Health experts see rise in maternal mortality after Roe

Note: Select mortality data not available due to reliability and confidentiality constraints;  Data: CDC;  Map: Jacque Schrag/Axios
Note: Select mortality data not available due to reliability and confidentiality constraints; Data: CDC; Map: Jacque Schrag/Axios

The six states with the nation’s highest maternal mortality rates quickly outlawed abortion after the Roe v. Wade decision overturned, fueling concerns about more children being born in areas with poor health outcomes and fewer maternal and child safety programs .

Why it matters: Women in the U.S. were already more likely to die during or after pregnancy than anywhere else in the developed world, and public health experts predict things will get worse in the post- Roe landscape as providers of health services weigh legal exposure against clinical decisions.

News Movement: Arkansas, Kentucky, Alabama, Tennessee, Louisiana and Mississippi top the CDC’s list of states with the highest maternal mortality rates, each with more than 30 deaths per 100,000 live births. Each had “trigger” laws, or abortion bans, that went into effect immediately after the Supreme Court struck down the federal right to the procedure.

  • Maternal mortality rates in states with “trigger” laws are, on average, nearly twice as high as states with laws protecting access to abortion.
  • Most of these states have been identified as “maternity deserts,” lacking hospitals offering midwifery care, birth centers, and no midwifery providers.
  • The combination of more restrictive abortion laws, more births and inadequate care could leave these states “completely unprepared for the impact on the lives, health and well-being of women, children and families that these bans will cause,” said Andrea Miller, president of The National Institute for Reproductive Health, which advocates for access to abortion care.
  • Maternal mortality in the US could increase by 24% if a national abortion ban is enacted, according to a University of Colorado study.
  • If abortion were illegal in the 26 states that either already banned abortion or were likely to do so, there would have been 64 more maternal deaths in 2020, the study, which has not yet been peer-reviewed, found.

The other side: Anti-abortion forces dispute any link between abortion bans and maternal mortality.

  • It’s “dishonest and scientifically inaccurate” to claim a link because the CDC’s data is “incomplete,” said Tara Sander Lee, senior fellow and director of life sciences at the Charlotte Lozier Institute, an anti-abortion research organization.
  • The data “make it impossible to calculate the true maternal mortality rate in the United States,” Lee added.

The big picture: Maternal mortality is a driving force in health policy decisions, with more states taking steps such as expanding Medicaid coverage for maternity services.

  • The rise in pregnancy-related deaths in minority communities is drawing more attention to a mix of maternal health standards and entrenched health disparities.
  • The topic joins the heated national debate over abortion.

  • The University of Colorado study, which was not peer-reviewed, predicted that in the first year after a national abortion ban, the number of maternal deaths would increase by 13 percent, from a baseline of 861 to 969. In subsequent years, maternal deaths deaths will increase by 210, or 24%.

Between the lines: States with restrictive laws instead of outright bans — such as Ohio, which bans the procedure after six weeks into pregnancy — may also see an increase in maternal mortality, said Katie McHugh, an OB-GYN and abortion provider in Indiana and a member of the Doctors board. in reproductive health.

  • “There is an opportunity to intervene and terminate the pregnancy early,” McHugh told Axios, but added that “when people decide to terminate their pregnancy for a medical reason, it’s almost always discovered later.”
  • “Medical conditions develop and are diagnosed during pregnancy, and this does not reduce the risk of long-term effects on the health of the pregnant woman. In fact, sometimes the diagnoses made in the middle of pregnancy are the most devastating.”

What we watch: Some state laws contain exceptions to save a pregnant woman’s life. But how doctors must prove which patients qualify in an emergency can put providers in an untenable position and be “confusing for medical practitioners,” said Jen Villavicencio, head of equity transformation at the American College of Obstetricians and Gynecologists. gynecology.

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