilson said. “Not only did it not improve, it didn’t stay the same — it got worse.”

The causes of these disparities aren’t always simple to identify, and they’re even harder to fix. It’s a combination of diminished health care access, systemic racism, and the impact of “social determinants of health” — the conditions in which someone is born, lives, works and grows up.

Wilson said she and her sister are prime examples. They grew up in poverty, without health insurance, routine doctor’s visits or consistent access to healthy food.

“We started behind the ball,” she said. “We’ve had so many hard things happen to us that have contributed to our health by the time we’re of childbearing age.”

Maternal health advocates in Texas say addressing these disparities will take more than fixing labor and delivery practices. It will require building a comprehensive health care system that addresses a community’s needs across the board, starting long before pregnancy.

In the end, Wilson’s sister survived her postpartum health scare. But the experience reminded Wilson why she volunteers her time to read, review and analyze stories of women who have died from pregnancy and childbirth.

“When you look at the work marginalized people do, they do it because they don’t feel like they have any choice,” she said. “If we want to see things change, and we want to be safe, we have to advocate for our own safety.”

See here for some background. There’s way too much for me to try to capture in an excerpt, so go read the whole thing. Rep. Shawn Thierry, who experienced some of these problems herself a few years ago when she was giving birth, is and has been working on getting legislation passed to address the issues, which includes things like expanding health care access, gathering better information, and strengthening the maternal mortality review process. See above for my assessment of the likelihood of passage. Rep. Thierry will need a lot more like-minded colleagues to make that happen, and we are very much not there yet. But the work is happening, and will continue to happen.

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One Response to A closer look at the maternal mortality report

  1. Thank you for covering this.

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