The Texas Maternal Mortality Crisis: Looking Towards Solutions

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The Texas Maternal Mortality Crisis: Looking Towards Solutions​

February 2019

Sarah Gonzales Claytor

By Sarah Gonzalez Claytor (@lapetite_syrah)
Center for Health and Social Policy Ambassador


Texas made big news in 2016 when the media reported that its maternal mortality rate had more than doubled between 2010 and 2012. In 2018, new research commissioned by the Texas Maternal Mortality and Morbidity Task Force found that the shocking increase was due in part to reporting errors on death certificates. While the accurate rate of 14.6 deaths per 100,000 live births is not as steep an increase as the original rate of 38.4 deaths, Texas still has an alarming maternal mortality problem.

Panelists at the 2018 Texas Tribune Festival dug into the question posed by moderator Marisa Evans: “We’ve been talking about maternal mortality for two years, what has changed?”

Dr. Carla Ortique, vice chair of the Texas Maternal Mortality and Morbidity Task Force, shared sobering statistics of the inequalities behind the raw numbers. Black women are more than twice as likely to die from a pregnancy related cause than white women, even when controlled for other factors. Compounded by those other factors, such as the fact that more than 12% of Black women lack health insurance, compared to 8% of white women, the overall rate of Black maternal mortality rate is three to four times higher than that of white women.  “Many of these women die not because the diseases aren’t preventable, but because we don’t care enough about women’s lives,” said Dr. Ortique. She noted that women are eligible for Medicaid while pregnant, but lose that coverage two months after giving birth. “If women had access to healthcare across the continuum of their reproductive lives, we would have healthier pregnancies, healthier babies, and healthier mothers. It’s less cost on society, simple math.” She called on states to establish committees to examine maternal mortality and determine which deaths are preventable and how we can prevent them.

Shawn Thierry is a Houston-area state Representative in the Texas House, and her district encompasses three of the zip codes with the highest maternal mortality rate. She spoke to the racial and gender biases that affect Black women most profoundly. Thierry cited a shocking study from 2016 showing that medical students and physicians still believe the medical myth that Black people experience pain less intensely than white people. These pervasive racial stereotypes show how important and necessary implicit bias training is. Other solutions include bundles—a set of evidence-based practices—to improve maternal health, such as hypertension and substance abuse bundles. The latter is especially relevant, given that drug overdoses are currently the #1 cause of death within a year of giving birth.

In the current 86th Texas legislative session, there are several bills that can help mitigate the maternal mortality rate. Thierry has authored HB 411, which would extend the period of Medicaid coverage to cover women for up to twelve months after childbirth or a miscarriage. HB 25, authored by Rep. Mary González, would make it easier for women to access health care services by allowing children under the age of thirteen to accompany their mothers on Medicaid vehicles. Previously, children were not allowed in these vehicles; this forced mothers to find childcare during their postpartum appointments, potentially restricting access if they could not. Finally, the solution that is most comprehensive and common sense, HB 282 would expand access to Medicaid for up to 1.2 million Texans. Rep. Carol Alvarado’s measure would address issues from substance abuse disorders to high blood pressure to postpartum care through a woman’s lifetime.

These policy changes are an investment in Texas’ future, and represent a vital opportunity to keep our mothers alive and thriving.   

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Sarah Gonzalez Claytor is a first-year Master of Public Affairs student and CHASP Ambassador at the LBJ School of Public Affairs, pursuing Certificates in Nonprofit Studies and Women and Gender Studies. Prior to coming to the LBJ School, Sarah worked in school operations, evaluating and adjusting processes to be more efficient, as well as engaging families in their student's education. This experience, along with working as a case manager with single mothers experiencing homelessness, was pivotal in convincing Sarah of the need for social policy that addresses the intersections of inequality. She is especially interested in policies that affect access to reproductive healthcare, including comprehensive sex education, birth control, abortions, and prenatal and postnatal care, especially for women and LGTBQ people of color. After graduation, Sarah hopes to work in policy evaluation and advocacy to advance reproductive justice in marginalized communities. Sarah is also the 2018-2019 Community Engagement Committee Chair for the student group Social Policy Network (SPN).

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The views, information, or opinions expressed by blog contributors are solely those of the individual authors and do not necessarily represent those of the Center for Health and Social Policy, the LBJ School of Public Affairs, or The University of Texas at Austin or affiliated employees.