As a new presidential administration with a disdain for science and a commitment to disinformation takes office, health care advocates and stakeholders must brace themselves for scientific data collection to be influenced by political agendas or to stop altogether. For example, some states have recently made changes that impair a key producer of maternal health data and recommendations—maternal mortality review committees (MMRCs)—simply to avoid acknowledging fallout from the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization.
Lack of access to essential health care like abortion has contributed to maternal deaths, and it will continue to do so. But that’s not something anti-choice stakeholders want to hear or want the public to know. They would rather not understand the causes of maternal death at all than acknowledge lack of access to abortion care as a factor.
Maternal mortality review committees play a critical role in determining the causes of maternal death and making recommendations on how to prevent deaths going forward. The committees are only useful if they actually review deaths and take an unbiased look at causes and solutions. Unfortunately, these committees are already riddled with unhelpful politics and challenges. Reducing or restricting their functions because of anti-abortion politics will only worsen the United States’ maternal health crisis.
MMRCs have a duty to produce data on causes of maternal mortality.
The Centers for Disease Control and Prevention (CDC) defines maternal mortality review committees as “multidisciplinary groups that convene at the state or local level to comprehensively review deaths that occur during or within 1 year of the end of pregnancy.” These groups report their findings to the CDC through the Maternal Mortality Review Information Application (MMRIA) system that allows for data standardization—an important factor when gathering data from various state and local jurisdictions.
It is important to note here that these groups are tasked with reviewing deaths that occur within one year of the “end of pregnancy,” which may happen through a live birth, spontaneous abortion (commonly known as miscarriage), induced abortion (medication or procedural), or stillbirth. Regardless of how a pregnancy ends, MMRCs have a duty to review a maternal death case and examine all the factors that may have contributed to that person’s demise. Of all pregnancy-related deaths, more than 80 percent are preventable and the recommendations made by thorough, unbiased reviews of cases can ensure that deaths like these are avoided in the future.
MMRCs also have a duty to the American people, as there is no way to end the United States’ maternal health crisis without a comprehensive understanding of all contributing factors. In fact, the CDC has noted that MMRCs are “the best source for prevention strategies.”
Good policymaking relies on evidence.
Unbiased, evidence-based decisionmaking—which in this political moment is a fairytale dream—is the only way to create policies that help meet the needs of most people. Biased decisions that disregard data can only privilege certain groups and leave others to suffer. When it comes to maternal health, this suffering not only affects women, but their infants, children, and broader families. Data shows that when a family loses a mother, there are long-term generational consequences.
Ignoring evidence on the contributors to and causes of maternal death puts our entire society at risk of a lower quality of life and wellbeing. And it puts the most vulnerable and marginalized groups at the greatest risk. These include low-income individuals and those without unfettered access to high-quality health care. While the recent narrative has focused on racial inequities in maternal and infant mortality, it remains true that these rates are also higher for low-income families and those living in rural areas. Furthermore, the United States has the highest rate of maternal mortality among nations with similar GDP, despite the immense amount spent on health care.
At the local level, states with the most abortion restrictions also have the highest maternal mortality rates. There is something fundamentally wrong with how American systems treat women, people of color, low-income earners, and with how pregnant women are (or are not) cared for. Rather than provide a living wage, adequate housing, efficient transportation, and affordable fresh food (factors that have been proven to contribute to better health outcomes), decision-makers prioritize corporations’ profit.
The American health care industry is just that—an industry; that is, a business enterprise that profits at the expense of the people it is supposed to care for. Health care is a commodity when it should be a social good. There is certainly enough information to make a broader case that healthy people lead to a healthy and thriving populace that increases a nation’s economic productivity. Instead, mothers are left to die from preventable causes so that companies can benefit in the short term.
Deaths will go unexamined due to anti-abortion politics.
Unfortunately, when it comes to reproductive and maternal health, data doesn’t seem to matter. States are on track to stop the process of collecting data, reviewing it, and making viable recommendations for political reasons. Anti-abortion stakeholders have let their political stance compromise a scientific process and they have shirked their duty to protect women’s lives by identifying solutions to maternal deaths. In some states, the same people that enacted abortion restrictions are the same people responsible for the maternal mortality case review process. This precludes unbiased reviews of maternal deaths and meaningful recommendations.
Some states are taking drastic actions to halt or bury the data. In November 2024, Georgia dismissed its entire thirty-two-member Maternal Mortality Review Committee after ProPublica reported on two maternal deaths believed to be related to abortion bans. Advocates anticipate that recruiting an entirely new committee will cause delays in the review process as well as changes to how cases are reviewed in the future. Georgia law prohibits abortion care after six weeks into a pregnancy—a time when many women are first recognizing signs of their pregnancy or considering taking a pregnancy test.
Idaho’s short-lived MMRC was retired in July 2023 after a total abortion ban took effect in August 2022. For the foreseeable future, any cases of maternal death will not be reviewed in Idaho, whether they were connected to lack of abortion care or not.
Texas’ MMRC refused to review 2022 and 2023 maternal death cases following the Dobbs decision and the state’s implementation of a near-total abortion ban in 2022. Abortion is only allowed in Texas in cases of imminent threat to life, but the law also requires a physician to attempt to save the life of the fetus. Anyone who performs a prohibited abortion could face a first- or second-degree felony charge. There is no doubt that some people will go without life-saving abortion care because providers are afraid of possible penalties—and the MMRC could refuse to consider those cases at will.
Additionally, a number of states are lagging two or more years behind in reviewing maternal deaths despite the fact that the CDC has provided funding to specifically facilitate the review process. Currently, there is nothing in place to compel states to review cases in a timely fashion or review them at all.
Protecting data is more important than ever before.
Hours after the inauguration of the Trump administration, the website reproductiverights.gov was deleted. In the days that followed, the Trump administration rescinded Executive Order 14009, “Strengthening Medicaid and the Affordable Care Act,” which was issued by President Joe Biden in 2021. Government websites were also scrubbed of the word “abortion” and outgoing reports from federal health agencies were halted. The administration also briefly suspended funding to a broad swath of federal programs, including the Title V Maternal and Child Health Services block grant and the new Transforming Maternal Health Model. There is certainly more to come.
The Trump administration also continues to threaten to cut Medicaid to fund tax cuts for the wealthy and evict recent immigrants. Medicaid covers more than 40 percent of all births in the United States and covers health care costs for over 72 million Americans. Medicaid cuts will worsen access to essential health care and negatively affect individual health status as well as population-level health outcomes.
These sweeping changes do not bode well for anyone, especially all the people whose lives could be saved with evidence-based decision making. While it seems there is little to be done at the federal level, state-level stakeholders still have a few opportunities to act. In particular, they can:
- gather and archive any available data on maternal and reproductive health,
- engage state legislators in bolstering MMRC legislation,
- demand that existing MMRCs review all available data,
- organize to ensure more community-based advocates and people from affected communities have an opportunity to serve on MMRCs,
- secure philanthropic funding for research and reporting on preventing maternal death, and
- educate the public on how politics has a direct impact on maternal health outcomes.
It may be too little, too late but every path is worth exploring to gather the data necessary to end the American maternal health crisis.
Tags: maternal death rate, abortion access, maternal health
Why Protecting Data Is the New Priority for Maternal Health
As a new presidential administration with a disdain for science and a commitment to disinformation takes office, health care advocates and stakeholders must brace themselves for scientific data collection to be influenced by political agendas or to stop altogether. For example, some states have recently made changes that impair a key producer of maternal health data and recommendations—maternal mortality review committees (MMRCs)—simply to avoid acknowledging fallout from the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization.
Lack of access to essential health care like abortion has contributed to maternal deaths, and it will continue to do so. But that’s not something anti-choice stakeholders want to hear or want the public to know. They would rather not understand the causes of maternal death at all than acknowledge lack of access to abortion care as a factor.
Maternal mortality review committees play a critical role in determining the causes of maternal death and making recommendations on how to prevent deaths going forward. The committees are only useful if they actually review deaths and take an unbiased look at causes and solutions. Unfortunately, these committees are already riddled with unhelpful politics and challenges. Reducing or restricting their functions because of anti-abortion politics will only worsen the United States’ maternal health crisis.
MMRCs have a duty to produce data on causes of maternal mortality.
The Centers for Disease Control and Prevention (CDC) defines maternal mortality review committees as “multidisciplinary groups that convene at the state or local level to comprehensively review deaths that occur during or within 1 year of the end of pregnancy.” These groups report their findings to the CDC through the Maternal Mortality Review Information Application (MMRIA) system that allows for data standardization—an important factor when gathering data from various state and local jurisdictions.
It is important to note here that these groups are tasked with reviewing deaths that occur within one year of the “end of pregnancy,” which may happen through a live birth, spontaneous abortion (commonly known as miscarriage), induced abortion (medication or procedural), or stillbirth. Regardless of how a pregnancy ends, MMRCs have a duty to review a maternal death case and examine all the factors that may have contributed to that person’s demise. Of all pregnancy-related deaths, more than 80 percent are preventable and the recommendations made by thorough, unbiased reviews of cases can ensure that deaths like these are avoided in the future.
MMRCs also have a duty to the American people, as there is no way to end the United States’ maternal health crisis without a comprehensive understanding of all contributing factors. In fact, the CDC has noted that MMRCs are “the best source for prevention strategies.”
Good policymaking relies on evidence.
Unbiased, evidence-based decisionmaking—which in this political moment is a fairytale dream—is the only way to create policies that help meet the needs of most people. Biased decisions that disregard data can only privilege certain groups and leave others to suffer. When it comes to maternal health, this suffering not only affects women, but their infants, children, and broader families. Data shows that when a family loses a mother, there are long-term generational consequences.
Ignoring evidence on the contributors to and causes of maternal death puts our entire society at risk of a lower quality of life and wellbeing. And it puts the most vulnerable and marginalized groups at the greatest risk. These include low-income individuals and those without unfettered access to high-quality health care. While the recent narrative has focused on racial inequities in maternal and infant mortality, it remains true that these rates are also higher for low-income families and those living in rural areas. Furthermore, the United States has the highest rate of maternal mortality among nations with similar GDP, despite the immense amount spent on health care.
At the local level, states with the most abortion restrictions also have the highest maternal mortality rates. There is something fundamentally wrong with how American systems treat women, people of color, low-income earners, and with how pregnant women are (or are not) cared for. Rather than provide a living wage, adequate housing, efficient transportation, and affordable fresh food (factors that have been proven to contribute to better health outcomes), decision-makers prioritize corporations’ profit.
The American health care industry is just that—an industry; that is, a business enterprise that profits at the expense of the people it is supposed to care for. Health care is a commodity when it should be a social good. There is certainly enough information to make a broader case that healthy people lead to a healthy and thriving populace that increases a nation’s economic productivity. Instead, mothers are left to die from preventable causes so that companies can benefit in the short term.
Deaths will go unexamined due to anti-abortion politics.
Unfortunately, when it comes to reproductive and maternal health, data doesn’t seem to matter. States are on track to stop the process of collecting data, reviewing it, and making viable recommendations for political reasons. Anti-abortion stakeholders have let their political stance compromise a scientific process and they have shirked their duty to protect women’s lives by identifying solutions to maternal deaths. In some states, the same people that enacted abortion restrictions are the same people responsible for the maternal mortality case review process. This precludes unbiased reviews of maternal deaths and meaningful recommendations.
Some states are taking drastic actions to halt or bury the data. In November 2024, Georgia dismissed its entire thirty-two-member Maternal Mortality Review Committee after ProPublica reported on two maternal deaths believed to be related to abortion bans. Advocates anticipate that recruiting an entirely new committee will cause delays in the review process as well as changes to how cases are reviewed in the future. Georgia law prohibits abortion care after six weeks into a pregnancy—a time when many women are first recognizing signs of their pregnancy or considering taking a pregnancy test.
Idaho’s short-lived MMRC was retired in July 2023 after a total abortion ban took effect in August 2022. For the foreseeable future, any cases of maternal death will not be reviewed in Idaho, whether they were connected to lack of abortion care or not.
Texas’ MMRC refused to review 2022 and 2023 maternal death cases following the Dobbs decision and the state’s implementation of a near-total abortion ban in 2022. Abortion is only allowed in Texas in cases of imminent threat to life, but the law also requires a physician to attempt to save the life of the fetus. Anyone who performs a prohibited abortion could face a first- or second-degree felony charge. There is no doubt that some people will go without life-saving abortion care because providers are afraid of possible penalties—and the MMRC could refuse to consider those cases at will.
Additionally, a number of states are lagging two or more years behind in reviewing maternal deaths despite the fact that the CDC has provided funding to specifically facilitate the review process. Currently, there is nothing in place to compel states to review cases in a timely fashion or review them at all.
Protecting data is more important than ever before.
Hours after the inauguration of the Trump administration, the website reproductiverights.gov was deleted. In the days that followed, the Trump administration rescinded Executive Order 14009, “Strengthening Medicaid and the Affordable Care Act,” which was issued by President Joe Biden in 2021. Government websites were also scrubbed of the word “abortion” and outgoing reports from federal health agencies were halted. The administration also briefly suspended funding to a broad swath of federal programs, including the Title V Maternal and Child Health Services block grant and the new Transforming Maternal Health Model. There is certainly more to come.
The Trump administration also continues to threaten to cut Medicaid to fund tax cuts for the wealthy and evict recent immigrants. Medicaid covers more than 40 percent of all births in the United States and covers health care costs for over 72 million Americans. Medicaid cuts will worsen access to essential health care and negatively affect individual health status as well as population-level health outcomes.
These sweeping changes do not bode well for anyone, especially all the people whose lives could be saved with evidence-based decision making. While it seems there is little to be done at the federal level, state-level stakeholders still have a few opportunities to act. In particular, they can:
It may be too little, too late but every path is worth exploring to gather the data necessary to end the American maternal health crisis.
Tags: maternal death rate, abortion access, maternal health