A recent article in the journal Obstetrics and Gynecology has received a good deal of media coverage over the past month, as it reports a consistent increase in the U.S. maternal mortality rate since 2000. However, most of the attention from outlets such as the Huffington Post and ABC News has been focused particularly on the data from Texas, where the maternal death rate nearly doubled between 2010 and 2011 and has remained high since.
The article’s authors seem genuinely puzzled as to the cause of this sharp increase: “In the absence of war, natural disaster, or severe economic upheaval, the doubling of a mortality rate within a two-year period in a state with almost 400,000 annual births seems unlikely.” Indeed, if the Texas figures are correct, the maternal death rate in Texas is comparable to that of Washington, D.C. – a city with a higher poverty rate than Texas and with considerably worse public-health metrics.
Unsurprisingly, much of the media is attempting to argue that this increased maternal death rate is the result of the Texas state legislature’s 2011 cuts to the state family-planning program, but these claims are highly misleading. For one thing, there has been no increase in the unintended-pregnancy rate in Texas, and the state’s abortion and birth rates have both decreased since 2011. In fact, the unintended-pregnancy rate cited by the media comes from one contraception program run by the Texas Women’s Health Program, which reported a slight increase of 37 Medicaid births in a subset of Texas counties between 2011 and 2012.
In addition, data from the Texas Department of State Health paints a different picture than the one laid out in the Obstetrics and Gynecology article. State health data indicate that there was a consistent but gradual increase in the maternal death rate between 2000 to 2010, but the number of maternal deaths was the same in 2009 as it was in 2011.
Even if we take the original article’s data at face value, the cuts in the state family planning program do not coincide with the sharp increase in the maternal mortality rate. The article asserts that the maternal mortality rate sharply increased in 2011, but the family-planning-program cuts didn’t begin to take effect until 2012, well after the reported increase. In fact, a 2016 article in the New England Journal of Medicine found that contraceptive claims in Texas didn’t begin to decline until 2013.
The Texas legislature has appointed a commission to investigate this increase in maternal deaths. Hopefully the commission will be more diligent than the mainstream media, which seems uninterested in real analysis but all too happy to quote Planned Parenthood statistics and place all the blame on the legislature for its cuts to the Texas Family Planning Program.