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Texas Won't Study How Its Abortion Ban Impacts Women, So We Did
https://bsky.app/profile/charlesornstein.bsky.social/post/3limb5gfmvs2rLink to tweet
https://www.propublica.org/article/texas-maternal-mortality-analysis-methodology
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A first-of-its-kind analysis by ProPublica found that the sepsis rate in second-trimester pregnancy loss hospitalizations increased by more than 50% after Texas’ near-total abortion ban went into effect in September 2021. The analysis also identified at least 120 in-hospital deaths of pregnant or postpartum women in 2022 and 2023 — an increase of dozens of deaths from a comparable period before the COVID-19 pandemic......
Sepsis Rate Findings
Our analysis found that the sepsis rate in second-trimester pregnancy loss hospitalizations increased after the state’s ban went into effect, and the surge was most pronounced in cases in which the fetus may still have had a heartbeat when the patient arrived at the hospital.
In the nine quarters before SB 8 went into effect, the sepsis rate in second-trimester pregnancy loss hospitalizations was 2.9%. In the nine quarters after SB 8 went into effect, the sepsis rate was 4.5%, an increase of 55%.....
Pregnancy-Associated Hospital Deaths
We found 120 women who died while hospitalized during pregnancy or up to six weeks postpartum in 2022 and 2023 in the inpatient billing data. The Texas Maternal Mortality and Morbidity Review Committee will not review deaths from these years, stating that they will skip to 2024 in an effort to get a more “contemporary” view of deaths, a choice that faced widespread criticism. (The committee chair said there was “absolutely no nefarious intent” behind the decision.)
To identify inpatient deaths in the Texas hospital discharge data, we included all records with a “patient status” of “expired” and with a diagnosis or procedure code indicating that the patient was pregnant or up to six weeks postpartum, with a specific postpartum complication based on the “Identifying Pregnant and Postpartum Medicaid and CHIP Beneficiaries” code list by the Centers for Medicare & Medicaid Services. The CDC looks at deaths up to within one year of a pregnancy’s end, but our dataset doesn’t explicitly identify pregnant or recently pregnant patients, so we were limited in the hospitalizations we could identify through codes.
Our tally does not include those who died in a hospitalization that took place separately from the end of a pregnancy, unless the patient was diagnosed with a specific postpartum complication. We did not filter for age and gender for our death records, as that data was less reliably filled out than the diagnosis and procedure codes......
Texas and National Rates of Maternal Mortality
The hospital billing data only includes information about Texas, so to compare with national rates, we used data from the CDC’s WONDER portal, which is based on birth and death certificates. For this analysis, we used a definition of maternal death recommended by CDC research guidelines for this data source. Our denominator includes all live births. For statewide rates, we use the state of residence of the mother in both the numerator and denominator. Rates are reported per 100,000 births.
Between 2019 and 2023, we found a 33% increase in maternal mortality rates in Texas, compared with a decrease of 7.5% nationally during the same time.
While both nationally and in Texas rates of maternal mortality peaked in 2021 during the COVID-19 pandemic and have dropped since, rates in Texas remain higher than before the pandemic.
Sepsis Rate Findings
Our analysis found that the sepsis rate in second-trimester pregnancy loss hospitalizations increased after the state’s ban went into effect, and the surge was most pronounced in cases in which the fetus may still have had a heartbeat when the patient arrived at the hospital.
In the nine quarters before SB 8 went into effect, the sepsis rate in second-trimester pregnancy loss hospitalizations was 2.9%. In the nine quarters after SB 8 went into effect, the sepsis rate was 4.5%, an increase of 55%.....
Pregnancy-Associated Hospital Deaths
We found 120 women who died while hospitalized during pregnancy or up to six weeks postpartum in 2022 and 2023 in the inpatient billing data. The Texas Maternal Mortality and Morbidity Review Committee will not review deaths from these years, stating that they will skip to 2024 in an effort to get a more “contemporary” view of deaths, a choice that faced widespread criticism. (The committee chair said there was “absolutely no nefarious intent” behind the decision.)
To identify inpatient deaths in the Texas hospital discharge data, we included all records with a “patient status” of “expired” and with a diagnosis or procedure code indicating that the patient was pregnant or up to six weeks postpartum, with a specific postpartum complication based on the “Identifying Pregnant and Postpartum Medicaid and CHIP Beneficiaries” code list by the Centers for Medicare & Medicaid Services. The CDC looks at deaths up to within one year of a pregnancy’s end, but our dataset doesn’t explicitly identify pregnant or recently pregnant patients, so we were limited in the hospitalizations we could identify through codes.
Our tally does not include those who died in a hospitalization that took place separately from the end of a pregnancy, unless the patient was diagnosed with a specific postpartum complication. We did not filter for age and gender for our death records, as that data was less reliably filled out than the diagnosis and procedure codes......
Texas and National Rates of Maternal Mortality
The hospital billing data only includes information about Texas, so to compare with national rates, we used data from the CDC’s WONDER portal, which is based on birth and death certificates. For this analysis, we used a definition of maternal death recommended by CDC research guidelines for this data source. Our denominator includes all live births. For statewide rates, we use the state of residence of the mother in both the numerator and denominator. Rates are reported per 100,000 births.
Between 2019 and 2023, we found a 33% increase in maternal mortality rates in Texas, compared with a decrease of 7.5% nationally during the same time.
While both nationally and in Texas rates of maternal mortality peaked in 2021 during the COVID-19 pandemic and have dropped since, rates in Texas remain higher than before the pandemic.
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