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healthHealth and Medicine

Why Is The Pregnancy-Related Death Rate In Texas The Highest In The US?

author

Robin Andrews

Science & Policy Writer

clockJun 6 2017, 15:42 UTC

What's happening in Texas? Olena Yakobchuk/Shutterstock

Texas has a problem that is suspiciously unique to the states – as reported by the Associated Press, it has the highest pregnancy-related death rate in not just the US, but the entirety of the developed world with the exception of Mexico.

Citing a study by the University of Maryland looking at maternal mortality rates across all US states and territories, it is being reported (accurately) that the nationwide rate has increased from 18.8 per 100,000 live births in the year 2000 to 23.8 in 2014, a near-27 percent increase. California’s rate has dropped from 21.5 to 15.1 in the last decade or so, but plenty of states have seen the rate jump up – most notably in Texas.

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The Lone Star State, between the year 2000 and 2010, saw the rate slowly increase from 17.4 to 18.6. Dramatically, between 2010 and 2014, it jumped to 35.6, a truly remarkable and distressing figure. It’s being widely reported that the change was due to funding cuts to reproductive health clinics, but what’s the truth behind the story?

It’s no secret that GOP lawmakers generally have an agenda against reproductive care. Repeated and flagrant attempts to ban abortion clinics and defund Planned Parenthood, for example, make the headlines at least once every few months. It’s also true, of course, that this has a direct impact on the public’s health.

Texas maternal mortality rates. MacDorman et al./Obstet Gynecol 2016

Back in 2011, as a Congressman, Vice President Mike Pence helped the House pass an amendment to defund Planned Parenthood, which is a top provider of contraceptives. During his first year as Governor of Indiana, he closed Scott County’s only Planned Parenthood Clinic, which meant there was nowhere else for residents to get sexual healthcare or tests.

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Then, in 2015, there was a HIV outbreak. This was not a coincidence.

It’s not surprising then that people have linked the defunding of reproductive health clinics in GOP-governed Texas to skyrocketing maternal mortality rates.

Curiously, during the recent doubling of death rates, legislators also failed to vote on measures that would directly address this problem due to Republican infighting. Several key women’s health clinics were also closed during this period of time.

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However, it’s important to note that the University of Maryland study only observed trends in the death rates – it did not offer a definitive explanation as to why the trends in Texas were changing so dramatically. It could be that there is a link with the funding cuts, but the researchers also suggest that this spike could also be due to a sampling error, one linked to poor record-keeping in the state prior to 2011.

Either way, let’s not ignore the overarching problem here: There has been a 27 percent increase in maternal mortality cases in just 14 years in the richest country in the world. That, indubitably, is a depressing failure that runs contrary to plenty of other developed nations.

Let’s take the US’ 2010 figure of 16.9 deaths per 100,000 live births. France (10.0), the UK (8.2) Germany (7.0), Canada (6.6), Sweden (4.6) and Italy (3.9) all put the American healthcare system to shame in this regard.

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There’s no doubt that there is a healthcare link here, and although it’s difficult to say what it may be, it may not even be that complex a problem to solve. One of the most common causes of death in this sense is postpartum hemorrhaging (PPH) – excessive bleeding. Every 10 minutes, a woman giving birth dies of PPH.

Combined maternal and post-one-year maternal mortality rates in California. MacDorman et al/Obstet Gynecol 2016

With the application of a $3-a-piece drug, a third of these deaths could be prevented. It looks like the US needs it more than most – that, and a healthcare bill that doesn’t cut support programs for the poor more than anyone else.

It might also be worth looking at what California's healthcare system is doing that others states are not.

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[H/T: AP]


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