According to a recent report from the Centers for Disease Control and Prevention, the number of pregnancy-related deaths in the U.S. rose in 2020, the first year of the pandemic. The report finds there were 23 deaths per 100,000 births, which is up from 20 in 2019. The report did not examine what role the pandemic played in the increase, but it could have been related to people delaying visits to healthcare providers.
The report also cited racial disparities as the maternal mortality rate for Black women was three times higher than White women. The U.S. has the highest maternal death rate among developed countries and is the only industrialized nation where numbers are increasing.
Black women in Texas are “disproportionately” impacted as they account for 11 percent of live births but 31 percent of maternal deaths. Texas has the highest number of uninsured residents in the U.S. and the highest percentage of uninsured women of childbearing age. According to “Babyscripts,” a virtual maternal care company, Black women have higher rates of preterm birth, low birthweight and increased infant mortality. Black women are most likely to be uninsured, fall into coverage gaps when Medicaid is not expanded and experience higher rates of chronic disease. The upcoming Black Maternal Health Week (April 11-17) will focus on these challenges.
Some of the leading causes of maternal death include infection, hemorrhage, preeclampsia and cardiovascular conditions. Studies indicate 80 percent of maternal deaths are preventable. Many of the symptoms include severe headaches, dizziness, vision impairment, fever, swelling in the hands or face, vaginal bleeding, difficulty breathing and suicidal thoughts. If you have friends with these symptoms, listen to their concerns and encourage them to seek immediate care. You can also go with them to the provider and offer to talk with her doctor.
The American Rescue Plan Act, enacted by Congress and signed into law by President Joe Biden in 2021 to address maternal deaths, allows states to extend Medicaid coverage for a full year postpartum. Our most recent legislative session addressed postpartum coverage. The Texas House passed a bill to extend our postpartum coverage to 12 months. We thank the Texas House for this meaningful legislation and applaud them for addressing disparities in maternal healthcare. Unfortunately, when the bill went to the Texas Senate, the legislation was modified to reduce the coverage to six months. While we are glad to have increased maternal coverage, the legislation fell short of what is needed in Texas, though allowed by Medicaid.
When our legislature convenes next year, two items that will save lives in Texas is to extend postpartum coverage to 12 months and expand Medicaid coverage to approximately 1.5 million Texans. Many of these uninsured residents are people of color.
We can help the maternal mortality problem in Texas by working collaboratively for increased healthcare coverage, access and outcomes for the good of all Texans.
Steve Love is the CEO and President of the DFW Hospital Council.