Examining the Impact of Abortion Laws on Maternal Mortality: A Closer Look at Texas and Georgia
Last month, reports emerged of efforts in both Texas and Georgia to halt investigation and analysis of maternal mortality in the years since Roe v. Wade—the Supreme Court ruling that protected the right to an abortion—was overturned. These efforts to hinder examination of the impacts of strict state abortion laws on pregnant people are a political play that only serves to put women and families at risk of even greater harm.
In the aftermath of the 2022 Dobbs decision lies a murky patchwork of abortion laws—protections in some states and criminal charges in others—that has created significant confusion among the public and health care providers about how to get and provide adequate reproductive health care. Both Texas and Georgia have passed state laws limiting people’s access to an abortion – with Texas passing a near-complete ban, and Georgia implementing a limit of up to six weeks into gestation—a period in which many women may not even know they are pregnant.
In Georgia, the state Maternal Mortality Review Committee (MMRC), a committee of health care providers and public health experts convened by the state Department of Public Health, was disbanded after “confidential information was […] inappropriately shared with outside individuals,” according to the department’s commissioner. This decision followed an investigation by ProPublica into the cases of two women – Amber Thurman and Candi Miller – who died in part due to the consequences of the state’s strict abortion law. Amber’s death was attributed to delayed care, whereas Candi felt she could not seek medical care altogether due to fear of the state’s law. Information provided by the Georgia MMRC to ProPublica reporters determined that the deaths were preventable, yielding a backlash by the state government, which dismissed all members of the 32-person committee. While members of the committee are required to sign confidentiality agreements, which may have been violated when this information was shared with ProPublica, the state’s punitive response of dismissing the entire committee seems a bridge too far. Furthermore, the families of both women reportedly wanted information about their cases made public. This incident also calls into question whether the MMRC will be reconstituted through a politically motivated process that favors candidates that support that state’s abortion restrictions.
In Texas, the state Maternal Mortality and Morbidity Review Committee took it a step further, deciding to ignore the data altogether. The committee decided to not review cases from 2022 and 2023 to “be more contemporary.” This political maneuver, thinly veiled as a decision to eliminate the backlog of cases, is reckless. Investigations into the root causes of maternal mortality are necessary to prevent similar cases in the future. And if state legislators voted to restrict reproductive health care, then they must also be willing to face the evidence about how these decisions impact their constituents. By burying their heads in the sand, legislators and regulators aren’t supporting healthy women and families but putting them in much greater danger. Suppressing scientific investigation costs lives.
Research published in JAMA Pediatrics found that after Texas passed its abortion ban in 2021, infant and neonatal mortality increased. Similarly, a recent national study found that infant mortality increased by 7 percent overall after the Dobbs decision. Furthermore, evidence suggests that after the Dobbs decision, there are fewer clinics that provide abortions (and other critical reproductive health care), lower quality maternal health care in those states with abortion bans, and an increase in abortions across the country.
This issue hits home for me. I gave birth to my daughter earlier this year, and nothing affirmed to me more that reproductive care is medical care than being pregnant myself. She was born via emergency c-section—a series of events that required swift and unfaltering action by my providers. That’s as it should be—health care providers should be able to offer the necessary care to their patients without fear of politically-motivated investigation or prosecution. I am fortunate to live in a jurisdiction where reproductive health care is protected, but state lines shouldn’t determine one’s ability to access adequate reproductive care.
When access to medical care is restricted, people die. The United States has one of the highest rates of maternal mortality among OECD countries, and these deaths are especially high among Black and Indigenous women. State MMRCs are convened to investigate these cases and are one of the only bodies tasked with determining whether the deaths were preventable. Pretending we can make the problem go away by ignoring it is as counterproductive as it is immoral. When politically-motivated actors suppress and sideline the work of independent committees tasked with reviewing scientific evidence, we all suffer.
